Jatin Jain Data Infosys Limited Jaipur

Mumbai CUMBALLA HILL HOSPITAL

View Larger Map

JATIN JAIN Right Knee Broken ACL

Location : Mumbai : Doctor Anant Joshi (Sachin Tendulker's doctor)
The doctor suggested for 2 arthroscope surgery first surgery will be done in feb 2011 next after 3 months

The Operation will be done in 
CUMBALLA HILL HOSPITAL AND HEART INSTITUTE
93/95, August Kranti Marg, Mumbai - 400 036.
Phone : 2380 3336, 2388 8621 
Fax : 2380 5898, 2380 3672
E-Mail : chh@vsnl.com
www.cumballahillhospital.com

PLEASE HELP ME

My Name is  Jatin Jain from Jaipur I had a accident from my activa scooter in 14 november 2008

I had a MRI in that I found my ACL is Broken-Then is went to Dr. S.B. Solanki (Tagore Hospital Jaipur) for my ACL  checkup – he suggested me operation – on 8^th January 2009 I had operation (bajaj allianz cashless treatment) 2 screw are put in my right knee – brace was put on for 1 & half month and then my physiotherapy exercise was started….

Till March 2009 month I had my bed rest.. then doctor told me to join some fitness center..

From 1april I joined my office Iam website & Graphic Designer in DataInfosys Limited Company Jaipur approx 10hrs sitting work I do daily .

Now its almost  1.5 years gone still my knee is not bending properly

·        95 to 105 degree  after doing – sit-ups – legpress-legpull in fitness center

·        Not able to walk properly

·        There is FFD (fixed flexion deformity) approx 10hrs sitting work I do daily is this the reason

·        I have put on weight right now 93 kg

·        I found your name on internet

·       PLEASE HELP ME

·       I can come to Mumbai also

Cardiothoracic Surgery Artificial Heart Devices: LVAD

NewYork-Presbyterian is a leader in the development and implantation of the LVAD (left ventricular assist device), a mechanical pump that augments the function of the left ventricle – the heart's most critical pumping chamber. These artificial heart devices consist of an electric pump, an electronic control system, and a power supply. The pump is implanted into the upper part of the abdominal wall and is connected to the heart at two points. A tube carries blood from the left ventricle to the pump.

Blood is pumped through a second tube to the aorta, from which it is distributed to all parts of the body, thereby helping a weakened heart circulate blood. A third tube extends to the outside of the body. In this tube are wires that connect the pump to the small controller which can be worn on a belt. The controller is connected to small batteries that are worn on a shoulder holster.

NewYork-Presbyterian offers several types of FDA-approved LVADs for use as a bridge to transplantation, allowing critically ill patients to live productive lives at home while waiting for a heart donor. NewYork-Presbyterian is also participating in ongoing clinical investigations of the next generation of LVADs.

In addition to patients who are waiting for a heart transplant, there are up to 100,000 people who are terminally ill with end-stage heart failure and for whom transplant is not possible. Clinical trials conducted at NewYork-Presbyterian have led to FDA approval of one of these devices — the HeartMate LVAD — for use both as a bridge to transplantation as well as for long-term therapy in the treatment of end-stage heart disease in patients who are not eligible for heart transplantation. Research conducted at NewYork-Presbyterian has demonstrated that patients with the implanted HeartMate LVAD had much better survival rates and quality of life compared patients who were treated with medication and medically monitored. Ongoing and future clinical investigations at NewYork-Presbyterian will examine other LVADs that are much smaller and more durable for long-term use in heart failure patients.

Current LVAD Clinical Investigations

• Micromed DeBakey VAD bridge to transplant trial. A small axial flow pump is used to bridge patients to transplant who are on the transplant waiting list and have become too sick for transplant. The trial is a multi-institutional pivotal trial.
   
• Thoratec HeartMate II Bridge to Transplant Trial. Another small axial flow pump is used to bridge patients to transplant who are on the transplant waiting list and have become too sick for transplant. The trial completed the feasibility study phase in which we enrolled the largest number of patients in the country.
  
  
  We are currently conducting pivotal trials using the same device. The pivotal trials consist of two studies. One is a bridge to transplant therapy and the other a destination therapy. In the multi-institutional bridge to transplant trial, a small axial flow pump, HeartMate II, is used to bridge patients to transplant who are on the transplant waiting list but who have become too sick for transplant.
  
  In the HeartMate II Destination Trial, the device is used to help patients with end-stage heart failure who not eligible for heart transplantation. We are enrolling patients for this multi-institutional, randomized trial.
   
• Impella Feasibility Trial . The device is a small axial flow pump that can be inserted through the ascending aorta or the femoral or axillary artery. The device is designed to help patients in acute cardiogenic shock, such as large myocardial infarction, severe myocarditis, and post-cardiotomy shock. The trial is now completed and we are in the process of conducting a pivotal trial.
   
• VentrAssist VAD Bridge to Transplant Trial. A small centrifugal flow pump, a third generaton pump, is used to bridge patients to transplant who are on the transplant waiting list but who have become too sick for transplant. The trial is a multi-institutional feasibility trial.

USA new york hospitals

 Cardiology

Advanced Diagnostics

An acute or chronic heart condition can become evident during a routine annual physical exam or through a specific set of symptoms, and expert diagnosis is crucial in determining the most appropriate course of treatment. Patients at NewYork-Presbyterian are examined by world-class physicians who provide a full range of diagnostic services for adults and children with heart disease.

As one of the nation's largest clinical and research institutions, NewYork- Presbyterian has access to the most advanced diagnostic equipment, often years before other hospitals. Our state-of-the-art diagnostic services include:

Cardiac catheterization, when making an accurate diagnosis must rely on more invasive procedures. NewYork-Presbyterian?s cardiac catheterization laboratories offer coronary angiography for the detailed evaluation of the extent of anatomic blockages in the coronary arteries as well as intravascular and intracoronary ultrasound, in which detailed images of the heart and coronary arteries are created using sound waves.

At NewYork-Presbyterian, we are now also evaluating the functional significance of arterial blockages, using a tool called fractional flow reserve (FFR). This involves placing a tiny catheter across a blockage, to measure the difference in pressure before and after the use of a drug that challenges the heart's ability to function. It allows us to see the effects of a narrowed vessel in real time.

Electrocardiographic tests, considered the first diagnostic tools for evaluation of anatomic changes and arrhythmias, use an electrocardiogram (ECG) to assess the electrical activity produced by the heart. In addition to the resting 12-lead ECG, the electrical activity of the heart can be examined over 24 hours, by using portable ambulatory recorders. Event recorders can be used over even longer time periods to detect infrequent rhythm irregularities. The ECG can also be examined during exercise testing.

Electrophysiological studies that allow physicians to expertly diagnose irregularities in heart rhythm. These studies are useful for defining the origin and risk of supraventricular and ventricular tachycardias and in designing the appropriate therapy for these conditions.

Advanced imaging techniques such as

• Echocardiography, a noninvasive procedure that produces a graphic image of the heart's movement, valves, and chambers using high-frequency sound waves.
• Magnetic Resonance Imaging (MRI), which creates high quality images of the heart throughout its pumping cycle. MRI is also important to help distinguish heart muscle that is irreversibly damaged from muscle that can be restored to some degree of function.
• Nuclear imaging techniques such as single photon emission computer tomography (SPECT), positron emission tomography (PET), and MUGA scans, which evaluate not just how organs appear but how well they are functioning.

Tilt table testing for evaluation of patients with syncope (fainting). Syncope is a sudden loss of consciousness due to a transient drop in blood pressure. At NewYork-Presbyterian, physicians with expertise in the diagnosis and treatment of syncope use the most advanced techniques to determine whether syncope is being caused by an underlying cardiac arrhythmia.

physiotherapy knee exercise

Arthroscopic Setup

Arthroscopic Setup

Jatin Jain have 2 screw in Right Knee

Jatin Jain had ACL Operation In 8th January 2009 and still facing problem in Knee Bending
my operation was done in Tagore Hospital Jaipur Dr.Solanki did my operation..


but still till date i am not fit and facing problems in my Right Knee i took Physiotherapy Treatment for 8months still no improvement its costly 200Rs for 45 minutes i used to give now i have stooped it was proving very costaly and i could not affort  .. I took 6months bed rest away from work(job)


Thanks to my boss Dr.Ajay Data Sir (Data Infosys) ..iam back on job

..but still not fit i have showing several doctors in jaipur all suggest my small operation again arthroscopic surgery and 25 days bed rest +  Physical exercise

Jatin Jain
Graphic Designer
Data Infosys Limited
Mobile:9828180603
Jaipur-Rajasthan-India

Important exercises you will begin the day of surgery

These exercises are crucial to your rehabilitation and the following is a general guide for the rehabilitation following knee surgery. Physical Therapy Programs are individualized for each patient by a doctor or physical therapist and a successful outcome is dependent on adequate communication between the patient, therapist and surgeon. Considering those points, these are just guidelines.

Elevate your affected leg, it must be elevated above heart level, usually requiring 4 or 5 pillows. under your leg. Just propping it on the couch, or recliner is not enough, and the more you can elevate and ice, the less pain and swelling you will have.

Squeeze & tighten this muscle tight for 2 seconds, twenty times, and try to do 10 or more sessions each day. Monitor your progress by comparing your muscle contraction to your unaffected leg, and it is wise to do these exercises for both legs.

The Heel Prop is The Most Important Exercise You Will Do. Prop your heel as shown in the photo above. Relax your leg (when you are relaxed, your leg and foot will rotate out slightly and this is good). Allow your knee to straighten as much as possible. This can also be achieved by propping your heel on a chair facing you or on the arm of a couch. as long as nothing is under your knee. Do this every hour for 3-10 minutes.

ACL Reconstruction with Meniscus Repair

Anterior Cruciate Ligament (ACL) Reconstruction Animation

KNEE ARTHROSCOPY

Arthroscopy: What is it?

Arthroscopy is a surgical procedure in which a small fiberoptic telescope (arthroscope) is inserted into a joint. Fluid is then inserted into the joint to distend the joint and to allow for the visualization of the structures within that joint. Usually the surgery is viewed on a moniter so that the whole operating team is aware of the type of surgical procedure that is being performed.

Arthroscopes are approximately 5 mm in diameter, so the incisions are very small (approximately 1/8 inch). During the procedure, which is conducted under anesthesia, the inside of the joint is examined for damaged tissue. The most common types of arthroscopic surgery include removal or repair of a torn meniscus (cartilage), ligament reconstruction, removal of loose debris, and trimming damaged cartilage.

Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the knee with long incisions (arthrotomy). The benefits of arthroscopy involve smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.

While an arthroscope is used in many different types of surgical procedures, the recovery time and outcome of the procedure is related to the type of injury and the type of arthroscopic surgical procedure performed. For example, an arthroscopic surgical ligament reconstruction will take longer to heal and the recovery time will be longer then the patient who has an arthroscopic removal of a loose body.

THIS MATERIAL DOES NOT CONSTITUTE MEDICAL ADVICE. IT IS INTENDED FOR INFORMATIONAL PURPOSES ONLY. PLEASE CONSULT A PHYSICIAN FOR SPECIFIC TREATMENT RECOMMENDATIONS.

POST-OPERATIVE PERIOD

Postoperatively, it is possible to bear weight (partial weight bearing) on the surgically treated leg by using crutches for the first 7 - 10 days after surgery. Patients may stop using crutches when comfortable. Supervised physical therapy often is started by the second to third day after surgery.

Figure 10: CONTINUOUS PASSIVE MOTION - ORTHOLOGIC
In addition, a continuous passive motion device is applied to the injured leg post-operatively. Most patients use this device while sleeping for the first two weeks. This device very slowly moves the knee, thereby decreasing the risk of stiffness and loss of motion. Following an initial 6-10 week period of supervised physical therapy, most patients will progress to a self-directed program that is done in a health club. Typically, it takes the reconstructed ligament approximately 9 months to heal. Until released by your physician, contact sports, racquet sports, skiing, tennis, martial arts, and sports that require rapid direction changes must be avoided.

ARTHROSCOPIC ACL (SURGERY) RECONSTRUCTION

SUMMARY

Figure 1: Right Knee - Frontal View with Patella Removed

The anterior cruciate ligament (ACL) is the major stabilizing ligament of the knee. The ACL is located in the center of the knee joint and runs from the femur (thigh bone) to the tibia (shin bone), through the center of the knee. In this position, it functions to prevent a buckling type of instability of the knee. (For more information on the ACL: KNEE JOINT - ANATOMY & FUNCTION.)

Figure 2: Right Knee - Arthroscopic View of Intact Anterior Cruciate Ligament
Usually the tearing of the ACL occurs with a sudden direction change or when a deceleration force crosses the knee. The patient often feels or hears a popping sensation, has the rapid onset of swelling, and develops a buckling sensation in the knee when attempting to change direction. (Click HERE for an animation of an ACL tear.)

DIAGNOSIS AND TREATMENT

The diagnosis of an ACL injury is usually arrived at by determining the mechanism of injury, examining the knee, determining the presence or absence of blood within the joint, and performing diagnostic studies. These may include x-rays, MRI scans and stress tests of the ligament.
The initial treatment of an acute ACL injury often includes ice, anti-inflammatory medication, and physical therapy which is directed at restoring the range of motion of the injured knee.



Figure 3: Right KneeSurgical treatment of the torn ACL usually involves an arthroscopic surgical reconstruction of the injured ligament.

Figure 4: Arthroscopic Knee Surgery with Instruments in PlaceAlthough a number of different types of tissue have been utilized to reconstruct the ACL, the most common type of ACL reconstruction involves harvesting the central third of the patellar tendon with a bone block at each end of the tendon graft. After performing a diagnostic arthroscopic examination of the knee, the central third of the patellar tendon is harvested. (Click HERE for a computer animation of tendon harvesting (mpg file) courtesy of Rob Kroeger.)

Figure 5: Left Knee - Graft HarvestThe remaining tendon is then repaired. After harvesting the tissue, drill guides are used to place holes into the tibia (bone below the knee)

Figure 6: Left Knee

Figure 7:Intraoperative photo of drill hole in femur for ACLand femur (bone above the knee). By placing the drill holes at the attachment sites of the original ligament, when the graft is pulled through the drill hole and into the knee, it will be placed in the same position as the original ACL. (Click HERE for a computer animation of drilling the holes (mpg file) courtesy of Rob Kroeger.)
After pulling the graft through the drill holes and into the joint to replace the torn ACL, the graft is then held in place with bioabsorbable screws or metallic screws.

Figure 8: Left KneeFastening the graft in this manner allows new blood vessels to grow into the transferred graft and for healing to occur. Typically, the procedure is performed on an outpatient basis.

Figure 9: Lateral Intraoperative X-Ray demonstrating Placement of Metallic Screw for ACL Graft Fixation in the Femur

The anterior cruciate ligament (ACL)

Let's begin with the basics of knee anatomy. The knee joint is made up of three bones and a variety of ligaments. The knee is formed by the femur (the thigh bone), the tibia (the shin bone), and the patella (the kneecap). Several muscles and ligaments control the motion of the knee and protect it from damage at the same time. Two ligaments on either side of the knee, called the medial and lateral collateral ligaments, stabilize the knee from side-to-side.



The anterior cruciate ligament (ACL) is one of a pair of ligaments in the center of the knee joint that form a cross, and this is where the name "cruciate" comes from. There is both an anterior cruciate ligament (ACL) and a posterior cruciate ligament (PCL). Both of these ligaments function to stabilize the knee from front-to-back during normal and athletic activities. The ligaments of the knee make sure that the weight that is transmitted through the knee joint is centered within the joint minimizing the amount of wear and tear on the cartilage inside the knee.
The weight-bearing surfaces of your knees are covered with a layer of cartilage (referred to by doctors as"articular cartilage"). There are also two shock absorbers in your knee on either side of the joint between the cartilage surfaces of the femur and the tibia. These two structures are called the medial meniscus and the lateral meniscus. The menisci are horseshoe-shaped shock absorbers that help to both center the knee joint during activity and to minimize the amount of stress on the articular cartilage. The combination of the menisci and the surface cartilage in your knee produces a nearly frictionless gliding surface. The knee is an incredible joint. It is strong, flexible, and very tough.