13th Indian Arthroscopy Congress: Updates on Arthroscopy & Sports Injury

The three days prestigious 13^th Indian Arthroscopy Congress (IAS), was kick started here on Friday. Briefing media about the significance of this Congress Dr. Raghuveer Reddy K., renowned Shoulder & Knee specialist; Consultant, SISA & Organizing Secretary, IAS–2014; Dr. Anant Joshi, Renowned Sports surgeon from Mumbai and Consultant for BCCI; Dr. A. B. Imhoff, Germany and Dr. Adrian Wilson, U.K., said, Arthroscopy & sports medicine is the subspecialty of orthopaedics, which deals with the treatment of joint injuries and various sport related injuries. It is a reconstructive surgery done arthroscopically via keyhole size incision, which is used to treat different types of joint injuries and age related degenerative changes in joints, with the aid of fiber optic camera along with other operating instruments.

Though it is called as sports injury, it’s not necessarily related to sports or occurs only to sports person, but any human being can sustain this injury in their routine life style or any incidental event or accident. Since past few years this subspecialty has been making rapid strides in our country and the awareness amongst the public about its beneficial aspects has been increasing. Indian surgeons are constantly in pursuit to stay abreast with rest of the world by learning the ever evolving newer techniques in this field and are extending the best of the treatment available, to their countrymen. The medical fraternity believes that, this subspecialty of orthopaedics is still in budding phase in India and has a long way to go, as only few surgeons are practicing this specialty and the learning curve is steep.

Speaking on the occasion Dr. Raghuveer Reddy K., said, the speciality of Arthoscopy has made several advances in the recent years. The advent of the latest procedure of Realignment Oesteotomy can avoid and postpone a knee joint replacement by 10 to 15 years. In Western countries especially Germany, most doctors and patients up to the age 65 years opt for realignment osteotomy instead of knee replacements. Realignment Oesteotomy surgeries are minimally invasive. They preserve the knee anatomy and thereby delay the need for a joint replacement for several years. Biggest advantage being no restrictions on physical activities after an osteotomy. Realignment Oesteotomy surgeries could grow exponentially in India in the coming years. In case of shoulder muscle tear the latest procedure is to suture the tendons as tendons don’t heal on their own.

According to Dr. Raghuveer Reddy, unlike in the west the common problem in Indian population is Multi-ligament ruptures, this is largely due to high incidence of road accidents. Doctors in West come across very few multi-ligament ruptures. Multi ligament ruptures can now be treated with Allografts. Allografts are ligaments harvested from cadavers and implanted in patients. He said, Single stage cartilage Implant is another new procedure, where the bone marrow drawn from the patient is made in to a concentrate of stem cells through centrifuge and implanted on the knee. However Single stage cartilage implant is relevant for young patients, as one grows older the stem cell production subsides.

Dr. Raghuveer Reddy K., a leading expert in Arthoscopy and one of the few surgeons practicing this specialty for the past fifteen years in Hyderabad, has travelled abroad to different countries as fellow, to learn advance techniques from the masters and implement the same in India. He believes in learning new techniques and keeping himself updated with the latest developments in this field and has been constantly doing that and in this pursuit of constant learning and spread the knowledge among the colleagues, he has gone a step ahead and pleaded for a chance to organize the 13^th Indian Arthroscopy Society Congress in Telangana to benefit the medical fraternity here. This national level annual conference is being held in Hyderabad from October 10^th to 12^th 2014, under the auspices of Indian Arthroscopy Society, the parent body thriving to develop the field of arthroscopy & sports medicine.

This congress is a part of continuous medical education to discuss the recent advances and newer techniques. Around 106 eminent surgeons from different parts of the world 95 national & 11 international will throw light on the latest advances and deliver talks on evidence based medicine, as the theme of the congress is “CONSENSUS & CONCERNS.” Around 700 Orthopaedic surgeons from across the country and abroad will be attending this congress.

During this 3 days congress, 20 surgeries will be operated at SISA & NOVA hospital and will be telecasted live at Taj Krishna. These surgeries will be performed by stalwarts of this field. These 20 surgeries will be on different aspects like Single stage cartilage repair; Sports related injuries; Knee surgeries like Anterior cruciate ligament (ACL), Posterior cruciate ligament (PCL) reconstructions; shoulder surgeries like Rotator cuff repairs, Recurrent shoulder dislocation etc.

There will also be a web telecast of 3 live shoulder surgeries from Dallas, USA on 10^th evening, during which there will be exchange of knowledge between surgeons from both the countries as a part of continuous medical education.

The purpose of this conference is to gain knowledge about recent developments and techniques, so that benefit of the same can be extended to our patients, like single stage cartilage repair can help reduce the patient’s treatment and recovery time, as the surgical treatment will be completed in one surgery only. Unlike  previously, where it was done in 2 stages, in first stage the cartilage cells are harvested from the joint after which they are cultured in laboratory for 6 weeks and then again implanted into the defect in joint, thus consuming lot of time of patient as a result he has to be off work for long time.

ACL is the primary stabilizer of knee joint; it also has a proprioceptive function which enables a person to know the position of his leg. When this ligament is injured one will have instability of knee joint, insecurity due to which one cannot do activities like climbing stairs, running dancing, jumping confidently. ACL ligament reconstruction is generally done using patellar tendon or 2 hamstring tendons viz. Gracilis & Semitendinosis . But now with the recent techniques it is done with one hamstring tendon only, thus reducing the hamstring weakness, which is seen with 2 tendons reconstruction and with this technique the reconstructed ligament is even more strong.

New concept – Anterolateral ligament Ligament found and its reconstruction.

Rotator cuff stabilizes shoulder joint and aids in movement & strength of shoulder joint. New implants and technique have been developed to repair rotator cuff tears, like knotless anchors, double row technique and special instruments like rotator cuff biter & suture retriever, all which helps in reducing the operative time and aids in faster recovery of patients. Shoulder dislocations occur due to lose capsule or defect in glenoid or humerus. Newer techniques like iliac bone grafting are used to reduce the incidence of recurrence. Newer techniques for repairing rotator cuff tear without using implants also presented.   

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