How to Save Your Money by Undergoing Partial Knee Replacement Surgery in India ?

Partial knee replacement surgery is also known as Unicompartmental Knee Replacement Surgery. This surgery is recommended to patients who have severe arthritis in knees and all other treatments gave failed to provide them with relief.

Traditionally, patients who are suffering from advanced arthritis of the joint undergo total knee replacement in which all the cartilage is removed from the knee joint are replaced with an artificial implant.  Whereas in partial knee replacement surgery only the damaged areas of the cartilage from the joint is removed without disturbing the healthy parts of the joints. Partial knee replacement surgery is performed by making a small incision and involves faster recovery. This surgery use implants which are placed between the end of the thigh bone and the top of the shin bone. This surgery can also be performed to replace the part of the joint under the kneecap.

Partial knee replacement can be considered at any age. This surgery offers an opportunity for younger people to preserve more bone whereas in the case of older people partial knee replacement is a less stressful surgery as it involves less pain and less risk of bleeding.

Who Are The Candidates For Partial Knee Replacement Surgery?

Partial knee replacement surgery is recommended to patients who are suffering from severe arthritis in knees and all other conservative treatments have failed to provide them with relief. Conservative treatments include medicines, injection, exercises and physical therapy. Partial knee surgery is possible if arthritis in the knee is confined to a limited area. In case if arthritis is more widespread than partial knee replacement is not an appropriate option. The ideal candidate for partial knee surgery are:-

•    Not overweight.

•    Older than 55 years.

•    People who are not laborers or athletes.

•    People who have intact ligaments.

•    All treatments have failed.

Surgical Procedure of Partial Knee Replacement

Partial Knee Replacement surgery requires resurfacing of the damaged surfaces of the knee joint. The artificial knee joint used in the surgery is designed in such way that it fits over the edges of the damaged joint to replace the damaged areas with one that can be used pain-free.

The surgery takes around 4-6 hours and is performed under general anaesthesia. To perform this surgery the surgeon makes an incision of 10 cms in the middle of the knee over the top of the kneecap which provides the surgeon with access of the entire knee. The surgeon then removes the damaged bone and tissue. An artificial implant which is made of plastic and metal is placed into the knee. Once the artificial implant is placed it is attached with the help of bone cement. The surgeon then closes the wound with stitches. There are two main techniques to perform partial knee replacement surgery Repicci method and oxford method. The method used for the surgery varies from patient to patient.

Risks Associated With Partial Knee Replacement Surgery

Following are some of the risks and complications can arise while performing the surgery:-

•    Blood clots.

•    Buildup of fluid in the knee joint

•    Failure of implants.

•    Damage to the nerves.

•    Loosening of Implants.

•    Damage to blood vessels.

•    Pain with kneeling.

•    Reflex sympathetic dystrophy which occurs in very rare condition.

Successful Partial Knee Replacement Surgeries in India

The knee replacement surgery success rate in India is very high. India has a large pool of highly skilled and qualified orthopaedic surgeons who add to the success rate. Hospitals in India are equipped with the latest techniques, technology and uses most modern equipment. Partial knee replacement surgery cost in India is very less as compared to any other country. Undergoing partial knee replacement surgery in India can be quite beneficial for patients can save a huge amount on the surgery.

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PRL-Secreting Pituitary Tumors

PRL-secreting pituitary tumors are those adenomas found growing in the pituitary gland which affects the production of Prolactin in the body. PRL-secreting (Prolactin-secreting) tumors are benign and non-cancerous abnormal growth seen in the pituitary tumors at times. This tumor affects the production of the Prolactin hormone in the body as well as several other complications.

Prolactin is a naturally-occurring hormone which is mainly responsible for the production of breast milk in women after pregnancy (lactation process). Prolactinoma is the tumor which affects the production of Prolactin in the patient.

Signs and Symptoms of PRL-Secreting Pituitary Tumors

As the pituitary tumor causing Prolactinoma in a person is a normally slow-growing type of tumor its signs and symptoms might not be noticed even after years into its development in the pituitary gland.

Signs and symptoms are mostly noticed as the pituitary tumor starts to affect the production of Prolactin in the body, leading to hyperprolactinemia as well as from the pressure being put by the tumor on the surrounding soft tissue structure such as the nerves.

As higher than normal levels of Prolactin cause problems with the reproductive system (hypogonadism) several signs and symptoms are exclusive to men and women separately.

In women, PRL-secreting pituitary tumors can result in:

• Abnormal menstrual cycle
• Irregular periods
• Milky discharge from breast without pregnancy or breast-feeding
• Vaginal dryness during sexual activities
• Acne
• Excessive body hair growth

In men, PRL-secreting pituitary tumors can lead to:

• Reduced facial and body hair
• Erectile dysfunction
• Gynecomastia (abnormally large breast in men) 

The common signs and symptoms of PRL-secreting pituitary tumors are:

• Decreased bone density
• Hypopituitarism  - decreased hormone production
• Fatigue
• Headaches
• Infertility
• Impotence
• Loss of libido (sex drive)
• Vision problems

As the tumor affects the menstrual cycle in women, they tend to notice the signs earlier as compared to men. In men, the symptoms are mostly noticed when the large tumor begins to cause headaches and problems with the vision.

Diagnosing PRL-Secreting Pituitary Tumors

In case the signs and symptoms of PRL-secreting pituitary tumors are noticed it is advisable to consult a doctor/physician at the earliest for better and effective diagnosis.

The patient might be required to undergo any of the following tests for effective and precise diagnosis of PRL-secreting pituitary tumors:

Blood test – Testing the blood helps to determine the level of Prolactin in the body as well as the level of the other hormones regulated by the pituitary gland. Pregnancy test will also be performed for women belonging to the child-bearing age (pre-menopausal).

Brain imaging – Brain imaging techniques such as MRI (magnetic resonance imaging) and CT (computerized tomography) can help to detect the location and size of the pituitary tumor precisely.

Vision test – Testing the vision can help determine of the pituitary tumor is causing pressure and affects the optic nerve which is located very close to the pituitary gland inside the skull.

Treating PRL-Secreting Pituitary Tumors

PRL-secreting pituitary tumors (Prolactinoma) is ideally treated using advanced minimally invasive surgical treatment methods today.

The main aims of the surgery are to:

• Restore normal levels of Prolactin in the body
• Restore normal function of the pituitary gland
• Decrease size of pituitary tumor
• Treat complications caused by pressure from the pituitary tumor on surrounding neural and vascular structure.

The surgical treatment of PRL-secreting pituitary tumors requires the surgeon to use advanced minimally invasive endoscopic surgical method to perform this pituitary tumor surgery. The surgeon will not make large incision instead the natural passage created by the nasal cavity is used to gain access to the tumor in the pituitary gland situated just behind the nose at the base of the skull.

PRL-secreting pituitary tumors need prompt diagnosis and effective treatment in order to restore normal hormonal functions in the body as well as to improve the quality of life of the patient.

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Most Effective Treatment procedure for Acromegaly

Acromegaly is the condition where the body and its various parts experience excessive growth due to the excessive production of the growth hormone by the body as a result of a pituitary tumor.

Acromegaly is relative to over-production of the growth hormone (GH) by the pituitary gland which results in the face and the appendages to become abnormally large. This also has an adverse effect not only on the bones but also on the heart.

There are various types of treatment available for acromegaly and the exact type of treatment method for the individual case will be decided by certain factors pertaining to the patient as well as the details of the case. As this is a gradually progressive disorder it can sometimes be years before the patient can even experience any sign or symptoms.

Causes of Acromegaly

A pituitary gland tumor is the main cause for the development of acromegaly in a person. The pituitary gland is the smallest, but most important, hormone-secreting gland in the body. It is mainly responsible for producing various important hormones itself as well as for regulating the production of chemicals and hormones by the other glands present in the entire body.

One of the main hormones produced by the pituitary gland is the growth hormone (GH), which is responsible for helping the bones and organs to grow at a uniform and normal rate. At times, a tumor in the pituitary gland can affect the function of the pituitary gland and cause it to produce excessive amounts of the GH. This leads to the bones and the organs in the body to grow at an abnormally fast rate.

Overgrown organs and bones can also lead to other health disorders as well as health risks if left untreated for long.

Signs/Symptoms of Acromegaly

The first sign to be noticed is the abnormal rate at which the hands and feet seem to grow. This is usually noticed when the patient is unable to wear a used shoe or a ring due to enlarged hands and feet.

This condition also affects the facial features, such as the tongue, nose and the lips, making them thick and coarse in appearance. The teeth are also seen creating more space between them as the jaw bone grows larger. The brow becomes more prominent and the lower jaw is seen growing as well.

Other more commonly seen signs may include:

•           Painful joints
•           Rough body hair
•           Deeper voice
•           High blood pressure
•           Cardiac (heart) disorders
•           Nerve problems
•           Thicker skin
•           Headaches
•           Excessive sweating
•           Extreme body odor
•           Sleeping disorders
•           Fatigue
•           Weak muscles
•           Decreased libido (sex drive)
•           Irregular menstrual periods (in women)
•           Erectile dysfunction (in men)

It is advised to consult an experienced physician/doctor in case any of these signs or symptoms are seen as these can lead to other major health problems if left untreated.

Most effective treatment procedure for Acromegaly

Although, there are various pituitary tumor treatment methods used in treating the condition and the symptoms of acromegaly the most effective treatment has been found to be the surgical treatment method. This is the most effective treatment method for large-sized pituitary tumors which tend to affect the surrounding healthy soft tissue structure.

Earlier this surgery used to be performed using conventional method of surgery by accessing the pituitary tumor through a hole in the head (craniotomy) however with the advances in surgical science surgeons today use to more efficient and minimally invasive transsphenoidal endoscopic pituitary tumor surgical technique. In this the surgeon will not need to make incisions but will gain access through the natural passage created by the nasal cavity (nose).

This advanced and minimally invasive surgical method has its own benefits over the conventional trans-cranial surgical approach as it needs less (or no) incisions, requires less surgical time, less recovery time, less pain and decreases the risk of post-surgical complications to almost negligible levels.

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What happens after Treatment for Pituitary Tumors?

What happens after Treatment for Pituitary Tumors?

In most cases of pituitary tumors the treatment is aimed at removing or destroying the tumor completely. Although the treatment process tends to be advantageous indeed, it can also be taxing to worry about the possible risk of complications, such as the tumor recurring or growing in another part. This is one of the most common worries in people after undergoing treatment for pituitary tumors.

In rare cases, the tumor might not be accessible enough to be removed completely and the surgeon will remove (destroy) as much of the tumor in the pituitary glands as possible. In such cases, the patient might be on a medicine schedule and other treatments to help control the growth of the tumor further on.

Post-Treatment Care

Post-treatment (follow-up) care is very important to ensure the success of the treatment for a pituitary tumor. Even after the treatment is completed, the doctor will still wish to observe your condition closely right after the procedure.

It is advisable to attend all your appointments with the doctor after the treatment for pituitary tumors and also to follow every instruction carefully. Remember to report any new (or recurring) symptoms to the doctor immediately.

Surgical treatment is the most common and effective treatment for almost all forms of pituitary tumors. In case a patient suffers from a hormone-making (functional) pituitary tumor, the doctor can easily perform a hormone-measurement test to determine whether the hormones are at normal levels at various intervals after the surgical treatment.

Blood tests can help determine the level of functioning of the remaining pituitary gland. Even after the doctor has determined the remaining normal pituitary gland is working you will still be required to come to further appointments. Hormone levels need to be checked periodically to ensure that the remaining pituitary gland is functioning normally and the risk of the pituitary tumor recurring is lowered. Magnetic resonance imaging (MRI) scans are also performed regularly. In case the tumor removed was large in size then the patient might also be examined by an ophthalmologist and a neurologist to check for normal functioning of the eyes and the nerves respectively.

In case of radiotherapy for treating pituitary tumors, the patient might to go for regular checkups till a few years after the pituitary tumor surgery. As it is hard to predict the radiation therapy’s effectiveness in destroying individual tumors, the doctor will take every precaution, including regular check-ups for a few years to ensure that the tumor was successfully destroyed. The doctor will also check the function of the pituitary glands at regular times. MRI scans and hormone-measuring tests are commonly performed as part of the follow-up care after a radiotherapy treatment for pituitary tumors.

The most common phenomenon after a surgical or radiation therapy for pituitary tumors is the hormonal deficiency experienced. This can be addressed with hormone replacement procedure. Adrenal steroids and thyroid hormones can be administered in the form of pills.

For men, testosterone is often given to boost the libido (sex drive) as well as to help avoid weakening of bones (osteoporosis). This can be administered either as a gel, liquid or in the form of a patch to be applied on the skin. This can also be taken as an injection on a monthly basis or even implanted as a pellet under the skin after every couple of months.

For women of younger age, estrogen hormone supplements can be administered using either as a skin patch or in the form of pills to avoid premature onset of menopause. In most cases, the doctor will also administer progesterone, along with estrogen, as the hormonal deficiency from the pituitary gland can lead to infertility. In such cases, hormone therapy is used to increase the chances of fertility.

In case the tumor was smaller in size then the doctor might perform the MRI scan once or twice to ensure that the tumor has indeed shrunk in size.

In case the pituitary tumor was an ACTH-producing (growth hormone) tumor then the doctor may advise for a more frequent follow-up. The doctor will observe the symptoms as well as the level of hormones in the body regularly. Periodic check-ups for high blood pressure and heart conditions is advised for people with growth-hormone producing tumors in the pituitary gland.

In very rare cases after the surgery for removing pituitary tumors, the patient may suffer from diabetes insipidus for a short period of time. This can also be treated successfully. In case of mild form of diabetes insipidus fluid intake can help with the problem however for more severe form ‘desmopressin’ is prescribed by the doctors (nasal spray/tablet). It is highly advised to drink as much fluid as possible in such situations.

You should also ask the doctor whether the pituitary tumor might be due to a genetic pre-disposition (hereditary). Several tests are in the works which will soon help determine whether an individual is likely to be affected by a genetic defect which develops pituitary tumors.

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