QA
Q: Can you explain some of the advanced surgical techniques for Total Knee Replacement? A: There have been great improvements in the UAE in the way that we perform surgical knee operations and in the way that we care for our post-operative patients. Technology has helped us tremendously to do the cuts for the bone in order for it to match exactly with the implant surfaces and to allow the patient to have the best fit for their knee. This means better mechanical movement, which means better stability and outcome. As an example of the advancement at the American Hospital, we started doing the PSI Total Knee Replacement (PSI meaning: Patient Specific Instrumentation). In this kind of surgery we scan the patient’s knee before the operation and then we send the detailed scans over to Europe. We then analyse the data with them, and based on the actual dimensions of the patient, we custom make the surgical instruments in order for us to get a perfect cut for the implant. This naturally helps us to calculate exactly the amount of bone we need to remove
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with Dr. Samih Tarabichi, Director of the Joints Replacement Center of Excellence at American Hospital Dubai, UAE
Syrian-born Samih Tarabichi specialises in joint replacement and is based at the American Hospital in Dubai. Working as a consultant to Zimmer, a US manufacturer of orthopaedic products, Dr Tarabichi has helped develop knee implants that allow for ‘full flexion capability’, or bending by as much as 150 degrees, enough for the recipient of a replacement joint to pray five times per day or relax comfortably. Arab Health spoke to him about some of the surgical challenges faced with joint replacements, and the advancement of care in this area in the Middle East.
and to minimize it as much as possible. This kind of improvement will decrease the incidence of infection because these instrumentations are only for one time use for that specific patient. It also decreases inaccuracy during the surgery.
Q: What implants are currently available for joint replacements? Which is better and why? A: When total knee surgery started over 30 years ago, we used to have very limited options as far as sizes for the implants. The idea of the total knee replacement is practically to resurface the bone only, and to try to maintain as much bone as possible. Initially we had limited sizes, which meant more bone had been
sacrificed than what we do today. As the industry improved, we had multiple sizes to better match any patient. There are basically multiple companies
who control the market, most of which are American. There are now variable options in knee constrain implant meaning that we try to preserve as much as possible from the patient’s ligament; however, in certain situations there is also ligament damage, so the amount of constrain on the implant is variable between different systems. There has been also another option, which is cementless total knee replacement, where we fix the implant to the surface by biological means, meaning we do not use the glue material to fix the bone.
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