Apollo doctor pioneers new method of Knee replacement without the use of Tourniquet

TNN Bureau. Updated: 12/15/2017 5:13:04 PM Health and Lifestyle

Jammu, Dec15: Dr Yash Gulati, Senior consultant, Orthopaedic surgeon, Indraprastha Apollo Hospitals, New Delhi has been successful in implementing a pioneering method of knee replacement without the use of tourniquet.

Taking a different approach from the traditional approach towards limb surgeries, Dr Gulati, who is a Padma Shri award winner, conducted surgeries without using tourniquets which he found out is more beneficial for the patient.

While Apollo conducts 500 of knee replacement surgeries every year, what is remarkable about this technique is that it is setting bench mark in surgical standards across the medical community.

Lata Sharma, a 50 year old woman from Meerut, after a long period of pain and suffering, had both of her knees replaced at Indraprastha Apollo Hospitals. Due to rheumatoid arthritis, she had severe deformities in both the knees, to the extent that she could not stand or walk independently. The condition was worsening by the day and a knee replacement was imminent.

But unexpected complication arose when Dr. Yash Gulati, senior surgeon, noticed that the patient had low haemoglobin and relatively fragile skin, “Use of tourniquet (tight band in thigh to stop blood flow during surgery) could have badly damaged her skin, leading to micro-vascular damage, excessive pain, slow recovery and slower mobilisation.”

Tourniquet means “tying a tight band around something”, and is a practise which has been around for more than 200 years. It is used in major surgeries of upper and lower limbs to prevent the flow of blood to the site of the surgery, making the operative field very clear by increasing visibility. Since it allows for a more precise operation and decreases the time consumption, its use becomes a preferred tradition which most doctors follow without question.

Dr. Yash Gulati is not only questioning this practice openly, he is also performing successful surgeries without the use of tourniquet. “There are many negative effects associated with the use of tourniquet. Damage to the muscles and calcification in the blood vessels of the arm or the leg can actually be the cause of gangrene. When the blood flow is restored after taking the tourniquet off after surgery there can be reactionary swelling which can be tremendous and the metabolic products which get accumulated in that area bring out toxic materials like lactic acids which can circulate into the whole body and cause damage. Injury to the skin underneath can include development of blisters, bleeding under the skin, and possible ischemia beyond the area where the tourniquet was tied during the surgery.” According to Dr. Gulati the post- operative management is much easier and the post- operative pain is much less when the surgeries are conducted without the use of tourniquet.

Lata Sharma, who was operated on both her knees without the use of tourniquet, is very happy with the successful outcome.

“After the second day of the operation, I started walking. There was no pain or haematoma. Within one week I was discharged from the hospital and since then I have not experienced any pain or complications. I have to undergo physiotherapy for three months. But from not being able to walk without help due to pain to complete independence, needless to say I am happy with the results.”

Knee replacement in India is increasing due to increase in better access to medical facilities, rising household incomes and better technology available at multi-specialty hospitals. With this trend, it is imperative that people be aware about their options when they opt for surgery as an option. Surgery without the use of tourniquet has the potential to make the post-op recovery much easier on the patients. Doctors should discuss with their patients the pros and cons of the scenario and accordingly, allow the patients the choice between a traditional and a modern approach.


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