Increased rate of accidents and falls among people can lead to an increased rate of damaged bones, joints and the spine. Bones and joints have the capability to withstand the whole weight of the body, but a minor impact on weak bones can create a major injury. Damage to the bones, joints or the spine requires essential surgery. These surgeries help to regenerate the damaged parts of the body. Three Best Rated® sat down with three award-winning surgeons to learn about the three most common surgical procedures that give new life to damaged bones, joints and spines.

ACL Reconstruction, or Anterior Cruciate Ligament Reconstruction, is performed in the knee joint to replace the torn anterior cruciate ligament with a surgical tissue graft (a semitendinosus tendon). “The knee joint has four major ligaments and two menisci. Among this, the anterior cruciate ligament injury is the most common ligament injury of the knee,” Dr. Prathmesh Jain explains. This ACL ligament can be injured through a common sports injury such as a high-velocity RTA or, less commonly, low-velocity twisting. “In India, many two-wheeler accidents lead to ACL injuries,” Dr. Prathmesh says. “A torn ACL makes the knee unstable and prone to injuries.” Physicians suggest to address the ACL injury within three months or it may result in further damage to the knee. Instability, locking, difficulty using stairs (specifically downstairs) are the most common symptoms for ACL ligament injury. When chronic ACL injuries are left untreated for a long time, it will lead to medial meniscal tears, whereas acute ACL injuries cause lateral meniscal injuries.

Once ACL reconstruction is done successfully, the chance of further injuries is reduced and makes the knee more stable and long-lasting. Astonishingly, most of the athletes are back to their sports shortly after surgery. In India, many desk-bound persons can also suffer from ACL injuries. “Lack of aerobic exercise and training may ... lead to joint injuries,” Dr. Prathmesh states. For a physically unfit person, it is essential to do some aerobic exercises and practice safe sports techniques to prevent injuries. If not, it may lead to weak quadriceps and hamstring muscles.

Total Knee Replacement, or Knee Arthroplasty, is performed to replace the damaged or worn surfaces of the knee with a prosthesis to relieve pain and increase mobility, allowing the patient to do everyday activities normally. Traditionally, a long vertical incision is used to view and access the joint for a knee replacement. However, minimally invasive total knee replacement takes a different approach. “The surgeon uses a shorter incision to expose the joints. It is a different and less-invasive technique, with the goal of reducing postoperative pain and speeding recovery,” Dr. Rajat Jangirstates.

Minimally invasive total knee replacement is not suitable for patients who are overweight, have already undergone any other knee surgeries, have significant knee deformities or have health problems that may slow the healing process. They may have a higher risk from this surgery. The physician will conduct a thorough evaluation and consider several factors in determining the suitability of the procedure with the person. A patient with a thinner and healthier body, as well as motivation to participate in the rehabilitation process, may be more suited for this type of surgery. “Minimally invasive knee replacement is one of the evolving areas and more research is needed on the long-term function and durability of the implants,” Dr. Rajat says. This surgery has many benefits including less damage to soft tissues, quicker healing, less pain and a faster recovery. A patient should always talk to their doctor before undergoing this procedure.

Lumber Discectomy is performed to remove a portion of a degenerative disc (herniated disk) in the lower back that can disturb or press the nearby nerve. This stress on nerves will create pain, weakness and numbness in the back, legs and arms. Complete rest, physical therapy and pain medication are common ways to deal with a herniated disk. However, for some, surgery may come as one of the best options. Whenever the patient experiences trouble standing, walking or difficulty doing everyday activities, the physician may recommend Lumbar Discectomy surgery as an option.

Discectomy is performed in two ways: Open Discectomy and Microdiscectomy. In the most common one, open discectomy, a small posterior incision is made in the back, or neck, and the degenerative disc portion is removed. In the modern Microdiscectomy, a thin tube is used to remove the disc through a smaller hole in the back. This thin tube has a microscope for visualization and better illumination, high-speed driller, Leksell Rongeurs and more. After the surgery, Dr. Pramod Giri recommends avoiding lifting heavy objects, twisting or bending of the back, as well as driving, consuming alcohol and smoking. Physical therapy and walking frequently will help to speed up the recovery. “Saving human life is important but preventing the plight of neurological diseases is the aim,” Dr. Pramod says.

Dr. Prathmesh Jain is currently practicing as the director of the Advance Knee and Shoulder Hospital in Ahmedabad. He completed his graduation and postgraduation at AIIMS in New Delhi. In 2008, he was selected for the prestigious ACGME accredited Arthroscopy and Sports Medicine Fellowship at Sports Orthopedics and Spine in Jackson, Tennessee, under the mentorship of Dr. Keith Nord. He is one of the first U.S. sports fellowship-trained sports medicine surgeons in India. He specializes in Anatomical Single Bundle Quadrupled Enforced Ligament Reconstruction, which uses a single tendon with a fixed-loop button on the femur and biocomposite screw fixation on the tibia. The procedure is short and he strives to reconstruct the natural knee anatomy. He always follows the SAFE technique - Simple, Anatomical, Flawless and Efficient. Dr. Prathmesh has completed more than 3,000 successful ACL reconstruction surgeries. He also specializes in treating sports medicine, frozen shoulder, rotator cuff injuries and shoulder pain syndromes. Dr. Prathmesh Jain has been recognized for his excellence as one of the three best orthopedic surgeons in Ahmedabad, Gujarat, for 2019 by Three Best Rated®.

Dr. Rajat Jangir is an expert in the field of joint replacement, arthroscopy and sports surgery. He received his M.S. Orthopedics from BJ Medical College Civil Hospital in Ahmedabad. Currently, he is practicing as a consultant arthroscopy and sports surgeon at Ligament and Joints Clinic in Jaipur. Dr. Rajat is the head of the Arthroscopy and Joint Replacement Unit and associate professor at Mahatma Gandhi Medical College. In 2015, he completed his postgraduate in sports medicine from the International Olympic Committee in the U.K. He has successfully completed Rajasthan's first All Inside Physical Preserving ACL reconstruction in a 13-year-old athlete. He has also provided treatment for the state and national athlete teams. He has been a faculty member in many international and national conferences and has presented, and published, research papers in national and international journals. His clinic “Ligament and Joints Clinic” was awarded amongst the most promising orthopedic clinics in India by Silicon India healthcare magazine in 2018. From 2012 to 2019, they have performed nearly 2,000 arthroscopic surgeries and 1,000 joint replacement surgeries. Dr. Rajat Jangir was named one of the top three orthopedic surgeons in Jaipur, Rajasthan, for 2019 by Three Best Rated®.

Dr. Pramod Giri has been practicing as a neurosurgeon for over 15 years. He has received his MBBS and M.S. (Master of Surgery) from the Government Medical College in Nagpur. During his MBBS in 1995-1996, he received the Dr. Ramadwar Ideal Student Award. He also received the Braun National Scholar Award while completing his MCh. He completed his MCh in neurosurgery from The Sanjay Gandhi Institute Of Medical Sciences in Lucknow. Presently, he is the director of Neuron - Brain Spine and Critical Care Centre and head of Department of Neurosurgery for the Government Medical College of Nagpur. He has completed almost 30,000 neurosurgeries. Recently, he has renovated one of the operation theatres to a high standard for the benefit of the poor, complete with 150 beds, high-tech equipment like Neuronavigation, Portable CT machine, Robotic Neurorehab of HOMA and more. He was awarded as the Best Cerebrovascular and Skull Base Neurosurgeon in West India for 2017, Lokmat Vidharbha Icon Award in 2018 and Samaj Bhushan Award in 2018. Dr. Pramod Giri has been recognized for his excellence as one of the three best neurosurgeons in Nagpur, Maharashtra, for 2019 by Three Best Rated®.

Disclaimer: This article and the information within are for educational purposes only and should not be used as medical advice. This article is not intended to and should not be relied upon as medical opinion, advice or diagnosis. This article should not and is not intended to replace the advice of a trained, licensed medical professional in your area.