Orthopedic

UMA SANJEEVANI has the slogan “Quality Health Care with Dedication in affordable Cost” and we actually provide it. It has the achievement of among the best hospitals in the Delhi/NCR for 23 years. This hospital has multiple specialties in both adult and paediatric. This medical and surgical hospital is best known for less medical mistakes and patient car

Orthopaedics is a medical specialty that focuses on the diagnosis, correction, prevention, and treatment of patients with skeletal deformities - disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin. These elements make up the musculoskeletal system.

Your body's musculoskeletal system is a complex system of bones, joints, ligaments, tendons, muscles and nerves and allows you to move, work and be active. Once devoted to the care of children with spine and limb deformities, orthopaedics now cares for patients of all ages, from new-borns with clubfeet, to young athletes requiring arthroscopic surgery, to older people with arthritis.

The physicians who specialize in this area are called orthopaedic surgeons or orthopaedists

Role of the orthopaedist
Orthopaedists use medical, physical and rehabilitative methods as well as surgery and are involved in all aspects of heath care pertaining to the musculoskeletal system. It is a specialty of incredible breadth and variety. Orthopaedists treat a immense variety of diseases and conditions, including fractures and dislocations, torn ligaments, sprains and strains tendon injuries, pulled muscles and bursitis ruptured disks, sciatica, low back pain, and scoliosis knock knees, bow legs, bunions and hammer toes, arthritis and osteoporosis, bone tumours, muscular dystrophy and cerebral palsy, club foot and unequal leg length abnormalities of the fingers and toes, and growth abnormalities.

  • In general, orthopaedists are skilled in the:
  • Diagnosis of your injury or disorder
  • Treatment with medication, exercise, surgery or other treatment plans
  • Rehabilitation by recommending exercises or physical therapy to restore movement, strength and function
  • Prevention with information and treatment plans to prevent injury or slow the progression of diseases

Typically, as much as 50 percent of the orthopaedist’s practice is devoted to non-surgical or medical management of injuries or disease and 50 percent to surgical management. Surgery may be needed to restore function lost as a result of injury or disease of bones, joint, muscles, tendons, ligaments, nerves or skin.

The orthopaedist also works closely with other health care professionals and often serves as a consultant to other physicians. Orthopaedists are members of the teams that manage complex, multi-system trauma, and often play an important role in the organization and delivery of emergency care.

A field known for innovation
Like other branches of medicine, remarkable technological advances have significantly shaped the field of Orthopaedics in recent years.

  • Arthroscopy - the application of visualizing instruments to assist in the diagnosis and surgical treatment of internal joint diseases - has opened new horizons of therapy
  • Exciting cellular research may enable Orthopaedic surgeons to stimulate the growth of ligaments and bone in patients someday in the future
  • Great advances have occurred in the surgical management of degenerative joint disease. For example, orthopaedic surgeons can replace a diseased joint with a prosthetic device (total joint replacement)
  • Research is progressing on "growing" articular cartilage in joints, which may one day reduce the need for some people to get joint replacements

Specialties
While most orthopaedists practice general orthopaedics, some may specialize in treating the foot, hand, shoulder, spine, hip, knee, and others in paediatrics, trauma or sports medicine. Some orthopaedists may specialize in several areas.

Treatments.Orthopaedic patients have benefited from technological advances such as joint replacement, and the arthroscope that allows the orthopaedist to look inside a joint. But your visit will start with a personal interview and physical examination. This may be followed by diagnostic tests such as blood tests, X-rays, or other tests.

Your treatment may involve medical counselling, medications, casts, splints, and therapies such as exercise, or surgery. For most orthopaedic diseases and injuries, there is more than one form of treatment. Your orthopaedist will discuss the treatment options with you and help you select the best treatment plan to enable you to live an active and functional life.

Orthopedics and radiology medical badge set. Human bone labels with hand, foot, knee, spine, arm, elbow, finger, pelvis and shoulder, ribbon banner and star. Clinic, diagnostic center, hospital design

Orthopaedics facts

  • Injuries to the musculoskeletal system (bones, joints, muscles, ligaments, tendons) or conditions like arthritis, osteoporosis rank number one in visits to physicians’ offices
  • One in seven Americans has a musculoskeletal impairment.
  • The number of persons incurring musculoskeletal injuries is 28.6 million annually — accounting for more than one-half of all injuries in one year.
  • Musculoskeletal conditions and injuries account for 137.6 million visits to physicians’ offices and hospital outpatient and emergency departments every year
  • Musculoskeletal conditions and injuries account for 137.6 million visits to physicians’ offices and hospital outpatient and emergency departments every year
  • Approximately 7.5 million musculoskeletal procedures are performed by physicians every year
  • Arthritis is the leading chronic condition reported by the elderly
  • Back or spine injuries are the most prevalent musculoskeletal impairments.
  • Sprains or dislocations and fractures account for almost one-half of all musculoskeletal injuries
  • Each year, musculoskeletal injuries nationwide cause children to stay home from school thousands of days
  • Currently employed workers lose thousands of days of work because of musculoskeletal injuries nationwide

Why Uma Sanjeevani

Uma Sanjeevani was founded in April 1993 by Dr Amod Pal Singh as a result of the intense need for medical care they witnessed the Gurgaon they resided in. In 1993, Uma Sanjeevani was the first hospital of its kind to be established in Gurgaon. The Uma Sanjeevani has other hospital in Sector 55 Gurgaon.

Uma Sanjeevani provides comprehensive and world-class orthopedic services. This department offers specialized care in the field of complex trauma, poly-trauma, Sports Injury and related sub-specialties. Orthopedic department at our hospitals delivers personalized care utilizing the latest research and evidence-based medicine. The department provides management related to disorders of bone, joint and a variety of musculoskeletal disorders.

Some of the procedures that we take care are joint, knee, hip and shoulder disorders, arthritis and custom implant surgeries. We treat sports-related injuries, which can be extremely painful and traumatic. Arthroscopy, knee, shoulder and ankle arthroscopy, recurrent shoulder dislocation, rotator cuff repair, sub acromial decompression, Msaicrominal and articular cartilage implantation are some of the other procedures done routinely.

The Hospital provides care for over 10,000 patient a year and performs over 3000 surgeries each year. The hospital has well equipped operating rooms, Enough bed capacity and over 100 staff helping provide care for patients suffering from conditions like clubfoot, cleft lip, Sports Injury and palate, curvature of the spine and disabilities stemming from polio, cerebral palsy, burn contractures and other congenital abnormalities. The hospital also provides prosthesis & amp; orthotics appliances; It fits artificial limbs for those with amputations of legs and arms and also special shoes to support weak or deformed legs and feet.

Surgery, therapy, orthopedic and rheumatology icons with flat symbols of doctors, operation table and surgery tools, checkup form and thermometer, x ray scan, medicines and crutch, prosthetic leg, bandage, spine and instruments

Uma Sanjeevani is registered with Medical Practitioners and concerned authorities as a faith based medical institution and a Continuing professional development provider.

SPORTS MEDICINE AND ARTHROSCOPIC SURGERY

Sports medicine is a specialty that addresses the prevention, diagnosis and treatment of injuries caused by participation in sports or exercise. Our sports medicine team focuses on rapid recovery and safe return to activity. A personalized treatment program is developed based on each individual’s injury, age, sport and other lifestyle needs. Movement patterns, body alignment and treatment goals are also unique factors contributing to all therapy and rehabilitation plans. Many of our therapists and physicians are former athletes themselves, and understand the demands of the sport.

PLATELET RICH PLASMA THERAPY

Platelet-rich plasma therapy, sometimes called PRP therapy or autologous conditioned plasma (ACP) therapy, attempts to take advantage of the blood's natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, or even bone.

Although not considered standard practice, a growing number of people are turning to PRP injections to treat an expanding list of orthopaedic conditions, including osteoarthritis. It is most commonly used for knee osteoarthritis, but may be used on other joints as well.

When treating osteoarthritis with platelet-rich plasma, a doctor injects PRP directly into the affected joint. The goal is to:

  • Reduce pain
  • Improve joint function
  • Possibly slow, halt, or even repair damage to cartilage

Platelet-rich plasma is derived from a sample of the patient's own blood. The therapeutic injections contain plasma with a higher concentration of platelets than is found in normal blood.

What is plasma?

Plasma refers to the liquid component of blood; it is the medium for red and white blood cells and other material traveling in the blood stream. Plasma is mostly water but also includes proteins, nutrients, glucose, and antibodies, among other components.

What are platelets?

Like red and white blood cells, platelets are a normal component of blood. Platelets alone do not have any restorative or healing properties; rather, they secrete substances called growth factors and other proteins that regulate cell division, stimulate tissue regeneration, and promote healing. Platelets also help the blood to clot; a person with defective platelets or too few platelets will bleed excessively from a cut.

There is no universally accepted medical definition for “platelet-rich plasma,” so a PRP injection that one patient receives can be very different than that of another. Variations occur for many reasons, including:

  • Patient characteristics. Blood composition (e.g. number of platelets) can differ from patient to patient.
  • Processing of blood. How a patient's blood sample is processed (e.g. centrifuged and filtered) affects the concentrations of platelets and white blood cells in a PRP injection.
  • Additives. Doctors may augment platelet-rich plasma with substances that are thought to enhance the PRP's healing properties.

How PRP production and composition affects the therapy's effectiveness is not well understood. Until more research is done, patients considering platelet-rich plasma therapy should take time to learn what is known about PRP.

What Does Platelet-Rich Plasma Therapy Do?

Experts are unsure exactly how PRP therapy may alleviate symptoms for certain orthopaedic conditions. Doctors who use PRP therapy to treat osteoarthritis theorize that the platelet-rich plasma might:

  • Inhibit inflammation and slow down the progression of osteoarthritis
  • Stimulate the formation of new cartilage
  • Increase the production of natural lubricating fluid in the joint, thereby easing painful joint friction3
  • Contain proteins that alter a patient's pain receptors and reduce pain sensation

It could be that platelet-rich plasma does all of these things, or none. More large-scale, high-quality clinical studies are needed before scientists can know

PRP Injection Preparation and Composition

PRP solutions can vary because they are made from patients' blood, and each patient's blood is a little different. In addition, different physicians have different approaches for formulating and preparing a PRP solution for injection. As of the date of this article, there are no consistent guidelines for use of this injection to treat osteoarthritis.

The following explains what is currently known about how PRP solution is made and components of the formula.

How Is Platelet-Rich Plasma Made?

The most common way to prepare PRP involves centrifuging a patient's blood sample. A vial of blood is placed in a centrifuge, where it is spun at intensely high speeds. The spinning causes the blood to separate into layers:

  • Red blood cells, approximately 45% of blood, are forced to the bottom of the vial.
  • White blood cells and platelets form a thin middle layer, called a buffy coat, which comprises less than 1% of the centrifuged blood.
  • "Platelet-poor" plasma, or plasma with a low concentration of platelets, makes up the remaining top layer, about 55% of the centrifuged blood sample.

Once the centrifuge process is complete the doctor or medical technician will remove the vial from the centrifuge and prepare the PRP solution for injection.

Centrifugation speed and time can vary. Differences in centrifugation speed and time affect the composition of PRP. There is no clear consensus on what centrifugation process produces the best results for treating osteoarthritis.

What Is in a Platelet-Rich Plasma Injection?

All PRP injections are not the same. The exact make-up of platelet-rich plasma depends on several variables, including the concentration of platelets, the concentration of white blood cells, and the use of additives.

  • Concentration of platelets
    • Normal blood has 150,000 to 450,000 platelets per microliter (μL), and the concentration of platelets in platelet-rich plasma can vary from 2.5 to 9 times that.6Concentration levels depend on the individual's blood, how much blood was drawn, the centrifuge process (e.g., rotation speed and duration), and other clinical preparation methods.
    • While it may seem logical that plasma with the highest possible platelet concentration will get better results than plasma with a lower platelet concentration, that is not necessarily the case. One lab study suggested that plasma with concentrations 2.5 times that of normal blood was ideal, and higher concentrations might actually limit new cell growth. More research is needed in this area.
  • White blood cell count
    • The immune system depends on white blood cells to fight infection, but the cells' role in PRP therapy is unclear.
    • Some experts suspect that white blood cells inhibit tissues' ability to heal, perhaps promoting inflammation, scar tissue, and damage to nearby tissues.8 Other experts think that, while white blood cells may not aid tissue healing, they have no negative effects, or may have beneficial effects. As with the concentration of platelets, the concentration of white blood cells is determined by an individual's blood as well as clinical preparation methods.
  • Additives
    • Some doctors mix additives into the platelet-rich plasma. These additives, called thrombin and calcium chloride, artificially activate the platelets, stimulate clotting, and may enhance platelet-rich plasma’s regenerative properties.

Efficacy of Platelet-Rich Plasma Injections

PRP has been used in surgeries to promote cell regeneration since 1987, and a growing body of evidence shows it is a viable treatment for tendinosis.12,13,14,15 Not until recently, though, have experts researched and debated whether or not platelet-rich plasma (PRP) injections are an effective treatment for osteoarthritis.

Nearly all of the research investigating the use of PRP to treat osteoarthritis and other cartilage defects has been done since 2000, and the vast majority of research articles on the topic have been published since 2010. Not all studies support the use of PRP to treat osteoarthritis; however, experts who have reviewed the existing body of research believe the evidence is largely encouraging and merits further investigation.

Knee Osteoarthritis Treated with PRP

Researchers studying PRP and osteoarthritis often work with patients who have knee osteoarthritis, a condition that experts estimate will affect nearly half of all Americans at some point during their lives. Two clinical studies that examine PRP to treat knee arthritis are described below.

  1. One study, published in 2013, involved 78 patients with osteoarthritis in both knees (156 knees). Each knee received one of three treatments: 1 PRP injection, 2 PRP injections, or 1 placebo saline injection. Researchers evaluated the subjects' knees 6 weeks, 3 months, and 6 months after injection. Researchers found:
    • Knees treated with 1 or 2 PRP injections saw a reduction in pain and stiffness as well as improvement in knee function at 6 weeks and 3 months.
    • At the 6-month mark positive results declined, though pain and function were still better than before PRP treatment.
    • The group that received placebo injections saw a small increase in pain and stiffness and a decrease in knee function.
      The platelet-rich plasma used in this clinical study had 3 times the platelet concentration of normal blood and had been filtered to remove white blood cells.

PRP Injection Preparation and Composition Method in Uma Sanjeevani

  • Cold PRP Centrifuge
  • 20 ml blood after first (soft) spin ... 2600 rpm × 12 min.
  • RBC packing is brought to level ... plunger pushes up the Buffy coat layer and seals the supernatant with Buffy coat in the chamber above.
  • Supernatant locked upper chamber mixed uniformly by gentle shaking.
  • 2nd spin (hard) 3600 rpm × 6 min ... see residue settled at bottom of upper chamber ...
  • Upper 2/3 constituting PPP drawn out after 2nd spin ... residue is PRP 3 - 4 ml ... Pic is taken after shaking.
  • Platelet concentration is 5 - 6 times of original level.
  • PRP to be injected in OT aseptically after drawing out in syringe with Calcium gluconate (1/4th of the volume of PRP)
  • Blood was drawn in a 20 cc syringe containing 2 cc of Sodium citrate
  • The above write up is about method of preparing PRP from 20 cc of the patient's own blood.
  • PRP or Platelet Rich Plasma injections have been given worldwide by orthopaedic surgeons for musculoskeletal pains and degenerative joint disease (osteoarthritis) since 20 years or so with good results ... they are particularly useful in chronic pain or pain recurring despite rigorous conservative management including anti-inflammatory analgesics & regular physiotherapy & in some cases where local injections of steroids have been ineffective ...
  • PRP injection is considered superior to steroids and even Hyaluronic Acid as it is prepared from the patient's own blood and less likely to cause allergic reaction from foreign material ... it is better also as it is known to act at a biological level by releasing healing or growth factors which help restore the damaged tissue to its normal biology ...
  • The platelets in the patient's blood sample are concentrated 3 to 5 times by removing the RBCs and part of the plasma containing less concentration of platelets or the Platelet poor plasma (PPP) using a special centrifuge machine for PRP ...
  • The injection needs to be given with full aseptic care by the specialist in a sterile environment like the OT or minor OT like all intra-articular or musculoskeletal injections given for chronic pain relief ...
  • After an injection, the patient may feel increased pain for 3-4 or more days, for which cold fomentation and analgesics such as Paracetamol or Tramadol are recommended ...
  • Pain relief ensues in majority of the patients for varying periods & extent in case OA knee and other joints, and long term relief is obtained in cases of musculosketal pain due to plantar fasciitis, Achillis Tendinopathy, Tennis Elbow and Rotator Cuff Tendinopathy amongst others.
  • The injection can be repeated again with good relief, after 3 to 6 weeks or later if required.