A US citizen recently underwent a knee replacement surgery to fix a deformity that had troubled him all his life. For the past three years, 69-year-old Mohammad Shafiq had been dealing with extreme pain in his right knee. The pain increased every day, making his knee movements difficult. As the Chief Executive Officer of a leading Dubai-based company, Shafiq had to travel a lot. However, the knee pain created problems when he got on or off the plane, affecting his travel plans.
“I travel around the world a lot. The pain had started affecting my work,” said Shafiq. When it became unbearable, he consulted Dr Samih Tarabichi of Burjeel Hospital in Dubai for an advanced surgery.
Rare and unique surgery
Shafiq’s X-ray showed an unusually large-sized bone that most implants available on the market would not cover. The doctor came to the conclusion that the best option would be to use a custom-made implant and preserve the posterior cruciate ligament which controls the back-and-forth motion of the knee.
“The custom-made implant made it possible to perform a cruciate-retaining surgery. We did not have to resect the posterior cruciate ligament during surgery, thereby maintaining the normal structure of the knee,” said Dr Tarabichi, adding that this made it a unique surgery.
One of the advantages of retaining the ligament is that the patient can move or walk just one hour after the surgery. “Studies show that cruciate-retaining implant gives a more natural feeling for the patient and a better outcome than the posterior cruciate-sacrificing implant,” the doctor added. Shafiq was able to move his knee just one hour after the surgery. He started walking independently within a few hours of the procedure, which is not common in other knee surgeries.
For the custom-made implant that fits Shafiq, the doctor did a CT scan and sent the dimensions to the manufacturer in Switzerland. The manufacturer then created a virtual model and made the implant based on it. It took 3-4 weeks for the company to finish the product.
In the cruciate-sacrificing method, the surgeons intentionally cut the posterior cruciate ligament and insert an implant that has a special mechanism that holds the joint together. Though it is an effective approach, this method can result in prolonged postoperative hospitalisation.
A distinct method
According to Dr Tarabichi, the implant must fit the patient perfectly. “It’s like wearing a shirt. If it is not of the proper size, you won’t be comfortable wearing it,” he added. There are about 24 types of implants available, that can cater to each person’s anatomical difference.
“When we retain the posterior cruciate ligament, the surgery becomes more delicate and more precise. The implant will be balanced perfectly on the original natural ligament that the patient has. Statistics show when we preserve the cruciate ligament, the implant can last longer for the patient, throughout his lifespan,” Dr Tarabichi said.
The cruciate-retaining implant method has a much better survival rate than the cruciate-sacrificing implant method, according to Dr Tarabchi. “Total knee replacement is becoming more and more sophisticated. There are multiple options that we can offer to the patient based on their size, need, lifestyle, etc. The older concept of one-size-fits-all does not work anymore. Studies show that the more precise and specific it is to the anatomy, the better the result and survival strength of the implant,” he added.
A much-relieved Shafiq said, “I have lived with knee pain for the past three years. But Dr Tarabichi helped me walk within hours of the surgery. In 2011, Dr Tarabichi performed knee replacement surgery on my left leg. This time, I am happy that my surgery was done using a new method and I hope this technology will be a steppingstone in orthopaedic care,” said Shafiq.
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