The Hindu : Tamil Nadu / Chennai News : Arthroscopy `cheaper, less painful'

Online edition of India's National Newspaper
Tuesday, Feb 08, 2005

Tamil Nadu

Tamil Nadu - Chennai

Arthroscopy `cheaper, less painful'

By R. Sujatha

CHENNAI, FEB. 7. Arthroscopy is a less painful and cheaper option for treating damaged knee cartilages than surgery, but rehabilitation takes longer, says consultant orthopaedic surgeon, A.K. Venkatachalam.

MRI scan

People suffering from knee pain are generally referred for surgery, but this may not be required.

An MRI scan can reveal whether the knee pain is caused by lack of cartilage or a damaged cartilage.

Dr. Venkatachalam says that bowlegs, knock-knees and other deformities can cause pressure on the knee joint. The condition can damage knee cartilages, particularly among sportspersons and obese or elderly people.

When the bone is damaged, the condition is known as osteoarthritis, and requires knee-replacement surgery. Such surgery may not be necessary in case of cartilage damage.

Shock absorbers

Cartilages are healthy tissues, which act as natural shock absorbers. The damage to a cartilage begins as a lesion.

If left untreated, it develops into ulcers leading to bone damage. The damage can be seen only in an MRI scan. An X-ray will not reveal the damage. Treatment methods include restorative procedures and can cost up to Rs. 12 lakhs.

In an open-knee surgery, a piece of good cartilage is removed from the knee and cultured for six weeks.

A piece of membrane is taken from the tibia and the damaged knee bone is patched up. Then the cultured cartilage is packed on the damaged area.

The good news is that cost can be brought down to Rs.40,000 with arthroscopy.

`Super clot'

The procedure involves making three-millimetre holes in the knee bone to let blood flow.

It forms a `super clot' and helps form a reparative tissue called fibro cartilage.

"But the rehabilitation is lengthy. A person is asked to swing his/her knees hundreds of each day. He has to walk with crutches on the good leg," says Dr. Venkatachalam.

The condition where the cartilage is damaged is called osteochondritis and is found in 30 to 40 per cent of the general population.

Usually, it manifests itself in middle-aged people, though it can affect children too, says Dr. Venkatachalam, a consultant at the Department of Atomic Energy Hospital in Kalpakkam.

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