A three-day master's course in spinal surgery, trauma surgery and joint replacements offered by the Indo German Orthopaedic Foundation was inaugurated at MIOT Hospitals on Friday.

Addressing journalists, P.V.A. Mohandas, Managing Director, MIOT Hospitals, said the IGOF was started in 1992 as a result of his friendship with some top German orthopaedic surgeons during his training days. The aim of the Foundation is to have an ongoing dialogue between the two nations, allowing for full and free exchange of the latest orthopaedic techniques.

Two courses are currently being offered in India every year and fellowships are also offered for young Indian surgeons to be trained abroad.

Prithvi Mohandas, secretary, IGOF, said the techniques and protocols in orthopaedic surgery were changing rapidly and surgeons needed to update themselves regularly.

The conference, inaugurated by Madurai-based orthopaedic surgeon Devadoss, focussed on the most difficult areas in trauma, spine surgery and joint replacements and had invited the top surgeons of the world to provide solutions to these problems.

The problem with using joints is the production of debris when one surface moves on the other. This debris causes destruction of the bone and loosens the artificial joint, Dr. Prithvi pointed out. The issue with joint replacement, therefore, is how to make the implant last longer, Dr. Mohandas explained. With most of the technical issues in joint replacement being resolved or overcome, and with younger patients turning up for surgeries, it was imperative to make the joint last for life, he added. It is also necessary to ensure a good quality of life post-surgery.

Spine surgery

As far as spine surgery goes, the perception that the spine should not be touched was slowly giving way to some very complex surgeries that have enabled disabilities to be corrected, Dr. Prithvi said. Ian David Farey, a spine surgeon from Australia, said with improved technology in the field, there had been better results.

Even for quadriplegics or paraplegics, it was possible to take the pressure off the nerve and stabilise the spine, allowing for better mobility and the best chance of recovery.

Frank Kandziora, a spine surgeon from Germany, said the biggest challenge in the future would be the degeneration of the spine, and osteoporosis.

Several attempts were on to investigate the potential of stem cells to regenerate the nerves, but no major breakthrough had been achieved.

In the area of trauma surgery, hospitals are not treating patients with polytrauma, multiple injuries involving various parts of the body, thanks to better roads, and faster speeds on the roads.

The trend is to have a trauma leader who will assess the patient from head to toe, identifying the area that requires immediate intervention, stabilises the patient and treats him as a whole, Dr. Prithvi explained.

This will ensure that when a patient recovers sufficiently to go home, he has no deformities caused by neglect during the treatment period.