Fortis Hospitals Puts 27 Year Old Nigerian Back on her Feet After Multiple Joint Replacement Surgery

May 13, 2010

MUMBAI, India, May 13, 2010 /PRNewswire/ — Fortis Hospitals Mulund,
Mumbai, performed a multiple joint replacement surgery on a 27 year old young
Nigerian patient. Rebacca underwent a hip and a shoulder replacement surgery
by Dr. Sachin Bhonsle, Consultant Orthopedic Surgeon, after years of
suffering in pain and immobility.

Rebecca was suffering from a sickle cell disease since birth; an
inherited (genetic) disorder where the RBC (red blood corpuscles) assumes an
abnormal shape of a sickle under certain conditions. Any stress, injury, or
operation can lead to change in shape of the RBCs. But they are extremely
sensitive to drop in oxygen saturation of blood. This causes immediate

Sickle cells contain abnormal haemoglobin, known as ‘haemoglobin S’,
which causes the cells to have a sickle shape. Sickle-shaped cells don’t move
easily through blood vessels. The clumps of sickle cells block blood flow in
the blood vessels that lead to the limbs and organs. Blocked blood vessels
can cause pain, serious infections, and organ damage. It can be at times life

    Commonest problems encountered are:

    1. Sickle crises - painful abdominal emergencies because of
       blockage of blood vessels to abdominal viscera.

    2. Anaemia - red blood cells are easily destroyed and their
       life span is reduced causing anaemia.

    3. Avascular necrosis (AVN) of bones - certain bones with
       peculiar blood supply undergo AVN because of blockage of the artery.
       Once the blood circulation is lost the bone crumbles and the adjoining
       joints undergo arthritis. Commonest are hip and shoulder joints.
       Remodelling of entire skeleton is affected sometimes.

In Rebecca’s case the disease was severe to the degree that 93% of her
haemoglobin was abnormal. This resulted in extreme abdomen pain and loss of
blood supply to bones. Due to the lack of blood flow in her bones she
developed avascular necrosis in her hip joint and right shoulder. “She came
to us in a complete immobile state with a painful right hip and shoulder
which were completely damaged. The sickle disease had affected her knees as
well” said her surgeon Dr. Sachin Bhonsle, Consultant Orthopedic Surgeon.

“We had three major challenges before we decided to go ahead with the
surgery. Firstly, control of her Sickle cell disease – Rebecca had 93%
‘haemoglobin S’ (HbS). Subjecting her to trauma of a major surgery like joint
replacement, associated blood loss and stress would have precipitated a life
threatening sickle crisis. To reduce her HbS to about 30% we had to perform
an exchange transfusion. Exchange transfusions involved removing blood with
HbS and replacing it with fresh blood of compatible donors. It took about
five days to restore the HbS to a safe level, after which she was ready for

Secondly, there was the challenge of doing a shoulder and hip replacement
at same time. Thirdly, when doing a joint replacement on very young patient
it is important to perform a joint replacement surgery which would give her a
long lasting and better quality of life.”

After proper examination we decided to go ahead with the replacement of
right hip and shoulder. A decision was taken to use an ‘uncemented hip
replacement’ of a robust construction, which has a potential to last a
lifetime. A ceramic bearing was chosen for this hip which again will never
wear out.

Dr. Bhonsle used a minimally invasive approach to replace Rebecca’s right
hip whereby the hip joint was reached by minimal disruption with just a 4
inch cut. Because of avascular necrosis the bone quality was very hard and
difficult to prepare, but it was achieved using careful and specialized
instrumentation. Uncemented prosthesis was securely implanted and a ceramic
bearing was fitted. Rebecca’s hip was ready to use. Similar minimal invasive
approach was taken to the shoulder joint. Cemented shoulder prosthesis was
selected and secured.

Rebacca was able to walk on the 2nd day of her surgery. Following the
surgery her pain has gone completely. She had a speedy recovery and was able
to get back to her normal course of life within few weeks of the surgery.

    For More Information Please Contact:

    Priyam Bortamuli
    PR & Communication
    Email - priyam.bortamuli@fortishospitals.in
    Mobile - +91-9845558559

    Or enquiries@fortishospitals.in

SOURCE Fortis Hospitals Limited

Source: newswire

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