Expert Speaks: Latest Orthopedics Welfare with Dr. Ramkinkar Jha

We are back with the latest edition of #ExpertSpeaks and we had the opportunity to discuss orthopedics with the best orthopedic surgeon in India, Dr. Ramkinkar Jha from artemis Hospital, Gurgaon.

From latest innovation to everything in between, Dr. Jha shared his insights on the development in orthopedics care. Dr. Ramkinkar Jha has over two decades of experience and is the chief and unit head of the orthopedics department a Artemis Hospital.

Yapita Health spoke with the AIIMS graduate, who also has a gold medal from his graduation. The following sections are from Yapita’s conversation with the expert.

On Advances in Orthopedics

YH: Ankle replacement surgeries are considered common in countries like the UK. How is the situation different in India?

Expert: Ankle replacement has been successfully done in Britain, but it is not widespread or common in India due to the limited awareness and training. I have done a few myself with successful outcomes, but the demand is very low in comparison to knee or hip replacement.

Patients with severe ankle arthritis mostly opt for fusion surgeries in India.

YH: What challenges do you see in revision joint replacement cases?

Expert: Revision cases are becoming more common now - this is one of the significant barriers the discipline is facing right now. These are highly complex compared to primary procedures as bone stock is poor and the implants may need to be customized.

3D printing of implants has helped us manage such cases making revision surgeries more successful for us.

On Robotics and Navigation in Surgery

YH: How do robotic and comouter-assisted orthopedic surgeries help patients?

Expert: The navigation systems and robotic assistance improve accuracy in joint replacemen, especially in hips and knees. Such technologies help us place the implant in the most precise alignment which increases the longevity of the joint.

Robotic setups are costly and there is a higher risk of infection due to high operative times, but with the right infection control setting, it is a success.

YH: What is the approximate cost difference for robotic joint replacement surgeries?

Expert: In India, a computeer-assisted or robotic knee replacement can cost around ₹5-6 lakhs per knee, while a hip replacement may range from ₹6-8 lakhs. Shoulder replacements are advanced surgery and the costs can go up to ₹12 lakhs.

On Sports Injuries and Arthroscopy

YH: What types of sports injuries do you commonly see?

Expert: Sports injuries in India are increasing with the growing interest in athletics. We frequently treat conditions like rotator cuff tears in the shoulder, ACL is another common injury people come to me with.

Meniscus injuries in the knee and ankle ligament injuries such as ATFL tears are also common. Most of these are managed with minimally invasive arthroscopic techniques which allow faster recovery and better outcomes in the long run.

Orthopedic Oncology

YH: Have you treated cases of orthopedic cancer? Could you share a example?

Expert: Some of the more challenging cases I have handled apart from revision surgeries are bone cancers. Recently there was a osteosarcoma case, then I have also come across chondrosarcoma and Ewing’s sarcoma.

Although these cases require multidiscilinary approach, there have been success with combination of high-dose chemotherapy with BMT. Redo or revision surgeries after tumor resections are also an approach we take.

Regenerative Medicine and Stem Cells

YH: Regenerative medicine is often spoken of as the future of orthopedics. What are the options available?

Expert: We now use variety regenrative therapies such as platelet-rich plasma injections to growth factor concentrates and stem cell therapy. Bone marrow aspirate concentrate or BMAC are also showing much better results than PRP.

It is especially useful for cartilage repair and early arthritis management.

YH: And what about advanced stem cell applications?

Expert: Stem cells are one of the most exciting field today. So far, mesenchymal stem cells have been used in orthopedics (joint cartilage regenration), but now new research shows that pluripotent and totipotent stem cells can also be helpful.

One day, it could also be used for generating functional organs. A typical mesenchymal stem cell treatment costs around ₹3.5-4 lakhs and involves preparation for a few days in advance.

YH: How do you manage very complex or traumatic cases where part of the bone is lost?

Expert: Severe trauma or partial tibia loss is a common issue I have dealt with - the go-to option is Ilizarov fixator method for limb lengthening and reconstruction. In some cases, an allograft is used for replacing lost bone segments.

These surgeries are demanding but they save limbs that might have to be amputated.

Final Thoughts from Expert

Our conversation with Dr. Ramkinkar Jha highlighted the latest advancements in orthopedics and approaches that are currently saving lives. One of the leading orthopedic surgeons in india, Dr. Jha has been instrumental in helping improve the lives of thousands.

Get in touch today to get a consultation with Dr. Ramkinkar Jha.