Mumbai: Rare surgery has 71-year-old back on his feet

Mahim hospital successfully removes stones from both of elderly patient’s knees; only the fourth such operation in India

A city doctor and his team have successfully removed stones from both knees of a 71-year-old male patient. Due to the deformity of the bones, the doctor also performed knee replacement surgery. The hospital claims that this is the fourth case in India and the ninth in the world where stones have been removed from both knees.

Prahlad Pawar, 71, a resident of Pune, had been suffering from severe knee pain and progressively worsening leg deformity for nearly 10 years. He was barely able to walk due to the deformity and thus was brought to SL Raheja Hospital in Mahim. Dr  Siddharth M Shah, a consultant-orthopaedics and joint replacement surgeon at the hospital, explained that after multiple tests, the patient was diagnosed with Synovial osteochondromatosis, a rare condition. Involvement of both knees in this condition is even rarer. The patient had an extensive manifestation of the disease, with multiple large stones in and around the knee, as well as severe knee arthritis and a tibial bone defect.

Surgery only option

Dr Shah said, “Surgery was the only option to relieve the patient from this condition, as there was damage to the tibial bone due to bone erosion. Instead of a standard total knee replacement, a complex knee replacement was required, involving the augmentation of the tibial bone defect with augments and additional support with a stem. The presence of stones close to important ligaments and blood vessels posed another challenge, as their removal required utmost care to avoid damage to these vital structures. Damaging the blood supply of the leg could result in amputation. Therefore, the stones were removed carefully, ensuring no harm was done to the blood vessels and ligaments of the knees.” The doctor successfully removed the largest stone, measuring 6.0 x 4.5 x 2.5 cm, from the left knee, and a stone measuring 5.5 x 4.0 x 2.0 cm from the right knee.

Stones removed from patient Prahlad Pawar’s knees

Pankaj Pawar, the patient’s son, spoke to mid-day and shared that his father, who is a farmer, could barely walk due to immense knee pain prior to the surgery. He had been enduring the pain for the past 10 years. They decided to seek treatment in Mumbai after hearing about a successful operation performed by the same doctor on someone they knew. The day after the surgery, Pankaj’s father began walking with the support of a walker.

Cause of the disease

The exact cause of synovial osteochondromatosis is not known. The lining of the joint, known as the synovium, normally produces synovial fluid to lubricate the joint and nourish the cartilage. In this condition, the synovial lining generates small nodules of cartilage that can grow to various sizes. These nodules may harden or ossify, forming bone, and can become detached from the synovial lining, resulting in loose bodies or stones in the knee.

9th
Case in the world

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