Dr.Nagpal Hip and knee Joint Replacement centre and Hospital

Hip Replacement

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a semi (half) replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or fix severe physical joint damage as part of hip fracture treatment. A total hip replacement (total hip arthroplasty) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently the most common orthopaedic operation, though patient satisfaction short and long term varies widely.
A hip replacement may be necessary when the hip joint becomes so badly damaged that it causes pain, which interferes significantly with your quality of life and can not be controlled with simple measures such as painkillers.


CEMENTED: This refers to how the stem in affixed to the femur (as far as I know, nearly all cups are uncemented these days). In cemented stems, the stem is thinner and the space intentionally left between the stem and the cortex of the femur is filled with a cement.
Advantages are instant fixation, and works even for femurs with very large canals or when bone quality is poor. Disadvantages include cement tends to degrade and break down with time, especially if the patient is very active, and removing all the little pieces of cement from the canal can be very difficult during revision. Also, nasty chemicals can reach out of the cement (some patients react to this) and the chance of embolism is higher during implantation due to the large bolus of “sludge” that they can SEE (with ultrasound or something) pass through the veins and heart just after cemented THR. Also, quality of the fixation is HIGHLY physician-dependent, and varies with such things as just how the cement is mixed up and applied.

UNCEMENTED: Stems are much thicker and are designed to be “press-fit” into the femoral canal which is reamed out to exactly fit the stem; over time, the bone grows onto the stem, locking it in place. Most uncemented stems have a porous coating near the head end of the shaft to give a rough substrate for the new bone growth to attach to. Some have a hydroxyapatite (HA) coating — HA is a natural component of bone, and stimulates earlier on-growth and therefore early fixation. There are also various other differences in stem design to help give rotational stability, prevent the stem impinging on the cup liner, be more flexible, etc. For example, Fettos lateral flare stem purports provide better distribution of stresses and therefore less thigh pain and also longer lifetime of stem.
Advantages: If good bone ongrowth occurs, uncemented stems are believed to be able to last longer than cemented stems as there is no cement to break down and bone is self-repairing, believed to be better for active patients.
Disadvantages: Higher risk of femoral fracture during implantation, requires patient have good bone quality, less stable initial fixation, if well grown in it can make removal very difficult during revision, early designs of uncemented stems proved dissappointing in people and although the manufacturers have addressed the known weaknesses there is simpy no long-term data proving that the new stems will last longer than the cemented stems.

CERAMIC: A Ceramic on Ceramic hip replacement uses a material called alumina ceramic to reproduce the weight bearing surfaces of the hip joint (the ball and socket) rather than metal on plastic or metal on metal surfaces. Ceramic on Ceramic components have demonstrated significantly less wear compared to conventional hip replacement systems and it is therefore anticipated that this characteristic will extend he life of the implant.

Dr.Nagpal Hip and knee Joint Replacement centre and Hospital

Knee Replacement

Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.Debilitating pain from osteoarthritis is much more common in the elderly.
Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with ceramic(oxinium)/ metal and plastic components shaped to allow continued motion of the knee.
The operation typically involves postoperative pain,for which epidural anaesthesia is preffered and includes vigorous physical rehabilitation starting from the 1st post-operative day. The patient is made to walk with support of a walker from the 2nd post operative day, and the use of support (walker, stick) is advised for 6 weeks till the patient is confident enough to walk without support.


Unicompartmental arthroplasty (UKA), also called partial knee replacement, is an option for some patients. The knee is generally divided into three “compartments”: medial (the inside part of the knee), lateral (the outside), and patellofemoral (the joint between the kneecap and the thighbone). Most patients with arthritis severe enough to consider knee replacement have significant wear in two or more of the above compartments and are best treated with total knee replacement. A minority of patients (the exact percentage is hotly debated but is probably between 10 and 30 percent) have wear confined primarily to one compartment, usually the medial, and may be candidates for unicompartmental knee replacement.
Advantages of UKA compared to TKA include smaller incision, easier post-op rehabilitation, better post-operative range of motion, shorter hospital stay, less blood loss, lower risk of infection, stiffness, and blood clots, but a harder revision if necessary. While most recent data suggests that UKA in properly selected patients has survival rates comparable to TKA, most surgeons believe that TKA is the more reliable long term procedure. Persons with infectious or inflammatory arthritis (Rheumatoid, Lupus, Psoriatic), or marked deformity are not candidates for this procedure.
There are various types of injection available to reduce the appearance of fine lines and wrinkles. However the most common procedures include:

  • Muscle Relaxants (botox) – Muscle relaxing injections use the botulinum toxin to block nerve impulses which cause muscle contraction. This temporary treatment is very popular as relaxants block the nerve impulses that cause muscle contraction providing the appearance of smoother skin.
  • Dermal Fillers– Fillers work by plumping out wrinkles and laughter lines in the face. Fillers are a non-surgical treatment frequently used for smile lines.

Brands Under Knee Replacement

Fully Robotic Knee Replacement

Cuvis Joint Robot System is the most advanced surgical cutting edge robotic technology supporting surgeons with Personalized Preplanning and Precise Cutting for predictable and consistent results. It is made up of three key components: the Main Console, the Robotic Arm, and the Planning Device. The Main Console with Optical Tracking System (OTS) aids in real-time monitoring and directs the surgeon through the procedure. The majority of the bone cutting is done by a robotic arm with a milling tool positioned on its tip.

Gold Knee

Cobalt chrome (CoCr) knee implants are used for knee replacements since 50 years. However, Meril has patented a new technology called Opulent Bionik Gold Knee. It comprises a TiNbN coating with the least wear property, which is 40% lesser than regular CoCr, the hardest surface (8 times harder than CoCr), 2 times stronger than other implants of similar category and the most biocompatible non-allergic surface material. This knee implant system, with a base science of the Freedom Knee, is a ray of hope for young and old patients who want to enjoy an active, long-term and quality performance.

8 Times Harder Than Regular COCR Implants
2 Times Harder Than the Zirconium Oxide Implants
Least Allergic (Ionic Release of a Mere 0.0008 Times of Regular COCR)
Friction Is Less Than Half of Regular COCR Knees.


More than a decade ago, Smith & Nephew introduced OXINIUM◊ Oxidized Zirconium. This patented metal alloy is available for many of our knee and hip implant systems. The combination of hardness, smoothness and scratch-resistance makes it a superb choice for hip and knee implants. OXINIUM material—a metal alloy with the surface transformed to ceramic using a patented process—has proven to be a superior metal for use in hip and knee implants due to its reduced friction and increased resistance to scratching and abrasion. These superior properties result in significantly less wear than can be produced by cobalt-chrome alloy (historically the material of choice in hip and knee implants).
Some facts that may interest you:
OXINIUM material has a surface hardness that is over twice that of cobalt-chrome OXINIUM material may last longer than other implants as it reduces more than half of the implant wear common to other knees and hips based on lab simulator studies OXINIUM material avoids the risk of brittle fracture that can occur with ceramic implants OXINIUM material is 20% lighter than cobalt-chrome OXINIUM material contains <0.0035% for detectable nickel, the leading cause of negative reactions in patients with metal sensitivities

Dr.Nagpal Hip and knee Joint Replacement centre and Hospital

Hitech Physiotheraphy

Physical therapists provide services that develop, maintain and restore people’s maximum movement and functional ability. They can help people at any stage of life, when movement and function are threatened by ageing, injury, diseases, disorders, conditions or environmental factors. Physiotherapists are experts in movement and function who work in partnership with their patients, a physiotherapist can also help prevent further injury by listening to patients needs and expectations, working together to plan the most appropriate treatment for any individual condition, including setting goals and treatment outcomes.

After operation must be follow the therapies by Physiotherapists. They help to functions, movement of joints properly and back to life again as you desired.

Dr.Nagpal Hip and knee Joint Replacement centre and Hospital


Life always presents us with multiple surprises and they are not always pleasant ones. If you are someone who has been a victim of such an unpleasant incident, be it a road traffic accident or an assault, we understand as a trauma care management center, that your troubles do not end with the endless surgeries, and that traffic accident rehabilitation requires more care than most other conditions. You have a long way to recover from your injuries physically and to prepare yourself for a new leaf of life. We understand what it means to face multiple injuries and recover from it. We offer polytrauma treatment for through our inter-disciplinary approach. Be it post bone fracture treatment, spinal cord injury treatment or brain injury rehabilitation, we have it all covered..

Refers to a combination of injuries such as brain injury, spinal cord injury, fractures, amputation, burns, etc. caused by a road traffic accident or assault Individuals affected by this condition can have a wide range of symptoms depending on the combination of injuries and their severity Each of these injuries’ symptoms, medical complications and how we can help are discussed in detail in their respective section


Time duration of treatment and expectations depend on the combination of injuries, severity and chronicity of injury and they are discussed in detail in their respective sections.

The Primary goal is complete neurological and/or musculoskeletal recovery, which is often possible in these cases (unless there is an associated major spinal cord or brain injury then it will be difficult) as well as resolution of associated symptoms such as fatigue, pain, depression, and decreased endurance. We will also help you be independent/self-sufficient and integrate you into the community (return to work, return to driving, return to doing activities you did before) despite your physical and/or cognitive limitation (if you have any).

Dr.Nagpal Hip and knee Joint Replacement centre and Hospital

Computer-Assisted Total Knee Replacement

Computer-assisted total knee replacement is a procedure that utilizes sophisticated computer imaging to assure the highest level of precision during the knee replacement procedure. With the aid of a real time infrared based tracking system, we can achieve virtually perfect alignment and soft tissue balance, which are the two most critical components of a successful knee replacement.

How does computer-assisted surgery work?

In some ways, computer-assisted surgery is similar to the commonly used GPS systems found in aircraft and automobiles. Both systems localize specific positions in space in relation to their surroundings. Where the GPS system uses satellites and the concept of triangulation to locate positions, the surgical navigation system uses an advanced stereotactic camera and an infrared light source to locate points in space. The sophisticated software system used during surgery measures the position of your bones and the surgeon's instruments in relation to each other simultaneously at all times throughout the procedure. To establish these critical relationships, specialized reflective markers are attached to the bones and the surgeon's instruments. The motion of the bones and instruments are then tracked by an infrared stereotactic camera, which is integrated into the system's computer. The navigation software then creates a 3-D animated model of the patient's actual knee joint. This model is displayed on the systems monitor for the surgeon to visualize during the procedure. With the data obtained, the navigation system computes precise distances and angles and alignment to assure the highest degree of accuracy in placing the prostheses. This level of precision is far greater than that achieved by conventional knee replacements (commonly used) where instruments that determine the new knee alignment are literally placed "by eye". This commonly used (by eye) approach can lead to malaligned surfaces in the knee, which results in early failure.

The importance of achieving precise alignment in total knee replacement is conceptually similar to the importance of alignment on the tires of a car. Tires that are not aligned perfectly will wear out on one side, resulting in the need to be replaced. When your knee replacement is not aligned precisely the forces across the components are uneven, which results in premature wear and failure of the surgery. The end result is the need for an early repeat or "revision" of your knee replacement. Avoiding a repeat knee replacement is an important goal and should be avoided if possible.

Dr.Nagpal Hip and knee Joint Replacement centre and Hospital

Sports Medicine & Arthroscopy

This title includes a variety of sports and activity related injuries, affecting performance and participation. These injuries may occur due to the lack of preventive awareness, poor conditioning and improper nutrition leading to suboptimal performance and injuries. Therapy post surgeries for sports injuries is important to nurse the individual back to health. Injuries can be sustained while playing sports or even during practice sessions. The most common sports injuries like cartilage injuries, knee and shoulder injuries have the risk of permanent loss of functional ability if not treated properly on time. Sports medicine physicians can restore sportspersons to their original state of physical activity and health, thus optimizing performance once again. It is also important to minimize the occurrence of injuries in the future..

After operation must be follow the therapies by Physiotherapists. They help to functions, movement of joints properly and back to life again as you desired.

We strive to be the best Sports Rehabilitation Center by offering preventive care for athletes.

Our center has exclusive rehabilitation for sports injuries. We have some of the best sports doctors to facilitate sports injury recovery and help our athletes go back on track faster.

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