Mumbai: Jaslok Hospital achieves a remarkable milestone in the field of orthopaedic surgery with the successful Total Knee Replacement (TKR) procedure on a 193 kg patient, marking a significant breakthrough in addressing the challenges faced by overweight individuals seeking knee surgery.
Total Knee Replacement is a life-changing procedure for individuals suffering from debilitating knee pain, restoring mobility and enhancing their quality of life. However, overweight individuals often encounter barriers in accessing this treatment due to increased surgical risks and technical complexities.
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The case of 72-year-old Mr. Richard Koszarek, weighing 193 kg patient admitted to Jaslok Hospital, exemplifies the dedication and innovation required to overcome these challenges. Dr Rajesh Nawalkar, Senior Consultant Orthopedics & renowned orthopaedic surgeon, led the multidisciplinary team, including Dr. Altaf Patel, Director General Medicine, Dr. Prerana Gomes, Additional Director Anaesthesiology and Dr. Dheemant Goleria, Consultant Plastic & Reconstructive Surgery in meticulously planning and executing the surgery.
One of the primary challenges in TKR for overweight patients is anaesthesia risk and the heightened potential for embolism. Additionally, the use of a tourniquet, a standard practice in TKR surgeries, poses technical difficulties due to the larger thigh circumference, increasing the risk of tissue damage and complications.
To address these concerns, Dr Nawalkar collaborated with instrument manufacturers to design specialized instruments tailored to the patient's unique anatomy, ensuring optimal surgical outcomes. Moreover, extensive pre-operative evaluations and consultations were conducted to ensure patient readiness and informed consent.
The surgery, performed on January 7, 2024, was a testament to meticulous planning and expert execution, with no complications reported during the procedure. However, the journey to recovery was equally crucial, with rehabilitation playing a pivotal role in achieving successful outcomes.
Under the guidance of Dr. Stanley and the dedicated rehabilitation team, the patient received tailored care, including specialized aids for ambulation and ablution, facilitating a smoother recovery process. The support of Jaslok Hospital's management and staff was instrumental in realizing this remarkable medical achievement.
Speaking about challenges in the surgery of such unique case Dr Rajesh Nawalkar, Senior Consultant Orthopaedics stated-"Every patient is different, and it's crucial to adapt our surgical techniques to address their specific circumstances. By customizing our approach and collaborating closely with our colleagues, we were able to overcome the challenges posed by the patient's weight and achieve a successful outcome."
Adding to this Dr Prerana Gomes, Additional Director, Anaesthesiology said, "Managing anaesthesia for morbidly obese patients undergoing total knee replacement requires a comprehensive understanding of their physiological needs and potential risks. Our team approached this aspect of the surgery with utmost care, ensuring the patient's safety and comfort throughout the procedure."
Speaking about his life, Mr. Richard Koszarek mentioned, “Most of the doctors in India and overseas didn’t agree to perform surgery because of my over-weight, however with the guidance of Dr Altaf Patel and with the trained surgical skills of Dr Rajesh Nawalkar, I was finally operated and today I am back on feet.”
Dr Milind Khadke, Director Medical Services proudly mentioned “Today, as we celebrate this milestone, we also recognize the importance of perseverance, innovation, and collaboration in overcoming barriers to healthcare access. This case serves as an inspiration to individuals struggling with obesity-related knee issues, highlighting the possibility of achieving positive outcomes through specialized care and expertise”.
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