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Specialisations

Dr. Sanjib Kumar BEHERA is a pioneer in the field of orthopedics and well known for his expertise in Joint Replacement (Knee and Hip), Arthroscopy (All Joints), Trauma (Injury, Accidents and Major Fractures), Shoulder, Spine, Elbow, and Ankle Surgery. With over 20 years of experience, Dr BEHERA’s skills and knowledge have addressed the issues of countless patients successfully. Be it for an infant or an elderly, from the simplest orthopedic cases to the most complex, each case is unique and no single treatment can work wonders for everyone with the same problem.

Find brief of some of the areas that Dr.BEHERA specializes in:

HIP ARTHRITIS: Arthritis is a general term covering numerous conditions where the joint surface (cartilage) wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons. Often the definite cause is not known. When the articular cartilage wears out, the bone ends rub on one another and cause pain. There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always, it affects people as they get older (osteoarthritis).

WHAT IS ARTHIRITIC HIP ?

The cartilage lining is thinner than normal or completely absent

  • The degree of cartilage damage and inflammation varies with the type and stage of arthritis
  • The capsule of the arthritic Hip is swollen
  • The joint space is narrowed and irregular in outline; this can be seen in an X-ray image
  • Bone spurs or excessive bone can also build up around the edges of the joint
  • The combinations of these factors make the arthritic Hip stiff and limit activities due to pain or fatigue

Diagnosis: The diagnosis is made on history, physical examination and X-rays. There is no blood test to diagnose the wear and tear of Hip arthritis.

Indications: Total Hip Replacement (THR) is required for arthritis of the Hip that has failed to respond to conservative (non-operative) treatment.

You should consider a THR when you have

  • Arthritis confirmed on X-ray
  • Pain not responding to analgesics or anti-inflammatory
  • Limitations of activities of daily living (ADL) including your leisure activities, sport or work and Morning Walk.
  • Pain that keeps you awake at night (Night Cry)
  • Stiffness in the Hip making mobility difficult while doing your normal activity like getting into car, climbing steps, sitting in chair or Sofa etc

What is 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 hemi (half) replacement. This 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 or total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called prosthesis. Hip prosthesis consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they're designed to be accepted by your body — and they're made to resist corrosion, degradation and wear.

Is Hip Replacement Surgery for You? The decision to have hip replacement surgery should be a cooperative one made by you, your family and your orthopedic surgeon. Recommendations for surgery are based on a patient's pain and disability, not age or weight. Most patients who undergo total hip replacement are age 50 to 80, but orthopedic surgeons evaluate patients individually. Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

KNEE REPLACEMENT In the contemporary times, our lifestyle habits pose a serious challenge to our body and the knees are the first to bear the brunt of these changes. Owing to such habits, many people experience knee pain caused by wear and tear, an injury or hectic routine. Some other people suffer similar pain due to aging and arthritis.

What is Knee Replacement? A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material, metal and plastic components shaped to allow continued motion of the knee.

Indications Total knee replacement can be performed to correct mild valgus (outward bending) or varus (Inward bending) deformity, if one experiences extreme pain when performing physical activities requiring a range of movement in the knee joint.

Is Knee Replacement Surgery for You? Total knee replacement surgery is considered for patients whose knee joints have been damaged by progressive arthritis (age or activity related), trauma (accidents), rheumatoid arthritis and psoriatic arthritis (disease) or other rare destructive diseases of the joint. Regardless of the cause of the damage to the joint, the resulting progressively increasing pain and stiffness and decreasing daily function lead the patient to consider total knee replacement.

Total knee replacement surgery includes 4-5 inches incision over the knee, 3-5 days of hospitalization, physical therapy can begin 24 hours after surgery. A unique device that can help speed recovery is the continuous passive motion (CPM) machine. It constantly moves the knee through various degrees of range of motion, while the patient relaxes.

Patients will start walking using a walker and crutches. Eventually, patients will learn to walk up and down stairs and grades. A number of home exercises are given to strengthen thigh and calf muscles.

One month post surgery the patient reports relief from stiffness, pain and starts enjoying social activities with were inhibited earlier.

The hip and knee arthroplasty is a reliable procedure to the present day, with favorable results over time and a success rate >90%. However, there are also reported failures, complications or residual pains which are not exempt even in the non-prosthetic implants. The implant that lasts a lifetime does not exist, even if we can predict its survival beyond the 15-20 years of operation.

The Orthopedic Surgeon and Physical therapist work together to achieve the best clinical outcome for the patient.

Post-op precautions Remember this is an artificial Hip or Knee and must be treated with care.

Avoid the combined movement of bending your hip and turning your foot in. This can cause Dislocation. Other precautions to avoid dislocation are

You should sleep with a pillow between your legs for 6 weeks. Avoid crossing your legs and bending your Hip past a right angle

  • Avoid low chairs
  • Elevated toilet seat helpful
  • You can shower once the wound has healed
  • If you have increasing redness or swelling in the wound or temperatures over 100.5° you should call your doctor
  • If you are having any procedures such as dental work or any other surgery you should take antibiotics before and after to prevent infection in your new prosthesis. Consult your surgeon for details Your Hip replacement may go off in a metal detector at the airport

Failure to relieve pain Very rare but may occur especially if some pain is coming from other areas such as the spine.

OSTEOTOMY Osteotomy is a unique surgery not done in many centres.

Knee osteotomy is a surgical procedure in which the surgeon removes or adds a wedge of bone to the top of your tibia (shinbone) or the bottom of your femur (thighbone). This provides a less worn area of articular cartilage to the weight bearing part of the joint.

Osteotomy is typically recommended for those with arthritis damage in just one area of the knee. Arthritis on just one side of the knee can cause the knee to bend inward (valgus deformity) or outward (varus deformity). This can be corrected by the removal or addition of a wedge of bone. (Traumatic injury or even birth defects can also cause misalignment for which osteotomy is an appropriate surgical intervention.)

Many patients who undergo knee osteotomy will eventually need a total knee replacement. The osteotomy will buy them a varying amount of time before the need for total joint replacement becomes necessary.

We as a prominent team in India perform the highest number of Osteotomy with the best results compared to the internationally acclaimed.

ARTHROSCOPY Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it could mean the difference between leading a normal life or putting up with a debilitating condition. Surgery can be regarded as part of your treatment plan- it may help to restore function to your damaged joints as well as relieve pain.

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an arthroscope, a type of endoscope is inserted into the joint through a small incision to evaluate or to treat many orthopedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction, and trimming damaged cartilage. It has helped patients recover from the surgery in a matter of days, rather than the weeks to months required by conventional, 'open' surgery method.

The surgeon looks at a video screen which is connected to a camera that is inserted into the body, together with working instruments.

It is technically possible to do an arthroscopic examination of almost every joint in the human body. The joints that are most commonly examined and treated by arthroscopy are the knee, shoulder, elbow, wrist, ankle, foot, and hip.

In a Knee arthroscopy, a surgeon will look inside the knee joint, repair torn ligaments and remove damaged parts. Two or three very small incisions are made on the front of the knee. A fiber optic camera is inserted through one incision. A surgical instrument is inserted through the other incision.

The surgeon can then examine and repair the knee. Knee scopes are most often performed for meniscal tears (torn cartilage). A degenerative tear can be debrided (cleaned up) during the arthroscopy. A traumatic sports-related tear can be debrided or repaired via arthroplasty.

Because of the minimal soft tissue damage resulting from an arthroscopy, recovery is relatively quick. It is a relatively easy surgery and most patients go home immediately after the scope. Patients will typically be able to resume normal activity and return to work within two or three weeks. The knee will be swollen for less than a week.

Shoulder Arthroscopy for shoulder pain, dislocation of shoulder and rotator cuff tear and loose bodies.

Elbow Arthroscopy-procedures are performed for elbow contracture, deformity and loose bodies inside the joint.

Ankle- Bone defect and injury which cause painful ankle and decrease range of moment of ankle.

Wrist- We do a special procedure in wrist CARPEL TUNNEL SYNDROME RELEASE

Trauma Trauma refers a life-threatening medical emergency - a body wound or shock produced by sudden physical injury, as from violence or accident. It usually results in secondary complications such as circulatory shock, respiratory failure and death. Resuscitation of a trauma patient often involves multiple management procedures. It needs urgent attention.

Management of orthopedic trauma usually requires a combination of diagnostic skills and surgical technique. Dr.BEHERA has a great sense of spatial awareness and 3D reasoning (the ability to think clearly and rationally under pressure) which helps him work in a physical as well as an intellectual capacity.

SPORTS SURGEON Sports Medicine is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of injuries due to athletic activity. Delay in treatment can lead to further injury.

Dr. Behera specializes in Sports Medicine and Arthroscopy and in the diagnosis and treatment of all athletic injuries and has expertise in reconstructive surgery. - Knee and Shoulder, everything from the latest surgical techniques to good, old-fashioned care and compassion for athletes of all ages. With his personalized care and rehabilitation he ensures that his patients recover swiftly, and get back to their top performance and stay healthy.