Total knee replacement is a surgery usually performed in a patient suffering from age

related degenerative arthritis after the age of 60 to 65 years. Number of patients suffering from chronic dis-abling pain in knees with far ad-vanced degenerative osteoarthritis at much younger age of even 40 years is increasing. This is mainly due to change in life style, overweight and over loading of joints, repetitive sports injuries at a younger age, lack of physical exercise and early hor-monal changes especially in females.

There are varieties of methods available to treat arthritis at a younger age. For example these pro-cedure are Arthroscopic debride-ment of knee (Cleaning of Joint), high tibial osteotomy (cutting the bone below the knee and changing the angle) and uni-compartment knee replacement (changing half the knee joint). These procedures work in early moderate stage of os-teoarthritis when the disease in-volves only inner or one compart-ment of the knee. In a patient with advanced stage these methods will not work. So then what is the answer for advanced stage of arthritis in young patient?

Undoubtedly total knee replace-ment is the solution for advanced

stage of osteoarthritis of the knee. Main concern in young patients is longevity of procedure and implant. They are in their highest productive stage of their life between 40 to 60 years of age. None of the traditional total knee implant has longevity of

15 years or more. The failure in knee replacement

at any age is due to wear out of plas-tic between the articular surfaces of two components of knee implant or prosthesis. Life expectancy of conventional older implant has been 15 years. If a younger patient has to undergo knee replacement this material should have better longevity. Fortunately with chang-ing technology they also have better material available to enhanced lon-gevity of total knee replacement material. There is newer material like Oxinium is available to use. This brings down wear rate of plas-tic to 90%, hence increasing longev-ity. There is another design known as Rotating Platform Knee System. This also has low wear rate as com-pared to other conventional de-signs. One can add computer-assist-ed surgery (CAS), which helps in more accuracy and precision of do-ing total knee replacement. This accuracy and precision for a well aligned and balance knee is the key for long-term success. Hence, CAS along with modern implant will achieve success and result with longevity.

There are newer implants avail-able to even provide better durabil-ity and stability at any range of

movements of knee during all ac-tivity levels. These are the preferred implant in younger patients. So today in 2015 they have many im-plant and technology to offer to a patient were longevity of proce-dure, activity level and patient sat-isfactions is taken care of.

Contact Details:Dr Sanjeev Jain

Joint Replacement SurgeonDr L H Hiranandani Hospital

Powai, Mumbai

M.CH. Orth. (UK), M.S. Orth., FASIF (Germany), Fellowship -

Joint Replacement (Primary & Revi-sion), Hip Resurfacing & Sports

Medicine (USA)Sangeev.jain@hiranandanihospital.org

Dr L H Hiranandani HospitalMumbai’s First NABH

Accredited Hospital Hillside Avenue, Hiranandani

Gardens, PowaiMumbai - 400076

Tel: 25763300/3333Fax: 25763344/3311

For Appointment Contact: 25763500

Email:wecare@hiranandanihospital.org

Website:www.hiranandanihospital.org

Changing Scenario and DemandArthritis in younger patient and Newer Advances in Total Knee Replacement

Dr Sanjeev JainJoint Replacement SurgeonDr L H Hiranandani HospitalPowai, Mumbai

The iconic healthcare institution of Mumbai, Dr. Balabhai Nana-vati Hospital, blessed by Ma-

hatma Gandhi and inaugurated in 1950 by India’s first Prime Minister Jawa-harlal Nehru, is now reintroduced as Nanavati Super Speciality Hospital.

Nanavati Super Speciality Hospital has been at the forefront of healthcare for 65 years. Today, the 350 bed facility housing 55 speciality departments of-fers a plethora of services in practi-cally every field of modern medicine and healthcare. Their well-equipped hospital rooms, state-of-the-art de-partments and technologically advanced systems are all backed by the expertise and reputation of over 350 consultants, 100 resident doctors, 475 nursing staff and 1500 employees.

Radiant Life Care Private Limited, a professionally man-aged healthcare services pro-vider, has now taken charge of re-developing and managing the facility as a high end Quaternary Care Facility. Radiant also plans to augment the hospital’s clinical pro-grammes across all specialities includ-ing Cardiac Sciences, Neuro Sciences, Orthopaedics, Nephrology & Urology, Paediatrics, Oncology, transplant pro-grammes for Bone Marrow, Liver and Kidney, and an advanced Acute Emer-gency Care Centre over the next six months.

In agreement, Prof. Dr. Pradeep Bhosale, Director – Arthritis & Total Joint Replacement Surgery, Nanavati Super Speciality Hospital, adds, “The hospital offers dedicated services for Trauma and General Orthopaedics, Spine Surgery, Sports Medicine and

Joint Reconstruction including Mini-mally Invasive Surgery (MIS) for Total Knee Replacement, Total Hip Replace-ment, Hip Resurfacing, Unicondylar (Partial) Knee Replacement as well as Replacement of Shoulder and Elbow joints. The Centre for Orthopaedics, Joint Reconstruction and Spine Sur-gery regularly carries out

arthroscopic procedures for sports and other injuries, limbs salvage surgeries for bone tumours and reconstruction surgeries for de-formities.”

The Centre is ably supported by world-class physiotherapy and reha-bilitation unit for post-surgical care. The Centre has a dedicated team for the treatment of spinal ailments in-cluding Minimal Invasive Spine Sur-gery (MISS), Mobilization Solutions

and Spinal Fusion procedures, deliv-ered using some of the most advanced techniques and technologies in this field.

Radiant is working towards further bolstering the hospital’s operations, introducing global best practices, ex-panding operations and transforming

the existing 350-bed facility

into an 800-bed quaternary care institution. Nanavati Super Spe-ciality Hospital is now poised for a quantum leap which aims to bring in not only the best clinical and nonclin-ical talent but also the ultra-modern equipment and technology enabling delivery of the highest standards of healthcare. In the near future, Nana-vati Super Speciality Hospital will be one of the largest quaternary health-care institutions in the country.

NANAVATI SUPER SPECIALITY HOSPITALDEDICATED TO THE PASSION FOR HEALING

Living a healthy lifestyle is what we all wish for

but not all of us are blessed with perfect me-tabolism and body, never the less it is no more a limitation for us,thanks to Dr. Mohit Bhandari's state of the art weight loss & diabetes surgery centre in Indore. It is India’s most sought after center in the country for pa-tients looking for Robotic Bariatric Surgery, a techni-cally sound and swift pro-cess to go under the knife.

Dr. Mohit Bhandari’s weight loss & diabetes sur-gery center, Mohak Bariat-rics & Robotics is liberating people from obesity. Dr. Bhandari is the youngest surgeon to perform more than 3500 bariatric surgeries and more than 250 robotic surgeries in his stint as a sur-geon. Elsewhere in India where Doctors are stillhopping onto conventional laparoscopic procedures,Dr. Bhandari has moved ahead to the most advanced way of Bariatric surgeries. Even, the Surgical Review Corporation, USA has desig-nated Mohak as an Interna-tional Centre of Excellence in Bariatric & Metabolic Sur-gery and Dr. Mohit Bhandari has Surgeon of Excellence.

Dr. Mohit has always been a pioneer in introducing medical advancement into practice and has proved his mettle. Owing to this trend, Dr. Bhandari is operating with Da Vinci robotic system which translates surgeon’s hands into small, ultra-pre-cise movements of tiny surgi-cal instrument inside the patient’s body. The three di-mensional magnified vision with this machine makes the

surgery happen with precision. The 360 de-gree wrist movement allows the surgeon to have more precision, dexterity and control leading to acceptably low complications, mi-nus trauma rates, com-paratively low pain and scarring, low infection rates, shorter hospital stay and a major cut

down on gastrointestinal leaks which in total makes the surgery, a zero pain expe-rience.

The credentials ofDr. Bhandari’s are plenty and going by his academic and professional excellence one is sure to believe that this man will only do excel-lence with his hands. Attrib-uted with hundreds of op-erations under his name, there are plenty of cases in his record book who can’t be happier with the way they look post surgery, making Indore stand out in the map of Bariatric surgery in the country.

Contact Details:Mohak Bariatrics

and RoboticsIndore- Ujjain State

Highway, MR- 10 Crossing, Indore M.P

Helpline Nos.: 9893048981,9669338222;

Tel No. : 0731-4231700-20

Country’s Highest Volume Robotic Bariatric Center at Indore now

Hemkumar Goyal-Turned over a new leaf

Subhjeet Kaur-Impossible made Possible

Team that toils relentlessly to help achieve a newer you

BEFORE

BEFORE

AFTER

AFTER

Robotic Bariatric Surgery- Humane Touch Beyond Excellence for a Rejuvenated you!

Dr. Mohit Bhandari

The Source of LifeA sip of it is enough to quench the thirst

and just the fact that it is 100% natural. Aava India’s Highest selling Natural Min-eral Water (in terms of bottle sold) is not passed through any chemical purification process or Reverse Osmosis or U. V. Rays ensuring that every single drop you con-sume is thoroughly natural. This chemi-cally treated R O water has low pH value is unstable and has the unique property of absorbing carbon dioxide from the at-mosphere and becoming acidic and de-minerilized for the consumer. Aava has an alkaline pH value of 7.9-8 which makes it a wellness water.

The Origin and Health BenefitsAava, is a natural mineral water origi-

nating from the foothills of the Taranga, in the Aravalli range.Aava is filtered through layers of clay and alluvial as the

water travels from the catchment area to the confined and protected underground aquifers where it is bottled at source. Aava naturally contains minerals like calcium, magnesium and other minerals that are known to have positive health implica-tions for Digestion, Stomach Ulcers, ner-vous disorders, memory loss, Osteoporo-sis, Arthritis, Cataract, Vitamin B12 defi-ciency etc.

Real Mineral Water with actual Minerals in itAll bottled waters are generically called

mineral water. But it is infact the very op-posite. 99% of bottled waters are processed and demineralised packaged drinking R O waterThere are 3850 licenses of Pack-aged drinking water under ISI 14543 and only a handful licences of natural min-eral water like “Aava” under ISI 13428. (BIS Standard).

Packaged water is processed by

U.V.Chemical disinfection and R.O. which demineralizes the water, making it acidic to drink. Aava is truly certified Natural Mineral water enriched with the good-ness of natural minerals that make it healthy Alkaline and neutral to drink.

Quality MattersAava is put through strin-

gent testing of more than 50 chemicals and microbiological test every fortnight at Nationally Accredited Laboratories apart from the daily test in-house 28 tests at Aava’s modern in-house laboratories. Aava is certified by the Bureau of Indian Stan-dards and FSSAI . Most impor-tantly, in today’s pesticide era Aava can boast of pesticide free water. Aava’s manufactur-ing processes are certified Food Safety and Quality Com-pliant with HACCP and ISO: 9001 certifications. Aava is an ISO 14001 certi-fied environment friendly water in India because not a drop of water is wasted in

bottling Aava.

Setting StandardsAava is India’s highest selling

Natural Mineral Water with nearly 280 million bottles sold worldwide. Its sells one mil-lion bottles a week. Each day 1,50,000 bottles are consumed in top airlines, like Air India, Jet Airways, Indigo and

foriegn airlines, top hotels like The Oberoi, JW Marriot and

Taj Sats, high end Restaurants and golf courses like GVB, Will-ingdon. Aava has also won many international awards for its bottle design, quality and innovation.

On the completion of their 10 year journey, Behram Meh-ta, M D and Promoter of Aava Water says “We bottle trust and wellness, not mere water.

Aava is Gods own water, which rejuvenates your senses and en-

riches the body with natural minerals which are essentially for a healthy body and mind”.

HEALTH IN A GLASS OF AAVAAava’s Natural Mineral Water is naturally Alkaline, and full of natural minerals which brings about a new vitality, health and wellness

Friday, 31 July, 2015 | Mumbai 3

Continued from page 1

In the perceptual module, a strucutred questionnaire was administered among selected respondents to arrive

at a ranking & rating of lifestyle hospitals & clinics in respective therapeutic areas viz Diabetology, Othopaedic, Bariatric, Trichol-ogy, Dermatology & Plastic Surgery. Each respondent was asked to give ratings for only those hospitals/ clinics that he/she was aware, considering them as best at na-tional and their zonal level (in their respec-tive therapeutic areas) – 5 each hospital/ clinic respectively to avoid investigation fatigue to ensure quality data.

A sample survey of 900 was conducted in select cities – Delhi-NCR, Mumbai, Chen-nai, Kolkata, Bangalore, Hyderabad, Ahmedabad, Chandigarh, Pune, & Kochi. There were two main respon-dent categoriesv - those who are the experts in their therapeutic areas (Experts) and those who have undergone for elective pro-cedures/ treatments (Ac-tive Users). The respon-dent categories included:Experts

Consultants/ Sur-geons from respective ther-apeutic areas

Active Users Past as well as current users of

lifestyle therapeutic areas An extensive 6 weeks field work was con-

ducted from beginning the 2nd week of May 2015

MODULE 1DESK RESEARCH (LISTING ELECTIVE LIFE-STYLE TREATMENT HOSPITALS & CLINICS)

The module 1 was a secondary research module. A comprehensive list of elective lifestyle treatment hospitals & clinics were generated for respective therapeutic area with the help of internet, magazines, etc. The list was further refined to those list of hospi-tals & clinics which provides only elective procedures & treatment in respective treat-ment areas;

Orthopedics procedures like joint replace-ments, etc.; Bariatric procedures like gastric bypass, sleeve gastrectomy, etc. ; Trichology (excluding only hair transplants), Dermatol-ogy (excluding only cosmetic surgery) & Aesthetic procedures like Plastic Surgery, Cosmetic Surgery, Reconstructive Surgery, Maxillofacial Surgery, etc.

MODULE 2PERCEPTUAL SURVEY

A perception questionnaire was adminis-tered to respondents. The same also checked for awareness scores. Respondents were al-

lowed to respond for those hospitals/ clinics only which were known to them.

Respondents were provided a list of pa-rameters to evaluate the hospitals/

clinics & rate on a scale of 1-10 where 1 was poor & 10 was excellent. The list of parameters to be covered in

the survey was arrived at based on discussions with

experts from the respec-tive therapeutic areas – Diabetologists/Endo-

crinologists, Orthope-dics, Bariatric Surgeons,

Trichologists, Dermatolo-gists & Plastic Surgeons/Cosmetic Surgeons.

The following key parameters were covered in Perceptual Rating Infrastructure

Modern Techniques Quality of treatment Convenience Range of services Value for Money Overall Brand Value

The questionnaire was so designed that both experts & past/ current users of respec-tive therapeutic areas were exposed to the same parameters – this ensured that the scores of different stakeholders could be cor-related and collated to arrive at a single final score.

MODULE 3FACTUAL DATA COLLECTION

Around 600 lifestyle hospitals/ clinics were sent the factual data questionnaire and then rigorously followed up telephonically.

The factual data sheet was focused on the following information areas:

Infrastructure/ facilities Technology availability Modern day equipments available Research facilities Doctors/ consultants/ surgeon empan-

elment Recognitions / certifications Value for money

Geographic presence International exposures Overall image/ legacy

ANALYSIS AND FINALRANKINGSA robust approach was followed to arrive at the final rankings. The step by step process is given below:Perceptual Score

Ratings on various parameters for each hospitals/ clinics

Calculating importance of various pa-rameters to arrive at weights for each param-eter – we used a regression model to arrive at the importance of various parameters

Calculation of raw scores and weighted scores for each parameter

Calculation of overall score for each hospital/ clinic using importance weightage.Factual Score

The information collected correspond-ed to similar parameters as in the percep-tual survey

A detailed scoring system was devel-oped for each parameter

After assigning scores to each param-eter, raw scores were calculated

The raw scores were weighted by their importance to arrive at weighted scores

The final hospital/ clinic score was calculated as in the perception survey

The final score for a hospital/ clinic was an average of Perception Score and Factual Score - equal weightage was given to both

Some caveats/assumptions: Best efforts were made to reach every

hospital/clinic; however any hospital/ clinic that did not send complete “Fact-Sheet” within the allotted time was assigned an average Factual score for calculating their overall ranking

Any hospital/ clinic which expressly stated that it did not wish to participate in the survey was excluded from the survey.

Sole hospital/clinic within their allotted categories have not been ranked vide this survey.

ALL INDIA LIFESTYLE HOSPITAL & CLINIC RANKING SURVEY 2015 - METHODOLOGY

About i3 ResearchConsultants (i3RC)

i3 Research Consultants (i3RC) is a boutique research & consultancy firm that is focussed on offering Superior Client Service, Strategic Insights, Innovation, Quality & Commitment. i3RC has a young and dynamic team of researchers who are very passionate about their work and are always willing to put that extra effort to make every project a great success. In ad-dition i3RC has a team of highly experienced industry experts as consultants who provide their expertise for specific projects. i3RC is a full member of MRSI and follow MRSI code of ethics while conducting every research project. Given

their commitment to quality, i3RC has developed a 3 tier and multi stage quality control system to deliver excellent quality.

i3 Research Consultants (i3RC) has rich experience is conducting different ranking surveys across domains. In this regard i3RC team have together worked out rigorous

scientific methodology.About NutcrackersNutcrackers are solution providers to tough

problems. Their modus operandi is simple. They get to the heart of the problem with a keen analytical eye and then having unearthed the insight, suggest solutions according to the client’s marketing chal-lenge. The solution may result in a strategy recom-mendation as a consultant may provide, or creation as an ad agency would or even executing like a

production house/activation agency would.

Note: Present survey has been conducted by an independent Research Agency named i3 Research Consultantsusing stated methodology for arriving at given rankings.