Orthopedics Treatments Facilities at Indraprastha Apollo Hospitals Delhi, India

1.    We have highly skilled, qualified and experienced orthopedic surgeon 

2.     Excellent clinical outcomes of high tech orthopedic procedure

a.      Operation theatres equipped with laminar air flow

b.     State-of-the-art instruments

c.      Image Intensifiers, Digital X-ray, 64 slice CT, 3 Telsa MRI

d.     Intra-op monitoring

e.      Well-equipped ICU for postoperative care

f.       Very low incidence of postoperative infection

Excellent backup of physiotherapy services

Orthopaedic Treatment and Services at Indrapratha Apollo Hospitals Delhi, India

Joint Replacement:

·         Computer navigated and minimally invasive total knee replacement

·         Unicondylar knee replacement surgery-bone preserving surgery

· Total hip replacement (including alternative bearing surface like including metal on mental, ceramic on ceramic & proxima hip resurfacing)

·         Revision knee and hip replacement surgery

·         Total shoulder replacement

·         Total elbow replacement

·         Finger joint replacement surgery

Spine Surgery:

·         Microdiscectomy

·         Endoscopic Spine Surgery

·         Corrective Surgery for Scoliosis

·         Disc Replacement

·         Comprehensive Management of Spine Injuries

·   Computer Navigation aided Spine Instrumentation and other procedures

Trauma and Fracture Surgery:

·         Traditional fracture fixation using AO swiss implants

·         Advanced plates & screws (AO)-locking comprehensive plates and screws

·         Closed locked intramedullary nails

·         Minimal invasive surgery in fracture fixation

·         Corrective surgery of malunion and non-union fractures

·   Acute fracture management-shaft fractures, intra articular fractures, pelvis and acetabulum fractures and open fractures

Arthroscopic Surgery:

·         Key hole surgery for knee, shoulder, elbow and ankle disorders

·         Arthoscopic cruciate ligament reconstruction

·         Arthoscopic meniscectomy & meniscal repair

·         Arthoscopic synovectomy

·         Arthoscopic removal of loose bodies

·         Arthoscopic adhesiolysis for stiff knees

·         Arthoscopic shoulder stabilisation

·         Arthoscopic rotator cuff repair

·         Arthoscopic subacromial decompression

Pediatric Orthopedics:

·     Deals with all orthopedic disorders in infants, children and adolescents :

·          Trauma –injuries to the growing skeleton

·          Congenital limb deformities- clubfoot, bowlegs, knock-knees, trigger fingers, etc.

·          Hip dysplasias and dislocations (DDH)

·          Bone and joint infections-septic arthritis and osteomyelitis

·   Gait problems and limb length discrepancies- toe walking, stamping, broad base, crouched and scissored gait

·          Cerebral poliomyelitis and meningomyelocode sequelae

·-Multidisciplinary approach, appropriate surgeries when needed followed by focused rehabilitation

State–of–the–art Technology:

Orthopedic Navigation System- Computer Aided Surgery (CAS) CAS has changed the face of spine & orthopedic surgery, by means of more options and better outcomes. Navigation is basically done for:

·         Spine Surgery

·         Trauma Surgery

·         Hip Resurfacing

·         Total Hip Replacement

·         Total Knee Replacement

Benefits:

·         Minimally invasive surgery

·         Higher surgical precision

·         Reduces risks

·         Increase the life of the implant

·         Reduce blood loss

Department of Physiotherapy and Rehabilitation Medicine:

Rehabilitation of people who have undergone orthopedic surgical procedures is vital to the process of restoring a person’s fitness, so that by the end of the course of treatment they are as healthy as ever. A well- equipped and state-of-the-art physiotherapy and rehabilitation medicine department to assist the patients in their optimal rehabilitation, with dedicated professionals to guide the patients in achieving realistic goals.

Department of Accident & Emergency:

Emergency services and emergency department forms the most important & indispensable part of our hospital. The fully developed emergency system focuses on various components of triaging, pre hospital ambulatory services both and and air, trauma systems and management, medical education, training, etc. The Department of Accident & Emergency is operational round the clock, 24 hrs a day, 365 days in a year, and is an essential element in sustaining health of the community. Since it is a highly critical area, patients coming in odd hours, with-a-lots of apprehension and the protocols are organized properly.

Ambulance Services- Land & Air:

Ambulance or rescue services form an integral part of our Accident & Emergency Department. Ambulance is a medium or vehicle for emergency protocols and care, which carries equipment, staff and medicines for optimal and ideal emergency care at the scene and during the period of transportation of the patient to afford maximum and avoid aggravation of his or her condition.

Institutes of Orthopaedics at Indraprastha Apollo Hospitals Delhi, India

The Apollo Institutes of Orthopaedics at Indraprastha Apollo Hospitals is at the forefront in offering the latest in orthopaedic treatments and surgical techniques. The centre performs surgical procedures which include the most current arthroscopic and reconstructive techniques – including major joint replacements including the hip resurfacing and shoulder surgeries, arthroscopies, laminectomies, the most delicate hand surgeries and much more. The most advanced medical equipment and a team of highly experienced surgeons is supported by the most advanced state-of-the-art technology.

The Apollo Institutes of Orthopaedics at Indraprastha Apollo Hospitals Delhi is at the forefront of current Orthopaedics and offers the latest in orthopaedic treatments and surgical techniques. The center perform advanced surgical procedures which include the most current arthroscopic and reconstructive techniques – including major joint replacements, revision joint replacements, hip resurfacing and shoulder replacement surgeries, knee, shoulder & hip arthroscopies, advanced spine surgeries, hand surgeries and much more.

Our team of highly experienced surgeons are supported by the most advanced medical equipment, computer navigation and imaging equipment. Indraprastha Apollo Hospital is also one of the first centers for Articular cartilage Implantation (ACI) in northern India. It offers all type of cartilage regeneration surgery, including micro-fracturing, mosaic-plasty, ACI. It is also one of a few centers having a dedicated pediatric orthopaedics unit offering the whole range of pediatric orthopaedics. Orthopaedic surgery & traumatology has seen significant developments in the diagnosis & treatment of various diseases of the bones & joints & the treatment of fractures & dislocations etc. It now considered to the most sought clinical branch in passing out medical students.

Most of the injuries can now be managed in such a ways that people can return to their work in very short span of time & the fracture healing occurs in good alignment & much faster, with the use of modern fracture fixation techniques. Most sports injuries (like ligaments, meniscus, cartilage etc.) can now be treated with key-hole (arthroscopic) surgery. Severely damaged joints can now be replaced making the person active again. These artificial joints behave almost like normal joints & can last for about 20-25 years, in most patients. 

Spinal surgery has seen significant advances with the advent of operative microscope, image intensifier etc making it a very safe & reliable surgery. Bones & Joint problems of children like CTEV, DDH etc. are being treated by specialists in Pediatric Orthopaedics Since the inception of the Apollo Institutes of Orthopaedics in 1995, we have been pioneer in doing various routine & high-end surgeries, like modern fracture fixation techniques, using interlocking nails, locking plates etc.

Arthroscopic surgery of various joints like knee, shoulder, ankle, elbow etc. are being routinely performed here. Procedures like Arthroscopic ACL reconstruction, meniscal surgery, Bankart’s & rotator cuff repairs are being done successfully. Recently, we have established the 1st centre in Northern India to perform Cartilage transplantation.

All types of joint replacement surgery e.g. primary, complex primary & revision replacements are being done in large numbers with excellent outcomes. Micro-discectomies, spinal decompression & fusion surgery are being done routinely.

Apart from the clinical work, the institute has regular academic teaching program. We are running DNB accredited course. There are regular publications in the national & international journals from the clinical work of the institute. Most of the consultants are invited to give lectures as faculty in various national & international conferences & seminars.

We also organize various workshops & conferences in the hospital regularly. Apollo Institutes of Orthopaedics has been ranked as one of the best institutes in the country. The institute has very senior & experienced Orthopaedic surgeons with adequate International experience & education. Each surgeon has some special area of interests in various fields of Orthopaedic surgery & hence offers specialized treatment in that sub specialty.

This busy institute has 11 full time senior consultants, who offer wide range & high-end orthopaedic treatment to the patients who are visiting from within & outside India. We have dedicated & well equipped Orthopaedic OT complex with laminar flow & various modern equipment like image intensifier, operating microscope, computer navigation system, top of the line arthroscopy system etc. Backed by the Physiotherapy & Radiology department, Apollo Institute of Orthopaedics has a very high success rate in all the procedures that it undertakes.

Neurology Procedure in Indraprastha Apollo Hospitals Delhi, India

Paediatric Neurosurgery:

For anomalies and tumors of the brain and spinal cord in infants and children. For children born with anomalies of the brain, spinal cord, skull deformities and spinal deformities, Apollo Hospitals offers the best care, in the form of programmable shunts for hydrocephalus, repair of meningo-myeloceles, correction of cranio-synostosis (early, abnormal closure of skull bones) and correction of spinal deformities. Children with tumors of the brain and eyes are also treated.

Stereotactic Biopsy:

Stereotactic biopsy/aspiration involves no opening of the skull and is suitable for small, deep seated tumors. It is performed under a CT / MRI scan guidance having precise computer calculations. Over 1000 stereotactic biopsies and craniotomies (open surgeries with precise localisation of the tumor by stereotaxy) have been performed.

Stereotactic Radiosurgery:

Stereotactic radiosurgery (SRS) uses diverse, precisely focused radiation beams to treat tumors and diseases in the brain, neck, etc.

It is not a surgery in the traditional sense because there is no incision. Instead, SRS uses 3-D imaging to target high doses of radiation towards the affected area with minimal impact on the surrounding healthy tissue.

Like other forms of radiation, stereotactic radiosurgery works by destroying the DNA of the targeted cells. The affected cells then lose the ability to reproduce, which causes tumors to shrink.
When doctors use stereotactic radiosurgery to treat tumors in areas of the body other than the brain, it's sometimes called stereotactic body radiotherapy (SRBT) or stereotactic ablative radiotherapy (SABR).

Types of stereotactic radiosurgery

Three types of technology are used to deliver radiation during stereotactic radiosurgery.

·         Linear accelerator (LINAC) machines use X-rays (photons) to treat cancerous and noncancerous abnormalities in the brain and other parts of the body. LINAC machines are also known by the brand name of the manufacturer, such as CyberKnife, Axesse, Novalis Tx, TrueBeam and XKnife. These machines can perform SRS in a single session or over three to five sessions for larger tumors, which is called fractionated stereotactic radiotherapy.

·         Gamma Knife machines use 192 or 201 small beams of gamma rays to target and treat cancerous and noncancerous brain abnormalities. Gamma Knife machines are less common than LINAC machines and are used primarily for small to medium tumors and lesions in the brain associated with a variety of conditions.

·         Proton beam (charged particle radiosurgery) is the newest type of stereotactic radiosurgery; it is available only at a few centers in the world. Apollo Hospitals is the first to bring it to India. It can treat brain cancers in a single session using stereotactic radiosurgery or use fractionated stereotactic radiotherapy to treat body tumors over several sessions.

How it works:

All types of stereotactic radiosurgery and radiotherapy work in a similar manner.
The specialized equipment focuses many small beams of radiation on a tumor or other target. Each beam has very little effect on the tissue it passes through, but a targeted dose of radiation is delivered to the site where all the beams intersect.

The high dose of radiation delivered to the affected area causes the tumors to shrink and blood vessels to close off over time following treatment, robbing the tumor of its blood supply.

The precision of stereotactic radiosurgery means there's minimal damage to the healthy surrounding tissues. In most cases, radiosurgery has a lower risk of side effects compared to other types of traditional surgery or radiation therapy.

Neuro Endoscopic Surgery:

This procedure has reduced the hospital stay of the patients and has helped in quicker recovery from hormonal problems. Patients who have a leak of the brain fluid through the nose can also be treated by this relatively less invasive technique. Neuroendoscopy Equipments are also used routinely for minimally invasive endoscopic removal of certain tumors (eg. intraventricular and pituitary tumors), third ventriculostomy in the treatment of hydrocephalus, drainage of brain abscesses and cysts.

Neurosciences (Neurology & Neurosurgery) - Facilities in Indraprastha Apollo Hospitals Delhi, India

Dedicated Neuro and Neuro critical care Team Neuroradiology:

·   Multislice Computerized Tomography (64 slice CT) - Computed tomography (CT) scanning is a state-of-the-art medical imaging technology essential to many neurological and spinal procedures.

·        3T Magnetic Resonance Imaging (MRI) - Delivers the highest resolution brain imaging to identify any brain malformations, tumors, strokes, or injury that may generate a seizure disorder.

·         Digital Subtraction Angiography (DSA) - Detects abnormalities of the blood vessels of the brain such as narrowing and blockage, or malformations.

Neurophysiology:

·     Electroencephalogram(EEG)- An EEG is conducted to record and analyze electrical signals generated by the brain

·        Electromyogram (EMG)- The EMG is an essential test to diagnose any nerve or muscle disease, which helps to establish an appropriate treatment.

·           Nerve conduction velocity test (NCV) - is an electrical test that is used to detect signs    of nerve injury.

·     Evoked Potentials (EP)- measure the electrophysiological responses of the nervous  system to stimuli

·       Video EEG- This non-invasive procedure is used to establish the diagnosis of various  forms of seizure activity

·         Trans cranial Doppler (TCD)- non invasively measures direction and velocity of blood  in major intracranial vessels

Dedicated Operating Rooms (7 and 8) - state of the art operating theatres which are equipped with latest equipment. Dedicated Neuro ICU - 11 beds Dedicated Neuro ICU (post op)-7 beds The Stroke ICU -6 beds.

Specialized Equipment:

·         Interventional Neuro Radiology

·         Microsurgical Instrumentation

·         Neuroendoscopy

·         Spinal Instrumentation

·         Novalis Tx Unit

Specialized services:

·         Stroke Programme

·         Comprehensive Epilepsy Programme

·         Movement disorder Programme

·         Pain management

Neuropsychology

Neurosciences (Neurology & Neurosurgery) - Specialized Services in Indraprastha Apollo Hospitals Delhi, India

Stroke Programme:

Patients with ischemic stroke can urgently be taken up for a wide range of interventions including intravenous thrombolysis, intra-arterial and mechanical thrombolysis. A round the clock facility for imaging with CT scan head and MRI is also available with a functional DSA laboratory dedicated for such intervention.

Comprehensive Epilepsy Programme:

Patients with difficult to control seizures can be evaluated with a delicate Video EEG set up. There is a group of patients of epilepsy who do not respond to any combination of various anticonvulsant drugs. These patients are evaluated and treated by epilepsy surgery including excision of focus, removal of solitary lesions, hemispherectomy, and corpus callosotomy and subpial transactions by specially trained neurosurgeons specialized in epilepsy surgery.

Movement disorder Programme:

The neurology department is geared to treat a wide variety of movement disorders such as tremor, dystonia, Parkinsonism, tics, chorea and myoclonus Botulinum toxin injections are routinely being given for dystonias such as cervical dystonia (torticollis), blepharospasm, hemifacial spasm and writer’s cramp. In conjunction with specially trained neurosurgeons, we run a successful deep brain stimulation (DBS) surgery program and routinely perform other functional stereotactic brain surgeries for treatment of advanced Parkinson’s disease, generalized dystonias and severe tremor.

Neurosciences (Neurology & Neurosurgery) - Neurosurgery in Indraprastha Apollo Hospitals Delhi, India

Institute of Neurosciences – Department of Neurosurgery Our vision at the Apollo Centre for Neurosciences is to bring healthcare of international standards within the reach of every individual and to achieve excellence in everything we do. We're passionate about making our patients better.

Neurosurgery is a highly complex surgical branch which deals with the brain, spine and nerves. It requires a high level of surgical expertise. (as every neuron is important) State of the art equipment and years of experience backed by a good Intensive care unit and other specialty backup is essential to give an excellent outcome.

Common problems that a neurosurgeon deals with are head injury, spinal injury, brain tumors, spinal tumors, brain hemorrhage, hydrocephalous, nerve injuries or tumors, disc prolapse or herniation, spinal dislocation, unstable spine, congenital malformation like atlanto-axial dislocation, spinal dysraphism etc.

The other diseases in which advanced neurosurgery may be required are seizure or epilepsy control and movement disorders like Parkinson’s disease. We offer services for children, adults as well as the geriatric patients. Advances in neuroanaesthesia, neurosurgical intensive care and neuro-imaging technology have played a significant role in the development of modern neurosurgery.

These have not only decreased the mortality but also improved the functional outcome. The focus has now shifted to minimally invasive techniques to further decrease the mortality and morbidity associated with surgery.

It is no longer enough to save life - preservation of all functions, good cosmesis, shorter hospital stay and avoiding pain and discomfort are equally important. To fulfill these aims of excellence in neurological health care, the Apollo Institute of Neurosciences has been set up as a part of Dr. Prathap Reddy's vision of World Class Health Care facilities in India.

To achieve these goals our hospital constantly upgrades its technology and makes sure the team of doctors are updated with the latest available treatment procedures in the world and are skilled to carry out these procedures.

A super specialty tertiary care centre, Apollo Institute of Neurosciences is designed to provide the highest levels of professional expertise and leadership in all major disciplines of neurosciences through an integrated team of neurologists ,neurosurgeons, neuroanesthetists and intensivists along with rehabilitation specialists dedicated to provide total patient care.

Services:

Apollo Institute of Neurosciences is equipped with facilities at par with the best in the world. The most modern technology and equipment is provided to cover the entire range of neurological diseases. More than 1000 major neurosurgical – cranial and spinal operations are being carried out every year.

Major procedures done at our hospital include:

·         All brain tumors surgery and micro neurosurgery

·         Skull base surgery

·         Vascular procedure for AVM, aneurysm clipping and coiling backed by the state of art DSA suite

·         Hydrocephalous

·         Endoscopic surgeries for pituitary and intraventricular tumors and hydrocephalous - endoscopic third ventriculostomy

·         Head injury, Spinal injury including Polytrauma patients

·         Frame based and frameless stereotactic surgery

·         Radio surgery with Novalis

·         Functional Neurosurgery for movement disorders like deep brain stimulation

·         Epilepsy surgery with intra-operative EEG and video EEG

·         Awake Craniotomy

·         Minimally Invasive Neurosurgery

·         Pediatric Neurosurgery

·         Spine surgery for spinal tumors ,Degenerative and Congenital spinal disorders

·         Spinal instrumentation for Spinal listhesis /unstable spine

·         Lumbar and Cervical discectomies, artificial disc replacement and Endoscopic discectomies

·         Spinal cord stimulation for pain relief

·         Percutaneous pedicle screw fixation

·         Peripheral nerve injuries

·         Traumatic nerve injuries

·         Neuralgias

·         Nerve tumors

·         Nerve entrapments

·         Procedures for pain relief like Nerve root blocks, Facet blocks

·         Radiofrequency Rhizotomy

·         Intrathecal Morphine pump for chronic pain

·         Intrathecal Baclofen pump for spasticity

·         Neurointervention procedures:

·         Aneurysm coiling – including complex aneurysms

·         Embolisation of arteriovenous malformations

·         Embolisation of spinal arteriovenous fistulas

Pre-surgery embolisation of vascular tumors