Revolution in Knee & Hip Joint replacement- FIFO Technique

Dr. Manuj Wadhwa
A breakthrough in latest concepts in Knee and Hip Replacement Surgery comes with first time ever Launch of FIFO (Fast in Fast Out) Technique which combines benefits of minimally invasive surgery, patient specific high performance implants with higher flexibility, modified pain control concepts and minimal bleeding even to suit our geriatric population. With this revolutionary technique patients can walk 3 hours after surgery which has become almost painless now.
The modified concept launched in country by Dr Manuj Wadhwa, Chairman and Executive Director IVY ELITE Institutes of Orthopaedics & Joint Replacement, has minimal blood loss with a combination of advanced muscle sparing surgical exposure, specialized mix of latest techniques like digital surgery and better patient-specific implants.
With an experience of over 30,000 Joint Replacements done there was need for an innovation and blend of technologies to give minimal pain, Fast Track surgeries which are safe, faster on rehabilitation and accurate to have capability to last life time for majority of patients.
Minimally invasive tissue sparing joint replacement
A new minimally invasive procedure may help individuals who face advanced osteoarthritis of the knee and hip continuing “Keeping pace with life”.
The Tissue Preserving Total Knee Replacement surgery goes beyond the general scope of conventional TKR surgeries using smaller incision and special instruments to approach the knee from the front with minimal trauma to the soft tissue, muscles and tendons. The specialized technique perfected by Dr Manuj Wadhwa allows the advantage of satisfactory surgical exposure in all patients including the very obese with easy implantation of standard implants with specialized instrumentation. Patients expect a painless, functional stable knee as their first priority, but deep knee flexion is unquestionably next in line!
We have almost stopped the use of blood transfusions for knee replacement surgeries, even for patients who have been operated on both knees in one sitting,” says Dr Wadhwa.
Improved Pain Control Concepts
Pain during and after joint replacement surgery is the biggest hindering factor for physical and emotional recovery of patients undergoing joint replacement surgery. If the pain can be controlled then not only can it be very comfortable for the patient but also it will lead to a much faster and quicker recovery. Now the ultimate concept in best centers globally is based on reduced tissue trauma surgery and pain control using cocktail of medicines to be injected in soft tissues around the knee during surgery making patients feel more comfortable post surgery. As per Dr. Wadhwa most of these patients are even able to raise their legs a few hours after surgery.
Apart from MIS techniques also there is recently an increased demand in Asian population for patient specific high flexion implants giving higher flexibility and ability to sit cross legged or even in a few to squat post surgery. This also comes with additional durability for younger population where longevity of these artificial parts is a serious concern.
The combination of minimally invasive techniques, better implants and modified concepts in pain control with less bleeding available as FIFO with Dr Wadhwa at IVY Elite Institute at IVY Hospital Mohali are a drive for a significant number of International patients coming to North India for these modern concepts, expertise and infrastructure available here.
Advantages of FIFO ( Fast in Fast Out) Joint Replacement
The overall impact of tissue preserving TKR surgery is that there is less soft tissue sacrificed during Surgery. Post surgery pain is considerably reduced and substantially less bleeding. This technique allows faster rehabilitation, better muscle strength & early return of knee motion. Most patients can walk on day 1 after surgery.
The ultimate goal is to reduce the need for hospitalization without additional resources – while maintaining a very high patient satisfaction and very few complications
After surgery recovery time is less than one third of that with conventional TKR technique
The Fast Track technique at IVY Elite has dramatically shortened rehabilitation and return-to-work times. Even more significantly, it has allowed many patients to take few steps within 3-5 hours after surgery. The fact that such procedures are now accessible is enhancing the quality of life for many patients and allowing them to lead more active lives.”
(The author is a MS, MCh Ortho (UK) Ranawat Joint Replacement fellow (USA) Chairman & Executive Director Ivy Elite Institutes of Orthopaedics & Joint Replacement Ivy Hospital Mohali)

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