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Is Oxidized Zirconium Or Cobalt-Chromium Knee Replacement Surgery Suitable For An Elderly Patient?

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Posted on Tue, 19 Mar 2019
Question: Dear Sir,
we recently visited doctor for My Mother Knee pain.They Suggested to do for Knee replacement.In that they had following implants are present
Oxidized Zirconium
Cobalt-Chromium

Wanted to check with would be the best implant which would last longer without any sideeffets.
Also doctor mentioned that they would be using Computer Based navigation during knee replacement which would cost 58k extra .So wanted to confirm is it worth and what would be the benefits/disadvantages if we opt for Computer Based navigation during knee replacement
doctor
Answered by Dr. Dr. Praveen Tayal (45 minutes later)
Brief Answer:
Detail below.

Detailed Answer:

Hello,

Artificial replacement parts can be made of strong plastic, metal, or ceramic. All knee replacements, partial or total, will have parts made of a few different materials (likely metals and plastic). In most cases, each component is built from titanium, cobalt-chromium alloys, or a titanium and cobalt mixed metal. The chosen materials must be durable, allow for some flexibility with movement and be biocompatible (meaning it will not be rejected, corrode nor react with the body).

Cobalt-Chromium Alloys— Chromium alloys are one of the most commonly used materials in implant components. This metal is biocompatible, tough, durable and will not be broken down inside the body. This material is commonly used for the femoral implant since it is very sturdy and the femoral implant has a lot of traction against the plastic spacer during movement. For those with nickel allergies, some particles from this metal can get into the bloodstream and cause a reaction. Please let your surgeon know if you have an allergy as there are alternatives.

Another option to eliminate nickel to the nth degree is to pair a ceramic femoral implant with a zirconium alloy tibial component. This new material has zero nickel and is thought to be competitively long-lasting. In saying this, ceramic implants are more costly and can be more susceptible to fracturing since the material is brittle. So Oxidized Zirconium is best till date.

Computer-assisted surgery is used to improve the positioning of implants during total knee arthroplasty. Computer-assisted navigation reduced the outliers of alignment and component malpositioning.

The advantages of computer-assisted navigation are increasing the accuracy of bony resection and decreasing the chance of malposition of the implants. The surgeon can estimate the level of femoral and tibial joint line intraoperatively. This also helps soft tissue balancing and can quantify the size of the gap and the stability.

Computer-assisted navigation requires new instrumentation and increases the operative time by up to 20 minutes. Another possible complication of CAS is an increased incidence of deep infection due to the longer exposure time.

The procedures appear cumbersome in comparison to those of the conventional technique. It may require a number of cases before the surgeon feels comfortable with the navigation system.

I hope this answers your query.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

Regards,
Dr. Praveen Tayal, Orthopaedic Surgeon


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (19 minutes later)
Thanks for your reply.
So will go ahead with Oxidized Zirconium for implant.
So as per your feedback Computer Based Navigation increases the chances of Infection since they would be pinning the needles to get the accurate position in System.
So would you give me input on Pinless Computer based navigation system?.whether it would chances of any infection Compare to Computer based navigation system.
doctor
Answered by Dr. Dr. Praveen Tayal (11 minutes later)
Brief Answer:
Fewer chances are there.

Detailed Answer:

Hello,

Chances of infection are there in every surgery but pinless computer-based navigation system will have a lesser chance as Compare to a computer-based navigation system.

Hope my answer is helpful.

Regards,
Dr. Praveen Tayal, Orthopaedic Surgeon
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12310 Questions

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Is Oxidized Zirconium Or Cobalt-Chromium Knee Replacement Surgery Suitable For An Elderly Patient?

Brief Answer: Detail below. Detailed Answer: Hello, Artificial replacement parts can be made of strong plastic, metal, or ceramic. All knee replacements, partial or total, will have parts made of a few different materials (likely metals and plastic). In most cases, each component is built from titanium, cobalt-chromium alloys, or a titanium and cobalt mixed metal. The chosen materials must be durable, allow for some flexibility with movement and be biocompatible (meaning it will not be rejected, corrode nor react with the body). Cobalt-Chromium Alloys— Chromium alloys are one of the most commonly used materials in implant components. This metal is biocompatible, tough, durable and will not be broken down inside the body. This material is commonly used for the femoral implant since it is very sturdy and the femoral implant has a lot of traction against the plastic spacer during movement. For those with nickel allergies, some particles from this metal can get into the bloodstream and cause a reaction. Please let your surgeon know if you have an allergy as there are alternatives. Another option to eliminate nickel to the nth degree is to pair a ceramic femoral implant with a zirconium alloy tibial component. This new material has zero nickel and is thought to be competitively long-lasting. In saying this, ceramic implants are more costly and can be more susceptible to fracturing since the material is brittle. So Oxidized Zirconium is best till date. Computer-assisted surgery is used to improve the positioning of implants during total knee arthroplasty. Computer-assisted navigation reduced the outliers of alignment and component malpositioning. The advantages of computer-assisted navigation are increasing the accuracy of bony resection and decreasing the chance of malposition of the implants. The surgeon can estimate the level of femoral and tibial joint line intraoperatively. This also helps soft tissue balancing and can quantify the size of the gap and the stability. Computer-assisted navigation requires new instrumentation and increases the operative time by up to 20 minutes. Another possible complication of CAS is an increased incidence of deep infection due to the longer exposure time. The procedures appear cumbersome in comparison to those of the conventional technique. It may require a number of cases before the surgeon feels comfortable with the navigation system. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards, Dr. Praveen Tayal, Orthopaedic Surgeon