Vedant Tiwari, a 19-year-old athlete, faced a life-changing event. He was injured in a road traffic accident. The incident resulted in dislocation of his right knee. The injury was so severe that the blood flow to the leg was cut off and bone was visible from the wound, putting him at risk of leg amputation and serious infection.
Dr. Nilesh Aggarwal, Director and Chief Neurosurgeon, New Era Hospital, appointed a dedicated team of doctors to treat Tiwari. Dr. Piyush Nashikkar, a renowned orthopedic and sports medicine surgeon was leading the team. Prompt and precise actions were taken. The initial surgeries were aimed to restore blood flow to Vedanta’s leg and prevent infection. During these surgeries, the PCL ligament and the meniscus (knee cushion) were also repaired. “After saving the leg and preventing infection, our focus shifted to making the knee functional,” Dr. Nashikkar said while explaining the challenging sequence of treatment.
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Saturday 02 Nov. 2024
Dr. Nashikkar explains, “A large portion of bone was missing and three important ligaments (namely ACL, PCL, and MCL) were torn in Vedant’s Knee. The junction of four bones, the femur (thigh bone), patella (knee cap), tibia and fibula (leg bone) forms the knee joint. In Vedanta’s case the inner part of the femur bone (medial femoral condyle) was lost through wound. This bone is covered with articular cartilage (knee polish). When the polish of the knee deteriorates, painful arthritis begins.”
Vedant’s situation was discussed with him and his relatives. All possible solutions were discussed. The main challenge was to rebuild the missing parts of the knee (bones and articular cartilage), without which Vedanta would never have been able to walk properly. Bone and articular cartilage transplantation was the best possible solution to restore knee anatomy. In medical language, this procedure is called osteochondral allograft transplant (osteo meaning bone, chondral mean polish, allograft meaning from cadaver).
Vedant and his family opted for osteochondral allograft transplant surgery. In this first-of-its-kind surgery in India, the damaged bone and polish of the knee is replaced with good bone and polish from a cadaveric donor. Given the severity of Tiwari’s injuries, securing an appropriate sized & shaped medial femoral condyle osteochondral allograft was a daunting task. Enquiries were sent to known centres across the globe. After persistent efforts for about 3 months, the team succeeded in obtaining a fresh allograft of appropriate size and the surgery was successfully performed on 11th April 2024.
After fusion of the grafted bone, ACL and MCL ligament reconstruction surgery was performed. Dr. Anand Sancheti, Director & head of cardiothorasic department explains, “At New Era Hospital, Dr. Nashikkar routinely performs the arthroscopic ligament surgery (telescope) but to our knowledge it was first time in the world where ligament reconstruction (MCL) surgery was performed on the transplanted bone.”
Currently, Vedant Tiwari is undergoing physiotherapy and has regained near-normal painless movement. Dr. Nashikkar praised Vedant and his family for their courage, patience and faith. He said, “Vedant underwent five surgeries. Technology and NewEra Hospital gave him hope that he can lead a normal life again.”
NewEra Hospital, renowned all over India for its liver and kidney transplant, became the first hospital in the country to perform bone and cartilage transplant (osteochondral allograft transplant) and the first in the world to perform ligament reconstruction surgery on transplanted bone. Directors Dr. Anand Sancheti, Dr. Nilesh Agarwal and Dr. Nidhish Mishra congratulated Dr. Nashikkar and the team for their efficient and pioneering work. They envisioned a future and the beginning of a new era in the treatment of arthritis where natural cartilage transplant will eliminate the need for joint replacement surgery. Dr. Nidhish Mishra, Director & head Cardiology Department praised Vedant for his resilience, patience and courage and hoped that his example will inspire other patients to believe in miracles. For more information, please contact Dr. Piyush Nashikkar, Orthopaedic and Sports Medicine Surgeon, NewEra Hospital, Nagpur.
