Dr. P.K. Banerjee
MS(Orth),Mch(L’Pool),FRCS(Edin & Glsg)HOD,Orthopaedics & Traumatology.
 
Total Knee Replacement at P.H. & B.K.R.R.C. started in 1994 and approximately 1200 Surgery has been performed till date with an astounding success rate. Total Knee Replacement in this Hospital is performed by a team of various distinguished orthopaedic Surgeons of international repute supported by a large , efficient and dedicated staff of anaesthesiology , fellows, residents , physical assistant, physical therapists nursing and para medical staff. Outstanding diagnostic, surgical and rehabilitation services enable us to offer complete care and bring the benefits of latest advances. 

Total Knee Replacement is an increasingly effective and desirable approach to a range of problems effecting the Knee. This procedure offers many years of improved mobility and reduced pain improve the quality of life. This is a major surgery but still year roughly 2,50,000 people benefit from it all over the World especially after remarkable improvements in technology in the last decade.
  

Dr. Asim Kumar Pal MD , FRCP Consultant Rheumatologists

Gout is a name given to a group of metabolic diseases in which clinical manifestations are associated with tissue depositions of crystals of monosodium urate monohydrate from hyperuricaemic body fluids . Gout includes : (1) hyperuricaemia (2) acute arthritis, tenosynovitis, bursitis or rarely cellulitis (3) chronic tophaceous gout (4) urate- nephrolithiasis and (5) urolithiasis. The biochemical hallmark of gout is hyperuricaemia; prolonged elevation of serum uric acid is a necessary but not sufficient pre-requisite for the development of clinical disease.

History of gout : The distinctive clinical features of gouty arthritis were recognized by Hippocrates in the fifth century B.C. and were described in the oldest known medical text. The Roman physician Galen (who was the first to describe gouty tophi) and Celsus recognized that gout afflicted the rich and the powerful , specially those who were most overindulgent. The medieval concept that gout arises as a consequence of poisonous "noxa" appears to be the basis for the term gout ,which is from latin word 'guta' meaning ' a drop' . Van Leeuwehoek, the Dutch microscopist, sketched needle shaped crystals obtained from a gouty tophus in 1679.

Hyperuricaemia : Among mammalian species , only man and great apes excrete uric acid as the end product of purine metabolism, reflecting the lack of enzyme uricase which catalyzes the degradation of uric acid to tha readily excretable compound allanation . Urate , the ionized form of uric acid predominate in plasma , extracellular fluid and synaovial fluid , with approximately 98% existing as monosodium urate at p H 7.4 ; Plasma is saturated with monosodium urate at a concentration of 6.8 mg/ dl at 37 C . At higher concentration (even at 80 mg/dl) precipitation (of urate crystal) does not occur, perhaps because of the presence of solubilizing substance in plasma. Hyperuricaemia is defined, if serum uric acid concentration is greater than 7.0 mg/dl. Hyperuricaemia can result from increased uric acid production or decreased excretion or combination of two.