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Most of us may not be aware, but the knee is the largest joint in the human body and contributes the maximum to a person’s physical movement from one place to another. The knees play a significant role in a variety of movements including squatting, supporting the weight, running, kneeling, sitting, etc.

Whether it is a severe accident, osteoarthritis that set in with age, or other reasons, the result could be stiff, painful knees. The first line of treatment would be exercise, physiotherapy, and medications. However, if these do not work, then surgical treatment is the choice. Though usually it is reserved for people over the age of 50, there could be exceptions.

Given the number of functions it is involved in, when a serious procedure like knee replacement is being considered, the pain that the person would go through and the recovery time are two important parameters to address. It is best that the patient has a detailed discussion with the doctor and gets all doubts clarified. This will help both the patient and the doctor have realistic and practical expectations about what to expect after the surgery.

So, when pain and stiffness make knee replacement inevitable, prepare for it. The following sequence outlines what happens right from surgery to recovery.

1. Under general anesthesia, the damaged portion of the knee is removed, and a prosthesis (metal or plastic) is used to replace the removed portion.

2. Hospital stay can range from 3 to 5 days.

3. In about a month, the patient will have remarkable recovery, with almost no pain.

4. Though not advisable, most patients would be able to stand and do basic movement on the day of surgery.

5. Begin walking with the support of parallel bars and continue using cane/walker/crutches for the first few days to avoid overload on the knees.

6. With proper support, walking is possible in 3 to 5 days. Continue using a cane for the next few weeks to strengthen the knee.

7. Schedule a postoperative visit in the 4th to 6th week after surgery.

8. Draw up an exercise routine with your physiotherapist.

9. Ice pack can be applied to control swelling.

10. Driving should be possible, once you are off pain medications, as these can make you drowsy.

11. Blood clot in the surgical site causing a bruise will disappear in a couple of weeks.

12. Knee replacement is almost magical as in the long run (10 years postoperatively), there is a good 98% chances of success.

Having said this, it is important to remember each person responds differently to the procedure and therefore treatment/rehabilitation is completely personalized.

Knee replacement surgery is a procedure that is used to replace a worn out knee joint with an artificial knee joint. Such a surgery is advised if your knee is causing pain and limiting your daily activities, provided other treatments have failed to cause the desired impact.

Once the knee replacement surgery is completed, the focus shifts to the recovery phase.

1. The duration of the recovery depends on the type of surgery and the individual.

2. After the surgery, painkillers are administered to provide relief from the pain.

3. In some cases, oxygen is administered through various tubes if required.

4. A blood transfusion may also be required after a knee replacement surgery.

5. The surgical wound will require a dressing to allow it to heal faster and prevent infection.

6. A drain will be attached to the wound to drain out the blood from it and prevent accumulation of blood in the wound.

7. The dressing of the wound should be changed regularly.

Post- Surgery Care

• Post-surgery, you will need assistance to help you walk. If the surgery that you underwent was minimally invasive, then you should be able to walk on the very same day. Your physiotherapist will prescribe and show you some exercises to strengthen the knee. It is important that you follow his/her instructions to avoid complications.

• A passive motion machine is sometimes prescribed as it helps to restore the movement of the knee. It helps in reducing the swelling by keeping your leg elevated and moving the knee when you are lying down.

Here are some knee replacement recovery tips:

1. Avoid doing any work that puts pressure on the knees.

2. Eat nutritious meals so that the body receives proper nourishment, thus allowing your leg to heal faster.

3. Avoid heavy exercises which can strain your knees.

4. Perform all the exercises prescribed by your physiotherapist to speed up the recovery process.

5. Do not sit with your legs crossed for a few months after the surgery.

You can be diagnosed with a tennis elbow even if you have never been on a tennis court! A tennis elbow refers to tendinitis or swelling of the tendons in the elbows and arms. Tough tissue bands that join the muscles of the arm to the bone are known as tendons. This affliction is one of the most common reasons for elbow pain and can affect men and women at any age. However, it is most commonly seen in patients who are around 40 years old.

Tennis elbow develops gradually and is triggered by repetitive motions that strain the muscles or put too much pressure on the tendons such as sports that involve swinging a racquet, weight lifting or hobbies like carpentry, knitting, typing or painting.

Most cases of tennis elbow resolve themselves with time as long as you rest the elbow and give your tendons a break. Some things you could do to speed up the healing process are:

1. Soak the elbow in an ice bath for half an hour every 3 to 4 hours. This should help relieve the pain and reduce swelling.

2. Use an elbow strap to support the arm and prevent further strain in the injured tendon.

3. Exercising the arm to reduce stiffness and increase the possible range of motions. This will also make your tendons more flexible. However, exercises should be done only under a physiotherapist’s guidance so as to prevent any further damage. Additionally, your doctor may also suggest physiotherapy, to strengthen and stretch the arm muscles.

4. Over the counter, anti-inflammatory medicines such as ibuprofen or aspirin can also help reduce the pain and swelling. These drugs should not be used without a doctor’s guidance as they can cause a number of side effects. In some cases, these side effects can slow down the healing process.

5. Painkiller or steroid injections may also be prescribed to temporarily ease the pain and swelling around the elbow.

In some cases of severe tennis elbow, these forms of treatment may not be effective and if you are still suffering from pain and swelling for over 4 months, you may need to consider surgery. Surgery for tennis elbow involves removing the damaged section of the tendon and repairing the remaining part.

Recovery from a tennis elbow may seem slow but it is essential to be patient and avoid lifting weights or putting any strain on the arm during recovery. Once the swelling has completely gone down and you feel no pain or tenderness in the area, only then should begin using your arm normally.  

Knee pain should not be taken lightly and medical assistance must be sought, if it has been there for a long time. With knee replacement surgery you can resume to a healthy lifestyle.

Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.

Surgery Types-

Knee replacement is mainly of two main types:

1. Total knee replacement where both the sides of knee joints are replaced
2. Partial knee replacement where only single side of the joint is replaced

Procedure-

In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage, and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.

In total knee replacement, four steps are performed:

1. Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone.
2. Replacement with metal components, which help as a recreated surface of the joint
3. Incision of knee cap with a resurface made of a plastic button, which is optional based on the case
4. Insertion of a medical-grade plastic spacer amid the metal components. This creates an effortless gliding surface.

After general or spinal anaesthesia, an incision of 8-12inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material.

After Effects of the Procedure-

After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.

There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.

Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all!

A herniated disc also known as a slip disc or prolapsed disc refers to the problem where one of the discs located in between the bones of the vertebrae(backbone) gets damaged and stacks itself upon the nerves. The tender inner portion of the disc gets protruded over the outer ring. Herniated disc causes severe neck pain and back pain. It occurs when the outer ring gets weak and tears down. The most common symptoms include pain and numbness, especially on one side of the body. The pain extends down to the arms and legs. It worsens during nighttime. The muscles become weak. Overweight people are likely to have this disease, as the discs carry extra weight. Old people are vulnerable to a slip disc.

Effects of Herinated Disc:
- An untreated case of herniated disc may cause permanent damage to the nerves.
- In certain cases, a herniated disc is capable of cutting off nerve impulses to the "caudal equine"nerves, present in the lower back and legs. This leads to loss of bladder control or bowel control.
- Saddle anaesthesia is another long-term effect. Nerves are compressed by the slip disc, causing loss of sensation in the inner portions of your thighs, the back of your legs and surrounding the rectum region.
- Symptoms may improve or worsen.

Diagnosis of Herinated Disc:

Treatment or diagnosis of herniated disc or slip disc can be either conservative or surgical in nature. The nature of treatment is determined according to your discomfort level and the kind of pain you are experiencing, or how much the disc has slipped out.
- The pain caused by herniated disc can be relieved by undertaking an exercise schedule which includes stretching and strengthening the spine and its surrounding muscles.
- A physiotherapist should be appointed for recommending the types of exercises.
- Taking pain relievers also soothes the pain.
- Stronger medicines prescribed by doctors include-muscle relaxers, narcotics to deal with the pain, medicines for nerve pain such as "gabapentin"  or "duloxetine".
- In case of the symptoms not subsiding within a span of six weeks, a surgery may be recommended by your doctor. The surgeon may have to remove the damaged part of the disc. This surgery is called a microdiskectomy.

The thought of going under the knife to treat your spine problem may give rise to a range of emotions; make you ponder over a number of things such as the recovery period, procedure and techniques involved and so on. Nonetheless, before opting for the surgery, there are certain points that you should go over and these are:

• Be well aware of the cause of your pain - Identifying the cause that is behind your pain is vital in order to decide whether the surgery is going to prove beneficial in the long run or not. If the cause is not identified as the right one, the surgery may prove futile and you may not get the pain relief that you're looking for.
• Gather detailed information about your spine surgeon - Before visiting the spine surgeon, you should collect detailed information about the specialist so as to be able to come up with appropriate questions concerning the surgery. From questions concerning about the surgeon's success and complication rates, numbers of surgeries performed to qualifications of the surgeon, these and much more should be part of your evaluation process.
• Prepare yourself before a consultation - It's good to prepare yourself before a medical consultation. Whether it's researching about the surgery and your condition or being well aware of your family's medical history, or details about the pain that you experience, or your expectations from the surgery, every aspect should be covered so that you derive the maximum benefit from your meeting.
• Carry out your own research - Carrying out your own research on the alternatives before opting for the surgery can put you on a better footing. It's imperative to compare the opinion put forward by the surgeon from genuine sources so that you're better able to understand the merits and demerits of the treatment.