PANDIAN'S MULTISPECIALITY CLINIC

Torn cartilages are quite a common form of injury occurring in the human body. While one can’t always be too cautious of injuries, one can still try to be conscious of their muscles and do not move about in an abrupt manner to cause injury to themselves. Further, even though torn cartilages are very common, they are quite painful and most often they occur in the knee. Here are some tips to ensure that your torn cartilage heals well and you are exposed to less pain during the healing period:

1. Rest: You must take rest. While it is advised to take bed rest, humanly it is impossible to spend all day in bed. Thus one can move about a little but avoid walking and straining their legs and knee too much. At times crutches can be taken while taking a few steps in the room.

2. Ice Therapy: Putting ice bags in the affected area helps in relaxing the muscles and reducing the pain quite a lot. Though previously people adhered to putting hot water bags, the scenario is slowly changing to ice therapy.

3. Compress: When you are suffering from a torn cartilage, the doctor often puts a bandage on the knee to compress the area. This is done so that the muscles are brought together and they can heal on their own with time and rest.

4. Elevate the Knee: Often it is seen that during such cases, the knee or the hands are rested in an elevated platform. This platform is created with the help of a pillow mostly. This lets the cartilage get time to rest and heal on its own.

5. Avoid Strenuous Activities: This includes jumping, running, jogging, kicking etc, when it comes to the legs and writing, lifting weight etc. when it comes to the hands. These activities require a lot of strength and power and most of all the use of the cartilages. Since the cartilages are torn and in their healing mode, it is best to avoid such activities for a certain amount of time to not put pressure on the cartilages and damage them further.

6. Painkillers: It has been already mentioned that the healing period can be painful. Thus, the doctor may prescribe some painkillers to ease the pain during this time.

Thus, these are some of the easiest ways to deal with a torn cartilage. The recovery period may be painful, but it happens to many people and is completely healable in nature.

My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting?

You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts.

What are the advantages of doing both the knees in one sitting?

• Exposure to the risk of anaesthesia reduced to only once
• Aids simultaneous rehabilitation especially in severely deformed knees
• Bilateralprocedure reduces cost
• Earlier return to baseline function and convenience for the patient and relatives
• Shorter cumulative hospital stays

What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same?

The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery.

Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures.

Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty.

What is the latest Technology available which could help improve surgical outcomes?

Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions.

Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended.

Practical Benefits Of Custom Fit Knee Replacement

• MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients
• No intra medullary instruments so minimal chances of fat embolism
• Minimally Invasive (just a 4-5 inch incision)
• Improves the speed of the operation theater time (40% reduced surgical time)
• Increases implant inventory efficiency (know sizing)
• Faster recovery of the patient
• Perfect patient alignment thus better mobilization

What is the role of body exhaust 'space' suits in Bilateral TKR?

• 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons.
• Space suits are used to help reduce contamination from the operating teams from entering the wounds.
• The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.

The shoulder is one of those joints in your body that enjoys the maximum wear and tear by virtue of being an extremely mobile joint and one of the most over-worked as well. This increases the risk of dislocation and instability. Arthritis is one of the most common causes of pain, as per various medical reports and is usually found to affect the tendons, ligaments, and even the muscles and joints of the body due to excessive wear and tear. There are various kinds of shoulder arthritis and treatments that are available. Read on to find out more.

1. Rheumatoid Arthritis: This autoimmune condition creates stiffness in the shoulders along with rheumatoid nodules or small bumps under the skin of this region. It may affect both shoulders at the same time. Swelling or inflammation of the joints is a common occurrence in this condition along with fever, fatigue and weight loss.

2. Osteoarthritis: This form of arthritis basically has to do with wear and tear of the connective tissue and bones. The symptoms are pretty severe and can go from tenderness to pain and stiffness with an increased risk of bone fractures.

3. Post Traumatic Arthritis: PA or post traumatic arthritis occurs due to an injury in the shoulder and can cause instability as well as dislocation of the shoulder. A sports injury is the most common cause of this kind of arthritis. Pain and inflammation are the most common outcomes of this kind of injury and arthritis.

4. Avascular Necrosis: When the tissues of the shoulder joints go through damage, it leads to this form of arthritis. Joint dislocations and fractures are the most common causes of this kind of damage. This usually happens because blood flow does not happen over the long arm bone to reach the shoulders due to the damage rendered to the tissue. Excessive alcohol consumption and high steroid intake can also lead to this damage.

5. Rotator Cuff Tear Arthropathy: This kind of arthritis is caused due to a rip in the shoulder cuffs.

Treatment Measures-

The most common forms of treatment include surgery like joint replacement surgery (replacing the damaged parts of the shoulder with an artificial prosthetic joint), Arthroscopy (cleaning out of the joint with minor incisions), and resection arthroplasty (removing the bone from one’s collarbone). Also, corticosteroid injections can be given and anti-inflammation drugs like ibuprofen can be prescribed for this condition. Exercises and physical therapy will also be helpful in such cases so as to strengthen the shoulder and joints.

It is important to also make lifestyle changes to give rest to the shoulder and abstain from too much alcohol consumption.

The sciatic nerve is one of the largest nerves in the body. It goes from the lower back all the way down to the base of the leg. When there is a disorder associated with the sciatic nerve, it is known as sciatica. Sciatica, however, does not necessarily need a surgery or a very elaborate procedure to fix the problem. Most commonly, it is treated simply by practicing a number of simple exercises.

Here are some of the most common exercises prescribed to treat sciatica:

1.        Reclining pigeon pose
There are three main forms of the pigeon pose. These are sitting, reclining and forward. It is recommended that if you are just starting your treatment for sciatica that you use the reclining pose. In this pose, you are supposed to hold your left leg in the air at a right angle to your back. Then you are supposed to hold your ankle against the knee. Finally, repeat this stretch with the right leg as well.

2.        Knee to opposite shoulder
In this stretch, the starting position is on your back side. You have to have your legs out and feet upwards. From this position, try to bring your right leg towards your left shoulder. Hold this for 30 seconds and then release and relax. Repeat this exercise three times and then repeat the whole procedure with your other leg. Only take your leg as far as it will go.

3.        Sitting spinal stretch
At the start of this exercise, sit on the ground with your legs going straight outwards and your feet flexed in the upward direction. Pull your left knee and then put it on the outside of your right knee. Finally, place your right elbow on the left knee so that your body turns to the left. Hold for 30 seconds and then relax before repeating with the other knee.

4.        Standing hamstring stretch
Put your foot on an elevated surface such that it is above the floor but not above hip level. Flex your toes forward such that your feet and legs are nearly in a straight line. Bend as far towards the foot as possible. However, do not stretch so far that you feel pain. Finally, repeat this procedure on the other side after release.
 

Poor posture while sitting, standing, lying down or moving around is a major cause of back pain. Sitting and standing for long time put considerable pressure on the lower back, in fact, standing exerts up to five times more pressure than lying down, and sitting is even more strenuous.