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9 month pahle mera inguinal hernia ka operation hua tha. To Kya ab me gym kr skta hu. Or agar abhi nahi kr skta to Phir Kb kru.
Is shoulder dislocation require surgery? Allopathic surgeons have suggested it. Suffer the problem since 15 yrs. Can not move right hand straight upward. If not no problem. Any other remedy or exercise. Dislocation happen only if I move my right hand straight upward. Feel uneasy in right shoulder if carry weights. At this age l am afraid of operation.
I have pain in my leg from last two days, before that I was suffering from chikungunya. please sugs me a good solution.
I am 34 year old male and have pain in between thumb and 2nd finger, of left hand, from 4-5 days, I cannot pick up a bit heavy thing.
My uncle is suffering from a pain in shoulder with fibroid in it. Please suggest medication whether to go for operation or it will be okay with medicines. Please consult MRI report and ultrasound which I am enclosing with this. Is it a chance of tumour?
A fracture is a complete or incomplete crack, which appears on a bone due to application of intense pressure or force. A fracture results in extreme pain, and the bone becomes immobile. Any kind of movement boosts the pain. Fracture pain occurs in three distinct stages. Acute pain is felt immediately after a fracture while sub acute pain occurs over the weeks that follow after a fracture. The third stage or chronic pain occurs when the fracture and soft tissues around it have healed.
Fracture pain is quite intense in nature and proper precautions should be taken while dealing with them:
- Development of fracture pain: When a bone undergoes a fracture, the ligaments and tendons are also damaged. While the bone slowly heals, ligaments and tendons fail to heal equally well or completely. Post fracture pain also develops when the outside of the bone does not heal completely. This usually does not appear in an X-ray.
- Treatment of fracture pain: Modern medications can be utilized to treat a fracture pain. Steroid injections and prescribed anti-inflammatory medicines help in treating a fracture pain. However, these remedies cause side effects, which are harmful for the body. Cortisone shots are utilized for the same purpose as well.
- Prolotherapy: Prolotherapy is an approach where ligament and tendon strengthening is stimulated along with repairing. This technique ensures complete treatment of the fracture, and the risk of long-term complications like arthritis is absent. In cases of fracture pain, which occurs due to the incomplete healing of the outer part of the bone, Prolotherapy helps in strengthening the fibro-osseous junction at the source of the pain. This will stop the nerve endings from firing. Prolotherapy provides speedy recovery and accounts for making the injured bone stronger than before. This process is often undergone by athletes. The procedure is undertaken only after thorough examinations for detection of the root cause of the pain. Prolotherapy is considered to be the best treatment for repairing tendons and ligaments, which commonly cause fracture pain. The body is simply stimulated and the painful areas are repaired. This is done by the introduction of a mild inflammatory reaction to the area of the weak tendons and cartilages. The results obtained after Prolotherapy are permanent and the fracture pain is unlikely to reoccur.
- Splints are utilized to stop the movement of fractured bone and braces can be used to support the bone. Plaster cast also supports and immobilizes the fractured bone. Traction and surgical implants are other treatment measures.
- Fracture pain occurs not only because of the broken bone, but also because of the weakened ligaments and tendons around the bone. Fracture pain should be handled very carefully, and proper control measures should be applied.
Dear Team, I am getting pain in my left shoulder and its not radiating to the total arm. No other discomfort too. I feel shortness of breath also. I experienced this kind of problem four months ago, Doctor advised for ECG and my ECG was normal. Now I am getting the same problem. Kindly advice.
I am playing volley ball after 3-4 years approximate. My both hands and fingers are in so much pain. As I played from the middle and theirs a tournament is going on. So I can't quit it. Please suggest anything that gives my hand and finger relief.
Benefits of Bilateral Total Knee Replacement
I am Dr. Rakesh Nair. I am an exclusive knee replacement surgeon practicing at Zen Hospital in Chembur. I am also attached to the Fortis Group of Hospitals at Vashi and Mahim and Holy Family Hospital at Bandra. Today, I am going to talk about Bilateral One Stage Total Knee Replacement. To understand the basic term which I have used here when I say Bilateral One Staged, I say both knees and one sitting. They are done together once the patient is wheeled in. They are not done in a gap of a few days. That’s what I mean by both knees and one sitting.
In the surgery, all we remove is hardly 7-8 mm of bone from the thigh bone and around 7-8 mm from the shin bone, that is the lower part and all we do is just change the cap. It’s like changing the cap of a tooth, so your bone and your muscle are your own. We are not chopping off the whole knee and replacing it. So, that is the reason why I am using the terminology Knee Resurfacing, we are changing only the cap.
Once the cap is changed, we are able to mobilize the patient, the same evening if required. And, with the advanced anesthesia techniques that we have, I am able to make the patient walk the same evening. So, there are some videos here also which would tell you the same where the patient has been operated in the morning by around 12 o’clock once he or she is wheeled out the operation theatre. In another four hours by 4 o’clock evening, the patient is walking with full weight on the leg without much pain because of the pain techniques that we in terms of the pain management.
Now, why would I say that we should be doing both knees in one sitting? So, what are the advantages of doing both knees in one sitting? If you see the further videos which I would also show you, most of the patients who come to me have severe deformities. They, like, have severe bow legs, legs which are severely bent, either towards the inside or either towards the outside. So, doing one knee and then doing another knee is not going to help at all because the patient is not going to be able to walk. So, when I do both knees in one sitting it restricts the surgical procedure so it is like saying I do everything under one anesthesia. The patient gets short of medication. The medicines also which go into the body is once you are wheeled into the operation theatre. The most important part is that the patient can be mobilized very easily because immediately both the legs are straight and the patient can walk with full weight bearing on both the legs. So, I can make the patient walk in the evening or the next day depending on how strong the bones and the muscles are. Another thing is, it reduces the hospitalization also, plus the hospital cost also goes down because we don’t double use the medication nor the stay is doubled. The stay is same; it varies between 3-7 days depending on how strong the patient's knees are before surgery. So, I would definitely advocate doing both knees in one sitting.
What are the main advantages and what would you say in terms of why wouldn’t we do a knee after a week or 10 days? There are studies which say that it is not the number of joints, so the number of knees you do in which causes the problem or the commonest cause which is an infection. The problem arises if you keep on wheeling the patient into the operation theatre. So, if somebody says that we do a knee today and then we do a knee after 4 or 5 days then cases of infection will increase because the patient is being wheeled into the operation theatre on two separate occasions. So, it is not that I have not done both the knees in one sitting, which is a better option because the chances of infection are less than doing one knee now and then doing the other knee after 4-5 days, where the patient gets the same medicines repeatedly plus he is bought into the operation theatre again and his stay also increases in the hospital.
We would be showing you some videos where the patient, how the patient is walking before surgery. If you see most of these patients, the legs are severely deformed. So, all of them I have been able to do a One Staged Bilateral Knee Resurfacing where I have done both the knees in one sitting. You see them how they are walking before surgery, you see them how are they are walking after surgery. And, if you compare the function, they are really able to walk very comfortably.
My patients even sit cross-legged after surgery but that is not. I will show you one of these videos which are showing the patient sit cross-legged after surgery. But that is not something which we promote. It is just to show that they get very good function and they would definitely be able to sit cross-legged but that is not something we tell the patient to do because that compromises on the life of the knee. So, there are a lot of records and results which say that, whether we do a Bilateral One Staged Knee Replacement or whether we a One Staged Knee Replacement, the complications in terms of infection, an embolism is always similar. In fact, it is much more in a unilateral knee than in a bilateral knee.
We use body exhaust play suits, again, during surgery. I will show you this video which is showing you the body exhaust play suits where we are working in a very sterile environment. We would not want to give any infection even from the OT personnel to the patient. So, these are body exhaust playsuits which prevent the impure air breath out of the operating team, it is not allowing it to go to the patient. In fact, it is sucked up by a rotating fan which is there on top of the body exhaust playsuits and the whole impure air is taken out from the patient’s atmosphere. Even our conventional methods of mixing cement have been changed and we are using basically vacuum mixing for cement so there again is no impurities in the bowl in which we are mixing the bone cement to fix the implants to the bone.
We have all the options in terms of the knee replacement where we even have computer assisted Total Knee Replacement. We have Unilateral Knee Replacement where basically the unilateral knee replacement is used for younger patients who have deformities or pain in the insides of the knee where only a part of the knee has been damaged, the rest of the bone is all right, that’s where we use the Unilateral Knee Replacement. The latest what we have is the Customized Jigs in Total Knee Replacement where we get the MRI done of the affected knee. On the basis of the MRI, ceramic Jigs are made and on the basis of the ceramic Jigs, the positioning of the implant can be as perfect as required. Obesity has always been, the patient has always come up to me saying, “Doc, I am little on the heavier side, I am so heavy, is it a contraindication to my surgery?” So, obesity as such is not a contraindication to surgery. Definitely chances of wound healing are a problem but, instead of a week to ten days, it will take another week to ten days for healing. Otherwise, it is not a contraindication to the surgery.
Now, a very important question which comes from the patient is, “Doctor, how long will these knees last?” So, I give a very simple answer to that is that, the more you take care of it, the longer it will last. So, the longevity of the knee all depends on how strong your muscles are before surgery, how strong your bones are after surgery or before surgery and depending on that we normally get a bone density done for the patient and we treat the patient either on a yearly injection for osteoporosis or daily injection which are meant to fill up the bone and that decides on how well the implant is going to hold on and how long the life of the knee is going to last.
For further information, you need to contact me through lybrate.com.