Clubfoot is a deformity of the foot in infants. The condition is usually present from birth. This happens when the tissues linking the muscles to the tendons are shorter than usual, as a result of which the infant s foot appears twisted and out of shape. The condition can be mild or severe, depending on the symptoms. Often times, babies who are born with clubfoot have it in both the legs.

How to identify if your child has clubfoot?

Since the condition is present from birth, the symptoms are also easily observable. Identifying the following signs can help detect if your child is born with clubfoot-

  A foot that turns downward and inward and toes that point towards the opposite foot
  The affected foot may appear half an inch shorter than the normal foot size
  The heel of the affected foot may be smaller in size than it normally should be
  The calf muscle on the affected leg will be underdeveloped (appear slightly smaller)
  If the condition is severe, the foot may be twisted upside down

Despite its unusual shape, clubfoot does not cause pain or discomfort. The doctor will most likely notice the symptoms after the infant s birth. He/she will recommend appropriate treatment of the condition, or refer to an orthopaedic who specializes in muscle and bone ailments.

What is the treatment of clubfoot?

Clubfoot is curable so parents need not worry about their child living with a lifelong deformity.

Depending on the severity of the condition, the orthopaedic will either use devices, resort to stretching methods, or will recommend surgery.

  Ponseti Method (stretching and casting) - It is the standard treatment worldover. It starts at birth or anytime within two weeks of age and has best results in younger kids. It involves stretching the clubfoot and casting it in correct position several times over the months to restore the foot shape.
  French Functional Method (stretching and taping) - The doctor will stretch the affected foot and tape it in position several times over a couple of months to realign the shape. It, however, has very limites following.
  Surgery - Surgeries may be needed in older neglected kids or adults. The surgeon performs a surgical procedure (Achilles tenotomy) to lengthen the tendon of the clubfoot and realigns the joints and bones. Following the surgery, the child will need to be in a cast for about 2 months. Further, to prevent the recurrence of the condition, the child will be advised to wear braces for a year at least.
  Devices - They are adjunctive maintenance devices which are used by doctors in treatment of clubfoot. They are applied to the body to stabilize and limit or protect the movement of the damaged joint.

Parents should seek medical intervention if their baby is born with clubfoot. If the condition is not treated early, the child may face difficulty walking, or may even develop other disorders affecting the joints, like arthritis.

Clubfoot - Ways To Identify & Treat It Well!

When there is a fracture of the bone, the affected site may be plastered for the fracture to heal. In some cases, this may not be enough to mend the bones and surgery may be required along with bone grafting to rectify the condition. A new form of therapy, involving a less invasive procedure has been developed. It involves culturing the stem cells and using the same to mend and regenerate parts of the bone.

What does the treatment involve?

In this process, one cultures cells from the patient s body. The cells are extracted from the bone marrow. These cells are cultured in the lab and injected back to the affected region of the body. Research has shown that after the injection, the treatment takes anywhere between 7 to 8 weeks to repair the fracture completely.

Since stem cells are being harvested from the patient and not from a third-party, the treatment does not have any ethical constraints. However, more studies are being conducted to prove without a doubt that the same does not cause any damage to the body of the patient in the long run.



It is likely that this procedure will replace rudimentary surgical techniques, such as bone harvesting, in the future. It is far less invasive and does not result in extreme pain or prolonged hospitalization.

The future of the treatment: 

While stem cell culture has been around for a few years now, the use of the same procedure to treat fractures is The Latest Technology. It is in its early stages, which is why such a form of treatment is not offered by all hospitals across the globe and very selective surgeons having experience of the procedure would perform it.

Additional research and studies are being conducted to further confirm the efficacy of the treatment. Research has revealed that stem cell insertion in the bone can be used to regrow defects and heal non-unions of a bone. In some cases, repeated stem cell insertion may be required. The bone that grows as a result is as strong as the other bones in the body.

Stem Cell Culture For Broken Bones - What Is It?

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

Spondylolisthesis refers to the condition which affects your spinal bones or lower vertebrae. Due to this condition one of the lower vertebrae overlaps the bone directly beneath it. Although a painful condition, it can certainly be treated with both surgical and therapeutic methods.

People with spondylolisthesis often find it difficult to perform routine activities. They usually encounter symptoms such as- persistent pain in the pelvic region, lower back; stiffness in the legs, hamstrings and hip muscles.

What causes spondylolisthesis?
The causes of spondylolisthesis can vary with lifestyle, heredity and age. Children may develop this condition due to an injury or birth defect. Nevertheless, people belonging to all age groups are susceptible to spondylolisthesis if the condition is genetic.

Over exercise or strenuous physical activities can cause spondylolisthesis because over stretching and carrying heavy weight or strain puts too much stress on the lower back.

Participating in sports like football, gymnastics, weightlifting are likely to trigger spondylolisthesis.

Spondylolisthesis can also be triggered due to sondylolysis. The vertebrae safeguard the spinal cord and work with tendons, ligaments, joints and muscles to provide flexibility, structure and support to the neck. Any sort of damage or wear and tear in the protective cartilage and bones in the neck can lead to cervical spondylosis, which in turn leads to spondylolisthesis.

What is the treatment for spondylolisthesis?
Treatment of spondylolisthesis depends on the severity of the pain. While non-surgical methods help ease the pain, a surgery is recommended when the bone has slipped to such an extent that your spine doesn t respond to medications.

Non-surgical treatment includes the following-

Taking anti-inflammatory drugs like ibuprofen to ease pain.
Practicing a few physiotherapy exercises to reduce lower back pain.
Use of minimally invasive Epidural Steroid Injections (EPIs) to get relief from lower back pain and pelvic pain caused by inflamed spinal nerves. When over-the-counter medications fail to treat tSpondylolysthesishe condition or ease the symptoms, then a surgery is inevitable.
Discectomy- It is a surgical procedure that makes small incisions to remove a part of the damaged disc to relieve pressure from the surrounding spinal cord or nerve root.
Laminotomy- This refers to a minimally invasive procedure that removes a part of the lamina which is the upper surface of the vertebra. This process is used to create more space within the spinal canal.
Foraminotomy- With this method excess bone tissues are removed so that they don t make the foramen narrow and compress the nerve root. Removing these extra tissues reduce back pain and ease symptoms triggered by nerve compression.
Medical attention is crucial for countering symptoms of spondylolisthesis. Although this condition may not seem life-threatening, if left untreated, it can lead to chronic, persistent pain and permanent nerve damage.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Spondylolysthesis - A Condition Which Affects Your Spinal Bones!

If you are the on the wrong side of your fifties, then you will know the importance of regular checkups to the orthopedist. Aging related physical changes such as greying hair and wrinkles are a few things that you can cope with easily, however, when it comes to the health of your bones and muscles, you need to be very careful. You need to be particular about being active, as it can help reverse or reduce the risks of most of the bone disorders that you may suffer from. Ageing affects both the muscles and bones, but not always in the same manner. So, it is important that you understand how each is affected by ageing.

Changes in your muscles due to aging
As you age, your muscles tend to lose strength and size. This can make you prone to fatigue, weakness and a decrease in your tolerance levels to exercise. The various factors that play a role in this are:

Modifications in your nervous system can impair the ability of the muscle to contract.
The muscle fibers in the body reduce both in size and number.
The replacement rate of the muscle tissue in the body falls.
Changes in your bones due to aging
Ageing impacts the structure of the bone and leads to a loss of the bone tissue. Aging causes low bone mass, thus rendering them weak. This means a simple fall can have a serious effect on your bones.
The various causes that can bring about these changes are:

Loss of vital minerals such as calcium
Being physically inactive
Undergoing hormonal changes in the body such as menopause, wherein the body loses minerals from the bone tissues. In case of men, progressive decline of sex hormones can lead to changes in the bone structure.
Common conditions that affect your musculoskeletal system in your old age:

Osteoporosis: This disorder results from a loss of bone density resulting in fragile bones. This makes the bones highly susceptible to fractures and breakage.
Rheumatoid arthritis: An autoimmune disorder that usually develops after the age of 40; here, the immune system of the body attacks the body tissues, thus leading to inflammation in your joints.
Osteoarthritis: It is a disorder of the joints which is caused by deterioration of the cartilage that cushions the joints.

Old Age - How It Impacts Your Muscles & Bones?

The shoulder is a complex joint consisting of a number of bones, ball, socket, and cartilage. For people suffering from arthritis of the shoulder joint, a total replacement of the shoulder joint is often a successful procedure. It significantly improves pain and range of motion. However, in case the patient is suffering from a special type of arthritis of the joint known as  cuff tear arthropathy , a total shoulder replacement often does not produce the desired result. These people suffer from large rotator cuff tear as well as arthritis. For such patients, a reverse shoulder arthroplasty often show better results. 

Reverse Shoulder Arthroplasty 

In traditional total shoulder replacement, the device put into the joint consists of a plastic cup fitted into the glenoid bone, also known as the socket, and a metal ball attached to the top of the humerus, the upper arm bone. In a way, it mimics the configuration of the original shoulder joint. However, in case of reverse shoulder arthroplasty, the positions of the metal ball and the socket are interchanged. The plastic cup is attached to the humeral head whereas the metal ball is attached to the glenoid bone. 

Benefits of the Procedure 

A reverse shoulder arthroplasty works better for patients who have a large rotator cuff tear along with arthritis. There are a number of rotator cuff muscles in the shoulder and they help to hold the arm in position as well as provide power to the arm during extreme movements. In case of people with large rotator cuff tear and arthropathy, the upper arm has to rely on different muscles for movement because the rotator cuff muscles don t function. Hence, the arm has to depend on other muscles such as the deltoid muscles, to position and power the arm. This is why a reverse arthroplasty is carried out.

Who Can Undergo This Surgery?

Every patient with cuff tear arthropathy is not a candidate for reverse shoulder arthroplasty. Surgeons recommend this surgery when the patient is suffering from: 

  A total tear of the rotator cuff which cannot be repaired 

  A special type of shoulder arthritis known as cuff tear arthropathy 

  An unsuccessful shoulder replacement surgery 

  Extreme shoulder pain along with difficulty in lifting the arm over the head or away from the body 

  A complex type of fracture in shoulder joint 

  A chronic dislocation of the shoulder 

  A tumor in shoulder joint 

Doctors can also suggest this procedure if the patient had previously tried other remedial measures such as medications, rest, physical therapy, injections, etc., but was not successful in alleviating the pain and improving the range of motion of the shoulder. 

Conclusion 

There are some medications that you need to stop before the surgery since they may cause excessive bleeding after the surgery. Some of these medicines are blood-thinning medicines and Non-steroidal anti-inflammatory medicines.

Revision Replacement - What Should You Know?

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