Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Are you suffering from arthritis and looking for effective treatment options? Arthritis is a chronic, systematic inflammatory disease that causes damage to your joints and connective tissues. The knee is primarily affected by this condition and there are three main forms of arthritis which occur in your knees. There are several treatment options and procedures for treating arthritis. They are as follows:

Several medications are used for arthritis treatment. They are:

Analgesics: These medicines help in pain reduction but do not heal inflammation.
NSAIDS: NSAIDS or non-steroidal anti-inflammatory drugs are used for reducing inflammation and pain as a result of arthritis.
Counter-irritants: These include creams and ointments containing capsaicin or menthol. Applying these creams on the skin helps with pain relief.
DMARDS: Disease-modifying antirheumatic drugs are used in case of rheumatoid arthritis. These help in slowing down your immune system from targeting your joints.
Corticosteroids: This form of medicine includes cortisone and prednisone and helps in reducing inflammation and suppressing your immune system. These can be injected into your joint or taken orally.
Therapy
Physical therapy is beneficial for certain types of arthritis. Exercising helps in improving your range of motion, and the strength of your muscles which surrounds the affected joint. Splints and braces are prescribed in some cases.

Surgery
When all other treatment measures fail, a surgery may be required to be carried out.

Joint repair: In some cases, the surface of your joints can be realigned and smoothened in order to improve function and eliminate pain. These surgeries are arthroscopically performed via incisions made on the joint.
Joint replacement: During this surgery, your damaged joint gets removed and replaced with an artificial joint. The hip and knee joints are commonly replaced surgically.
Joint fusion: This surgical procedure is used in case of smaller joints of your body. The ends of the two bones in your joint are removed and the removed ends are locked together till they heal into one unit.
Alternative treatment options
You can also opt for certain alternative remedies for arthritis. Some of them are as follows:

Acupuncture: In this therapy, fine needles are inserted at certain points on your skin for reducing arthritis pain.
Yoga and tai chi: The movements associated with yoga and tai chi are slow and stretching in nature. These help in improving joint flexibility. Your range of motion gets improved as well.
Light massages which involve stroking and kneading of your muscles help in increasing blood flow. This warms up the affected joints, providing temporary relief from arthritis pain.

Arthritis - How to Treat It Effectively?

Fibromyalgia is a condition that causes chronic pain in muscles, soft tissues, tendons, and joints. For some, it can also cause memory problems, fatigue, mood swings and lethargy. Fibromyalgia is not a disease but a syndrome. The same can be effectively managed through wellness, medicine, massage and alternative medicine. This condition is more observed in women than man. Luckily through, this condition is not life threatening and does not damage muscle and joints.

What are the symptoms?
The most common symptom of Fibromyalgia is the pain. The experience of pain can be burning, deep, shooting or ache at regular intervals. Tender points around the soft tissue can be visible. This worsens at night. Some common indications of this condition include less sleep, headaches, depression, fatigue and other cognitive issues. With proper care the symptoms do improve, it, however, is a long-term condition and chances are that the pain might return in the long run.

How does massage help?

Massage can prove to be extremely beneficial for this lot. Research indicates that massages such as Shiatsu, myofascial release and Swedish improve the condition for better. Mentioned below are few benefits that have been observed in patients of different age group:
An evening session with a massage therapist will help a patient to get sound sleep at night. This ensures that the body rejuvenates and repairs during the sleep. The patient feels more energetic than ever before.
Massage improved muscle tonicity: Massage helps to improve the lethargic muscle aid strength and vitality to the body. It is essential to include more petrissage strokes during the massage session to accomplish the goal.
Massage helps a great deal to improve mental clarity. A healthy, relaxing massage session can relieve mental stress, gives clarity to thinking and resolves the cognitive issues that a person is facing.
A person suffering from Fibromyalgia can get relief from headache with proper massaging. Massage greatly improves the flow of blood to the brain and the spinal cord region thereby, ensuring that headache is greatly reduced. Relief from headache can improve the overall health of a patient.
Massage can reduce the level of depression and anxiety faced by a person suffering from fibromyalgia. Depression and anxiety leads to hormonal fluctuations leading to appetite, mood swings, constant irritation etc. A regular massage session can restore the body homeostasis thereby keeping the body condition normal.
Regular massage session will improve the overall pain level of the patient and give a chance to the muscle to gain extra strength. With proper care and therapy, it is entirely possible to cure the condition for good. 
However, it is also necessary to continue with the session. Giving up massage therapy after temporary relief won t serve the purpose for long-term pain relief.


Fibromyalgia Pain - Can Massage Help Reduce It?

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Psoriasis is a skin disease, which develops in men and women often during middle age and above. Although tests and researches are being carried out in various laboratories around the world, the exact cause of this condition is yet unknown. Psoriasis is not infectious. In other words, it does not spread by coming in contact with someone suffering from it. In case you see that you are just developing psoriasis or it is in its early stages, then you can opt for some simple and natural methods of curing it. These home remedies fall under Ayurvedic treatments and help you in getting rid of this disease before it spreads further into your body.

Moist skin: Apply lots of moisturizer on your body. This is done to keep the skin moist and supple. The more your skin becomes dry, the chances of it bleeding and causing infections increase. It is often recommended to apply body oil or sesame oil before taking a bath as it softens the skin.
Use natural body soaps: Sometimes the body soaps that you use are made of harsh chemicals. These chemicals come in contact with your body and aggravate the infection furthermore. You can use home made natural soaps, which are made of natural ingredients and are gentle on your skin.
Avoid skin injuries: Skin injuries like a cut, bleeding, blisters etc. can be harmful for psoriasis. They can aggravate the inflammation and cause more damage. In fact, it is recommended that you apply moisturizer and sunscreen every time you step out of the house in order to protect your skin from further damage.
Use medicines after consultation: Certain medicines have the ability to flare up the effects of psoriasis. Thus, when you develop this disease, it is advised that you meet a general physician and discuss your medicines with him/her in order to control the same.
Reduce stress: Stress levels contribute a lot to psoriasis. Thus, you need to relax as much as possible. You can try out yoga and meditation to keep the stress level down and in turn control this disease as well.
Wear cotton clothes: Wear clothes that you are comfortable in and those which do not cause irritation on your skin. Synthetic clothes sometimes cause a lot of irritation and rashes on the skin. It is something that should be avoided.
These are some of the quick and natural remedies to cure yourself of psoriasis as early as possible.

Psoriasis - 6 Ayurvedic Remedies That Can Help!

Juvenile arthritis also known as juvenile rheumatoid arthritis and is a chronic, systematic and inflammatory disease, which causes damage to joints or damages of connective tissues. Symptoms include fever, rashes and hepato-spleenomegaly. This disease is persistent and inflammatory in nature and occurs before the age of sixteen. Homeopathy is widely used to cure juvenile arthritis. Here is a list of the best homeopathic medicines used to treat juvenile arthritis along with the symptoms based on which they are prescribed.

 Abrotanum: this homeopathic medicine is used when a child is suffering from juvenile arthritis and is unable to move. Symptoms include soreness and paleness and the condition worsens in the morning. Gouts may occur in the wrists or ankles. Inflammatory rheumatism is indicated before the start of swelling. Marasmus of children may occur signified by marked emaciation, especially in the leg. The skin tends to hang loose and gets flabby. Constipation and diarrhea occur.
 Aconite: aconite is a homeopathic remedy, which is used in arthritis where there is tearing pain in the limbs. Violent pulls in the joints and bones are experienced. Contraction of the tendons and feeling stiff in the flexor muscles are other symptoms. Cramps affect several limbs. Aconite is used in early stages of juvenile arthritis. Atmospheric changes affect the patient, and dark hair, and eyes are developed. The muscle fibres becomes rigid.
 Apis: apis is used in oedematous swellings and synovitis. The knee gets swollen, sensitive, sore and shiny along with stinging pain. The feet also swell and feel extra large. There is a rheumatic pain in the backside and in the limbs. The fingertips and hands become numb, and the patient is tired. Glands are enlarged or indurated.
 Arsenicum album: this homeopathic medicine is used in juvenile arthritis where the patient experiences acute pain in the arms and hands. The pain begins from the elbow and extends to the armpits. There is an acute, pulling and shooting sensation in the wrists. The fingers swell as well along with pain in the finger bones. Cramps occur in the legs and swelling is felt in the palms at night. The hips experience acute pain as well, which extends to the thighs, groins and ankle bones. 
 Belladona: belladona is used for joint and bone pains. The pains generally increase at night and during the afternoon. Any kind of movement or touch leads to aggravation in the pain. Palpitations in muscles are caused. Cramps, spasms and movements which are convulsive are indicated.

Homeopathy is an ideal remedy for treatment of juvenile arthritis. Homeopathy being purely natural has no side effects and puts a check on all underlying causes of juvenile arthritis.

Is Homeopathy a Cure for Juvenile Arthritis?

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