Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended world-wide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.

Modern technological advances have made computer assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. A perfect alignment and balance is achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.

There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.

In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channelled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred as prosthesis. The design of these highly flexible implants replicate knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. Post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.

Knee Replacement

The medical term  spina bifida  or spinal bifida refers to a congenital defect in the spine. In simpler terms, spina bifida is a defect in the neural tube. Based on the severity of this disease, spina bifida can be divided into three different types:

Myelomeningocele
Meningocele
Occulta
The symptoms of spina bifida vary depending on each of these three types. Let's take a closer look at its symptoms here:

Myelomeningocele

Myelomeningocele is the most severe form of spina bifida. In this type of neural defect, spinal canal of the baby remains open in the middle or lower back along a few vertebrae. Due to this opening, a sac is formed at the back of the baby at birth, which exposes the baby to several life-threatening infections.

Some of the common symptoms of this type of spina bifida are:

Seizures
Presence of uneven hips
Deformed feet
Curved spine or scoliosis
Bladder and bowel problems
Muscle weakness
Paralyzed leg muscles.
Physical deformities from moderate to severe levels are also very common in this type of spina bifida.

Meningocele

Meningocele is a ratherrare form of spinal bifida in which a sack of fluid stays in open at the back of the baby. Here the protective membranes that usually stay around the spinal cord push out through the vertebrae s opening. Though this sack contains no part of the spinal cord, it may cause minor disabilities.

Some common symptoms of this kind of spina bifida are:

Membranes forming a visible sack on the back at birth
Presence of a small opening in the baby's back
The good news is that this sack can be removed through surgery without hampering the normal development of the spinal cord.

Occulta
Spina bifida occulta is the mildest form of spina bifida, which, in majority of the cases, often stays hidden as its symptoms are rarely visible. As it doesn t even cause any form of disabilities, it generally goes unnoticed. It doesn t cause any damages to the nerves or the spinal cord.

Some common symptoms of occulta are:

Presence of a gap between the vertebrae
An area on the back formed with extra fat
Acluster or small group of hair on the back
A dimple or birthmark on the back.
In this kind of spina bifida, neither any sack of fluid is formed, nor are there any visible opening in the back. Sometimes, people who have spina bifida are not aware of it due to its minimal symptoms.
Spina bifida usually affects a child before birth, when the brain or the cord or the protective covering over them fails to develop completely. Knowing about the symptoms can be one of the best ways to identify and diagnose this disease and opt for proper treatment solutions. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

Spinal Bifida - Know The Signs That Indicate It!

Exercising and sports activities are necessary evils in your life. While they keep your body fit, you are also exposed to injuries at the same time. Of all the injuries, muscle strains are the most common ones. These might look very ordinary or minor, but remember there is an intense pain attached to it. So much so that you might even feel suicidal at times. Poor conditioning, over exertion and a faulty warm up session, can lead to muscle sprain. Strains are very common in certain regions like lower back, neck, shoulder and hamstring muscle (at the back of the thigh).

Don t need medical treatment
In most cases, muscle strains don t need medical treatment. But it is important to provide the right supplies and rest to the victim. For treating a muscle sprain, you will need ice, plastic bag, towel, compression bandage, pillows and over-the-counter painkillers. You may also need certain devices to assist you, depending upon the area that has been affected. These devices include crutches, slings, braces and wheelchairs. These devices help in stabilising the affected area (especially the muscle there.)

RICE Method
As per the data by American Academy of Orthopaedic Surgeons (AAOS), the most effective way to treat muscle sprains is by following the Rice method. The word rice stands for- rest, ice, compression, and elevation. The patient must take adequate amount of rest and not undertake physical activities. He or she must give proper time for healing of the injury or wound, prior to resuming back regular activities. If the sprain is chronic, take total bed rest. It is often advised to apply ice compression to the affected area for about 8 to 10 times a day. Try to compress your muscle by putting mild pressure to avoid swelling or any kind of inflammation. For this, it is best to tie up a bandage around the affected part. It is generally advised to elevate the injured part above the heart to avoid or reduce the swelling of the area. Sometimes, physical therapy is also needed to treat the sprains.

Risks of strain treatment
There are certain risk factors associated with muscle strain treatment. It is bad to take too many painkillers as they can affect other organs like kidneys, gut and heart. You should also avoid applying the ice pack directly on the skin for a prolonged period. Also, if you undertake a surgery to fix muscle strain, you are at the risk of suffering bleeding, developing blood clots, infection, pain and stiffness.

Muscle Sprain - How It Can Be Treated?

From marathon runners to footballers, amongst athletes, 'pulling a hamstring' is the most common type of injury. The hamstring is a group of four muscles at the back of your thigh. When one of these muscles gets overloaded or begins to tear, it is known as a hamstring injury. While a hamstring injury is painful, it does not indicate the end of an athlete's career.

Minor hamstring injuries may heal by themselves. In cases where one of the muscles is torn, surgery is required to repair and reattach the muscles. Recovery time depends on the severity of the injury. Stretching and exercising the muscles of the leg are the most important parts of rehabilitation. The healing of a hamstring injury can be divided into four stages.

1. Acute phase: The first five days after a hamstring injury is known as the acute phase of rehabilitation. The aim of treatment at this phase is to reduce inflammation and keep the other muscles from atrophy. For minor hamstring injuries resting the leg, using ice packs and keeping the leg elevated can accelerate the healing process. Once the pain and swelling has decreased, patients can use a cane or crutch to exercise the leg.

2. Subacute phase: From the fifth day to the 3rd week after the injury, the focus of the treatment shifts from minimizing swelling to strengthening the leg and increasing the range of possible motions. At this time, an athlete can resume cardiovascular training. Swimming and other forms of aquatic training are said to be especially beneficial to the treatment of hamstring injuries.

3. Remodeling phase: The remodeling phase continues upto 6 weeks after the injury. Strengthening the leg is the focus of this stage of treatment. Using ankle weights can be beneficial towards strengthening the leg muscles. It is important to be careful about the weight being used and to gradually increase this weight to avoid an added injury.

4. Functional stage: This stage can last upto 6 months until the athlete can regain full function of his or her leg. As the athlete's gait gets back to normal, they may start jogging and short sprints. Gradually, more sport specific exercises may be added to the workout.

There is no fixed time when an athlete can return to active sports after a hamstring injury. While players with minor injuries may return to the field after 3 weeks, athletes with muscles tears may take upto 6 months to recover completely. Hamstring injuries tend to reoccur and hence before they can get back to active sports, an athlete must pass an isometric strength test and flexibility test. This ensures that there are no subtle after effects of the injury that can increase the risk of a repeat injury.

Hamstring Injury Recovery and Return to Sports

Bone Fractures: Causes and Symptoms

'Fracture' is a medical term for a broken bone. According to an estimate, an average person has two fractures within their lifetime. When a force exerted is stronger than the bone itself, it can lead to a fracture. The risk and chance of fracture depend on your age. With age, bones tend to become brittle and, hence, a fall that would have been potentially harmless years ago can lead to a broken bone at a later age.

There are many types of bone fractures, but the main types are:

Closed fracture: A fracture in which the bone breaks but does not tear through the skin

Open fracture: Where the broken bone punctures through the skin and protrudes out. There's a greater chance of bone infection in an open fracture

Displaced fracture: In this type of fracture the bone snaps into more than two parts

Nondisplaced fracture: The bone cracks partly or wholly but it does continue to move

Some of the common signs and symptoms of a fracture are:

- Bruising and swelling of the bones
- Open fractures marked by protruding bones from the skin
- Loss of locomotive and functional ability of the injured area
- Deformity of the injured area
- Pain in the event of movement of the injured area

A fracture can be caused by a number of reasons, and they are:

- Injuries and accidents
- Falls and slips
- Wear and tear through overuse
- Sport injuries
- Fist fights and brawls
- Osteoporosis (a disease which causes bones to weaken in adults)
- Osteomalacia ( a disease caused due to softening of your bones, which is caused by a vitamin D deficiency.) Soft bones are more likely to bow and fracture than are harder, healthy bones.

Note:

Osteomalacia is not the same as osteoporosis. Osteomalacia occurs due to a defect in the bone-building process while osteoporosis develops due to a weakening of existing bones.



Bone Fractures: Causes and Symptoms

When the median nerve that runs through the palm and forearm is twisted or squeezed, a condition called the Carpal tunnel syndrome (CTS) occurs. This carpal tunnel is a passage that is narrow and is present in the ligaments and tendons. This nerve is responsible for offering a feeling sensation to the palm, index finger, thumb, and the middle finger. A part of the ring finger too shares the same. The median nerve is compressed when the tendons are irritated. This leads to pain in the forearm and arm, palm, and wrist. Additionally, this condition can cause numbness and weakness.

How it begins? 

This condition does not occur suddenly but gradually. In the initial stage, the sufferer experiences burning, itching, and numbness in the palm. The thumb, index and the middle finger feel these symptoms. The affected individuals may notice that the hands are swollen and rendered useless. You may feel pain and numbness in one or both the hands during sleep. Slowly, the numbness and pain keeps increasing and can be felt during the day. This is why you may want to shake off hands multiple times.

Factors responsible for this condition: 

Various factors can trigger Carpal tunnel syndrome. If you have had any injury to the wrist in the past that caused swelling, you may suffer from this syndrome. For instance, a sprain or fracture can trigger a Carpal tunnel syndrome. A thyroid gland that is overactive or underactive, arthritis, and overactive pituitary gland, too, can cause this condition. If your occupation involves an excessive movement of the wrists or if your lifestyle involves excessive work stress and the use of vibrating tools, then also this syndrome may affect you. Compression of the median nerve or narrowing of the space for the median nerve are the two other reasons. Fluid retention during menopause or pregnancy can also result in Carpal tunnel syndrome.

Will you be at risk?

Women are more likely to suffer from this condition as compared to men because the carpal tunnel is smaller in the former group. The symptoms are first seen in the dominant hand. The high-risk group includes diabetics and people who suffer from other metabolic disorders. People who are working with industries that deal with manufacturing, cleaning, assembly, sewing, or poultry or fish packing mostly face this disorder.

What can you do?

Surgical and non-surgical treatment methods are available for Carpal tunnel syndrome. When you are diagnosed with Carpal tunnel syndrome, undergo the treatment as advised by the doctor. Wear a splint at nights. During days, when you see swelling or redness of the palm, apply cooling packs. Take breaks from work, if it involves pressurizing the median nerve or if there is any narrowing of the space. Chiropractic therapies, acupuncture, and yoga are known to offer relief as well.

Prevention techniques: 

To prevent Carpal tunnel syndrome, always ensure you stay in the right posture. Use a fingerless glove as this keeps the wrist and palm warm. Take frequent breaks from the task that you are performing, especially the ones that require too much of the wrist movement. Job demands should be considered, however, rotating tasks with colleagues can provide an excellent relief. If your doctor feels that surgery is the only option left to provide relief, then you need to go for the same. With the two options of open release surgery or endoscopic surgery, you can expect symptoms to be relieved as soon as the procedure is conducted. 

Things You Need To Know About Carpal Tunnel Syndrome! 

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