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

A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.
Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.


Time Duration of a Therapy Session:
While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.


Physiotherapy in a Hospital:
If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.


Physiotherapy at Home:
Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.


In the Clinic:
Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. 




How Long Do You Need Physiotherapy Post-Fractures?

The human spine has 33 vertebrae. However, some conditions can fuse these vertebrae. Ankylosing Spondylitis is one such condition. This disease may also be known as AS or Bechterew's disease. It is an inflammatory disease that can make the spine less flexible by fusing the vertebrae of the lower back together. In some cases, it can also affect the rib cage and make it difficult to breathe. This disease typically affects more men as compared to women. Most patients begin showing symptoms in early adulthood.

Ankylosing Spondylitis affects the sacroiliac joints. These joints are located just above the tailbone. It causes inflammation of the spinal bones that in turn cause pain and stiffness. With time, this inflammation spreads to the entire spine and the vertebrae begin fusing together. This can make movement difficult and painful. In severe cases, it can also lead to the development of a hunchback. This disease also affects the other tissues of the body. For example, it can affect other joints and aggravate arthritis or affect organs such as the kidney, heart, lungs, and eyes.

A specific cause has not yet been identified for Ankylosing Spondylitis. However, studies show that genetic factors can be a trigger. In particular, the presence of the HLA-B27 gene increases a person s risk of developing symptoms pertaining to this condition. However, it is important to note that merely the presence of this gene does not make Ankylosing Spondylitis inevitable. Other genes that are associated with this disease are ARTS1 and IL23R. These genes influence the functioning of the immune system. While it can affect people of all ages, adults are at a higher risk of suffering from this condition.

In many cases, the initial inflammation of the spine is due to a bacterial infection of microbial infection. Though the infection itself may be treated and cured, it may cause the immune system to react and trigger inflammation. Once activated, if the immune system cannot be turned off, this inflammation will continue and can trigger Ankylosing Spondylitis. In each case, the disease presents a unique pattern of progression.

There is presently no cure for this condition, but with an early diagnosis and treatment, the symptoms can be managed and progression can be slowed. This treatment usually takes the form of medication to relieve pain, inflammation and discomfort and physical therapy. Surgery cannot be used to treat Ankylosing Spondylitis but in cases where it has caused severe joint damage, surgery may be advised to replace the damaged joint.

Ankylosing Spondylitis - What Are The Causes?

A set of cartilage discs present between the vertebrae, ensures that the spinal column can withstand the weight of the upper body. If these discs tear or get injured, the condition is commonly known as slipped disc. In medical terms the same condition is known as prolapsed intervertebral disc. Here is a look at the causes, symptoms and treatment for this painful condition.

Causes for Prolapsed Disc
Intervertebral cartilage discs undergo normal wear and tear with age. However, there are other underlying causes for a slipped disc.

Sitting for prolonged period of time may lead to the disorder
Repeatedly lifting weight in such a manner that all the pressure is exerted on the vertebrae may also lead to a prolapsed intervertebral disc. Example   Exercising with incorrect posture
Alcohol consumption and smoking
Sedentary lifestyle and lack of exercise
Accidental trauma to the spinal region
Diet not consisting of all the essential nutrition
Family history of the same condition
Tweaking one s lifestyle is generally enough to ensure that people are not affected by the condition.

Symptoms of prolapsed intervertebral disc

Patients claim to feel pain radiating from their spinal region to the calves of their feet. This sciatic nerve may get compressed due to the disorder, leading to such a pain.
Tingling sensation in the lower and upper back regions. This sensation may also spread to the arms and legs.
Patients complain of a weakness or numbness in the buttock area, feet and legs.
Treatment for prolapsed intervertebral disc

Limited activity is advised after diagnosis, but complete bed rest is not recommended.
Ice packs should be applied at first. After the pain resides, heat should be applied on the region.
Physical therapy and certain exercises are prescribed by the physician
Anti inflammatory drugs can help control the condition and relieve some of the pain.
Surgery is considered only if the condition does not subside after 4-6 weeks. However, such a surgery is risky and may cause permanent nerve damage.
If you feel that you are at risk of prolapsed intervertebral disc, consult a physician immediately. Follow the recommendations of the doctor, so that you do not have to go through the pain associated with the condition.

Prolapsed Disc - What Causes It?

Paralysis means the loss of normal muscle function in a part of the body. It can occur to any part of the body such as just the legs, just the arms, or complete lower or upper body paralysis. The signals from the brain to that part of the body will stop, as a result of which, the person will not be able to move that part of the body. There will be a complete loss of sensation in that body part, the person will not be able to feel any pain or anything else.

Types of Paralysis:
Based on which part of the body is affected by paralysis, you can classify paralysis into four types:

When just one limb is paralyzed, it is called MONOPLEGIA.
When one side of the body is paralyzed, such as a leg and an arm, then it is called HEMIPLEGIA.
When the lower part of the body is paralyzed, then it is called PARAPLEGIA.
When both your legs and arms are paralyzed, it is called QUADRIPLEGIA.
How is Paralysis caused?
Our sensation and movement are controlled by the peripheral nervous system and the central nervous system. So, when there is any disruption in the communication between the brain and the muscles, muscle movement and control will be affected. In the long term, this will cause weakness in the muscles and finally, end with paralysis.

How does physiotherapy help with paralysis?
Basically, there is one important thing that you need to know about paralysis and that is there is no treatment available for paralysis. But physiotherapy offers a ray of hope. It may not help in treating this problem totally, but the person with paralysis will be able to get independent and more mobile.

The first thing you need to do is, you should start the physiotherapy treatment as soon as a person is affected with paralysis. You should not waste a lot of time. Early treatment can offer better results.
The main objective of physiotherapy for any patient is to make them as mobile as possible.
When you are undergoing physiotherapy treatment for paralysis, it will stop the progress of the paralysis.
If the paralysis is due to an external injury to your brain, then you will be highly benefited by physiotherapy. The physiotherapist will start working on the external swelling and also on the muscles that are not affected by the trauma. This will result in making a paralyzed person more mobile.
Physiotherapy is always considered as one of the best treatments for many health conditions. Many experts recommend physiotherapy for paralysis.

How Does Physiotherapy Help In Paralysis?

Physiotherapy can greatly help a patient of paralysis by making him/her independent to the maximum extent. Physiotherapy also plays an important role in negating potential complications after a paralysis. Although the process of rehabilitation can take time, it produces significantly encouraging result for a patient to continue with it until full recovery. The recovery depends on the type of paralysis a person has undergone. Notably, there are four types of paralysis:

Hemiplegia

Quadriplegia

Paraplegia

Monoplegia

Role of Physiotherapy-

The process of physiotherapy should resume as soon as the patient is stabilized. It not only helps in relaxing muscles, but also helps in smooth blood circulation. Long-term therapy can ensure muscle tone and overall well-being of an individual.

In the case of an external injury related to the brain, physiotherapy can speed up the recovery and reduce swelling to a significant extent. Some of the benefits are-

Physiotherapy can help a person regain the highest possible mobility.

Physiotherapy can increase the respiratory function of a person.

It helps the person in bringing down blood pressure and contracture.

A physiotherapist also focuses on unaffected area and works on them to ensure that the unaffected part of the body, in no way, loses mobility and retains the natural strength.

Physiotherapy also helps to manage a paralyzed bladder.

A physiotherapist suggests proper wheelchair, splint, braces, orthosis etc. These help a person to reintegrate quickly after the paralysis.

Physiotherapy lifts the morale and motivation of a patient by addressing post-traumatic experiences such as denial, anxiety, hostility, depression and anger.

It also serves as a perfect guide for the family of the patient.

Exercises that a Physiotherapist Suggests-

Aerobic Exercise: This is a set of physical exercises that lets the muscle tissues exchange oxygen at a rapid rate. The goal is to enhance the function of the motor neuron and the aerobic capacity of a patient. Support straps and gain belts might be required for a patient to stand on feet. A handrail helps to walk during this phase.

Physical Conditioning: Balance, stability, and coordination is the motive of any physical program for a paralyzed individual. Passive or active motion exercises help an individual to regain function of the limbs. Passive exercise also helps to regain strength. A physiotherapist rotates the thumb of a patient in such a way that the back of his hand faces forward.

Leg Rotations: One common exercise that is tried by a physiotherapist is to make the patient lie down on a mat with his/her legs straightened. Supporting the knee joint and the ankle, the right leg is moved outward and pulled backward. This is again repeated with the other leg.

Physiotherapy For Paralysis

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