Mobility for a person is very important, and when you look through, the hip is a very important component to this. It connects the upper and lower parts of the body and helps in movement. It is a ball and socket joint, where the hip bone provides a socket, into which the upper part of the thighbone (femur) sits into, allowing for free movement.

Like any other human organ, the hip also is prone to damage. Be it natural ageing, infection, injury, or diseases, hip movement can be affected, leading to limited movement and increased pain and stiffness. For these people, being able to get back a hip which will allow them to be back on their feet is a boon for sure. It helps in relieving pain and improving mobility, almost giving people a second lease of life.

Reasons for hip replacement:

With natural ageing, the hip joint can lose its ability to move, due to normal wear and tear of the hip and thigh bones
Diseases of the hips (infectious or autoimmune) can also lead to hip replacement
Injury or trauma is another major cause that requires hip replacement
Joint problems, leading to repeated dislocations
Tumours of the relevant bones
Understanding the procedure in detail

The affected bones (whether diseases or worn out) are replaced with a prosthesis which is compatible with the normal body tissue.
While some materials fuse to the natural bone, others do not and are simply placed as a separate unit
This is a surgery which requires hospitalisation and stays for up to 5 days depending on patient s overall health condition
The entire procedure may take a couple of hours and is usually done under general anaesthesia
An incision is made through the side of the hip
Both the hip and the thigh joints are prepared, diseased tissue removed, re-shaped, etc. to make way for the prosthesis
The prosthesis is introduced through the same incision and positioned into place
As noted earlier, there are two types. The ones which fuse to the bone have pores in them into which normal bone eventually grows.
The other variety is the cemented version, and a glue is used to keep it in place
Most doctors now use a combination, that is cement a porous prosthesis, into which bone will grow, and the incisions are closed
The patient stays in the hospital for 1 to 4 days depending on overall health
Once discharged, infection and pain control are continued
Exercise and physiotherapy play a major role in restoring normal function
Weight management is also very important

Hip Replacement - Understanding The Procedure In Detail!

Ayurveda is something which is very potent and its efficacy has been proven over the years. Arthritis is painful and has the ability to make a person feel pretty much like his or her hands are tied! However, while not much can be done to liberate a person to his or her pre-arthritis level of ease, the issue can be controlled and Ayurveda can really work wonders!

When you prefer an Ayurvedic treatment to help a person who is suffering from arthritis to experience lesser pain in his or her daily life, it is important to correct anything which may be wrong with digestion. This is because digestion, which is not optimal, leads to a situation of a build-up of ama, which is a lethal side effect of low-quality digestion.

It is believed that correcting a person s food intake will reduce the amount of ama one has in their body and as a result of the same, reduce the inflammation and the consequent pain which a patient of arthritis has to put up with on a daily basis.
If a person does not suffer from other lifestyle issues such as diabetes, making the effort to fast in accordance with the guidelines which have been set out as per the Ayurveda knowledge bank can have great benefits for the problems faced due to having arthritis.
The Magic of Ayurveda!

There is a herb known as Guggul, which is quite helpful, especially if a person is diligent about its consumption. This would mean that it be taken by him or her twice a day, along with some warm water. The dosages are small and usually range between 1 to 3 gms.
Ayurveda is a symbol of natural solutions to the health problems of people. As a result, it is only reasonable to expect a lot of the field to be centred on lifestyle habits and more so around food, as it is true, in this case at least, that we are what we eat.
In order to ease the pains of arthritis, it is very important to avoid oily food items and prefer a fruit diet such as apples, papayas and oranges. Tea, coffee and alcohol consumption should be kept to a bare minimum.
Arthritis is something which is frustrating, for sure. But, as long as a person is taking steps in the right direction, the issue will be a lot easier to deal with!

Ayurvedic Management For Arthritis!

If you are an avid runner, then you might also be well aware of the type of running injuries one is prone to. It might be foolish to say that running injuries can be prevented. It is because these injuries do happen quite often. Though these cannot be prevented, these can definitely be treated. Furthermore, precautions from your side can always be taken to make sure that these injuries do not cause a major impact on your health and can be cured without much of a hassle. Here are some important points that you need to remember to avoid running injuries or to lessen their adverse impact on your body.


Flexible Body: Flexibility is an important part of a runner s body. You not only need to have the stamina to run, but also must possess flexible features to get you out swiftly from any serious damage. Flexibility is attained when you do regular exercises and stretching in particular. It makes your muscles resilient towards many injuries and provides your body a better shape and long lasting stamina as well.
Strengthen Your Body: Body strength is required if you want to avoid any sports injuries. Special strength training sessions are organised with the coaches of sportspersons. These sessions help in building up muscle strength. This would, in turn, lessen muscle fatigue and make you able enough to perform better.
Balanced Diet: It does not matter whether you are an athletic or not, a balanced diet is needed for everyone. Balanced diet does not mean picking and choosing of food. It means a proper diet chart, mapping everything that your body needs to stay fit. Furthermore, it should contain ample amount of water to keep you hydrated.
Take Rest When Required: It is often said by the elders that too much of work would ruin your health and body. Thus, even for the athletes, it is important to take rest in between periods of heavy training sessions. This would give you a chance to relax your body and relieve you of all the stress. Furthermore, if you are injured or hurt, it would give you ample time to recover from your injuries.
Wear Proper Shoes: As a runner, you need to take care of all parts of your body. This would also include your legs. To prevent any sprains or muscle injury in the leg and to practice for long hours, proper running shoes are needed.  


How To Avoid Running Injuries?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Rheumatoid arthritis is an auto-immune chronic disorder that might cause abnormal swelling in the joints when the joint tissues are attacked by the human immune system. The more frequently used body joints, such as the knees, fingers, shoulders, wrists, elbows and hips commonly get affected by the disease. Rheumatoid arthritis can also occur in the ligaments or tendons and might affect areas such as the kidney, bone marrow, eyes, lungs, and heart.

If rheumatoid arthritis is not diagnosed on time, it might lead to future complications, such as blood cancer in the lymph regions, osteoporosis (a medical condition resulting in the weakness of the bones), infections, stiffening of the arteries and dry mouth.

What exactly causes the disease is not known, but a significant damage to the immune system might cause the inflammation of the joints, resulting in this condition. Obesity, a family history of this condition and other lifestyle habits such as smoking tobacco put one at higher risks of this disorder.

The symptoms of rheumatoid arthritis might vary among people. The most common symptoms of rheumatoid arthritis are;
1. Severe pain in the morning
2. Episodes of mild fever with severe pain
3. Redness and inflammation of the joints which might cause intense pain
4. Stiffness in the joints
5. The pain might increase in low-temperature conditions
6. Acute lethargy and weight loss

Treatments
The treatment of rheumatoid arthritis includes a prescribed dosage (depending on the intensity of the condition) of non-steroidal anti-inflammatory drugs such as ibuprofen, anti-rheumatoid drugs such as methotrexate and steroid drugs such as prednisone to reduce the swelling and the subsequent pain. Performing regular exercises in order to retain the flexibility of the joints with appropriate consultation from the physiotherapist might cure rheumatoid arthritis. 

Persistent Stiffness in Joints - Can it be a Sign of Rheumatoid Arthritis

The pain which a person experiences as a result of having a herniated disc can be quite debilitating, to tell you the truth. However, taking into due account the fact that all a person in such a situation would want would be to be up and running as soon as possible.

In order for this to happen, as would be expected, he or she would need to go through the options which are available for treatment of a herniated disc. There are various types of herniated disc treatments which are available though it can be said that conservative treatments are preferred as these treatments do not require surgery to be carried out on the person who is suffering from the issue.

The course of this sort of treatment lasts somewhere between one month to one and a half months. The aim of conservative treatment is to reduce or minimise the pain that is automatically associated with a herniated disc. There is a strategy to help a person improve by which he or she is provided with medicine for the purpose of pain relief while physiotherapy is made use of to make the underlying condition better.

Surgical treatment may be required, if the case is such that the person has lost a great degree of function and is in pain that seems to be pretty much unbearable. `If the person has a lumbar herniated disc, then the conservative treatment for this sort of case would require him or her to apply ice and heat from a warm source to provide relief to the area. If the pain is very bad yet the person is determined not to undergo surgery then the answer would be to consume some oral steroids or narcotic pain medications. One should surely keep in mind that this is only to carried out as per the prescription of a doctor who is trained and experienced to a sufficient degree.

If surgery is required for this sort of herniated disc, then it is likely to be a lumbar decompression surgery which aims to allow for the growth of the spine back to health as a result of removing the herniated disc. When it comes to cervical herniated disc treatment, conservative solutions include using drugs like ibuprofen and physical therapy; similar to solving lumbar herniated discs. However, surgical treatment for cervical herniated discs warrants anterior cervical decompression; where the disc is removed from the front of the neck.

 What Therapy Is Best For Herniated Disc?

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