Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area. 

Causes of Hip and Knee Pain 

Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include: 

  Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis. 

  Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain. 

  Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area. 

  Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury. 

  Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces. 

Knee Replacement Procedure 

  Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone. 

  Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone. 

  Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition. 

  Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components. 

Hip Replacement Procedure 

  Metal stem replaces the damaged femoral head and positioned into the femur s hollow center. 

  On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head. 

  The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place. 

  A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface. 

Take Away 

Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.

Primary Knee & Hip Replacement - Know More About Them!

Radiology is a special branch of medical science that uses various techniques of imaging for the diagnosis and the treatment of several types of diseases in the body. The different types of imaging techniques used in radiology are X-rays, Computerised Tomographic scan (CT Scan), ultrasound, Magnetic Resonance Imaging (MRI) and nuclear medicine which includes Positron Emission Tomography(PET).

Role played in evaluating hip replacement
Hip replacement surgeries have become extremely common in the recent times, and radiological evaluation remains the mainstay of the overall hip replacement procedure. Thus, the role played by radiology is quite significant in such situations. All the specific anatomical landmarks and the measurements are used to make sure the placement is perfect during the hip replacement surgery. Radiological imaging helps in the assessment of the following conditions that are as discussed below.

The length of leg
The inequality in the length of the two legs is prevalent after a hip replacement surgery which can create a great deal of discomfort and inconvenience to the patients. A greater difference in the length of the two legs increases the chances of dislocation, and this is a situation where radiological evaluation plays a crucial role. With the help of radiological imaging, the length of the legs can be made almost equal.

The horizontal center of rotation
In this case, horizontal center of rotation helps in the assessment of the acetabular component of the prosthesis. This is calculated by the measurement of the distance between the center of the head of the femur and the acetabular teardrop. This distance should be bilaterally equal, and it is just not possible without the help of the imaging techniques of radiology.

Acetabular inclination
The acetabular inclination is the angle formed between the face of the cup and the transverse axis. If the angle is less, then it results in a stable hip, but the abduction is limited. On the other hand, if the angle increases then there are high chances of dislocation of the hip. Thus, with the help of radiological evaluation, proper and effective angular inclination is given which is optimum for the patient.

The stem positioning of the femur
The main aim of the stem positioning of the femur in a hip replacement surgery is placing the stem in a position which is neutral within the shaft. To get a proper idea of the positioning, the imaging techniques are of utmost importance which cannot be achieved perfectly without the imaging.

Thus, the crucial role the different techniques of radiological imaging plays during the overall procedure of a hip replacement surgery can be perceived. With the use of the different imaging techniques, the results obtained are closer to perfection.

How Radiological Evaluation Can Help In Case Of Hip Replacement?

If you have been facing back problems in the form of pain and discomfort for a long time despite undergoing treatment and medications, then you must be wondering whether you should go for a spine surgery. With the advancement in technology in the field of medical surgery, spine surgery has gained popularity owing to its effectiveness and high success rate. However, there are plenty of misconceptions regarding spine surgery, which need to be busted so that people do not make decisions based on these false beliefs.

Here are five myths about spine surgery debunked-

  Myth: Surgery is a must if you have damaged discs.
Fact: Many people live with a herniated disc. It is a fairly common spinal condition. The common belief is that you need to undergo a surgery to fix the problem. However, it is not true. In fact, many people have found relief from back pain following non-surgical methods such as physiotherapy and low-key exercises. These are the initial course of the treatment and usually, the patient sees positive results after the completion of the course.

  Myth: Surgery can relieve you from back pain completely.
Fact: Spine surgery is meant to correct spinal problems by restoring the functioning of your spine and reducing back pain. However, a surgery cannot relieve you from the pain completely. In other words, it cannot fix the problem entirely. There are certain parameters, which you need to correct on your own. These include maintaining a healthy body weight, living a healthy and active life, eating a balanced diet etc. Nevertheless, if the spine problem/injury is diagnosed early, the chances of a successful spine surgery increase.

  Myth: Spine surgery has serious repercussions, and it is not worth a try.
Fact: Like all other types of surgery, spine surgery too has a few risks or side effects associated with it. The most common types include blood clots, infection, weakness, and bleeding. However, these are not as serious as it sounds like. Since most of the surgeries are minimally invasive today, the minor side effects do not last more than a week and recovery takes place sooner. The side effects can also be managed with pain management medications well so the patient need not worry.

  Myth: Visiting a spine surgeon means you will definitely need a surgery.
Fact: Your orthopaedic may advise you to see a spine surgeon if the symptoms of your spine injury/problem become severe. This does not necessarily mean you will have to undergo a surgery. Sometimes, the doctor may schedule an appointment with the surgeon to have a unique perspective of the condition. Surgery is prescribed only as the last resort.

  Myth: Undergoing a surgery once means you will need another one soon.
Fact: If you have gone under the knife once, it does not necessarily mean you will need another surgery soon. Multiple surgical procedures are required only if the patient has sustained complex trauma to the spine. Such cases are rare. Usually, the patient undergoes spine surgery once, following which he/she is provided with a post-operative guideline. The guideline suggests engaging in mild exercises and making vital lifestyle changes to ensure fast recovery.

If you have been suffering from persistent, recurring pain in the back or neck that has altered or affected your quality of life in a negative way, its time you should consult a doctor. Do not hesitate if you need to undergo e a spine surgery urgently. The facts stated above will help clear your mind and eliminate any false belief that you had been holding in.

Spine Surgery - Busting The Myths Around It!

Joint pain is considered to be one of the first few signs of aging. According to the science of Ayurveda, joint pain is triggered mainly by an accumulation of toxins in the body. These toxins can create an imbalance in the doshas which in turn can cause pain and inflammation on the joints. Along with joint pain, a person is likely to experience a loss of flexibility, weakness, tenderness and enlargement of the joints.

Unlike some popular forms of medication that focus on relieving the pain, Ayurveda addresses the root cause of the issue. Panchkarma aims at cleansing the body of toxins and clearing blockages in the body s digestive and circulatory system. This helps the vatta dosha flow easily through the body and reduces pain associated with arthritis etc. Panchkarma can be defined as a collection of five ayurvedic techniques. These are:

Vasti or Medicated Enema: Vasti aims at removing toxins and waste products from the body through the colon. In doing this, it cleanses the digestive channels and improves circulation of air or the vatta dosha in the body. With better circulation, joint pain is effectively reduced. An enema also nourishes the body and gives it the strength to rebuild tissues while boosting the immune system.
Abhyanga or Full Body Massage: This technique helps I the removal of toxins from deep tissues within the body. It pacifies the vatta and nourishes the body while simultaneously reducing stress and enabling better quality sleep. A full body massage also helps calm the body both physically and mentally.
Potli or Poultice Massage: As the name suggests, a potli involves massaging the body with medicated herbs tied together in a tiny bundle that has been warmed with medicated oils. This potli is then used to massage the entire body. This technique helps relax the muscles of the body and soothes the aggravated vatta dosha. It is very effective when it comes to providing relief from joint pains caused by arthritis, spondylitis, muscle cramps etc.
Pizhichil or Rich Oil Massage: A rich oil massage involves subjecting the body to streams of lukewarm oil that has medicinal properties while simultaneously softly massaging the body. This type of massage helps relieve tension and stress and is a very effective remedy against joint pains. It is highly recommended in the case of rheumatic diseases.
Svedana or Steam Bath: A steam bath helps cleanse the body both physically and mentally by aiding in the removal of toxins through sweat and calming the mind. It also helps soften the muscles and tissues and dilates the channels in the body.

Joint Pain - How Panchkarma Therapies Can Help You?

Physiotherapy plays a pivotal role in helping a person recover after a hip replacement surgery. It brings back the old flexibility and prevents blood clots in the area where the procedure has taken place. After the surgery team gives its green signal, a physiotherapist starts working with a patient for a full recovery. 

Here is a list of some common exercises that a physiotherapist suggests after a hip replacement surgery:

Walking: It is important to use the crutches for a time period of 4-5 weeks post the procedure. Until the surgeon or the physiotherapist advises against using the crutches, it makes sense to use it while walking. It makes sense to retain the normal walking posture by using the crutches rather than limping without it. A physiotherapist reviews the pressure exerted by the arm while holding a crutch, before advising the patient to get rid of the crutches.
Increasing hip flexibility: This is a basic form of exercise where an individual lies on one side of the body with knees and hips bent. A pillow is placed in between the knees. While doing this, it should be ensured that both the feet is kept together and the back muscle is not twisted. The top knee should be slowly raised like an opening of the calm shell. This position should be maintained for 4-5 seconds.
Strengthening the hips: The body should rest on the stomach. The buttocks should be tightened and one leg should be slowly lifted. This position should be maintained for a stretch of 3-5 seconds. The same should be repeated for both the legs.
Strengthening the hip and the stomach muscle: The body should rest on the back with a leg bent. The stomach muscle should be tightened and the bent leg should be lifted carefully while ensuring that the bend does not supersede more than 90 degrees. While keeping the stomach muscle tight, the lifted leg should slowly come down to touch the surface. This act should be repeated for 5-6 times.
Strengthening the thigh muscle: While sitting in a steady chair, an elastic loop should be wrapped around the ankles. The elastic loop should be stretched with one leg while keeping the other foot firmly rooted to the ground. The lifted foot should slowly come down to the normal position. The same act should be repeated for 4-5 times.
Improving balance: An elastic loop should be tied to one leg of a table and the other end of the loop should be tied to one ankle. The table should be held on for maintaining balance. Maintaining an erect position, the tied up ankle should be stretched sideways. The position should be maintained for 3-5 seconds to return back to normal standing position.

How Physiotherapy Can Improve Recovery After Hip Replacement Surgery?

While it may be obvious that no form of pain is welcome, it can be said that pain which is felt on account of being affected by sciatica is especially unwelcome. Taking that into due account, the good news is that physiotherapy can go a long way in helping by improving this sort of pain.

The longest nerve in the whole human body is the sciatic nerve, so it can be expected that when there is trouble with this nerve, the pain would be pretty significant. The leg pain which is caused to a person when this nerve happens to be getting pinched is known as sciatica.

There is a range of treatments when it comes to how something as painful as sciatica is to be solved. Now, while it is true that a solution such as making sure there is an amount of bed rest which is sufficient is very important, to say the very least, it is often the case that the person with sciatica would like his or her recovery to be hastened.

In order to make sure that this is the case, physiotherapy is quite useful. There are various forms of physiotherapy which can be made use of, and the decision as to which sort of physiotherapy a person would be best suited to would obviously be part of the subjective assessment of the person by a practitioner who is well qualified and experienced.

Some of the solutions when it comes to physiotherapy being used in order to treat sciatica are quite innovative, to say the very least. For example, there is physiotherapy instrument mobilisation, which is also known as PIM. What this entails is that a mechanical spring-loaded instrument is used in the process which serves the purpose of mobilising the spinal cord of a person along with his or her peripheral joints.

One form of physiotherapy oriented treatment which is used to address the issue of sciatica is real-time ultrasound physiotherapy. It can be said that this is not close to as cutting edge as physiotherapy instrument mobilisation is but it does serve as a rather dependable and useful way to battle sciatic pain. This form of physiotherapy makes use of ultrasound technology to analyse how the muscles function and then using that as a basis to create a list of physiotherapy exercises to be done by the person who is having sciatica. Rather than medicines, physiotherapy improves sciatica by getting a person to use oneself!

How Can Physiotherapy Help With Sciatica Pain?

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