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

Damaged hips can cause great distress in carrying out daily activities, such as walking, getting dressed and many more. If you have damaged one or both of your hips, and it causes you great pain, you may require a hip replacement. It is a common form of surgery in which a damaged hip joint gets replaced with an artificial one. This is known as prosthesis.

Conditions which lead to hip replacement

Osteoporosis where the cartilage inside a hip joint gets worn out, and the bones rub with each other as a result
Rheumatoid arthritis, which is caused when the immune system attacks the hip joint lining by mistake
If the hip joint gets damaged severely during an accident or fall
The purpose of a replaced hip joint is to provide pain relief, improve the hip s function, improve your ability to carry out day-to-day activities and improve your overall quality of life.

Procedure
A hip replacement is usually carried out under general anesthesia. An incision is made in the hip by the surgeon and the damaged hip joint is removed through it. It is replaced with an artificial metal alloy or a ceramic joint. The surgery takes approximately 60 to 90 minutes for completion.

Recovery
After the surgery, a walking aid such as crutches is required for up to four to six weeks. You may enroll for an exercise program, which aims at regaining and improving the new hip joint functions. Regular activities can be restored within two to three months. A year is required for utilizing the new hip joint normally.

Risks of hip replacement
There may be several complications as a result of a hip replacement. They include:

Dislocation of the hips
Infection at the surgery wound
Injury to nerves and blood vessels
Difference between the lengths of two legs
Fractures
Alternative
Hip replacement surgery has an alternative type of surgery, which is called hip resurfacing. During this surgery, the damaged surfaces of the bones within the hip joint are removed and replaced with a metal surface. Less bone is removed in this surgery. However, the metal surface may cause complications and health hazards.

Hip replacement is being improved upon with the advent of technology. Stronger and newer materials are being developed for prosthetics, which will allow enhanced joint mobility and a longer wear. New cement-less implants are also being developed. Also surgery assisted by computer is being used for generating an image of the hip joint.

 Hip Replacement - An Overview!

Endoscopy refers to inserting microscopic cameras into the body through tiny incisions which throw up pictures of the inside of the body onto a screen. Endoscopy has been used for diagnostic purposes since the 1970s. Endoscopy for surgery has become popular from the 1990s.

Endoscopic spine surgery is a state-of-the-art surgery technique which involves micro incisions and minute tubes that cause almost no damage to surrounding tissues and muscles. It is a minimally invasive surgery and it is also called a pinhole surgery.

What are the advantages of endoscopic pinhole spine surgery?

There are a lot of reasons why doctors opt for an endoscopic surgery-

  It is also called Minimally Invasive Spine Surgery (MISS) because it causes little blood loss
  Recovery is almost immediate. A person can resume everyday activities within a week
  Very little pain around the surgery region so minimum pain medication is needed.
  No muscle or bone is removed.
  Since screws and rods are not used, full mobility of the spine can be restored
  The wounds are minute and do not usually require stitches and thus no ugly scars are left after the wounds heal.

What are the characteristics of an endoscopic spine surgery?

  The surgery is performed under local anaesthesia
  The person is discharged within 24 hours of the surgery
  The incisions that are made are microscopic

What are the different types of endoscopic surgery?

Endoscopic discectomy:
It is the least invasive of all spinal surgeries. It is used for treating herniated discs. Endoscopy reveals images of the spine. Through the same tunnel, surgery tools are inserted and the bulging or herniated disc is pulled out with a grasper. The wound does not always require stitches to close it.

Endoscopic Laminotomy:
This a substitute for open laminotomy. The camera helps locate exactly where the target area is. Then an incision is made below and above the lamina to relieve the pressure compressing the nerve.

Endoscopic facet rhizotomy:
With microscopic cameras, the nerves causing pain are identified and then the laser is used to numb these nerves which relieve pain. This type of surgery can also remedy a previously botched spinal surgery, facet joint arthritis or facet joint pain

Endoscopic foraminotomy:
This type of surgery again uses microscopic surgical tools guided by a tiny camera to enlarge a narrowed neuro of spinal nerve root canal to give it more room to move about without being compressed.

Endoscopic Spine Surgery & Pinhole Technique!

Shin splints' is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.


Causes
When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.


Some other causes of shin splints are 
1. Muscle imbalance in the glutes or the thighs
2. Anatomical deformity such as flat foot
3. Not using proper form during training
4. Lack of flexibility
5. If you wear improper shoes during workouts, then it may lead to shin problems
6. Running downhill may lead to excessive stress on the shin leading to shin splints


Symptoms
The symptoms of shin splints are: 
1. You may experience swelling in the lower leg
2. A dull pain in the front portion of the leg
3. Tenderness around the shin area
4. Numbness around the shin area
5. Inflammation in the shin area
6. You may experience severe pain while walking


Treatment
The basic treatment for shin splints is the rice (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition.

Causes and Symptoms of Shin Splints

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

There are many changes that take place in our face and body as we start ageing. While the face starts to show the signs of ageing earliest-in the form of wrinkles and fine lines as well as a sagging chin and neck, the effect of ageing on the body might be slightly late. The skin may sag or you may end up putting on weight in various parts of the body like upper arms, which may look unsightly and bring down your level of confidence as well. Signs of ageing can often make you shy away from living your life to the fullest. 

For the sagging upper arms, one can always get a procedure called an Arm lift. This is also called a Brachioplasty. This is a cosmetic procedure that can be conducted to tighten the skin of the arms from the elbow upwards. Let s see how this procedure works.

What does it do?

Excess fat tends to accumulate in both arms togather with weight gain. Person face laxity in this area after massive weight loss or with body ageing.
Arm Lift is a surgical procedure to tighten the skin in the arms through the removal of excess fat deposits as well as skin.
Who can opt for this surgery?

Any person who is medically fit having arm disfigurement can opt for this procedure. Patients who have signs of ageing or excessive weight gain are the best candidates for this kind of surgery. Also, it may be used by the patients who are suffering from sagging skin after losing a great deal of weight which may lead to an appearance of bat s wings on the sides.

How is this procedure conducted?

This surgical procedure is conducted by a Cosmetic Plastic Surgeon. It s a day-care procedure. The doctor begins by marking the various areas of concern having excess fat and flabby skin. Thereafter, the doctor proceeds to remove the excess skin so that the arms are tightened getting more youthful look. This is done under anaesthesia to make patient pain-free. The skin that is removed is usually shaped like an ellipse. In many cases, there may be a need to conduct a liposuction if the patient has excess fat as well. Once the excess skin has been removed, skin edges are approximated with meticulous sutures with various Plastic Surgery techniques.

Recovery usually takes 5-7 days. Person can resume routine activities from very next day. Sometimes you might be advised a pressure garment for better outcome.

Upper Arm Lift - What It Can Do?

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