Devine Health Centere

Knee replacement is a surgery wherein an artificial joint is used to replace a diseased, damaged or worn out knee. This surgery is common among people who fall in the age group of 60-80, but recent trends seem to suggest that younger people are opting for this surgery as well. The lifetime of the artificial knee joint is around 20 years, provided the knee is well cared for.

Why do you need knee replacement?

Most common reason is “high grade osteoarthritis” due to wear and tear of the knee joint. The pre-hospital study of the Knee joint is mandatory and would decide what kind of Replacement is suitable to the patient. If there is diabetes or hypertension associated with this, then it should be controlled well before undergoing surgery. Hemoglobin of at least 10 gm% is required.

If the mobility in your knee joint is reduced leading to impaired functioning of the knee joint, then you might need a knee replacement surgery. You may experience pain while walking, sitting and, in some cases, resting as well.

Some of the common reasons why you may opt for this particular surgery are:

1. Gout, where, small crystals are formed inside the joint.
2. Rheumatoid Arthritis, an autoimmune disorder, wherein the immune system of the body attacks the body’s healthy tissues.
3. Hemophilia, wherein, the blood ceases to clot normally.
4. Injuries to the knee.
5. Disorders that cause unusual bone growth (bone dysplasias).
6. Death of bone in the knee joint following blood supply problems (avascular necrosis).
7. Knee deformity with pain and loss of cartilage.
8. Unusual growth of bones in the knee joint.

Knee replacement surgery is classified into:

1. Partial Knee Replacement: In this surgery, only one part of the joint is replaced.
2. Total Knee Replacement: Total knee replacement surgery involves replacement of both sides of the knee joint.

The usual hospital stay period is around 2-3 days after the surgery is completed. Initially, you will require the help of crutches to walk for at least 2 months. You may also be asked to do gentle knee strengthening exercises. It may take up to 3 months to recover completely from a knee replacement surgery.

Life is constant game of changes and people who can adapt to it and move on generally tend to find their pockets of happiness. From bad finances to lack of love to a near ones loss, each of us constantly face struggles that can leave us drained and depressed. People often work on these external factors to find their happiness. Those who suffer from depression as an illness though find it taking over multiple spheres of their lives disabling them from doing routine tasks with ease. Depression, like other diseases, can also have a biological origin. 

Several theories concerning the biologically based cause of depression have been suggested over the years. Simply put, chemical imbalance in the brain can be a trigger to depression. As the 'command center' of our body, the brain uses a number of chemicals as messengers to communicate with other parts of itself and with the nervous system. These chemical messengers, called neurotransmitters are released and received by the brain's nerve cells called neurons. Neurons are constantly communicating with each other by way of exchanging neurotransmitters. This communication system is essential to all of the brain's functions.

Among the biological causes of depression, the most prominent and widely researched is the monoamine hypothesis. The three main monomine triggers of imbalances that trigger depression are neurotransmitters called serotonin, norepinephrine and dopamine. Serotonin regulates functions like sleep, aggression, eating, sexual behavior, and mood. Similarly, the catecholamine hypothesis suggests that a deficiency of the neurotransmitter norepinephrine (also known as noradrenaline) in certain areas of the brain was responsible for creating depressed mood. Norepinephrine helps our bodies to recognize and respond to stressful situations. 

Dopamine plays in important role in helping each of us seek out our 'high' or 'pleasure' from rewards. Low dopamine levels may in part explain why depressed people don't derive the same sense of pleasure out of activities or people that they did before becoming depressed.

Another leading cause of clinical depression is focused on the endocrine system. The endocrine system is responsible for making hormones and releasing them into the blood to regulate processes like reaction to stress and sexual development. Hormonal irregularities may lead to depressive symptoms like loss of appetite and sleep. It is further observed that those who have particular endocrine disorders sometimes develop depression, and some individuals who are depressed develop endocrine problems despite having healthy glands. 

In a research done among depressed individuals, over half had a hormone called cortisol in excess in their body and abnormal times of secretion. 

Depression can have many triggers and origins and it is important to see the right doctor who can treat the cause, triggers and symptoms in addition to the disease. Depression has a genetic predisposition. Also, the faulty thought pattern alters the physiology by upsetting the hormonal balance. Psychological professional help should be a priority in depression and its role should not be under emphasized.

What is salt and sodium?

Salt is made of sodium (40% by weight) and chloride (60% by weight). Sodium is a crucial electrolyte in the body. Sodium is an essential nutrient necessary for maintenance of plasma volume and blood pressure, acid-base balance, transmission of nerve impulses and normal cell function.

Different types of salt?

• Table salt or common salt
• Sea salt
• Himalayan rock salt (sendha namak and black salt)

The primary advantages of various types of salts other than common salt is having trace minerals (in very small amounts) and lack of processing and additives.

How salt intake normally?

WHO recommends that adults consume less than 5 g (just under a teaspoon) of salt per day. This goes around 2300mg of sodium per day. But, most Indian people consume too much salt - on average 9-12 grams per day.

What are health hazards of high salt intake?

• Hypertension
• Stroke
• Heart disease
• Kidney disease
• Obesity

How high intake of sodium cause kidney disease?

High salt intake is associated with kidney disease by two mechanisms:

Causing hypertension, vascular injury and proteinuria.

FOOD containing high salts?

Fast foods, preserved and packaged foods like:

• Prickles
• Anchovies
• Soups
• Bread products
• Prawns
• Salted and dry-roasted nuts
• Salt fish
• Smoked meat and fish
• Soy sauce
• Stock cubes

Many snack foods - chips, crackers, and pretzels - contain several hundred milligrams of sodium per serving.

Conditions where low salt is beneficial?

Hypertension, Heart Failure, Kidney disease, Nephrotic syndrome, Kidney stones and Patient on diuretics or ACEi or ARB.

How to reduce sodium (salt) intake?

• Not adding salt during the preparation of food
• Not having a salt shaker on the table
• Limiting the consumption of salty snacks
• Choosing products with lower sodium content
• Remove salt from recipes whenever possible
• Use salt substitutes wisely
• Eat more fresh fruits and vegetables and low-fat dairy
• Use onions, garlic, herbs, spices, citrus juices and vinegars in place of some or all of the salt to add flavour
• Drain and rinse canned beans (like chickpeas, kidney beans, etc.) and vegetables
• Combine lower-sodium versions of food with regular versions. This will not differ much in taste. This works especially well for broths, soups and tomato-based pasta sauces.
• Cook pasta, rice and hot cereal without salt
• Cook by grilling, braising, roasting, searing and sautéing to bring out natural flavors. This will reduce the need to add salt
• Incorporate foods with potassium like sweet potatoes, potatoes, greens, tomatoes.