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Dr. Biren Nadkarni - Orthopedist, New Delhi

Dr. Biren Nadkarni

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics

Orthopedist, New Delhi

19 Years Experience  ·  700 at clinic  ·  ₹300 online
Dr. Biren Nadkarni MBBS, MS - Orthopaedics, Fellowship in Joint Replacement ... Orthopedist, New Delhi
19 Years Experience  ·  700 at clinic  ·  ₹300 online
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Causes and treatment of knee pain in youngsters<br/>Causes and treatment of knee pain in youngste...

Causes and treatment of knee pain in youngsters

Hello everybody I am Dr. Biren Nadkarni, consulting orthopedic and joint replacment surgeon attached to Holy Family and Sitaram Bhartia Hospitals in New Delhi. Today I am going to talk about knee pain in young people.

Knee pain is always discussed in context of old people where it is more seen in lines of arthritis, osteoarthritis, or rheumatoid arthritis. But we get a lot of patients who have the problem of knee pain especially in younger age group. I thought I should devote this session to this knee pain in younger age group.

First and foremost problem we see in patients of younger age groups with knee pain is anterior knee pain or patellofemoral knee pain.

What exactly are the causes ? If this is your knee joint (displaying with a model of knee joint) and this is how your knee cap behaves every time on bending, there is a problem when the kneecap tends to rub on one side and you can see a friction happening here. This is a common problem occurring in young ladies and it's called anterior knee pain and more technically chondromalacia patellae.

We normally tell our patients that this is not a precursor of arthritis, it is mainly an inflammatory problem where the under surface of the knee cap gets inflamed and leads to constant pain specially on sitting for long durations. It is in fact called a movie theatre sign because people who sit for 2/3 hours and suddenly want to get up , they feel knee pain and they are not able to straighten their knee.

The problem is normally addressed by physiotherapy. Of course we need to get x-rays and investigations , but what they respond to is good physiotherapy and anti inflammatory medications.


And if the problem we face in younger people are ligament injuries especially anterior cruciate ligament injuries. All adolescent people who have had injuries while playing soccer or any other games or while running and in your country specially bike injuries are a major problem which leads to this problem. These people normally come to us with instability, pain when walking for long distances, swellings in the knee and this causes lot of pain.

Anterior cruciate ligament injuries is normally treated by anterior cruciate ligament reconstruction which is an arthroscopic procedure, and it’s a day care procedure or normally a one day admission procedure and the patient is discharged the next day.

Similar to anterior cruciate ligament injuries, we also have Meniscus injuries. Meniscus are two cushions in the knee joint and they tend to reduce the loads on the joint as the patient puts weight on the joint.

So the blue tissue (displaying from the model) you can see is basically a meniscus, there is one on the inside and one on the outside. This is the medial meniscus and this is the lateral meniscus, and if you have a tear here, it will also cause a lot of pain. Medial and lateral meniscus tear can occur independently or they can occur with other injuries like Anterior cruciate ligament injuries. These injuries are normally treated by arthroscopic evaluation, repairs or meniscectomy and sometimes we require repair also for them,

I would like to ask my viewers if they have any queries , they can see my profile on Lybrate and contact me.
 

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Personal Statement

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Biren Nadkarni
Dr. BirenNadkarni is a consultant orthopaedic and joint replacement surgeon at Joint and Bone solutions which is a center for joint replacement and arthroscopy in HauzKhas , New Delhi. He has overall 14 years of clinical experience. He holds MBBS from Maulana Azad medical college Delhi, MS ? Orthopaedics from University college of medical sciences, M.ch orthopaedics and fellowships in joint replacement from various countries like England, Germany and Austria. He has been awarded SIROTaward , USA-2002. He specializes in Hip and Knee arthritis both surgical and conservative management. He has undertook many knee and shoulder surgeries including revision surgeries. Dr. Biren has also done various traumatic surgeries including plating, open reduction , nailing, keyhole surgery , arthroscopic surgery and reconstruction of the fractures, sports injuries which involves ligament reconstruction, Meniscal injury etc. Knee treatment includes Total Knee replacement, Partial knee replacement, Revision knee replacement, Customized knee replacement, Hipflex knee replacement, Intraarticular injections, osteotomy for correcting malalignment of knee. Hip treatment includes Minimal invasive hip replacement, Partial or bipolar hip replacement, ceramic total hip replacement. Management of open fractures, management of non-union of long bones, deformity correction surgeries are his other interests. Apart from his joint center, Dr. Biren is presently practicing at SitaramBhartia Institute of science and research at Qutab Institutional area New Delhi, Cygnus Orthocare Hospital at safdarjung development area New Delhi and Holy family hospital New Delhi. Consultation fees for Dr. Biren isRs. 800 per visit. Appointment can be booked online through his weblinkhttp://www.drbirennadkarni.com/our-doctor/ . Dr. Biren has given many satisfying treaments and results to his patients and is now recognized all over Delhi NCR.

Info

Education
MBBS - Delhi University - 1999
MS - Orthopaedics - Delhi University - 2002
Fellowship in Joint Replacement - USAIM (University of Seychelles,American Institute of Medicine) - 2010
...more
M.Ch - Orthopaedics - USAIM (University of Seychelles,American Institute of Medicine) - 2013
Languages spoken
English
Hindi
Awards and Recognitions
AO Trauma & Arthroscopy Fellowship (Austria)
Zimmer Joint Replacement Fellowship (Germany)
Diploma SIROT
Professional Memberships
Indian Orthopaedic Association
Delhi Orthopedic Association
Indian Arthroscopy Society

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D-8,LGF Hauz Khas opp Hdfc Bank New Delhi Get Directions
700 at clinic
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Multimodal Pain Relief After Total Knee Replacement

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
Multimodal Pain Relief After Total Knee Replacement

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain.

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

  1. Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

  2. Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

  3. Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

  4. Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

  5. Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

  6. Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery. If you wish to discuss about any specific problem, you can consult an orthopedist.

4483 people found this helpful

Intra-articular Injection in the Knee For Osteoarthritis

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
Intra-articular Injection in the Knee For Osteoarthritis

What are they?

Intra-articular injections or intra-articular corticosteroid injections are steroid medicines that are injected into the joint space directly, for curing and treating painful and inflammatory arthritic joint syndromes. In general, this procedure of treatment is adopted by orthopedic practitioners since steroidal drugs, when administered orally, are hardly of any use for osteoarthritis patients.

Steroids are natural substances which are akin to the hormones in your body. Steroids are mostly taken for reducing inflammation. Apart from inflammation in the bones, intra-articular corticosteroid injections are also administered for alleviating inflammation in the ligaments and tendons in patients suffering from osteoarthritis.

Note that intra-articular corticosteroid injections are prescribed to osteoarthritic patients only if the pain and inflammation do not subside with the use of NSAIDs and analgesics. Corticosteroid injection often provides temporary relief, when other oral medicines have failed to provide comfort to the patient.

Hyaluronic Acid Injections

Another form of intra-articular injection is the one containing intra-articular hyaluronic acid. Hyaluronic acid is a natural fluid that aids in lubricating the joints and allows them to function smoothly. It acts as a shock absorber in your body. However, with osteoarthritis, the hyaluronic acid in the affected joints wears out. Depending on the type of injection, you may get one shot of hyaluronic acid intra-articular injection, or three to five injections spaced a week apart.

The Process

The process of administering such injections needs the doctor to first clean the area. In case of swelling, local painkillers can be injected. Next, the doctor inserts a needle to withdraw the excess fluid that’s within the knee joint and then with the same needle in place, the doctor finally injects the medication into the knee joint.

The basic side-effects of intra-articular injections include mild pain at the site of the injection along with a small buildup of joint fluid. However, these side-effects are usually never a matter of concern and they get resolved on their own within a span of a few days. If you wish to discuss about any specific problem, you can consult an orthopedist.

4112 people found this helpful

All About Knee Replacement

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
All About Knee Replacement

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. If you wish to discuss about any specific problem, you can consult an orthopedist.

4350 people found this helpful

How To Deal With Fibromyalgia?

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
How To Deal With Fibromyalgia?

Fibromyalgia is a condition characterised by extreme muscle pain that is followed by weakness, fatigue and issue with the state of mind. It is believed that fibromyalgia causes painful sensations by affecting the way your mind forms pain signals.

Indications now and then start after a physical injury, surgery, disease or critical mental anxiety. In different cases, side effects progressively show after some time with no single occasion that triggers it.

Here are some coping methods you can use to help yourself live well with fibromyalgia:

  1. Minimize stress and tension in your life. Stress may play an essential part in activating fibromyalgia side effects and its symptoms. Many individuals with fibromyalgia tend to feel on the edge, anxious, and inactive around the time when the side effects fibromyalgia flare up.

  2. Exclude yourself from unpleasant circumstances. People tend to amplify issues, making them appear to be far more prominent than they are. When you think of something to be a last chance situation, despite the fact that in reality, it is not, your body responds as though you are at risk. Work at treating your feelings as problems come by.

  3. Make worksite adjustments. To continue working full-time, you should stay rationally and physically ready to handle your employment obligations. To keep away from stress and tension, you may need to give additional time during the day to complete your personal needs and sort out your problems. Converse with your manager and work out a timetable that allows you to manage your time.

  4. Coordination. Coordination is important with an unending condition like fibromyalgia. Transparent conversations diminish the problems amongst you and your companion, family, friends and colleagues.

  5. Figure out how to say no. Failing to say no to excessively numerous requests will make you overburdened. That will add to your anxiety level. To help yourself say ‘no’ to a convincing companion, consider the circumstance before you reply and also think about the time you will be saving.

  6. Keep a diary. Writing in a diary consistently can turn into a great channel for analyzing yourself and your situation. A few people can also figure out when their fibromyalgia symptoms started. That can help them see how and when the symptoms began.

  7. Take a hot shower. Take a hot shower, a hot tub bath, or a steam bath. To begin with, it will help you to unwind the muscles that are tense. It will also decrease the pain and make your muscles more flexible and effortless to move.

  8. Exercise frequently. As per physiotherapists, exercising routinely is vital to get rid of fibromyalgia. In light of the pain, delicate muscles, continuous weakness, and stiffness felt by individuals with fibromyalgia, many have turned out to be physically unfit. Hence, all of the above-mentioned treatments are very important in order to stay fit. If you wish to discuss about any specific problem, you can consult a rheumatologist.
4004 people found this helpful

Arthritis - How it Impacts Your Hip Bone?

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
Arthritis - How it Impacts Your Hip Bone?

If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

  1. When the joints have formed improperly.
  2. In case of inherited defects in the cartilage.
  3. When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.

How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

  1. Joint stiffness, especially after waking up in the morning.
  2. Joint stiffness after sitting for a long period.
  3. Swelling, pain, and tenderness in the hip joint.
  4. A crunching feeling or sound of bones rubbing against one another.
  5. The inability to move the hip for carrying out daily activities.

Treatment
The aim of osteoarthritis treatment is to improve the patient’s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

  1. Proper joint care and rest
  2. Using a cane while walking for taking weight off your hip
  3. Losing excessive weight
  4. Non-drug pain relief measures for controlling pain
  5. Regular exercise
  6. Several medicines, including NSAIDS and other prescribed pain medication
  7. Surgery
  8. Alternative therapies

Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell. Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal. If you wish to discuss about any specific problem, you can consult an orthopedist.

4313 people found this helpful

What causes knee pain in youngsters ?

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
Play video

Causes and treatment of knee pain in youngsters

Hello everybody I am Dr. Biren Nadkarni, consulting orthopedic and joint replacment surgeon attached to Holy Family and Sitaram Bhartia Hospitals in New Delhi. Today I am going to talk about knee pain in young people.

Knee pain is always discussed in context of old people where it is more seen in lines of arthritis, osteoarthritis, or rheumatoid arthritis. But we get a lot of patients who have the problem of knee pain especially in younger age group. I thought I should devote this session to this knee pain in younger age group.

First and foremost problem we see in patients of younger age groups with knee pain is anterior knee pain or patellofemoral knee pain.

What exactly are the causes ? If this is your knee joint (displaying with a model of knee joint) and this is how your knee cap behaves every time on bending, there is a problem when the kneecap tends to rub on one side and you can see a friction happening here. This is a common problem occurring in young ladies and it's called anterior knee pain and more technically chondromalacia patellae.

We normally tell our patients that this is not a precursor of arthritis, it is mainly an inflammatory problem where the under surface of the knee cap gets inflamed and leads to constant pain specially on sitting for long durations. It is in fact called a movie theatre sign because people who sit for 2/3 hours and suddenly want to get up , they feel knee pain and they are not able to straighten their knee.

The problem is normally addressed by physiotherapy. Of course we need to get x-rays and investigations , but what they respond to is good physiotherapy and anti inflammatory medications.


And if the problem we face in younger people are ligament injuries especially anterior cruciate ligament injuries. All adolescent people who have had injuries while playing soccer or any other games or while running and in your country specially bike injuries are a major problem which leads to this problem. These people normally come to us with instability, pain when walking for long distances, swellings in the knee and this causes lot of pain.

Anterior cruciate ligament injuries is normally treated by anterior cruciate ligament reconstruction which is an arthroscopic procedure, and it’s a day care procedure or normally a one day admission procedure and the patient is discharged the next day.

Similar to anterior cruciate ligament injuries, we also have Meniscus injuries. Meniscus are two cushions in the knee joint and they tend to reduce the loads on the joint as the patient puts weight on the joint.

So the blue tissue (displaying from the model) you can see is basically a meniscus, there is one on the inside and one on the outside. This is the medial meniscus and this is the lateral meniscus, and if you have a tear here, it will also cause a lot of pain. Medial and lateral meniscus tear can occur independently or they can occur with other injuries like Anterior cruciate ligament injuries. These injuries are normally treated by arthroscopic evaluation, repairs or meniscectomy and sometimes we require repair also for them,

I would like to ask my viewers if they have any queries , they can see my profile on Lybrate and contact me.
 

3108 people found this helpful

Knee Pain - It May be a Sign of Arthritis?

MBBS, MS - Orthopaedics, Fellowship in Joint Replacement , M.Ch - Orthopaedics
Orthopedist, Delhi
Knee Pain - It May be a Sign of Arthritis?

If you are suffering from arthritis, it is important for you to know about how it affects your knee and other joints. Arthritis is a chronic, systematic inflammatory disease which damages your joints and connective tissues. Your knee is commonly affected by arthritis and there are three primary types of arthritis that occur in the knees. They include osteoarthritis, rheumatoid arthritis and post-traumatic arthritis.

Types of arthritis 
The different types of arthritis affecting the knees occur due to different reasons. Osteoarthritis is a progressive condition, which wears away the joint cartilage over time. Rheumatoid arthritis is an inflammatory condition, which may occur at any age. Post-traumatic arthritis occurs after an injury is inflicted to the knee and may occur several years after a ligament injury or knee fracture.

Major symptoms

  1. Arthritis pain may occur all of a sudden, but commonly develops slowly. In the early stages, the pain is observed in the morning after you have been inactive over the night. Pain is likely when you want to move around. Pain may be experienced even when immobile.
  2. Periodic inflammation is a common symptom of arthritis of the knee. This happens because of the formation of bone spurs or excess fluids in your knee. The swelling gets pronounced after being inactive for a long period. The skin on your knee may look red and feel warm while you touch it. This may lead to chronic inflammation, which is very difficult to manage.

Treatment
There are several ways of treating knee arthritis. The mode of treatment depends on the severity and cause of knee arthritis. NSAIDS or nonsteroidal anti-inflammatory drugs are commonly prescribed for dealing with arthritis pain temporarily. Other medicines used for knee arthritis treatment are as follows:

  1. Analgesics, which help in pain reduction act as good alternatives to NSAIDS.
  2. Corticosteroids are used for reducing inflammation.
  3. Certain DMARDs or disease-modifying antirheumatic drugs are used.

Certain injections that are used for helping with knee arthritis. They include:

  1. Hyaluronic acid supplements, which ease the pain and inflammation by lubricating your knee joints.
  2. Corticosteroid injections also soothe inflammation and pain.

You may also require a surgery for dealing with knee arthritis when other modes of treatment fail. The most common surgeries are as follows:

  1. Total joint replacement, where your knee is replaced with a prosthetic made of metal, plastic or ceramic.
  2. Osteotomy, where the knee bones are modified for controlling pressure and damage in the knees.
  3. Arthroscopy, where an incision is made in the knee for removing damaged parts.

It is recommended for you to consult a doctor, if you experience any symptom of knee arthritis. Early treatment will prevent the condition from worsening.

4067 people found this helpful

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