Dr. Prabhat Agarwal

Hello,I am doctor Prabhat Agarwa,l Orthoscopic consultant in Shanti Mukand Hospital Delhi.

Today I am going to tell you about very common injury seen in day to day practice, that is anterior cruciate ligament injury. This ligament is inside our knee joints and it attaches to the high bone which is femur and leg bone which is tibia. It helps in stability of the knee joint and when somebody is involved in road traffic accident or any sports injury there is rotational movement in the knee and this ligament that injured, it can rupture and it can tear. So, what happens, patient developed swelling and pain in the knee joint with the hematoma formation, in acute phase it is very painful, in acute phase we stabilized the knee with brace support, we give ice pack and some physiotherapy. After cooling down period when there is instability of the knee joint, ACL ligament has to be reconstructed. Harvest the graph from the lateral, medial side of the knee and we prepare it in a fraction which is similar to the anatomical ACL which is already inside the joint and which has ruptured and we fix that graph inside the joint with the minimal invasive method because it is arthroscopic surgery. After the period of surgery, patient usually does not stay in the bed, from the very next day they can move on and they have to take physiotherapy for 2 to 4 weeks and after that they become totally asymptomatic and they can enjoy their free injury activities levels. The symptoms I have mentioned, if you are suffering from any of these instability, pain or swelling or recurrent capitals in the knee joint.

You can visit my clinic and I assure you complete recovery from your symptoms and full functional results. Thank You.

Tennis elbow is a type of tendinitis. It is usually the swelling of certain ligaments. It causes pain in the elbow as well as the arm. These ligaments are bands of strong and stretchable tissues that connect the muscles of your lower arm to your elbow. In spite of its name, you can in any case get tennis elbow regardless of the possibility that you have never been close to a tennis court. This is merely a name for the condition and has little to do with the sport. It can affect anyone who indulges in a swinging motion.

Any repetitive exercises that require a tight grip, particularly in cases where the thumb and the initial two fingers are used frequently, may cause tennis elbow. Tennis elbow is the most common reason for patients to see their doctors for elbow torment. It can occur in individuals of all ages; however, it is most common and normal at about the age of forty.

This condition is usually caused when there are repeated contractions of the lower arm muscles that you use to raise your hand and wrist as well as to straighten it. The repetitive movements and pressure to the tissue may bring about a series of little tears in the ligaments that connect the lower arm muscles to the hard surface on the outside of the elbow.

Tennis elbow ordinarily occurs after some time. Dull movements such as holding a racket during a swing can strain the muscles and put a lot of weight on the ligaments. That consistent pulling can cause a small amount of tears in the tissue. Tennis elbow may be caused because of the following reasons:

1. Playing tennis
2. Playing racquetball
3. Playing squash
4. Fencing
5. Weight lifting or any other stressful exercises involving the muscles

In tennis, the following moves can lead to tennis elbow:

1. One-handed backstroke with a poor stance or lose hand
2. A late forehand swing bringing a bend in the wrist altogether
3. Snapping and turning the wrist while hitting with full power
4. As the name suggests, playing tennis, particularly repeated use of the backhand stroke with poor strategy, is a conceivable reason for tennis elbow.

However, a number of other basic arm movements can also cause tennis elbow. It can also affect individuals with particular occupations or while performing leisure activities that require heavy arm movements or gripping, for example, the following:

1. Carpentry
2. Excessive writing
3. Painting
4. Raking
5. Weaving or knitting
6. Utilising plumbing devices
7. Driving screws
8. Chopping cooking ingredients or vegetables, especially meat
9. Repetitive computer mouse utilisation
10. Lifting heavy materials or even grocery bags

There are a number of ways to treat a tennis elbow. These include certain over-the-counter (OTC) medicines. If those do not work, seek the help of a specialist or physiotherapist. He or she can recommend you the right kind of medicines as well as exercises needed for the recovery.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Both young and old are vulnerable to fractures. While the former gets them during intense physical activities, the latter experience fractures due to less bone density. Thus, quite common, they are, however, if you experience a persistent pain in the fracture spot even after undergoing treatment, you must visit your doctor without delay as it might be a case of nonunion.

Despite modern treatment methods that heal most fractures, sometimes new bone tissue doesn't begin to form and repair the broken pieces. This hindrance to the healing of bones is known as ‘nonunion.' Patients suffering from nonunion of fractures usually feel pain in the fractured area even after the fracture disappears and can last for months or years. In some cases, these pains may get triggered, if pressure is applied to the fractured area.

Why does a nonunion occur?
The three most important aspects of bone healing include stability, blood supply, and nutrition. If the broken bones that have been put together are moved out of place before they fully heal, it can lead to complications. Cases, where surgical fixation is involved, can be disrupted due to various reasons, including ineffective surgery which can happen due to unforeseen complications and can cause nonunion.

• Limited blood supply to the fracture site can be caused due to a lack of or disruption of the body's healing cells. Blood supply to the injured area usually returns to normal during the healing period, but there might be medical complications that prevent fractured bones from healing.
• Nutrition is the third biggest factor that can cause nonunion of fractures if the patient does not have a well-balanced diet and lacks essential vitamins, calcium, and proteins in the body. Dietary guidelines need to be followed to allow proper healing.
• Other situational risk factors that may contribute to nonunion include age, diabetes, infections, anemia or use of tobacco and other forms of nicotine.

Treatment of A Nonunion

• Depending on the situation, treatment is possible using both surgical and non-surgical methods. A bone stimulator may be used to treat a nonunion non-surgically. This small device helps send ultrasonic waves to stimulate healing, and through repeated usage of the device, it can help patients start healing.
• Surgical treatment involves the usage of a bone graft that can help new bone (or bones) to grow in the affected area. Bone grafts are surgically planted, and they provide fresh bone cells and necessary chemicals that the body needs for healing. Surgeons make an incision and remove pieces of bone from different areas of the patient and transplant them into the affected area. Bone harvesting can be a painful process, but it does not affect the bodily functions or cause any cosmetic problems in any way to the patient.
• In many cases, bone harvesting can be avoided by using allografts (bone grafts from cadavers) or other substitutes (known as osteobiologics) made of chemicals that can be fixated both internally and externally.
• These methods kickstart the healing process and allow the fractured bones to heal and return the area to its normal and undamaged state.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Life is beautiful and exciting, but any impaired movement can take our routine for a toss. Especially, with conditions such as arthritis, it gets tougher. But there are numerous modern-day procedures available to treat such issues, and one such method is the Arthroscopic surgery. It is performed on the joints to diagnose and treat the joint problems and abnormalities.

In this surgical procedure, small incisions of around ¼ inches are made to several parts of a joint area for inserting an Arthroscope which is attached to a small television camera, and it lets the surgeons have a closer look at the interiors of the joints. Whether it's finding out the cause of a joint abnormality or visualizing the issue for treating or repairing it, arthroscopic surgeries can take care of both. Let's take a closer look at some of the most common queries regarding arthroscopic surgeries.

Why are arthroscopy surgeries performed?

When it comes to diagnosing as well treating inflammatory, non-inflammatory and different types of infectious arthritis and injuries in the joints, orthopedics usually recommends arthroscopic surgeries. From treating tears or dislocations in the joints of the shoulder, knee, wrists to issues caused by arthritis, and treating cartilage damages such as in the ankles or elbow, arthroscopic surgeries are performed for a wide variety of reasons.

How long it takes to recover completely?

As the effect of the sedatives and anesthesia, patients tend to feel dizzy and sleepy right after the surgeries. Even, sometimes mild pain can be experienced too which usually goes away in a few days with the help of right medications. The surgical incisions, being tiny, also tend to heal within a few days after the surgeries with proper care. Usually, the patients are likely to resume their daily activity, except the stressful ones, within a few weeks. However, depending on the severity of the joint condition and the condition of the patient, the recovery time can vary.

Are there any risks involved in these surgeries?

Potential complications of any kind are not common in arthroscopic surgeries. However, sometimes, patients may feel pain slight pain in the joint or joint stiffness, severe swelling, and even redness or numbness. Joint infection and bleeding into the joint are two other complications that are also very rare.

Remember, though it is mostly an outpatient procedure, still, a spinal, regional, local, or general anesthesia is required depending on the condition of the patient. These surgeries tend to cause less tissue damage as well as less pain with smallest of cuts compared to other traditional surgical procedures. In case you are facing joint issues, consult with your orthopedic to know whether you are the right candidate for arthroscopic surgeries or not.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Human bones are continuously being removed and formed which is necessary for its proper maintenance. However, in certain cases, especially with aging, some bones and joints will be worn down to an extent where the body will not be able to reform them. This is especially true in the case of hips which may become worn due to age or other problems within the body. 

Hip Replacement Surgery 
When this happens, a hip replacement surgery can be performed to replace the original joints with a prosthesis or artificial hip which is usually made out of metal or a specially formed composite material or even a combination of the two. Along with other parts, it replaces the natural hip with an artificial hip to restore mobility and other related functions.

Benefits of Hip Replacement Surgery:

1. Lessening hip pain - This is one of the major factors as well as symptoms of requiring hip replacement surgery. Due to the grinding down of the bones, even the slightest movement causes pain and after the surgery and the recovery period, the pain is lessened.
2. Correction of bone deformity - When the bones grind down and are abnormally reformed, deformities may occur reducing mobility. Artificial hips will ensure that deformities are corrected and resulting problems are thus eliminated.
3. Return to normal activities and resumption of normal activities - This is possibly one of the primary advantages of this surgery, although it entails a long recovery period. However, most patients can get back to their normal activities and are able to resume a pain free life.
4. Ability to have painless sleep - Many people who suffer from hip displacements or bone deformities are not able to sleep properly due to pain. After the surgery and the recovery period, they can return to normal functions and habits, thus are able to sleep properly.
5. Leg strength increase - Many patients tend to have an increase in their leg strength as one side of the hip tends to become very weak due to bone problems before surgery. After surgery and recovery, the same side tends to have an increased strength due to the implant.
6. In most cases a lifelong solution to hip problems - As the hip replacement prosthesis is made out of metal and if the operation is successful, it usually tends to last till the end of a person's life and this area usually doesn't tend to have problems again.

In case you have a concern or query you can always consult an expert & get answers to your questions!