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Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Knee replacement
Treatment of Nerve And Muscle Disorders
Treatment of Hip Disorders
Neuro Physiotherapy Treatment
Treatment of Knee Injury
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Treatment of Sports Injuries
Treatment of Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
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Orthopedic Physical Therapy
Treatment of Shin Splints
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I am 27 years old man. I have a problem in my leg. My pcl is injured during an accident before a week. My knee is swelling and even I can not walk properly. So kindly suggest me the procedures for healing and also for the operation process. I have gone through medical treatment. doctor suggested me to heal the swelling first then after Only the operation process. I have gone through physical therapy and my swelling has gone little bit better. So can I start my rehabilitation process further or not? What is the time duration for rehab? Do my pcl be same as before after reconstruction or not? Do I have to take some medicine?
I have knee pain for two or more weeks. Pain increases while driving. I Am having 85 kg and 5.10 height. Little belly. 3 minutes only walk. No exercises. I use non get. Food literally. What I want to do for reduce the pain. I am 35 years old. What I want to do as exercise. Please help me.
Hello Doctor, I often get pain in my lower back (2 - 3 months interval), which gets reduced in 2 - 3 days I take a pain killer and some rest. What should I do to be permanently well?
Dear Sir, I am 56 year old man, having low back problem with displaced L4 /L5 bones, Also facing right knee pain. There is pain in left buttock that spreads upto below left knee also, Taking calcium and Dycerin now as advised by local Doctor. But no such benefit. Many says that this is sciatica issue. Feeling pain through out the day.
Sir, my dad has a pain of left shoulder from 2 years .we consulted doctor several times he has taken ecg & said no problem, but the pain is normally having ,and also not possible to lift the hand above shoulder level. Pls reply Sir in this regard.
Shoulder pain while lifting overhead objects might be a result of strenuous activity involving tendons impinging bones of the shoulder. Impingement syndrome is also called swimmer’s syndrome.
What causes it?
It is caused by activities involving tendons and bones of the shoulder, for example strenuous activities, such as swimming, tennis and gym activities involving muscles of the shoulder. Even reaching for overhead objects and painting might aggravate impingement syndrome. If not treated at the right time, the syndrome might become extremely painful as the tendons begin to tear.
General pain in the shoulder is one of the most common symptoms, especially while reaching for overhead objects or using shoulder and arm muscles in general. If it occurs for a prolonged period of time, then it might actually lead to a tendon tearing and leading to a rotator cuff tear. This would overtime lead to decreased ability to use the arm muscles and the bicep muscles might tear as a result of prolonged negligence, despite swimmers syndrome. A doctor would recommend a physical exam and x-ray to rule out possibilities for bone abnormalities and arthritis.
How to prevent and treat it?
Those who have extreme shoulder pain and have been diagnosed with swimmer’s shoulder are referred to a physiotherapist with whom, regular sessions help restore mobility of the affected areas. The physiotherapist recommends the patient numerous stretching exercises to practise, preferably under a hot shower. In addition to physiotherapy, a doctor will prescribe powerful painkillers which have to be administered orally on a regular basis.
These oral painkillers, such as ibuprofen have to be taken under the guidance and prescription of a doctor as they will have a host of side effects such as acidity and should be taken post meals. In case of ineffectiveness of orally administered painkillers, cortisone based injections might be given, but it is a double-edged sword as the effectiveness of these injections decrease over time and it might make the muscles and tendons weak. If you wish to discuss about any specific problem, you can consult an Orthopedist.
I get caught by Cold and Cough every now and then. And mostly the Sneezes. Back to Back Sneezes are pain for me. What might be the Cause? Can you help me out here?
My legs are paining from back side. When I touch them it pains. And also my knees pains. What shall I do? Please advise.
Benefits of Bilateral Total Knee Replacement
I am Dr. Rakesh Nair. I am an exclusive knee replacement surgeon practicing at Zen Hospital in Chembur. I am also attached to the Fortis Group of Hospitals at Vashi and Mahim and Holy Family Hospital at Bandra. Today, I am going to talk about Bilateral One Stage Total Knee Replacement. To understand the basic term which I have used here when I say Bilateral One Staged, I say both knees and one sitting. They are done together once the patient is wheeled in. They are not done in a gap of a few days. That’s what I mean by both knees and one sitting.
In the surgery, all we remove is hardly 7-8 mm of bone from the thigh bone and around 7-8 mm from the shin bone, that is the lower part and all we do is just change the cap. It’s like changing the cap of a tooth, so your bone and your muscle are your own. We are not chopping off the whole knee and replacing it. So, that is the reason why I am using the terminology Knee Resurfacing, we are changing only the cap.
Once the cap is changed, we are able to mobilize the patient, the same evening if required. And, with the advanced anesthesia techniques that we have, I am able to make the patient walk the same evening. So, there are some videos here also which would tell you the same where the patient has been operated in the morning by around 12 o’clock once he or she is wheeled out the operation theatre. In another four hours by 4 o’clock evening, the patient is walking with full weight on the leg without much pain because of the pain techniques that we in terms of the pain management.
Now, why would I say that we should be doing both knees in one sitting? So, what are the advantages of doing both knees in one sitting? If you see the further videos which I would also show you, most of the patients who come to me have severe deformities. They, like, have severe bow legs, legs which are severely bent, either towards the inside or either towards the outside. So, doing one knee and then doing another knee is not going to help at all because the patient is not going to be able to walk. So, when I do both knees in one sitting it restricts the surgical procedure so it is like saying I do everything under one anesthesia. The patient gets short of medication. The medicines also which go into the body is once you are wheeled into the operation theatre. The most important part is that the patient can be mobilized very easily because immediately both the legs are straight and the patient can walk with full weight bearing on both the legs. So, I can make the patient walk in the evening or the next day depending on how strong the bones and the muscles are. Another thing is, it reduces the hospitalization also, plus the hospital cost also goes down because we don’t double use the medication nor the stay is doubled. The stay is same; it varies between 3-7 days depending on how strong the patient's knees are before surgery. So, I would definitely advocate doing both knees in one sitting.
What are the main advantages and what would you say in terms of why wouldn’t we do a knee after a week or 10 days? There are studies which say that it is not the number of joints, so the number of knees you do in which causes the problem or the commonest cause which is an infection. The problem arises if you keep on wheeling the patient into the operation theatre. So, if somebody says that we do a knee today and then we do a knee after 4 or 5 days then cases of infection will increase because the patient is being wheeled into the operation theatre on two separate occasions. So, it is not that I have not done both the knees in one sitting, which is a better option because the chances of infection are less than doing one knee now and then doing the other knee after 4-5 days, where the patient gets the same medicines repeatedly plus he is bought into the operation theatre again and his stay also increases in the hospital.
We would be showing you some videos where the patient, how the patient is walking before surgery. If you see most of these patients, the legs are severely deformed. So, all of them I have been able to do a One Staged Bilateral Knee Resurfacing where I have done both the knees in one sitting. You see them how they are walking before surgery, you see them how are they are walking after surgery. And, if you compare the function, they are really able to walk very comfortably.
My patients even sit cross-legged after surgery but that is not. I will show you one of these videos which are showing the patient sit cross-legged after surgery. But that is not something which we promote. It is just to show that they get very good function and they would definitely be able to sit cross-legged but that is not something we tell the patient to do because that compromises on the life of the knee. So, there are a lot of records and results which say that, whether we do a Bilateral One Staged Knee Replacement or whether we a One Staged Knee Replacement, the complications in terms of infection, an embolism is always similar. In fact, it is much more in a unilateral knee than in a bilateral knee.
We use body exhaust play suits, again, during surgery. I will show you this video which is showing you the body exhaust play suits where we are working in a very sterile environment. We would not want to give any infection even from the OT personnel to the patient. So, these are body exhaust playsuits which prevent the impure air breath out of the operating team, it is not allowing it to go to the patient. In fact, it is sucked up by a rotating fan which is there on top of the body exhaust playsuits and the whole impure air is taken out from the patient’s atmosphere. Even our conventional methods of mixing cement have been changed and we are using basically vacuum mixing for cement so there again is no impurities in the bowl in which we are mixing the bone cement to fix the implants to the bone.
We have all the options in terms of the knee replacement where we even have computer assisted Total Knee Replacement. We have Unilateral Knee Replacement where basically the unilateral knee replacement is used for younger patients who have deformities or pain in the insides of the knee where only a part of the knee has been damaged, the rest of the bone is all right, that’s where we use the Unilateral Knee Replacement. The latest what we have is the Customized Jigs in Total Knee Replacement where we get the MRI done of the affected knee. On the basis of the MRI, ceramic Jigs are made and on the basis of the ceramic Jigs, the positioning of the implant can be as perfect as required. Obesity has always been, the patient has always come up to me saying, “Doc, I am little on the heavier side, I am so heavy, is it a contraindication to my surgery?” So, obesity as such is not a contraindication to surgery. Definitely chances of wound healing are a problem but, instead of a week to ten days, it will take another week to ten days for healing. Otherwise, it is not a contraindication to the surgery.
Now, a very important question which comes from the patient is, “Doctor, how long will these knees last?” So, I give a very simple answer to that is that, the more you take care of it, the longer it will last. So, the longevity of the knee all depends on how strong your muscles are before surgery, how strong your bones are after surgery or before surgery and depending on that we normally get a bone density done for the patient and we treat the patient either on a yearly injection for osteoporosis or daily injection which are meant to fill up the bone and that decides on how well the implant is going to hold on and how long the life of the knee is going to last.
For further information, you need to contact me through lybrate.com.