Dr. Sudhir Seth

Your bone is a living tissue that constantly undergoes the cycle of breakage and replacement. Osteoporosis is a condition wherein the rate at which new bones form cannot match up to the worn out bones, thus making the bones fragile and brittle. Osteoporosis mainly affects the wrist, hip or spine and can result in a stooped posture accompanied by height shrinkage and back pain caused due to a collapsed vertebra.

Reasons Behind Osteoporosis

1. Hormones: Lowered estrogen count in women and testosterone in men as a result of ageing or other treatments can result in this condition. Excess thyroid secretion in the body, an overactive adrenalin gland or parathyroid gland can also accelerate bone loss. Women are more vulnerable to osteoporosis during menopause.

2. Prolonged use of injected: Prolonged use of injected or oral corticosteroid medications such as cortisone or prednisone messes with the bone-building process. Medicines used to combat cancer, gastric reflux and seizures can be responsible as well.

3. Medical Conditions: Certain medical conditions such as rheumatoid arthritis, cancer, liver or kidney disease increases the risks of acquiring osteoporosis.

4. Sedentary Lifestyle: A sedentary lifestyle with not much physical activity along with an excessive consumption of alcohol and tobacco makes you susceptible to osteoporosis.

Treatments for Osteoporosis:

1. Medication: Commonly prescribed medicines for remedying fractures include bisphosphonates such as Zoledronic acid, Ibandronate, Risedronate and Alendronate.However these medicines are not free of side-effects such as abdominal pain, nausea or heart burn. In case, your regular medicine doesn’t work, you can use Denosumab and Teriparatide as alternatives but only after consulting your physician.
2. Hormone Therapy: Estrogen therapy for women after menopause helps sustain bone density. However such procedures can escalate the dangers of getting afflicted with cancer, heart diseases or conditions such as blood clotting.
3. Alternative Medicine: Ipriflavone, a laboratory manufactured product, when combined with calcium can curb chances of bone loss and alleviate pain. If you wish to discuss about any specific problem, you can consult an orthopedist.

Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced with artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.

When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of  people over 50 years when have pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.

Aim of the surgery

1. Correct the deformity: Relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
2. Anaesthesia: Usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes a general anaesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
3. Recovery: Stand up and walk a few steps with a walker the day after the procedure i.e. in 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking, progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.
4. Activities: Normal walks of 3 to 5 km per day Climbing stairs, cycling, swimming, and driving can be performed with the new implant(s) now.
5. Avoid: Squatting/kneeling Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports Longevity of joints: 15-35 years depending on the materials used.

Slip disk is a condition of the spinal column which consists of a stack of vertebras from the cervical, thoracic and the lumbar spine.The bones of the spine are cushioned by disks that are present to absorb shocks. Trauma to the spine may cause the disk to bulge or be ruptured. This may lead to pain in the neck and the back. 

Causes of slip disk

Slip disk is caused when the jelly like substance present in the disks bulges out. The damaged disk thus puts pressure on the adjacent nerve causing excruciating pain. The various causes of a slipped disk are:

1. Incorrect form during exercise: If you are into weight lifting, it is important that you use proper form during exercising. Moves like barbell squat and deadlifts can put pressure on the spine and lead to disk problems, if not done correctly. Make sure you work on your core strength and keep your lower back straight while exercising. 

2. Smoking: Smoking causes the disks to lose their flexibility and thus, increases the risk of slipped disk.

3. Ageing: Ageing decreases the content of water in the spine, thus leading to inflexibility.

The symptoms of slip disk are:
1. Pain on one side of the body that tends to aggravate over time
2. Activities such as sitting and coughing may lead to pressure on the spine causing pain
3. Your range of motion on certain movements may be restricted
4. Pain in the neck while moving it
5. Numbness in the shoulder and the neck region
6. You may experience tingling sensations in the genitals, hips and the legs
7. You may have muscles spasms which lead to sudden contraction of the muscles
8. It may also lead to partial paralysis of the lower body

Prevention
1. If you are overweight, try to reduce weight and then focus on maintaining healthy weight levels
2. Maintain proper posture while sitting or standing
3. Exercise on a regular basis to build strength and keep your joints healthy
4. Don't remain in seated position for an extended period of time. Take small breaks in between to stretch

Joint replacement surgery

It is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced by artificial joints: metallic, plastic and ceramic joints. These surfaces closely replicate the original anatomy. 

When do you need a knee replacement?

You suffer from severe pain/deformity in the joint (knee in this case);
The pain/stiffness and deformity makes simple tasks hard to do;
Severe grade iv osteoarthritic knees in people over 50 years when pain, swelling plus/and deformity fail to respond to medicines, physiotherapy, injections and rest.
Aim of the surgery is to:
Correct the deformity 
Relieve the pain and
Give near full movements almost immediately after the procedure.
Details including techniques and safety:

It is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
Anesthesia: usually it is the spinal cord/epidural where one is rendered numb for 3-4 hours waist down. Sometimes a general anesthesia is given.
A 4-5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimeters) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
Recovery:

Stand up and walk a few steps with a walker the day after the procedure i. E. In 24 hours.
Physiotherapy in hospital for 5-7 days and/or walking.
Progressively longer walks/ exercises over the following 15 days.
Stitches removal in 15 days.
The patient can return back to normal activity 4-8 weeks the surgery.

Activities:
Normal walks of 3-5 km per day
Climbing stairs, cycling, swimming, and driving can be performed with the new implant (s) now.
Avoid: squatting/kneeling
Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports

Longevity of joints: 15-35 years depending on the materials used.