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Treatment of Knee replacement
Treatment of Joint And Muscle Problems
Acl Reconstruction Procedure
Hip Replacement Surgery
Joint Replacement Surgery
Ligament Reconstruction Surgery
Joint Pain Treatment
Knee Osteotomy Treatment
Treatment Of Meniscus Injury
Meniscus Injury Treatment
Treatment of Shoulder SLAP (Tear) Lesions
Rotator Cuff Injury Treatment
Joint Replacement Surgery
Soft Tissue Injury Management
Shoulder Replacement Surgery
Treatment of Joints And Musculoskeletal Disorders
Articular Degenerative Disease Treatment
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Patient Review Highlights
I was amazed that other doctors before him were not able to even diagnose my problem, but Dr Sharat did it immediately and started the joint pain treatment for it. Almost all doctors suggested surgery for it, but I did not wanted to go for it . Due to my problem my daily activities were suffering. Even in case of long queues, the staff was managing people in a very positive manner.
I thought it was something very normal, but then I realised the shoulder pain is something else. By chance, I approached Dr Sharat for second opinion and thank god, i did because, he treated me without any surgery and all. He is so pleasant to talk to and always ready to answer your doubts. During the treatment, he supported me a lot. Thanks to him I am much better now.
It was getting very difficult for me to cope with my lower back pain. From quite some time i was suffering from pain, but never gave much importance to it. I owe Dr Kumar a big thanks for making me fine again. It was an amazing experience as everyone in the Apollo Health City is so nice. Not only he is very calm and composed, but is also a very understanding doctor.
After my accident, I was suffering from unbearable pain on my left shoulder, which became a major problem as it was affecting my daily routine, so I fixed up an appointment with Dr P. Sharat Kumar at his clinic in Jubilee Hills, Hyderabad. The treatment provided by him was just unbelievable as after few sessions I was feeling amazing and no trace of pain was there.
I have had this leg pain from quite some time. Initially the leg pain wasnot that severe but then it became worse. He is not just friendly, but also is very motivating. Over the period of time the leg pain treatment has helped me a lot. The overall atmosphere in the Apollo Health City is very soothing.Dr Kumar with great ease handled my case.
I was suffering from acute pain in my hand for which I chose to consult Dr Sharat Kumar .Even after my treatment with my old doctor, I never felt so much relief, but he has treated my completely. It was getting very difficult for me to cope up with my pain in my hand.But after his treatment I am perfectly fine.
Dr Sharat Kumar has so much knowledge that for everything my family takes his reference. They took very nice care of me, i never felt that I am in a Apollo Health City. Even though it's been more than a year, still if I sometimes feel pain and call him, and he still takes my call in case of any emergency.
The medication dr P.Sharat Kumar gave me regarding my back pain were really helpful at his clinic Apollo Health City in Hyderabad. now I can say my upper back pain is reduced by 80 %.Overall it was a good experience.Thank You :)
Knee problems can be quite annoying but if this problem becomes regular, it brings life to a standstill. The movement becomes restricted. Many associated problems slowly crop up. Thus, it is best to nip the problem in the bud. While some people might experience a problem in the full knee, in some people, only a single compartment (tissue or cartilage) of the knee may be affected. For such patients, Unicondylar Knee Replacement comes as a blessing.
The Unicondylar knee replacement, also known as the Unicompartmental Knee Replacement or Partial Knee Replacement is the most sought-after knee replacement surgery. The surgery involves replacing only the worn out or affected part (cartilage) of the knee, thereby preserving the healthier cartilages and tissues of the knee.
In the last few years, incidences of osteoarthritis have been on the rise. The unicondylar knee replacement surgery has made life a lot easier for people suffering from osteoarthritis (a condition where the articular cartilage or the connective tissue present within the knee joint begins to wear out).
The unicondylar knee replacement is ideal for people with:
- Severe osteoarthritis (Median or Lateral) that results in painful, swollen and stiffened knee.
- Only a small portion of the knee is affected.
- A person experiences great difficulty in movement.
- People over 48 years of age are mostly advised to undergo this surgery. Many young people with osteoarthritis opt for this surgery.
However, the surgery may not be a wise idea for
- A person with Rheumatoid Arthritis and Angular Deformity (acute).
- A person whose larger portion of the knee is affected.
- A person who had undergone osteotomy (surgical excision followed by reshaping of bones).
- People with an unstable or weak knee should avoid this surgery.
Pre- surgery, a person should
- Avoid taking any anti-inflammatory and herbal medicines (minimum 10 days before the surgery).
- Get yourself medically examined for any health complications (that might interfere with surgery).
- Follow a healthy lifestyle. Avoid smoking and drinking.
- For the surgery, the patient is either given a general anesthesia or a spinal (or epidural) one.
- Next, a compressing device (tourniquet) is put around the upper part of the thigh. This is done to avoid excessive blood loss during the surgery.
- A 7cm incision is made over the knee.
- The damaged parts (bones and cartilages) of the knee are then carefully removed.
- The surgeon next replaces the excised parts with metallic implants. Once the metallic part fits into the knee, it is adhered to the bone with (or without) bone cement.
- The surgeon then stitches the incised area, followed by dressing and bandage.
The recovery time is quick, between 3-4 weeks. However, the concerned person may require physiotherapy for the next 3-6 months.
- The surgery is less invasive with a quick recovery time.
- The surgery replaces only the affected knee part.
- Blood transfusions are seldom required.
- A person gets back to normal life faster.
- The surgery requires less time (~ 1-2 hours).
You need to be careful about:
- Infection at the incision site, though it is very rare.
- Injury in blood vessel, ligaments, or nerves.
- Fracture in the bone
If you are about to undergo a knee replacement surgery, it is important to know the extent of pain that it involves, and the recovery period that follows. A knee replacement surgery is a major surgery, and a patient needs a lot of time to adjust to the replacement of his knee. The time of recovery depends on the patient and form of surgery that has been undertaken. The steps of recovery after a knee replacement surgery are as follows:
- After the surgery, you will be given painkillers which you can self-administer using a switch. You may also require an oxygen mask or blood transfusion.
- You may require crutches and should walk within a frame. The ability to get back to walking without any help depends on the patient.
- You will be taught exercises for strengthening your knees in the hospital by a physiotherapist.
- It is likely for you to experience some initial discomfort during exercising and walking, as your legs may become swollen.
- Putting on a passive motion machine may be beneficial in restoring movement in your knees when you are lying in bed.
- It is likely for you to spend a period of three to five days in the hospital, based on your condition and its progress.
- An enhanced recovery program may be suggested by your surgeon in which you may start walking from the surgery day itself.
Recovery at home
- It is normal for you to feel tired and fatigued at home in the beginning. A knee replacement surgery is a major surgery, and the tissues and muscles around your knees require time to heal properly.
- You should arrange for a person who would help you while you go out for a few weeks after the surgery.
- It is very important for you to practice the exercises prescribed by your physiotherapist. This is a vital part of speedy recovery and you should not avoid them.
- You will be able to stop depending on crutches or walking frames and go back to your regular activities and schedule, six weeks after the surgery.
- The swelling and pain associated with the surgery may take around three months to depart.
The recovery process usually continues for two years after undergoing the surgery. During this period, scar tissue heals and your muscles get restored through exercises. It is recommended for you to avoid any kind of extreme sports or movements in which there is a risk of falling, such as mountain biking, or skiing.
Have you suffered from a dislocated kneecap and are looking for effective treatment options? A dislocated kneecap is a very common form of injury that takes around six weeks time to heal. It is generally caused by a blow or a change in direction when your leg is planted on the ground. Such injuries are common during sports and dancing. The patella or knee cap, which sits at the front of the knee, glides over a groove in your joint, on straightening or bending your leg. Dislocations make it come out of the groove, leading to the tearing of the supporting tissues.
- When your kneecap gets dislocated, it is likely to look out of place, or the angle will seem odd.
- Other symptoms include severe knee pain, inability to walk, swelling of the knee, inability to straighten the knee, and a popping sensation in the knee.
- A dislocated knee cap is not something very serious and it pops back in place on its own in many cases. However, it is recommended for you to get it diagnosed and treated by a health professional.
- In case your knee cap goes back into place on its own, you should visit a minor injuries unit or MIU, or an accident and emergency department.
- If your kneecap does not go back into place by itself, you need to call an ambulance and avoid trying to put it back in place by yourself.
- On the way to the hospital, or while you wait for the ambulance to arrive, you should sit, keeping your leg in a position that is most comfortable for you.
- If your kneecap does not correct itself by the time you reach a hospital, it has to be manipulated back in place by a doctor. This process is called reduction.
- You will be given medication to ensure that you keep relaxed and free from pain during the procedure.
- After the knee cap is put back in place, an X-ray has to be undertaken to check out if your bones are in the right position. Signs of other damages are also analysed.
- After the procedure, you will be prescribed painkillers. Your leg will be immobile and put in a removable splint for some time.
- For effective recovery, you should undergo physiotherapy for several weeks.
A surgery for a dislocated kneecap may only be required to be undertaken in case of a fracture or associated injuries like a ligament tear. A surgery may also be required in case you had experienced a knee cap dislocation in the past.
The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.
Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.
- Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
- Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
- Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.
- A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
- A collision or a hit, especially on the knee (while playing football).
- Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury
- An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
- There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
- Sometimes a pop in the knee can be heard just at the time of the ACL injury.
- Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
To diagnose the extent of the damage, the doctor may suggest
- Physical examination, including a quick brief about the case history.
- Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
- In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.
A group of tendons and muscles that surround the shoulder joint are known as rotator cuff muscles. These muscles allow the tip of the upper arm to be fixated on the shoulder socket. Rotator cuff injuries tend to occur if you perform repetitive movements overhead with professional such as carpenters, tennis players and painters are at the highest risk of this injury.
The muscles that constitute the rotator cuff are:
- Teres minor
The primary function of the muscles mentioned above is to work together in stabilizing the shoulder joint. A rotator cuff injury leads to problems in these muscles and may lead to impaired functioning of the shoulder.
The symptoms of rotator cuff injury are:
- You may experience pain when you move your shoulder
- An inability to lift your arm overhead
- You may hear clicking sounds while moving your shoulder
- You may face difficulties in performing activities such as swimming and painting
Rotator cuff injury may result from the following causes
- Calcific tendonitis: This condition is characterized by accumulation of calcium in the rotator cuff tendon. It results in stressing the tendon which causes you to experience pain.
- Rotator cuff tears: Tears may occur in the rotator cuff muscles that may be complete or partial in nature. Lifting heavy weights while doing shoulder exercises may cause these tears.
- Subacromial impingement: Any activity that requires you to lift your arm up causes the humeral head (arm bone head) to be pushed down below the rotator cuff. If the humeral head is not in its position, then it may result in pain.
This condition is treated by using various methods, such as medications and physiotherapy. NSAIDs are prescribed to treat the pain along with various physiotherapeutic exercises to strengthen the joints. In severe cases, surgery may be required to fix the injury. It is recommended to balance the shoulder muscle strength by focusing on exercises that work the rotator cuff. Any external rotation movement helps in strengthening the rotator cuff.
Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.
Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include
1. Certain medical conditions and health disorders such as
- Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
- Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.
2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.
3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.
People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.
Symptoms characteristic of AVN of the hip
- Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
- As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
- In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).
In case you have a concern or query you can always consult an expert & get answers to your questions!
Ankle instability is often caused by damage to the lateral ankle ligaments. This typically causes strain and in further severe forms results in injury to the ligaments. This may further cause a feeling of instability in the ankle and eventually predispose the individual to get recurrent ankle sprains even with very minimal twists.
Symptoms: The symptoms of ankle instability include weakness and wobbliness in the ankle or a continuous feeling of falling down while walking on uneven surfaces. People with ankle instability often experience the feeling of rolling outwards or giving way. Sometimes, after the initial injury that led to the condition of the unstable ankle, patients often feel that something has not been right ever since that injury causing them to frequently lose their balance. The condition may result in the swelling of the ankle and increased vulnerability towards twists or sprains resulting from the weakness in the ankle and its inability to support the body weight.
Treatment: More often than not, patients with ankle instability may be treated without surgery by merely supporting the muscles that control the hinge joint of the ankle. This is done using supportive braces or shoes to reduce the threat of frequent ankle sprains and by avoiding activities that involve higher risk.
The treatment for ankle instability involves a range of exercises that focus on the strengthening of muscles to account for the balance provided by the ligament formerly. If pain is encountered while performing specific activities, patients are advised to use a tape or special shoes while performing the activity. If the problem still persists and goes extreme, the individual is recommended to opt for a surgery.
The surgical intervention for ankle instability can be categorized under anatomic reconstruction and peroneal substitution ligament reconstruction. The former aims to allow the stretched or torn ligament to heal in a shortened position by using the individual's own tissue or a cadaver tendon. In the latter, the torn ligament is completely replaced by using another tendon from the patient's own ankle.
Both the methods have their own pros and cons and the choice of a particular method is dependent on the physician after careful examination of the individual case. In most cases, the patient is advised physiotherapy or exercise and surgery is, but rarely advised. Even after the surgery, patients are asked to undergo a variety of exercise techniques and therapy. In case you have a concern or query you can always consult an expert & get answers to your questions!
The rotator cuff is made up of four muscles and the tendons attached to them under the shoulder roof that lowers and raise the arm. Acromion is an extension of the shoulder blade. Subacromial bursa lies in the space between the acromion and the rotator cuff. Subacromial bursa is a sac filled with fluid that allows the rotator cuff beneath the acromion to glide smoothly when the shoulder is moved.
If the four tendons in the rotator cuff are injured, strained or a bone spur develops on the acromion, it can result in the swelling of tendons and also in the rubbing or pinching against the acromion as space between the tendons and acromion gets narrowed. The tendons get irritated when they pass through this acromial space. This is called subacromial impingement.
Subacromial impingement is also known as shoulder impingement syndrome, supraspinatus syndrome, painful arc syndrome, thrower's shoulder and swimmer's shoulder.
Repeated activity where the shoulders are moved overhead like in tennis, painting, swimming, lifting and abnormalities in bones and joints are the risk factors of subacromial impingement.
The exact cause of impingement is not explicitly known.
- Tendon may split if there is continuous wear and tear
- It may be caused by minor injuries. However, this injury may be triggered by repeated overhead activities as well.
- Age is another cause. As one grows older, bone spurs may develop on the acromion. Also the tendons are prone to tearing after the age of 40.
- Sometimes the acromion shape can make people prone to subacromial impingement.
Subacromial impingement presents itself with the following symptoms:
- Reaching above behind your back and reaching overhead with your arms gets difficult.
- Shoulder muscles weaken
- The tendons can actually tear in two if injuries persist for a considerable duration. This can result in rotator tear cuff. Elevating your arms gets very difficult.
- Bicep tears are common if impingement persists.
Blood plasma enriched with platelets is known as Platelet Rich Plasma (PRP). Being a rich source of similar platelets, PRP can perform healing of tissues and bone by using various cytokines and growth factors. Plasma therapy using platelets is a renowned procedure and is extensively used in other methods such as orthopaedics, dentistry and dermatology. Indications in dermatology that require PRP are wound healing, androgenetic alopecia,face rejuvenation etc. Various protocols are used for the preparation of PRP and although no fixed procedure exists, the principle methods include gathering of platelets in groups, which are 3 to 5 times greater than the physiological quality. This is followed by infusing this concentrated plasma in the tissue where recuperation is needed.
PRP is used in tissue repair due to the growth factors present and their efficiency to heal various injuries. Calcium chloride and thrombin are used to activate the platelets that are gathered in the PRP. PRP contains cytokines and growth factors that include:
- Keratinocyte growth factor
- Fibroblast growth factor
- Insulin-like growth factor 1
- Insulin-like growth factor 2
- Platelet-derived growth factor
- Epidermal growth factor
- Transforming growth factor
The effectiveness of PRP is being evaluated through research. The effectiveness is influenced by factors such as
- Area of the body that is treated
- Whether the illness is chronic or acute
- Health of the patient
There are two standard methods of preparation of PRP. In both the processes, the patient's blood (anticoagulated using citrate dextrose) is collected and passed through two centrifugation processes, which are designed to separate the concentrated PRP from the red blood cells and plasma deficient platelets. Production of PRPs vary according to different techniques and equipment.
In humans, PRP has been used to treat different kinds of ailments such as androgenic alopecia, osteoarthritis, nerve injury, plantar fasciitis and chronic tendinitis. It is also used in plastic and oral surgery as well as for bone repair. Following 6 weeks of therapy, the patients are advised to rest. 6-12 weeks later, they are re-checked for improvement. In some cases, there might be a requirement of more than one injection. Most of the patients report that they are able to return to normal activities within 3 months.
A meniscal tear is a typical injury occurring in the knee. The meniscus resembles a C-shaped plate (cartilage) that is rubbery in nature and pads your knee. Every knee contains two menisci, one each at the external and internal edge. The menisci helps in keeping your knee firm by adjusting your weight over the joint. A torn meniscus could keep your knee from working properly.
A meniscal tear is typically brought about by turning or twisting immediately, usually with the knee being twisted while the foot is firmly fixed. Meniscus tears occur in case one lifts heavy objects or during playing or other physical sports. The meniscus gets worn as you grow older. This can damage all the more effortlessly.
The symptoms of meniscal tears include:
- Pain in the knee
- A tendency of knee to 'lock' or get stuck
- Popping sensation during the injury
- Difficulty in straightening and bending of the knee
Although there might not be much pain initially, but as the inflammation occurs, severe pain will be felt. A thorough examination would be conducted by the doctor where he would evaluate your injury and details of the x-rays. In severe cases, MRI scans might be required.
Details about the location and size of the tear would affect the treatment. In case the tear is small, the outer portion of the meniscus, also known as the 'red zone' is capable of healing itself on account of its healthy power supply. On the other hand, the 'white zone' which consists of the inner two-third part of the meniscus does not have a good supply, thus rendering the tear occurring in this region is incapable of healing by themselves.
Surgery is not required for all meniscal tears. Nonsurgical treatment is sufficient if the knee is stable and non locking. Recovery can be sped up by performing the following actions on the knee:
- Ice should be applied regularly to limit swelling and it is advised to be continued till the pain is relieved.
- Elevating: This should be done using a pillow while sitting or lying down.
- Compressing: A neoprene type sleeve or an elastic bandage should be used to limit the swelling.
- Resting: Limit exercises to walks if the knee hurts. Crutches should be used to soothe the pain.
- Medications: Consuming anti-inflammatory medications
In case you have a concern or query you can always consult an expert & get answers to your questions!