Navneet Sinha Clinic

Have you undergone cartilage damage recently and are seeking ideal treatment measures? Cartilage damage is a common form of injury that involves your knees. Other joints such as the ankles, elbows and hips may also be affected by cartilage damage. Cartilage, the tough and flexible tissues covering the surface of your joints, acts as a shock absorber, allowing the bones to slide over each other. Cartilage damage may occur because of injuries such as a gradual wear, sports injuries and osteoarthritis. While acute cartilage damage may heal on its own, severe damage may need treatment via surgical measures.

Treatment

Physiotherapy

• Physiotherapy is effective when you experience difficulty in moving your affected joint.
• It is also an important part of recovery if you have to undergo surgical procedures for treating cartilage damage.
• A physiotherapist will teach you certain exercises that are effective for strengthening the muscles that surround and support your affected joint.
• This helps in reducing pain and pressure on the joint.

Surgery

• Severe and serious cartilage damage does not heal effectively on its own, and a surgery may be required for treatment.
• Usually, surgery is performed by using Arthroscopy. This is a form of keyhole surgery in which certain instruments are inserted into your affected joint via incisions or small cuts.
• In some cases, larger incisions have to be made.
• Such surgeries are carried out after giving general anesthesia to the patient.

The most common surgeries that are undertaken in cases of cartilage damage include the following:

Lavage and debridement

• In this form of surgery, your joint is cleaned for the removal of any loose tissues.
• The damaged edges are trimmed to be made smooth. Sometimes, the damage may also be repaired during the same time.

Marrow stimulation

• In this procedure, tiny holes are made on the bone beneath your damaged cartilage that releases the bone marrow in it.
• The marrow cells stimulate the production of new cartilage.

Mosaicplasty

• In this procedure, small plugs of healthy cartilage from areas of a joint that are non-weight bearing are removed and used for replacing areas of the affected cartilage.

Osteotomy

• This procedure involves the alteration of the alignment of your leg for reducing pressure on the damaged area.
• It is effective in improving pain.
• A wedge of bone may be removed or added from your thigh bone or shin bone.
• The bone gets fixed with a plate till it gets healed.

In some cases, a joint replacement surgery has to be carried out. In this procedure, the entire affected joint is removed and replaced with an artificial joint. Hip replacement and knee replacement are common examples of this kind of surgery.

Knee pain is something that can affect anyone - irrespective of their age. While sometimes it may be of minor importance - and can easily be handled by self-care, often, lingering pain is a manifestation of some other serious underlying problem, such as arthritis. In this case, it is imperative that you consult a doctor and take appropriate measures to combat it.

Causes :

Arthritis: The chief cause of lingering knee pain, arthritis itself can be of a number of types:

• Osteoarthritis, which is a result of deterioration of cartilages due to wear and tear
• Rheumatoid Arthritis, an inflammatory chronic disorder
• Septic Arthritis, causing pain, swelling and redness.
• Gout caused due to the development of uric acid crystals in the joints

Fractures: These are caused by the breaking up of the kneecap due to falls or collisions.
ACL Injuries: Caused due to the tearing of the anterior cruciate ligament (that connects the femur and the shinbone). Especially common in sportspersons such as footballers or basketball players.
Meniscus tears: The meniscus or the rubber-like cartilage (that acts as a shock absorber) can be torn by sudden jerks or excess pressure.

Symptoms:The major symptoms of knee pain include weakness, redness, instability, stiffness or the inability to properly straighten or move the leg. Often, a deformity is also visible, such as a bone sticking out of the leg - in which case it is advisable to consult a doctor immediately.

• Possible risks: Factors which include the odds of being inflicted by knee pain and cause serious complications include :
• Being overweight: This exponentially increases the stress or pressure that is applied on the knee joints - even in doing mundane tasks like walking up and down stairs.
• Excessive physical activity: Some activities, such as sports apply excess stress on the knees as compared to other tasks.
• Loss of muscle flexibility: Tightness or weakness in muscles causes increasing number of problems in the knees.

Staying healthy involves a wholesome state of being where the mind and body are in perfect sync. A less than properly functioning body can leave you in a state of potential depression after a certain point of time, while a depressive mind can leave you feeling less than stellar where you end up imagining and experiencing pain. The health of your bones and joints is one such area that requires even more care as you start growing older. Wear and tear is just one of the reasons for degeneration while fractures and injuries can lead to a sudden halt of normal functioning of the bones and joints too.

So how can you ensure bone and joint health in the long run? Follow our tips!

1. Eating Right: Pick calcium rich food like dairy products that have a low fat content, including milk and yogurt. Also, have a daily dose of green, leafy vegetables and plenty of citrus fruit and juices for your fill of calcium. Further, food like eggs and soybeans which have lots of vitamin D can also help in retaining good bone and joint health. Vitamin C rich fruit like watermelon, oranges, squash and tomatoes also help in natural tissue and cartilage repair. And finally, get plenty of vitamin K to retain good bone density for a prolonged period with ingredients like leafy green vegetables, eggs and cheese.
2. Exercise: This is the key to good bone and joint health. Much like machinery and tools, the bones and joints of your body can also wither with disuse and prolonged inactivity. Make sure that you indulge in exercises like long walks and muscle strengthening exercises which will give your joints and bones good amount of strength as well. Remember to speak with your doctor before you start a new exercise regime so that you avoid anything that may be harmful in case you have any other ailment. Low impact exercises will strengthen the spine, while fat burning and weight loss exercises will ensure that there is less pressure on the knees and lumbar area. Swimming and resistance building exercises can also be practised for these purposes.
3. Abstinence: A major factor in promoting better bone and joint health is abstinence from all those things that can create problems in the long run, like smoking, drinking excessively and even too much consumption of caffeine and fatty food. All these things can create depletion of the natural bone mass. Also, switching to a lower heel for everyday wear footwear and changing your position during your time at your workstation are a few things that will go a long way.

Take care of your bones and joints the right way today, for a healthier tomorrow.

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

• Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.
• Consult the right physician instead of doing exercise that can aggravate your pain.
• Take a break from work and go for short walks, every couple of hours. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

Spine surgery is conventionally performed as ‘open surgery’, which means the region being worked on is opened with a long entry point to permit the surgeon to view and access the area. Technical and scientific advances have permitted more back and neck conditions to be treated with a less obtrusive surgical technique. The minimal invasive spine surgery (MISS) does not include a long cut, and it prevents causing damage to the muscles around the spine. As a rule, this causes less pain after the surgery and a speedier and healthy recovery.

Spine surgery is normally suggested when non-surgical treatments like medicinal or exercise based methods have not helped in lessening the excruciating symptoms of your back problem. Moreover, surgery is just considered if your doctor can pinpoint the correct reason of your pain, for example, a herniated circle or spinal stenosis. 

MISS is also called less obtrusive spine surgery. In these procedures, surgeons utilise particular instruments to get to the spine through little cuts. The surgery process is as follows:

1. During the surgery, a little entry point is made and the tubular retractor is embedded through the skin.
2. It is also inserted into the delicate tissues down to the spinal cord.
3. This makes a passage to the little range where the problem exists in the spine.
4. The tubular retractor holds the muscles open and is set up all through the surgery.
5. The surgeon gets to the spine utilising the little instruments that fit through the focal point of the tubular retractor.
6. Any bone or disk material that is expelled goes out from the retractor.
7. Any gadgets needed for the fusion process, for example, screws or rods, are embedded through the retractor.
8. A few surgeries require more than one retractor.
9. Keeping in mind the end goal to see where to put the entry point and embed the retractor, the surgeon is guided by fluoroscopy.
10. This strategy shows ongoing X-ray pictures of the patient's spine on a screen throughout the surgery.
11. The surgeon additionally utilises a microscope to enlarge the view through the retractor.
12. Towards the end of the procedure, the tubular retractor is expelled and the muscles come back to their original position.
13. This restrains the muscle damage that is more ordinarily found in open surgeries.

It is very important to talk about these risks with your doctor before your surgery or procedure.

1. Infection: Antibiotics are consistently given to the patient some time before, during, and regularly after the surgery to reduce the danger of infections.
2. Bleeding: A specific measure of bleeding is normal; however, this is not commonly dangerous.
3. Pain in the grafted area: Some patients will encounter surgical pain at the bone joint site.
4. Recurring symptoms: A few patients may encounter a repeat of their side effects.
5. Pseudarthrosis: Patients who tend to smoke are more prone to pseudarthrosis. This is a condition wherein there is insufficient bone formation. In case that this happens, a minor surgery may be required.
6. Nerve damage: It is possible that the nerves or veins might be harmed during these operations. These complications are extremely uncommon.
7. Blood clots: Another complication is blood clots in the legs. This poses a threat because these clots can break off and settle in the lungs. If you wish to discuss about any specific problem, you can consult an Orthopedist.

Along with bones, the human structure is also supported by cartilage. Cartilage is a tough, flexible tissue that acts as a cushion between bones at joints. Some parts of the body such as the outer structure of the ear is completely made up of cartilage. Damage to the cartilage can cause pain. inflammation and in some cases even a degree of disability. Since cartilage does not have a blood supply, cartilage damage takes longer to heal than other injuries.

There are three main causes of cartilage damage

1. Direct impact: Cartilage can get damaged by heavy impact during a bad fall or an accident. For this reason, sportspersons have a high risk of suffering from cartilage damage.
2. Wear and tear: Over time, joint experiences wear and tear that can damage cartilage. The knees are often most affected by this. Obese people are at a higher risk of knee cartilage injury than others because of the additional pressure being out on the knees.
3. Lack of movement: Long periods of immobility or inactiveness can also cause damage to cartilage.

A physical examination may not be enough to diagnose cartilage damage as the symptoms of this condition are very similar to that of a sprain or ligament damage. In addition to a physical examination, a doctor may use Magnetic resonance imaging (MRI) or Arthroscopy. An MRI uses radio waves and a magnetic field to create a detailed image of the body. Arthroscopy involves the insertion of a tube-like instrument into the joint to determine the extent of cartilage injury.

Treatment for cartilage damage is both surgical and non-surgical.
Non-surgical treatment includes exercises, steroid injections and physical therapy.
If the patient does not respond well to this form of treatment, surgical options may be looked at. The type of surgery required depends on the age and activity level of the patient along with the extent of the injury.

Some of the surgical options include:

1. Debridement: This involves using a small arthroscopic instrument to smoothen the damaged cartilage and remove loose edges. This prevents the cartilage from rubbing against adjacent bone and muscle tissue.
2. Marrow stimulation: By drilling small holes under the damaged cartilage, the surgeon exposes blood vessels that lie inside the bone and trigger the formation of a blood clot. This, in turn, triggers the development of new cartilage.
3. Mosaicplasty: This procedure involves the transference of healthy cartilage from one part of the body to another. It is used for isolated cases of cartilage injury on patients who are below the age of 50. If you wish to discuss about any specific problem, you can consult an Orthopedist.