Dr. Karan Kishore Mane

Your knee is a very complex structure consisting of bones, ligaments, cartilage, tendons, muscles and meniscus. Most people encounter knee pain at some point in their lives. If your knee pain is chronic in nature, then it may last for a prolonged period.

Many causes may be responsible for your knee pain. Some of the causes are stated as follows:

1. Your knee is very much prone to injuries. Knee injuries may happen due to accidents, falling down carelessly or while playing sports. The most common knee injuries that may be the cause for your knee pain are mentioned as follows: 

• Fractures may cause you to feel pain in the areas of your knee bones.
• Anterior Cruciate Ligament injury (ligament injury caused by twisting and a sudden motion) or Medial Collateral Ligament injury (injury to the tissue in the insides of your knee) is very common to sportspersons and may be the reason for severe knee pain.
• Sometimes your knee bones may get dislocated from their usual alignment. This can also make you experience severe knee pain.
• Ligament injuries, meniscus tear or tendon tear can also be responsible for your knee pain.

2. Sometimes pain in your buttock or foot region can also result in mild knee pain.

3. At times chronic problems like osteoarthritis that affects the cartilage can cause the problem of knee pain. Other chronic problems like Gout, rheumatoid arthritis can also cause severe knee pain.

4. Being overweight can also result in knee pain.

The symptoms of knee pain may be different in each case. The most common symptoms are mentioned below:

• Stiffness of knee
• Swelling of your knee
• You may also feel unstable
• Difficulty in walking or bending of your knee.
• You may notice redness in your knee area.

Knee pain must not be ignored. It is highly recommended for you to seek advice from an orthopedic as soon as you encounter any of the above mentioned symptoms.

In general, anterior cruciate ligament injuries, or ACL injuries, are understood to be tears in any of the several knee ligaments joining the upper leg bone and the lower leg bone. This can vary from minor injuries, such as small ligament tears, to more serious cases, like complete tears or when the ligament and one of the bones gets displaced from the other. These injuries usually occur during sports activities, like soccer, basketball, football, gymnastics, tennis, volleyball, etc. An untreated ACL injury can lead to a condition called an ACL deficiency. This can cause a lot of problems with regard to knee movements as the bones may rub against each other, causing a lot of pain. In some cases, the cartilage covering the ends of the bones may get damaged, eventually tearing and trapping the cushion pads supporting the knee joints.

Symptoms

Signs and symptoms of anterior cruciate ligament may include:
1. You are unable to move properly.
2. You experience immense pain while walking up and down stairs.
3. You are unable to engage much in physical activities.
4. Your knee begins to swell gradually.
5. You can sense a loud popping sensation when moving your knee.

6. You experience feelings of instability.

Causes
Anterior cruciate ligament injuries generally occur during sports. Here are some common possible instances that might happen during a game:
1. Sudden arrest in motion
2. An unsteady landing from a jump
3. Direct blows to the knee from tackles
4. Sudden shifts in direction

Treatment
Treatment of ACL injuries normally involves the following:

1. Immediate medical attention along with intense first aid care

2. Sincere adherence to the R.I.C.E model of self care -
- Rest: proper rest for a couple of weeks or months depending upon the severity of the injury
- Ice: using ice packs to help cool the nerves
- Compression: ice treatment further helps in compression
- Elevation: when lying down in bed, it is strongly recommended that you keep your affected leg at a slightly higher position, through the use of pillows or cushions

3. Success rehabilitative therapy for several weeks

4. Anterior cruciate ligament surgery or reconstruction

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

Hip replacement surgery is a method wherein a defective hip joint is removed and replaced with an artificial hip joint. This procedure is only opted for after all the other treatments have failed to yield the desired effects. Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. The goals of this surgery are to:

• Relieve pain

• Help the hip joint work better

• Improve walking and other movements.

Who Should Have Hip Replacement Surgery?

The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:

1. Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)

2. Osteonecrosis (a disease that causes the bone in joints to die)

3. Injury of the hip joint

4. Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:

1. Walking aids, such as a cane

2. An exercise program

3. Physical therapy

4. Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

The Procedure-

Hip replacement surgery is a procedure that can either be performed by traditional means or a minimally invasive procedure. The primary difference between the two procedures is the size of the incision. The procedure begins with the doctor administering local anesthesia, though in certain cases, general anesthesia is also administered.

1. An incision is then made along the hip and the muscles that are connected to the thigh bone are shifted, so that the hip joint is exposed.

2. An equipment is then used to remove the ball socket of the joint by cutting the thighbone.

3. The artificial joint is then fixed to the thighbone and it is allowed to adhere properly.

4. Once the joint is fixed, the ball of the thighbone is then put in the hip socket.

5. The fluids from the incision area are then allowed to drain.

6. The hip muscles are then put in place and the incision is closed.

Post -surgery-

After the surgery, the recovery stage begins. The period of hospital stay post-surgery usually lasts for 4-6 days. A drainage tube is attached to the bladder to get rid of waste products from the body. Physical therapy begins immediately after the surgery and you will be able to walk after a few days with walking aids. The physical therapy continues for a few months after the surgery.

After care-

It is advised to avoid activities that involve twisting your leg for at least half a year. You should also avoid crossing the leg along the mid portion of your body. Your physiotherapist will provide you with exercises that aid to help you recover. Avoid climbing stairs and sit on chairs that have strong back support.

Get a diagnosis before anything else. It is really important to know what is causing your pain. See a doctor before you start doing any exercises or taking any medication. There are many reasons your hip could be in pain, including arthritis, bursitis, or an injury you've got while playing a sport. Always ask your doctor what you should and should not be doing, given the cause of your hip pain.

1. Ice your joints: Holding ice to your hips will reduce inflammation of your joints. You should hold an ice pack to the affected area for 15 minutes several times a day. If you find that the ice pack is uncomfortably cold, wrap it in a towel and then place it on the pained area.

2. Heat your joints if you have arthritis in your hips: Heating your joints can soothe the pain you feel. Consider taking a hot bath or shower, or soak in a hot tub if there is one available to you. You could also consider purchasing a hot pad that you can place directly on your hip. Do not use heat to soothe your joints if you have bursitis. Heat can cause hips affected by bursitis to actually become more inflamed.

3. Get some rest: If you have injured your hip, the best thing you can do is to simply give your hip time to heal. Avoid anything that causes you to feel pain in your hip. Instead, grab an ice pack, a bowl of popcorn and watch some movies. You should give your hip a rest for at least 24 to 48 hours.

4. Avoid high-impact activities: If you are in severe pain, chances are you won’t feel like running or jumping anyway, but it is good to keep in mind that these activities should be avoided. High-impact activities will cause your joints to become more inflamed, thus causing your more pain. Instead of running, try taking a brisk walk, as walking has much less of an impact on your joints.

5. Consider losing weight: The more your body weighs, the more weight your painful hip is burdened with supporting. Losing weight can help ease hip pain simply by removing some of that weight that stresses the cartilage and joints.

6. Choose the right shoes: You should buy shoes that give you as much support as possible. Look for shoes that have great cushions, or have removable insoles so that you can add orthopaedics. The sole should have good shock absorption, should limit pronation (turning or rotating the foot) and will evenly distribute pressure along the length of your foot.

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