Dr. Karan Kishore Mane

Human bones are continuously being removed and formed, which is necessary for its proper maintenance. However, in certain cases, especially with aging, some bones and joints will be worn down to an extent where the body will not be able to reform them. This is especially true in the case of hips, which may become worn due to age or other problems within the body. 

Hip replacement surgery: 
When this happens, a hip replacement surgery can be performed to replace the original joints with a prosthesis or artificial hip, which is usually made out of metal or a specially formed composite material or even a combination of the two. Along with other parts, it replaces the natural hip with an artificial hip to restore mobility and other related functions.

Benefits of hip replacement surgery:

1. Lessening hip pain: This is one of the major factors as well as symptoms of requiring hip replacement surgery. Due to the grinding down of the bones, even the slightest movement causes pain and after the surgery and the recovery period, the pain is lessened.
2. Correction of bone deformity: When the bones grind down and are abnormally reformed, deformities may occur reducing mobility. Artificial hips will ensure that deformities are corrected and resulting problems are thus eliminated.
3. Return to normal activities: This is possibly one of the primary advantages of this surgery, although it entails a long recovery period. However, most patients can get back to their normal activities and are able to resume a pain free life.
4. Ability to have painless sleep: Many people who suffer from hip displacements or bone deformities are not able to sleep properly due to pain. After the surgery and the recovery period, they can return to normal functions and habits, thus are able to sleep properly.
5. Leg strength increase: Many patients tend to have an increase in their leg strength as one side of the hip tends to become very weak due to bone problems before surgery. After surgery and recovery, the same side tends to have an increased strength due to the implant.
6. In most cases a lifelong solution to hip problems: As the hip replacement prosthesis is made out of metal and if the operation is successful, it usually tends to last till the end of a person's life and this area usually doesn't tend to have problems again.

Do you remember the last time you had a searing knee pain in the middle of your morning run? It was probably because you did not warm up properly. The incidence of injuries in various sports has gone up in the recent times, and it is mostly due to the lack of proper warm up exercises. However, other factors come into play as well, such as the pressure of increased workload on the current batch of athletes, missing a trick or two with the proper technique to be followed, etc.

In order to reduce the risk of an injury, it is advised to follow these simple tips:

1. Set realistic goals for yourself: Don’t go overboard with anything that includes repetitively stressing and straining your body over a certain degree. If you are planning to go for a run or hit to the gym, make sure you set goals that you can sustain and find feasible. One example of this would be to not increase the amount of weight drastically while lifting weights as it can lead to serious injuries.

2. Follow the right technique: Proper technique is very important in sports, a lack of which can lead to injuries. Ask your trainer to observe your form when you perform any activity. Focus on your breathing and posture when you are exercising.

3. Warm up before you begin exercising: Warming up before you exercise or play a sport is important as it helps loosen your muscles and boost blood circulation. It drastically reduces the risks of sustaining injuries, and also prepares your body for the subsequent exercise.

4. Cool down: Similar to an essential warm up is the need to cool down; it is another aspect that should not be ignored. Cooling down usually consists of stretches and postures that promote flexibility. The muscles become sore after working out. Stretching can help reduce post workout pain and make the joints flexible. Cooling down also helps in eliminating lactic acid from the muscles, which means less pain after exercise.

5. Listen to your body: During an activity, if you feel that you can no longer carry on, terminate the activity. The chances of injury rise if you continue to push your body over your threshold limit. If you think that you can no longer carry on doing something without risking an injury, avoid doing it altogether. Listen to your body, and it shall never fail you.

Osteoporosis is a commonly experienced condition where the bones tend to get thin and become hollow over time. This is a condition that is experienced mostly by people who are over the age of 50 years, and even more commonly by women who have been through menopause. Other risk factors include smoking as well as medication which can lead to such degenerative diseases as a side effect. Let us find out about living with osteoporosis and the many myths and facts surrounding the same-

1. A Natural Part of Aging: This is a fact. While not everyone who ages will wind up with this condition, it is commonly experienced by patients who are growing old. One can resort to taking calcium supplements as well as plenty of Vitamin D in order to prevent the risk of fractures that are a common occurrence in such a condition where the bones become too hollow. Also, mild and moderate exercise will help the condition.
2. Only Female Patients: This is a myth. While it is true that women form a major risk group when it comes to this condition, there are many men who also suffer from it. It has been demonstrated by various medical studies that one in every five men in the USA alone are prone to this condition. Furthermore, due to exercise, sports and other heavy manual work, young men are more likely to end up with a fractured bone than an aging woman.
3. Worry only when you are Old: This is also a myth. One must remember that the major bone mass forms by the time a person hits the age of 18 to 20 years. This is the time when nutrition, exercise and lifestyles must be structured in a way that such troubles like osteoporosis will not follow you into the later years when your bones begin to age. Ample and strong bone mass nourished by proper habits, will help in preventing such conditions to a large extent.
4. Fractures only happen if you Fall: This is another myth. It is important to keep in mind that living with a condition like osteoporosis means that you have to be vigilant at all times in your daily routine and other activities. Strain on the bones can also lead to fractures, and one does not necessarily have to fall down to get one. Leaning over too much can also lead to a fracture!
5. You can feel the Degeneration: It is another myth that you can actually feel your bones getting weaker. Usually, there are no symptoms of this condition until it has progressed to a particularly painful stage in your life. The best way to find out if you are suffering from osteoporosis is by taking a bone density test. 

Inflammation or swelling can be caused due to body's natural response to injury or disease. And arthritis is a disease in which the joints in your body swell. The inflammation or swelling can cause discomfort in the form of pain, stiffness as well as difficulty in movement.

Some of the common causes of arthritis are:

1. Infections in the joint.
2. Genetic makeup in which arthritis can be a hereditary trait
3. Imbalance in the immunity system
4. Physically taxing work life or injuries caused in an accident

Risk factors associated with arthritis:

1. Obesity - Excess weight can put a lot of pressure on the joints, on the knees and hips in particular. Hence, obese people have more chances of developing arthritis than fitter people.
2. Age - The risk of arthritis can increase with age. Types like osteoarthritis, rheumatoid arthritis and gout are more common in the old age.
3. Joint injury - Joint injury caused due to accidents or due to sports activities can trigger arthritis. People with previous joint injuries can develop arthritis in that joint.
4. Family history - You can be prone to develop arthritis if it runs in the family. It can occur due to its hereditary trait hence making you more vulnerable to the environmental factors which contribute to developing arthritis.
5. Gender - Your sex is an important factor as women are more likely to develop rheumatoid arthritis while men are prone to suffer from gout.

Tips to deal with arthritis:

1. Take Vitamins and olive oil: Vitamins are crucial, especially A, C and D. Vitamin A can be found in carrots. vitamin D can yet again be found in fish while vitamin C can be found in strawberries, mangoes, pineapples and oranges. Olive oil is also useful because it contains polyphenols which reduce the chances of developing arthritis.
2. Control your weight: This is very important, especially for your knees. It has been proven by researchers at John Hopkins University that if you are 10 kg overweight, then 30 to 60 extra kilograms of weight fall on your knees.
3. Take Omega-3 fatty acids: Research proves that the regular consumption of Omega-3 fatty acids, present in fish, result in decreased risks of rheumatoid arthritis. Omega-3 fatty acids are also found in foods such as olive oil and walnuts.

The medical term used to describe a broken wrist is wrist fracture. The fracture might be in the 10 bones, which make up the wrist or in the radius. Some fractures can be serious while others may be tiny. The serious fractures make the bone unstable and these might require surgeries to cure. Open fracture is when the bone breaks and it breaks through the skin. This might cause an infection to the wounded area.

• Causes: The most basic cause of a wrist fracture is injury. Any fall on your outstretched hand and you might have to nurse a fractured wrist. This type of fracture is common among sportsmen. If you are suffering from osteoporosis, then you have a high risk of getting a wrist fracture. Traumatic accidents may also cause severe wrist fractures.
• Symptoms: The symptoms of a wrist fracture can be extremely painful. The pain escalates whenever you try to move your wrist or flex it, even if you are just flexing your fingers. Sometimes your hand or arm may even become extremely numb when you fracture the wrist. The muscles in the area become tender and swell up. It is almost impossible to move the wrist after it gets fractured. The fracture causes the wrist or rather the hand to appear deformed. The area around the fracture might even get bruise and a fractured wrist also affects the blood flow in the area. You might even injure your muscles, ligaments, tendons and nerves.
• Diagnosis: To confirm and check the level of severity, you are generally asked to get an X-ray done. In order to get a more detailed look at the fracture, you might have to undergo CT or MRI scans as well. Usually to treat a fracture, you will have to wear a splint and move your hand as least as possible. But keep moving you're your fingers otherwise they might get stiff. Your doctor will inform you from when you will be able to move your wrist. Until then try to keep your movements to the minimal.

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!