Dr. Kunal Makhija

With age, the mobility and flexibility of the knee joint reduces significantly. This can affect one’s lifestyle as simple activities such as walking or lying down become painful and difficult. Moreover, there is the emotional stress resulting from an inability to perform routine activities smoothly. In short, any serious problem of the knee joint can affect your ability to function well.

Apart from medications and exercise, the only way to permanently treat such problems in the knee is to go for a joint replacement surgery. The Subvastus approach is often considered to be the best form of knee replacement for a number of reasons.

Subvastus Knee Replacement
Here is a look at the step-by-step procedure for performing a subvastus total knee replacement surgery.

1. An 8-10 cm long incision is made on the knee.
2. The thigh muscles are left intact and the knee joint is accessed from below the quadriceps.
3. The bones in question are cut into place without actually separating them
4. The kneecap is pushed to the side and is generally left intact in the subvastus approach.

Advantages of Subvastus Knee Replacement
This form of surgery is greatly preferred over the conventional knee replacement surgeries. Its benefits include-

1. Minimally invasive- A very small incision is made for the surgery (8-10 cm), which means that the risk is lower. Comparatively, in conventional knee replacement, the incision is around 20-25 cm.
2. No trauma to muscles- In subvastus approach, the muscles are not cut in order to get to the joint. Instead, surgeons simply bypass the quadriceps and get to the joint from a different angle. This ensures that muscle integrity is intact.
3. Quicker recovery- Since the incision being made is smaller and since the muscles are not cut into during the surgery, patients recover much faster in case of subvastus knee replacement. Patients will be able to walk within 2 weeks of the surgery and resume normal life in just 2-3 months.
4. Full bend to the knee- Care is taken during the surgery to ensure that the implanted joint achieves a full bend from the very outset of recovery.

Given the advantages, If you are eligible for the subvastus knee replacement surgery, opt for it.

Hip replacement is a surgery in which a specialist doctor surgically removes an agonizing hip joint afflicted with arthritis and replaces it with a man-made joint usually produced using metal and plastic elements. It is usually done when all other treatment choices have been tried and have proven unsuccessful in providing satisfactory pain alleviation. The technique is to mitigate the pain in ahip joint, in order to make walking and other physical exercises easier.

The surgical procedure is as follows:

• Hip replacement surgery can be performed generally or by utilizing what is called a non-obtrusive method. The primary difference between the two methodologies is the number of entry points needed for the surgery.
• During standard hip replacement surgery, you are given general anesthesia to relax your muscles; this will keep you from feeling any pain during the surgery or being awake during the surgery. A spinal sedative might be given to counteract pain as an add-on option.
• The specialist will then make a cut at the edge of the hip and move the muscles connected to the highest point of the thighbone to uncover the hip joint.
• Next, the ball part of the joint is taken out by cutting the thighbone with a saw. At this point a fake joint is attached to the thighbone using a material that allows them to stay intact.
• The specialist then readies the surface of the hipbone - evacuating any harmed ligament - and joins the substituting attachment to the hipbone.
• The new ball part of the thighbone is then embedded into the new joint part of the hip. The specialist then reattaches the muscles and shuts the entry point.

There are some things you need to keep in mind and be attentive about, post the surgery. These are as follows:

1. You will probably remain in the healing facility for four to six days and may need to remain in bed with a pad between your legs to keep the new hip joint set up.
2. A seepage tube will be set in your bladder to help you urinate without having to walk to the bathroom.
3. Non-intrusive treatment usually starts the day after surgery and within the days you can go around with a walker or a walking stick.
4. You will continue with the non-intrusive treatment for quite a long time which could be a number of months post the surgery.
5. For anywhere in the range of six to twelve months after hip replacement surgery, rotating or putting pressure on the operated leg needs to be limited to a great extent. You need to likewise not cross the operated leg past the midline of the body nor turn it inwards.
6. You cannot twist the hip past ninety degrees. This includes both twisting forward at the abdomen and crouching.
7. Your physical advisor will tell you the methods and equipment that will help you comply with the above rules and precautionary measures while performing every day exercises.

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

Are you experiencing knee pain and seek ideal treatment for your condition? Knee pain is a very common issue which may develop in any bony structure of your body, comprising your kneecap, the knee joint, ligaments, and cartilages of your knee. Knee pain is common in people of all ages, and simple home remedies can be used to treat knee pain effectively. In severe cases, professional treatment or help is required.

Symptoms

• The location of your knee pain varies based on the structure that is involved.
• Your whole knee may swell up and seem painful in the case of infections and inflammatory processes. On the other hand, a bone fracture may show symptoms in one specific area.
• The severity of knee pain may vary from acute to serious and disabling.

Other common symptoms associated with knee pain include the following:

• Difficulty in walking because of knee instability.
• Limping because of discomfort.
• Difficulty in going up and down the staircase because of ligament damage.
• Swelling and redness.
• The inability of extending the knee.

Causes
Knee pain may occur because of several reasons, and factors. Generally, knee pain is classified into 3 primary categories. They are:

• Acute injuries that include broken bones, a meniscal tear, or a torn ligament.
• Medication conditions which commonly include the likes of arthritis, and various infections.
• Conditions that occur on account of chronic use and overuse, such as patellar syndromes, tendinitis, bursitis, and osteoarthritis.

Treatment

There are several treatment measures for knee pain, based on the cause, your condition, and severity. The most common treatment procedures include the following:

Medications

• Several medications are used for the treatment of an underlying medical condition that causes knee pain, for effective pain relief.

Physical therapy

• Strengthening of the muscles surrounding the ankle makes it stable and helps in achieving the best mechanical movements.
• This is effective in avoiding injuries and preventing an existing injury from worsening.

Injections

• Several injectable medications are injected into your knee directly.
• Corticosteroids and lubricants are commonly used for dealing with inflammation in the knee, and for improving movement and pain.

Surgery

• In case of severe and persistent knee pain, a surgery may be required. Knee operations include arthroscopic surgeries, total knee replacement and much more.
• Arthroscopic surgery is the most common procedure in which injuries in your knee are repaired and pieces of loose cartilage and bone are removed.
• During partial knee replacement, the damaged parts of your knee are replaced with metal and plastic parts. Only a part of the knee joint gets replaced.

There are several other therapies that are also beneficial for the treatment of knee pain. You can opt for acupuncture, which is ideal for osteoarthritis patients. Glucosamine and chondroitin supplements are also prescribed in some cases. In case you have a concern or query you can always consult an expert & get answers to your questions!

Hello! friends,

I am Dr. Kunal Makhija. I am in Orthopedist and a joint replacement surgeon practicing in Mumbai and Navi Mumbai.

Today we will talk about knee pain. The second most common complaint in any Orthopaedic clinic. We won't discuss any surgeries or any treatment or any medicines. We will discuss the basics of knee pain, what is the physiology of the knee pain and what a common man should know about knee pain. The most common causes of knee pain are osteoarthritis, injury, synovitis or softening of cartilage. Now to understand all four things, I will explain to you what these 4 things are and how can you tackle them and how can you come to know that what these things represent.

A knee consists of the femur bone, tibia bone, these are the ligaments and these white cushion like the thing is a cartilage. Usually, in case of the softening of cartilage, there is softening of these white cushion like materials which is extremely common behind kneecap or patella. So usually the patient will present with patellofemoral pain which is more while climbing down stairs or when he or she is sitting for long and he starts walking, the first few steps would be extremely painful.

This is mainly because of the softening of cartilage behind the kneecap known as chondromalacia patella. The second cause is an injury. The injury will be of ligament or of this meniscus. A ligament injury or a meniscus injury will cause pain in ligament injury one will have extreme instability especially while running, climbing down steps or hopping. In meniscus injury, there would be a pain while long walks and extreme flexion of the knee. The third cause is synovitis. Synovitis is swelling in the knee which will be associated with extreme swelling, redness, and warmth usually associated with some viral infection or maybe the underlying cause.

The patient will have extreme pain associated with body aches for fever and he or she might proceed with a viral infection like the common cold and all. The fourth cause is osteoarthritis which is very well known and it is a degeneration of this white cartilage. Usually, this is a mild form of degeneration, you can see this and this is the severe form of degeneration. This cartilage when destroyed will cause extreme pain in all movements and might cause deformity in the knee as well.

So all these four common causes, they are not always in extreme form. They might start with a mild form, then go to moderate and severe form. So before they go to the severe form and they hamper your regular activities, one can start the prevention as soon as there is some knee pain. These are lifestyle changes, physiotherapy and some exercises. Lifestyle modification means if one is going to the gym, I would suggest cycling and swimming are the best exercises for knee. One can even walk in water if one does not know swimming and one should avoid treadmill and be climbing downstairs because a knee is a joint which accommodates all weight while walking. When a person is walking, suppose a 50 kg person is walking while climbing downstairs the knee joint will experience twice.

Joint pains can be a cluttered affair and believe it or not 9 out of the 10 cases have to live with the pain despite all the treatment options aiming to reduce the agony. There may be several instances where you might be coming across the term “joint replacement surgery”. No, no need to panic! We are not living in the 1960’s anymore. We are living in the age of cut throat medical innovations that is actually hard to keep up. To sum up in a layman’s turn joint replacements have become as easy as dressing a wound. 90% of the cases are carried out within few hours and the patient is required to stay not more than a day or two at the hospital. the patients no longer have to dedicate a part of our lives for the recovery. Let us have an in-depth look at it.

One shouldn't wait for the condition of knee joints to get worse and visit a well-known orthopaedic and go ahead for the procedure. Since, it involves the portion of your knee cartilage or a portion of the joint being scrapped/cut to pave way for the artificial joint parts to be attached getting the best treatment is a must. So, make no mistakes!

Knee replacement has always been a complex procedure but with the advancements in the field, the process has become much more simple and easy. Discuss the procedure in detail with your doctor and also ensure that you choose a clinic with a good reputation for such a course of action. Joint replacements in today's time last much longer and with proper maintenance and care, they can in some cases, last for a life time.

Once you have decided to go for the treatment get a detailed list of activities that can be carried out for a speedy recovery. Usually, these would involve medications and physiotherapy exercises. Also, the recovery period is minimal and once completely cured, you can get back to normal day to day activities. Do note that you go in for an authentic and established replacement center and avoid falling prey to the fly by wire clinics that have mushroomed in every street corner. Also, ensure that you choose the procedure that fits your budget and insurance plan.

Joint replacement procedures usually do not require any maintenance and if needed you might have to go for regular checkups to make sure that the joints carry on well. Choose the best clinic for the replacements and live a healthy and fruitful life. In case you have a concern or query you can always consult an expert & get answers to your questions!

The knee is one of the biggest and most complex joints in the body. The knee is joined by the thigh bone (femur) to the shinbone (tibia). The little bones that keep running nearby the tibia (fibula) and the kneecap (patella) are alternate bones that make the knee joint. Ligaments associated with the knee-related leg muscles move the knee joint. Tendons join the knee bones and provide help to the knee:

• The foremost tendon keeps the femur from sliding in reverse on the tibia (or the tibia sliding forward on the femur).
• The back tendon keeps the femur from sliding forward on the tibia (or the tibia from sliding in reverse on the femur).
• The average and horizontal tendons keep the femur from sliding side to side.

Some of the most common knee joint conditions are as follows:

1. Chondromalacia patella: Irritation of the ligament underneath the kneecap (patella), bringing about knee pain. This is a typical reason for knee pain in youngsters.
2. Knee osteoarthritis: Osteoarthritis is the most widely recognized type of joint inflammation and regularly influences the knees. It is caused by maturing and wear and tear of the ligament. Its indications may include knee pain, swelling and stiffness.
3. Meniscal tear: Damage to a meniscus, the ligament that supports the knee, regularly happens when the knee is twisted.
4. ACL strain or tear: The ACL is in charge of a substantial part of the knee's flexibility. An ACL tear regularly leads to the knee popping out and may require surgical repair.
5. PCL strain or tear: PCL tears can bring about pain, swelling, and knee unsteadiness. These wounds are less normal than ACL tears, and exercise based recovery is generally the best alternative.
6. Patellar subluxation: The kneecap slides or separates along the thigh bone during movement, causing pain around the knee cap.
7. Patellar tendonitis: Inflammation of the ligament related the kneecap (patella) to the shinbone. This happens mostly in competitors from rehashed bouncing.

Some of the most common and effective knee treatments are as follows:

1. RICE treatment: Rest, ice, compression and elevation stand for RICE. The RICE treatment is a great solution for some knee conditions.
2. Pain medications: Over-the-counter medicines or pain relievers, for example, acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) can treat most knee joint pains.
3. Non-intrusive treatment: An exercise routine can strengthen the muscles surrounding the knee, expanding the knee's strength.
4. Cortisone infusion: Injecting steroid into the knee that can diminish pain and swelling.
5. Hyaluronan infusion: Injection of a “gooey” material into the knee that may diminish pain from the joint and delay the requirement for a knee surgery.
6. Knee surgery: Surgery might be done to amend a number of knee conditions. Surgery can supplant or repair a torn tendon, expel a harmed meniscus, or replace a seriously harmed knee.
7. Arthroscopic surgery: An endoscope is embedded into the knee joint. Arthroscopic surgery has a shorter recovery and restoration period than open surgery.

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

Knee joint surgery is a long and arduous procedure in most causes. However, outpatient procedures sometimes take less than an hour and require minimal recovery time. It is commonly conducted in cases of:

1. Progressive arthritisa
2. Injury, dislocation or fracture
3. To fix deformities

If one is aware of these informative tips post-surgery, recovery can be a less painful and easier process :

1. Clean linen sheets to prevent infection to the wound
2. In case of pain, ice packs over the bandage can be used. However, one should be cautious as extended use of ice can result in cold burns
3. Installation of preventive fall equipment is necessary to ensure that the patient does not sustain further injuries post-surgery.
4. Knee surgery recovery can be very time consuming in which case, the patient may experience high levels of anxiety, and depression. A close friend should be available in times of emotional need to reduce negative feelings.
5. Crutches and other supportive objects should perpetually be in close proximity to the patient as it can be very difficult for patients to reach their close destination without the help of these necessities when in need.
6. In case of intensive pain attacks, the patient should be taught relaxation techniques such as breathing in and out or breathing intensively in settled intervals
7. The patient should be put on a strict diet consisting of fruits, vegetables, carbohydrates and healthy fat to allow faster recovery
8. The patient should also get 8-10 hours of sleep daily to allow the system to recover on its own
9. The patient should not put pressure on their body during the recovery time, especially the injured area

It is a prerequisite for the families and loved ones of the patients to show emotional support as feelings of isolation can cause further pain to the patient. Along with that, the patient should keep a positive attitude during the course of their bed-rest time. If one keeps these tips noted, recovery can be a less arduous condition.

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

When performing simple daily activities like climbing stairs, getting out of a chair, or walking tend to become a rather painful experience, knee replacement surgery seems to be the only suitable solution. Referred to as arthroplasty, it is a common surgery nowadays and ideal when several other therapies and injections fail to bring back the knees into the normal functioning order. Below are some the things that one can expect from a knee replacement surgery.

1. Medications: It is quite natural to receive lots of prescribed medicines right after the completion of the surgery. From antibiotics to painkillers, one needs to be ready to have various medicines which are meant to relieve the pain of the surgery as well as to prevent blood clots. However, the drug dosages continue to get lesser, after each passing day, depending on how well the knees are performing.
2. CPM: Taking the help of CPM or continuous passive motion becomes necessary for many people after having the knee replacement surgery. Depending on the condition of one’s knee, one might need to spend time in a CPM system, which helps in keeping the knee flexible. There’s a cradle in the machine for the legs, and the machine is fitted with the joint position and leg length. One can adjust the level up to which the machine can bend the knees, depending on their comfort level.
3. Walking: The majority of the people who undergo knee replacement surgery can walk the very day of the surgery or the next day. Most of the people become able to bear the weight of the replaced knee with the help of crutches or walkers. However, one can expect a bit of pain when starting to walk for the first time after surgery.
4. Rehabilitation: The primary purpose of rehabilitation after a knee replacement surgery is to make one capable of bending his or her knees at least 90 degrees which is essential for performing the daily activities easily. Several therapies can make the rehabilitation process a success and make the knees bendable more than 90 degrees in most of the cases.
5. Exercise: Most people go home within a few days after a knee replacement surgery and is essential to take care post-surgery. The best way to maintain the good health of the knees is by performing the exercise program regularly, which is suggested by the doctors. Following the exercise program regularly and performing regular short walks, can make the knees flexible like before while regaining their strength as well as the motion range more quickly.

It's best to visit one's doctor from time to time, even months after the knee replacement surgery is done to not only monitor his or her knee replacement; but also to ensure that there are no risks of any complications. In case you have a concern or query you can always consult an expert & get answers to your questions!

Mobility for a person is very important, and when you look through, the hip is a very important component to this. It connects the upper and lower parts of the body and helps in movement. It is a ball and socket joint, where the hip bone provides a socket, into which the upper part of the thighbone (femur) sits into, allowing for free movement.

Like any other human organ, the hip also is prone to damage. Be it natural ageing, infection, injury, or diseases, hip movement can be affected, leading to limited movement and increased pain and stiffness. For these people, being able to get back a hip which will allow them to be back on their feet is a boon for sure. It helps in relieving pain and improving mobility, almost giving people a second lease of life.

Reasons for hip replacement:

1. With natural ageing, the hip joint can lose its ability to move, due to normal wear and tear of the hip and thigh bones
2. Diseases of the hips (infectious or autoimmune) can also lead to hip replacement
3. Injury or trauma is another major cause that requires hip replacement
4. Joint problems, leading to repeated dislocations
5. Tumours of the relevant bones

Understanding the procedure in detail

1. The affected bones (whether diseases or worn out) are replaced with a prosthesis which is compatible with the normal body tissue.
2. While some materials fuse to the natural bone, others do not and are simply placed as a separate unit
3. This is a surgery which requires hospitalisation and stays for up to 5 days depending on patient’s overall health condition
4. The entire procedure may take a couple of hours and is usually done under general anaesthesia
5. An incision is made through the side of the hip
6. Both the hip and the thigh joints are prepared, diseased tissue removed, re-shaped, etc. to make way for the prosthesis
7. The prosthesis is introduced through the same incision and positioned into place
8. As noted earlier, there are two types. The ones which fuse to the bone have pores in them into which normal bone eventually grows.
9. The other variety is the cemented version, and a glue is used to keep it in place
10. Most doctors now use a combination, that is cement a porous prosthesis, into which bone will grow, and the incisions are closed
11. The patient stays in the hospital for 1 to 4 days depending on overall health
12. Once discharged, infection and pain control are continued
13. Exercise and physiotherapy play a major role in restoring normal function
14. Weight management is also very important

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

Osteoarthritis is a condition that causes cartilages in the joints of a human body to wear away. The joints in your body are made of bones and the ends of each bone have cartilages to prevent friction between them. Certain factors like age, nutrition or health threats can cause the cartilages to break down into bits and pieces. As a result, bones come into direct contact with one another causing the joints to swell or to turn tender.

Take a look at the following factors that can cause osteoarthritis

1. Stress on specific joints due to certain postures: The triggering cause behind acute joint pain could be the way you sit for long hours in a day. A sportsperson might face joint pains due to his or her occupation. Similarly, any person required to sit or stand for a long stretch of time due to his/her jobs can suffer from osteoarthritis as well.
2. There might be a deformity in any of your joints: A person born with joint deformities might suffer from arthritic problems later in life. Severe accidents can lead to deformities too.
3. You may have suffered injuries that resulted in the condition: Joint pains needn’t always require an impactful injury. Mild or heavy injuries can lead to arthritis all the same. Defects in the joint cartilage could be passed on through genes.
4. Age could also be a contributing factor: If a person is aging, his or her chances of developing osteoarthritis increase manifold. Age can make your bones and cartilages go weak. As you grow older, the capacity of your bones to absorb nutrition also decreases.

Prevalent symptoms that help you identify osteoarthritis

1. A grinding sensation in the joints: A person suffering from osteoarthritis will experience continual bouts of grinding pain in the joints. This may keep him or her from walking, sitting, working or even resting. The grinding sensation is indeed disabling.
2. You tend to face stiffness in the bones: Patients with this kind of arthritis have been reported with lacking flexibility in their joints. If they are sitting for too long, or have been inactive for some time or might have just woken up from sleep, they are likely to experience stiffness in their bones. Joints even turn sore in such situations.
3. Extra bits of bones could create trouble: Extra bits of bones that develop at a later age are also referred to as bone spurs. They stick around the sore area and make movement a real challenge.

Modes of treatment
If osteoarthritis is detected at an early age, it can be fought against using medications. However, when the disease is really discomforting, treatment procedures like acupuncture or regimented exercising can help a patient. Yoga also does wonders to remedy joint pain. Surgical procedures are also available but they should be fallen back upon as a lender of the last resort.