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Knee Injury Tips

Knee Replacement - Is Second Surgery Actually Required?

Dr. Vikas Mehra 90% (12 ratings)
Fellowship in Joint Replacement, M S Ortho, DNB (Orthopaedics)
Orthopedist, Chandigarh
Knee Replacement - Is Second Surgery Actually Required?

Of all the joints in the body, the knees probably see the maximum wear and tear. In cases of severe osteoarthritis, or injuries which destroy the knee joint, a total knee replacement surgery may be advised. This procedure involves the replacement of diseased cartilage and bone in the knees with artificial materials.

In cases of osteoarthritis and other such degenerative conditions, this procedure is performed only when the adjacent joints such as the hips are strong and healthy. Before the procedure, you may be advised to discontinue any blood thinning and anti-inflammatory medication. Your doctor will also conduct blood and urine tests to check for signs of anaemia, abnormal metabolism and infections. You may also be asked to lose weight if you are on the heavier side to reduce the pressure on your knees.

A total knee replacement surgery is usually performed under general anaesthesia. The lower end of the femur bone or thigh bone and the upper end of the tibia or calf bone are removed and replaced with a metal shell and plastic piece respectively. In some cases, a plastic ‘button’ may also be placed on the surface of the knee cap. If the posterior cruciate ligament in intact it is left as is or it is replaced by a polyethene post to stabilise the joint and prevent the calf from slipping backwards.

In most cases, a patient is discharged after 3-5 days of hospitalisation following the surgery. Post-surgery, it takes about a month for the patient to experience notable improvements. For optimal results, total knee surgery must be followed by physiotherapy and regular exercise. This helps prevent scarring and keeps the muscles strong enough to maintain joint stability. Exercising can also reduce recovery time. However, not all exercises are advisable. Avoid running, jumping, climbing stairs and contact sports which have a high risk of knee injury. Swimming is highly encouraged as it boosts endurance and muscle strength without putting any pressure on the joint.

In some cases, a second surgery may be required in cases of total knee replacement to fix fractures, loosening or complications of the artificial joint. As with any other surgical procedure, a total knee replacement surgery also has risks. Some of these are:

  1. Formation of blood clots that can cause shortness of breath, chest pain and shock
  2. Urinary tract infection
  3. Nausea and vomiting
  4. Knee pain and stiffness
  5. Nerve damage
  6. Internal bleeding in the knee
  7. Increased risk of infections

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

2683 people found this helpful

How To Treat Torn Cartilage?

Dr. Saravanan Manoharan 85% (10 ratings)
MS - Orthopaedics, MBBS
Orthopedist, Chennai
How To Treat Torn Cartilage?

Torn or damage cartilage is not just a problem for the sportsmen. It can occur to anyone. It is generally caused due to a direct hit on the body parts. Its treatment is far more complicated than a simple bone injury. The best sign to know whether or not you have injured your cartilage is to check out your activities. If you have hurt your joint and don’t notice major symptoms, like if you are still capable of putting weight on and move the joint, you might have had a cartilage injury. It doesn’t hurt you a lot in the beginning, but might get worse later. 

Here are the initial care and self-treatment procedure: 

  1. Protection: It is the first thing that has to be kept in mind. You must protect the affected area from any further injury. Thus, providing an external support, for example, use a knee brace. 
  2. Rest: Provide complete rest to the affected joint. The rest is must during the first two or three days. Crutches may help the situation if you’ve got an injury around your knee or ankle. It is then advisable to return back to light activity over the next few days or weeks, as prescribed by the doctor. 
  3. Ice: It is best to apply an ice pack to the injured area for about 15 to 20 minutes in every two to three hours. This must be repeated in the first two to three days. 
  4. Compression: Use a bandage to provide the needed compression to the injured area to avoid any swelling and movement. This will not let things go beyond control. 
  5. Elevation: You must keep the injured area raised. Keep it supported on a pillow to reduce swelling. 

If there is an unbearable pain, take painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). If your condition doesn’t improve after the initial therapy, you must consult a doctor immediately. 

  1. Physiotherapy: It can be helpful in treating the affected joint. If there is any difficulty in moving the affected joint, you must opt for physiotherapy. A professional will be able to teach you exercises that will strengthen your muscles and provide support to the joint. This will help you in getting rid of the pain. It can be also beneficial at a time when you are recovering from any surgical procedure. 
  2. Surgery: If physiotherapy doesn’t work, it means you have severe cartilage damage. In that case, you might be advised to take up surgical procedures to set things in proper shape. Surgery is done either by opening the joint or by Arthroscopy. There are various types of surgery which can be done. 1st the old and successful surgery wherein damaged part of the cartilage is debrided and filled with normal cartilage from the non-weight bearing part of the joint. 2nd is ACI (Autologous Chondrocyte Implantation) is a 2 stage procedure wherein chondrocyte is grown using stem cell and implanted in defect part in 2nd stage. 3rd is multiple drilling of the area usually done in childrens.

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

2281 people found this helpful

Disadvantages Of Exercising Outdoors!

Dr. Hitesh Khurana 87% (40 ratings)
MPTh/MPT, Bachelor In Physiotherapy, Mater of Physiotherapy
Physiotherapist, Delhi
Disadvantages Of Exercising Outdoors!

Exercising outdoors is fun and refreshing in its own way. An early morning jog or doing pull ups on the goal post are fun ways of working out. Summers are usually the best time to take your workouts outside, as it decreases stress levels and revitalizes your body. It is also a good method to increase vitamin D levels in the body as the body is exposed to the sun.

In spite of this, there are some disadvantages of taking your workout outside. Let's focus on them:

1.Chances of accidents go up
It is very common to see people jogging on the road with their headphones plugged in. Incidents of joggers being hit by cars are fairly common, due to the fact that they are unable to hear the honking of a car or may change course along the road without realizing a vehicle is nearby.

2.Too much exposure to the sun
Long distance runners are mostly affected as they log plenty of miles. This can lead to ultraviolet ray exposure which increases the risk of skin cancer. It can also lead to sunburns and tanning of the skin. It is also known to suppress immune system and increase the risk of various infectious diseases.

3.Injury problems
Working outdoors increases your chances of injuries. Running on hard surfaces tends to cause damage your calf, hamstrings and thighs. It can put more stress on your knee, calf and cause various problems such as runner's knee and shin splints.

4.Difficult to find Help
If you suffer from a serious injury while exercising outside, then it may be difficult to find help. If you injure a joint and are unable to walk, then it may be a problem in getting you proper treatment. This delay in treatment may cause the injury to aggravate.

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

3895 people found this helpful

Knee Injuries - What Things Should You Know?

Dr. Rahul Bade 89% (10 ratings)
MBBS, DNB (Orthopedics)
Orthopedist, Pune
Knee Injuries - What Things Should You Know?

Knee injury can occur from the direct blow as well as through stretching and twisting injuries. At times the ligament that holds the knee in place gets stressed and results in sprains. Depending on the extent of the ligament and fibre damage, the sprains are graded. Then there are knee injuries that are caused by overuse of it. These injuries cause harm to the tendons and the muscles. Since the knee is interconnected to a lot of other structures, any damage to the knee can have serious repercussion to other connected bones and ligaments.

What are the Risk Factors?

  1. Muscle imbalance leading to hamstring spasm.
  2. Imbalance of the thigh muscle leading to injury of the knee.
  3. Pregnant women and people who are overweight are at increased risk of  knee injury

Signs and Symptoms of a Knee Injury:

Knee injuries that are serious in nature can result in instant swelling along with difficulty in bending it. People may find it difficult to bear any sort of weight whatsoever. Joint pain, swelling, inflammation of the muscles are some of the other symptoms of injury to the knee. Pain, instability, locking of the knee can be felt while walking fast or climbing stairs.

When to Contact a Doctor?

Any knee injury should be instantly reported to a doctor. Signs such as deformity, loss of sensation, cold ankle, swelling of knee etc. are signs of a knee injury. A doctor should be consulted, if home remedies such as rest, elevation, compression and ice treatment fail to fetch any fruitful results. If the swollen area has become warm and red and accompanies fever, it is a sign to visit the doctor.

How is a Knee Injury Diagnosed by a Doctor?

A doctor starts the diagnosis with medical history along with physical exam of the patient. Doctor first does a thorough inspection of the nerve and blood supply of the area.The next step of the diagnosis includes palpation. This is a step where the doctor tries to find out the exact location of the pain and tries to correlate the same with the injury location. The doctor might also stress the ligament in order to find out if they are fine. Other imagery tests such as X-ray and MRI are performed to find out the exact location of the injury.

Treatment Available-

The nature of the injury decides the treatment plan. In many cases, the injured area is suggested to be kept at rest or moved in the specific direction as per the direction of a physiotherapist. For serious injuries with a tendon or ligament injury, a reconstructive surgery is necessary to get the knee to the original condition. The type of surgical procedure depends on the kind of Injury one have faced.

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

2514 people found this helpful

Runner's Knee - What Should You Do To Manage It?

Dr. Shekhar Srivastav 85% (10 ratings)
MS - Orthopaedics, MBBS
Orthopedist, Delhi
Runner's Knee - What Should You Do To Manage It?

Runner's knee is a painful condition that is usually encountered by athletes who indulge in varied exercises like running, jumping, walking, biking and more, on a regular or professional basis. The kneecap is a region that gets affected with aches and pain when a person is suffering from Runner's knee. This condition can occur due to a fall or constant bending of the knee, which can lead to misalignment of the knee joints and knee cap. Also, weak muscles and lack of balance during physical activities can add to the risk of contracting this condition.

Here's how you can deal with it.

  1. Give it Rest: Literally! Suffering from Runner's knee could also mean that your body is trying to ask you to slow down. Wear and tear from excessive levels of physical activity can lead to Runner's knee, and in such cases, the best way to come back to peak physical form is to take some rest so that the knee is free of activity and consequent pain until it is ready to take on exercise again.
  2. The Only Way is 'Up': When you are suffering from pain in the region behind and around the knee cap due to Runner's knee, the best way to alleviate the pain is to place your knee in an elevated position. Get yourself some comfortable cushions and pile a few of them up before placing your knee on top. This position will give support even as blood circulation increases and inflammation, if any, decreases.
  3. Anti-inflammation Medication: See your doctor for chronic Runner's knee and find out if you are suffering from inflammation which may require the help of medication. This medication can bring down and gradually eliminate the inflammation or swelling, to give you relief from the pain. Remember to check for side effects before you take these medicines, though.
  4. Strengthening Exercises: A sure shot way of dealing with chronic pain is to do some muscle strengthening exercises as prescribed by your orthopaedic specialist or a physiotherapist. Doing these exercises will give your muscles the strength to support your knees in a better way while you indulge in athletic activities. Remember to substantiate these exercises with a calcium and protein rich diet as well.
  5. Cold Compress: In case you have had a fall or suffered an injury which has led to Runner's knee, you can make use of a cold compress or an ice pack to relieve the pain for some time. Ice is a well-known treatment for acute and sudden pain.

Runner's knee is a condition that needs care, rest, and medication if it is persistent. If these methods do not help, you should see a doctor for scans and tests. In case you have a concern or query you can always consult an expert & get answers to your questions!

 

2436 people found this helpful

Physiotherapy Treatment of Mcl Injuries - Mechanism of Injury

Dr. Vishwas Virmani 93% (19570 ratings)
MPT, BPT
Physiotherapist, Noida
Physiotherapy Treatment of Mcl Injuries - Mechanism of Injury

MECHANISM OF INJURY 

The MCL is often injured as a result of a valgus force or combined valgus and external rotation forces. This injury can be caused by an external force such as a blow to the lateral aspect of the knee or falling to the side with the ipsilateral leg kept firmly fixed. Injury to the MCL is often associated with contact sports such as football in which there are frequent blows to the lateral side of the knee.

The deep portion of the MCL attaches to the periphery of the medial meniscus, and this firm attachment can often cause a peripheral tear due to a valgus force. 

TREATMENT OF MCL INJURIES 

The literature suggests that certain conditions must be met before optimal healing of the MCL can occur: 

1) the torn ligament fibers must remain incontinuity or be confined within a well-vascularized soft tissue bed; 

2)controlled, functional stresses help stimulate and direct the healing process and 

3) there must be some protection against harmful stresses during collagensynthesis and the remodeling or maturation phases. 

Thus we have to come toadopt the following criteria for surgical repair of the medial collateral ligament; 

1) failed conservative non operative treatment; 

2) complete rupture of the MCL with concomitant anterior cruciate ligament instability.

The severity of injury determined on physical examination determines the rehabilitation course and duration. The rehabilitation program is the same for minor to severe (grade 1 to grade 3) MCL sprains. However, the duration of treatment in each phase may be extended. The non operative rehabilitation of MCL sprains is based on five basic rehabilitation of MCL sprains is based on five basic rehabilitation principles: 

  • The effects of  immobilization must be minimized. 
  • Never over stress healing tissue. 
  • The patient must fulfill specific criteria to progress from stage to stage. 
  • The program must be adaptable to each patient. 

With these basic principles in mind, our rehabilitation program is based on early motion, early weight bearing, early control of pain and effusion, and retardation of muscle atrophy (especially the quadriceps).

Torn Cartilage - Is Surgery Required For It?

Dr. Akhilesh Rathi 87% (44 ratings)
MCh Ortho, DNB Ortho, MS Ortho, MBBS
Orthopedist, Delhi
Torn Cartilage - Is Surgery Required For It?

Torn or damage cartilage is not just a problem for the sportsmen. It can occur to anyone. It is generally caused due to a direct hit on the body parts. Its treatment is far more complicated than a simple bone injury. The best sign to know whether or not you have injured your cartilage is to check out your activities. If you have hurt your joint and don’t notice major symptoms, like if you are still capable of putting weight on and move the joint, you might have had a cartilage injury. It doesn’t hurt you a lot in the beginning, but might get worse later. 

Here are the initial care and self-treatment procedure: 

  1. Protection: It is the first thing that has to be kept in mind. You must protect the affected area from any further injury. Thus, providing an external support, for example, use a knee brace. 
  2. Rest: Provide complete rest to the affected joint. The rest is must during the first two or three days. Crutches may help the situation if you’ve got an injury around your knee or ankle. It is then advisable to return back to light activity over the next few days or weeks, as prescribed by the doctor. 
  3. Ice: It is best to apply an ice pack to the injured area for about 15 to 20 minutes in every two to three hours. This must be repeated in the first two to three days. 
  4. Compression: Use a bandage to provide the needed compression to the injured area to avoid any swelling and movement. This will not let things go beyond control. 
  5. Elevation: You must keep the injured area raised. Keep it supported on a pillow to reduce swelling. 

If there is an unbearable pain, take painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). If your condition doesn’t improve after the initial therapy, you must consult a doctor immediately. 

  1. Physiotherapy: It can be helpful in treating the affected joint. If there is any difficulty in moving the affected joint, you must opt for physiotherapy. A professional will be able to teach you exercises that will strengthen your muscles and provide support to the joint. This will help you in getting rid of the pain. It can be also beneficial at a time when you are recovering from any surgical procedure. 
  2. Surgery: If physiotherapy doesn’t work, it means you have severe cartilage damage. In that case, you might be advised to take up surgical procedures to set things in proper shape. Surgery is done either by opening the joint or by Arthroscopy. There are various types of surgery which can be done. 1st the old and successful surgery wherein damaged part of the cartilage is debrided and filled with normal cartilage from the non-weight bearing part of the joint. 2nd is ACI (Autologous Chondrocyte Implantation) is a 2 stage procedure wherein chondrocyte is grown using stem cell and implanted in defect part in 2nd stage. 3rd is multiple drilling of the area usually done in childrens.

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

3337 people found this helpful

Ligament Injury Of Knee - How Arthroscopic Surgeries Can Help?

MS - Orthopaedics
Orthopedist, Hubli-Dharwad
Ligament Injury Of Knee - How Arthroscopic Surgeries Can Help?

Our knee is supported by several ligaments which help in movement. But what happens if you tear a crucial knee ligament? Tears or 'ruptures' in ligaments of the knee are common in sportsmen and/or accident victims, especially of the anterior cruciate ligament (ACL).

Though the ACL is not the only ligament of the knee, it is one of the most crucial to maintain stability of the knee joint. Any tear of this ligament frequently leads to chronic knee instability. When a tear in this ligament happens, patients know it immediately as they report feeling or hearing a “pop” along with pain and a feeling of an unstable knee.

Types of ACL injuries
ACL injuries can be classified by the amount of damage to the ligament. They can be partial or complete tears.

  • Grade I Sprain: In this there is some stretching and micro-tearing of the ACL, but it is otherwise intact. This does not require surgery.
  • Grade II Sprain or partial disruption: In this there is some tearing and separation of the ligament fibres and the ligament is partially disrupted. Usually, the knee joint is also moderately unstable. Arthroscopy surgery may be required.
  • Grade III Sprain or complete disruption: In this, there is total rupture of the ligament and the ligament is completely disrupted and the joint is unstable. Surgery is usually recommended for the young and active.

Treatments
There are many different ways that this ligament can be reconstructed depending on the age, activity level, and gender of the patient. ACL tears can be treated using arthroscopy and minimally invasive surgical techniques.

Though non-surgical methods are available, like rehabilitation and physical therapy, they don’t help much with complete ACL tears.
1. Exercises- this helps to increase the range of motion of the injured knee, decrease the amount of swelling, and maintain muscle control.
2. Arthroscopic surgery for reconstruction of the ACL

It can be of 2 types- Repair and reconstruction of the ACL.

  • A repair means that the injured ligament is left in place and the doctor tries to fix it back to the tibia or femur bones of the leg from which it has torn. This is a half-baked option as it does not restore full knee function.
  • A reconstruction, on the other hand, means that the ACL is substituted by a new ligament. The surgeon creates a soft tissue “graft” and uses it to reestablish knee stability. The body populates the graft with living cells and permanently attaches it in place. And, it usually takes about 4 to 6 months for the graft to start functional like the real ACL. Reconstruction surgeries help patients to get back to the same or higher degree of activity without pain or instability. The ‘graft’ usually comes from 2 sources
    • Taken from elsewhere in the patient’s body, called an autograft
    • Donated by donors, called an allograft

Knee arthroscopic surgery is a minimally invasive surgery which is done using pin hole cameras and under general or local anesthesia. The torn ligament is removed and the graft is introduced in its place and secured.

Post surgery outlook

  • Immediately after the surgery, the patient is placed in a brace. He or she can leave the hospital the same day if he/she wants.
  • The patient has to use crutches for preventing putting weight on the operated leg.
  • After-care is crucial for full functioning of the operated knee. The early postoperative period is devoted to restoring motion and decreasing swelling. After this the focus shifts to strengthening the knee joint.
  • The recovery of function following an arthroscopic ACL reconstruction continues over a few months and it usually takes 2-3 months for the patient to feel normal.

As long as the operated knee is cared for properly and other injuries are avoided, the benefits of the surgery are usually permanent.

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

2486 people found this helpful

Anterior Cruciate Ligament Injury - Know Everything About It!

Dr. Deepak Thakur 84% (114 ratings)
M.CH. (Ortho), MS - Orthopaedics, MBBS
Orthopedist, Delhi
Anterior Cruciate Ligament Injury - Know Everything About It!

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!

2612 people found this helpful

Knee Sprain - How It Can Be Treated?

Dr. Nithin Kumar Bejjanki 87% (120 ratings)
Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS), MBBS, Fellow of Academy of General Education (FAGE)
Orthopedist, Hyderabad
Knee Sprain - How It Can Be Treated?

 A knee sprain is a disorder that is characterized by tearing of the ligaments of the knee. The ligaments are tissues in the knee, whose function is to keep the bones together. They also help in keeping the bones and the knee joint in their proper position. In terms of function, they help you walk, turn and twist. Usually ligaments get sprained due to sports or exercise related injuries.

Causes

  1. If the knee is directly hit: Sprains occur when the knee is hit directly by a strong force on the sides, front or back of the knee. It may also occur, if you trip or fall on your knees. Car accidents and football tackles are other instances where the knee may be impacted in this manner.
  2. A sudden twist to the knee joint: If the knee joint is suddenly twisted, then it may result in knee sprain. This usually occurs in situations wherein you plant your foot and then suddenly turn from the knee. This can occur in various sports such as football or hockey where you run and change direction suddenly.

Symptoms
The symptoms of knee sprain are pain in the knee joint, impaired movement and swelling. You will have difficulty while walking as the knee may give out or buckle. In some cases, you may also hear a painful pop from the knee joint.

Treatment
The treatment of a knee sprain begins with a proper diagnosis wherein you may have to undergo various tests such as X-rays or MRI. Once the diagnosis confirms that it is a knee sprain, treatment will begin. The various modes of treatment include:

  1. Acetaminophen: This medication is used to reduce fever and pain resulting from knee sprain.
  2. NSAIDs: Non-steroidal anti-inflammatory drugs such as ibuprofen also reduce swelling and pain.
  3. Physical support devices: You may also use splint or an elastic bandage to provide support to the knee joint so as to allow the area to heal faster.
  4. SurgerySevere ligament tears in young patients will require surgery to regain full and normal function to carry on playing regular sports in future.

In addition to the treatment, plenty of rest is required. Do not carry out tasks that require you to move your knee excessively as it may damage it further. Perform stretches and strengthening exercises to keep the joints strong and mobile. Sometimes ligament injuries are serious and do not settle down with the above measures.

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

4987 people found this helpful
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