Hello everyone, I am doctor Sirish Dutt Mishra. I am a senior Orthopaedic surgeon and I am a visiting consultant to Indraprastha Apollo Hospital in New Delhi and Fortis Hospital, Vasant Kunj. So dear friends after reviewing a lot of queries on Lybrate, I came to know that knee pain is the most common complaint which everybody is confused about and wants to know about. So let's talk about the very very common complaint which called knee pain, knee pain can happen at different ages and each age as a different cause for it as regular we can have a knee pain following an injury which can happen because of any fracture, which can happen because of any ligament injury. Knee pain can also happen because of as a referred pain, whereas, referred pain is something when the problem is somewhere else but the weakness coming towards the knee. The most common preferred pain to the knee comes from the hip, it can come from other areas as well and the third is one can have a mild infection in running which can give rise to knee pain and fluid collection in the knee its called synovitis in the knee. Another reason for the knee pain is sports injuries where is there is a damage to the cartilage, the damage to the cartilage can happen after the sports injury in younger people as well as it can happen because of the ageing process. Where the lubrication of the knee goes down and the pressure on the cartilage becomes more and resulting in the damage to the cartilage. So I would like to show you a model what is actually a cartilage, so cartilage is a layer on the bone, ends of the bone which are meeting to form a joint, in the case of a knee there is a thigh bone and there is a leg bone. So in between the ends, there is a cartilage this is a thick parting which keeps the joint awake and pain-free. So here you can see the blue covering which is called the cartilage. So the cartilage damage which happens because of the injury or because of the ageing process is the damage to these areas, we are going to talk about this more today because this is the one of the most foremost cause in the middle age and higher age group. The earlier thus treatment for the treatment for this is a very step by treatment, it can be treated easily with the medication if the cartilage damage is low you can treat with the medication and there is physiotherapy and lot of people recover very very well, especially the younger people. Those people who do not recover by the simple medication rehabilitation of Physiotherapy can be take up another option which is called viscosupplementation these are injection which lubricant injection which is given in that knee which is fairly in that procedure and the knee is lubricated back again and it helps in the building of the cartilage. Now regeneration of the cartilage is the future of treating the cartilage damages. Regeneration is something in which we take in the piece of the bone with the cartilage and then grow that cartilage outside the body then put it back in the knee so that cartilage is back repaired back to where was, it is called a chondron procedure and then one of the specialists doing a lot of chondron procedure. It has brilliant results and it saves a lot of people from progressing from mild to moderate to heavy cartilage damages. And third of course we know is the knee is replacement, knee replacement surgery is a brilliant surgery it has excellent success rate if it is done by the person who is well trained and done in a setup which is geared up for this because all these replacement surgeries are just not procedures, they are regime which has to be followed in a certain manner. Starting from the taking care about the fitness of the patient whose to be taken for surgery, then comes that doing the procedure in a correct manner and after the procedure the right amount of rehabilitation to be given to the patients. All these things if they are taking care off, they give brilliant results and people are very very happy. Those people who are unhappy with their surgery, with their knee replacement, some or other aspect of these regimes is not being followed or unfortunately, some complication must have occurred because of any cause which can result in a compromising result. So the knee pain, the myth has that all knee pain in older age requires a knee replacement no it is not that, a lot of knee pain lot of cartilage damages resulting in higher age group can be treated without a surgery. Of course in a patient who will have a larger deficits or larger cartilage damages or osteoarthritis may require a knee replacement surgery as I gave great emphasis to it that knee replacement surgery is a brilliant surgery and fairly a safe if taken up in a good setup, in a good screening of a patient and the good procedure done. In the last I would love to show you the x-rays what a normal knee x-ray shows and what we call an osteoarthritis knee x-ray, so I would be next time will be going for the X-ray and explaining to you that how do we come to know that a knee is in osteoarthritis knee choir, an intervention or a treatment. So as we were talking about as I was telling you what does the X-ray of normal knee looks like, so x-ray on the right side is a person of about 30 years and this is a well-balanced knee where you can see these faces are well balanced and me put in alignment so this shows that this may have got a good cartilage and is a nearly a normal knee, whereas, if we see this x-ray you can see there is lot of imbalance very very obvious that the spaces are reduced and there are extra bone formation like you see easiest and fairly this padding has gone down that is why these bones are there in actually touching eachother so this is called ostoarthritis knee. So the last x-ray which I show you that is the changes in a osteoarthritis that knee cartilage damage. So I hope my talk has been useful to you and if you have any queries you can put the queries on Lybrate I will be happier to answer you. Thank you very much.