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Knee Problem

Written and reviewed by
MS - Orthopaedics, MNAMS (Membership of the National Academy) (General Surgery) , DNB (Orthopedics), MBBS
Orthopedic Doctor, Delhi  •  9 years experience
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Hi friends,

I am Dr. Sunny Chopra. Today we will discuss about knee problems. In today's era we have seen that many problem occur in the knee. In young age we having a sports injury in the knee like ACL tear, meniscal tear, ligament tear. In middle age we having a osteoarthritis, chondromalacia patella and in more elderly age group we having a severe arthritis of the knee that leads to difficulty in walking, bearing weights, squatting, sitting cross legged. We go step by step in all these cases. Next will discuss of sports injury first as I am sports injury specialist, we work even toward the minimal invasive orthopaedic surgeries and all that. So this is our knee joint. This is a ligament which is known as ACL ligament. Mostly sports injuries like cricketer, basketball player, volleyball player we having that ligament get torn and that leads to instability in the knee, instability doing sporty activity, difficulty in walking, running, climbing stairs and patient having complaint of more of knee instability rather than pain in the knee. So, we don't get to scare off these cases, we having a good ro material of knee orthoscopically. We through the orthoscopically, we reconstruct this ligament and we doesn't do many and we doesn't do so much muscle cut, we doesn't do so much of blood loss. We use the knee arthroscopy technique, minimally invasive knee technique and we reconstruct this ligament and we put the patient on rehabilitation next day, we walk the patient next day and more importantly patient within the span of 4-6 weeks start jogging and start climbing stairs and after 12-24 weeks patient can go for daily day to day activity and over a period of 6 months to 1 year, patient can resume his sporty activity and all that. In a knee, we having a one more problem is of that meniscal tear is there. We repair the meniscal, we try to preserve the meniscus and if the meniscus is unrepairable, complex tear is there, we do the meniscectomy, sub-total meniscectomy.

Basically meniscal act as a shock absorber, it basically distribute the force; dissipate the force over the tibia. So meniscal having a balancing. Definitely there are tear which are we can't handle, which has to be do the meniscectomy. In those cases we do all this technique through the arthroscopy technique. Then we having a PCL behind. We do the PCL reconstruction via the minimally invasive knee arthroscopy surgeries. Then we come to middle age patients who having osteoarthritis but not so severe arthritis in that cases in those cases if the patient having a grade 1, grade 2 osteoarthritis knee in that cases we tried to preserve the joint, we do the joint preservation surgeries, we initially put the patient on rehabilitation, knee physiotherapy. We just start the viscous supplementation also; we give the lubricants and all that. Some injection are they are time bearing, they just we apply the injection in the knee joint at the age of 45-50 years to buy the time for the joint preservation surgeries.

There are Synvisc one, there are visco-supplementation many injection, they are mostly of sodium hyaluronic acid and many patients of this grade 1 and grade 2 arthritis, they get benefits of that. Then patient who are in the Kellgren-Lawrence grade 3 and grade 4 classification who having a severe arthritis, patient can't walk even for 100 steps, patient can't bend his knees, patient having difficulty pain for that grade 3 and grade 2, we do joint inflammation surgeries, we do osteotomy of the knee joint like there is osteotomy, proximal fibular osteotomy and definitely through the knee arthroscopic debridement and lavage and then we do the proximal fibular osteotomy. In that cases we achieve many good result of grade 2 and grade 3 arthritis. Even in cases they having uni-compartment involvement, deformity not as such in that cases also we do uni-compartmental knee replacement. Only the involved compartment knee replace, for that the patient as thin lean patient and activity range of motion should be full, no deformity less than 50 degree deformity is there, for that cases we need to do the uni-compartment knee replacement. In both the compartment involved, patellofemoral joint is also involved, patient deformity also there, age is 65-70 years, then we go for total knee replacement. This is the total knee replacement. These just do the shape guard of the joint which is destructed. We remove the joint, we put a femoral component, we put a tibular component, we allow the patient to walk next day in uni-compartment.

In uni  unicondylar knee, we walk the patient next day immediately 24 hours after the surgery. We rehabilitate up 2-3 weeks and in bi compar in in both knees in both knees we allow the patient to walk 48-72 hours. We do both knees simultaneously also. We do one by one knees also. It depends on the patient, pre-anaesthesia condition, if the patient is having diabetes, patient is hypertensive or patient having a other co morbidities. We do the one stage procedure one knee and then 6 months after 2nd knee. If the patient having a no co morbidities, patient is fine, patient having more knee crippling so we can do the both knee knee replacement in the same sitting also. Don't get scared of knees treatment and all that from the Doctor Chopra spine joint solution, we having a diversity of the knee treatment from young age, from sports injury, from the middle age, from the old age. So don't get panic, don't get disheartened that we having a sports injury, we having a old age disease, we having a middle age disease, we having a complete solution from young age to old age of knee. Thanks to all listening and thanks to our God almighty.

Thank you

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