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My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting?
You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts.
What are the advantages of doing both the knees in one sitting?
- Exposure to the risk of anaesthesia reduced to only once
- Aids simultaneous rehabilitation especially in severely deformed knees
- Bilateralprocedure reduces cost
- Earlier return to baseline function and convenience for the patient and relatives
- Shorter cumulative hospital stays
What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same?
The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery.
Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures.
Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty.
What is the latest Technology available which could help improve surgical outcomes?
Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions.
Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended.
Practical Benefits Of Custom Fit Knee Replacement
- MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients
- No intra medullary instruments so minimal chances of fat embolism
- Minimally Invasive (just a 4-5 inch incision)
- Improves the speed of the operation theater time (40% reduced surgical time)
- Increases implant inventory efficiency (know sizing)
- Faster recovery of the patient
- Perfect patient alignment thus better mobilization
What is the role of body exhaust 'space' suits in Bilateral TKR?
- 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons.
- Space suits are used to help reduce contamination from the operating teams from entering the wounds.
- The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.
In case you have a concern or query you can always consult an expert & get answers to your questions!
World arthritis day is recognised on october 13th every year to raise the awareness about arthritis. Early identification of the arthritis helps in proper advice and treatment, hence prevent further complications.
Q: what is arthritis?
A: Arthritis is a disease of joints due to infection or inlammation. Person having arthritis experiences joint pain.
Q: what are the causes of arthritis?
A: 1) Sedentary lifestyle (lack of exercise) specially in young people
2) Obesity or overweight: known to cause osteoarthritis
3) Infections: bacterial and viral infections
4) Autoimmune: rheumatoid arthritis, psoariasis
5) Vitamin d deficiency.
Shoulder pain while lifting overhead objects might be a result of strenuous activity involving tendons impinging bones of the shoulder. Impingement syndrome is also called swimmer’s syndrome.
What causes it?
It is caused by activities involving tendons and bones of the shoulder, for example strenuous activities, such as swimming, tennis and gym activities involving muscles of the shoulder. Even reaching for overhead objects and painting might aggravate impingement syndrome. If not treated at the right time, the syndrome might become extremely painful as the tendons begin to tear.
General pain in the shoulder is one of the most common symptoms, especially while reaching for overhead objects or using shoulder and arm muscles in general. If it occurs for a prolonged period of time, then it might actually lead to a tendon tearing and leading to a rotator cuff tear. This would overtime lead to decreased ability to use the arm muscles and the bicep muscles might tear as a result of prolonged negligence, despite swimmers syndrome. A doctor would recommend a physical exam and x-ray to rule out possibilities for bone abnormalities and arthritis.
How to prevent and treat it?
Those who have extreme shoulder pain and have been diagnosed with swimmer’s shoulder are referred to a physiotherapist with whom, regular sessions help restore mobility of the affected areas. The physiotherapist recommends the patient numerous stretching exercises to practise, preferably under a hot shower. In addition to physiotherapy, a doctor will prescribe powerful painkillers which have to be administered orally on a regular basis.
These oral painkillers, such as ibuprofen have to be taken under the guidance and prescription of a doctor as they will have a host of side effects such as acidity and should be taken post meals. In case of ineffectiveness of orally administered painkillers, cortisone based injections might be given, but it is a double-edged sword as the effectiveness of these injections decrease over time and it might make the muscles and tendons weak. If you wish to discuss about any specific problem, you can consult an Orthopedist.
With increasing online consultation platforms and apps it is imperative that a patient shares correct complaints to the doctor online. This will avoid wrong medical advices and treatment which may worsen the patients condition. I request patients to share their complaints in the following format.
A doctor will analyze and come to a conclusion to what disease you have based on the history given by you and the laboratory tests (blood test, urine test etc). He starts asking your symptoms/problems step by step. The problems you have should be explained in a sequence of its occurrence.
Describe your problems in the following headings, I suggest writing down in piece of paper and tell your doctor:
1) Onset of your illness: when and how did it start, was it constant/intermittent, gradual/ sudden?
Example: fever is throughout the day, high fever in the evening or night, present for some time and absent later.
2) Does it follow any time pattern, how long? since how many days?
3) Site: in case of pain mention the site preferrably by pointing it by your index finger.
4) Character: in case of pain, what is the pain like e. G. Sharp, burning, holding?
5) Radiation: does the pain move anywhere?
6) Associations: is there anything else associated with your fever e. G. Sweating, vomiting, burning sensation during urine, headache, loose motions, difficulty in breathing, pain.
7) Exacerbating/relieving factors: does anything make your symptom better or worse?
8) Severity: how severe is the pain, consider using the 1-10 scale?
Kindly get your previous reports and doctor notes so that the doctor will know your previous condition which may the reason for your present symptoms, in turn helps in identifying your condition and treat you appropriately.
Drug history: kindly keep your prescriptions safe. It tells what condition you had been diagnosed to have and treated for that illness. Whether you have completed your treatment? or you have taken your tablets as per schedule (twice or thrice a day). Some drugs are associated with allergy and side effects if used on long term.
Family history: tell your doctor if any of your family members had similar illness. Some genetic conditions are seen in off-springs/children of affected human being. Occurrence of similar illness at the same time among family members and neighbors may indicate an infectious disease (example: dengue, malaria, chikungunya, tuberculosis).
Be frank with your doctor about your smoking and alcohol habits, describe in detail
1) Since how many years you had been smoking/alcohol?
2) Quantity: how many per day? or how many quarters per day?
Examination: cooperate with the doctor while examining you.