TOTAL HIP REPLACEMENT

Total hip replacement is a surgery for arthritis of the hip joint and in case of fracture of neck of the femur bone in some patients. In the surgery, we change the degenerated and 8 writing portions of two bones in the head and neck of the femur (the ball) and acetabulum( the cup). The degenerative portion of bones is replaced by metals and material is known as highly Chrome link polyethylene.

-No

-only people with severe arthritis of hip joint who are not responding to other treatments need a Total hip replacement

1 hour – 1 hour 30 minutes

-Infection in an uncontrolled diabetic patient

-Dislocation

with modern-day anesthetic techniques and pain medication is not very painful in fact pain is similar for any other surgery.

-After 48 hours from surgery for most of the patients

-In a very selected group of patients weight bearing can be delayed for 2 to 3 weeks

-Generally, on the next day of surgery, a patient can sit and stand a knee Hexion extension.

-After 48 hours from surgery patients will start working with the help of Walker. And thereafter he or she can start stair climbing also. The patient will need Walker for 30 days. After he or she can walk independently.

yes, it is beneficial for most of the patients to take the help of any physiotherapist for a period of 15 days to 1 month.

JOINT REPLACEMENT

Arthritis naturally means inflammation of joints. It is a degeneration of joint cartilage ligaments and bones.

You will experience some symptoms like 

-pain

-Stiffness of joint

 -Some abnormal sound or crepitus while moving the joint

-restriction in joint movement

-swelling of joints

-Not always

-In fact at the beginning of arthritis pain may be very occasional only after prolonged activity involving the joins or after a certain posture. Squatting (using Indian toilet) or commode leg sitting in case of hip and knee joint arthritis. In fact, all the symptoms of arthritis are mostly very minimum at the beginning. The severity symptom increases as the disease become more severe.

-yes, one can try to prevent the rate of increase in the severity of arthritis

-by doing some exercise as prescribed and demonstrated by your treating doctor

-adopting some lifestyle occasions like avoidance of Squatting (using Indian toilet) or commode leg sitting in case of hip and knee joint arthritis.

Maximum 5 to 10% of people having arthritis need a joint replacement. But the percentage of people acquiring joint replacement depends on the type of arthritis he or she is having.

The most common type of arthritis is osteoarthritis.

Only 5 to 10% of people having osteoarthritis needs joint replacement

Type of arthritis are

  • Rheumatoid arthritis
  • Ankylosing spondylitis 

People suffering from these types of arthritis need a Joint Replacement.

when symptoms are severe and not responding to the other treatment modalities and their restriction of day-to-day activities of the patients due to arthritis.

-Exercise as prescribed and demonstrated by your doctor

-lifestyle modification

-Medicines like pain-relieving agents, cartilage vitamins, etc

-Injection in the joint

Most common joint replacement are

-knee joint replacement

-hip joint replacement

Joints which can be replaced if severely arthritic are

-shoulder joint replacement

-elbow joint replacement

-ankle joint replacement

It is almost 98%

(Nobody can ensure 100% success in any surgery)

TOTAL KNEE REPLACEMENT

Total knee replacement is a surgery for arthritis of knee joint. In this surgery, we change the degenerated and athletic portion of two bones that is femur and tibia (which forms the knee joint). The degenerate portion of femur and tibia is replaced by metals.these metals can be Cobalt chromium titanium stainless steel for oxonium. In between the metal abore i.e, metal in femur and metal below i.e, metal in the tibia. A disc has applied that act as a cushion. This cushion is made of highly cromlinked polyethylene.

-No

-Only people with severe arthritis of knee joint who are not responding to other treatment need total knee replacement

Infection in uncontrolled diabetic patients.

With modern-day anesthetic techniques and pain medications, it is very painful. In fact, pain is similar for any other surgery.

After one day or two days from surgery

Generally on the next day of surgery patient can sit and start knee Hexion extension or even start the walk

After 48 hours from surgery patients will start walking with the help of Walker and thereafter he or she can start stair climbing also

He or she will need Walker for 15 to 30 days. Then he or she can walk independently.

Yes for some patients particularly elderly female patient

BONE FRACTURE

You should give support to the fractured part (limb) by yourself or with the help of others and rushed to the nearby orthopedic surgeon or hospital. Your consulting orthopedic surgeon will examine you prescribe an x-ray of involved part and prescribe you some pain-relieving medications or injections. Further management will be decided after observing the X-ray.

It depends on

  • Site of injury fractured bone
  • type of fracture
  • Displacement of fractured bone fragments
  • Whether there is any external bleeding with fracture
  • Whether there is any associated injury of nerve or ligaments etc

Depending on the above factors. Some patients can be managed to non-operatively like

  • plastic cast immobilization
  • Brace immobilization
  • Application of crepe bandage
  • Arm pouch bag

With pain-relieving medication and ice compression in the fractured part and some patients do need surgery. In surgery generally, fracture bone is stabilized and fixed using a metal nail or metal plate or screws.

It is either titanium or stainless steel

Regarding the union of fracture, there is no difference but there are certain differences is regarding other aspects like

  • Titanium is relatively lightweight
  • Titanium is MRI compatible
  • according to some study, there is relative Li less chance of infection if a titanium implant is used
  • Titanium implants are costly

For most of the fractures, it is more than 95%.

The chance of complications following fracture surgery is less than 5%. The complications are

  • Infection
  • Non-union ( fracture fails to unite after surgery)
  • Implant breakage

One can keep the implant for lifelong if anybody wants to remove that the implant can be removed after one and a half to two years at least (after the bone is United)

It depends, But it may take from 2 months to 6 months. If a bone fails to unite after 9 months from surgery we call it NON-UNION.

All the titanium implants are MRI compatible. Some Steel implants are also MRI compatible but not all.

No, Further to the surgery along with bone grafting will lead to the bone union in most of the patients with non-union after the first surgery.

SPORTS INJURY

Sports injury means injury to the musculoskeletal system while doing supporting activity or running jumping lifting heavy weight or any type of physically strenuous activity.

  • Ligaments
  • Muscles
  • Tendons
  • Nerves( occasionally)
  • Bones
  • Cartilages
  • Clinical examination by your doctor
  • X-Ray
  • MRI – very useful to diagnose muscle ligament or tendon injury
  • City scan (occasionally)

A sports injury can be treated with

  • Rest
  • Avoidance of spotting activity of physically strenuous activities
  • Pain-relieving medication
  • Muscles tendons and ligaments healing medication
  • Cartilage vitamins
  • Injections
  • Exercise or rehabilitation
  • Surgery (in some patients)

Yes, In some patients who are not responding to non-surgical treatments for those who are having a specific pattern of injuries not amenable to non-surgical treatment.

This is microsurgery where we introduce a camera (arthroscope) inside the injured part (mostly joints) through small holes that is a keyhole and perform the surgery.

It depends on the severity of the injury site of injury duration of injury acceptor it may vary from 3 weeks to 6 months.

All the titanium implants are MRI compatible. Some Steel implants are also MRI compatible but not all.

DEGENERATIVE SPINE DISORDER

These are age-related spine disease. it occurs in aged people due to wear and tear of spinal or vertebral column.

  • Pain
  • Stiffness of back
  • Sometimes pain radiating from back to leg
  • One should adopt some postural modifications like
  • Avoid prolonged forehead bending and sudden heavy weight lifting
  • Sitting with back and arm or elbow support etc

Yes, absolutely
Exercise as shown by your doctor should be done on regular basis

when your pain or discomfort is so severe that it is affecting your day to day activities and is not improving with postural modification and home remedies, you should consult Orthopedist.

  • X-ray of spine
  • An MRI of the spine in selected patients
  • Postural modification
  • Exercise
  • Hot compression (sometimes ice compression is also helpful )
  • Medications
  • Injections
  • Operation (in a very few selected patients)