Sant Parmanand Hospital

Hi,

I am Dr. Shekhar Srivastav, Orthopedist. Today I will talk about arthritis of the knee joint. You must have seen your parent or family member having knee arthritis. Joint is covered with cartilage. It is a cushion like structure which helps in weight transmission and smooth motion of the joint. So, what happens as it ages, slowly cartilage gets destroyed. Cartilage gets destroyed because of wear and tear. So, this problem starts from one side of the knee. As the arthritis progresses, the whole knee joint gets destroyed. It gives the deformity in the joint and the bone. The knee becomes bent. Patient starts having pain and difficulty in walking. Then gradually as the arthritis progresses, they have pain even at rest. That is the condition when they start coming to us for the treatment.

This can be prevented if we take care of the same. Many factors which are responsible for it. First and foremost is ageing, genetics, lack of exercises because it makes your muscles weak, obesity, weak bones, injury, infection, rheumatoid arthritis. So, take proper take care of your knee joint. You should not allow your weight to become more. Avoid obesity. Take care of muscles and for that do exercises. Maintain proper strength of your bone. Take calcium and vitamin-D supplements. If arthritis is settled, we give medications to prevent further loss of the cartilage. If arthritis is advance, in that case surgery is needed. Keyhole surgery can also be done which is known as arthroscopy. We remove the loose cartilage and meniscus. We can also go for knee replacement. So, in nutshell, Arthritis is not totally preventable but proper care of knee joint can control your symptoms and you can carry on with your activities.

Thank You.

Dear friends,

I’m Dr. Shekhar Srivastav. I’m senior consultant of orthopedic at Sant Permanand hospital and I have clinic at Jagriti Enclave name Prime Specialty Clinic.

Today I ll be speaking on knee arthritis and its management, the causes of knee arthritis and how do we manage it. Now if we see the knee is compose of these two bones, this is a thigh bone and this is a leg bone and this forms a knee joint. Now the knee joint’s end of the bone is covered with cartilage. Now cartilage are cushion like structures which helps in shock absorptions and helps in smooth motion of the knee joint. Now when this cartilage get destroyed you get arthritis. So there are many causes of arthritis like infection it can be any inflammatory cause, trauma. But the most common cause is aging process. As we age due to wear and tear the cartilage gets destroyed and start getting this arthritis. So the patient will first complain of pain and stiffness while walking. Then he will have difficulty in climbing up the stairs or having difficulty walking long distances as the problem increases you will have problem in getting up from sitting position, complain of pain, stiffness and swelling in the knee joint and in the severe stages there will be the deformity of the knee. You must have seen your neighbors or your parents having bow legs which is because of advance form of arthritis of the knee joint the osteoarthritis of the knee joint. Now there are many factors which contribute to arthritis of the knee joint. The most common being is aging process i.e. because of wear and tear but we also see arthritis more in females or there is also some sort of family tendency it means that if your parents were having arthritis then there is slightly higher chance that you may develop arthritis. How can we prevent it? So there are various things which you can do to prevent the symptoms of arthritis.as you know that it is an aging process so it can’t be stopped but the pain or disability arising from it can be prevented. First of all you have to maintain your weight so, obesity is one of the major causes of the arthritis so you should prevent obesity, you should keep your muscles strong by doing exercises, you should keep your joints flexible by exercising by stretching exercises and then there are also some medications. Physiotherapy, medications they all helps in preventing arthritis. But if you don’t get better with that means arthritis is severe then in that case sometimes you need injections. Now injections are given inside the knee joints and if given judiciously they will give very good relief.in very severe cases when the joint is totally destroyed, the joint is deformed, the limb is not align properly then in that case surgery is needed. There are different type of surgeries for arthritis which will be decided by your orthopedic surgeon. Now we have arthroscopy which is just a key ball incision surgery or we can have alignment surgery. One of the most common procedure we perform is knee replacement. Now people have misconception that in knee replacement whole of the knee is removed, it’s not done in that way. We just gave shape at the end of the bone and we put cap over it just like this so you just gave shape at the end of the bone and you applied a cap over it similarly for the leg bone also. You put the cap over it and in between there is a plastic type thing which allows smooth motion of the knee joint. So these are the various causes and treatments of arthritis. The treatment varies according to the grade of arthritis and that is decided by your orthopedic surgeon.

If you want to know more about the problem or if you have any problem or if you want to contact us, you can contact me at lybrate or you can contact me at Sant Permanand hospital or in my clinic Prime Specialty Clinic at Jagriti Enclave. Thank you!

Dear friends, I am Dr Shekhar Shrivastav. I am senior consultant orthopaedic at Sant Parmanand Hospital, Delhi. Today, we'll be discussing Arthritis and specifically arthritis of the knee joint.

Now people usually come and ask me what do you mean by arthritis. So arthritis is the inflammation of the joint. Joint is made up of two ends of the bone which are lined by an articular cartilage which helps in a smooth motion of the joint. So when that cartilage gets destroyed you get arthritis. Now it can get destroyed due to various reasons but the most common reasons are due to ageing process which we call osteoarthritis. So there is degenerative wear and tear of the joint which leads to osteoarthritis or there can be an inflammatory cause such as rheumatoid arthritis which involves the lining of the joint and damages the cartilage. Now then people ask or most of the people who come to us with arthritis involve arthritis of the knee joint. So knee joint is the joint which is common in which is most commonly involved in osteoarthritis of the knee joint. The patient usually comes with pain, swelling and stiffness. They have difficulty in walking, climbing stairs and sometimes in severe cases, they have pain even at rest.

How do we manage that?

Now in order to manage that first, we should know what is the cause of arthritis? So we do some x-rays. X-rays give us an idea about the cause of arthritis as well as the extent of the damage. Now we also go for some blood tests which will give us an information if it's because of an inflammation or any infection. So these are the various causes of arthritis.

Now how do you manage our practice?

 Patient has a company with pain, swelling and such disability so initially, we start with conservative management which is nonoperative management. So in that we ask the patient to do some lifestyle modification like we asked them to avoid using stairs or if they are using stairs then they have to use a railing so that there is not much stress on the joints. If they are into sports then we ask them to shift from contact sports like jogging or Aerobic to low impact exercises like swimming or cycling. We send them for physiotherapy. Physiotherapy helps a lot in arthritis. It helps in gaining strength in the muscles which protects the joint and it also gives increased flexibility and moment of the joint. We can give some medications and form of painkillers and thin perimeter because they reduce the inflammation, reduces the pain and in acute cases we can also inject the region.

Now, in severe arthritis when all this treatment has failed in that case it requires surgery. Surgery can be in different form. If the patient is having any loose fragment which is causing locking, then, in that case, we can go for arthroscope which is a keyhole surgery, where we make just small incisions like the tip of this pen, we put our instruments inside and we take out that piece which is a simple thing. In severe cases, we go for replacements. So it can be either partial replacement or total knee replacement. Now in severe cases with patients of great disability who have difficulty in walking who have pain on each step, who have pain even at rest, knee replacement surgery is a boon for these patients. It increases their activity, it increases their social life and it also makes them more mobile.

So if you want to know more about arthritis, if you are suffering from this problem and you want treatment you can contact me through lybrate or you can contact me at Sant Parmanand Hospital, Delhi.

Thank you.

Causes, symptoms and treatment of Frozen shoulder

Hello friends! I am doctor Shekhar Srivastav a senior orthopedic consultant at Sant Parmanand hospital in Delhi. Today we will discuss a very common topic that is frozen shoulder. It is commonly seen in general population, more commonly seen in middle aged persons. Though it is seen in almost all classes of people, but it is more commonly seen in people who have diabetes, thyroid problems or if they have any heart problem.
Sometimes it is also seen after trivial trauma. It usually happens because of the capsule which surrounds the shoulder joint, it becomes stiff and inelastic.

Gradually the patient starts having pain and it also reduces the movement of the shoulder joints. Initially the patient gets pain while moving the shoulder but then gradually he can also feel the pain during the rest period. Sometimes it even disturbs the sleep. The treatment includes usually exercises and medication. Now many a times we see patients going to quacks for treatment where they forcibly move the joint and this can lead to complications such as fractures or damage to muscles and ligaments inside the joints. So this should be totally avoided. The proper treatment would be to consult an orthopedic surgeon who will give you some medication and will also send you for some supervised physiotherapy.

Exercises to stretch the stiff capsules are very essential for treatment. It usually takes two to three months to get resolved. Sometimes the stiffness is too much and it may persist for months together. If it doesn't improve with medications and exercises in that case we go for surgery. The surgery in this case is not an open surgery but it’s a key hole surgery where we make small cuts like the size of a tip of a pen. So we make few cuts behind and infront of the shoulder and through these cuts we release the capsule all around the shoulder. So the patient gets his motion and pain also decreases. But this is reserved for only those patients who don’t improve with medications and exercises. The mainstay of the treatment remains medications and exercises.

So in frozen shoulders what I would like to suggest is you should take proper treatment, you shouldn't go to quacks which may cause more damage to your shoulder joint, but instead you should consult an orthopedic surgeon. For that you can visit Lybrate to find out the appropriate orthopedic surgeon for you. Thank You.