KK Health Care Centre

Hi,

I'm Dr Sanjay Kapoor. Consultant Orthopedic Surgeon. Today I will talk to you about a very common condition which is known as knee arthritis. Now, what is knee arthritis? Knee arthritis is a condition in which there is a degeneration of the knee joint and what happens is with the overuse, with increased body weight, with lack of exercise, with aging, sometimes genetic, sometimes deformity, sometimes because of trauma, the joint is weakened. The space between the knee joint, the middle space, the lateral space and the space in the front that is decreased, it could be due to this degeneration of the meniscus, medial, lateral, sometimes due to the erosion of the cartilage inside the knee joint both medial and lateral as well below the patella bone because of this degeneration the patient comes and complains of pain around the knee joint or in the knee joint, difficulty in climbing stairs, difficulty in getting up from the bed, difficulty in walking so basically day-to-day activity of the patient is restricted.

This condition is increased these days even in the young population mainly because of lack of exercise because of weight gain and because of faulty lifestyles. In the aging population, it is expected because of the degeneration of the joint inside, but the area which I want to stress is that what can be done to decrease the chances of this condition in the young population.

So in the young population, the message would be we should avoid certain activities like climbing off stairs, sitting cross-legged and doing the regular exercises of the knee as well as all the joints of the body, a brisk walk is very important. The lifestyle changes which is required in such patients and when the patients especially the young patient if he develops the pain around or in the knee joint he should immediately come to the doctor and report the condition so that the proper diagnosis can be done and the staging of the disease can be done, because in mild to moderate kind of arthritis when the meniscus is preserved and cartilage is preserved or there are early changes in the cartilage or meniscus that can be reversed with medications hence exercises will strengthen the muscles around the joint and the joint can be saved.

Now, once the disease has reached the stage of severe arthritis then there is not much role of any kind of medication, in those patients which are usually elderly age group we can do certain surgical procedures. Suppose even only the medial side of the joint is involved then there is partial knee replacement surgery can be done in which the other compartments of the knee can be saved and the middle joint is replaced, but once all the other compartments of the knee are involved then the option will be of total joint replacement in which the whole of the knee joint is replaced and this surgery usually lasts for about 45 minutes to 1 hour and patient is mobilized in the second or third day and with exercises which are done after the surgery, it usually takes one to one and a half months for the patient to start walking at his regular pace and start doing his day-to-day activities.

The clear-cut message for knee arthritis would be that if the disease is diagnosed early and regular exercises and lifestyle modifications, control of weight these all things are done then these surgeries could be avoided and knee can be preserved for a longer period of time.

Thank you

Hey,

I am Doctor Sanjay Kapoor, consultant orthopedic surgeon. Today I will talk to you about a very common condition which is known as tennis elbow or lateral epicondylitis. This condition usually occurs in young male and female. These days, especially with the overuse of computers, laptops, mobiles. The action of the finger movement, as well as the wrist movement, has tremendously increased because of which there is a problem in the lateral aspect of the elbow, typically at this point the patient comes in and says that I have pain in this area, I have difficulty lifting objects or have difficulty in typing, so this condition is usually diagnosed on the basis of clinical examination usually the patient come here and says there is a tenderness in an area. So when you press this area there is a typical severe pain and we ask for few clinical examinations like we ask the patient to dorsiflex the wrist against the resistance, in this movement patient also typically feels the pain.

Apart from clinical examination, we advise few x-rays to rule out any pathology in the bones or in the joint, few blood tests are also ordered to rule out any kind of infections or any kind of inflammation which is going inside the joint. Once these things are ruled out, the common treatment for this condition is usually we give some splint to the patient so that the moment of the rest are avoided for a few days.

Also some kinds of fomentation, hot water fomentation or cold packs application are done in the inflamed area or in the painful area, sometimes physiotherapy is also advised to control the inflammation, but the most important thing will be restriction of activity especially in which the forearm muscles, the extensor muscles of the forearm are used, so with the use of medical management, precautions, the main is the overuse of the wrist extensors of forearm extensors muscles, with fomentation, with rest this condition is easily treatable.

The message for the general population will be to avoid the overuse of your wrist or forearm or finger movements plus you should stress on regular exercises so that the muscles of the forearm, muscles of the wrist is strengthened and such conditions can be avoided.

Thank you

Good Evening,

My name is Dr. Sanjay Kapoor, Orthopedist. Today I will tell you about avascular necrosis of the hip. This is the condition in which the ball of the hip joint or the femoral head is necroseda means the shape of the head is changed. The normal shape is ovule or round. But in this condition shape of the ball is badly degenerated. What are the causes of it? First cause is idiopathic. No.2 is post-traumatic. If the patient is chronic user of alcohol and smoke, than this can also lead to this condition. Now what are the treatment. Treatment depends on the stage of the disease. Few medicines are available which can control the disease.

We also ask patient to stop taking steroids. Now the 3rd stage is hip replacement. But that is done when the head is totally degenerated. In this surgery we replace the head of the femoral and the socket of the hip joint is also replaced. Now this disease usually occur in younger people. We should be aware of this disease as this effect younger people. The most common cause is prolonged use of steroids, chronic alcohol intake and smoking. Patient usually neglects such diseases. But you should go to the doctor at earliest so that disease can be detected early and we can try to cure or stop the disease progression. If disease goes at the stage of 3 or 4 than we can not stop the disease but still treatment is available. That is why we go for replacement surgery. You can book an appointment through Lybrate.

Thank You!

Good Afternoon!

I am Dr. Sanjay Kapoor, the consultant orthopedic surgeon in KK Health Care Centre, Sec-5, Gurgaon. Today I will tell you about osteoarthritis of the knee. This is the normal knee joint. It has femoral bone, leg bone which is called as tibia bone and at the internal part one is medial and another one is known as lateral meniscus. So, what happens in arthritis is degeneration of this meniscus or washers. So, as the patient walking on his knee due to the degeneration, the bone starts to rub against each other. And the patient starts to have pain and difficulty in walking. So, the patient usually comes to my OPD, they complain of pain, restriction of movements of the knee, difficulty in climbing stairs and getting up from chairs.

Now we have to grade what type of arthritis patient is having. We divide arthritis into 3 stages. Mild, moderate and severe. In mild arthritis, there is minimal degeneration of the knee joint which can be easily tackled with medications, exercises, physiotherapy and restriction of your activities like sitting cross legs or climbing stairs and we usually advise the patient to not to sit on the floor. Then comes moderate arthritis where there are more degeneration and the space between the femoral and the leg bone they start to decrease and the patient starts to have more pain, more difficulty in climbing stairs and walking. Now again we have to see the condition of meniscus inside and the condition of the cartilage which is covering the bone.

Now, this assessment can be done by doing x-rays. Sometimes, even MRI also adviced. This can also be tackled with medications. Some kind of injections is also available which we put inside the knee joint which helps in extending of the cartilage, meniscus, and washers. Plus, regular exercises, weight control, the regular walk is advice for the patient. Now next comes severe arthritis in which cartilage and meniscus is totally worn out. The cartilage is totally gone and bone starts to rub against each other. So, the patient also develops some kind of deformities of the knee and he has severe difficulty in walking, in climbing stairs and doing day to day activities. In this kind of joint, we again do x-rays, MRIs and also we can do an arthroscopy in which we evaluate the joint.

Now, depending upon the age of the patient. If the patient is young, then we have surgeries available like one is know as high tibial osteotomy in which axis of the knee joint is changed so that the load which is coming on the joint is decreased and the patient can carry with the same joint for few more years. Then only one compartment, the medial compartment is involved in this arthritis unicompartmental arthroplasty option is also available for the patient. In this only one compartment is changed and the rest of the joint is not touched. The patient is very happy with that kind of joint. But if all the compartment of the knee is involved and severely degenerated than we give the option of total knee replacement. It is also having an excellent result for the patient.

As a message to the general public is if they control their weight, regular exercises and they avoid sitting cross legs, minimal climbing of stairs and take proper care of the knee joint and as soon they start to have the complaint of knee joint, they should contact to the doctor as early as possible. So, that the problem can be tackled right away with medications and exercises. Because if they will try to postpone then usually patient comes at the stage when there is very little to do with the help of medicines and exercises. Then we have to take surgical interventions. For any orthopaedic problems or any joint-related problems you can visit at our hospital, KK Health Care Centre, Sec-5, Gurgaon. Also, you can book an appointment with Lybrate.

Thank You.