NuLife Hospital

Hello,

I am Dr. Hardeek N Ghundiyal practicing Orthopaedic surgeon in Mumbai. So, today I would like to speak about osteoarthritis of the knee joint. There are various type of Arthritis of the knee joint - broadly they are divided into primary and secondary. Osteoarthritis comes in the primary category while the secondary category is post-traumatic or post-infectious Arthritis. However, today I will talk only about the osteoarthritis of the knee.

Osteoarthritis is a progressive form of Arthritis and is characterized by breakdown of the cartilage of the knee joint. It is also called as wear and Tear Arthritis. It is usually found in the people more than 60 years of age however young people can also have it. The common joints affected for Arthritis is the knee joint .

Spine is also affected in Indians. In some Western countries, hip joint is also affected. The common symptom of arthritis is the pain which is gradually increasing over a period of time and which becomes a disability for the patient. The other symptoms being stiffness - stiffness is usually present in the morning times and as the patient walks, stiffness comes down. The other symptoms of the deformity of the legs are in which the bones become crooked. The last thing is the bone grating sensation as the patient makes the movement of the knee joints.

The bones rub against each other which causes the patient to give a grating sensation when the patient moves his knees. The most common factor for the osteoarthritis is the age. As one grows old, osteoarthritis is pretty much evident in the knees. The factors being the gender, females are more affected in osteoarthritis than the males, maybe because of postmenopausal arthritis mostly osteoporosis leads to the Apparatus. 

Weight is the third important factor which causes osteoarthritis. While the weight is less,  the stress and strain is reduced at the joint which causes delayed osteoarthritis. Osteoporosis is also one of the important factors causing osteoarthritis. If the calcium levels of the bones are less,  the bone grating and osteoarthritis increases. There is no specific treatment for osteoarthritis.

However joint functions can be improved with daily exercises in the form of swimming. Swimming is the best exercise for the patient with osteoarthritis. Second exercise is walking. Routine walk of at least 30 minutes per day is sufficient enough. The other exercises are bicycling and yoga can also be done. Loss of weight is the most important modifying factor for the osteoarthritis.

Various splints are available for osteoarthritis which help in preventing the deformity of the leg. Medications are available in the form of nonsteroidal anti-inflammatory drugs, steroids or disease-modifying agents. With all these medications and exercises with the weight loss, if the deformity and the pain persists, the last option to go for is total knee replacement. Knee replacement is actually resurfacing of the bones of the knees in which a part of a leg bone and part of a thigh bone is cut and it is replaced by metallic objects with a plastic part in between the metallic objects , so that the bone grating is avoided. The metal parts blide against the plastic and hence the pain of the knee joint is almost negligible and the movements are preserved.

I am Dr Hardik Ghundiyal, practising orthopaedics surgeon since 7 years in Bombay. I am mainly into minimal Invasive Joint replacement surgeries.

Knee Replacement surgeries have been done all over the globe since last 30 years. And they have been very successful. In the past, if the patients had arthritis, we could only give them pain killers. But as if now when a patient comes with knee stiffness, pain, deformity, we can provide them with the total knee replacement. We always give a non-surgical conservative approach to the patient when the patient comes with arthritis. If that fails and they are not relieved from the pain, then we give them the option of total knee replacement. About 5,000,00 total knee replacement is being done all over the globe every year. Most of the people who have experienced knee replacement they think that they could have done it before because the pain relief is so good.

When we do a total knee replacement, we do not cut 2 inches or 3 inches of bone from the thigh, instead, we do re-surfacing of the knee. In the normal knee, there are smooth surfaces on the both sides which glide easily when the movement of the knees are done. But in the arthritic knee, the surface is pitted and get rough because of which the pain is there when they glide on each other.

In the total knee replacement surgery, we change the rougher surface into a smooth gliding prosthetic material so that they glide on each other without any pain and patient get pain free movements. The material has been improved drastically from last 15-20 years. The process however remains the same but the plastics, the poly ethylene which is used in between the metal surfaces have been improved drastically by durability as well as the strength. The research has improved the longevity and the prosthesis.

During surgery, we use a muscle sparing approach, that means we do not cut-open muscles while doing the surgery. The patient is mobile as early as possible. The patient is able to stand and walk up on the same day of the surgery. If a patient is comfortable, we make them able to walk also. Hence the hospital stay is reduced and it is minimized to 2-3 days only.

The recovery of the patients depends on how active was the patient pre-operative. Some patients need a walker, walking aid, some patients are mobile without any support. Most of the times, you can get back an activity within month time a surgery.

For more information, you can contact me through lybrate.com.

Benefits of Total Knee Replacement

hello, I am Dr. Hardik Ghundiyal practicing in Bombay since last six years. I am mainly into total knee replacements. I have been doing a minimally invasive total knee replacement since last six years. In this replacements, I usually do not cut open the muscles.

The advantages of this procedure are that it is a minimal invasive. The small incision and the recovery of the patient are very fast. Well in my process the patient can stand on the same day of the surgery and walk on the other second day itself. The third day usually all my patients get discharged from the hospital and the amount of movement of the knee the amount of motion of the knee is usually same as pre-operation or maybe 10 to 20 21 degrees more than what the preoperatively it was.

Depending also on the medical condition and obesity of the patient. Age is not the criteria for the total knee replacement as per everyone’s belief. It can be done at the old age also. The whole criteria being the pain and the disability of the patient. If it is a 90 year old patient but is walking everywhere, confined to bed only because of the knee pain of course he is a patient for the total knee replacement and we will would like to go ahead and give the best results for him, the same if the 60 years old guys who is confined to the bed and is not able to walk there is no point of doing total knee replacement for such kind of patients as he is never going to walk in his life.

So against all the beliefs age is never the criteria for total knee replacements. For more information you can contact me on lybrate.com