ORTHOPEDIC CARE FOR YOUR AGING LOVED ONES

 Orthopedic Care for Your Aging Loved Ones

Hello there,

I'm Dr. A. Mohan Krishna, a senior consultant Orthopedic Surgeon at Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana. Aging is a natural part of life, and as we grow older, our bodies, especially our bones and joints, undergo various changes. Ensuring optimal orthopedic health for our aging loved ones is crucial to maintain their mobility, independence, and overall quality of life. In this blog post, I'd like to discuss several common orthopedic problems in the elderly and how we can address them.

*Understanding the Aging Process and Orthopedics*

As we age, our bodies naturally undergo changes which can affect our bones, joints, and muscles. These changes can lead to a range of orthopedic issues such as decreased bone density, increased joint wear and tear, and reduced muscle mass and strength. Understanding these changes can help us to better manage and prevent orthopedic problems in our elderly loved ones.

*Common Orthopedics Issues in the Elderly*

1. *Osteoarthritis:* This is a degenerative joint disease that commonly affects the elderly. It occurs when the protective cartilage that cushions the ends of your bones wears down over time, leading to pain, stiffness, and reduced mobility.

2. *Osteoporosis:* This condition is characterized by a decrease in bone density, which can lead to an increased risk of fractures. It is more common in women, but men can also be affected.

3. *Fractures:* Due to the decreased bone density and increased fall risk associated with aging, fractures are a common orthopedic issue in the elderly. Hip fractures, in particular, can have serious consequences and require immediate medical attention.

4. *Spinal Disorders:* Conditions such as spinal stenosis, herniated discs, and degenerative disc disease can cause back pain and mobility issues.

*Managing Orthopedic Conditions in the Elderly*

1. *Regular Check-ups:* Regular orthopedic check-ups can help detect problems early and initiate appropriate treatment.

2. *Healthy Diet and Lifestyle:* Consuming a diet rich in calcium and vitamin D, maintaining a healthy weight, and quitting smoking can help to maintain bone health.

3. *Physical Therapy and Exercise:* Regular, low-impact exercises such as walking, swimming, and yoga can help to maintain mobility and strength, reduce pain, and improve balance, thereby reducing the risk of falls.

4. *Medications and Surgery:* Depending on the condition, medications, injections, or even surgery might be required. It's crucial to discuss these options with your healthcare provider.

5. *Fall Prevention:* This is paramount in caring for our aging loved ones. Simple steps like removing tripping hazards, installing handrails, and ensuring adequate lighting can help prevent falls.

Remember, every individual is unique, and the approach to their care should be personalized. At Apollo Hospitals, we are committed to providing compassionate, comprehensive care for your aging loved ones. If you have concerns about the orthopedic health of an elderly family member, don't hesitate to reach out to us.

Take care,

Dr. A. Mohan Krishna,

Senior Consultant Orthopedic Surgeon,

Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana.

UNDERSTANDING KNEE PAIN IN YOUNG ADULTS

Understanding Knee Pain in Young Adults: 

Insights from Dr. A. Mohan Krishna, Senior Consultant Orthopedic Surgeon at Apollo Hospitals

Hello, I’m Dr. A. Mohan Krishna, a senior consultant orthopedic surgeon at Apollo Hospitals. Knee pain is often associated with aging, but it is increasingly becoming a common issue among young adults. As an orthopedic surgeon, I frequently see young patients struggling with knee pain, and I want to share some key information to help you understand the causes, symptoms, diagnosis, and treatment options available.

 Common Causes of Knee Pain in Young Adults

Knee pain in young adults can arise from various factors, including:

1. **Sports Injuries:** High-impact sports like football, basketball, and soccer can lead to acute injuries, such as ligament tears (e.g., ACL), meniscal tears, or patellar tendinitis (jumper's knee).

2. **Overuse Injuries:** Repetitive stress from activities such as running or cycling can lead to conditions like patellofemoral pain syndrome or iliotibial band syndrome.

3. **Structural Abnormalities:** Some individuals may have anatomical variations that predispose them to knee pain, such as flat feet or misalignment of the knee joint.

4. **Trauma:** Falls, accidents, or direct blows to the knee can cause injuries to ligaments, cartilage, or bones.

5. **Underlying Medical Conditions:** Conditions such as rheumatoid arthritis, gout, or osteochondritis dissecans can also lead to knee pain in younger individuals.

 Symptoms to Watch For

Recognizing the symptoms of knee pain can help in seeking timely medical attention. Common symptoms include:

- **Pain:** This may be localized to a specific area of the knee or more generalized.

- **Swelling:** Inflammation may occur around the knee joint.

- **Stiffness:** Difficulty in bending or straightening the knee.

- **Instability:** A feeling that the knee may give way during activities.

- **Popping or Clicking Sounds:** Unusual noises during movement can indicate underlying issues.

Diagnosis: How We Identify the Problem

If you’re experiencing knee pain, it’s essential to consult a healthcare provider for a thorough evaluation. The diagnostic process typically involves:

1. **Medical History:** Discussing your symptoms, activity level, and any previous injuries.

2. **Physical Examination:** Assessing the knee’s range of motion, stability, and areas of tenderness.

3. **Imaging Tests:** X-rays can help identify fractures or structural issues, while MRI scans are useful for assessing soft tissues, including ligaments and cartilage.

Treatment Options: Finding Relief

Treatment for knee pain in young adults will vary depending on the underlying cause and severity of the symptoms. Here are some common approaches:

1. **Non-Surgical Treatments:**

   - **Rest and Activity Modification:** Taking a break from activities that exacerbate the pain can promote healing.

   - **Physical Therapy:** A tailored exercise program can strengthen the muscles around the knee and improve flexibility.

   - **Medications:** Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and reduce inflammation.

   - **Ice and Elevation:** Applying ice to the knee and elevating it can help reduce swelling.

2. **Surgical Treatments:**

   - If conservative treatments fail, surgical options may be considered. These can include:

     - **Arthroscopy:** A minimally invasive procedure to repair or remove damaged tissues.

     - **Ligament Reconstruction:** Surgery to reconstruct torn ligaments, such as the ACL.

     - **Cartilage Repair:** Techniques to repair or regenerate damaged cartilage.

Preventive Measures: Protecting Your Knees

Prevention is key when it comes to knee health. Here are some tips to help protect your knees:

- **Warm-Up and Stretch:** Always warm up before engaging in physical activity and include stretching exercises to improve flexibility.

- **Strength Training:** Strengthening the muscles around the knee can provide better support and stability.

- **Use Proper Technique:** Whether you’re playing sports or exercising, using the correct technique can help prevent injuries.

- **Listen to Your Body:** If you experience pain, don’t push through it. Take breaks and seek medical advice if necessary.

Conclusion

Knee pain in young adults is a significant concern that can impact daily activities and quality of life. Understanding the causes, recognizing symptoms, and seeking timely medical attention are crucial steps in managing this condition. If you or someone you know is experiencing knee pain, I encourage you to consult with a healthcare provider for a thorough evaluation and appropriate treatment options.

At Apollo Hospitals, we are committed to providing comprehensive orthopedic care tailored to the needs of each patient. If you have any questions or concerns about knee pain or other orthopedic issues, please don’t hesitate to reach out.

Stay active and take care of your knees!

**Dr. A. Mohan Krishna**  

Senior Consultant Orthopedic Surgeon  

Apollo Hospitals

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This blog aims to educate young adults about knee pain and encourage proactive healthcare management. Always consult with a healthcare professional for personalized advice and treatment options.

Frozen Shoulder: Expert Treatment Recommendations by Dr. A. Mohan Krishna, Consultant Orthopedic Surgeon at Apollo Hospital

 

Introduction

Are you experiencing stiffness and pain in your shoulder that's making it difficult to perform day-to-day activities? Welcome to the club of frozen shoulder sufferers. Frozen shoulder, also known as adhesive capsulitis, is a condition that affects the shoulder joint. It occurs when the tissues in your shoulder joint become thicker and tighter, which eventually makes it difficult to move your shoulder. The causes of frozen shoulder aren't always clear, but it usually affects people who've had an injury, surgery, or conditions that limit shoulder movement. Initially, you may only feel a dull ache in your shoulder before it progresses to severe pain. As the condition worsens, night pain and stiffness, combined with limited movement, make it outright unbearable. Frozen shoulder can last for several years before it completely heals. In the next sections, we'll discuss how to diagnose and treat frozen shoulder, including the different surgical procedures available.

Diagnosis of Frozen Shoulder

Frozen shoulder can be diagnosed through physical examination and imaging tests. During a physical examination, the doctor will assess the mobility of your shoulder, look for any visible deformities, and apply pressure to determine the level of pain. Imaging tests such as X-rays, Ultrasound, and MRI scans may be conducted to rule out other possible conditions. The doctor may also ask about your medical history to determine any underlying medical conditions that may be causing the frozen shoulder. The diagnostic process helps the doctor ascertain the severity and stage of the condition and develop a personalized treatment plan that is best suited for your individual needs. Remember, the earlier the diagnosis, the better the chances of effective treatment.

Treatment Options for Frozen Shoulder

Frozen Shoulder: Expert Treatment Recommendations by Dr. A. Mohan Krishna, Consultant Orthopedic Surgeon at Apollo Hospital. Treatment Options for Frozen Shoulder So you’ve been diagnosed with a frozen shoulder? That’s tough luck, but the good news is that there are several treatment options that can help you recover much faster than you thought. Let’s take a look at the various ways you can get your frozen shoulder treated. Medications There are several pain relief medications that your doctor may prescribe to you. These include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to help reduce inflammation in the shoulder joint. Additionally, your doctor may also prescribe stronger medications if necessary. Physical therapy Physical therapy can help you regain mobility and restore function in your shoulder joint. Your therapist will work with you to design a treatment plan that involves gentle exercises to help stretch and strengthen the joint. Regular physical therapy sessions can go a long way in reducing the pain and stiffness associated with frozen shoulder. Minimally invasive procedures If physical therapy and medications don’t work, you may want to consider minimally invasive procedures such as arthroscopy, where a small camera is inserted into the joint and used to guide the surgeon while removing scar tissues and adhesions. Other minimally invasive procedures include hydrodilatation which involves the injection of a sterile fluid into the joint capsule to help stretch it. Surgical Procedures When all else fails, surgery may be the only option left. Your doctor may recommend surgery if you do not experience any relief from non-invasive treatments or the mobility of your shoulder is severely limited. Surgical procedures for frozen shoulder may include manipulation under anesthesia, where the surgeon moves the shoulder joint in different directions while the patient is under anesthesia. Other procedures include shoulder arthroscopy and shoulder replacement surgery. In a nutshell, there are many treatment options available to you if you are suffering from frozen shoulder. Medications can help with pain relief, physical therapy can help restore mobility, and minimally invasive procedures and surgery can help in severe cases. The key is to work closely with your doctor and therapist to find the best treatment plan that works for you.

Surgery for Frozen Shoulder

Having exhausted all non-surgical approaches to treat frozen shoulder, surgery remains the only viable alternative. Surgery for frozen shoulder is typically a last resort option in the event all other interventions fail. There are two different surgeries that may be performed to address frozen shoulder, namely manipulation under anesthesia and arthroscopic capsular release. Manipulation under anesthesia involves you being put under anesthesia while your doctor forcibly manipulates your arm to remove the adhesions causing the frozen shoulder. On the other hand, arthroscopic capsular release entails your doctor making small incisions in your shoulder and inserting a camera and tools to detach the adhesions, allowing for improved movement. Following surgery, you may have to wear a sling for a while as you convalesce. You may also need to undergo physical therapy as part of your rehabilitation process, which may last between six weeks and six months.

Rehabilitation and Prevention

The road to recovery from frozen shoulder doesn't end after treatments or procedures. Post-treatment rehabilitation is fundamental in restoring your shoulder's mobility and functionality. As you may have noticed, frozen shoulder can restrict you from your daily activities and generally impact your quality of life. But don't worry, it's not the end of the world. Physical therapy is crucial in post-treatment rehabilitation. It gradually progresses by reducing pain and stiffness, restoring function, and improving strength and range of motion. It may include exercises such as stretching, low-impact aerobic conditioning, and weight-bearing exercises. The exercises help you reach behind your back, up above your head, and across your body. Sounds easy, right? Well, it's not a walk in the park because some exercises can be painful, but, hey, you got this! Prevention is always better than cure, and in the case of frozen shoulder, the saying stands. It would be best if you made some lifestyle adjustments. Specifically, everyone should have periodic check-ins with their doctors. Secondly, stretching exercises can be beneficial to prevent frozen shoulder. Still, ensure you don't force your shoulder too much during the exercises as this may lead to injury. Lastly, try not to have sedentary days but remain active with activities such as swimming, cycling, and walking. Overall, post-treatment rehabilitation and prevention of frozen shoulder are crucial components for maintaining your shoulder's functionality and mobility after treatment. Don't be afraid to take it slow and steady, and remember to make those lifestyle adjustments to avoid future episodes of a frozen shoulder.

Conclusion

Frozen shoulder is a common problem that affects a significant number of people. Fortunately, with the right treatment and management, you can alleviate symptoms, restore function and reduce pain. Treatment options for the frozen shoulder include medications, physical therapy, minimally invasive procedures, and surgical procedures if required. If conservative treatments don't work, surgery may be necessary. Following surgery, careful rehabilitation is necessary to restore full m

Gout - Gouty Arthritis

Gout:

Gout is a medical condition, a metabolic disease in which crystals of Uric acid (Monosodium urate) gets deposited in joints and tissues. These crystals are the by-product of body’s Protein degradation.

Causes:

The proteins that we consume in our diet get digested and undergo various steps of degradation in our body. Uric acid is produced during this process is usually excreted from intestine and kidneys.

High levels of Uric acid can be produced due to

Intake of protein rich diet- high purine dietAbnormalities in chemical pathways that leads to excessive production of uric acidCertain drugs like Aspirin (Salicylates), Diuretics (Kidney drugs) interfere with the excretion of uric acid thereby raising its level in blood.

The body’s own overproduction of uric acid is an inherited condition and is present from birth.

Symptoms :

Uric acid is deposited in the form of crystals (Monosodium urate) in joints and tendon. This result in intense irritation, inflammation and pain in the joints and tendon tissues. The joint becomes hot, red and swollen.

Classically the big toe joint of the foot is affected, but ankles, knees, elbows and joints of hand and feet can be involved. Large joints like hip and shoulder joints tend to be spared.

Predisposing factors:

Men are more likely to be affected than women.The commonest age for the first attack is between 30 and 60.

Risk factors include.

A high alcohol intake. Alcohol by itself  does not cause gout, but it will stimulate gout attacks in those who are affectedA protein rich diet.Certain races, like Maoris and Polynesian- who have higher blood levels of uric acid are more susceptible to goutObesity,Conditions that cause high cell turnover, such as polycythaemia (increased red cells), lymphomas and various other cancers can increase blood uric acid levels.A family history of gout,Drugs like Diuretics (drugs increasing urine flow) or low dose salicylates,Kidney diseases,

Some percentage of patients suffering from Gout can have renal colic due to deposition on uric acid crystals in the kidneys.

Diagnosis:

History and complaints

Sudden onset of severe pain, swelling and redness of joint in great to of the foot.Sometimes swelling of joints of foot, ankles and handsHistory of similar episodes in the past.

Examination:

Red, tender, swelling of joint of great toe or other involved joints.Long standing cases uric acid crystals deposit in tendons, tissues appear as swellings called Gout tophi. More common around the elbow, wrists, finger and toe joints and sometimes on the earlobe.

Investigations:

Blood tests: Raised blood uric acid levelsDoubtful cases: Fluid examination from Gout swelling for Uric acid crystals.X rays: in long standing cases shows joint destruction

Treatment:

Acute attack:

Acute attack of gout is characterised by hot, swollen, red and painful joint of great to of foot.

Non-steroidal anti-inflammatory drugs in acute attacks help in reducing the pain and swelling. They should be given in high doses initially.Colchicine is one of the oldest known drugs and can be taken during acute painful phase.New drugs are available that can be given during acute attacks which can reduce blood levels of Uric acid.

Drug treatment:

Drugs in the treatment of gout are given to control the levels of uric acid in blood and to prevent long term complications. Drug dosage should be adjusted according to the levels of uric acid in the blood.

Allopurinol is one of the oldest and common drug used to control the levels of uric acid in blood. This drug inhibits xanthine oxidase which converts xanthine into uric acid.Probenicid and Sulphinpyrazone – Promotes excretion of uric acid through kidneys.

Prevention:

Once you are diagnosed with Gout, you’re a patient of gout for your life.

Avoid Protein rich diet – High Purine foodsAvoid Dehydration: especially in hot weathersAvoid unaccustomed strenuous exercise.Care should be taken in patients on long term diuretics and low dose aspirin.

Regular medications to control the uric acid levels by the advice of physician or orthopedician.

Complications of untreated Gout:

Long term complications of uncontrolled gout can cause

Joint damage (Arthritis),Formation of gout tophi (swellings around the joint) andRare complication of chronic kidney disease.

Synovial fluid replacement therapy

 

 

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