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

Synovial fluid replacement therapy

 

 

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Arthroscopy (keyhole surgery)

What is Arthroscopy?

Greek word for joints is “Arthros”, and Greek word for looking is “Scope”, so arthroscopy means looking in to the joints. Since this is done through a small cut it is commonly known as a minimally invasive surgery or a key hole surgery. It can be performed on many joints like shoulder, elbow, wrist, hip, knee and ankle joints, though shoulder and knee are the commonest.

Why Arthroscopy?

When investigating the conditions of the joints it is very helpful  to be able to look inside the joint in order to see exactly what is going on in addition to examining the joint from outside. It is done with special equipment. Operative procedures for any abnormalities can be done through a second small cut. It is routinely done as a planned procedure as a day case, but sometimes it is done as a matter of urgency, for example following injury to a joint like a twisted swollen knee joint.

What are the advantages?

a) Small incisions and small scares.

b) Less tissue damage and less chance of infection.

c) Less pain and disability after surgery and patient can return to sedentary work almost immediately and to more vigorous work within 1 to 2 weeks.

d) Better diagnosis of many joint problems.

e) Most procedures can be performed as outpatient basis. If hospitalization is required most procedures need 1-2 days of stay compared to several days of stay with open procedures.

f) Some procedures can be done better with arthroscopic surgery and perhaps for some that is the only way they can be done.

Preparation for surgery

After deciding to proceed with arthroscopy some basic blood tests are done and patient’s fitness is assessed. Like any other surgery patients would be asked not to eat or drink any for at least 6 hours prior to surgery. Patients can watch the surgery if it is done under regional anaesthesia.

 After surgery

Prescription would be given for pain killer tablets and other medicines as necessary. The joint needs to be rested a little for a couple of days but like in case of arthroscopy of the knee joint you can walk to and from the toilet with crutches but to avoid excessive use of the joint. One important aspect is physiotherapy to get full movement in the joint and to strengthen the muscles around the joints. Within the limits of pain these exercises can be started as soon as possible after surgery. The exercises can be carried out many times in a day.  Start with 4-6 repetitions of each exercise, increasing to as many as you feel able to do without getting any pain. When you had any other reconstructive surgery like ligament and meniscal surgery post operative care and advice will be different. Similarly arthroscopy of shoulder would be followed up by specific exercises depending upon the type surgery. You would be asked to visit the hospital after 2 days for a change of dressing.

 Common conditions needing Arthroscopy

Knee Arthroscopy:

A torn meniscus ( to repair or remove), a torn anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), For removal or biopsy of inflamed or damaged lining of the joint(synovium), Misalignment of the kneecap (patella), Small pieces of broken cartilage and loose bodies in the knee joint, Removal of Baker's cyst(a swelling behind the knee that is filled with fluid), Some fractures of the bones of the knee. Washing the knee which is constantly sore due to arthritis can also be beneficial.

Shoulder Arthroscopy:

Arthroscopy of the shoulder may be recommended for infective arthritis(septic lesions), biceps tear, SLAP lesions, Rotator cuff lesions, impingement syndrome, recurrent dislocation of shoulder and other  instability problems with or without hyper laxity, Frozen shoulder, loose bodies etc. Problems associated with the other joints in shoulder joint complex i.e. subacromial joint, acromio-clavicular joint are also easily examined giving access to rotator cuff lesions, acromion pathology and  clavicular problems.