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.

How to Identify Health Issues of Vitamin D Deficiencies ?

 Vitamin D is essential for strong bones. It helps the body absorb calcium from the food that we eat. Lack of vitamin D can lead to bone diseases such as rickets and osteoporosis. But did you know that deficiency of vitamin D can also affect your overall health and well-being?

Dr. A. Mohan Krishna, an orthopedic surgeon at Apollo Hospitals, suggests that being aware of the following symptoms can help identify vitamin D deficiencies:

1. Muscle Weakness: Vitamin D is necessary for the proper functioning of muscles. Deficiency of vitamin D can lead to muscle weakness and aches in various parts of the body.

2. Chronic Pain: Muscle and joint pain, particularly in the lower back and knees, can be a sign of vitamin D deficiency.

3. Mood Swings: Vitamin D plays a crucial role in the production of serotonin, a hormone responsible for regulating mood. Low levels of vitamin D can lead to mood swings and depression.

4. Frequent Infections: Vitamin D is vital for a strong immune system. A deficiency can make you susceptible to infections like cold and flu.

If you experience any of the above symptoms, it's essential to get tested for vitamin D deficiency. This can be done through a simple blood test. If diagnosed with a deficiency, your doctor may recommend taking supplements or increasing sun exposure.

Don't ignore the signs of vitamin D deficiency. Take care of your bones and overall heal

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

KNEE PAIN IN YOUNG ADULTS - CHONDROMALACIA PATELLA

CHONDROMALACIA PATELLA (ANTERIOR KNEE PAIN)

Introduction:

The most common location of knee pain in young adults is at the front of the knee joint. The problem usually arises from patella (Knee cap bone) and surrounding soft tissue.

Knee cap (Patella) is a small bone which lies in front of lower end of thigh bone (Femur). The back side of knee cap is lined by smooth tissue called cartilage. This covering helps the patella to glide in a groove on the lower end of thigh bone. The knee cap is held on the top by thigh muscles (Quadriceps) and lower part is connected to the shin bone by Patellar tendon. Function of knee cap is to aid knee movement and stabilize knee joint while walking.

Causes:

There are many theories suggesting softening and micro injuries to this lining resulting in pain. It could be due to repetitive micro trauma during falls, or vigorous unaccustomed exercises etc. Abnormal position of knee cap over the knee joint with or without weak ligaments may also damage the cartilage lining. As cartilage lining gets softened and roughened it may cause pain and crepitus (clicks and sounds) over the knee cap. Obesity makes the condition worse.

Complaints:

• Pain in front of knee.
• Pain on climbing up and down the steps or ramps.
• Sudden ‘catch’ over the knee cap while getting up from the ground.
• Dull aching pain after sitting for long time.
• Discomfort during squatting (Using Indian toilet) and sitting cross legged.
• Ocassional clicks and sounds over the knee cap.
• Swelling.

Diagnosis:

Orthopaedician can make diagnosis based on your symptoms and examining the knee. Grating sensation behind knee cap might give us some idea of the roughness of patella when you tighten the knee cap muscles.

Some times there may be a little swelling the joint.

Tests:

Blood tests are normal.

X-rays are not helpful as the problem is with cartilage lining which cannot be seen on X-rays.

MRI (Magnetic resonance Imaging) scans can detect changes in the cartilage, but is used as last resort in unresponsive cases.

 Arthroscopy: It is possible to look inside the knee joint and back of the knee cap with pencil shaped camera (Arthroscope) to confirm the diagnosis. But arthroscopy is not done just for diagnosis and is only done if there is any need for surgery.

Treatment:

This condition generally improves over a period with some changes in the life style. But in some patients, symptoms persist for several years.

Analgesics (Pain Killers): Simple pain killers like Paracetomol and tramadol may be sufficient in most of the cases. Sometimes anti inflammatory medications (NSAIDS) may be necessary for a short period.

Nutritional supplements to cartilage lining like Glucosamine, Chondroitin, MSM and collagen peptides can be taken for 2 to 3 months which may relieve the symptoms.

Injections:

In some unresponsive cases Intra articualr Hyaluronic injections can help. They act by providing lubrication between joint surfaces and help to nourish cartilage lining of knee cap.

Physiotherapy:

Strengthening the anterior thigh muscles (Quadriceps) and muscles around the knee cap (VMO) helps to keep knee cap in right position.    

Surgery:

Surgical management is last resort in severe or unresponsive patients. It can be performed with arthroscope (Key hole surgery). The principle is to smoothen the rough surface of the back of knee cap. In some cases where there are large defects in the cartilage, multiple drill holes into the bone may help regrow some cartilage. Now a days we are combining this procedure with stem cell treatment in selective cases.

Do's & Dont's:

Please avoid any movement or position of which makes you feel the pain. It is better to avoid kneeling, squatting or sitting cross legged. One may go up and down the steps occasionally but avoid repeated stair climbing. Pain may get worse with exercise bicycle and walking on a treadmill with upward gradient (slope).