Archive | March 2017

Knee Pain Relief: an ACL Injury & the Role of Reconstructive Surgery

Tears or ruptures of the Anterior Cruciate Ligament (ACL) are common damages in athletes of different ages and activity levels.  ACL tears are treatable using arthroscopy and nominally invasive surgical methods. The medical success rates for ACL reconstruction exceed 95%. The anterior cruciate ligament is one of the main supportive ligaments in the knee. It runs from the lower leg bone (tibia) to the thigh bone (femur) at the knee. This ligament provides knee immovability by preventing extreme forward movement of the tibia in relation to the femur and is also significant in controlling rotation of the two bones.

While the ACL is not the most usually injured knee ligament, tears of this ligament normally lead to chronic knee instability or “giving way. Anterior cruciate ligament tears most commonly result during athletics from vital cutting, landing, deceleration or twisting damages. It is less common for ACL tears to happen as a result of physical contact or collisions during athletics.Many patients who undergo an ACL tear will know immediately that something “feels wrong” with the knee. Several patients report feeling or hearing a “pop” linked with pain and a sense of the knee “giving out”. The joint will usually swell within several hours which results in limited motion of the knee. It will become painful to bear weight on the damaged leg, and the patient will prefer to walk with assertive devices for added support, such as crutches or a cane. Sometimes, the patient may know-how the knee “giving way” when stressed with simple activities such as walking or changing directions.

What Causes an ACL Injury?

An ACL injury is generally sports-related knee damage. About 85% of sports-related ACL tears are “non-contact” damages. This means that the damage occurs without the contact of another player, such as a tackle in football. Most often ACL tears happen when pivoting or landing from a jump. Your knee gives-out from under you once you tear your ACL. Female athletes are known to have a higher risk of an ACL tear, while contributing in competitive sports. Unfortunately, understanding why women are more inclined to to ACL injury is uncertain. There are some suggestions it is bio mechanical, power and hormonal related. In truth, it is possibly a factor of all three.

What are the Symptoms of an ACL Injury?

The diagnosis of an ACL tear is made by numerous methods. Patients who have an ACL tear generally sustain a sports-related knee injury. They may have felt or heard a “pop” in their knee, and the knee generally gives-out from under them. ACL tears cause knee swelling and pain.

How is an ACL Injury Diagnosed?

On clinical knee checkup, your physiotherapist or sports surgeon will look for signs of ACL ligament instability. These special ACL tests places stress on the anterior cruciate ligament, and can notice an ACL tear or rupture.

How is an ACL Injury Treated?

Many patients with an ACL tear start to feel healthier within a few days or weeks of ACL injury. These individuals may feel as though their knee is normal again, as their swelling has started to settle. However, this is when your problems with knee instability and giving way may start or worsen.ACL tears do not essentially require ACL reconstruction operation. There are several significant factors to consider before deciding to undertake ACL reconstruction operation.

  1. Your age
  2. If you regularly perform sports or activities that normally require a functional ACL
  3. If you experience knee instability
  4. You need to plan for the future

If you don’t contribute in a multi-directional sport that requires a patent ACL, and you don’t have an unstable knee, then you may not need ACL operation.

Facts about Bankart Repair Surgery

Background:
Shoulder instability is an important medical problem. Arthroscopic surgery is an established cure modality in shoulder instability, but it continues to be linked with a high rate of repetitions and complications. The cause of the study was to examine late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder unsteadiness and non-engaging Hill-Sachs lesion, with special attention on the incidence and causes of reappearances and complications. Glenohumeral instability can be considered by the direction of instability, the chronicity, and the etiology. Understanding the pathophysiology and etiology associated to the patient’s glenohumeral instability may aid in shaping their risk of recurrence and ultimately monitor management. A thorough history and physical checkup are essential. Age, activity level, athletic participation, and hand dominance should be noted. The examiner should ask about instability in the other joints, particularly the contralateral shoulder. If a painful event is related to the patient’s symptoms, the location of the arm and amount of energy involved during the result should be noted. If the patient cannot recall the position of the arm during the result, knowing the position of the arm that replicates symptoms is also useful.

Important Prevention to be taken post-surgery:
•Sleeping:
For the first three weeks your sling belt must be worn in bed. Sleeping can be little uncomfortable if you try and lie on the operated arm. We advise that you lie on your back or on the reverse side, as you choose. Ordinary pillows can be used to give you ease and support. If you are lying on your side one pillow a little folded under your neck gives enough care for most people. A pillow folded in half supports the arm in front and a pillow stuck along your back helps to avoid you rolling onto the operated shoulder during the night. If you are lying on your back, bond a pillow tightly in the middle or use a folded pillow to backing your neck. Place a folded pillow underneath the elbow of the operated arm to support that.

•Follow up Appointments:
An appointment will be made for you to see the shoulder surgeon or specialist therapist 4 weeks post-operatively.

•Daily Activities:
For the first two to three weeks most activities of daily living for example eating, dressing, cooking etc must be carried out by your un-operated arm. If suitable an occupational therapist will be available to give you guidance on how to do this.

•Leisure Activities:
Your physiotherapist and shoulder surgeon will advise you when it is safe to start again your leisure activities. This will vary according to your activity and level, as well as the period required to rehabilitate your shoulder muscles with physiotherapy.

Know All About Knee Joint Replacement Surgery

What is a Knee Joint Replacement?
The orthopedic technique of knee joint replacement is also called as the Total Knee Arthroplasty (TKA). This surgery involves replacing the current knee joint with a man made one. Orthopedic Mumbai knee surgeons replace knee joints in order to end ache, painfulness, and loss of function.

Are you a candidate for a Knee joint replacement?
Both prolonged osteoarthritis and rheumatoid arthritis usually cause people to lose knee function and harm the joint to the degree that they require a knee joint replacement (total knee arthroplasty or TKA). But knee injury may also stem from damage or infection. Sometimes, people with stark rheumatoid arthritis of the knee can need a TKA at an early age.

What are the current advances in Knee Replacement Surgery?2.jpg
Minimally invasive surgery has transfigured knee replacement surgery as well as several fields of medicine. Its key characteristic is that it uses specified techniques and instruments to allow the knee surgeon to achieve major surgery without a large incision. Nominally invasive knee joint replacement needs a much smaller incision, 3 to 5 inches, versus the normal approach and incision. The smaller, less intrusive approaches result in less tissue injury by allowing the knee surgeon to work amid the fibers of the quadriceps muscles instead of needing an incision through the tendon. It may lead to less aching, reduced recovery time and better gesture due to less scar tissue formation.

How do Mumbai knee surgeons accomplish a Knee Joint Replacement? How long does the process last?
slide1-img.pngThe surgery for total knee replacement may last around 45 mins to one hour and involves an incision over your knee. The thighbone and shinbone will be cut to formulate them for the new pieces. The patella will be stimulated at the beginning of the technique, and later bone cement will be used to secure the prosthesis to it. This is the customary way the procedure has been performed. Some modifications to the process can be made and partial knee replacements are options for certain joints, as well. You will generally leave the hospital within a few days of the process and attend a rehabilitation flair that will help you get used to your current knee and ultimately help you return to all your activities and expectantly many that you gave up due to aching or incapability of your “old” knee to grip.

How long will the patient require physical therapy after Knee Replacement?
After knee replacement surgery, you are generally sent home or to a rehabilitation clinic, depending on your state at that time. If you are sent to a rehabilitation facility, the average rehabilitation stay is around five to ten days. If you are sent straight home from the hospital, your doctor will generally have a physical therapist come to treat you at your home. Your doctor also may have you go to a casualty physical rehabilitation facility as the final stage of the rehabilitation procedure. Outpatient treatment may last from one to two months, depending on your development. Remember, every person is diverse and the course of rehabilitation will be dogged on an individual basis with the assistance of your knee surgeon and physical therapist.