Dr. MANOJ KUMAR KHEMANI
(Specialist Orthopaedic Surgeon)
Categories
Treatments

Arthroscopy

What is Arthroscopy?

Arthroscopy is a specialized branch of Orthopaedics in which the operation is performed through very small key holes with the help of miniaturized cameras.

The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joint.”

What is the function of a ligament?

Ligaments bind two bones in such a way that the joints can move in a restricted way. They prevent excessive and abnormal movement in the joints and also provide protection from the dislocation.

How does a ligament get injured?

Ligament injury or ligament tear is caused due to excessive bending or torsional force along a joint. The ligament fails to hold the joint in place and gives away. Ligament injuries are commonly known as “ligament sprain”.

Types of Ligament injuries

There are 3 grades of ligament injuries depending on the severity of the tear.

Common ligament injuries

Almost any joint can have ligament injury. However few joints are more susceptible to these injuries. Joints which frequently suffer from ligament injuries are:

  • Ankle
  • Knee
  • Lower back
  • Wrist
  • Elbow

Diagnosis:

Ligament injuries are frequently missed as they are not visible on x-ray. A missed grade II or III sprain cam cause prolonged discomfort to the patient.

Thorough clinical examination can help in diagnosing the injury. MRI scan can pick up ligament injuries.

Treatement:

Treatement depends on the grade of injury and the joint involved.

  • Grade I injuries are treated with rest, ice compression and analgesics.
  • Grade II injuries are treates with braces with a longer period of rest.
  • Grade III injuries are treated with absolute rest or in plaster if possible.

Some ligaments with grade II of III injuries never heal by themselves (e.g.- Anterior cruciate ligament of the knee). These ligemants require surgical intervention. Read about ACL injuries under Arthroscopy.

Categories
Treatments

Ligament Injury

What is a Ligament?

A ligament is a tough bundle of fiber which connects two or more bones to each other around the joints. These are made of collagen fibers and are not visible on X-rays.

What is the function of a ligament?

Ligaments bind two bones in such a way that the joints can move in a restricted way. They prevent excessive and abnormal movement in the joints and also provide protection from the dislocation.

How does a ligament get injured?

Ligament injury or ligament tear is caused due to excessive bending or torsional force along a joint. The ligament fails to hold the joint in place and gives away. Ligament injuries are commonly known as “ligament sprain”.

Types of Ligament injuries

There are 3 grades of ligament injuries depending on the severity of the tear.

Common ligament injuries

Almost any joint can have ligament injury. However few joints are more susceptible to these injuries. Joints which frequently suffer from ligament injuries are:

  • Ankle
  • Knee
  • Lower back
  • Wrist
  • Elbow

Diagnosis:

Ligament injuries are frequently missed as they are not visible on x-ray. A missed grade II or III sprain cam cause prolonged discomfort to the patient.

Thorough clinical examination can help in diagnosing the injury. MRI scan can pick up ligament injuries.

Treatement:

Treatement depends on the grade of injury and the joint involved.

  • Grade I injuries are treated with rest, ice compression and analgesics.
  • Grade II injuries are treates with braces with a longer period of rest.
  • Grade III injuries are treated with absolute rest or in plaster if possible.

Some ligaments with grade II of III injuries never heal by themselves (e.g.- Anterior cruciate ligament of the knee). These ligemants require surgical intervention. Read about ACL injuries under Arthroscopy.

Categories
Treatments

Osteoporosis

Have you ever thought why people have hip fracture or wrist fracture or spine fracture after simple injuries ?

Having a fracture after falling from bed or slipping in bathroom is not normal.

All or most of these people are of age 50 years or above.

So why does it happen? The culprit is “OSTEOPOROSIS”.

What is Osteoporosis ?

Osteoporosis is a disease of the bones in which it thins and weakens so much that it breaks with minimum force. In simple terms osteo-porosis means “porous bone”. People with osteoporosis most commonly break their hip, spine, or wrist bone, but any bone can be affected.

Osteoporosis is now recognized as a world wide problem. It is estimated to affect 200 million women worldwide ! Even men are not spared. 1 in 3 women and 1 in 5 men over the age of 50 are at a risk of osteoporotic fracture. Although osteoporosis can strike at any age, it is most common among older people, especially older women.

What causes Osteoporosis?

Our bones are living tissues and are constantly changing. This change is so slow that we hardly realize it. Throughout our lives, the body breaks down old bone and replaces it with new healthy bone. We attain a maximum bone density at the age of 20-25 years (peak bone mass). As we grow old, the process of breaking down bone increases and less new bone is formed.

In osteoporotic people, this new bone has a poor framework and can break easily.

Osteoporosis depends on these factors:

  • Peak bone mass
  • Rate of bone break down
  • Rate of new bone formation

It is often called “silent killer” because bone loss occurs without symptoms. People may not know that they have weak bones until a sudden bump, or fall causes a bone to break. The resulting fracture can prove to be costly. The patient may need a plaster, operation, and sometimes may have to live with a long term disability.

Prevention, diagnosis and treatment

Now-a-days there are various tests and scans available to diagnose osteoporosis. The good news is that there are many steps that can be taken to prevent and treat osteoporosis. With a combination of lifestyle changes and appropriate medical treatment, many fractures can be avoided.

Categories
Treatments

Total Knee Replacement (TKR)

Knee joint is one of the most complex joints in our body. Thanks to over 50 years research in the structure and function of the knee we now have an extremely successful technology and expertise in replacing the knee joint. Total knee replacement is now a well established method of treating advanced osteoarthritis.

Total knee replacement consists of resurfacing of the damaged bone with suitable metallic component. The whole bone is not replaced. In fact we try to preserve as much bone as possible.

Our knee joint is made up of three bones : Femur, Tibia and the Patella. In TKR the damaged surface of femur and tibia is replaced. The patella may or may not be replaced depending on the surgeon’s judgment.

This allows correction of any deformity in the knee. (Bend knees can be straightened). Since there is no bone to bone friction there is marked relief in the pain during walking.

Total Knee replacements lasts really long

A well fitted knee prosthesis can last for many years. However, just like a normal knee joint it also wears with age. In young patients due to higher level of activity there is a possibility that they may require revision surgery later on. In older patients the prosthesis is expected to last for lifetime.

Modern knee prosthesis are designed to last over 20 years. These are made of extremely durable titanium and cobalt-chrome alloys. The implants are made to behave like the natural knees. With newer implants knee bending up to 130° is possible.

Knee replacement
Total knee replacement

Who needs replacement ?

Correct patient selection is the most important criterion for successful Total Knee Replacement (TKR); not all patients require this procedure. Surgeons typically perform TKR in cases of grade IV Osteoarthritis, where conservative methods have failed to provide significant pain relief, rather than in grade I or grade II arthritis. Timely and appropriate treatment can potentially delay the need for surgery for many years.

In India, many people neglect knee problems, allowing them to persist for several years. This delay in treatment can be detrimental to knee health. For patients in the early stages of arthritis, preserving natural knee function for several years without surgery may be possible.

I strongly advise against ignoring knee pain. Seeking treatment today can help you bid farewell to knee pain. In cases where knee problems have progressed, knee replacement offers an excellent option for regaining pain-free knee function.

 

Advanced low cost Knee Replacement solution advantages:

  • Imported implant
  • Faster recovery
  • Less hospital stay
  • Less painful
  • More flexibility of the knees
  • Modernized operation theater
  • Implant cost at govt. rates
Categories
Treatments

Total Hip Replacement (THR)

Unlocking Mobility: A Comprehensive Guide to Total Hip Replacement Surgery

If you or a loved one is facing hip pain that limits daily activities, exploring the world of total hip replacement surgery could be a game-changer. In this article, we’ll break down the essentials of total hip replacement, shedding light on what it is, who might benefit from it, the procedure itself, and what to expect during recovery.

total hip replacement


Understanding Total Hip Replacement (THR)

What is THR?

Total hip replacement (THR), also known as hip arthroplasty, is a surgical procedure designed to relieve pain and improve mobility in individuals with severe hip joint damage. This damage is often caused by conditions like osteoarthritis or injuries that affect the hip joint.

Who Needs hip replacement?

This procedure is typically recommended for individuals experiencing persistent hip pain that interferes with daily activities, despite conservative treatments such as medications and physical therapy. It’s a viable option when the hip joint’s function is significantly impaired.


The Surgical Journey

Preparing for Surgery

Before the surgery, thorough medical evaluations and discussions with the orthopedic surgeon are crucial. They will assess your overall health, discuss any existing conditions, and ensure you’re mentally and physically prepared for the procedure.

total hip replacement xray

The Procedure Unveiled

During the surgery, the damaged hip joint is replaced with a prosthetic implant. The surgeon removes the damaged cartilage and bone and inserts the artificial joint components, aiming to restore smooth movement and alleviate pain.

Recovery Roadmap

Post-surgery, a rehabilitation plan is tailored to each patient. Physical therapy plays a vital role in rebuilding strength and mobility. Following the prescribed exercises and gradually increasing activity levels are key components of a successful recovery.


Post-Surgery Life

Benefits of Total Hip Replacement

The primary goal of this surgery is to improve the quality of life by reducing pain and enhancing mobility. Patients often experience increased joint function, enabling them to resume activities they once enjoyed.

Potential Risks and Complications

While total hip replacement is generally safe, like any surgery, it carries some risks. Infection, blood clots, and implant-related issues are possible complications. However, advancements in surgical techniques and post-operative care have significantly minimized these risks.


Conclusion: A New Chapter Begins

THR is a transformative journey towards regaining freedom of movement and a life unhindered by hip pain. By understanding the process, preparing for surgery, and actively participating in the recovery process, individuals can pave the way for a brighter, more mobile future.

Embrace the possibilities. Explore THR and step into a life of renewed vitality.


Dr Manoj Kumar Khemani

Crafted with care by Dr. Manoj Kumar Khemani – Leader in Orthopedic Excellence

Categories
Treatments

Fracture Treatment

The incidence of fracture has vastly increased worldwide in recent times. The reason is fast moving lifestyle causing increased number of accidents, lack of exercise and poor diet causing weak bones (osteoporosis) and increased life expectancy. Nearly every household has or knows somebody who is suffering from a fracture. In spite of it being such common problem there is hardly any awareness regarding the approach to proper treatment in fractures.

Although fractures might not be entirely preventable there are ways to minimize your fracture risk. One way is by building stronger bones and keeping them healthy.

In case of fracture I advise that you do not panic. Follow these simple first aid measures.

First Aid Measures:

If a person is suspected of having a fracture, do the following :

  • Try to maintain the patient still and composed. Prevent unnecessary movement arising out of anxiety or fear. Do Not Panic.
  • Examine the person closely for the presence of other injuries and call for medical help. If medical help is quickly available, hand over the patient to them for further treatment.
  • If there is a break in the skin surface, it can be rinsed to remove any visible dirt or other potential contamination. However, vigorous flushing or scrubbing of the wound should be avoided.
  • In case of bleeding from the injured limb use a cloth or cotton bandage to compress the bleeding site. Do not attempt to find the source of bleeding.
  • The broken bones can be immobilized with the help of splints. Rolls of newspaper, cardboard or strips of wood can be used. It is important to immobilize the area both above and below the injured bone.
  • Ice packs can be applied to reduce pain and swelling. Do not put ice directly over the skin. Keep the ice in a cloth or polybag and then apply it.
  • Do not give the person anything to eat or drink as this will cause any emergency operation difficult.
  • Take the patient to nearest hospital or medical facility for primary care. Treatment by Orthopaedic surgeon is preferable.

How do I Know I have a fracture ?

Pain and swelling in an area is hallmark of a fracture. If your limb is moving abnormally its most likely to be fractured. Sometimes it is difficult to know that there is a fracture. X-rays can detect most of the fractures. In some cases a CT-scan or an MRI scan may be needed.

Somebody has a fracture, what to do ?

Follow the First Aid guidelines given above. Contact your nearest medical centre with orthopedic facilities.You can get in touch with me also through the helpline number given above.

Do I need an plaster or operation ?

Its best to leave it to your Orthopedic Surgeon to decide.

I have swelling even after opening of plaster.

It is quite common to have some swelling (especially in the legs) after opening plaster. There is no need to get worried. This swelling can last for a variable period from a few days up to 2 months. You should consult your doctor if there is excessive pain and stiffness or if the swelling persists for more than 2 months.

My fracture is not healing !

Once in a while I get patients whose fractures are difficult to heal. One common reason for it is that there is less bone formation around the fracture site. In such situations you may need operation with bone grafting to stimulate the healing process.

What is a Synthetic plaster ?

A Synthetic plaster is made out of fiberglass, a kind of moldable plastic. These casts come in many bright colors and are lighter. They are tougher and more durable than the traditional plaster of paris casts.

Fiberglass plaster are strong enough to allow immediate weight bearing.

Synthetic plasters can be combined with waterproof liners to give you a waterproof plaster.