Joint Replacement

What is arthritis?

Degenerative joint disease or degenerative arthritis, arthritis (OA) is the most common chronic condition of the joints, affecting approximately 17-20 % of Indian population. Almost any joint can be afflicted with arthritis , although amongst the Indian population it is most commonly seen in knees &hips.

Joint surfaces in our body are covered with articular cartilage which provides a smooth surface for joints motion. With age or due to diseases like Rheumatoid arthritis, Nonspecific inflammatory arthirides cartilage breaks down exposing raw bones, making joint surfaces irregular rather than smooth.  Over time, bones may break down andmay develop growths called spurs. Bit by bit the cartilage is eroded. In the final stages of OA, the cartilage wears away completely and bone rubs against bone leading to joint damage and more pain.

Who’s Affected?

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 50 years. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.

How do you know its “arthritis”  ?

• continuous joint pains on weight bearing/relief at rest.
• Decreased walking distance
• Poor walking tolerance
• Transfer pains
• Rest pains in case of chronic arthritis of hip
• Change in the shape of your knees.(bowing/knocking)
• Change in the way you walk.(more of dragging)
• Inability to do overhead activities in case of shoulder replacement.

What are the investigations we do to confirm its “arthritis”  ?

• A simple x-ray should suffice although in some cases we might need an MRI scan

How do we manage?

In early stages, physiotherapy and analgesics are the main stays. how ever if  even after 2-3 months of conservative management there is no satisfactory relief , surgical management is advised.

What are the surgical options for treating “Arthritis”?

KNEE

High Tibial Osteotomy(HTO)- advised when the joint space is reduced but you can see a gap between the femur and tibial bone in your x-ray with bowing.( early ) This procedure corrects the bowing and straightens the leg with the help of a metal plate and screws.Joint space is preserved, shifts your weight off the damaged side of the joint.An osteotomy can relieve pain and significantly improve function in your arthritic knee.

Full weight bearing is started after a week. A patient will need to under go approximately 10 days of physiotherapy.

Total Knee Replacement

If you severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.You may even begin to feel pain while you are sitting or lying down.If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery.

Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.This surgery is like “Retreading an old tyre”. Very minimal amount of bone is removed to shape your knee, so that implant can be placed. A saphenous catheter and Epidural Catheter can be used for pain management postop.

A patient is made to walk the next day.Total hospitalisation is for 3-5 days.

At discharge, patients are instructed to continue rehabilitative exercises (physiotherapy) at home and visit the surgeon twice weekly for 2 weeks.In 4-6 weeks most of

In 4-6 weeks most of the patients are well rehabilitated back to their normal lives.

Total Hip Replacement

Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.If you have pain that limits everyday activities, such as walking or bending , Hip pain that continues while resting either day or night , Stiffness in a hip that limits the ability to move or lift the leg, Inadequate pain relief from anti-inflammatory drugs, physical therapy or walking supports then you need total hip replacement.

Arthritis of the hip joint

The damaged cartilage and bones are removed and then new implantsare positioned to restore the alignment and function of your hip.

Total Hip Replacement

A patient is made to walk the next day. Total hospitalisation is for 3-5 days.

Total Shoulder Replacement

If you have severe shoulder pain that interferes with daily activities, such as reaching into a cabinet(overhead activities), dressing, toileting, and washing , pain severe enough to prevent a good night’s sleep, Loss of motion and weakness in the shoulder and failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, or physical therapy you need a Shoulder Joint Replacement

Although Shoulder Joint Replacement is less common than knee or hip replacement, it is just as successful in relieving joint pain. In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. The treatment options are either replacement of just the head of the humerus bone (ball) or replacement of both the ball and the socket (glenoid)

You can be discharged 5-6 days after surgery.At discharge, patients are instructed to continue rehabilitative exercises (physiotherapy) at home and visit the surgeon twice weekly for 2 weeks.

In 4-6 weeks most of the patients are well rehabilitated back to their normal lives.