UNICOMPARTMENTAL KNEE PROSTHESIS

 

During knee replacement surgery in Delhi, the damaged bone and cartilage are covered with metal and plastic components. In a unicompartmental knee replacement (also called a “partial” knee replacement), only part of the knee is covered. This procedure is an alternative to total knee replacement for patients whose disease is limited to just one area of ​​the knee.

Because partial knee replacement is done through a smaller incision, patients generally spend less time in the hospital and return to normal activities sooner than patients undergoing total knee replacement.

ADVANTAGES OF PARTIAL KNEE REPLACEMENT

Several studies show that most patients who are suitable candidates for the procedure have good results with unicompartmental knee replacement in Delhi.
The advantages of partial knee replacement over total knee replacement include:

• Faster recovery;
• Less pain after surgery;
• Less blood loss;

DISADVANTAGES OF PARTIAL KNEE REPLACEMENT

The disadvantages of partial knee replacement compared to total knee replacement include:

• Slightly less predictable pain relief;
• Potential need for more surgery. For example, a total knee replacement in Delhi may be necessary in the future if arthritis develops in the parts of the knee that were not replaced;

SURGERY CANDIDATES

If your osteoarthritis has advanced and non-surgical treatment options are no longer relieving your symptoms, orthopaedic in Dwarka may recommend knee replacement surgery in West Delhi. In order to be a candidate for unicompartmental knee replacement, your arthritis must be limited to one compartment of your knee. In addition, if you have any of the following characteristics, you may not be eligible for the procedure:

• Inflammatory arthritis;
• Significant knee stiffness;
• ligament damage;

With proper patient selection, modern unicompartmental knee replacements have demonstrated excellent mid- and long-term results in younger and older patients.

YOUR SURGERY

A partial knee replacement operation typically lasts between 1 and 2 hours.

Partial knee replacement. There are three basic steps in the procedure:

• Prepare the bone. Your orthopaedic surgeon in Dwarka will use special saws to remove cartilage from the damaged compartment of your knee;
• Position the metal implants. The removed cartilage and bone are replaced with metallic coatings that recreate the joint’s surface. These metal pieces are typically held in the bone with cement;
• Insert a spacer. A plastic insert is placed between the two metal components to create a smooth gliding surface;

COMPLICATIONS

As with any surgical procedure, there are risks involved with a partial knee replacement. Your orthopaedic surgeon in West Delhi will discuss each of the risks with you and take specific steps to help prevent potential complications.

Although rare, the most common risks include:

• Blood clots. Blood clots in the leg veins are a common complication of knee replacement surgery. Blood clots can form in the deep veins of the legs or pelvis after surgery. Blood anticoagulants such as low molecular weight heparin and aspirin can help prevent this problem. Newer medications, such as rivaroxaban (Xarelto), may also be prescribed by your orthopaedic doctor in Dwarka, depending on your needs;
• Infection. After surgery, an infection may occur in the skin over the wound or deep into the wound. An infection can happen while you are in the hospital or after you go home. You will be given antibiotics before the start of your surgery and these will be continued for about 24 hours afterwards to prevent infection;
• Nerve or vessel damage. Although it rarely happens, nerves or blood vessels can be injured or stretched during the procedure;
• continued pain;
• Risks of anesthesia;
• Need for additional surgery;

RECOVERY

Hospital discharge. Patients with partial knee replacement generally experience less postoperative pain, less swelling, and have easier rehabilitation than patients undergoing total knee replacement. In most cases, patients go home 1 to 3 days after the operation. Some patients go home on the day of surgery.

Weight support. You will begin putting weight on your knee immediately after surgery. You may need a walker, or crutches for the first few days or weeks until you feel comfortable enough to walk without assistance.

Rehabilitation exercise. A physiotherapist in Dwarka will give you exercises to help maintain your range of motion and restore your strength.

Everything About Knee Replacement

THE KNEE JOINT

Joints are the areas where bones meet, and movement occurs. The knee joint is made up of the femur above and the tibia below. The two bones are separated by cartilage that acts as a cushion and allows movement.

REASONS FOR SURGERY

The reasons for total knee replacement surgery in Delhi are: severe pain, loss of mobility, or deformity of the knee. Symptoms may be due to osteoarthritis, rheumatoid arthritis, or trauma among others.

Osteoarthritis, commonly called "wear and tear," is the most common cause for a total knee replacement.

ABOUT KNEE REPLACEMENT

The knee joint is made up of the ends of the thigh bone (femur) and the shin bone (tibia). These bones normally slide over each other with ease because they are covered by soft cartilage. If an injury damages the cartilage or is worn away by arthritis, for example, it can make the joint ache or stiff.

Generally, a new knee joint improves mobility and decreases pain, although your new knee will not be able to bend as much as a normal knee joint.

Depending on the condition of your knee joint, they will replace part or all of your knee joint. A total knee replacement is more common.

Artificial knee pieces can be made of metal and / or plastic, and a knee replacement can last up to 20 years.

WHAT ARE THE ALTERNATIVES?

Knee replacement surgery in Delhi is generally recommended only if nonsurgical treatments, such as physical therapy and exercise, taking medication, or using physical support devices such as a cane, no longer help decrease pain or improve mobility.

Alternative surgical procedures include arthroscopy in Delhi (if the arthritis is not very severe) or osteotomy (in which the leg bones are cut and put back). You may have already had these procedures before your knee replacement.

The surgeon will explain your options.

PREPARING FOR A KNEE REPLACEMENT

The orthopaedic surgeon in Delhi will explain how to prepare for the operation. For example, if you smoke, they will ask you to stop smoking, as this increases your risk of chest and wound infection, which can delay your recovery.

Typically, you must stay in the hospital for about five days, and the surgery is performed under general anesthesia. This means that you will be asleep during the operation. Otherwise, if you prefer, the surgery can be performed under epidural or spinal anesthesia. This type of anesthesia completely numbs from the waist down, and you will remain awake during the operation.

If you are going to have general anesthesia, you will be asked to fast. This means that you should not eat or drink, normally, for about six hours before general anesthesia. However, it is important to follow the instructions of your anesthetist.

In the hospital, the nurse can check your heart rate and blood pressure and do a urine test.
Your surgeon will explain to you what will happen before, during, and after the procedure, and any pain you may have. This is your opportunity to understand what will happen, and it may be helpful to prepare questions about the risks, benefits, and other alternatives to the procedure. This will help you stay informed so that you can give your consent if you are asked to sign a consent form to carry out the procedure.

You may be asked to wear compression stockings on your unaffected leg to prevent blood clots from forming in your veins (deep vein thrombosis, DVT). You may need an injection of a blood-thinning medicine called heparin in addition to, or instead of wearing, compression stockings.

WHAT HAPPENS DURING A KNEE REPLACEMENT?

Generally, a knee replacement in Delhi takes about two hours.

The orthopaedic in Delhi will make a single cut (10 to 30 cm long) in the front of your knee. You will push the kneecap to the side to reach the knee joint. The surgeon will remove the worn or damaged surfaces from the end of the femur and the top of the tibia. Typically, he will remove the anterior cruciate ligament and may remove the posterior cruciate ligament. For support, the best orthopaedic in Dwarka will not remove the collateral ligaments. It will shape the surfaces of the femur and tibia to fit the artificial knee joint and then fit the new joint over both bones.

Sometimes the back of the kneecap is replaced with a piece of plastic. This is known as patella lining.
After placing the new joint, the surgeon will close the wound with stitches or clips and cover it with a bandage. The surgeon will place a tight bandage on your knee to help minimize swelling.

WHAT SHOULD I EXPECT AFTER

You will need to rest until the anesthesia wears off. After epidural anesthesia, you may not be able to feel or move your legs for several hours.

You may need pain relievers to ease any discomfort when the anesthesia wears off.

You may have an intermittent compression pump attached to special pads on your lower legs for the first day or so. By inflating the cushions, the pump encourages healthy blood circulation and helps prevent a DVT. You can also have a compression stocking on your unaffected leg. This helps maintain circulation.

A physiotherapist in Dwarka (a movement and mobility specialist) will visit you daily to guide you through exercises that will help you recover.

You will stay in the hospital until you can walk safely with the help of a cane or crutch. When you can go home, you will need to ask someone to drive you.

Before you go home, the nurse will give you recommendations for caring for your knee and a date for your follow-up appointment.

How long it takes for the sutures to disappear will depend on the type used in the surgery. However, for this procedure they usually go away in about six weeks. Nonabsorbable sutures and clips are removed 10-14 days after surgery.

RECOVERING FROM KNEE REPLACEMENT SURGERY

If necessary, you can take an over-the-counter pain reliever, for example acetaminophen or ibuprofen. Follow the instructions in the patient information leaflet that comes with your medicine, and if you have questions, ask your pharmacist.

Physical therapy exercises are an indispensable part of your recovery, so it is essential that you continue to do them for at least two months.

You will be able to move around your house and go up and down stairs. For a few weeks, some everyday activities, such as shopping, will be difficult for you to do. You may need to use a cane or crutches for about six weeks.

You may be asked to wear compression stockings at home for several weeks.

When resting, raise your leg and support your knee to help prevent leg and ankle swelling.

Depending on the type of work you do, you may be able to go back to work after six to 12 weeks.

Follow your surgeon's recommendations for driving. You should not drive until you are sure that you can brake in an emergency without discomfort.

WHAT ARE THE RISKS?

Knee replacement surgery in West Delhi is a common and generally safe procedure. However, in order to make an informed decision and consent, you must be aware of the possible side effects and risk of complications associated with this procedure.

Side effects

These are the unwanted, though mostly temporary, effects of successful treatment; for example, feeling dizzy as a result of general anesthesia.

Your knee will hurt and be swollen for up to six months.

You will have a scar on the front of your knee. You may not have sensation in the skin around the scar. This may be permanent, but it should get better in two years.

Complications

Complications are problems that occur during or after the operation. Most of the people are not affected. Possible complications from any operation include unexpected reactions to anesthesia, excessive bleeding, or clot formation, usually in a vein in the leg (DVT).

Complications specific to knee replacement are rare, but include:

• Wound or joint infection Antibiotics are given during and after surgery to prevent this complication.
• Unstable joint. The knee joint may loosen and may require surgery to correct it.
• Damage to blood vessels or nerves. It is usually mild and temporary.
• Scar tissue. Scar tissue formation can limit movement. You will likely need another surgery to correct it.

 

Knee Replacement Surgery For Accute Knee Pain

Knee replacement surgery, also known as "knee arthroplasty," can help relieve pain and restore function to severely diseased knee joints. This procedure involves cutting out damaged bone and cartilage from the femur, tibia, and patella, and replacing it with an artificial joint (prosthesis) made of metal alloys, premium plastics, and polymers.

To determine if a knee replacement in Delhi is right for you, an orthopedic surgeon in Delhi evaluates your knee's range of motion, stability, and strength. The use of X-rays helps determine the degree of damage.

Your doctor can choose from a variety of knee replacement prostheses and surgical techniques based on your age, weight, activity level, knee size and shape, and overall health.

One of the most common reasons for knee replacement surgery in Delhi is severe pain caused by damage to the joint due to wear and tear from arthritis (osteoarthritis). Osteoarthritis can wear down the slippery cartilage that helps the knee joint move smoothly. An artificial knee joint has metal alloy caps for the femur and tibia, and high-density plastic to replace damaged cartilage.

Knee Replacement Surgery

In traditional knee replacement surgery in West Delhi, the surgeon makes a long incision in the center of the knee joint, through muscles, tendons, and ligaments to reach the knee joint. In total knee replacement surgery in Delhi, the surgeon will remove damaged tissue and rebuild the surface of the knee joint with artificial materials. By replacing damaged and worn knee surfaces, total knee replacement surgery can reduce pain, correct leg deformities, and help many patients return to normal activities. Knee replacement surgery, called total knee arthroplasty, involves replacing damaged structures in the knee joint with metal and plastic pieces to restore normal knee function and relieve chronic pain.

In partial knee replacement, damaged cartilage and bone are removed and replaced in only one affected part of the knee joint. Total knee arthroplasty requires the implantation of an artificial joint to replace damaged or diseased cartilage and bone in the femur, tibia or patella. The procedure involves removing damaged bone and cartilage from the femur, tibia, and patella and replacing them with artificial joints (prostheses) made of metal alloys, high-quality plastics, and polymers. During this procedure, plastic and metal inserts are used to replace bone and cartilage in all parts of the knee joint, including the medial, lateral, and patella.

Surgeons cover the ends of the bones that make up the knee joint with metal or plastic parts, or implant a joint-shaped prosthesis. In total knee arthroplasty, orthopaedic surgeon in Dwarka uses metal to resurface the end of the femur (femur) and the thigh bone, where the two bones meet to form the knee joint. During surgery, the surgeon will remove diseased bone and cartilage where the femur (femur) and lower leg (tibia) meet at the knee joint. Surgeons left the original ligaments, tendons, skin, muscles and most of the bone and simply covered the damaged cartilage in the knee with metal plating.

Artificial knee joints have metal alloy caps for the femur and lower leg and high-density plastic to replace damaged cartilage. Knee replacement surgery in Delhi can help patients whose knee or knee joint has been damaged by injury due to osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. Knee replacement surgery may be appropriate when medications and other treatments fail to control knee pain. People who think they need medication for pain relief should consider seeing a joint replacement surgeon (an orthopaedic surgeon in West Delhi with experience in knee replacements) to determine if surgery is the best option.

Therefore, it is important that the best orthopaedic in Dwarka who performs a minimally invasive quadriceps-sparing total knee replacement is not only an excellent orthopaedic surgeon, but also an expert knee surgeon in West Delhi and minimally invasive knee arthroplasty. Even experienced knee replacement surgeons perform far more procedures using traditional methods than using less invasive methods; we know that the more procedures you do, the more reliable the results will be. Often, partial replacements are only beneficial for young people with symptoms in one part of the knee.

What is a total knee replacement?

 

The knee is one of the most important joints in the human body, and it allows you to walk, run and do a multitude of tasks. However, it can be affected by some diseases, being osteoarthritis one of the most limiting, explains the orthopaedic in Delhi.

Severe pain, stiffness, inability to move as before and swelling in the knee are symptoms indicative of osteoarthritis, that is, wear and tear on the knee.

In cases where the patient is very limited and does not improve with non-surgical treatment, also called conservative treatment, knee replacement surgery in Delhi may be necessary to place the total knee prosthesis.

Total knee replacement: understand more about this surgery

The prosthesis is a device that we implant in the diseased knee of people with arthrosis. Most often, the prosthesis is made of a metal alloy composed of chromium and cobalt. These metals are biocompatible, that is, they have a low risk of being rejected by our body. Therefore, they can be deployed safely. The procedure used by the orthopaedic surgeon in Delhi to place the prosthesis in the patient’s knee is called total knee arthroplasty.

After all, what is total knee arthroplasty?

This is a major surgery, characterized by the replacement of the diseased part of the knee with a new material, the prosthesis. When the entire knee is affected by arthrosis, we perform total arthroplasty. When only a small part of the knee is diseased, we can do partial arthroplasty, also called unicompartmental knee arthroplasty, explains the orthopaedic in Delhi.

Who is this surgery recommended for?

Patients with an advanced degree of arthrosis, who have severe movement limitations, severe pain, and who have not had satisfactory results with non-surgical treatment (eg, medications, physical therapy, viscosupplementation, platelet-rich plasma, shock waves, denervation of the geniculars).

Added to this, there are patients with arthrosis so severe that they are already directly indicated to undergo knee replacement in Delhi. Such patients are those with severe ligament instability (absence of ligament function), major bone deformity (varus or valgus greater than 20 degrees), or significant bone loss, explains the orthopaedic surgeon in Delhi.

I’m too young or too old to get a prosthesis. Is this right?

There is no maximum age to undergo surgery. What we assess, in the case of elderly patients, are their clinical conditions, that is, whether they support the procedure.

I have operated on patients over 90 years old with excellent results, without complications. Postoperative mortality is currently low and technology develops daily to make surgery even safer. Therefore, before fearing surgery, seek proper guidance from a trained orthopaedic in Delhi.

As for the younger patient, that is, those under 60 years of age, we prefer to postpone the procedure as much as possible, considering the durability of the prosthesis. After 10 years of the procedure, the number of people whose prosthesis remains functioning properly decreases progressively. As the young have more years to live than the elderly, the chance of the young person needing multiple replacements of the prosthesis is greater, says the orthopaedic doctor in Delhi.

In any case, what we take most into consideration is the patient’s quality of life. If the arthrosis is significantly deteriorating the quality of life, we opt for knee replacement surgery in Delhi. Otherwise, we maintain non-surgical treatment.

How long does a prosthesis last?

Just as your knee wears out, the prosthesis wears out over time. Studies show that the prosthesis lasts well for 10 years in 95% of people. After 20 years, the rate drops to 90%, but there is still a significant amount of people who continue with the prosthesis in good condition.

What is a knee replacement? All the information you need before the operation

 

Many times, the solution to a knee injury is through a surgical intervention and the placement of an implant. Next, we explain all the information you should know before the knee replacement surgery in Delhi.

What is a knee replacement?

A knee prosthesis is an implant that is placed to replace the damaged joint in order to perform its function and allow the patient to regain mobility in the affected area.

The artificial knee is designed to comply with all the characteristics of the native knee, it only differs in that it lacks sensitivity, therefore, the pain caused by joint wear does not exist, explains the orthopaedic in Delhi.

Types of knee replacement

Depending on the severity of the injuries that the patient presents, the orthopaedic doctor in Delhi assesses which type of prosthesis is the most appropriate.

There are two main types of prostheses: on the one hand, the unicompartmental prosthesis, in this case only the damaged areas of the joint are replaced, however, in cases of osteoarthritis, it does not prevent the disease from spreading through the joint.

Second, there are total knee replacements. These are more common and are characterized by the total replacement of the joint.

How is the knee replacement operation?

In the knee replacement surgery in Delhi, the patella is removed, and the distal ends of the femur and tibia are cut to fit the prosthesis to the joint space. Afterwards, the two components of the prosthesis are fixed to the bone, through a foundation technique. Finally, the muscles and tendons of the damaged joint are repaired, and the incision is closed.

The operation usually lasts between an hour and a half and two hours. An incision of about 20 centimeters is made, which reduces the patient’s bleeding and improves healing. The anesthesia used is usually spinal, that is, from the waist down, although in cases of osteoarthritis or coagulation problems, general anesthesia is applied, explains the orthopaedic surgeon in Delhi.

When to put a knee replacement?

Usually, the knee replacement in Delhi is implanted when the patient has tried other treatments and they have not been successful.

The most common cause for needing a prosthesis is osteoarthritis, since joint wear and tear causes pain that, in many cases, can be relieved with a prosthesis.

Also, a prosthesis may be needed when one after a bone break, the joint has not re-established properly. In cases of bone tumors, a knee replacement can also be used to replace the damaged bone.

How long does a knee replacement last?

Knee prostheses do not have an exact duration in time. They suffer slight wear over time, this is due to a reason: when a prosthesis is implanted, a sliding material must be included, on which friction is made during the movement of the joint. The material used is polyethylene which, thanks to its properties, mimics cartilage.

Polyethylene suffers wear, since it releases particles, which are absorbed by the defensive cells of the human body. These cells grow and, in some cases, attack the bone, causing a “particle disease”, that is, the loosening of the prosthesis.

In recent years, the quality of the materials has improved significantly, with which, we could say that knee prostheses could last up to 30 years.

Benefits of a knee replacement

The most common is that before undergoing a knee replacement in Delhi, the patient has undergone other treatments without obtaining results.

After the application of the prosthesis, the pain usually disappears in its entirety, or becomes a mild discomfort. Depending on the condition that occurs before the operation, the patient usually regain mobility significantly, and therefore improves their quality of life, since they can return to their day-to-day activities without experiencing pain.

How is the recovery after a knee replacement operation?

Recovery after the knee replacement surgery in Delhi usually requires a hospital stay of between three and five days. The patient begins to walk two days after the operation, helped by crutches and the distances are increasing.

Depending on the stiffness of the joint and the patient’s previous condition, the duration may be more or less long. In the case of knee prostheses, rehabilitation is of great importance, which begins a few days after the operation, with the use of machines that make it possible to increase the degrees of flexion and extension of the knee, progressively.

Complications after the implantation of a knee prosthesis

After the knee replacement in Dwarka, only 2% of patients present complications, the most common being related to the appearance of infections that, in some cases, require surgical treatment.

In addition, there are other factors that are directly related to the prosthesis: the loosening of the prosthesis, which can cause pain and, in some cases, a replacement of the prosthesis may be necessary.

As explained above, the prosthesis develops a slight wear over time. In some cases, it can lead to loosening of the prosthesis. A breakage of the prosthesis can also occur, although in very isolated cases.

Some patients may experience an injury to the nerves near the joint, in cases in which the deformity that is corrected is significant, but is not common, says the orthopaedic in Delhi.

Knee replacement infection

As mentioned, the most common complications are usually the appearance of infections. These usually appear in people with obesity or diabetes.

Prosthetic infection occurs when bacteria reach the surface of the knee replacement. If the patient’s immune system is not able to eliminate it, the bacteria can create a “biofilm”, that is, a protective environment that protects them from the immune system and antibiotics. Depending on the aggressiveness of the microorganisms, the infection will be more or less serious.

The most common types of prosthetic knee infection are:

• Acute infection: it is caused by aggressive bacterial contamination in the operating room, and usually occurs within four weeks after the intervention.
• Chronic infection: in this case, the infection, too, is contracted in the operating room, but it can manifest itself from the fifth week after the operation to one or two years later.
• Hematogenous infection: the infection is carried, through the blood, from another part of the human body to the knee replacement.
• Positive intraoperative cultures: detected when removing the prosthesis due to loosening.

When a knee prosthesis infection appears, it is usually approached with antibiotic treatment, but it is usual, that a surgical intervention is necessary, in which the infection is cleaned, and the infection is approached from within. In some cases, a replacement of the prosthesis is necessary, says the orthopaedic surgeon in Delhi.

Replacement of knee replacement

In some cases, replacement surgery for a knee replacement is necessary. Typically, this decision is made in the face of ongoing and limiting pain.

First, an X-ray of the patient is performed and, in case of observing the presence of radiolucencies, that is, lack of contact between the bone and the prosthesis, the intervention is carried out. In these cases, if the prosthesis is not changed, there may be a risk of a periprosthetic fracture, that is, a break in the bone that supports the prosthesis. Another cause is the appearance of an infection.

Normally, prosthesis replacement surgeries are performed using the anterior approach technique, in which the scar from the previous operation is intervened, explains the orthopaedic in Janakpuri.

Tips for caring for a knee replacement

Once the knee replacement surgery in Delhi has been carried out, it is important to take certain aspects into account, to keep the knee replacement in good condition.

In the first place, it is important to care for the wound after the operation, it must heal in the way the specialist indicates.

When you return to your normal routine, it is important to avoid impact sports, as they put pressure on the prosthesis and can cause overloading of the joint. Body weight should be controlled, as the greater the weight, the more pressure will be placed on the knee joint. Also, sudden movements with the intervened knee should be limited, it is advisable to avoid movements and positions that involve forced positions for the joint, suggests the orthopaedic in Delhi.

Throughout the post, it has been possible to observe how a knee prosthesis can be the solution to the existence of chronic pain or advanced osteoarthritis. It is important to follow certain guidelines after a knee replacement in Delhi to ensure a good recovery and a longer duration in time.

CARTILAGE DAMAGE IN THE KNEE

 

WHAT IS THE CARTILAGE IN THE KNEE FOR?

An approx. 5 mm thick layer of cartilage covers the bone in the knee joint. The smooth surface of the cartilage allows the joint to move smoothly. In addition, the cartilage causes an even distribution of pressure and shock loads on the underlying bones. This protects the bone and prevents or reduces overstressing. The cartilage has no nerves and stops growing after puberty. This layer of cartilage accompanies us throughout life.

HOW DOES CARTILAGE DAMAGE COME?

The cartilage undergoes natural aging. In doing so, it loses the ability to store water and the cartilage layer shrinks. The surface of the cartilage becomes brittle and cracks. This brittle surface is more prone to impacts and shear forces. This allows the cartilage to wear out or split off more quickly. Since the cartilage has no pain fibers, we do not feel this change at the beginning. Perhaps a rubbing noise (crepitation) is noticeable under greater stress. In contrast to cartilage, bone has pain fibers. If the bone is exposed, we feel the affected joint with the corresponding pain, explains the orthopaedic in Delhi.

However, the articular cartilage can also be damaged by chronic stress or an accident (trauma).

HOW DO YOU RECOGNIZE CARTILAGE DAMAGE?

With acute cartilage damage, patients complain of blockage of the knee joint, swelling and pain. The extent of the discomfort depends on the size and depth of the cartilage defect and its location.

In the case of chronic cartilage damage, patients report start-up, stress, and inflammatory pain. The knee is swollen, and the mobility of the knee joint is limited. In addition, the patients have an unsteady gait, the knee joint feels unstable and in some cases kinks, says the orthopaedic in Delhi.

HOW IS CARTILAGE DAMAGE DIAGNOSED?

The damage to the articular cartilage can appear superficially with small cracks on the one hand, but on the other hand affect the entire cartilage in the knee. This causes the rough, painful surface of the bone to emerge.

Cartilage damage is divided into four stages:

• Stage / Grade I: Soft cartilage
• Stage / Grade II: Rough surface with cracks
• Stage / Grade III: Deep cracks in the cartilage that go down to the bone
• Stage / Grade IV: Complete consumption of the cartilage with exposed boil; one also speaks of bald bones

In addition to the exact questioning (anamnesis) and well-founded clinical examinations of the knee joint, X-ray and MRI images are necessary. Based on these documents, the appropriate individual therapy can be discussed, says the orthopaedic doctor in Delhi.

WHAT TREATMENTS ARE AVAILABLE FOR CARTILAGE DAMAGE?

The cartilage damage looks different depending on the cause, whether accidental (acute) or wear-related (chronic) and is treated differently accordingly. In the case of acute cartilage damage, for example, we have a clearly defined defect (punch defect) compared to healthy cartilage with sharp edges. This is not the case with chronic cartilage defects. If the cartilage defect is not treated, there is further cartilage wear of the knee joint and, in the further course, knee joint osteoarthritis.

Conservative therapy for cartilage damage is very limited. After puberty, the cartilage loses its self-healing potential, i.e. from this point onwards we have to get by with the cartilage for our entire life. For these reasons, the natural course of cartilage damage leads to deterioration. The cartilage damage gets bigger and deeper over time, which leads to a clinical deterioration with corresponding pain and restrictions in everyday life and during sporting activity. With conservative therapy, cartilage damage cannot be cured, but only alleviated by slowing down the wear and tear of the cartilage. The following conservative therapies are possible:

• physical therapy
• Osteopathy
• Painkiller
• Cartilage Support Agents
• Lubricating syringes: Hyaluronic acid syringes temporarily improve the joint lubrication of the defective joint. This will reduce the inflammation in the joint and, accordingly, the patient will experience less pain. Injections with autologous blood are another option.
• More: Pay attention to your own weight or reduce it, a healthy balanced diet, regular training with guided movements such as swimming or cycling.

The surgical therapy of the cartilage damage depends on the size (extent) and depth of the defect and must be individually adapted. In addition, factors such as the integrity of the exposed bone, cartilage quality on the opposite side of the defect and the age of the cartilage defect play a decisive role, explains the orthopaedic surgeon in Delhi.

Furthermore, the younger the patient, the greater the chances of success of the methods described below for acute cartilage damage. These include:

• Fixation of the bone / cartilage splinter with a mostly dissolvable screw.
• Arthroscopic sealing of superficial cartilage tears.
• Microfracture: First, the cartilage defect is prepared in such a way that a clean, stable cartilage margin is present. Then small holes are made in the exposed bone with the drill or special awls. It is from these holes that blood comes out of the bone, which contains stem cells. Among other things, these stem cells can transform into cartilage and thus protect the exposed bones again. This method is mostly used arthroscopically (joint endoscopy) and is suitable for smaller cartilage defects (<2.5 cm2).
• Transplantation of cartilage-bone cylinders: This technique is also called mosaic plastic or OATS (Osteochondral Autologous Transplantation System). The method is also only used for smaller cartilage defects (<2.5 cm2). With special hollow punches, the body's own cartilage-bone cylinders are taken from an unloaded part of the knee joint and inserted directly into the cartilage defect. This method is used when, in addition to the cartilage defect, the underlying bone is also damaged.
• AMIC: The AMIC technique is used for larger cartilage defects. AMIC stands for autogenous matrix-induced chondrogens, i.e. matrix-induced own cartilage production. The cartilage defect is exposed and cleaned so that stable cartilage edges are present again. This is followed by micro-invoicing as described above.
• Cartilage transplantation: Another option would be to have your own cartilage cells grown in a laboratory from biopsies obtained from the first operation. This method is also called ACT (autologous chondrocyte transplant). After about four weeks of cultivation in a laboratory, the cartilage cells can be inserted into the corresponding defect in a second operation.
• Bone defects: If there are bone defects that are deeper than 4 mm, they must be filled with the body's own bone (e.g. thigh) or donor bones (cancellous plastic).

The above-mentioned surgical techniques are mainly used for acute cartilage defects. In addition to age, the opposite side of the cartilage defect also plays a role. This should not show any major damage, otherwise the rough surface can negatively affect the outcome of the operation. Another option for covering more chronic cartilage defects is knee replacement in Delhi of the injured cartilage.

If the cartilage wear has progressed so far that finally bone rubs on bone (end stage of osteoarthritis), a partial prosthesis (e.g. a sled prosthesis, a kneecap glider replacement) or a knee replacement surgery in Delhi is necessary. A correction of bowlegs / knock knees (so-called corrective osteotomy) is sometimes necessary.

WHAT IS THE AFTER-TREATMENT LIKE?

The follow-up treatment must be individually adapted to the previous operation. If cartilage therapy was carried out, the knee joint had to be relieved with walking sticks for six weeks. In the case of cartilage defects behind the kneecap, mobility is also restricted for six weeks. Patients with resurfacing can immediately put weight on and move the knee joint. To protect the soft tissues, however, walking sticks are recommended for around four weeks. Physiotherapy for several weeks to relieve swelling and strengthening and stretching of the thigh muscles are also important.

Knee Osteoarthritis: Chronic, But Manageable

Osteoarthritis is caused by changes in the structure of the cartilage. Does it have a cure?

The knee osteoarthritis is a chronic disease that progresses always has multiple causes and handling depends on the alteration that occurs in the daily life of the patient.

“As a disease, there is no cure. Once cartilage damage has occurred since a certain stage, there is no going back, there is no medicine to fix it. There are treatments for different stages, the initial ones are not aggressive, even the terminal ones that are aggressive,” indicates orthopaedic in Delhi.

The focus is always on improving the patient's ability to do work and physical activities. If osteoarthritis progresses, the best option would be to think about knee replacement surgery in Delhi.

The knee prosthesis is never the first option, since it lasts between 15 and 20 years, “so if you put it on at 43, you will need a knee replacement in Delhi, which is a major procedure. The ideal is to move forward with all the medical treatments and leave the prosthesis for the last moment, ”says Dr. Ashu Consul, orthopaedic surgeon in Delhi.

Orthopaedic doctor in Delhi adds that not only is the prosthesis expected because of its duration, but because medical technology is advancing rapidly and better elements may appear in the short term. But if the indication, due to the characteristics of the patient, is to go for surgery, you should not wait.

Osteoarthritis of the knee is a problem that affects the 80% of patients over 60 years, who have some degree of it. "The first treatment is conservative, if there is osteoarthritis it means that there are wear and tear of the cartilage and it may be small or progress, therefore, the first thing is to complement the musculature around the knee with exercise and analgesic treatment," says rheumatologist in Delhi.

When is knee infiltration used?

The infiltration is one of the options palliative treatment when acute episodes occur.

"To treat these episodes, local anti-inflammatory drugs are used and other elements, such as viscosupplementation with hyaluronic acid, exert their effect within three to four weeks., improve the mechanical conditions of the joint, improving the quality of the synovial fluid and producing less friction in a time, "orthopaedic doctor in Dwarka explains. In both cases, they are palliative treatments and only postpone the use of prostheses.

Knee Arthroscopy: General Information

What is knee arthroscopy?

Knee arthroscopy in Delhi is a minimally invasive procedure that allows access and treatment of injuries that affect the various structures of the joint. For this, 2 or 3 small incisions of less than one centimeter are made that allow access to the joint.

Most knee surgeries that do not involve the knee replacement in Delhi are performed with a complete or partial approach with knee arthroscopy. It is the technique of choice to deal with many injuries because it allows a better and greater visualization of the joint. In a non-aggressive way, all the points of the knee can be accessed to make a cartilaginous cleaning, small perforations of the bone that has lack of cartilage (microfractures), stabilize the cartilage and apply substances or elements that regenerate cartilage (plasma rich in platelets or stem cells).

Likewise, knee arthroscopy in Delhi is also used to support other open techniques, since it improves the diagnosis and prognosis of the patient's injury, as it is less aggressive.

Surgery can be performed under local, regional or general anesthesia, depending on the injury and the patient himself. The anesthesiologist will decide the best method for the patient, provided he suffers as little as possible, explains the best knee surgeon in Delhi.

Why is it done?

Knee arthroscopy in Delhi is used to resolve knee injuries. Thus, meniscus injuries are one of the most common pathologies and, thanks to arthroscopy, it is possible to preserve most of the menisci, since the resection is not complete but partial. Meniscal sutures and the possibility of transplanting the meniscus with knee arthroscopy are common techniques that allow better protection of the cartilage of the joint.

Another of the most dangerous injuries related to sports is the rupture of the anterior cruciate ligament. If this is injured, it causes instability in the knee that makes it impossible for the patient to practice practically any sport. Continued instability can injure surrounding structures, such as menisci and cartilage. Hence, it is necessary to reconstruct the anterior cruciate ligament with grafts, accessing the joint by arthroscopy, explains the sports injury specialist in west Delhi.

On the other hand, cartilage injuries (chondropathies, arthrosis or osteochondritis) are also very frequent. Preserving cartilage will also preserve the joint, avoiding wear and tear on the knee.

What does it consist of?

The orthopaedic surgeon in Delhi will make the small incisions in the knee to be able to access it. Firstly, you will fill the knee joint with a sterile solution and remove any cloudy fluid. This way you can see the joint clearly and in detail.

The specialist will then insert the arthroscope (a very thin device with a camera at its end) into the knee. This device sends the images to the television monitor, so that the surgeon can see all the structures in detail. Through the other holes the orthopaedic surgeon in Delhi will introduce the surgical material that will allow him to tackle the injury and repair the damaged structures.

It is a procedure that usually does not last more than an hour. After that, the patient will be transferred to a rehabilitation room and will be able to leave the hospital after two hours, more or less.

Preparation for knee arthroscopy

Before surgery, the patient must undergo a complete physical examination so that the orthopaedic in Delhi can assess his health and any abnormality that may interfere with the arthroscopy. Likewise, the patient must inform the surgeon of the medication they are taking, so that they can tell them which ones they should stop taking before the intervention. Some additional preoperative tests will also be performed, such as MRI, EKG, or blood tests.

Care after the intervention

Recovery after arthroscopy in Dwarka is faster than conventional open surgery. However, the advice of the orthopaedic doctor in Delhi must be followed so that the knee recovers correctly.

It is normal for the patient to suffer inflammation in the days after the intervention, so it is recommended that the leg be elevated during those first days after surgery. Also, applying ice will relieve pain and reduce inflammation.

Incisions should also be healed, keeping them clean and dry. The orthopaedic in Delhi will indicate to the patient when they can shower or change the bandage.

On the other hand, shortly after the intervention, the patient should begin rehabilitation exercises with a Physiotherapy specialist, who will establish a program appropriate to the patient and the injury. This will help you restore movement and strengthen your knee muscles.

Alternatives to this treatment

The alternative to knee arthroscopy in West Delhi will be conventional open surgery, which is currently only used in more severe cases, in which a prosthesis must be placed. Any other technique will suppose a greater invasion in the knee and worse postoperative, explains the orthopaedic in Delhi.

KNEE OSTEOARTHRITIS

Knee prosthesis is the best alternative to improve quality of life in those who suffer from severe pain and have mobility problems. Knee osteoarthritis is one of the most prevalent pathologies that has the most impact on the well-being of adults over the age of 50.

They find it difficult to climb or down stairs, walk or play a sport. The older the symptoms are more severe; pain, creaks and swelling in the knee. Because of this, they lose the ability - to varying degrees - to move freely. On average, at age 65 is when knee braces increase.

For young people, those who play high-impact, rebound sports have increased joint damage, they are also candidates for joint replacement surgery in Delhi due to joint cartilage wear or osteoarthritis.

What is osteoarthritis?

Osteoarthritis is a disease caused by changes in the structure of cartilage, in which their basic components are lost and this leads to dehydration and thinning of joint cartilage. It can affect all joints, although it is most common in hands, spine, hip, knee and ankle.

It is a disease of unknown cause, associated with genetic factors.

There are other less common causes called secondary osteoarthritis, where there is a common basis origin: overweight, prior trauma, metabolic diseases or rheumatism, such as arthritis. In the case of knee osteoarthritis, this joint is part of the mechanical body weight loading system and, for this reason, is more exposed to cartilage wear.

Cartilage is a layer of tissue, softer than bone, that lines the surface of the joints.

Over time, when worn wear, bone ends deform, leading to bone overgrowth and osteophyte formation (so-called "parrot peaks"), bone bumps that cause the joints to rub, causing pain, swelling and loss of mobility.

Symptoms

"Difficulties putting on socks or shoes, sitting on low furniture, knee pain when climbing stairs or slopes are among the most common complaints of initial osteoarthritis. They also tend to have discomfort at night, at rest, when they move during sleep," says orthopaedic in Delhi Dr. Ashoo Consul, expert on hip and knee.

In the face of any pain that tends to repeat itself, even if it is not constant, an evaluation is recommended, because when it is permanent and more intense it can be late for solutions.

Tests and diagnosis

For the diagnosis of knee osteoarthritis, clinical examination or evaluation by the best knee surgeon in Delhi is critical. Depending on this one, the exams are complementary and range from a simple X-ray to an MRI with contrast.

"Diagnosis involves certain treatments, which depend on the stage of osteoarthritis.

If it's initial, you may have conservative medical management. However, if patients have an important degree of joint destruction, with variable degree disability due to pain and deformity, surgery is recommended, to improve their quality of life", notes the orthopaedic surgeon in Delhi.

Treatment

Before knee replacement in Delhi, there are several medical treatment alternatives. However, osteoarthritis is a progressive chronic disease, which has no cure with medication and is irreversible. Conservative measures: Prior to the prosthesis, treatments for moderate osteoarthritis are as follows:

• Anti-inflammatory Drugs: These medications help relieve knee pain and decrease inflammation associated with osteoarthritis.
• Glucosamine and Chondroitin Sulfate: are medicines that act by trying to regenerate the cartilage worn by osteoarthritis
• Templates: The use of silicone gel damping insoles is recommended
• Orthosis: It is a special knee brace that is indicated when the knee is deviated, either very close knees or arched. The treatment that is most accommodating varies on a case-by-case basis, so it is advisable to consult the orthopaedic doctor in Delhi.
• Weight management: Overweight and obesity aggravate osteoarthritis symptoms. This is why it is advisable to visit an orthopaedic in Dwarka, nutritionist or nutritionist, who will evaluate the patient's condition to indicate a balanced diet and achieve their ideal weight.
• Kinesiotherapy: The recommended exercises are of flexibility of low or no impact, which improve muscle tone and mobility of the joint; done three times a week and with professional supervision, can improve a person's quality of life by increasing their abilities. Water activities also increase cardiovascular capacity. Improving quality of life is the best way to slow down the needs of a prosthesis.
• Biological surgery: When the damage is not extensive and the patients are younger. Biological surgery is used in areas that have lost cartilage with mechanical and biological stimuli, such as hyaluronic acid, platelet concentrate, and stem cells. "Biological surgery is generally designed for a single opportunity. Try to restore knee function for more vigorous activities. It's for less serious focal injuries and younger patients," explains surgeon at orthopaedic clinic in Delhi.

Surgery

Once the damage to the knee is more advanced and diffuse, especially in older patients, surgery is indicated as treatment. Arthroplasty or prosthetic surgery is aimed at both calming pain and returning the patient's joint mobility and muscle activity.

Thus, prostheses are indicated when the triggering disease has been aggressive enough, when there is a large pain or alteration of the function of this joint.

A prosthesis is an artificial part designed to replace a natural joint that is damaged and cannot be repaired.

This procedure replaces all damaged cartilage with a new artificial surface. "These new surfaces are usually a combination of noble metals and high-strength plastics. There are different types of surgeries: unicompartmental (partial prostheses) and total prostheses," explains orthopaedic in West Delhi.  

Recovery

"Knee replacement in West Delhi is for more advanced and diffuse damage in older patients. It is a major surgery, so the hospital stay is between three and five days, but patients go home autovalent, walking with the help of a cane and oral analgesia," says orthopedic in Delhi. Recovery from knee replacement surgery is slow and painful and, in most patients, it takes about two months, improving up to a year after surgery.

Meanwhile, unicompartmental or partial prosthetic surgery has the advantage of being a less invasive intervention and with a much faster functional recovery, than the total. Prosthetic knee surgery is endorsed as one of the most beneficial medical procedures in recovering patients' quality of life.