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.

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.

Types of knee prosthesis

 

Knee osteoarthritis is not the same for everyone. Therefore, the prosthesis cannot be the same for everyone. For each type of arthrosis, orthopaedic in Dwarka indicate a different prosthesis.

Unicompartmental or partial prosthesis

This prosthesis replaces only 1 part of the knee. We can divide the knee into three parts, the medial tibiofemoral, lateral tibiofemoral and patellofemoral.

When the person has osteoarthritis of only 1 of these parts, we can make a unicompartmental prosthesis. As it is not of the whole knee, we also call it a partial prosthesis.

bi-unicompartmental prosthesis

It is the union of 2 unicompartmental prostheses in the same knee, for example the patellofemoral unicompartmental and medial tibiofemoral. This type of prosthesis is made when the person has already made a unicompartmental prosthesis and has started to give problems in another part of the knee.

The bi-unicompartmental prosthesis can also be performed in the first knee replacement surgery in Delhi, when the person already has 2 parts of the knee with arthrosis (wear).

Total surface prosthesis

It is a prosthesis that takes the entire knee. There are several types of complete prosthesiss and one of them is the surface. This is the most performed when performing the first prosthesis surgery in the individual.

The total surface prosthesis has different types of models, such as some that maintain the posterior cruciate ligament, others that remove it, and others that have a rotating platform to better simulate the natural movement of the knee.

constricted complete prosthesis

This type of prosthesis is most used in cases of prosthesis revision, that is, in those people who have already made a prosthesis (of any of the types that I have already mentioned) and need to exchange it for a new one.

The constricted complete prosthesis can also be used in the first surgery, when the arthrosis is very severe. In addition, there are several levels of constriction of the prosthesis, ie, how much the prosthesis is able to “firm” the knee.

There are prostheses that we can call semi-constricted (also called non-connected), which are those that place rods (a kind of metal tube), shims (these are pieces to fill holes in the bone), tantalum cones, and have a special design to make the knee firmer, but not so firm as to greatly reduce knee mobility.

On the other hand, constricted prostheses, in addition to allowing the placement of rods, shims and cones, have the differential of restricting even more the movement of the knee and, therefore, are performed in even more severe cases.

We call these constricted prostheses hinged (or connected) prostheses because they function like a hinge on a door. And they are called connected because the femur component (piece that is on the thigh bone) is attached to the tibia component (leg bone).

Megaprosthesis or endoprosthesis

This type of prosthesis is also constricted, with the differential of having modules, which are metal bars that replace large pieces of bone.

Some megaprosthesis models are similar to those of amputees and, therefore, are called endoprosthesis.

As you may have already noticed, the megaprosthesis is performed in the most serious cases that exist, when the person loses almost the leg or the entire thigh. Therefore, it is also performed in people who suffer from bone cancer.

Before choosing the ideal prosthesis for you, we specialist knee orthopedists need to evaluate your knee through physical examination and imaging tests (radiography and tomography for example). So, if you have osteoarthritis in your knee, be it more or less severe, consult an orthopaedic in Delhi check the best type of prosthesis for you. Take care and prevent yourself!

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.

Knee Pain - Causes, How to Treat and Relieve Pain

 

Knee pain is one of the most frequent in the human body. It affects both the elderly, usually having a degenerative origin, and young individuals usually due to traumatic injuries or problems with the alignment of the kneecap (so-called patella syndromes), explains the orthopaedic surgeon in Delhi.

Generally, knee pain (whether mild or severe) has a pathological meaning, that is, there is a pathology or disease that is at the origin of it.

Constant knee pain is an indication (or symptom) that something is not right. In other situations, knee pain can be caused only by a specific situation of overload of effort, such as what occurs on a longer walk, or climbing inclines, or carrying excessive weights or even in more intense sports training. In these cases, a period of rest or sport break may be enough to resolve the situation, advices the orthopaedic in Delhi.

Knee Pain

For a better nosological characterization, there are several classifications of knee pain that systematize its various parameters:

• Knee pain location (anterior; posterior; medial or lateral interline; collateral ligament insertions; pes anserinus; iliotibial band; inferior pole of kneecap);
• Intensity of knee pain (mild; moderate; severe);
• Character of pain (prick; penny);
• Evolution time (acute or chronic);
• Laterality (left knee pain or right knee pain);
• Triggering factor (eg knee pain when squatting; knee pain after walking);
• Antalgic position (eg, improving pain with a bent knee);
• Response to anti-inflammatory medication;
• Accompanying symptoms (eg, crepitus; effusion; knee bounce or failure; blockage).

Causes of knee pain

The causes of knee pain can be numerous. Here are just a few of the most frequent ones.

knee arthrosis

Knee osteoarthritis is one of the most frequent causes of knee pain. Degenerative changes in the knee cartilage cause a “swollen” knee, due to the presence of joint effusion, chronic pain, of a slow evolution in the knee, of a mechanical nature (that is, which worsens with movements) in addition to joint crepitus (which the patients describe as “pain in the knees with popping”), explains the orthopaedic in Delhi.

meniscus injury

A sudden, sharp, internal pain or pain in the back when the knee bends is usually due to a meniscus tear. In this picture of knee pain, other symptoms are present such as edema (“swollen knee or knee swelling”) from intra-articular effusion. A baker’s cyst, which occurs when this fluid accumulates in a pouch behind the knee, can also be a cause of pain and discomfort later on, states the orthopaedic surgeon in Delhi.

knee sprain

Knee sprains can range from a simple strain, partial tear to a complete tear of the collateral ligaments, which result in pain with 2 distinct locations: medial knee pain and lateral knee pain. The cruciate ligaments are intraarticular and can rupture without causing great pain, so their clinical diagnosis is not always easy, says the orthopaedic doctor in Delhi.

Rheumatism

Knee pain due to rheumatism is usually inserted in a condition in which the patient reports polyarthralgia, that is, pain in multiple joints. The most frequent rheumatic pathology usually includes diseases such as rheumatoid arthritis and gout (due to an increase in uric acid).

Currently, with the development of biological therapies, it is possible to control the progression of rheumatic disease, but in advanced cases of rheumatoid knee, for example, arthroplasty surgery (through the placement of a total knee prosthesis by knee replacement surgery in Delhi, similarly to what is done in osteoarthritis of the knee).) allows reducing pain and restoring the patient’s quality of life, says the orthopaedic surgeon in Delhi.

patella syndrome

Patellar syndromes (what patients call a misaligned kneecap or kneecap out of place) are also a cause of knee pain. In extreme situations, patellar instability can result in kneecap dislocation.

Patellar syndromes normally affect young adults, requiring an adequate study of patellofemoral relationships. Strengthening and rebalancing the quadriceps muscles, namely the vastus internus oblique, are decisive in reducing the external hyper pressure of the kneecap, but surgery to realign the extensor apparatus may be necessary to reduce anterior knee pain and prevent progression to kneecap arthrosis, says the orthopaedic in Delhi.

knee tendonitis

Knee tendinitis usually causes pain at the insertion site of the inflamed tendon. They are most often located at the inferior pole of the patella, quadriceps insertion and the tendons of the pes anserinus. They usually force the patient to make ice, anti-inflammatories and rest for very variable periods, but generally have a good prognosis.

knee bursitis

Knee bursitis is caused by inflammation of the bursae or synovial pouches around the knee. They usually result from long periods of placing the knees on the floor, as in certain professions or activities (maids, religious, floor laying, etc…) especially in the pre-patellar area or pre-tibial tuberosity.

Other causes of knee pain

Although we have presented the main causes of knee pain, other pathologies may be at its origin. Consult orthopaedic surgeon in Delhi to get the proper diagnosis and treatment.

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.

Importance of Rehabilitation Surgery after Knee Replacement in Delhi

Have you wondered why your orthopedic surgeon refers the patient to the physiotherapist after the knee replacement in Delhi? This is because a regular physical activity is crucial to recovering soon after the surgery. The sole purpose of the regular exercise regime is to strengthen the muscles around the new joint to enable the active movements of the joint all once again.

Benefits of physical exercise after the knee replacement surgery in Delhi include:

• Restoring normal movements in the artificial joint
• Strengthening the joint and its surrounding muscles supporting for the joint movement
• Lowering pain and stiffness in the joint
• Getting back to routine physical activities
• Improving blood circulation right after the surgery to prevent the condition like blood clotting

Here are the reasons why Knee Surgeon Delhi refers their patient to the physiotherapy specialist:

• Promote healing – this is the most common reason why orthopedic doctors refer their patients for the physical therapy after the knee replacement in Delhi. Physiotherapy is advised to minimize the scar tissue and to retain the muscles after the surgery. However, don’t expect the recommendation from the knee surgeon Delhi because they are specialized only to diagnose and treat the knee injury, while physical therapist are specialized in dealing with the musculoskeletal system; thus, they are experts to help improving the join movability.

• Regain mobility – Surgeries on the lower margins in particular (say the knees and hips) require physical therapy to redeem mobility. This could be attaining back to everyday activities like walking and sitting, or persisting to more vigorous exercise, like participating in a race.

• Quicker recovery – Performing necessary rehabilitation exercise will help the body of the patient to recover soon from the surgical wounds. In case of knee replacement in Delhi, moving into the therapy room right after the surgery can lead to shorter stay in a hospital and better recovery.

Hence, the significance of rehabilitation therapies cannot be avoided in order if a patient wants to recover soon after the knee replacement in Delhi and resume to their routine activities.