SHOULDER PAIN WHEN RAISING AN ARM: CAUSES AND TREATMENT

 

The inability to raise your hand up is a fairly common problem. Shoulder pain can be one of the most tiring and painful conditions. Many of you will one day just wake up with this pain. Pain can be localized to the top or side of the shoulder joint. In some patients, pain is most pronounced in the evening and at night, in others it occurs only when the arm is raised up. Most of you will not remember any kind of shoulder injury. Most did not change their training regimes or make them more aggressive. In most cases, you are 40-60 years old, and this could be your dominant or non-dominant hand. Let’s take a look at the most common causes:

• Pain in the upper shoulder
• Shoulder pain when lifting the arm
• Restriction of movement in the shoulder joint.

According to the orthopaedic in Delhi, there are many problems that can lead to limited shoulder movement or pain when lifting or moving the arm. Most often these are problems with the rotator cuff.

The rotator cuff is the most common cause of outer shoulder pain in adults. This is also the main reason why you are unable to raise your arm up or are in pain when moving, explains the orthopaedic in West Delhi.

Shoulder pain can be caused by injury. Believe it or not, shoulder injury is a less common cause of pain.

Rotator cuff injuries are more likely to occur as a result of repetitive stress, for example, when working with weights, when throwing and throwing sports equipment. Damage to the rotator cuff can also occur from falls and prolonged work with raised arms (for example, cutting trees or painting a house).

The rotator cuff of the shoulder is formed by four muscles located under the deltoid muscle. Together, these muscles control movement in the shoulder joint, ensuring normal shoulder function.

If the rotator cuff becomes damaged, inflamed, or torn, you are unable to raise your arm upward.

Let’s take a quick look at each of the most common causes of pain and limitation of movement in the shoulder joint.

ROTATOR CUFF TENDONITIS

In persons over 30, rotator cuff tendinitis is very rare, and the most common cause of pain in the shoulder joint when lifting the arm up is rotator cuff tendinosis.

The term tendinosis refers to degenerative changes in the rotator cuff. Along with degeneration in the rotator cuff tendons, the number of blood vessels and nerves increases. This is how the body responds to degeneration and this is what causes the pain. The appearance of new nerve endings leads to pain during certain movements. If the pain is severe enough, you cannot raise your arm and sleep on this side.

Physiotherapy is usually effective in patients with rotator cuff tendinosis. If, despite treatment, pain persists, surgery is possible, which helps to reverse the changes and reduce the severity of pain, says the orthopaedic surgeon in Delhi.

PARTIAL TEARS OF THE ROTATOR CUFF

As you age or degenerate, a portion of the rotator cuff may separate from the bone to which it is attached. This is a natural stage in the progression of tendinosis. When a significant part of the rotator cuff is separated, a small gap or defect appears in it. This condition is called partial rupture. Partial tears are not large enough to cause impaired movement. However, if this gap is accompanied by pain, then the pain may be localized in the upper part or along the lateral surface of the shoulder. It will also hurt to raise your hand up.

Some partial tears hurt, others don’t. You can determine this during the examination. Most patients with partial tears of the rotator cuff respond well to physiotherapy. If physical therapy or other nonsurgical treatments are ineffective, surgery is likely to help relieve night-time pain and pain when raising an arm, says orthopaedic in Dwarka.

CALCIFIC TENDONITIS

Rotator cuff calcific tendonitis is a very painful condition. It is quite simple to diagnose it precisely due to the severity of the pain syndrome. The condition is characterized by the appearance of deposits of calcium crystals in the thickness of the tendons. Fortunately, in most such cases, surgery is not needed, and it is enough to inject a drug into the focus under ultrasound guidance, which helps to wash out calcium crystals. The operation is necessary only in rare cases.

PAIN IN THE SHOULDER JOINT AFTER INJURY

Some of you may be reading this article because you fell on your shoulder and you cannot raise your hand after that. In the event of injury, there is a possibility that the rotator cuff has torn off the bone. Therefore, in such situations, we recommend that you quickly contact a specialist. Now we’ll talk about what to look out for if you suspect you have a serious shoulder injury.

The rotator cuff controls movement in the shoulder joint. If a rotator cuff rupture occurs, your complaints and symptoms will depend on the size of the rupture. For the most significant breaks, you will not be able to raise your hand at all. Many patients with fresh massive tears in the rotator cuff require surgery to restore shoulder function. Thus, treatment for a rotator cuff tear depends on the cause of the tear.

ADHESIVE CAPSULITIS OR FROZEN SHOULDER

Adhesive capsulitis or frozen shoulder is a fairly common cause of pain and limited movement in the shoulder joint. The pain in this case can be localized in the upper shoulder or axillary region. In this condition, the ligaments and capsule around the joint thicken, become tense and inflamed. Diagnosis is simple enough … by definition, frozen shoulder is a lack of movement in one shoulder joint compared to the opposite one. Treatment for frozen shoulder is usually conservative and includes physical therapy. With the help of the block system, you can independently stretch the capsule of the shoulder joint. Sometimes orthopaedic doctor in Delhi can recommend the injection of corticosteroids into the joint to control inflammation. If physical therapy proves to be ineffective, doctor may recommend going for arthroscopy in Delhi.

ARTHROSIS OF THE ACROMIOCLAVICULAR JOINT

The acromioclavicular joint (ACS) is a small joint located at the top of the shoulder. This is the joint between the clavicle and the shoulder blade. Over time, this joint can undergo degenerative changes. ACS arthrosis is the # 1 cause of pain in the upper shoulder. With sufficient severity, this pain leads to a limitation of lifting the arm up and movement in the shoulder joint. Ice, heat, and anti-inflammatory drugs can help cope with pain in such cases. It is also possible to inject drugs directly into the joint. If this treatment is ineffective, surgery is possible.

The causes of shoulder pain vary by age. Some problems are more common in certain age groups. Tendonitis is more common in athletes at a younger age. In middle age, tendinosis, calcific tendonitis, arthrosis of the acromioclavicular joint (ACS), and frozen shoulder.

Orthopaedic surgeon in Delhi widely uses arthroscopy and other minimally invasive methods of treating shoulder joint pathology. Operations are carried out on modern medical equipment from major world manufacturers.

However, it should be noted that the result of the operation depends not only on the equipment, but also on the skill and experience of the surgeon. The orthopaedic in Delhi has extensive experience in treating diseases of this localization for many years.

Coxarthrosis - Hip Arthrosis

What is coxarthrosis?

The coxarthrosis or hip osteoarthritis is the result of cartilage wear this joint. Locally, there is disorganization of the collagen matrix and a decrease in proteoglycans, which have a chondro-protective effect, calling water by osmosis to its interior. As a consequence of the reduced osmotic effect of proteoglycans, the water content of the cartilage is reduced, as well as its thickness, and then osteoarthritis occurs.

Hip arthrosis is, together with knee arthrosis, one of the most frequent arthrosis in the body. It affects 10-20% of the population after the age of 60, with a higher incidence in men up to 45 years old and in women after this age.

The terms coxarthrosis, hip osteoarthrosis, hip osteoarthrosis and even hip arthrosis, are all synonymous and refer to the wear and tear of the hip cartilage.

Arthrosis can also reach other joints with the interphalanges of the hands, trapeziometacarpal (or rhizarthrosis, in the thumb) and spine, conditioning, in addition to pain, also functional impotence in the patients affected by it.

Bilateral, unilateral Coxarthrosis

The bilateral coxarthrosis, for achievement of both hips is very common particularly in the case of bilateral primary coxarthrosis. Unilateral affliction is often associated with secondary coxarthrosis, especially that resulting from traumatic causes.

Usually, there is no predominance of left or right coxarthrosis, and therefore, both sides can be equally affected.

Coxarthrosis - causes

Primary coxarthrosis is one that has no apparent (ideopathic) cause, other than joint wear and degeneration. However, coxarthrosis can have other causes and is then called secondary coxarthrosis.

The most frequent causes are the following:

• Traumatic (fractures and dislocations);
• Femoral-acetabular conflict and hip dysplasia;
• Avascular necrosis of the femoral head;
• Sequelae of congenital hip dislocation and childhood Perthes disease;
• Rheumatological and infectious diseases.

Coxarthrosis - risk factors

One of the most important risk factors, which must be controlled, is being overweight. The same is true of a sedentary lifestyle. However, overuse, as in some high competition athletes, can also lead to early joint wear, says orthopaedic in Delhi.

Circulatory, hormonal and metabolic disorders may also be factors to be aware of.

Although coxarthrosis is not genetically transmissible, there appears to be an increased incidence of arthrosis in certain families.

Coxarthrosis - symptoms

Coxarthrosis or hip arthrosis gives rise to the following symptoms:

• Pain in the hip, with mechanical character, that is, that worsens with the movements, sometimes with irradiation to the groin, thigh or knee;
• Crackling, joint stiffness and limited range of motion;
• Claudication during the march, which sometimes requires the support of Canadians;
• Muscle atrophy due to disuse;
• Progressive reduction of gait perimeter without pain.

In bilateral coxarthrosis, symptoms cause more marked functional impotence, and may even interfere with personal hygiene and activities of daily living.

Diagnostic Coxarthrosis

Coxarthrosis is generally easy to diagnose, as the orthopaedic clinic in Delhi is characteristic and a simple radiograph confirms it.

Usually, an X-ray of the pelvis under load and a profile of the hips are performed. In these exams, the hip affected by coxarthrosis has a reduction in the joint interline, the presence of subchondral sclerosis, as well as osteophytes. In more advanced cases, the femoral head may lose its normal sphericity.

When in doubt or when it is necessary to determine more accurately the degree of joint damage and cartilage destruction, a TAC may.

The determination of the degree of arthrosis can be assessed using two scales:

1. WOMAC
2. Kellgren-Laurence

Can Coxarthrosis be cured?

The coxarthrosis be cured, using hip arthroplasty. More important than the treatment, it seems to be the prevention of its evolution, through proper medication, weight control and physical exercise.

Next, find out how to treat hip arthrosis.

Coxarthrosis - treatment

In coxarthrosis, treatment initially involves a set of general measures, which are common to other forms of primary arthrosis and which we will describe below.

In the most advanced forms already with important functional attainment, the treatment for hip arthrosis involves undergoing hip replacement surgery in Delhi, with total hip arthroplasty, through the placement of a prosthesis in the hip.

Physical exercise and hip arthrosis

Intense physical exercise, with impact on the ground, practiced in a continuous and prolonged way over time, as it happens, for example, with the bottom runners, can condition an accelerated wear of the hip cartilage and, thus, cause hip arthrosis. Therefore, moderation in its practice is advised by orthopaedic doctor in Delhi, especially in individuals with overweight.

Hip arthrosis - indicated exercises

Hip arthrosis can benefit from regular practice of specific exercises in order to maintain mobility of the hip, counteract muscle atrophy, and improve the overall function of the joint. These exercises are usually practiced in water, in swimming or water aerobics classes, since there the sustaining effect will facilitate a painless mobilization with less effort than that performed under gravity.

The stretches, namely the muscles of the posterior aspect of the thigh, such as the isqueotibial muscles, also help to avoid contractures and vicious postures, both of the affected lower limb and of the spine.

Aerobic conditioning of the patient is also essential.

The improvement in the conditions of local circulation that most of these exercises cause, seems to have a beneficial effect in delaying the progression of the disease.

Other patients in the acute or advanced stage of the disease, may benefit from rest, to discharge the joint and relieve pain, in addition to lifestyle modification and weight reduction, explains orthopaedic in Dwarka.

Hip osteoarthritis - physiotherapy

One of the ways of controlling the symptoms of hip arthrosis may be the use of adequate physiotherapy in Dwarka.

Physiotherapeutic treatment for osteoarthritis involves:

1. Use of a series of devices for anti-inflammatory purposes, for example: ultrasound, short wave, tension, magnetotherapy;
2. Thermotherapy - heat or cold;
3. Manual techniques for stretching and joint mobilization;
4. Muscle strengthening through water aerobics exercises or with light loads.

Medicines for hip arthrosis

The prescription of analgesic and anti-inflammatory drugs helps to control pain and local inflammation, reducing the associated joint effusion and improving joint mobility.

Other remedies widely used for hip arthrosis may be glucosamine sulfate and chondrointin supplements. These are essential components of the joints and may be reduced when there is wear. Its intake seems to be beneficial, as it manages to reduce the amount of anti-inflammatory drugs needed to control pain.

Hyaluronic acid - hip arthrosis

The intra-articular injection of hyaluronic acid in the hip with osteoarthritis is considered a treatment with results proven by the literature. This product, which already exists in the joint, is injected as a gel and acts as a lubricant and shock absorber.

It has proven effectiveness in reducing pain and improving function, especially in arthritic joints, in stages of the disease not yet very advanced. It can be applied several times throughout life with or without ultrasound control.

Stem cell treatment

The treatment of arthrosis through the intra-articular application of stem cells (“stem cells”) seems to be able to present interesting results in animal experimentation. However, further studies are needed in the future until they can be considered as a first-line alternative in the treatment of coxarthrosis.

Surgical treatment

The arthrosis of the hip surgery, is classically in three types of operations:

1. arthrodesis (an operation aimed at obtaining joint fusion to cancel the pain) was used in young patients, but was practically abandoned because it completely removed joint mobility;
2. the reorientation osteotomies, in which the orthopaedic surgeon in Delhi tried to load the area of ​​the femoral head less affected by wear, failed due to incomplete and temporary relief of symptoms;
3. the hip replacement in Delhi came almost replace the previous 2 in view of the excellent results and the long survival that is currently possible to obtain.

Hip Fracture: Symptoms, Complications, and Treatment

 

Overview

A hip fracture means more than a broken bone. For the elderly, hip fracture means a major change in life.

Most likely, surgery will be needed, and recovery may take more than a year, says orthopaedic surgeon in Delhi. The activity and physical therapy, but also the help of the family and a caregiver will contribute to the recovery of mobility.

Most hip fractures are suffered by people over the age of 65. Those in this age group must be very careful to avoid falls.

In most people, the hip fractures in the upper thigh (femur), close to where the thigh bone joins the hip joint.

Symptoms

Signs and symptoms of a hip fracture include:

• Inability of the person to move immediately after a fall
• Severe pain in the hip or groin area
• Inability of the person to maintain weight on the leg from the body in which the fracture occurred
• Stiffness, bruising and local swelling
• Shortening of the foot on the side where the hip was injured
• External orientation of the foot on the side where the fracture occurred.

Causes

Falls are the leading cause of hip fracture in older adults. As people age, their bones become less resilient and are naturally prone to breakage, even after minor trauma. Children and young adults are more likely to have hip injuries, says the orthopaedic in Delhi.

The causes of hip fractures include:

• Female gender
• The presence of weak and tall people in the family or common cases of fractures among family members, in old age
• Unhealthy eating habits, inadequate calcium, and vitamin d intake
• Lack of activity
• Smoking
• Medical conditions that cause dizziness and balance problems or conditions such as arthritis which can interfere with the balance of the body
• The use of certain drugs that can lead to bone loss

Risk factors

Among the risk factors that can increase the risk of rupture of the hip bones are:

• The number of hip fractures increases substantially with age. As a person gets older, bone density decreases, vision and balance become weaker, and reaction time slows down. The combination of these factors can increase the risk of hip fracture.
• About 80% of hip fracture cases are reported in women. Women lose bone density faster than men because the decrease in estrogen levels that occurs with menopause accelerates bone loss.
• Chronic medical conditions. osteoporosisis the most important and best-known risk factor for hip fractures, but other medical conditions can increase the risk of bone weakening. Other conditions include endocrine disorders, such as hyperthyroidism and intestinal disorders characterized by low absorption of vitamin D and calcium.
• Certain medications. Some medications, usually those used for chronic conditions such as high blood pressure and asthma, have a gradual effect on bone health when used long-term.
• Nutrition problems. Lack of calcium and vitamin D in youth reduces bone mass and increases the risk of fractures later in life.
• Lack of physical activity. Some types of weight training and walking also help strengthen bones and muscles, and the risk of fractures will be lower.
• Tobacco and alcohol consumption. Smoking and excessive alcohol consumption can interfere with normal bone growth and remodeling processes, resulting in bone loss.

Complications

A hip fracture is a serious injury. Although the fracture itself is treatable, complications can endanger a person's life. If a person suffers from a hip fracture, surgery may be necessary.

The orthopaedic in west Delhi may use an external traction system that will allow the hip to heal. The biggest risk when using this system is that it can cause muscle damage and weakness, increasing the likelihood of permanent loss of mobility.

In addition, traction will keep the patient immobilized for a long time, during which time blood clots can develop in the veins of the legs.

Affected veins can be located on the surface of the skin, causing thrombophlebitis superficial or may be located deeper, in the muscles, resulting in deep vein thrombosis.

The risks of using the traction system include:

• The appearance of blood clots
• Bedsores
• urinary tract infections
• pneumonia
• Muscle weakness.

Treatment

Your orthopaedic doctor in Delhi will advise your patient to exercise as soon as possible after surgery. This helps prevent complications such as pneumonia, blood clots and scabies.

After the operation, it will be difficult for the patient to do many of the activities alone, so it may be necessary to be admitted to a rehabilitation center for a period after the operation. The more active a person is, the faster he will recover.

Ways to prevent

There are many steps that can be taken to prevent a hip fracture. One of the most important is to prevent osteoporosis, which can occur in both women and men. To slow down and prevent osteoporosis the orthopaedic in Dwarka advices to follow:

• Eat foods rich in calcium, milk, cheese, yogurt, dark green vegetables, seafood, almonds, but also supplements with calcium and vitamin D
• Avoid alcohol and smoking
• Some people will need treatment to slow the progression of osteoporosis
• Prevention of falls is very important
• Furniture, carpets, and electrical cables in the house will be arranged in such a way as to avoid bumps and other accidents
• Will not walk on ice
• Wear shoes with a sturdy, flat sole
• Have regular eye exams
• Exercise to maintain strength and balance
• Constantly take the medications recommended by the orthopaedic in Delhi, noting that some medications such as birth control pills sleeping, or painkillers may increase the risk of falls.

Conditions That Cause Knee Pain

 

Overview

Knee pain is one of the most common ailments among the population. Some of the most common reasons for knee pain are inflamed or torn ligaments and certain cartilage conditions, says orthopaedic surgeon in Delhi.

The knee is a complex joint and there can be several factors that cause pain.

In order to find out the reason for your knee pain, you will need to perform a thorough examination, such as an MRI or a special type of MRI, in which a dye is injected into the knee so that the joints can be seen in detail.

The treatment is prescribed and recommended after establishing the diagnosis, only by the orthopaedic in Delhi.

The main ailments

Bursitis. The bursa is a fluid sac that acts as a buffer and protects the joints in several areas of the knees. Overuse, falls can irritate the bursa, causing pain and swelling in the knees.

Iliotibial tendon syndrome. The iliotibial tendon is a hard tissue that makes the transition from the hip to the lower tibia. If it is irritated due to overload, it may become inflamed and cause pain on the outside of the knee.

Osgood-Schlatter disease. This condition leads to a painful inflammation, located below the knee, where the tendon at the patella "connects" to the tibia. It is caused by overload and irritation of the tendon; the pain can appear and disappear without treatment.

Osteoarthritis. This is a common cause for knee pain in athletes or non-athletes, but also for those over 60 years of age.

Tendonitis or swelling of the tendons. Tendons are strips of tissue that connect bones and muscles, and overuse leads to their inflammation. If not treated properly it can also cause knee pain.

Gonarthrosis. It is a degenerative condition of the knee joint, which arises from processes of degradation of joint components, especially the articular cartilage, as well as due to greater efforts than the knee joint can withstand.

The main causes of gonarthrosis are: standing for a long time, walking for a long time, carrying weights, but also problems related to overweight, as well as certain injuries.

Unfortunately, over time, this disease progresses quite a lot, especially in the absence of specialized treatment by orthopaedic in Dwarka. At first, the patient hears sounds like cracks in the knee joint, then there is pain for a long time standing.

When the disease is already in a more advanced stage, the pain appears more and more often while walking.

There is basically a limitation of knee mobility. In the final stage of the disease, the patient will experience persistent pain including rest, and the knee joint becomes swollen and increases in volume.

How to prevent knee pain

• Rest your knees, and in the evening try to sleep with them leaning on a larger pillow.
• Ice can be useful in case of inflammation and can reduce pain.
• Use an elastic bandage to support the affected joint.
• Your orthopaedic doctor in Delhi may recommend painkillers and anti - inflammatory drugs.
• Practice specific exercises, but only on the instructions of orthopaedic in West Delhi.
• Use your knees to prevent bursitis.

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.

Meniscus Injury: Symptoms and Treatment

 

Very often we hear people (young and old) with knee discomfort or accidents, which is one of the most common injuries, and end up sometimes undergoing meniscus surgery. With this article orthopaedic in Delhi explains you what meniscus are and how to treat your injury.

Definition of meniscus injury:

Meniscuses are fibrocar cartilage that are located inside the knee joint and are located between the femur and tibia.

There is a medial meniscus (inner part of the knee) and another side (outer part). It has a semi-lunar shape and its main function is to increase the depth of the relatively flat surface of the top of the tibia and be able to be a true cushion of the knee.

In younger patients, the meniscus is a fairly resistant and elastic structure and the rupture of the meniscus is caused by a significant twisting or turning of the knee.

In older people (40–45 years) who perform a sport, the meniscus becomes weaker, the tissue degenerates and is less resistant and the injury can be caused by minor trauma, for example, by rising from the squat position or by performing an exaggerated bending of the joint.

Usually, this type of injury is very much presented in contact sports such as football and rugby and is suffered by athletes in general.

1. Symptoms of meniscus injury:

The most common symptoms of meniscus tearing are:

• Pain
• Stiffness and inflammation
• Immobilization or locking your knee
• The feeling that your knee "collapses"
• You are not able to move the knee in the full range of motion.

The most common symptom with a torn meniscus is pain and pain can be diffuse, especially when there is significant inflammation of the knee. If the damaged part is large enough, a crash may occur. The blockage occurs when the broken fragment of the meniscus is trapped inside the hinge mechanism of the knee, preventing the total extension or bending of the knee.

2. Self-care to prevent meniscus injury:

It is always advisable to have a proper physical preparation, but not only from an aerobic point of view, but also from the point of view of strength and toning, which is the sense that alerts the body to the location of the muscles. Injuries are more common in people who do occasional physical activity and with very low physical preparation, says orthopaedic doctor in Delhi.

3. Treatment of meniscus injury:

It should always be evaluated by a specialist doctor and your orthopaedic surgeon in Delhi will treat your tear depending on the type of tear, size and location.

If the injury is longer and surgery has had to be performed, the period of return to normal activity will be longer and under specialized medical supervision.

In addition, depending on the type of tear you have, your age, activity level, and any related injuries, they will be factors that will influence your treatment plan.

4. Non-surgical treatment in meniscus:

If your tear is small and located on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms don't persist and your knee is stable, nonsurgical treatment might be all you need.

THE RICE protocol for meniscus injuries

This protocol is effective for most sports-related injuries. RICE stands for R-Rest, Ice, Compression, and E-Elevation.

• Rest. Leave for a while the activity that caused the injury. Your orthopaedic in West Delhi may recommend that you use crutches to avoid the weight on your leg.
• Ice. Use cold packages for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
• Compression. To prevent additional swelling and blood loss, use an elastic bandage for compression.
• Elevation. To reduce inflammation, lean when you rest and place your leg high above the level of your heart.

Orthopaedic doctor in Dwarka recommends that medicines are always under medical formula. Aspirin and ibuprofen reduce pain and inflammation. If you are going to consume anti-inflammatory drugs that are nonsteroidal.

Scoliosis: Diagnosis and Prevention

Scoliosis produces a more or less pronounced curvature in the spine and can be treated in various ways. Gait studies have an important role in its diagnosis and prevention.

When we talk about scoliosis, we immediately understand that we are referring to a curvature of the spine, but it should be noted that not all column curvatures are, says the orthopaedic in Delhi.

Curves derived from postural "bad habits", reflex curvatures caused by pain or contractures, or compensatory "scoliosis", in which the curvature occurs to compensate for other asymmetries, are not considered scoliosis.

Causes and symptoms of scoliosis

Depending on the type of scoliosis, these will have one or the other causes. As a general rule, scoliosis due to malformations is congenital, but can also manifest itself from other diseases. Despite this, most scoliosis is idiopathic, appears in childhood or adolescence, and its causes are unknown, explains the orthopaedic in Delhi.

Scoliosis, although congenital, is not detected in the new-born, but appears progressively in childhood and stabilizes when bone growth ends, after puberty, even increasing in old age if degenerative phenomena appear.

It should be noted that neither the postures adopted by the child, nor the intense practice of exercise increases the risk and that the greater the degree of curvature there is a greater volume of scoliosis in girls than in boys.

Studies show that scoliosis does not produce more back pain or more intense pain than patients who do not have it, at least in slight curvatures, nor that 'straightening' the spine leads to significant improvements in the quality of life of those who suffer it, except the merely aesthetic.

In severe curvatures it can present chronic back pain or in extreme cases even affect breathing or some organs, says the orthopaedic doctor in Delhi.

Scoliosis Treatment

Considering that scoliosis does not produce pain or relevant limitations - by itself and in degrees of slight curvature - the chosen treatment and its impact should be considered based on its consequences, that is, not choosing an overly aggressive treatment for a problem (scoliosis) whose effect is mainly aesthetic.

Depending on the degree of scoliosis, the indicated treatments (in order) are:

• Non-specific exercise: It simply seeks to improve the muscular and cardiovascular state, it has positive effects in terms of prevention and evolution of back pain, which is why it is highly recommended for children both for scoliosis itself and for their general health. and to establish in the child that healthy habit.
• Specific exercise: Traditionally it was prescribed with the idea of ​​developing muscles with the ability to reduce scoliotic curvature, but there is no evidence of its effectiveness in this regard, although it does exist when it comes to reducing the prescription of the brace.
• Corset: Its only objective is to stop the development of the curvature, but its continued use can generate muscular atrophy. Although the materials of current corsets are much more flexible to be more comfortable, they are less effective than rigid ones. Even so, the observable changes in a patient with a brace and another without a brace are not very relevant, so its use is being rethought - especially in children.
• Surgery: Only cases of scoliosis associated with other diseases or malformations need to be operated, so it would not make sense to submit a patient with idiopathic scoliosis to a surgical process since the risks and scars are considerable to obtain a merely 'aesthetic benefit. '. The surgery is aggressive and usually has relevant complications in 10.2% of the operated, some examples are; wound infections, respiratory or implant complications. In addition, scoliosis surgery involves loss of mobility of the spine or limitation of rotational movements, depending on the area of ​​the spine affected, explains the orthopaedic surgeon in Delhi.

Prevention

Although due to the origin of this 'disease' it is difficult to prevent it in most cases, there are certain recommendations to prevent it or not make it worse. The practice of exercises to strengthen the area, the practice of swimming (an exercise whose benefits for the back in general are well known), the correct postural hygiene, not abusing heels and visiting regularly a physiotherapist to assess our state and help us not aggravate scoliosis are the most common forms of 'prevention'.

Gait studies also play an important role in the diagnosis and prevention of scoliosis, especially in children and adolescents in whom it is still possible to act because they are in the growth phase, says the orthopaedic in Delhi.

WHY DOES THE KNEE CLICK?

Clicking in the knee joint is a fairly common cause of patients turning to orthopaedic surgeon in Delhi. In some patients, these clicks are accompanied by pain, but in most cases, these clicks do not cause any extraneous sensations. Some patients may have a history of trauma to the knee joint, in most cases, patients do not remember anything like this. One fine day, the patient simply notices that his knee has begun to click. Treatment is not necessary in all such cases, but in some of them it can be indicated.

The vast majority of patients who notice clicks in the knee do not experience pain, so do not worry about it. There are a number of interesting scientific studies that show that patients who have their knees clicked become very anxious. They begin to worry that clicks in the knee joint will lead to rapid wear of the articular cartilage and degenerative damage to the knee joint. In fact, clicks in the knee joint in the vast majority of cases are caused by the movement of normal anatomical structures in the area of ​​the knee joint. And this means that you will not have any osteoarthritis as a result. A number of studies have shown that clicks can be caused by gas in the knee joint. This is not dangerous. Also, clicks can be caused by movement of joint fluid in the joint cavity, explains the orthopaedic in Delhi.

Now let's talk about situations where clicks in the knee joint are accompanied by pain. Consider a number of the most common causes of this phenomenon.

WHAT CAUSES CLICKS IN THE KNEE JOINT?

Our knee joints are formed by three bones - the lower end of the femur, the upper end of the tibia and the patella. These bones are stabilized and held next to each other by a large number of ligaments. Movement in the knee joint is ensured by the coordinated work of powerful large muscles and tendons. Between the ends of the bones forming the knee joint are menisci, which are a kind of shock absorbers.

Any of the structures described may be damaged due to physical exertion, injury, or even due to normal wear and tear. Clicks in the knee joint can be caused by damage to almost any of the anatomical structures described above, explains the orthopaedic in Dwarka.

The most common causes of clicks and other extraneous mechanical sensations in the knee joint:

• Chondromalacia: This is a condition characterized by degeneration of the articular cartilage, such as the patella. As a result of degeneration, the normal smooth surface of the articular cartilage becomes uneven. When the uneven articular surface of the patella moves along the corresponding articular surface of the femur, clicks, noise, or crunching occur.
• Meniscus tears: between the joint ends of the femur and tibia in the knee joint are two menisci. The menisci resemble the letter “C” in shape and protect the articular surfaces of the bones that form the knee joint. When the meniscus is damaged, its torn fragment can cause clicks in the knee joint with certain movements.
• Cartilage defects: the bones forming the knee joint are covered with a thick and smooth layer of “articular cartilage”. Injuries and certain diseases, such as dissecting osteochondritis, can lead to defects in the cartilage layer. Such a damaged articular surface becomes uneven, as a result of which various mechanical sensations may appear, including clicks in the knee joint. This is not the most common cause of painful clicks in the knee joint.
• Dislocation of the patella. Dislocations of the patella are much more common than is commonly thought. If you have tucked up your foot and felt a click in the knee joint during any kind of sports, it is highly likely that the patella was dislocated. The patella is located in the groove on the anterior surface of the femur. Ideally, it should be located exactly in the center of this furrow. Sometimes the patella moves in the furrow in one direction or another, and sometimes it completely leaves it. Dislocation of the patella or a violation of its normal biomechanics is one of the most common causes of clicks in the knee joint. This is a very complex problem that requires a full examination by an orthopaedic doctor in Delhi who specializes in the problems of small tracking and instability of the patella.
• Syndrome of a pathological synovial fold: the synovial fold is a fold of the inner lining of the knee joint. Many people have such folds, but they are relatively infrequent cause clicks and pain in the knee joint. Over time or as a result of repeated loads, these folds can thicken and become inflamed, causing painful clicks in the knee joint.
• Osteoarthritis: This is a degeneration or "thinning" of the articular cartilage. Normal articular cartilage is an incredible smooth and even tissue. As osteoarthritis progresses, the surface of the cartilage becomes more and more uneven. Sometimes such cartilage can even peel off from the underlying bone, resulting in a cartilage defect. Any irregularities in the articular surfaces can cause clicks in the knee joint during movement.

If such simple means as a pressure bandage, muscle stretching and temporary limitation of physical activity do not bring the desired effect, it makes sense to consult an orthopaedic doctor in Dwarka.

There are other, less common causes of clicks in the knee joint. The causes described above usually cause not only clicks, but also pain in the knee joint. If clicks in your knee are accompanied by pain, we recommend that you consult your doctor.

For many of us, these clicks are completely painless. Sometimes their causes remain unknown. In many situations, these clicks can be considered a "norm" that does not require any treatment, says the orthopaedic in Delhi.

Wrist and Elbow Fractures: Symptoms and Treatment

To examine a distal radius fracture, your orthopaedic in Delhi will need to take an x-ray of the wrist. An open fracture is when the bone breaks through the skin. If the fracture extends into the joint, it is called an intra-articular fracture. Fractures that do not enter the joint are called extra-articular fractures.

Distal radius fracture treatment in Delhi includes the instantaneous measure of stabilizing the arm and placing an ice pack. It does this to keep the injury from getting even worse and to reduce swelling and control pain. A non-surgical option is casting if the bone is in good condition. The orthopaedic in Delhi may find it essential to straighten (or reduce) the bone to properly align it. Surgery is essential when the bone must be reduced through an incision. This is known as an open reduction, and these procedures generally require orthopaedic implants such as bone plates, pins, and / or bone screws to hold the bone parts in place.

Scaphoid fracture of the wrist

The scaphoid bone is one of several small bones in the wrist. It is located on the side of the thumb of the wrist where flexion occurs, just above the radius of the bone. When the scaphoid bone fractures, you will have pain, reduced wrist movement, swelling, bruising, and tenderness.

Most scaphoid fractures occur when falling with an outstretched hand. To identify a scaphoid fracture of the wrist, the physician will need to take radiographs to assess the displacement. However, several times, a break in this part does not appear immediately. If your orthopaedic doctor in Delhi suspects that the scaphoid is fractured, she will often apply a wrist splint for two weeks, and will come back sometime to repeat the analysis and possibly an MRI.

Scaphoid fracture treatment in Delhi depends on the precise location of the rupture. The fracture near the thumb usually heals for a few weeks with protection. If the fracture is more complex, the doctor may apply a cast to the wrist and monitor healing. Tears in the middle part of the scaphoid are more difficult to heal due to the limited blood supply.

The orthopaedic in Dwarka will generally suggest surgery for these types of scaphoid fractures. Your orthopaedic surgeon in Delhi will create a small incision and insert metal orthopaedic implants, to hold the bone in place when it heals. In rare cases, a bone graft is essential. Regardless of whether surgery is essential or not, you may need to wear the splint or cast for up to 6 months.

Elbow fractures

The bony aspect of the elbow that extends from the bone of the ulna arm is called the olecranon. This bulge is located under the skin with a slight protection against muscles or soft tissues. The elbow joint is made up of 3 bones, and these allow you to bend and straighten like a hinge. The humerus is the upper arm bone, the ulna is the lower arm bone, and the radius is the lower arm bone on the thumb side. When the elbow is injured, either by breaking one of these bones or by breaking a ligament that connects one bone to another, it can be painful, stiff and unstable.

Elbow fractures occur from a direct hit, such as being hit with a baseball bat, or indirectly from landing on an outstretched arm with the elbow locked in a straight line. Symptoms of an elbow fracture are bruising, sudden severe pain, swelling, inability to straighten the elbow, pain with movement of the joints, numbness in one or more fingers, and tenderness. To identify an elbow fracture, the orthopaedic doctor in Dwarka must look at the injury and take an x-ray of the joint.

Fracture treatment in Dwarka depends on the level of the injury. Some elbow fractures only require a sling, splint, or cast and conservative measures, while others require surgical intervention. If the bones are out of position, or if there are pieces of bone going through the skin, surgery will be required. The surgery is performed by expert orthopaedic surgeon in Dwarka using special orthopaedic instruments.

Typically, your orthopaedic surgeon in Delhi will make an incision over the back of the elbow and hold the bone parts and other structures together with wires, pins, braces, bone screws, and / or sutures. Once the surgery is done, a cast will be applied over a period of time and activity will be limited to allow for healing, says the orthopaedic in Delhi.

COXARTHROSIS (OSTEOARTHRITIS OF THE HIP JOINT)

Osteoarthritis, or arthritis due to wear and tear, is a common disease that occurs in people mainly middle-aged and elderly. According to rough estimates, in 2011 in the United States 29 million people suffered from this disease. Any joint of the body can be affected, however, the joints that bear the load are most often affected, including hip.

Osteoarthrosis of the hip joint or coxarthrosis in Latin - is characterized by the appearance of pain in the joint and limitation of movements. Patients may find it difficult to cope with everyday activities, such as tilting to tie shoelaces on boots, getting up from a chair, or taking short walks.

Osteoarthrosis progresses with time, so the sooner you start treatment, the less this disease will affect the way you live. There is no radical way to cure osteoarthritis, however, there are many ways to support therapy that will help you cope with pain and remain an active person, says the orthopaedic in Delhi.

HIP ANATOMY

The hip joint is a spherical joint. Its "nest" is called the acetabulum, which is part of the pelvic bone. The second part of the joint is the spherical head of the femur.

The articular surfaces of the bones forming the hip joint are covered with a smooth tissue called articular cartilage. Cartilage provides unobstructed gliding of bones relative to each other.

Inside, the joint cavity is lined with a thin membrane called synovia. In a healthy hip joint, synovia produces a small amount of synovial fluid, which serves as a lubricant for articulating surfaces and improves their mobility.

WHAT IS COXARTHROSIS?

Osteoarthrosis is a degenerative joint disease that most often occurs at the age of 50 years and older, although it can also occur at a younger age, says the orthopaedic in Delhi.

With coxarthrosis, the articular cartilage of the hip joint gradually wears out. At the same time, its surface becomes uneven, it becomes thinner and the distance between the bone surfaces of the articulating bones decreases. As a result, the cartilage wears out completely and the bone surfaces begin to come into contact with each other. In order to somehow compensate for the loss of cartilage, on the periphery of the articular surfaces, the bone begins to grow and forms bone growths - osteophytes.

Coxarthrosis develops slowly and the associated pain syndrome progresses just as slowly.

CAUSES OF COXARTHROSIS

Coxarthrosis does not have any one specific reason, however, there are several factors in which the development of the disease is more likely:

• Age
• Family history of osteoarthritis
• Previous hip injury
• Obesity
• Incorrect formation of the hip joint in the prenatal period - dysplasia of the hip joint

Even if you do not have the risk factors listed above, your likelihood of developing osteoarthritis still exists.

SYMPTOMS OF THE DISEASE

The most common symptom of coxarthrosis is pain. Pain usually develops and progresses slowly, but sometimes a sudden development of pain is possible. Joint pain and stiffness can be most pronounced in the morning, after prolonged sitting or a period of rest. Over time, the pain becomes more frequent, remains at rest and begins to bother the patient at night. Other symptoms include:

• Pain in the groin and thigh radiating to the buttock or knee
• Pain aggravated by intense physical exertion
• Hip stiffness that makes normal walking and joint movement difficult
• Sensation of joint blocking and crunching during movements associated with the presence of free fragments of cartilage and other tissues in the joint that interfere with normal movements.
• Reduced range of motion, affecting the patient’s gait and causing lameness
• Worse pain in rainy cold weather

CONSERVATIVE TREATMENT OF COXARTHROSIS

There is no radical way to cure coxarthrosis, but there are many ways to maintain therapy that can help you cope with pain and remain an active person.

As with degenerative damage to other joints, the initial treatment for coxarthrosis is conservative. The orthopaedic doctor in Delhi can recommend a variety of treatment options.

Lifestyle change. Some changes in your daily lifestyle will help protect your hip joint and slow down the progression of the disease.

• Minimization of those types of activity that increase pain, for example, climbing stairs.
• Replacing high-intensity loads (for example, running and tennis) with less intense ones (swimming and cycling).
• Weight correction, which will reduce the load on the hip joint, thereby reducing the severity of pain and improving its function.

Physiotherapy. It includes special exercises that help increase the range of motion and flexibility of the joint, as well as strengthen the muscles surrounding the joint. The orthopaedic doctor in Delhi and physiotherapist will help you choose the individual exercise program that best suits your needs and lifestyle.

Supporting aids. Using canes, crutches, or walkers will help increase your mobility and make you more independent.

Drug therapy. If the pain interferes with your daily life and you cannot cope with it by other means, the doctor may recommend that you add medications to the treatment.

• Over-the-counter analgesic can effectively help reduce the severity of pain in coxarthrosis. However, like any other drug, it can cause side effects and interact with other drugs that you take. We advise you to discuss possible side effects with your doctor.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and inflammation, and most of them are also OTC drugs.
• Corticosteroids are powerful anti-inflammatory drugs that can be administered orally or injected directly into the joint.

SURGICAL TREATMENT OF COXARTHROSIS

With severe pain and impaired joint function, when conservative treatment is ineffective, the orthopaedic doctor in Dwarka may recommend surgery.

Osteotomy. The operation consists in crossing the upper end of the femur or acetabulum and reorienting them in order to remove the load from the damaged part of the joint. In the treatment of osteoarthritis of the hip, this operation is rarely used.

Superficial arthroplasty. This operation consists in removing damaged cartilage and bone tissue of the acetabulum and replacing them with an artificial component. At the same time, the femoral head is not removed, and its articular surface is replaced by a smooth metal cap.

Total arthroplasty. This operation involves the complete replacement of the hip joint with artificial metal, plastic or ceramic components.

With total hip replacement in Delhi, the femoral head and acetabulum are replaced by artificial components.

Complications. Complications are possible in any surgical operation, and the orthopaedic surgeon in Delhi will do everything necessary to minimize their risk. The most common complications are:

• Infection
• Excess bleeding
• Thrombosis
• Hip dislocation
• Difference in limb length
• Blood vessel damage

RECOVERY AND REHABILITATION

After any operation on the hip joint, a rehabilitation period follows. The duration of this period depends on the nature of the operation performed.

Your orthopaedic in Delhi may recommend physiotherapy, which will help restore muscle strength and range of motion in the hip joint. After the operation, you will be using a cane, crutches, or walkers for some time.

In most cases, surgery can reduce joint pain and return you to an almost normal daily life.