Are you Suffering from Osteoarthritis?

What is Osteoarthritis?

Osteoarthritis is a common form of arthritis that is caused due to the gradual deterioration of the protective cartilage at the ends of your bones. Cartilage is a connective tissue that allows your joints to move freely and without friction. It can wear off over time, causing the bones in your joints to rub against each other. Besides the deterioration of cartilage, osteoarthritis can also affect the entire joint. It can cause the surrounding connective tissue to break down and damage the bone. It can also cause the joint lining to become inflamed. This condition can affect any joint in your body, but the most commonly affected areas are the joints in your spine, hands, hips and knees.

What are the symptoms of Osteoarthritis?

The symptoms of osteoarthritis develop gradually and become worse over time. Some of these symptoms are:

• Moderate to severe pain during or after moving affected joints
• Loss of flexibility and the inability to move the joint through its full range of motion
• Stiff joints, especially seen upon waking up in the morning or after being inactive
• Tenderness and swelling in the joints
• Grating sensation when you move the joint, sometimes accompanied with crackling or popping sounds
• Development of bone spurs around the affected joint

Am I at risk of developing Osteoarthritis?

There are certain factors that can increase your chances of developing osteoarthritis, such as:

• Old age
• Obesity - Being overweight can put more pressure on your joints
• Gender - Women are more prone to developing osteoarthritis
• Bone deformities - People who have defective cartilage or malformed joints pose a higher risk of getting osteoarthritis
• Joint injuries
• Genetics
• Metabolic diseases such as diabetes or hemochromatosis

Consult your orthopaedic doctor if you suspect the onset of osteoarthritis. The best way to treat this condition is through early detection and preventative measures.

Open Reduction with Plates and Screws

What is open reduction?

Open reduction is a surgical procedure to repair serious fractures and severely broken bones that cannot be fixed with a splint or cast. It focuses on displaced or unstable fractures or those which involve the joint surfaces.The term “open reduction” means that a surgeon will need to make an incision in the patient’s body to realign and repair the broken bone. It involves the use of hardware such as metal plates, screws, rods and pins to hold the bone together. Open reduction is an urgent procedure and is recommended if:

• The bone is broken in multiple places
• The bone has moved out of its original position
• The bone is severely broken and is sticking out through the skin
• To repair previously realigned bones that have not healed properly

What happens during open reduction?

During the surgery, the patient is given general or regional anaesthesia . An incision is made above the break and the broken pieces of bone are realigned into the right positions. A metal plate with pins or screws is attached to the bone where it will keep the broken pieces together. This part of the procedure is known as “internal fixation.” The incision is closed with stitches or staples and the area is protected with bandages, cast or splint. An open reduction surgery can take minutes to several hours and the duration and technique depend on the patient’s case. The surgeon will decide if the plates and screws are to be left in place or removed after healing. After the surgery, the patient will be taught exercises that will help with regaining range of motion and strength. If necessary, they will be instructed on how to use assistive devices like crutches or wheelchair. Each case is unique and recovery time depends on the extent of the injury and the patient’s health.

What is an external fixator?

In specific cases, an external fixator is a preferred technique instead of internal fixation. Here, metal screws or pins are inserted into the bone through small incisions made on the skin and muscle tissue. A rod or bar is used externally to keep the screws and pins in place and restrict movement of the area. Splints or casts cannot be used as this technique relies on external support. External fixator is recommended in cases where the patient has multiple breaks in the bone but cannot undergo surgery immediately,incase of extensive skin toes or damage or along with vascular injuries.

Knee Arthroscopy

What is Knee Arthroscopy?

Knee arthroscopy is a surgical procedure used to diagnose and treat knee joint problems. It involves the use of a thin tube with a camera called an arthroscope which is inserted into the knee. This gives the surgeon visual access to the inside of the joint which allows them to investigate possible issues and correct them. Knee arthroscopy is used to diagnose and treat various kinds of knee-related problems like maligned patella, torn meniscus and ACL tear,PCL tear,synonial disorders / diseases.

Who requires Knee Arthroscopy?

Doctors often recommend knee arthroscopy for people who suffer from persistent knee pain or immobility. This procedure helps them confirm particular problem and correct it. Knee arthroscopy is also used as an aid in arthroscopic surgeries which are performed to treat:

• Torn meniscus
• Torn posterior or anterior cruciate ligaments
• Knee bone fracture
• Mialigned patella
• Swollen synovium
• Baker’s cyst
• Cartilage defects.

What happens during a Knee Arthroscopy?

Before the knee arthroscopy procedure, the doctor will administer either local or general anaesthesia to help the patient be comfortable. A few small incisions are made in the knee and sterile saline is pumped into the joint to expand the area. The arthroscope is inserted into one of the incisions and the camera projects visuals onto a computer screen. The arthroscope is directed toward the specific point of the issue. Small specialised surgical tools are inserted into the joint through the other incisions and directed toward the same location to rectify the issue. After the procedure, the saline is drained from the joint and the incisions are closed with stitches.

What are the benefits of undergoing Knee Arthroscopy?

Knee arthroscopy is a minimally invasive procedure and is more comfortable compared to other open surgery procedures. The knee issue can be diagnosed and corrected using a small arthroscope without the need for large instruments. Knee arthroscopy is used to diagnose a wide range of knee problems, such as:

• Persistent joint stiffness and pain
• Damaged cartilage
• Floating pieces of cartilage or bone
• Fluid buildup which has to be drained
• Joint instability

Knee arthroscopy is a better choice than other procedures because it causes less tissue damage and pain. There is also a lower risk of infection and a faster healing time thanks to the small size of the incisions. Talk to your orthopaedic doctor today for more details on knee problems and how to treat them.

Intertrochanteric Fractures

What are intertrochanteric fractures?

An intertrochanteric fracture is a type of hip fracture that is normally caused by injury or falls. A trochanter is a bony protrusion on the femur where the thigh muscles and hip meet. Your body has two trochanters - greater and lesser trochanters. A fracture that occurs between these two trochanters is known as an intertrochanteric fracture. Intertrochanteric fractures common and make up about 50 percent of all hip fractures. The most common causes of this fracture are trauma or falls. Older people are more susceptible of developing intertrochanteric fractures as they have weaker bones and are at a higher risk of falling. Conditions such as long-term osteoporosis, low muscle mass or low bone density increases your chances of developing bone fractures.

How are intertrochanteric fractures treated?

The primary treatment for intertrochanteric fractures is surgery as these fractures can take a long period of time for healing on their own. The most common surgical method is closed Reduction and Internal Fixation (CRIF) where the broken bones are held in place with Nail/Screws/Pins or plates. A hip fracture or proximal femur fracture is serious condition that needs immediate medical attention and surgery. Intertrochanteric fractures are a type of proximal femur fractures and can cause severe pain, swelling and immobility. Surgery has to be immediately performed to repair the fracture and bring the broken pieces back together. An effective surgical method to treat a proximal fracture is using an intramedullary nail. This nail is inserted through the femoral canal and fixed at the upper part of the femoral head. This procedure ensures proper bone alignment and makes recovery faster and smoother. Recovery from an intertrochanteric fracture depends on the patient’s age and condition. Patient's are made to ambulate immediately after surgery.It typically takes three months or longer to fully recover from an intertrochanteric fracture. It is important to undergo rehabilitation or physical therapy to improve strength and mobility after recovery. This involves working on walking, standing, jogging and other basic everyday activities. Talk to our team of orthopaedic specialists today for more information on hip fractures and their treatment. They will also guide you on how to manage osteoporosis and other bone-related conditions for a longer, healthier life.

Hip Replacement Surgery

What is hip replacement?

Hip replacement is a surgical procedure to relieve pain and disability caused by severe hip damage brought on by osteoarthritis or injury or AVN. Osteoarthritis causes your joints to degenerate, leading to swelling, pain and reduced motion. It can limit your everyday activities and make it hard to walk or climb stairs. During this procedure, the surgeon will remove damaged bone and cartilage in your hip joint and replace them with prostheses. People who have shown little to no response to anti-inflammatory medicine, exercise and physical therapy are candidates for hip replacement surgery.

Why is hip replacement performed?

Hip arthertis can be very disabling and causes great difficulty even in activities of daily living.Hip replacement surgery is conducted to treat the disability and pain in the hip. It is recommended during any of the following cases:

• If the patient has long-term osteoarthritis or rheumatoid arthritis
• If the patient has suffered an injury to the hip such as a fracture or broken bones due to an accident or fall
• If other forms of treatment such as anti-inflammatory medication, pain medication, physical therapy or the use of assistive devices has been unsuccessful
• If the hip bone has undergone Avascular necrocis

What happens during this procedure?

A hip replacement surgery is performed under regional / general anaesthesia . An incision is made along the hip to allow access to the affected joint and bone. There are four basic steps in a hip replacement procedure.

• The affected femoral head is removed and replaced with a prosthetic metal stem which is inserted into the femur’s hollow centre
• A ceramic or metal ball is placed on top of the stem and is meant to replace the damaged femoral head
• The surface of the damaged cartilage inside the socket is removed and replaced with a metal component. The new socket is held in place with cement or screws
• A ceramic, metal or plastic prosthesis is inserted between the resurfaced socket and new ball to create a smooth gliding surface

After recovery, the patient is advised to undergo physical therapy to ensure that their new hip joint is functioning optimally. Strengthening exercises and physical activity is a must so that use of the hip joint is regained. Talk to one of our expert orthopaedic doctors for more details on hip replacement surgery and its benefits.

ACL Reconstruction

What is ACL reconstruction?

ACL reconstruction is a surgical procedure performed to replace a torn or damaged anterior cruciate ligament (ACL) in your knee. ACL injuries are commonly seen in people who play sports like soccer, football, basketball and gymnastics and after accidents. The ACL is a tissue found inside your knee. Its function involves knee flexion and extension and is vital for maintaining knee joint stability. This ligament can tear when the knee is moved suddenly while jumping or running. A ruptured ACL can make the knee unstable and the joint becomes more damaged over time, which is why it has to be replaced as soon as possible.

When is ACL reconstruction necessary?

People who lead a relatively inactive lifestyle with moderate exercise or recreational activities and have an ACL injury can treat their condition with a course of physical therapy. Surgical ACL reconstruction is recommended if:

• The patient is an athlete and wants to continue in their sport
• The knee injury has caused damage to the meniscus or more than one ligament
• The knee tends to buckle during basic everyday activities
• The patient is young and less than 30 years of age

Non-surgical treatments are recommended for people over the age of 45 and have no additional intra-articular injury. Treatment methods should be properly discussed with a medical expert.

What happens during ACL reconstruction surgery?

Before the procedure, the patient will be given regional or general anaesthesia to make them comfortable. ACL reconstruction is typically done with small incisions which allow a thin tube containing a video camera known as an arthroscope to be inserted into the joint space. The damaged ligament is removed and replaced with a segment of tendon that is extracted from another part of the patient’s knee or from a donor. Tunnels or sockets are drilled into the shinbone and thighbone to create the perfect position for the graft. After the graft is in place, it is secured to the bones with screws / buttons etc. The patient may have to use crutches or wear a knee brace until recovery is complete. Progressive physical therapy is recommended after recovery to strengthen muscles and regain full movement of the knee. It is advised to follow rehabilitation plans completely to ensure proper healing and achieving best outcomes from the ACL reconstruction procedure.

Treat Seizures in Children

A seizure is a medical condition that occurs due to abnormal brain function and results in change in attention, awareness and movement. There are different types of paediatric seizures that are categorised by the area of the brain affected. There are various reasons behind seizures and the condition is different in toddlers, pre-pubescent and adolescent children.

What causes seizures in children?

Unlike with adults, the cause of seizures in children is relatively unknown. Infections like meningitis, head trauma, developmental conditions like cerebral palsy and family history are some of the causes behind paediatric seizures. The most common type of seizures seen in children is febrile seizure, which occurs when the temperature rises while the body is fighting off an infection. Most common causes of paediatric seizures include:

• Infections
• Head Injury
• Metabolic disorders
• Reaction to medication
• Poisons
• Epilepsy (Seizure Disorders)

What are the symptoms of seizures in children?

There are different symptoms of seizures in children that are categorised by their symptoms. Some of the most common symptoms are:

• Generalised convulsions characterised by muscle spasms and rhythmic jerking of the limbs and body
• Loss of awareness and periods of blank staring
• Repetitive movements followed by confusion, difficulty in breathing, change in colour
• Convulsion and spasms in only one group of muscles or body part

Most children feel exhausted and sleepy following the seizure and also find it hard to remember the events of the episode.

First Aid

If your child is having active seizures, make him / her lie on a flat surface and turn him/her to one side (Preferably Left) to prevent any choking. Do not put anything in the mouth including water, your finger or any substance. Do not try to restrain his/her hands or legs meanwhile do not panic and seek medical attention.

How are paediatric seizures treated?

If your child is having a seizure, it is important to get medical attention immediately. A thorough examination will help the doctor determine the cause and appropriate form of treatment. The child will require certain investigations to arrive at a diagnosis which will aid treatment. In case of febrile seizures, the child will be given an antipyretic medicine to bring down their fever. The doctor will prescribe blood and urine tests to determine if the child is suffering from an infection. If this is their first seizure, a spinal tap or lumbar puncture may be conducted to confirm or eliminate meningitis. A CT or MRI scan is conducted to assess which part of the brain is causing the seizures. Based on the diagnoses, the doctor will prescribe medication to control and manage future episodes of seizures. Talk to your paediatric doctor today for more information of seizures and how you can protect your children.

Fight the Flu. Know How?

Children and fevers

All children get a fever from time to time. It means that their little bodies are fighting off an infection and they will be healthy in no time. But when your child wakes up in the middle of the night with a high temperature, it’s natural to get worried and wonder what to do next. A fever occurs when the body’s temperature increases to 99°F and higher. A fever is not a condition in itself. It is a symptom of something else, such as an underlying infection. When your child develops a fever, you should understand that their body is working on fixing an issue. Typically, a fever will subside in a couple of days. If your child has a very high temperature or a persistent fever lasting several days, take them to a doctor immediately.

What causes fevers in children?

As mentioned earlier, fevers develop when the body is trying to combat an underlying issue. Here are some common causes of fevers in kids:

• The most common cause of fever in children is viral infection. The body raises its temperature to fight off these infections.
• Newborns and infants are not capable of regulating their body temperature as well as older children. So it is common for babies to develop a fever if they are dressed in too many layers of clothing or if they are in a hot environment. Fevers in babies are not to be ignored and require medical attention.
• Children and babies can sometimes develop a low-grade fever after they have been given their vaccines.

When is a fever serious?

You don’t need to treat all fevers in healthy children, but you need to keep an eye on their body temperature during a bout. A doctor is the best person to decide when a fever is to be taken seriously or not. Consult a paediatrician when your little one develops a fever so you can prevent something more serious.

Febrile Illness

A fever is defined as a body temperature of 99°F or 37°C or higher. The body has natural ways to maintain a normal temperature, but it develops a fever in cases of an illness or infection. A febrile illness is when the body suddenly develops a fever. When your little one has a fever, it can be stressful. But understanding the causes behind the fever can help you take care of your child and have them feeling healthy in no time.

What are the causes of febrile illness in children?

Fevers are not an illness in itself but a symptom of an underlying issue or condition. Your child’s body temperature becomes raised when it is fighting against an infection or illness. The causes of fever in kids depend on whether it is acute (less than 7 days) or chronic (more than 10-14 days). Acute fevers in young children and infants are often caused by infections such as viral respiratory or gastrointestinal infections or bacterial infections. Chronic fevers that occur daily for 14 days or longer often have varied cause that required investigation. Febrile illness in children is a sudden spike in temperature as the body is trying to fight off invaders like bacteria or viruses. In most cases, the fever develops suddenly and subsides within a day or two. It can be hard to determine the underlying cause in such a short time. But in some cases, it can be a symptom of something more dangerous like malaria, dengue, encephalitis and other serious conditions. Some children may also experience seizures when they develop a high temperature.

How is paediatric febrile illness treated?

If your child’s fever lasts more than two days, you should take them to the doctor. In the meantime, speak to a doctor to understand if it is safe to give them paediatric antipyretic medication but if your child has very high fever and appears drowsy and sick, consult your peadiatrician at the earliest. Give your child plenty of fluids such as juices and soup. Dress them in light clothing to allow their body temperature to reduce. If necessary, give them a lukewarm bath. If the fever persists, the doctor may recommend a blood or urine test to determine the underlying cause. Talk to our team of experienced paediatrics for more details on fevers and other illnesses that can affect your child.