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Achilles tendon rupture

Achilles tendon rupture – treatment, surgery

What is Achilles tendon rupture?

An Achilles tendon rupture or rupture occurs when the tendon “ruptures or tears” leading to separation or discontinuity in the tissues that make up the tendon.

In terms of anatomy, the Achilles tendon, a sort of fibrous “ribbon” or “cord” that connects muscle to bone, is the largest and strongest tendon in the body that connects the calcaneus (heel bone) to the medial gastrocnemius muscles., lateral gastrocnemius and soleus muscles (popularly known as calf muscles or “leg belly” muscles). When the muscle contracts, it “pulls” the tendon, which in turn moves the foot.

The rupture often reflects the previous existence of tendinosis phenomena caused by sports microtraumas or degeneration (aging) of the tendon. In most cases, the tear occurs at the bottom of the tendon (just above the heel), but it can occur anywhere along the tendon. In the presence of a healthy tendon, the lesion can appear in the bone or muscle.

Total ruptures, partial ruptures

We can generically classify Achilles tendon ruptures into:

  • Total rupture – in the total rupture of the Achilles tendon, the tissues break completely, that is, the tendon is completely “separated”.
  • Partial rupture – in a partial rupture of the Achilles tendon, the tendon does not completely rupture, only an incomplete rupture occurs. Partial tears can vary greatly in severity according to the extent of the injury.

A total rupture is more frequent than a partial rupture. As a rule, a total rupture is a more serious injury when compared to a partial rupture and with more exacerbated symptoms. A partial tear can also present with pain that can range from moderate to severe and, if not recognized, it can quickly progress to a total tear.

See more information on treatments to better understand the different therapeutic approaches according to the extent of the lesion.

Achilles tendon rupture – causes

The Achilles tendon can lose elasticity and become “weak and thin” with age and lack of use. Then, it becomes prone to injury or breakage.

Rupture is more common in people with pre-existing Achilles tendonitis (tendon inflammation). Repetitive tendinitis and the consequent calcifications are a risk factor for tendon rupture.

Certain diseases (such as arthritis and diabetes) and medications (such as corticosteroids, for example) can also increase the risk of rupture.

Rupture occurs most often in the middle-aged male athlete. The injury usually occurs during recreational sports that require impacts with the ground, running, jumping, etc. Most of the time, these are football, athletics, tennis, basketball, among others. Injury can happen in these situations as a result of traumatic dorsiflexion when the muscle is strongly contracted causing it to tear.

Breaks can, however, also occur in everyday activities. For example, when falling from a significant height, when entering a pothole abruptly, traffic accidents, etc.

Achilles tendon rupture – symptoms

The signs and symptoms of Achilles tendon rupture are:

  • Sudden, severe pain may be felt in the “back” of the ankle or the “tummy of the leg”, often described as “being hit by a rock or shot” or “like someone stepping on the back of the ankle”;
  • A loud clicking sound can be heard;
  • A discontinuity (“gap”) or depression (void) can be felt and seen in the tendon above the calcaneus (heel bone);
  • Inability to stand on tiptoe on the affected side;
  • Initial pain, swelling (swelling) and stiffness may be followed by bruising and weakness (not being able to land on the foot, walking).

Achilles tendon rupture – diagnosis

The diagnosis is made by the orthopaedic doctor in Delhi after collecting the clinical history, performing the physical examination and some complementary means of diagnosis (MCDT).Bottom of Form

A simple test is to “stretch” the “calf or calf muscles” while lying on your stomach (Thompson test). In the impossibility of being able to elevate the foot, there is, most likely, a rupture in the tendon. This test isolates the connection between the “calf muscles” and the tendon and eliminates other tendons that may still allow poor movement.

The orthopaedic doctor in Dwarka may order the following tests to confirm the diagnosis and to know in greater detail the location and degree of severity of the lesion:

  • Plain radiography (XR) – not being a very useful exam, it can identify a bone fragment avulsion of the calcaneus;
  • Ultrasound or ultrasound – Ultrasound of the leg and thigh can help assess the possibility of deep vein thrombosis and can also be used to rule out a Baker’s cyst (or cyst). Ultrasound can identify Achilles tendon rupture or signs of inflammation (tendinitis or tendinosis);
  • Magnetic Resonance Imaging (MRI) – MRI is extremely sensitive for diagnosis and allows you to determine if there is still a tendon in continuity. It allows other diagnoses such as tendinitis, tendinosis and bursitis.

Pain in the “back of the heel” is not always due to an Achilles tendon rupture. In the differential diagnosis, tendinitis (inflammation of the Achilles) and bursitis (inflammation of the bursae) should be considered, among the most frequent pathologies that cause pain in the Achilles region.

Achilles tendon rupture – treatment

The objective of the treatment is to restore the function of the tendon, for this, it is necessary that the tissues that make up the tendon heal “united” with each other. In this way, it will be possible for the patient to return to the same level of activity before the injury. Regaining Achilles tendon function after an injury is critical to making walking possible.

Treatment reflects a balance between tendon protection and initial movement. Protection is necessary to allow time for healing and to prevent further injury. Moving the foot and ankle is necessary to prevent stiffness and loss of muscle strength.

We can divide treatment options into surgical and non-surgical. Conservative (non-surgical) treatment consists of a set of therapeutic attitudes aimed at healing the tendon and restoring its function without resorting to any type of surgical intervention.

The choice between surgical and non-surgical treatment can be controversial in some cases. Both surgical and non-surgical treatment will require an initial period of approximately six weeks of immobilization. For most patients, both treatment options have good functional results.

NON-SURGICAL TREATMENT

Nonsurgical treatment is often used for non-athletes or for people with a low general level of physical activity who will not benefit from surgery. In the elderly and people with clinical complications, conservative (non-surgical) treatment should also be considered as a first option.

Initially, a cast below the knee is performed with the foot in equinus (foot in marked plantar flexion, “down”). Although it is not routine, it is possible to perform an MRI to verify that the tops of the tendon are in contact. The cast is changed, at intervals of two to four weeks, to slowly stretch the tendon back to its normal length. This treatment usually takes 8 to 12 weeks. During this period, global strengthening and flexibility exercises are taught.

SURGERY (SURGICAL TREATMENT)

Surgery on Achilles tendon rupture is often indicated in healthy and active people who want to resume activities such as walking, running, cycling, etc. Even those who are less active may be candidates for surgical repair of the tendon. The decision to operate should be discussed with your orthopaedic surgeon in Delhi.

Surgery should not be performed if there is an active infection or damaged skin at or around the Achilles tendon rupture site. In addition, some diseases or lifestyle habits, such as diabetes, smoking habits, sedentary lifestyle, steroid use and inability to follow instructions after the operation, may be a contraindication for surgery.

Surgical intervention for an Achilles tendon rupture is usually performed on an outpatient basis. This means that the patient is operated on and goes home the same day.

We can identify two distinct surgical approaches:

The first is to perform the intervention percutaneously, allowing to perform a minimally invasive surgery, through small incisions. A kind of needles with attached sutures are passed, allowing the Achilles tendon to be sutured.

The second approach is the open approach (traditional method, where the surgeon makes an open incision to access the tendon). This starts with an incision made in the back of the leg, just above the calcaneus (heel bone). After the best orthopaedic in Dwarka finds the two ends of the torn tendon, these ends are sutured. The incision is subsequently closed.

The surgical technique will be previously determined by the orthopaedic in West Delhi, depending on the type and location of the rupture, among other factors. In the postoperative period, regardless of the surgical technique chosen, the patient is immobilized with an equinus foot.

Despite being a safe surgery, some complications can arise, such as risks associated with anesthesia, infection, damage to nerves and blood vessels and bleeding or blood clots, among others. A new rupture can also occur (recurrence).

Recovery after surgery

After the surgery, the patient is placed with a splint or a “plaster boot” from the foot to the knee. Usually, the patient cannot walk or put weight on the involved leg. Crutches, a walker or a wheelchair are used to allow the patient to remain mobile for the first few times. Patients are encouraged to keep the operated leg elevated above the level of the heart to decrease swelling (swelling) and pain.

Patients are usually seen in the office two weeks after surgery. The splint or cast is removed, and the surgical incision is evaluated. Stitches are usually removed at this point if necessary. After two to six weeks, depending on postoperative protocol and orthopedic in Dwarka preference, patients may be allowed to begin performing some force. For this, a “hiking boot” can be used. Ankle movement is often allowed and encouraged.

After six weeks, full-body strength is generally allowed. Physiotherapy in Dwarka will need to be started and is intended to restore ankle range of motion. Strengthening of the “calf muscles” and Achilles is gradually allowed as the tendon heals. It is usually possible to resume full activity after six months. Recovery time after surgery can extend up to a year, until the patient can achieve full rehabilitation.

Even in cases where surgery is performed, the above-mentioned therapeutic attitudes are included in the rehabilitation plan.

Hip Joint Wear

10 Common Signs and Symptoms of Hip Wear

Hip wear (hip arthrosis) is a very frequent and limiting problem. It is the aging of articular cartilage that is responsible for free joint movement and pain-free. When the cartilage is worn out, the hip joint can no longer move freely and bear load, causing pain and movement restriction.

About 10% of the population over 45 years has hip wear with painful symptoms and almost 30% of the population has changes in hip wear on imaging tests such as radiography or MRI, says the orthopaedic in Delhi.

Common Symptoms

If you have a suspected hip wear, these are 10 most common Signs and Symptoms, which may indicate an evaluation with the hip surgery specialist.

1. Pain in the groin area.

Pain in the groin region, or anterior region of the hip is perhaps the most common feature of the hip that is worn. This occurs by the characteristic of innervation of the joint that occurs by the same nerve roots that inners the groin region and anterior face of the thigh.

Pain in the groin area can occur because of other diseases, but it is very characteristic of the hip that has its cartilage worn out, states the orthopaedic in Delhi.

2. Stiffness of the hip joint. Loss of mobility.

One of the signs that a joint is worn is the loss of its function, which is precisely the ability to move the joint without pain.

When a joint is worn out, it ignites, and movement begins to cause pain. The result of this is that the patient himself begins to move the joint less as a way to protect himself from pain.

Thus, soft tissue structures such as capsule, muscles and tendons are retracted further reducing joint mobility, explains the orthopaedic doctor in Delhi.

3. Pain for lifting from low chairs or toilet.

Another striking feature of patients with hip arthrosis is the difficulty of getting up from low chairs and from the toilet.

This occurs because at the time of elevation, there is a sudden increase in load and pressure in the hip joint, which if worn out, will lead to a worsening of the pain, says the orthopaedic doctor in Delhi.

4. Claud gait, or “limp” gait.

The perfect functioning of the hip joint is essential for a balanced and pain-safe gait. When the hip is worn out, movement and change of loads on damaged cartilage can cause pain.

An immediate reflex is the decrease in the range of motion of the joint during gait and shortening of the pitch during the gait step on the worn hip.

All this gait movement in order to reduce the pain, ends up causing the “limp gait” or clauaudicante gait, explains the orthopaedic in Dwarka.

5. Pain to crouch and put on the shoes.

As much as it sounds like a simple activity, putting on simple shoes gets harder and harder for those who have hip arthrosis.

This occurs because the movement of putting on the shoes implies a large flexion of the hip and increased load on the joint, even if the patient is still.

A good alternative for patients who have hip arthrosis and pain to put on shoes, is to replace shoes with shoelaces with sneakers or shoes of the type “moccasin” that do not need to be tied, suggests the orthopaedic in Dwarka.

6. Pain to go up and down stairs and to get in and out of the car.

This complaint is very common in patients with advanced hip arthrosis. With the progression of wear, pain is worse in activities with hip flexion with load and rotational movements, says the orthopaedic doctor in Dwarka.

Everyday activities such as going up and down stairs and getting in and out of the car get more difficult, requiring the support of the hands and the other member to be executed.

7. Feeling of locking, clicking, or crackling of the hip.

In many cases of hip wear, there may be detachments of cartilage fragments and inflammatory process in the joint (synovite).

These factors cause noises called clicking, or the famous “crek crek”, explains the orthopaedic doctor in Dwarka.

8. Decreased ability to walk and use supports

The hip is fundamental for a correct efficient and pain-free gait movement. Hip wear in a load area prevents perfect joint slippage and causes pain at the time of limb support.

This leads to a decrease in the patient’s ability to walk who needs to stop after a few steps for pain relief or the need to use supports such as crutches or walking, explains the orthopaedic in west Delhi.

9. Decrease in sexual activity.

Hip wear can reach many patients with active sex life. This can be a big problem because pain and limitation of movements can decrease the willingness to have sex (libido) or impair the sexual act due to the accentuated symptoms, says the orthopaedic in west Delhi.

10. Discouragement to carry out daily activities.

Hip wear is a progressive and limiting problem. It is very difficult to assimilate the loss of function and quality of life that it causes.

The constant pain and limitation for small daily activities greatly affects the psychological of patients. It’s very difficult to live with that.

When the pain is strong and the discouragement is very strong, it is good to remember that there is always the solution of the surgery. Look for a reliable specialist orthopaedic doctor in west Delhi!

How many of these symptoms do I need to have to have surgery?

There is no specific number of symptoms that define the exact time of performing hip prosthesis surgery.

The higher the number of symptoms and the higher the intensity of them, the greater the chance of a hip replacement surgery in Delhi by a synthetic prosthesis.

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https://www.reddit.com/user/neoorthopaedics/comments/uf9o89/10_common_signs_and_symptoms_of_hip_wear/
https://sites.google.com/view/orthopaedic-in-delhi/blogs/10-common-signs-and-symptoms-of-hip-wear
http://publish.lycos.com/neoorthopaedicclinic/2022/04/30/10-common-signs-and-symptoms-of-hip-wear/
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Tendonitis

Signs of tendonitis and how to cure it

Repetitive strain or motion is often the cause of tendonitis. We explain how this injury alerts you to be taken seriously because it could become chronic.

Muscles are attached to bones by long, fibrous structures called tendons, which are responsible for transmitting the necessary force from the muscle to the bone to generate movement.

When a tendon becomes inflamed, we speak of tendinitis. However, although it is painful, it is usually not given too much importance and we do not “take care” of the injury as we should. An error because it can be repeated and cause a degeneration of the tendon or tendinosis (chronic tendinitis) or even its rupture, explains the orthopaedic in Delhi.

THE SIGNS OF TENDONITIS

The symptoms that warn us that we suffer an injury of this type are the following:

  • Pain is the main symptom, either near the joint or along the course of the tendon.
  • The discomfort worsens with movement and is more intense at night.
  • Palpation or rubbing also hurts.
  • Sometimes the area is red, hot, and swollen.

When we go to the orthopaedic doctor in Delhi after suffering an injury of this type, in principle, it is enough for the specialist to carry out a physical examination to detect it. If there are doubts, then you can send complementary tests. An imaging test (X-ray, ultrasound, MRI or CT) is usually performed to make the diagnosis.

The pain is close to the joint and increases with movement

Tendinitis must be differentiated from a sprain, which would be an injury to the ligaments that support the joint. Of course, a badly healed sprain can end up in tendinitis, explains the orthopaedic in Dwarka.

WHO HAS MORE RISK OF SUFFERING IT?

Any tendon in the body can become inflamed, but the most common tendinitis affects the heel, shoulder, wrist, and elbow.

  • The most common that originates in athletes and young people due to repetitive efforts on an area of ​​the body, especially when exercising, or due to overload due to repeated use of a tendon, for example if the computer mouse is used for hours with a position wrong hand, says the orthopaedic in Dwarka.
  • An overly sedentary lifestyle also favors tendonitis: the muscles are not in shape and can suffer at the slightest effort.
  • It can also appear in older adults, due to aging and natural wear of the tissues.

A repetitive stress or overload on the tendon causes it

  • Shoes that squeeze and materials that are not suitable for the foot or misuse of these (for example, running without sports shoes), can aggravate or cause Achilles tendinitis to appear.
  • On the other hand, certain systemic diseases, such as diabetes or rheumatoid arthritis, are capable of causing its appearance. It’s not common, but cholesterol drugs like statins can also cause it, says the orthopaedic in west Delhi.

5 TYPES OF TENDINITIS

Depending on the tendon that is injured, tendinitis adopts one name or another:

  1. Achilles tendonitis occurs when the Achilles tendon is injured.
  2. “Tennis elbow” or lateral epicondylitis appears due to inflammation of the tendons that are inserted into the lateral aspect of the elbow.
  3. Golfer’s elbow or medial epicondylitis occurs when the tendons of the elbow inserted on the inside of the elbow are irritated.
  4. Rotator cuff tendinitis is caused by inflammation of the tendons in the shoulder.
  5. Lastly, “De Quervain’s tendinitis” is caused by inflammation of the tendons of the thumb.

PREVENTION AND TREATMENT

In reality, it is quite easy to prevent it: it is enough to avoid repetitive movements and joint overloads, maintaining adequate muscle tone and warming up before starting to exercise or work if we are going to carry out tasks that involve physical effort of any muscle group, suggests the orthopaedic doctor in West Delhi.

How is such an injury treated?

  • During the acute condition: rest, combined with anti-inflammatories and analgesics, is the main treatment, which is why the area is usually immobilized with plaster splints or prostheses.
  • Combining cold and heat also relieves. Thus, ice helps reduce inflammation in the first 48 hours after the onset of pain. Apply it to the area 3 or 4 times a day for 15 minutes. After that time, you will notice relief if you follow the same routine but applying heat.
  • In the most “stubborn” cases that are not resolved with rest and anti-inflammatories, it is advisable to do rehabilitation in a center or with the help of a physiotherapist.
  • And if the pain persists, it may be necessary to apply other techniques (such as local infiltration of corticosteroids) or even operate.

Muscles and joint flexibility should be exercised

There may be a greater predisposition to re-suffer tendinitis if the injury has not been properly healed, as the ligament is distended, making it more unstable. To prevent relapses, it is important to maintain and train joint mobility and flexibility, and strengthen the muscles that support the joint, says the orthopaedic doctor in Dwarka.

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Patellar Tendinitis

Patellar Tendinitis

What is patellar tendinitis?

One of the most common knee tendinitis or knee tendinopathies are those that result from inflammation of the patellar tendon.

The patellar tendon attaches proximally to the lower pole of the kneecap (or patella). This sesamoid bone transmits the pulling force of the quadriceps muscle, allowing mobilization of the knee joint. Distally, the tendon insertion zone is located in the region of the anterior tuberosity of the tibia.

Both insertions can be the site of inflammation and pain in the anterior (or rarely lateral) region of the knee, explains the orthopaedic in Delhi.

Causes of patellar tendinitis

Knee tendinitis is an injury that is very often associated with high-intensity sports training, especially one that requires repeated pushing movements (“jumper’s knee”).

Therefore, knee tendinitis of this type occurs mainly in sports that involve jumping (volleyball, handball, basketball, etc.).

However, knee tendinitis can also develop in occasional exercisers or in patients who do not exercise at all, says the orthopaedic in west Delhi.

Symptoms of Knee Tendonitis

The main signs and symptoms are pain in the anterior region of the knee, which worsens when jumping or running and which is sometimes accompanied by edema (swelling).

Knee pain is sometimes so intense that it can cause lameness and difficulty walking, states the orthopaedic in Dwarka.

Diagnosis of patellar tendinitis

The diagnosis of patellar tendinitis is made clinically, namely the type and location of pain, the clinical history of practice of certain modalities, as well as the analysis of auxiliary diagnostic tests such as: Knee X-Ray, Knee Ultrasound and the Magnetic Resonance Imaging (MRI) of the knee.

In case of doubt about the diagnosis or difficulties in overcoming the symptoms, you should consult your orthopaedic doctor in Delhi.

Complications in patellar tendinitis

In more severe cases of patellar tendinitis, namely those with a longer duration, the chronic inflammation can lead to progressive weakening of the tendon, with the appearance of micro-tears and eventual evolution to a complete and total tear of the patella.

Is patellar tendinitis curable?

Yes, there is a cure, the prognosis depending on a series of factors such as the time of evolution and intensity of symptoms, athlete’s biotype / weight, knee morphology, type and intensity of the sport practiced, explains the orthopaedic in Dwarka.

Age also decisively affects recovery time, being obviously shorter in younger athletes.

Find out below how to treat patellar tendinitis.

Treatment of knee tendonitis (patellar)

The treatment of all knee tendinitis in general always involves conservative measures, such as resting, applying local ice, systemic or topical anti-inflammatory drugs (or remedies).

Physiotherapy is always an essential part of this treatment, allowing to speed up recovery and rapid return to sport.

Infiltration with PRP ‘s is considered in the literature as having a local analgesic effect and improving the regeneration process.

In cases that are very resistant to these treatments and that cause great functional disability, infiltration with corticosteroids should be carried out with consideration given the increased risks of tendon rupture, especially when applied multiple times.

SURGERY FOR TENDONITIS OF THE KNEE (PATELLAR)

Surgery (or operation) for the treatment of these types of pathologies is always a last resort, says the best knee surgeon in west Delhi.

The surgical procedure consists of debridement of the degenerated tissues, opening the lower pole of the patella and, if necessary, reinserting any areas of tendon rupture, explains the best knee surgeon in west Delhi.

Due to the risks of possible complications, namely the complete rupture of the tendon, postoperative recovery must always be very cautious, respecting the healing timings of the tissues involved and under the supervision of specialist orthopaedic surgeon in Delhi and Physiatry.

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Hip Osteoarthritis

Understand how to treat osteoarthritis and live without pain

Pain located in the hip, which appears mainly during the day or after getting up from a long period of sitting, may be caused by osteoarthritis of the hip, explains the orthopaedic in Delhi.

It is a problem that generates pain and decreases the patient’s movements, directly affecting the routine and the performance of simple activities, such as crossing the legs, getting into the car, tying shoes, standing, walking and performing physical activities, says the orthopaedic in Delhi.

Many people live with this type of pain for a long time and wonder if hip osteoarthritis is curable. In this article you will understand how to treat and control this problem.

Is hip osteoarthritis curable? Understand how it happens

Osteoarthritis in the hip is a problem caused by the loss of cartilage in the joint, which ends up causing the pain generated by the friction of bones where cartilage should be.

This is because the cartilage present between the bones of all joints in the body does not have the ability to hurt. Thus, we can move all our joints, without noticing anything wrong.

The problem begins when a cartilage injury begins that causes the bones to come into contact with each other in the joint. As said, cartilage doesn’t hurt, but bones do. From this initial injury, a path of pain and wear begins, explains the orthopaedic in west Delhi.

In practice, the hip is formed by the junction of two bone structures:

  • Femur Head – It is the round part of the hip joint, formed by the femur bone, which is the thigh bone.
  • Acetabulum – It is the part of the pelvis cavity formed by the bones of the pelvis.

These joints fit perfectly and tightly, allowing for correct and completely pain-free movement of the hip. The problem is when this joint is affected by diseases that cause cartilage loss – as is the case with osteoarthritis., states the orthopaedic in west Delhi.

Know the symptoms of osteoarthritis in the hip

The symptoms of osteoarthritis of the hip tend to evolve over time and tend to start with mild, localized pain in the hip, says the orthopaedic doctor in Delhi.

As wear and tear on cartilage progresses slowly, initial symptoms are usually mild and worsen over time.

The pain tends to worsen with the effort used in simple activities such as standing and physical activities, improving only when the patient is at rest.

Faced with worsening and worsening of symptoms, the joint starts to block movement, preventing the patient from performing activities such as putting on shoes, crossing the legs or cutting nails.

In more advanced stages, there may be pain even at rest, says the orthopaedic doctor in Delhi.

After all, is osteoarthritis in the hip curable?

Osteoarthritis in the hip is a problem that, in and of itself, has no cure.

However, no desperation. There are treatments that can and should be performed in order to reduce pain and improve symptoms caused by cartilage damage.

The first step for anyone who wants to improve from hip pain is to correctly diagnose the cause of the pain. This will help determine the best treatment approach and, of course, the best outcome. The evaluation and trust in qualified professionals can make a patient stagnant in treatment, live again, says the orthopaedic in Dwarka.

Learn about the main ways to treat hip arthrosis:

  1. Medicines

Patients who have severe, sharp pain may benefit from using anti-inflammatory drugs or corticosteroids in order to reduce inflammation quickly.

  1. Changing habits

It is recommended that those who have joint problems develop some habits such as:

  • Avoid consumption of sugar, alcohol and saturated fats, as these types of food can increase inflammation and increase pain.
  • Reduce the physical activity that causes hip pain.
  • Keeping the body moving with physical activity that does not generate pain and has a controlled impact.
  • Reducing body weight helps not only to lessen the weight on the injured joint, but also to control the process of widespread inflammation caused by fat in the body.
  1. Physiotherapy

Physiotherapy is done as part of treatment to reduce pain and reorganize body structures damaged by osteoarthritis.

It should be done with the guidance of a specialist physiotherapist, through analgesic and anti-inflammatory therapies, exercises that aim to improve joint lubrication, work on hip amplitude and function, as well as balance and body compensation techniques.

  1. Exercises

It is recommended to practice physical activities that help to strengthen the thigh muscles and work on stretching the region.

Activities such as pilates, water aerobics and cycling should be part of the routine of people who suffer from osteoarthritis in the hip, in order to preserve movements and improve the frame.

But beware, each person must be evaluated individually. An activity that can do a lot of good for one type of person can accelerate hip wear and tear in another.

  1. Hip Injection

Hip Injection is a technique that can be applied to the structures around or directly inside the joint, and it can have the function of reducing inflammation or improving the joint situation.

According to the objective, substances such as corticosteroids (to reduce inflammation) and hyaluronic acid (to improve joint lubrication and environment) are injected.

The type of injection must be done according to the medical advice of the specialist orthopaedic doctor in West Delhi, according to previous analysis and treatment objective for each patient.

  1. Hip Replacement Surgery

Surgery for osteoarthritis in the hip should only be performed under the guidance of a specialist orthopaedic surgeon in Delhi. It is recommended when other treatments do not help to control pain or when there is a well-defined intrinsic benefit.

The hip replacement surgery in Delhi consists of removing the two parts of the diseased bone and placing components of hip prostheses. In these cases, after recovering from anesthesia, while still under observation, the patient begins to walk with a walker, continuing the treatment with a physical therapist.

Osteoarthritis in the hip is treatable

Osteoarthritis in the hip has no cure, but it has treatment that should be used to reduce and control pain, regain joint mobility and return the patient’s quality of life, says the orthopaedic in Delhi.

With medical guidance, it is possible to control symptoms and identify the best way to lead a pain-free life without limitations due to osteoarthritis in the hip.

Living with pain is not normal. Look for a specialist orthopaedic doctor in Delhi to treat hip arthrosis and resume your routine activities.

Also visit:

https://neoorthopaedics.wordpress.com/2022/04/03/understand-how-to-treat-osteoarthritis-and-live-without-pain/
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https://neoorthopaedics.tumblr.com/post/680506153795534848/understand-how-to-treat-osteoarthritis-and-live
https://www.pearltrees.com/neoorthopaedics/blogs/id33250214/item437456458
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https://www.reddit.com/user/neoorthopaedics/comments/tv669f/understand_how_to_treat_osteoarthritis_and_live/
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Types of knee prosthesis

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!

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Hip Popping

The 3 main causes of hip popping

Many people when they walk, sit or simply move their leg, they hear or feel a popping sound coming from the hip joint. Others feel an audible click every time they bend their hips.

For other people, the pop can be seen with the twitching of the lateral muscles and the strange sensation that the hip has “gone out of place”. Others still feel a snap with the perception of locking accompanied by difficulty in moving.

Almost always, the hip crack does not come with pain. And while it may seem harmless, this condition can sometimes be the first sign that something is wrong with the hip, which can lead to further damage, explains the orthopaedic surgeon in Delhi.

Young women, athletes and dancers often experience this painless sensation harmlessly. So much so that snapping or snapping hip syndrome is also known as dancer’s hip.

What Causes Hip Cracking or Cracking?

There is not just one cause for the hip popping sensation. It can appear by changes in some structures around or even within the joint.

Knowing the cause of the problem makes all the difference not only for treatment, but also for identifying the severity and monitoring the injury, says the orthopaedic in Delhi.

External Hip Snap (on the side of the hip)

This first type of snapping is the most common cause of hip cracking. Often felt as a bump on the side of the hip, which can often be palpable.

It happens through the passage of the tendon from the side of the hip (iliotibial tract) over the most lateral portion of the femur bone (great trochanter).

When we walk or sit, this powerful tendon passes backwards and forwards from the bony ridge of the femur in a smooth motion. In some people, the hip bone can stick out and the tendon can become so tense that it ends up catching on the back of the bone.

If the person forces the movement, the tendon unscrews from the bone and passes quickly forward producing a snap and click.

The click occurs during the movement of bending or straightening the hip, when running or climbing stairs. Physical activities such as golf or efforts such as carrying suitcases or heavy backpacks can trigger rebound more easily.

Women are more affected by this type of snapping, as their hip and femur bones are more lateralized than men. This is because of the adaptation of female pelvis because of the birth canal.

Generally, this condition does not generate pain, only the sensation that it is possible to disengage the hip from its place – which does not really happen. Eventually, inflammation of the bursa, called bursitis, may occur as an associated disease, explains the orthopaedic doctor in Delhi.

Inner Hip Bump (in front of hip)

As with the side of the hip, the innermost part also has a popping or popping shape. The internal snap is caused by the tendon of the iliopsoas muscle, a powerful flexor of the thigh.

The movement of bending the hip with the leg rotated can lock the iliopsoas tendon over the head of the femur or over the edge of the pelvis cavity. When the tendon is too tense or the edge of the socket is too prominent, a movement with resistance is created that produces the click.

This form of clicking is felt as if it were on the inside of the joint, anterior to the hip and radiating to the groin. Because it is deep, it is not visible.

In this type of rebound, the hip pops when running, when rising from a sitting position, or when rotating the leg away from the body.

In some cases, internal snapping can damage the most peripheral cartilage of the hip joint, known as the labrum, and be associated with pain, explains the orthopaedic surgeon in Delhi.

Snapping from problems within the joint

A problem with the hip joint can cause the third type of click. Injuries with detachment or inflammation in the hip cartilage can produce a clicking, locking, and painful sensation.

Snapping due to cartilage damage can happen suddenly after trauma, such as a fall. Or even in people with wear and tear, osteoarthritis in the hip, in which symptoms may be less important and are associated with inflammation in the joint.

Loose pieces of bone or cartilage can lock the hip, causing pain and difficulty moving, explains the orthopaedic surgeon in Delhi.

Hip cracking is treatable

For most people with a cracked hip, without symptoms of pain, joint rehabilitation is enough to avoid injury or disability.

Ideally, you should receive a thorough medical evaluation regarding joint movement and possible risk factors, such as wear and tear. Anyone with a snap or click and pain should see a specialist orthopaedic in Delhi.

Conservative treatment

  • Rest: People with clicking in the hip joint should avoid movements that cause the click and restrict the overload on the joint, bursa and tendons. If the action of dancing, running or climbing stairs generates symptoms, these activities should also be excluded.
  • Medication: the use of anti-inflammatory drugs, for a short period of time, can make the rehabilitation period easier, especially for cases with pain and a lot of inflammation.
  • Physical Therapy: Some physical therapy techniques can help relax the muscles and tendons that cause internal and external snapping. Therapies that accelerate healing and decrease pain may also be employed.
  • Corticosteroid injection: hip injections may be a good option for the treatment of chronic pain conditions or those that do not improve with the above treatment measures. It is worth mentioning that it is not able to cure tendon tension, but it is a strong aid in controlling inflammation.

Surgical treatment

Hip cracking is very common among athletes and women. Even when there are symptoms of pain, he responds very well to non-surgical treatment, such as medication and physical therapy.

Only a minority of cases benefit from surgical treatment. Therefore, the correct type of procedure will depend on the cause of the pop, explains the orthopaedic doctor in Delhi.

Video arthroscopy of the hip is the most suitable method for cases of cartilage injury, with the aim of preventing the progression of the injury to wear.

In cases of tendon shortening, its lengthening or release can be performed by video arthroscopy in Delhi, depending on each particular situation.

Most importantly, whenever possible, determine the cause of the hip snap. Only then will there be a diagnosis of an injury that may eventually worsen in the future.

If you feel a click in your hip, avoid doing any activity that causes pain or reproduces the click.

And remember, keep your life moving.

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Total Knee Replacement

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.

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Knee pain

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.

Also Visit:

https://neoorthopaedics.wordpress.com/2022/03/04/knee-pain-causes-how-to-treat-and-relieve-pain/

https://neoorthopaedics.blogspot.com/2022/03/knee-pain-causes-how-to-treat-and.html

https://neoorthopaedics.tumblr.com/post/677809265836261376/knee-pain-causes-how-to-treat-and-relieve-pain

https://www.pearltrees.com/neoorthopaedics/blogs/id33250214/item432669505

https://diigo.com/0npdxz

https://www.reddit.com/user/neoorthopaedics/comments/t6m0jv/knee_pain_causes_how_to_treat_and_relieve_pain/

https://sites.google.com/view/orthopaedic-in-delhi/blogs/knee-pain-causes-how-to-treat-and-relieve-pain

http://publish.lycos.com/neoorthopaedicclinic/2022/03/04/knee-pain-causes-how-to-treat-and-relieve-pain/

https://www.evernote.com/shard/s518/sh/c973bc5e-161b-5001-e1fa-03cde06e8cf7/477aae89a3f3274ed9a86c24328ff7a8

https://theneoorthoclinic.wixsite.com/drashu/single-post/knee-pain-causes-how-to-treat-and-relieve-pain

http://theneoorthopaedic.weebly.com/blog/knee-pain-causes-how-to-treat-and-relieve-pain

https://theneoorthopaedic.webnode.com/l/knee-pain-causes-how-to-treat-and-relieve-pain/

https://site-3956990-5781-4708.mystrikingly.com/blog/knee-pain-causes-how-to-treat-and-relieve-pain

https://shortkro.com/knee-pain-causes-how-to-treat-and-relieve-pain/

https://www.atoallinks.com/2022/knee-pain-causes-how-to-treat-and-relieve-pain/

https://www.debwan.com/blogs/326650/Knee-Pain-Causes-How-to-Treat-and-Relieve-Pain

https://trendingnewswala.online/knee-pain-causes-how-to-treat-and-relieve-pain/

http://hellobiz.in/knee-pain–causes-how-to-treat-and-relieve-pain-301917

http://www.doctorsdirectoryindia.com/blog/blogDetails/4378

https://speora.org/knee-pain-causes-how-to-treat-and-relieve-pain/

https://telegra.ph/Knee-Pain—Causes-How-to-Treat-and-Relieve-Pain-03-04

https://www.hiidoc.com/knee-pain-causes-how-to-treat-and-relieve-pain/

arthroscopy in Delhi

ARTHROSCOPY: DIAGNOSTIC AND THERAPEUTIC PROCEDURE ON THE RISE

What is arthroscopy?

Arthroscopy in Delhi is a minimally invasive procedure used for the diagnosis and treatment of conditions that affect the joints. The doctor can view the internal structures of the ligaments directly by using an instrument called an arthroscope.

Orthopaedic surgeon in Delhi uses the arthroscope to diagnose and treat joint problems. An arthroscope is a small, tube-shaped instrument used to view the inside of a joint.

It consists of a lens system, a small video camera, and a viewing light. The camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. The arthroscope is often used in conjunction with other instruments that are inserted through another incision.

The joint most often examined by arthroscopy is the knee. However, arthroscopy can be used to examine other joints, including the following:

  • Shoulder
  • Elbow
  • Ankle
  • Hips
  • Wrist

knee anatomy

Joints are the areas where bones meet. Most joints are mobile and allow the bones to move. Basically, the knee is made up of two long leg bones joined by muscles, ligaments, and tendons. Each end of the bone is covered by a layer of cartilage that absorbs shock and protects the knee.

There are two groups of muscles involved in the knee, including the quadriceps muscles (located in the front of the thighs), which straighten the legs, and the hamstring muscles (located in the back of the thighs), They bend the leg at the knee level.

Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bones to each other. Some ligaments in the knee provide stability and protection for the joints, while other ligaments limit the back and forth movement of the tibia (shinbone).

The knee is made up of:

  • Tibia. Shin bone or largest bone of the lower leg.
  • Femur. Thigh bone or upper leg bone.
  • Ball joint. Knee bone.
  • Cartilage. A type of tissue that covers the surface of a bone at the joint. Cartilage helps reduce friction from movement within a joint.
  • synovial membrane. Tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
  • Ligament. A type of tough, elastic connective tissue that surrounds the joint to provide support and limit movement.
  • Tendon. A type of tough connective tissue that connects muscles and bones and helps control joint movement.
  • Menisci. Curved part of the cartilage of the knees and other joints that acts as a shock absorber.

Reasons to perform the procedure

An arthroscopic procedure may be used by orthopaedic in Delhi to diagnose and help treat the following conditions:

  • Swelling of the knee, shoulder, elbow, wrist, or ankle
  • Injuries, such as rotator cuff tendon tears or shoulder impingement syndrome (compression of the shoulder tendons caused by excessive squeezing and rubbing of the rotator cuff and scapula)
  • Cartilage damage, such as tears, injuries, or wear
  • Ligament tears with knee instability
  • tendon damage
  • Carpal tunnel syndrome in the wrist
  • Loose bones and/or cartilage, particularly in the knee, shoulder, elbow, ankle, wrist, or hip

Corrective surgery or biopsy may be done using arthroscopy. For example, torn ligaments can be repaired or rebuilt. Arthroscopic surgery in Delhi may eliminate the need for an open surgical procedure.

Your orthopaedic doctor in Delhi may recommend an arthroscopy for other reasons.

Also Visit:

https://neoorthopaedics.wordpress.com/2022/02/17/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://neoorthopaedics.blogspot.com/2022/02/arthroscopy-diagnostic-and-therapeutic.html
https://neoorthopaedics.tumblr.com/post/676427092600160256/arthroscopy-diagnostic-and-therapeutic-procedure
https://www.pearltrees.com/neoorthopaedics/blogs/id33250214/item430333317
https://diigo.com/0nivul
https://www.reddit.com/user/neoorthopaedics/comments/sul0z2/arthroscopy_diagnostic_and_therapeutic_procedure/
https://sites.google.com/view/orthopaedic-in-delhi/blogs/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise
http://publish.lycos.com/neoorthopaedicclinic/2022/02/17/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://www.evernote.com/shard/s518/sh/86a0d99d-a803-87e1-023b-20d2c0968f38/fd9b74041e99384c6ae2e072529c3af2
https://theneoorthoclinic.wixsite.com/drashu/single-post/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise
http://theneoorthopaedic.weebly.com/blog/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise
https://theneoorthopaedic.webnode.com/l/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://site-3956990-5781-4708.mystrikingly.com/blog/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise
https://shortkro.com/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://www.atoallinks.com/2022/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://www.debwan.com/blogs/307349/ARTHROSCOPY-DIAGNOSTIC-AND-THERAPEUTIC-PROCEDURE-ON-THE-RISE
https://trendingnewswala.online/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
http://hellobiz.in/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise-627338
http://www.doctorsdirectoryindia.com/blog/blogDetails/4268
https://speora.org/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/
https://telegra.ph/ARTHROSCOPY-DIAGNOSTIC-AND-THERAPEUTIC-PROCEDURE-ON-THE-RISE-02-17
https://www.hiidoc.com/arthroscopy-diagnostic-and-therapeutic-procedure-on-the-rise/