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partial knee replacement

UNICOMPARTMENTAL KNEE PROSTHESIS

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

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

ADVANTAGES OF PARTIAL KNEE REPLACEMENT

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

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

DISADVANTAGES OF PARTIAL KNEE REPLACEMENT

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

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

SURGERY CANDIDATES

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

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

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

YOUR SURGERY

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

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

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

COMPLICATIONS

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

Although rare, the most common risks include:

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

RECOVERY

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

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

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

Hip Fracture Treatment

HIP FRACTURES: ALL YOU NEED TO KNOW

The femur is the longest and strongest bone in the human body. For its fracture to occur, the effect of a sufficiently high force is necessary. One of these reasons could be, for example, a car accident.

The long, straight part of the femur is called the diaphysis. The fracture can occur at any part of it. Such fractures almost always require surgical treatment.

TYPES OF HIP FRACTURES

Depending on the energy of the injury, the nature of femoral fractures can vary greatly. Fragments may remain in their normal position (stable fractures) or significantly displaced (displaced fractures). The skin in the area of ​​the fracture may be intact (closed fracture) or it may be damaged, and the fracture may communicate with the external environment (open fracture).

Fractures are referred to by orthopaedic doctor in Delhi according to various classification systems. Hip fractures are classified according to:

  • Fracture localization (femur diaphysis is divided into thirds – distal, middle and proximal)
  • The nature of the fracture (the fracture line can be located in different ways: transversely, obliquely, etc.)
  • Damage to the skin and soft tissues in the area of ​​the fracture.

The most common types of hip shaft fractures are:

Transverse fracture. In this fracture, the line runs horizontally across the long axis of the thigh.

Oblique fracture. The fracture line is located at an angle to the axis of the thigh.

Spiral fracture. The fracture line is located in a spiral, as if surrounding the diaphysis of the thigh. The mechanism of such fractures is twisting along the long axis of the thigh.

Comminuted fracture. With such fractures, three or more bone fragments are formed. In most cases, the number of bone fragments is proportional to the severity of the traumatic effect that caused the fracture.

Open fracture. In such cases, the bone fragment can perforate the skin, or there is an open wound in the fracture area that communicates with the fracture zone. Open fractures are often characterized by greater damage to the surrounding muscles, tendons, and ligaments. These fractures have the highest risk of complications, especially infections, and usually take longer to heal.

CAUSES OF HIP FRACTURES

Fractures of the femur in young people are often the result of some kind of high-energy impact. The most common cause of hip shaft fractures is car accidents. Other common causes are pedestrian collisions with a moving vehicle and falls from a height.

Low-energy injuries, such as falls from their own height, can cause hip shaft fractures in older people with poor bone quality.

SYMPTOMS AND DIAGNOSIS OF FRACTURES

A hip shaft fracture usually immediately results in severe pain in the affected area. The victim loses the ability to lean on the injured leg, the hip may look deformed – it may be shorter and take an uncharacteristic position.

HISTORY AND PHYSICAL EXAMINATION

The orthopaedic in Delhi must know the circumstances of your injury. This information will help the orthopaedic surgeon in Delhi assess the energy of the injury and the presence of possible collateral damage.

It is important that the orthopaedic in Dwarka knows about any comorbidities you have – hypertension, diabetes, asthma, or allergies. The doctor will also ask you if you smoke or take any medications.

After discussing with you the nature of the injury and history, the orthopaedic in Janakpuri will perform a thorough physical examination. In doing so, the doctor will assess your general condition and then the condition of the injured limb. In this case, the orthopaedic in West Delhi will pay attention to details such as:

  • Visible limb deformity (unusual angle, rotation, or shortening of the limb)
  • Damage to the skin
  • Hemorrhage
  • Perforation with bone fragments of the skin

After a visual examination, the best orthopaedic in Delhi palpates the thigh, lower leg and foot, not the subject of possible pathological changes, tension of the skin and muscles in the fracture area. Also, the doctor will assess the nature of the pulse on the foot. If you are awake, your doctor will evaluate sensitivity and movement in your lower leg and foot.

RADIATION RESEARCH METHODS

Radiation testing allows the doctor to obtain more detailed information about your injury.

Radiography. It is the most commonly used method for diagnosing bone fractures. It allows not only to see the fracture, but also to characterize its type and localization.

Computed tomography. If the doctor needs more information about the nature of the fracture than is shown on the x-ray, the doctor may prescribe a CT scan. Sometimes the fracture line is very thin and almost invisible on radiographs. CT can help visualize these fractures more clearly.

TREATMENT OF HIP FRACTURES

CONSERVATIVE TREATMENT

Most hip shaft fracture treatment in Delhi require surgical intervention and rarely can be treated conservatively. So, the method of plaster immobilization is sometimes used to treat hip fractures in young children.

SURGERY

The timing of the operation. Most hip fractures are best operated within the first 24 to 48 hours after injury. Sometimes the operation is postponed due to the presence of life-threatening conditions or the need to stabilize the patient’s condition. To reduce the risk of infection in open fractures, patients are given antibiotics right after hospitalization. During the operation, open wounds, tissues and bone fragments are treated from contamination.

During the waiting period between admission to the hospital and surgery, the orthopaedic surgeon in Dwarka may temporarily fix your leg with a cast or skeletal traction. This allows you to maintain a more or less optimal position of the fragments and the length of the limb.

Skeletal traction is a system of blocks and weights with which bone fragments are held in one position. It allows not only to achieve the correct position of the fragments, but also to stop the pain syndrome.

External fixation. During such an operation, metal wires or rods are inserted into the femur above and below the fracture site, which are fixed to an external fixation device. This allows you to keep the fragments in the correct position.

External fixation is most often used as a method of temporary stabilization of a fracture in patients with multiple injuries, whose condition does not allow performing a more traumatic operation of internal fixation of the fracture. The second stage in such cases is performed after the patient’s condition has stabilized. In some cases, the external fixator is left on until the fracture is completely healed, but this is not common.

Intramedullary osteosynthesis. Today it is the most commonly used method of internal fixation of hip shaft fractures. In this case, special metal rods are used, which are inserted into the medullary canal of the femur. The rod passes through the fracture zone and holds the fragments in the correct position.

An intramedullary nail is inserted into the medullary canal from the side of the hip or knee joint. Above and below the fracture site, the rod is locked with screws to exclude mobility in the fracture area.

Intramedullary rods are usually made of titanium. They come in various lengths and diameters to fit most of the thigh bones.

Plates and screws. In such operations, the bone fragments are repositioned first, i.e. returning them to their normal position, after which the fragments are fixed from the side of the outer surface of the bone with a metal plate and screws.

This method is used when intramedullary osteosynthesis is not possible, for example, when the fracture line extends to the hip or knee joint.

RECOVERY AND REHABILITATION

Most fractures of the femoral shaft will heal within 3-6 months. Sometimes, for example, with open or comminuted fractures, as well as in smokers, it takes longer.

PAIN RELIEF

Pain after injury or surgery is a natural component of the healing process. Your doctor and nurses will do whatever is necessary to reduce pain and make your recovery more comfortable.

Various medications are usually used to relieve pain after an injury or surgery. These are paracetamol, non-steroidal anti-inflammatory drugs, muscle relaxants, opioids and topical drugs. In order to optimize the analgesic effect and reduce the patient’s need for narcotic analgesics, these drugs are often used in combination with each other. Some of these drugs can have side effects that affect your ability to drive or engage in other activities. The doctor will definitely tell you about the possible side effects of the drugs prescribed to you.

LOAD

Many doctors recommend starting movements in the joints of the operated limb as early as possible, but you need to load the leg when walking only in this way and only when and as your doctor permits.

In some cases, almost full loading is allowed immediately after the operation, but sometimes this is possible only after the first signs of fracture union appear. Therefore, we recommend that you strictly follow all the instructions of your orthopaedic surgeon in West Delhi.

You will need to use crutches or walkers when walking.

PHYSIOTHERAPY

After surgery, the muscles in the area of ​​the fracture are likely to be significantly weakened, so exercises to help restore muscle strength are very important during the rehabilitation process. Physiotherapy in Dwarka will restore normal muscle strength and joint mobility. It can also help you cope with postoperative pain.

A physiotherapist in Dwarka will likely start working with you while you are still in the hospital. He will also teach you how to use crutches or walkers correctly.

Contact Best Orthopaedic in Delhi for all Orthopaedic Treatments.

Knee Arthroscopy in Delhi

All About Knee Arthroscopy

What is knee arthroscopy?

Arthroscopy in Delhi is a surgical technique that allows you to directly see the inside of the knee joint and work inside it, without having to open it. Only two small incisions or cuts are made in the skin, about one centimetre each (which is why it is called a mini-invasive technique).

Arthroscopy in Delhi is considered the best current technique for meniscal injuries, adhesions, plica, loose bodies, cartilage injuries (chondroplasty) and reconstruction of cruciate ligaments, explains the orthopaedic in Delhi.

How is knee arthroscopy done?

The orthopaedic surgeon in Delhi, in order to see the inside of the joint well and avoid tissue injury with his manoeuvres, fills it with sterile pressure serum, which has the effect of inflating a balloon; and at the same time, it allows continuous joint washing, eliminating blood residues, excised tissue fragments, etc.

The patient lies on his back on the operating table. No system is necessary to pull the joint. You only need to lock the position of the thigh and the surgeon or assistant mobilizes the leg, opening the joint space.

Through an incision, a micro camera is introduced that illuminates and amplifies the interior of the joint, viewing the image on a television monitor. On the other hand, work instruments are introduced, such as probes, hand grippers and motorized smoothing devices.

The anaesthesia used is spinal anaesthesia (patient conscious but asleep from the waist down). Some sedation may be associated with this procedure to be calmer during the surgical act. General anaesthesia is reserved for special cases.

A tourniquet is used on the thigh to prevent bleeding from the knee during the operation, thus promoting vision through the camera.

Although it is a surgical act and requires the same aseptic conditions (cleanliness and sterility to avoid infection) as any other operation, the hospital stay is usually very short. In most cases, the patient can be discharged on the same day, when the anaesthetic effect has worn off. These operations can therefore be included in the program of major outpatient surgery, explains the orthopaedic surgeon in Delhi.

What does knee arthroscopy in Delhi show?

  • The appearance of synovialfluid (viscous fluid that lubricates the joint), which may be cloudy, contain blood or loose bodies, usually cartilage. Synovial fluid can be analysed to determine its composition in special cases.
    • The synovial membrane(the sac that lines the joint inside and produces synovial fluid). In certain cases, a sample (biopsy) is taken for analysis under a microscope.
    • The cartilage that lines the articular surfaces of the femur, tibia, and patella. It is palpated with a special hook to see the consistency and it is observed if it has injuries: wear (osteoarthritis), fissures, chondromalacia …
    • The menisci (internal and external): observed and palpated with the probe hook. Breaks, tearing, wear are detected …
  • The cruciate ligaments(anterior and posterior): they are seen and touched to determine partial or total tears, laxity, function … The collateral ligaments are not seen with this technique.
    • The way the patellamoves when the knee is bent and stretched, as well as the friction surfaces.

In which cases should an arthroscopy in Dwarka be performed?

Less and less to diagnose, as advances in ultrasound, CT (scanner) and nuclear magnetic resonance resolve it more and more frequently, although they are not infallible.

However, in cases of doubt or when a major intervention on the knee is planned, an arthroscopy can be performed beforehand, which will make it possible to confirm the diagnosis, rule out other injuries and decide the best possible treatment, which is also sometimes arthroscopic. Thus, in the same surgical act it is diagnosed and treated. In addition, there are patients who have contraindicated MRI (due to claustrophobia, or prosthetic heart valves), in those cases, diagnostic and therapeutic arthroscopy would be indicated by the orthopaedic doctor in Delhi.

Another diagnostic utility is to allow a synovial biopsy in certain diseases.

Currently, the main indications for performing a knee arthroscopy in Dwarka are:

  • Meniscal injuries: remove broken fragments, suture certain tears, regeneration techniques and meniscal reimplantation
  • cruciate ligament reconstruction: avoid opening the knee as before
  • cartilage injuries: cleaning, regenerative techniques (platelet growth factors, mosaicplasty)
  • removal of intra-articular loose bodies: fragments of detached cartilage or meniscus
  • removal of synovial plica or synovitis (synovial membrane hypergrowth)
  • cleaning on knees with osteoarthritis (wear) before reaching the total knee replacement

Recommendations at hospital discharge:
They are usually quite simple since it is a mini-invasive technique.

A compression bandage is placed, which the patient will remove at home after 48 hours. Then the first treatment is carried out, which consists of painting the two small wounds with Betadine and covering them with two adhesive dressings.

From there, the treatment will be repeated every day until the stitches fall out (about 2 to 4 weeks). It can be made to coincide with the shower as long as two rules are met:

  • quick shower: the less time the wounds are wet the better
  • WITH the dressings on: so that soap, shampoo, dirty water do not get into the wounds

After showering, the wet dressings are removed, the wounds are thoroughly dried with sterile gauze, painted with Betadine, and new dressings are placed.

From the moment the mobility of the legs recovers after anaesthesia, it is advisable to start walking. At first helped with crutches and following the indications of your orthopaedic surgeon in Dwarka regarding load (partial or complete). Usually, the patient leaves the hospital the same day walking with the help of two crutches.

An anti-inflammatory treatment is usually recommended at discharge for the first days.

It is advisable to apply ice locally for 10-15 minutes about 3-4 times a day to help reduce inflammation.

Depending on the diagnosis and treatment carried out, a specific physiotherapy may or may not be prescribed, with the recovery times greatly varying. The time in which you can return to sports or hard work depends on the injury: from 1 month to several months.

In the event of residual effusion (usually due to the persistence of the arthroscopic lavage fluid and more rarely due to bleeding into the joint, which is the hemarthros), an evacuating puncture may be necessary: ​​the area is punctured, and the excess fluid is extracted with a syringe. This procedure should only be performed by an orthopaedic surgeon in Delhi.

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