Arthritis and knee injury can limit the ability to extend and bend knees.

Over time, the deterioration or decline of the joint and surrounding tissue can make it difficult to perform the basic daily activities such as sitting and lying down. Total knee replacement surgery is a common solution for people who are facing knee deterioration after having taken conservative treatment in the form of medications, physiotherapy and other nonsurgical options. Total knee replacement or partial knee replacement provides the pain relief during movement, for more than 80-90 per cent of those who’ve undergone the surgery.

Most of these knee replacement procedures are done to replace knee joints damaged due to osteoarthritis. Total knee replacement surgery is considered one of the most effective as well as safest procedures in orthopaedics.

What is Knee Replacement Surgery?

Knee replacement surgery, also known as arthroplasty (Plasty- moulding, shaping), is a surgical procedure to repair a knee damaged by arthritis. This surgery may be considered for someone with severe arthritis or a severe knee injury.

During a knee replacement, a surgeon removes some cartilage and bone from the areas of the shinbone and thighbone, where they meet at the knee joint. The surgeon then replaces them with metal implant on both surfaces and a poly insert in between.. This gives both the bones of the knee joint smooth surfaces again so they can be easily flexed over each other.

What are the most common causes of knee replacement surgery?

Osteoarthritis:

This type of age-related arthritis is caused due to normal wear and tear of the knee joint. Osteoarthritis affects patients aged above 50 years due to more years of use, but younger people may have it too.

Osteoarthritis is caused by breakdown, inflammation, and the gradual and eventual loss of cartilage in the joints. When a person grows older the cartilage wears down and the bones rub together.

To compensate, these bones edges often grow thicker called osteophytes, which can further lead to more pain and friction.

Rheumatoid arthritis:

This is also known as inflammatory arthritis, the membrane around the knee joint to become thick and inflamed. Chronic inflammation damages the cartilage that leads to stiffness and soreness.

Post-traumatic arthritis:

This type of arthritis is after severe knee injury. When the bones around the knee break or ligaments tear, there is malalignment which will ultimately affect the knee cartilage.

What are the Types of Knee Replacement Surgery?

There are mainly two types of knee replacement surgery, total or partial.

Total Knee Replacement (TKR):

In TKR, the surgery mainly involves the replacement of both sides of the knee joint, which is the most common procedure.

The surgery lasts for approximately 2 hours. After the surgery and physiotherapy , the individual will have less pain and better mobility.

Partial Knee Replacement (PKR):

PKR is done only on one compartment of the knee joint most commonly done for medial or inner compartment. In this procedure, less bone is removed, so the incision is smaller, tissue handling is more localised.
PKR is suitable for those people with only one half of the knee is damaged. Post-operative rehabilitation is more straightforward and has less blood loss, lower risk of infection and blood clots.

Diet after a knee replacement surgery:

Eating good food which includes all the nutrients and protein is a very essential part of recovery. It will not only help you recover fast but will make you feel more energized. So, you can say that the food you consume will affect your well-being.

Include Lean protein

The most abundant protein in the body is collagen as it helps in getting tissue back together. Typically intake of protein should be around 0.8grams. But after a knee replacement surgery, you should increase this quantity. You should include at least 1.5 to 2.0 grams of protein. (If your weight is 68Kg then you should eat 102 to 136 grams of protein in one day. This means per meal it should be 25 to 30 grams and for two snacks 14 to 23 grams.)

Fibre

To feel energized all day long and concentrate on your work properly you should include soluble as well as insoluble fibre in your diet. Prunes are a very rich source of fibre, so you should eat a few of them each day. Some other food products are beans, legumes, apples, pears, bran flakes, oatmeal, and flax-seed meals. Given that moving around is limited in the first few weeks after surgery, constipation which may set in can be dealt with.

Bell peppers and Citrus Fruit

Vitamin C should be another essential part of your diet. For this, you should include bell pepper in the diet. (You will be surprised to know that one medium pepper contains 340 mg of Vitamin C). Especially if you have undergone the surgery which has a decent sized incision then this will really help the wound to heal faster. Other sources are guava, kale, citrus fruits, kiwi, and broccoli.

Nuts and seeds

Many seeds and nuts are excellent sources of zinc. Pumpkin, squash and sesame seeds contain zinc is very high amount and it helps the immune system to function properly. Moreover, it also helps in developing and activating the cells as well as promote cell growth. Oysters are considered as the highest concentration of zinc.

Pineapple & Papaya

Pineapple and papaya contain protease enzymes which help the body to digest proteins. These enzymes such as bromelain and papain help in reducing the swelling and inflammation. The problem is bromelain is found in the stem of the pineapple (that chewy part you do not eat!). Instead you should take a supplement like Bromelain with Quercetin which is also a great option.

Recovery exercises for knee replacement surgery:

1. Rest and Elevate:

Lie on your back and elevate your leg using pillows when icing and doing ankle pumps.

2.Ankle pumps and circles:

Pump your feet up and down by stretching your toes up toward you, then pushing your toes down away from you. In addition, rotate your feet at the ankle joint clockwise and counterclockwise.

3. Knee straightening stretch (sitting knee extension):

Sit on a sturdy chair with your leg straightened out in front of you, heel on an equal height chair or solid surface in front of you. Relax your leg and thigh muscles to let your knee straighten. You should feel a gentle stretch on the back of your knee. You can do thigh squeezes to increase the stretch.

4. Thigh squeezes (quadriceps sets):

Tighten the muscles on the front surface of your thigh by pushing the back of your knee down into the bed. Hold for 5 seconds and relax.

5. Heel slides (hip and knee flexion):

Bend your surgical hip and knee by sliding your heel up toward your buttocks while keeping your heel on the bed. Slide your heel back down to the starting position and relax. Keep your kneecap pointed up toward the ceiling during the exercise. You may want to use a plastic bag under your heel to help it slide easier.

6. Leg slides (abduction/adduction):

Slide your surgical leg out to the side, keeping your kneecap pointed up toward the ceiling. Slide your leg back to the starting position. You may want to use a plastic bag under your heel to help it slide easier.

7. Straight leg raises:

Bend your non-surgical leg with your foot flat on the bed. Tighten the muscles on the top of your thigh, stiffening your knee. Raise your surgical leg up (about 12 inches), keeping your knee straight. Work up to holding for 5 seconds.

8. Sitting kicks (long arc quadriceps):

Sit on a sturdy chair or on the side of your bed. Straighten your knee. Work up to holding for 5 seconds.

Zoi Hospital’s orthopaedic department might be your best option for treatment

In Zoi’s orthopaedics and traumatology department, each of our orthopaedic doctors is an expert in a specific area of orthopaedics, which means that you will always receive individualized care and specialized treatment.

The Department of Orthopedics and Traumatology specialises in handling accident and trauma cases, joint and bone diseases and sports injuries that require advanced surgical procedures and physiotherapy for a complete repair and rehabilitation.

Our orthopedic surgeons perform a variety of procedures including knee ligament tear surgery (with the most common being ACL repair surgery), partial and total knee replacement, total hip replacement, shoulder injury repair surgery and spine surgery (especially minimally invasive techniques), all of which are performed by some of the best orthopaedic surgeons in Hyderabad.

Zoi hospitals is among the few hospitals to perform computer navigation assisted knee replacement. The advantage of using computer navigation is the precision of cuts and implant placement which allows for early rehabilitation and increases longevity of the prosthesis.

At Zoi Hospitals, after completion of the procedure, you will be under the care of an intensivist, operating orthopaedic surgeon, physical therapist and dietician. Pain control measures are started immediately and gradual rehabilitation towards recovery is supervised by the team to ensure that you are discharged in a stable condition by the end of the third or fourth day of your hospital stay.

Procedure Time: 1 – 3 hours

Postprocedure Care: 1 – 5 days

Procedure Cost: Varies depending on the type of implants and use of computer navigation system.

Back to Work: 4 – 6 weeks

At Zoi orthopaedic hospital, we don’t just provide orthopaedic treatment, we make sure that you get back in action as soon as possible.

Shoulder problems can happen to anyone, whether or not you’re an athlete. Simple activities that require repetitive motion can bring on inflammation and make shoulder movement very painful. Shoulder replacement surgery can help minimize shoulder pain and bring back your range of motion, allowing you to return to your day-to-day activities.

Shoulder joint replacement while less common than knee or hip replacement is very effective in relieving pain and improving mobility due to arthritis or complex trauma. This procedure is recommended for people with severe pain, weakness or loss of motion in their shoulder who have found little or no relief from simpler treatments.

What is Shoulder Replacement Surgery?

Shoulder replacement surgery is a type of surgery that replaces the ends of bones in the shoulder joint. The shoulder has the head of the humerus (shoulder head) and the glenoid (shoulder cup). In this procedure, the whole or damaged parts of the shoulder joint are removed and replaced with prosthetic implants.

This helps to cut down on joint pain and enable further use of the arm. There are various reasons someone might need shoulder replacement surgery. Acute injuries as the result of an accident or injury, bone diseases such as osteoarthritis are another cause. And sometimes, the bones degrade naturally.

Types of Shoulder Replacement Surgery

The right procedure for a shoulder replacement surgery will depend on age, level of activity, and the severity and type of shoulder arthritis.

Total Shoulder Replacement Surgery

Your shoulder is a ball-and-socket joint. In this approach, the arthritic ball and socket are removed and replaced with a metal-and-plastic shoulder joint. Total shoulder replacement can be performed with or without a stem that fits inside the humerus bone. If you have good bone density, a stemless total shoulder can often be used. 

Total shoulder replacement can be performed for osteoarthritis (the kind that develops due to wear and tear) or rheumatoid arthritis. You must have a normally functioning rotator cuff to have this surgery.

Partial Shoulder Replacement

People who want to continue very heavy lifting or who only have damage to one side of the joint are advised to go for this surgery, which replaces only the ball of the joint.

Reverse Total Shoulder Replacement Surgery

If your rotator cuff is torn beyond repair and accompanied by arthritis, this may be your best option. In this approach, the ball and socket of the shoulder joint are reversed: A ball is attached where your shoulder socket normally sits, and a socket is fitted to the top of your upper arm bone. This allows you to use muscles other than the ones in the rotator cuff to move your arm.

Shoulder Revision Surgery

This may be recommended if you’ve had a previous shoulder replacement that failed, because of infection or because the implant was incorrectly positioned or has become loose. Zoi Hospital’s orthopaedic surgeons’ expertise in performing this procedure is well-known.

Causes of Shoulder Replacement Surgery

The most common causes of shoulder replacement surgery are:

1. Osteoarthritis of the shoulder (wear-and-tear on cartilage inside the joint) can develop from years of overuse, such as with tennis players, weightlifters and other athletes who put continual pressure on their shoulders). In other cases, an acute injury such as a torn rotator cuff or shoulder fracture triggers such long-term damage.

2. Forms of chronic inflammatory arthritis, (such as rheumatoid arthritis) and ankylosing spondylitis are autoimmune diseases with no completely understood cause. But many people with these conditions who have replacement surgeries experience improved function in the shoulder (and in ankylosing spondylitis patients, the elbow), as well as reduced pain.

Symptoms that help identify the need for a surgery

The most common indication that a person should get a shoulder replacement is shoulder pain due to arthritis that cannot be controlled with nonsurgical treatments. Such pain is usually accompanied by progressive stiffness and loss of motion, in which patients often experience a grinding or grating sensation within the shoulder joint. 

These symptoms and sensations indicate that bones of the ball and socket are rubbing against one another because the cartilage that should lie between them has worn away.

What is the procedure time for surgery?

At Zoi Hospitals, one of the best orthopaedic hospitals in Hyderabad,  a simple 1-2 hour surgery is done to make sure you live pain-free. Usually, you are made mobile the next day.

What is the cost of a shoulder replacement surgery?

At Zoi Hospitals, the cost of a surgery including preoperative and postoperative care is approximately 2 lakhs.

Diet after a shoulder replacement surgery

Eating good food which includes all the nutrients and protein is a very essential part of recovery. It will not only help you recover fast but will make you feel more energized. So, you can say that the food you consume will affect your well-being.

Include Lean protein

The most abundant protein in the body is collagen as it helps in getting tissue back together. Typically intake of protein should be around 0.8grams. But after a shoulder replacement surgery, you should increase this quantity. You should include at least 1.5 to 2.0 grams of protein. (If your weight is 68Kg then you should eat 102 to 136 grams of protein in one day. This means per meal it should be 25 to 30 grams and for two snacks 14 to 23 grams.)

Fibre

To feel energized all day long and concentrate on your work properly you should include soluble as well as insoluble fibre in your diet. Prunes are a very rich source of fibre, so you should eat a few of them each day. Some other food products are beans, legumes, apples, pears, bran flakes, oatmeal, and flax-seed meals.

Bell peppers and Citrus Fruit

Vitamin C should be another essential part of your diet. For this, you should include bell pepper in the diet. (You will be surprised to know that one medium pepper contains 340 mg). Especially if you have undergone the surgery which has incision then this will really help the wound to heal faster. Other sources are guava, kale, citrus fruit, kiwi fruit, and broccoli.

Nuts and seeds

Many seeds and nuts are excellent sources of zinc. Pumpkin, squash and sesame seeds contain zinc is  very high amount and it helps the immune system to function properly. Moreover, it also helps in developing and activating the cells as well as promote cell growth. Oysters are considered as the highest concentration of zinc.

Pineapple & Papaya

Pineapple and papaya contain protease enzymes which help the body to digest proteins. These enzymes such as bromelain and papain help in reducing the swelling and inflammation. The problem is bromelain is found in the stem of the pineapple (that chewy part you do not eat!). Instead you should take a supplement like Bromelain with Quercetin which is also a great option.

What are the limitations one might face after surgery?

Many patients are able to leave the hospital within one to three days, although full recovery can take significantly longer. Factors that affect recovery are based largely on age and overall health before and after the surgery. Full rehabilitation can take months; a normal pattern is roughly six weeks of limited activity, then more intense exercises, as well as stretches, until around the three-month mark.

To ensure the safest possible recovery after shoulder surgery, it can be beneficial to adhere to the following guidelines:

Wear your sling

When you are in public or moving around, it is recommended that you wear your sling, as it provides stability for your shoulder and allows you to heal properly. When you read, watch TV or work at a desk, it can be loosened, but it’s best to keep it secure the majority of the time.

Favour your hand

Avoid shoulder motion a much as possible, instead of bending your elbow, wrist, and hand to do low-impact activities like eating, writing and working at a computer.

Postpone housework

Or delegate the chores to others. After surgery, you will be advised to not lift or hold weight, and heavy housework like vacuuming is off-limits. Driving is also prohibited until further notice from your doctor. He or she will likely allow you to gradually add housework and driving back into your daily activities after approximately six weeks.

Do your list of exercises

Your doctor will prescribe exercises for you to do in order to regain full arm and shoulder movement without damaging the replaced shoulder. Exercising provides the range of motion you need to prevent your elbow and shoulder from getting stiff. While these exercises may be uncomfortable to do at first, they will get easier over time.

Choose ice over heat

After you do your recommended exercises, apply ice to your shoulder to reduce pain and swelling. Applying heat in the form of a heating pad or hot water bottle will only cause your joint to swell.

Zoi Hospital’s orthopaedic department might be your best option for treatment

In Zoi’s orthopaedics and traumatology department, each of our orthopaedic doctors is an expert in a specific area of orthopaedics, which means that you will always receive individualized care and specialized treatment.

The Department of Orthopedics and Traumatology specialises in handling accident and trauma cases, joint and bone diseases and sports injuries that require advanced surgical procedures and physiotherapy for a complete repair. Zoi Hospitals is among the few hospitals to perform computer navigation assisted shoulder replacement. The advantage of using computer navigation is the precision of cuts and implant placement which allows for early rehabilitation and increases the longevity of the prosthesis.

At Zoi orthopaedic hospital, we don’t just provide orthopaedic treatment, we make sure that you get back in action as soon as possible.

Orthopaedic problems don’t simply appear. Instead, they slowly develop over time. Because of this, it’s common for them to start appearing as people age. A few are lucky and dodge any serious issues, but those cases are certainly rare. Whether it’s osteoporosis or osteoarthritis, nearly everyone deals with something.

If you are concerned, it’s important to account for these problems now. Learning about your risk and what can compound issues can prevent serious injury down the road. Of course, orthopaedic problems aren’t like the rest. Very few are the result of genetics, but instead actions that you take every day. Whether it’s long hours at the computer or running in harsh conditions or the lifestyle changes which are everywhere now, the things you do or don’t do are what put you at risk. Taking action now is the best way to deal with these conditions, as prevention is often more effective than treatment.

If you take care of your health, you can prevent some of them, though. If you are concerned, these are some orthopaedic problems to watch for as you age.

What are the common orthopaedic problems in old people?

1. Osteoarthritis

1 in 3 older adults is affected by Osteoarthritis. This is a degenerative disease that largely affects the hands, ankles, fingers, spine, and knees. Osteoarthritis makes it difficult to perform everyday activities, especially those that require flexibility, movement or fine motor dexterity. Your orthopaedic specialist can recommend treatments to decrease the pain and increase ease of motion.

2. Fractures

This is another serious problem facing the elderly. As people age, their bone mineral density decreases. This is typically problematic in post-menopausal women. Decreased mineral levels result in weaker, more brittle bones. It gets worse as older adults have more unsteady balance and vision problems, this is the cause for increased risk of fractures. Strength training exercises are useful to increase bone strength, which can minimise the likelihood of fracturing a bone.

3. Dislocations

When a joint becomes dislocated, the bones that make up that joint shift from their original place. This commonly happens after a fall, in which the jolt knocks bones out of the joint. Older adults having dislocated joint experience immediate pain, which reduces after a physician helps put the joint back in place.

4. Osteoporosis

Bone mass peaks at about 30 years of age and starts decreasing as we age. This increases the risk of osteoporosis in older adults. This is a bone disease that is related to decreased bone density and low overall bone mass. When the bone production process cannot keep up with bone loss, the bones become brittle and weak.

Six ways to prevent orthopaedic problems while you age

1.Maintain a healthy weight:

For every 10 lbs. of weight gained, there is a 36% increased risk of developing osteoarthritis. Obesity also puts more weight on your joints, which can weaken muscles and make injuries more likely.

2. Keep it moving:

Good exercises for everyone – even those with some orthopaedic sensitivity – include stretching, walking, swimming and biking on level ground. Try to avoid exercises that put too much stress on your joints, like deep knee bends. But keep working to increase muscle mass no matter your age.

3.Develop a strong core:

Strong core muscles help you balance your body weight. Yoga and Pilates are two good kinds of exercise to strengthen your core and promote orthopaedic health.

4. Stretch before exercise:

Stretching is important to maintain flexibility, improve performance and decrease stress injuries like sprains and strains. If you’re going to lift weights or do high impact aerobics, work on warm-up and stretching exercises before and after exercise. These types of exercises promote increased flexibility and help prevent muscle and joint injuries.

5. Wear comfortable shoes:

Supportive shoes promote proper alignment. Women who wear high heels on a regular basis increase their risk of developing back pain and knee pain.

6. Get regular checkups:

Yearly visits to your primary care doctor are one great way to stay on top of your orthopaedic health. This is especially important for older adults, who can be more likely to develop arthritis and suffer injuries. A primary care doctor can discuss additional preventive measures to protect your orthopaedic and overall health.

When to visit a doctor? / If your home remedies fail, visit your doctor

If you’re still experiencing pain in your muscles, joints, or bones after following the tips above you might have to see a doctor. If you have any of the following symptoms, we recommend you make an appointment with your physician to be evaluated.

– You have pain, stiffness, or discomfort that are making it difficult to perform everyday activities

– You are experiencing chronic pain (pain lasting longer than 12 weeks)

– You’re noticing decreases in your range of motion

– You feel unstable while walking or standing

– You have had a soft tissue injury, and it’s not improving after 48 hours

Zoi Hospital’s orthopaedic department might be your best option for treatment

In Zoi’s orthopaedics and traumatology department, each of our orthopaedic doctors is an expert in a specific area of orthopaedics, which means that you will always receive individualized care and specialized treatment.

The department of Orthopedics and Traumatology specialises in handling accident and trauma cases, joint and bone diseases and sports injuries that require advanced surgical procedures and physiotherapy for a complete repair.

Our orthopedists perform a variety of procedures including knee ligament tear surgery (with the most common being ACL repair surgery, partial and total knee replacement, total hip replacement, computer navigation-assisted joint replacement, shoulder injury repair surgery and spine surgery (especially minimally invasive techniques), all of which are performed by some of the best orthopedic surgeons in Hyderabad.

At Zoi orthopaedic hospital, we don’t just provide orthopaedic treatment, we make sure that you get back in action as soon as possible.

Physiotherapists are trained health care professionals who have in-depth knowledge of how organ systems of the body function and specialize in hands-on clinical skills to assess, diagnose, and treat specific symptoms of illness, injury and disability.

When and why is Physiotherapy needed?

Physiotherapy can help people with a wide variety of musculoskeletal conditions and orthopedic problems like back pain, neck pain, frozen shoulder, knee pain, ligament injuries. They also help in relieving pain for most of the muscle and joint related injuries, post-fracture or post-surgical conditions and help the patient get back to normalcy.

Physiotherapy helps in also treating neurological conditions like brain stroke, paraplegia, peripheral nerve injuries. In the geriatric population, it helps them manage and go about conditions like Parkinson’s, balance training to prevent the risk of falls, while in gynaecological conditions, physiotherapy helps to ease the mother during her labour. In case of prolonged bed rest, they help in maintaining lung function and preventing infections like pneumonia and bedsores.

Some of the clinical areas where physiotherapy practises are also applicable are paediatrics and sports medicine.

In all the above-mentioned specialities once the disability sets in, due to the nature of a particular ailment, daily activities like moving around without support, walking, driving, doing household chores become a big challenge. It is under such circumstances when a designed active treatment plan of care that the patient is helped with.

Types of Physiotherapy treatments:

There are different procedures employed for every patient. This depends on the physical ailment, severity, age of the patient and more such factors. Some of the common procedures used are,

1. Exercise therapy

It involves the use of therapeutic exercise in a planned and systematic way to improve strength, reduce pain and enhance the performance of body movements which aim to restore full-fledged physical function.

2. Electrotherapy

It is the use of electrical current on specific areas of the body to treat pain and muscle weakness. This is done in the form of ultrasound, Transcutaneous electrical nerve stimulation (TENS), Interferential Therapy (IFT), Short Wave Diathermy (SWD) & muscle stimulation.

3. Manual Therapy

Manual therapy involves the use of hand techniques such as joint mobilisations, joint manipulations, spinal manipulation, instrument assisted soft tissue mobilisations(IASTM).

4. Muscle/Joint Kinesio & Rigid tapping

Neurodynamics is to treat musculoskeletal pain. It is also used for gait training, muscle stretching, ergonomic education and injury prevention.

Benefits of Physiotherapy:

Regular physiotherapy benefits people of all ages who suffer from any variety of ailments or injuries. From car accidents to sports injuries, lower back pain, post-surgery stiffness and musculoskeletal conditions, physiotherapy empowers you to strengthen your body to your pre-injury fitness level.

Say Goodbye to pain:

Pain comes in many forms and is usually the main reason to see a physiotherapist. Aches and pains can be the result of a motor vehicle injury, a sprained ankle from basketball practice, carpal tunnel syndrome from a poorly set up workstation, or chronic lower back pain that started long before you can even remember. It doesn’t matter how bad the pain is, if it affects your performance at work, at the gym, on the field or at home, you need to do something about it. Physiotherapy can help you manage, mitigate or even eliminate the pain so that you can get back to enjoying your physical activities.

Enjoy a Personalised Approach:

The beauty of physiotherapy is that, like other therapies, your path to recovery is completely tailored to your needs. Your physiotherapist will make an assessment of your pain and your physical capabilities and develop a personalized recovery program that can be adjusted at any time. Physiotherapy is not a one-size-fits-all solution for the simple fact that we are all so different, and even two people with the same injury may have a separate physiotherapy recovery program based on their age and ability.

Prevent future Injury:

Physiotherapists treat people of all fitness levels, from professional athletes to people who haven’t been to the gym in years. Depending on your injury, your physiotherapist will take the time to show you how to properly move your body in order to avoid stress on your joints and maximize the benefits of a workout, thereby preventing future sprain, strain or break.

To understand why it has become so common, we would have to analyze the evolution of humans. Humans evolved from walking on four legs to standing, after hundreds of years. But unfortunately, our spine is not yet adapted to prolonged periods of sitting. In modern society, we subject our spine to a restricted sitting position for 10-14 hours per day. This coupled with lack of fitness, obesity and stress worsens the existing condition.

It is imperative that the person takes certain precautions to prevent the condition from recurring.
Some steps one can take to avoid suffering from back pain are:

1. Adopt a correct posture while sitting.

2. Take frequent breaks from sitting. Do not sit continuously for more than 40 mins. Take a break, walk around for 5 minutes, stretch or even stand and work.

3. Practice regular back and core strengthening exercises. Indulge in swimming, yogasana, pranayama or pilates for at least 20 minutes a day.

4. Avoid junk food as excess weight around the waist directly affects the spine and causes pain.

5. Invest in an ergonomic chair.

6. Avoid lying in a bent posture to read books or watch TV.

Most of these back pains are self-limiting and disappear with rest, lifestyle changes, massages and if needed anti-inflammatory medications. A person who has experienced back pain and has recovered must know that the pain they have experienced is the beginning of their battle with spinal problems. However, a mindful note of the tips mentioned above and the day-to-day practice of the same would most likely help anyone dodge the lower back pain epidemic.

What is an Anterior Cruciate Ligament (ACL) surgery?

Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury.

What is an ACL injury?

An ACL injury is one of the most common ligament injuries in the body. An ACL injury occurs due to the twisting of the knee, suddenly and in the opposite direction of the thigh.

What are the symptoms of a typical ACL injury?

A typical ACL injury causes pain and buckling of the knee. The acute pain subsides for 2-3 days, after which, patients are left with the knee instability of varying degree. This non symptomatic injury, often makes patients have a false sense of complete recovery. But on repeat injury the instability becomes aggravated.

What are the causes of a typical ACL injury?

A few of the common causes of an ACL injury are listed below:
Suddenly slowing down and swiftly changing direction
Pivoting your foot in one place
Landing from a high jump incorrectly
Receiving a direct blow to the knee

Who are the commonly affected people?

Active young adults, athletes and two-wheeler drivers are the commonly affected individuals. But it can happen to anyone who is up and about. Getting off a moving bus for example, could lead to a twisted knee.

Do I Need This Surgery?

At Zoi Hospitals, ACL reconstruction is generally recommended by expert orthopaedic surgeons if:
1. You’re an athlete and want to continue in your sport, especially if the sport involves jumping, running or pivoting
2. More than one ligament in your knee is injured
3. The injury is causing hindrance to your everyday activities or is affecting your confidence to go back to the kind of lifestyle you want or had.
4. You’re young and can recover quickly

Treatment for ACL injury:

The treatment for an ACL injury is done by either repairing the torn ligament or reconstructing the deficient ligament. This is done by taking a graft from the hamstring tendons, patella or IT band on the outer side of the thigh.

‘Keyhole surgery’ is a short process which is performed by an orthopaedic surgeon. It is minimally invasive and done through sub cm incisions. Patients are made to walk on the same or next day of the procedure and most of them get back to work in two weeks. The time taken to start playing sports or squatting varies from 3-5 months, based on the patient’s rehabilitation program and fitness levels.

Cost and benefits of ACL surgery at ZOI:

Zoi has a team of two arthroscopy surgeons and three rehabilitation specialists who work together to customize the surgery and rehabilitation program to suit the individual.

At Zoi, the most common variety of ACL reconstruction is via the ‘All in Technique’. This technique has the benefit of minimizing the amount of graft harvested from the patient’s body, which helps in reducing tissue disturbance and in improving postoperative recovery.

Traditional ACL reconstruction entails sacrificing two of the hamstring tendons, whereas, with the ‘All in Technique’, the same results are achieved with one tendon only.

Zoi has the largest series of ‘All in Technique’ ACL reconstruction surgery in South India. The surgeons frequently demonstrate this technique to other arthroscopic surgeons at other locations. At Zoi Orthopaedic Hospitals, Hyderabad, we are committed to facilitating the best course of treatment for all patients. The cost at Zoi, Hyderabad, for this surgery is between 1-1.5 lakhs.

What are some simple exercises to practice for a quick recovery from ACL surgery?

In an ACL injury, the ligament in the middle of the knee which prevents the shin bone from sliding out near the thigh bone is partially or completely torn. This injury affects the stability of your knee, resulting in reduced knee strength and decreased motion.
According to expert orthopaedic surgeons of Zoi Hospitals, Hyderabad, after an ACL reconstruction surgery, physical rehabilitation will help you reap the full benefits of the surgery.

– Here are a few simple exercises to speed up the recovery process.

Ankle Pumps:

Lie flat on your back with your knees straight. Bend the ankle up and down as far as possible in both directions. Repeat with the other leg.

Heel Slides:

Lie flat on your back with your knees straight. Slowly slide your heel in toward your buttocks. Straighten back to starting position. Please keep your foot on the surface at all times. Repeat with the other leg.

Straight Leg Raise:

Lie flat on your back with your uninvolved leg bent and feet flat on the surface. Tighten your thigh and lift your involved leg. Keep your knees straight. Repeat with the other leg.

Side Lying Abduction:

Lie flat on your uninvolved side. Bend your uninvolved leg forward. Raise involved leg about five inches and then lower to starting position. Do not allow your toes or knee to turn upward. Repeat with the other leg.

Knee Press:

With your legs straight and a towel rolled up under your ankle, press your knee down for contracting your thigh muscles. Hold for 5 seconds and then relax. Repeat with the other leg.

Regular practice of the above-mentioned exercises will help anyone post an ACL operation recover faster and better. Also, a regular check-up now and then with the orthopaedic specialists at an orthopaedic hospital in Hyderabad, post surgery will help the doctor analyze the patients’ situation and heal suitably in a short time.

Read more about how to recover from an ACL surgery.

Using special instrumentation and video cameras, spine surgeons can now perform surgery through small incisions.

What is endoscopic spine surgery?

Endoscopic spine surgery is a Keyhole surgery of the spine. It is used to treat disc prolapse, disc bulges, sequestrated disc and canal stenosis of the spine.

Causes of endoscopic spine injury:

The human spine consists of bony blocks called ‘vertebrae’ which are stacked one on top of the other. The intervening space has an intervertebral disc, which consists of a jelly-like internal material called ‘nucleus pulposus’ and a fibrous external covering called ‘annulus fibrosus’.
Certain conditions cause the external covering to tear, leading the internal jelly-like nucleic fluid to leak into the spinal canal which comprises of the spinal cord.
The conditions which lead to this are mostly poor posture, sudden loading of the spine, injuries, smoking, being overweight and poor fitness.

Who needs an endoscopic spine surgery?

Patients who have suffered from a slipped disc, experience a sharp pain in the back associated with a catch, bent posture or sciatica (shooting pain going into the legs). This is a common illness which is estimated for over 40% of adults. Fortunately, the majority of the patients recover and become pain-free.

Patients who do not recover from this pain in four months, have an exponential increase of pain or have a neurological deficit in the form of numbness/weakness of the lower limb and bladder bowel disturbance, will need immediate surgery.

Types of Endoscopic spine surgery:

1. Traditional disc surgery:

A traditional disc surgery would consist of removing the posterior 1/3rd of the vertebrae (laminectomy) to access the disc. This results in prolonged recovery and de-stabilizing the spine which may eventually call for a second surgery in 15% of the operated patients.

2. Endoscopic discectomy:

An endoscopic discectomy achieves the same without disturbing the posterior part of the vertebrae. The advantages are lesser post-operative pain, faster recovery and less chance of failures. The spine surgeons at ZOI, Hyderabad, have been performing these procedures since the last 15 years.

Operation procedure:

In an endoscopic discectomy, the patient is anaesthetised, made to lie prone on the operating room and a small incision of 2-3 cms is made. A cannula is inserted under fluoro guidance up till the spine. Through this cannula, one camera and two surgical instruments are inserted. The prolapsed loose disc is identified and excised.

The procedure takes about 45- 60 minutes and then the patient is discharged either on the same day or the next day.

Treatment:

The normal recovery process varies from 1-3 months based on patient’s general health and weight. Most patients are made to walk on the same evening and are discharged the next day. Patients are encouraged to walk, perform their daily routine from the 2nd day onwards. Oral medications for pain, muscle relaxants and neurotonic drugs may be prescribed for a few weeks.

Recovery:

The recovery post endoscopic discectomy is very rapid compared to a laminectomy. Patients are permitted to walk, climb stairs and take part in activities which do not entail lifting weights, bending and floor sitting from the 2nd day onwards. Sitting at a desk and working is best avoided for a couple of weeks.

We advise patients to avoid sitting continuously for more than 45 minutes at a stretch, patients who are desirous of going back to work are permitted to do so with these precautions.

Driving a 4-wheeler for short distances is permitted based on the level of back pain and discomfort. However 2 wheeler driving is strictly prohibited for a minimum of 4 weeks.

Physical therapy:

At Zoi we do not advise exercises under the guidance of physical rehab specialist for the first 3 weeks. These 3 weeks gentle exercises are taught and the patient is encouraged to perform these by him/her self without a therapist.

Most patients are advised to undergo intensive therapy under the supervision of a physiotherapist from the 4th week onwards for 1-3 weeks.

The intention is to regain full fitness and get back to physical activity. Post completion of this, patients are permitted to perform floor sitting, 2-wheeler driving and playing sports.

Who are at risk of osteoporosis?

There are a few factors which increase the risk of osteoporosis. These factors include:

1. Age: With age, the risk of osteoporosis increases.
2. Gender: Women are more prone to osteoporosis than men. 1 in 3 women is at risk of osteoporosis whereas 1 in 5 men is at risk of osteoporosis. Women who are past menopause and older than 45 are more susceptible to it.
3. Hereditary: A family history of osteoporosis rises the risk of osteoporosis.
4. Sedentary lifestyle: Lack of a healthy lifestyle puts the younger generation at risk of osteoporosis.
5. Inadequate exposure to sunlight: This is a rising phenomenon even in tropical countries like India. Inadequate exposure leads to a deficiency of vitamin D which in turn hinders the development of bones.
6. Smoking: Recent research studies have shown that smoking is a risk factor for osteoporosis.
7. Consumption of alcohol: Alcohol affects all the parts of the body and chronic consumption of alcohol increases the risk of osteoporosis.
8. Zealous use of skin sunscreen creams
9. Irregular food habits: Consumption of food diet which is low in calcium can put one at risk of osteoporosis. Eating disorders that lead to being underweight also make a person prone to osteoporosis.
10. Medical conditions: People with underlying medical conditions like cancer, lupus, arthritis are also susceptible to osteoporosis.

What are the symptoms of osteoporosis?

Osteoporosis in the early stages does not showcase any symptoms. But over a period, bone degenerates progressively which show the symptoms like:

1. Back pain
2. Loss of height over time
3. A stooped posture
4. A bone fracture with minor accidents

How is osteoporosis diagnosed?

The bone density is measured by a machine that uses low levels of X-rays to determine the proportion of minerals in your bones. This is a Bone Mineral Density scan or BMD or DXA scan. We incorporate this scan in many of our health packages and we have special check-ups for detecting and assessing bone health.

How can one prevent osteoporosis?

A lifestyle management which includes regular exercise and healthy eating is vital to keep the bones healthy. A few ways to prevent osteoporosis are:

1. Body weight: Being underweight increases the risk of osteoporosis, therefore, an ideal weight for the body should be maintained for good health in general.
2. Healthy diet: Healthy food that ensures consumption of an adequate amount of nutrients should be consumed. Nutrients required to fight against osteoporosis are:
   • • a. Proteins: These are the building blocks of every bone. One should consume enough amount of proteins especially, vegetarians and vegans who do not get enough supply of proteins.
     • b. Calcium: Our bones are composed of calcium and other minerals. The old calcium is removed and replaced by new calcium. If new calcium is not supplied adequately, the bone grows weaker. Therefore, it is important to consume the correct amount of calcium through low-fat dairy products, dark green leafy vegetables, canned salmon or sardines with bones, soy products such as tofu
       calcium-fortified cereals and orange juice. Calcium supplements should be consumed only after consultation with an orthopaedic doctor.
     • c. Vitamin D: Vitamin D is essential for strengthening the bones as it helps in calcium absorption. Ensure your daily dose of vitamin D with a walk in the morning sun.Healthy diet: Healthy food that ensures consumption of an adequate amount of nutrients should be consumed. Nutrients required to fight against osteoporosis are:

3. Exercise: Exercising regularly helps in slowing the process of bone breakdown and thus retain bone strength.
4. Lifestyle changes: Along with a healthy diet and exercise, a lifestyle change such as avoiding smoking and drinking alcohol and coffee should be incorporated. People at higher risk of osteoporosis should check their calcium levels and bone density levels regularly.

What is ACL?

The ACL or Anterior Cruciate Ligament is one of the four ligaments of the knee joint. In the human body, the knee joins the thigh with the leg and consists of two joints – one between the femur (thigh bone) and tibia (shin bone) and the other between the femur and the patella (knee cap).

The ligaments are like tough elastic bands of fibrous tissue that holds the knee joint together and create flexibility in the knee joint.

Why does one need ACL Surgery?

ACL reconstruction surgery is needed when there is a tear in the ACL due to injury. ACL injury may occur due to playing sports which require pivoting and sudden change in direction of movement like cricket, football, basketball, tennis, badminton and others or it can occur in people who ride two-wheelers frequently where they need to turn their vehicles with support from one foot. Patients often report that they heard their knee “pop” while playing sports or riding a bike.

When the ACL tears it usually doesn’t heal by itself, in fact, it’s one of the few body parts that doesn’t heal by itself. The only solution is a reconstruction surgery.

Watch Dr Ramesh Chandra Katragadda, our expert Orthopedic Surgeon explain in detail about ACL reconstruction surgery.

What is the procedure to perform ACL reconstruction?

In ACL reconstruction, the torn ligament is removed and replaced with a piece of tendon from another part of the knee. This surgery is performed through small incisions around the knee joint.

Why is ACL reconstruction recommended?

If a patient has an ACL tear, every time they walk down the stairs, jump or play sports, the patient feels like the knee will buckle and sometimes the knee does buckle. An ACL reconstruction is recommended to get back to full fitness, not just settling for being able to walk. It’s highly recommended for sports persons or athletes as they can get back to playing sports after a few months of the surgery. It is also recommended for people who have a normal level of activity after the injury because there are chances of reinjury if the ACL tear is neglected.

Recovering After ACL Surgery

If the patient has had an ACL reconstruction procedure, they can begin walking the next day of the surgery. Before the patient is sent home, they are made to practice walking with crutches, and the surgeon may ask them to wear a knee brace or splint to help protect the graft.
Our expert surgeon gives patients specific instructions on how to control swelling and pain after surgery. In general, it’s important to keep one’s leg elevated, apply ice to one’s knee and rest as much as possible. Some medication will be prescribed and must be taken according to the instructions,

Patients must follow the surgeon’s advice on when to ice the knee, how long to use crutches and when it’s safe to bear weight on the knee. Patients are also instructed when they can shower or bathe, when they should change dressings on the wound, and how to manage post-surgery care.

Progressive physical therapy after ACL surgery helps to strengthen the muscles around the knee and improve flexibility. A physical therapist will teach the patient how to do exercises that they will perform either with continued supervision or at home. Following the rehabilitation plan is crucial for proper healing and achieving the best possible outcomes.

Successful ACL reconstruction paired with focused rehabilitation can usually restore stability and function to the knee. Within the first few weeks after surgery, the patient should strive to regain a range of motion equal to that of their opposite knee.
Usually the patient can walk on the next day, climb stairs after 40 days of the surgery, go for a jog after 2 months and ride a bike after 4 months of the surgery.

According to expert orthopedic surgeons and doctors of Zoi Hospitals, after the surgeons perform an ACL reconstruction surgery, physical rehabilitation will help you reap the full benefits of the surgery.

Here are a few simple exercises to speed up the process of the recovery.

Ankle Pumps:

While lying flat on your back with your knee straight, bend the ankle up and down as far as possible in both directions. Repeat with other leg.

Heel Slides:

While lying flat on your back with your knees straight, slowly slide your heel in toward your buttocks. You should then straighten to the starting position. Please keep your foot on the surface at all times. Repeat with other leg.

Straight Leg Raise:

While lying flat on your back with your uninvolved leg bent and your foot flat on the surface, tighten your thigh and lift your involved leg. Keep your knee straight. Only lift to the height of the uninvolved knee. Repeat with other leg.

Side Lying Abduction:

While lying flat on your uninvolved side bend your uninvolved leg forward. Raise involved leg about five inches and then lower to starting position. Do not allow your toes or knee to turn upward. Repeat with other leg.

                   

Knee Press:

With your legs straight and a towel rolled up under your ankle, press knee down for contracting your thigh muscle. Hold for 5 seconds and then relax. Repeat with other leg.

These exercises may not seem easy at first, but with time and repetition, you will be able to do them without much struggle. It’s also important to consult an orthopedic doctor or an expert physiotherapist to get the right information. If you’re looking for an orthopedic doctor’s and/or physiotherapist’s guidance, Zoi Hospitals has an expert orthopedic and physiotherapy and rehabilitation department that can guide you through this process. To know more about the department, click here : https://zoihospitals.com