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DISLOCATION

Bone Fractures & Joint Dislocation Two of the most common bone and joint injuries are fractures and dislocations. Both injuries should be considered emergency situations and set into place as soon as possible by a trauma specialist. Moving a fractured or dislocated bone may cause further damage to the bone and surrounding blood vessels, nerves and tissue. Types of bone fractures Bone fractures can happen in a variety of ways, including accidents, repetitive stress injuries, osteoporosis and tumors. The most common types of bone fractures are: Closed or simple bone fracture: a break in the bone in which the skin is still intact Open or compound bone fracture: a break in the bone in which the skin is perforated by the bone or by a blow at the time of the fracture Segmental or multiple bone fracture: a break at two or more places on the same bone Comminuted bone fracture: a break in which the bone is shattered into pieces The line of the bone fracture may be: Transverse: Forms a right angle with the axis of bone Oblique: Runs slanted to the axis of the bone Longitudinal: Runs along the line of its axis Joint dislocations Joint dislocation is the displacement of a joint from its normal position, usually caused by a blow, fall or other trauma. In addition to displaced bones, there may be damage to the joint capsule and surrounding muscles, blood vessels and nerves. Symptoms of joint dislocations include loss of motion, swelling and pain and sometimes a joint visibly out of place.

ARTHROSCOPY

Arthroscopy of the Knee Joint The arthroscope is a fiber-optic telescope that can be inserted into a joint (commonly the knee, shoulder and ankle) to evaluate and treat a number of conditions. A camera is attached to the arthroscope and the picture is visualized on a TV monitor. Most arthroscopic surgery is performed as day surgery and is usually done under general anesthesia. Knee arthroscopy is common, and millions of procedures are performed each year around the world. Arthroscopy is useful in evaluating and treating the following conditions Torn floating cartilage (meniscus): The cartilage is trimmed to a stable rim or occasionally repaired Torn surface (articular) cartilage Removal of loose bodies (cartilage or bone that has broken off) and cysts Reconstruction of the Anterior Cruciate ligament Patello-femoral (knee-cap) disorders Washout of infected knees General diagnostic purposes Basic Knee Anatomy The knee is the largest joint in the body. The knee joint is made up of the femur, tibia and patella (knee cap). All these bones are lined with articular (surface) cartilage. This articular cartilage acts like a shock absorber and allows a smooth low friction surface for the knee to move on. Between the tibia and femur lie two floating cartilages called menisci. The medial (inner) meniscus and the lateral (outer) meniscus rest on the tibial surface cartilage and are mobile. The menisci also act as shock absorbers and stabilizers. The knee is stabilized by ligaments that are both in and outside the joint. The medial and lateral collateral ligaments support the knee from excessive side-to-side movement. The (internal) anterior and posterior cruciate ligaments support the knee from buckling and giving way. The knee joint is surrounded by a capsule (envelope) that produces a small amount of synovial (lubrication) fluid to help with smooth motion. Thigh muscles are important secondary knee stabilizers. Investigations A routine X-Ray of the knee, which includes a standing weight-bearing view is usually required. An MRI scan which looks at the cartilages and soft tissues may be needed if the diagnosis is unclear. There is little value in the use of Ultrasound in investigating knee problems. Meniscal Cartilage Tears Following a twisting type of injury the medial (or lateral) meniscus can tear. This results either from a sporting injury or may occur from a simple twisting injury when getting out of a chair or standing from a squatting position. Our cartilages become a little brittle as we get older and therefore can tear a little easier. The symptoms of a torn cartilage include Pain over the torn area i.e. inner or outer side of the knee Knee swelling Reduced motion Locking if the cartilage gets caught between the femur a tibia Cartilage Tears Once a meniscal cartilage has torn it will not heal unless it is a very small tear that is near the capsule of the joint. Once the cartilage has torn it predisposes the knee to develop osteoarthritis (wear and tear) in 15 to 20 years. It is better to remove torn pieces from the knee if the knee is symptomatic. Torn cartilages in general continue to cause symptoms of discomfort, pain and swelling until the loose, ragged pieces are removed. Only the torn section is removed and the knee should recover and become symptom free. If the entire meniscus is removed, the knee will develop osteoarthritis in 15 to 20 years. It is standard to remove only the torn section of cartilage in the hope that this will delay the onset of long-term wear and tear osteoarthritis. Occasionally, provided the knee is stable and the tear is a certain type of tear in a young patient (peripheral bucket handle tear), the meniscus may be suitable for repair. If repaired, one has to avoid sports for a minimum of three months. Articular Cartilage (Surface) Injury If the surface cartilage is torn, this is most significant as a major shock-absorbing function is compromised. Large pieces of articular cartilage can float in the knee (sometimes with bone attached) and this causes locking of the joint and can cause further deterioration due to the loose bodies floating around the knee causing further wear and tear. Most surface cartilage wear will ultimately lead to osteoarthritis. Mechanical symptoms of pain and swelling due to cartilage peeling off can be helped with arthroscopic surgery. The surgery smoothes the edges of the surface cartilage and removes loose bodies. Anterior Cruciate Ligament Injuries Rupture of the Anterior (rarely the posterior) Cruciate Ligament (ACL) is a common sporting injury. Once ruptured the ACL does not heal and usually causes knee instability and the inability to return to normal sporting activities. An ACL reconstruction is required and a new ligament is fashioned to replace the ruptured ligament. This procedure is performed using the arthroscope. Patella (knee-cap) Disorders The arthroscope can be used to treat problems relating to kneecap disorders, particularly mal-tracking and significant surface cartilage tears. Patients may need to stay overnight if a lateral release has been performed as knee swelling is quite common. The majority of common kneecap problems can be treated with physical therapy and rehabilitation. Inflammatory Arthritis Occasionally arthroscopy is used in inflammatory conditions (e.g. Rheumatoid Arthritis) to help reduce the amount of inflamed synovium (joint lining) that is producing excess joint fluid. This procedure is called a synovectomy. After the surgery a drain is inserted into the knee and patients generally require one or two nights in hospital. Bakers Cysts Bakers cysts or popliteal cysts are often found on clinical examination and ultrasound / MRI scan. The cyst is a fluid filled cavity behind the knee and in adults arises from a torn meniscus or worn articular cartilage in the knee. These cysts usually do not require removal as treating the cause (torn knee cartilage) will in most cases reduce the size of the cyst. Occasionally the cysts rupture and can cause calf pain. The cysts are not dangerous and do not require treatment if the knee is asymptomatic. New Technology Isolated areas of articular cartilage loss can be repaired using cartilage transplant technology. This is a new and exciting field that is developing in the treatment of specific isolated cartilage defects in younger patients The process is called Autologous Chondrocyte Grafting . It involves harvesting cartilage cells from the affected knee, sending these cells to a laboratory and then culturing the cells to multiply into many cells. The large amount of cells produced are then placed back into the affected knee into the defect requiring resurfacing. Results are still short-term follow-up but are looking encouraging. After a major cartilage or ligament injury has been treated the knee can return to normal function. There is however a small increase in the risk of developing long-term wear and tear (Osteoarthritis) and depending on the degree of injury activity modification may be required. Activities that help prevent knees deteriorating quickly include: Low impact sports like swimming, cycling and walking Reducing weight and maintaining a healthy diet Arthroscopy of the Knee: Patient Information Please stop taking Aspirin and Anti-inflammatory medications 5 days prior to your surgery. You can continue taking all your other routine medication. If you smoke you are advised to stop a few days prior to your surgery. You will be admitted on the day of surgery and need to remain fasted for 6 hours prior to the procedure. The limb undergoing the procedure will be marked and identified prior to the anesthetic being administered. Once you are under anesthetic, the knee is prepared in a sterile fashion. A tourniquet is placed around the thigh to allow a ‘blood – free' procedure. The Arthroscope is introduced through a small (size of a pen) incision on the outer side of the knee. A second incision on the inner side of the knee is made to introduce the instruments that allow examination of the joint and treatment of the problem. Post-operative Recovery You will be taken to your room A bandage will be around the operated knee. Once you are recovered your IV will be removed and you will be shown a few exercises to do. Your Surgeon will see you prior to discharge and explain the findings of the operation and what was done during surgery. Pain medication will be provided and should be taken as directed You can remove the bandage in 24 hours and place waterproof dressings (provided) over the wounds. It is NORMAL for the knee to swell after the surgery. Elevating the leg when you are seated and placing ice packs on the knee will help to reduce swelling. (Ice packs on for 20 min 3-4 times a day until swelling has reduced) You are able t return to work when comfortable unless otherwise instructed. Appointment given 7-10 days after surgery to monitor your progress and remove the 2 stitches in your knee at 15 day post operative. Risks of Arthroscopy Post –Operative Exercises and Physical Therapy Following your surgery you will be given an instruction sheet showing exercises that are helpful in speeding up your recovery. Strengthening your thigh muscles (Quadriceps and Hamstrings) is most important. Swimming and cycling (stationary or road) are excellent ways to build these muscles up and improve movement.

Hip Replacement Surgeon

If you are thinking to undergo hip replacement surgery, then you must explore different aspects related to this surgery. You can also explore other treatment options, but this treatment will provide you permanent solution for your problem. Here we are providing some essential information about hip replacement surgery which will help you in taking your decision. The hip is one of the largest joints of the body. Arthritis is the most common cause of chronic hip pain & disability. Some of the common diseases or causes behind hip pain are given below: Osteoarthritis Rheumatoid arthritis Post-traumatic arthritis Avascular necrosis Childhood hip disease In case of hip damage or disability due to arthritis, fracture, injury or other conditions, it becomes difficult for the patients to carry out common day-to-day activities like walking, getting in and out of chair. The patient may feel pain and difficulty while performing these regular activities. Even resting may become uncomfortable for the patients. The candidates who can undergo total hip replacement surgery are: No age or weight restrictions are there for this surgical process. This surgery is based on the level of patient’s pain & disability and his/her medical history. The total hip replacement is also known as total hip arthroplasty. In the process of total hip replacement in Pune, prosthetic components are used to replace the damaged bone and cartilage. Your surgeon can recommend this surgery in case of following conditions: Restriction in regular activities like walking or bending due to hip pain. Difficulty in the ability to move or lift the leg because of stiffness in hip. Continuous hip pain even while resting, either day or night. When anti-inflammatory drugs, physical therapy, or walking supports are not sufficient enough to provide adequate pain relief. The hip replacement surgery can benefit the patient in case of above conditions and the patient can resume his/her routine activities through efficient post-treatment care. Dr. Rajendra Latkar has the expertise as one of the best hip replacement surgeons in Pune. You need to follow the instructions and exercises suggested by your surgeon after this treatment. This will help you in fast recovery and also in restoring your mobility and strength.

Joint Replacement - Dr Rajendra Latkar

Joint Replacement In Aundh Total Knee Replacement Surgery Healthy knees are mandatory to carry out everyday activities in a smooth manner as knee is the largest joint in the body. Any disease or injury can disrupt the components of knee and thus resulting in the muscle weakness and reduced function. The severe damage of knee due to arthritis or injury can cause pain and trouble in performing simple and regular activities like walking and climbing stairs. The knee pain and deformity generally takes places due to Arthritis. The three most common types of arthritis are osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. It is preferable to consider knee replacement surgery in pune rather than opting for non-surgical treatments such as medications and walking supports. These non-surgical treatments provide temporary results while surgical treatment provides long-lasting outcomes. The joint replacement procedures are safe and effective and they result in pain relief and correction of leg deformity. In this way, you’ll be able to resume your regular activities without any difficulty. The knee replacement in pune can also be known as knee resurfacing. In this procedure, the surface of the bones are replaced. This procedure of knee resurfacing can be divided into four steps which are: Preparing the bone Positioning the metal implants Resurfacing the patella (kneecap) Insert a spacer You should do a little research about the knee replacement cost in Pune before opting for a random surgeon. Furthermore, you also need to explore the treatment options and the reliable surgeons for the treatment of knee pain in Pune. The age and weight restrictions are generally not considered in case of total knee replacement surgery. The complexity of patients’s pain and disability decides the treatment procedure. There are several components that are considered by an orthopaedic surgeon for the evaluation of the case. These components are: Medical history Physical examination X-rays Other tests like blood test, MRI scan etc. Dr Rajendra Latkar is a preferable surgeon for performing joint replacement in Pune. He and his team of knee specialists in Pune have achieved successful results till now as they are skilled & experienced enough to handle the complex cases with the help of latest surgical innovations, modern tools & techniques.

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08042783152

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Pune, India, 411007

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