Wednesday, September 9, 2015

Lifestyle changes in knee osteoarthritis



Knee osteoarthritis is sometimes not considered to be a disease, it is simply a normal manifestation of ageing, like grey hair. Everyone will develop arthritis one day or the other, we are just genetically programmed to get it at different ages. Some develop it early, some develop it late. Knee arthritis is not the end of the road in terms of living an active lifestyle. With these suggested lifestyle modifications, you can delay or prevent the eventual manifestations of the disease.

Swim, swim, swim. It is a well known fact that in water we feel lighter due to the Archimedes principle. Stiff & painful joints ease up like magic in the water. If you don't know how to swim, simply walk across the length & breadth of the shallow section of the pool, or immerse your feet in the water, sitting on the edge. If you know how to swim, it is a great advantage. You know what, it is never too late to learn. If you also suffer from backache, it will improve with swimming. Another silent advantage is the amount of Vit D you make during an hour's swim with your body exposed to the sun!

Aerobic exercises for 30-60 minutes a day will keep you & your knees healthy. Brisk walking is one of the best forms of aerobic exercise. There is a lot of confusion regarding whether people with knee pain should do a regular morning walk or not. It is recommended that you walk on soft surfaces like grass or artificial turf or a high end treadmill with built in shock absorbing properties. Walking or running on hard concrete & similar surfaces can aggravate your knee pain. In case of confusion remember that apart from the knee you have a heart & a pair of lungs. They demand aerobic exercise & brisk walking is the best form of that. Exercise done properly didn't do anyone harm!

Resistance training or weight training done 2 times a week keeps your bones strong. You should do one type of exercise for the upper body like dumbbell curls & one variant for the lower body like the leg press. 8-12 repetitions should be targeted with 60-70% of the weight you can lift maximally. For example if you can do a biceps curl with 20 pounds, pick 12 pounds instead.

Let's face it. Orthopaedic exercise is boring. We forget to do it often enough. One of the biggest challenges is to remember when to exercise. If we set target oriented goals like doing a set of exercises immediately before breakfast, lunch & dinner, then we are more likely to remember to do the prescribed orthopaedic exercises.

Say no to certain things, like squatting, cross legged sitting. If you have a lift don't use stairs. If you don't have a lift, use the stairs as sparingly as possible. 


Watch this space for more relevant information that may help your sore knees. Till then get up & exercise!

Monday, January 17, 2011

Radiofrequency Chondroplasty, the latest buzzword for cartilage


Radiofrequency is a good tool in our hands that is enabling us to do our arthroscopic surgeries in a bloodless way. Chondroplasty or cartilage smoothening to put it roughly is an excellent procedure to smooth out mild to moderate cartilage defects & to get rid of the associated pain.

I use the Arthrocare Paragon T2, a state of the art temperature sensitive wand with a blue temperature sensitive ring which turns white when things get too hot. It relies on the Venturi effect (try to recall high school physics) to get rid of the irritating bubbles generated during the process.

On a lighter note the blue wand reminds me of carling beer, which has a lion as a logo. The lion should turn blue if the beer is kept at the right temperature.

Hamstring graft harvesting for knee ligament reconstructions


Hamstring graft harvest sets the tone for any arthroscopic ligament reconstruction procedure. It is technically demanding, yet once one masters the technique, the graft can be taken out through a tiny incision.

ACL reconstruction using quadrupled hamstrings graft


Arthroscopic ACL reconstruction is one of the most commonly performed ligament reconstruction surgery of the knee. It restores saggital & rotational stability to the knee & enables the patient to return to pre-injury levels of athleticism. This video demonstrates my technique of performing this surgery.

Video of arthroscopic surgery for the dislocating patella


The dislocating patella is a problem for which there is no clear solution. One of the minimally invasive methods to address this problem is to do an arthroscopic plication of the loose medial retinaculum.

Video of arthroscopic loose body removal from the knee


Loose bodies can play a cat & mouse game with the surgeon. Here you see 2 loose bodies of diametrically opposite sizes within the same knee joint & the video clearly shows how both can be removed with ease arthroscopically. Left alone these loose bodies cause recurrent episodes of locking & in the long run lead to early knee arthritis.