Using Total Knee Replacement for Knee Arthritis Problems

A knee joint works like a hinge at the junction of two bones, the thigh bone (femur) and the shin bone (tibia). The ends of the bones are covered with a thick cushion of soft, white cartilage. If this cartilage is damaged or worn away, the underlying bones rub together, causing the pain and inflammation of arthritis.

“Arthritis” is an inflammation of a joint causing pain, swelling, stiffness, instability and often deformity. Severe arthritis interferes with a person’s activities and limits lifestyle. The primary reason for a total knee replacement is to reduce pain and to improve your quality of life. It also helps to restore motion, straighten the leg; improve stability and the function of the joint. In total knee replacement, the surface of the joint is replaced with metal and plastic surfaces which can function similar to a normal joint.

This is accomplished by surgically trimming the arthritic ends of the bones and replacing them with new metal and plastic surfaces. In reality, a total knee replacement is a “resurfacing” of the joint. Most of the supporting ligaments, tendons and muscles around the knee joint are retained. The new joint’s surfaces mimic the natural knee it replaces.

Although the idea of getting an artificial knee joint may be intimidating, it is one of the safest and most effective medical procedures,it is important for care givers to know the kind of patients that actually qualify for 'having their knee Replaced" among those afflicted by severe knee Arthritis problems.

What Kind Of Patients Should Have a Total Knee Replacement?

Total knee replacement is recommended for patients with arthritis who have severe pain and limited function which significantly affects quality of life. The most common reason to have a total knee replacement is to relieve arthritic pain. The pain may not be excruciating at any particular time, but it is often chronic and disabling. Everyone’s pain is different, and the degree of pain sufficient to justify surgery should be decided by the patient and the doctor together.

Painful and arthritic knees can become unstable, causing falls and other injuries. Climbing stairs, getting up from chairs and extended walking can also be difficult.

While most arthritic knees are the result of degenerative arthritis or osteoarthritis, other conditions such as rheumatoid arthritis, trauma, prior surgeries, instability and tumors can also be relieved by total knee replacement.

How Long does a Total Knee Replacement Last?

It is next to impossible to determine on an individual basis it is impossible to predict how long a knee replacement will last. With newer materials and techniques, the lifespan of knee replacements continue to increase. The studies of modern knee replacement report clinical survivor ship of up to 97% of total knee implants at 12 to 15 years. A knee Replacement longevity also depends upon factors like lifestyle of the patient among many others..

Courtesy

Dr Neelam V. Ramana Reddy,
MS Ortho; MCh Ortho (UK)

Consultant Joint Replacement Surgeon Wockhardt Bone & Joint Hospital King Koti, Hyderabad.

To know more Wockhardt Hospitals Bone and Joint Care,center of Joint Replacements, or to schedule an appointment with Doctior Neelam Reddy,please visit wockhardthospitals

Benefits of Minmimal Invasive Knee Replacements

In Minimal Invasive technique the incision made is smaller than traditional knee replacement, also in the invasive procedure, the important quadriceps muscle and tendon are not disrupted as in traditional knee replacement. LifeART image ©2004 Lippincott Williams & Wilkins. All rights reserved.


Dr Neelam V. Ramana Reddy,Consultant Wockhardt Hospitals,Hyderabad shares his thoughts about Minimal Invasive Hip Replacement.

Total knee replacement (arthroplasty) is a surgery that is performed for severe degeneration of the knee joint. Knees wear out for a variety of reasons, which include inflammation from arthritis, injury or simple wear and tear arthritis.

Minimally invasive total knee arthroplasty (MIS) is one method of performing a knee replacement. It uses a smaller incision. Unlike conventional total knee replacement, which requires a large incision (8 to 12 inches) and significant disruption of the muscles and tendons. MIS Knee Joint Replacement is performed through an incision as small as 3 to 4 inches. In MIS procedures the amount of soft tissue (muscles and tendons, etc.) that are disrupted during surgery is reduced. Through that same small incision, the diseased surfaces of the knee joint are exposed and then replaced, one at a time, with the artificial joint components. This new technique is also called quadriceps-sparing knee replacement.

MIS Knee Joint Replacement is considered a giant step forward in total knee replacement for a number of reasons, which may include the following: a shorter hospital stay, faster recovery, less pain and much less scarring.

Potential benefits of this new techniques

1. More rapid return of knee function. Patients who undergo this procedure get muscle strength and control back more quickly than patients who have had traditional total knee replacement. This is because the quadriceps muscle and tendon are not divided in the course of the surgical exposure like in traditional knee replacement, and the kneecap is not everted (flipped out of the way) as it is in traditional total knee replacement. The recovery time is much quicker, often permitting patients to walk with a cane within a couple of weeks of surgery or even earlier.

2. Smaller incision. While this procedure would not be worth performing for cosmetic benefits, many patients do prefer the shorter incision. Traditional knee replacement incisions often measure 8” or longer; minimally invasive quadriceps-sparing knee replacement incisions are about 4” in length for most patients.

3. Decreased post-operative pain. This may be a function of the smaller incision and the fact that the incision stays out of the important quadriceps muscle/tendon group. The less-traumatic nature of the surgical approach also decrease post-operative pain and diminish the need for rehab and therapy compared to more traditional approaches.

4.Faster Recovery and Lesser Hospital Stay: Since minimally invasive procedure involves minimal incisions, there is less wounds to heal , which means faster recovery and early return to work.

Minimal invasive quadriceps-sparing total knee replacement is an evolution of surgical technique, which permits the use of time-tested implant designs. This gives some reassurance that while the surgical approach is new, the implants themselves have a good proven track record.

The Surgery would be a preferred choice for most patients, as there is no cost difference between the Conventional Surgery and the Minimally Invasive one. However as with all minimally invasive procedures the patient selection criteria is important, basically chronically deformed joints can not be dealt with, with this kind of surgery.

Article Courtesy :

Dr Neelam V. Ramana Reddy, MS Ortho; MCh Ortho (UK)
Consultant Joint Replacement Surgeon
Wockhardt Bone & Joint Hospital
Kamineni Wockhardt Hospitals,King Koti, Hyderabad.

For enquiries and scheduling an online appointment with Doctor Neelam Reddy,please write in to enquiries@wockhardthospitals.net

High Flexion Knee Replacements

We have with us Doctor Dr Neelam V. Ramana Reddy(MS Ortho; MCh Ortho (UK)) who is a Consultant Joint Replacement Surgeon,at Wockhardt Bone & Joint Care at Kamineni Wockhardt Hospitals, and King Koti Hyderabad.

Doctor Neelam talks to us about "Hi Flexion Knee Replacement"

Arthritis of knee is the world’s leading cause of disability. Arthritis causes pain, swelling, inability to walk, reduced bending of knee, inability to sit cross legged, deformity and so on.

Conventional total knee replacement is a well-known treatment for advanced knee arthritis. Knee replacement surgery provides excellent results to the patient, relieving him from pain. The surgery also improves walking ability and allows pain-free knee bending. Most importantly, it improves the quality of life of the patients.

Flexion is the action of bending a joint, such as your knee or elbow. The opposite motion is extension, which is the straightening of a joint. Generally, traditional knee replacements accommodate flexion up to 110 degrees and have not been designed to allow the patients to squat and kneel, which require higher flexion. Many daily activities require a higher range of motion: Gardening, golfing or activities such as kneeling for prayer and sitting cross-legged can demand up to 130-150 degrees of bending.

Recent innovation of knee design (High Flexion Rotating Platform Knees) is a breakthrough where complete flexion upto 155 degrees could be achieved. Desire for high flexion may be dictated by patient’s favourite activities or cultural background. Many daily activities require the ability to flex the knee beyond 120 degrees.

The fixed bearing conventional knee provides 110 degrees of flexion. For most patients, this is not enough. The rotating platform knee is specially designed to safely accommodate up to 155 degrees of flexion in patients who has good pre operative range of motion. This means that with appropriate rehabilitation a patient can resume an active life style after total knee replacement – deeply bending the knee for recreation. Day to day activities, which may include prolonged kneeling, squatting and cross-legged sitting, can be done.

Complete knee bending is a pre requisite for the patients of Asia, Japan and more so in Indian continent. This will raise high level of confidence in patients to get surgery done as they will also get good flexion. So now day’s patients should not hesitate to get knee replacement done due to reduced knee bending after knee replacement.

To know more about Knee Replacement Surgery or to fix up an appointment with Doctor Neelam Reddy, please write in to enquiries@wockhardthospitals.net or log on here

Rheumatoid Arthritis : Causes and Treatements

Today we have with us, Doctor Srinivas JV , Consultant Orthopedic Surgeon, Wockhardt Hospitals,Bangalore who will be explaining about Rheumatoid Arthritis, its causes and treatments.Doctor Srinivas has done his MS in (Orthopedics) from AIIMS, New Delhi, followed by a Fellowship In Joint Replacement Surgery And Arthroscopy From Charite, Hambolt University, Berlin, Germany.

Rheumatoid Arthritis is a chronic autoimmune disease that causes inflammation of the Joints and in some cases inflammation of the tissue around the Joints as well as other organs of the body. Autoimmune diseases occur when the bodies own immune system attacks tissue and cells in the body due to a failure to recognize its own constituent parts.

The disease is chronic in nature and requires prolonged periods of treatment. Medication is generally regulated according to the progress made by the patient. If Rheumatoid Arthritis is not detected in the early stages and treated accordingly irreversible joint damage could occur. Untreated cases could lead to major complications effecting the eyes, nervous system, lungs and kidney.

Joint replacement surgery may be necessary for joints that have been irreparably damaged, however this is only possible for the major joints i.e. hip, knee, shoulder and some times elbow.

Symptoms of Rheumatoid Arthritis

Rheumatoid Arthritis is characterized by Joint pain generally in the hands and feet accompanied by stiffness which is worse in the mornings, swelling in the joints and loss of proper function. The disease can affect people of all ages. In some cases the symptoms develop gradually over the years and in others there is rapid progression.

Causes

The exact cause of Rheumatoid Arthritis is unknown. The disease is thought to be a combination of genetic and environmental factors, hormones could also be involved. Rheumatoid Arthritis is an auto immune disease where the bodies own immune system attacks the joints and organs. The cartilage wears down, the space between the bones narrows and in advanced stages the bones rub against each other causing the bones to erode. The joints become very painful and inflamed.

Rheumatoid Arthritis is not hereditary however it is more prevalent in some circles of society than others

Diagnosis:

A simple blood test would be enough to diagnose the disease. However blood tests in the early stages may not detect it. Generally a 6 week period is given before the patient is treated to rule out other diseases.

Treatment:

Rheumatoid Arthritis needs to be treated with specific medication to help control and slow down the disease. Poor awareness of the disease among the general public and the medical community often leads to late or wrong diagnosis. Patients are generally treated symptomatically with pain killers, anti-inflammatory drugs and steroids that merely give temporally relief. However, the disease it self is not treated leading to complications and possible irreversible damage.

In recent times there has been a breakthrough in the treatment of the disease with biological therapy (designed to restore the ability of the body’s immune system). This new therapy has yielded good results and is increasingly being used for patients where conventional medication fails to work or where there are too many side effects.

What does the doctor say?

It is important to diagnose and treat the disease in the early stages to avoid complications later on in life. With the right treatment the quality of life can be improved.

The lack of awareness about the symptoms of Rheumatoid Arthritis among the medical fraternity often results in late diagnosis. In children the disease is often confused with Rheumatic fever where the children are treated wrongly, many children suffer from the disease for months and even years before the disease is diagnosed and the proper treatment is given.

Orthopedic Surgeons View

As earlier said, the disease has to be diagnosed at early stages and medical treatment instituted in these patients. In spite of treatment or due to inadequate treatment, people with rheumatoid arthritis develop severe joint destruction. The symptoms of severe destruction would be that the patient experience severe pain in the joint, restricted movements at the joint and difficulty to carry out the daily activities. Most common joints would be knee joints, hip joints, shoulder joints, elbow joints. Patient also develops pain and deformity of small joints of hands and foot making them difficult to carry out their daily activities.

The role of joint replacement surgeon comes only when there is severe destruction of major joints. Most commonly done joint replacements are for hip and knee. Very rarely shoulder and elbow replacement are done. Hip and knee replacement are indicated when patient is not able to walk and do their daily activities, joint pain is severe and not controlled by medications or when patient has developed deformities(commonly flexion deformity in hip and flexion, varus and valgus deformity in knees). By performing joint replacement surgeries these patients do experience complete pain relief in joints and there deformity completely corrected. They are able to move around and do their daily activities. It is seen that a procedure called synovectomy along with joint replacement will reduce the disease load in the body and requirement for medication is also reduced.

If the patients can over come the fear of surgical intervention and the financial burden for the surgery than they can have better quality of life after surgery.

Dr JV Srinivas,
M.S. (Orthopedics)
Consultant Orthopedic Surgeon
Wockhardt Hospitals, Bangalore

To Schedule an appointment with Dr JV Srinivas please write to enquiries@wockhardthospitals.com

Guide To Arthroscopy-Part 2

Arthroscopy can be used to treated varied bone and joint problems.They include 1)Rotator Cuff procedure 2) Repair or resection of torn cartilage from knee 3) Reconstruction of anterior cruciate ligament in knee 3)Removal of inflamed lining(synovium ) in knee ,shoulder, ankle, wrist 4)Removal of loose bones or cartilage in the knee,shoulder joint or wrist.

The extent of the surgery required and recovery time will depend upon the complexity of the problem.Occasionally during arthroscope, the surgeon may discover that the injury or disease cannot be treated adequately with arthroscope alone.The extensive open surgery may be perfomed while you are still anesthetized,or at a later date after you have discussed the finding with your surgeon

Possible Complications of Arthroscopy

Infections and instruments breaking are the most common complications,but occur in less than 1% of all arthroscopic procedures.

Advantages of Arthroscopy

Arthroscopic surgery is easier on the patient than 'open surgery". Arthoscopic surgery means less incisions,less wound trauma,and leseer recovery time.Most patients have their arthroscopic surgery as outpatients and are home several hours after the surgery.

Recovery after Arthroscopy:The small punctured wounds take several days to heal.The operative dressing can usually be removed in the morning after surgery and adhesive strips can be applied to cover the small healing incisions.

However it generally takes several weeks for the joint to maximally recover.As specific activity and rehabilitation program may take several weeks for the Joint to recover.As specific activity and rehabilitation program may be suggested to speed up your recovery and protect future joint function

It is no unusual for patients to go bacl t work or resume daily activities within a few days.Athletes and others who are in goof physical activity may in some cases return to their athletic activities within a few weeks.

What happens to You during Arthroscopic Surgery

During surgery the anesthesiologist or the nurse may start an IV (intravaneous).You will receive either local or general anesthesia.

After your anesthesia takes effect,the doctor will make two or three tiny incisions in your knee .A solution is injected to distend the knee cavity, and the arthroscope and a small tube with a powerful light and lens is inserted.The doctor examines your knee joint to determine what is causing the problem.Often, the injury can be repaired at this time,using special surgical instruments.Following arthroscopy the instruments are removed,incisions closed and knee is bandaged.

To Know more on Wockhardt Hospital Bone and Joint program write to us at enquiries@wockhardthospitals.com

Wockhardt Hospitals Guide To Arthroscopy-Part 1

What is Arthroscopy

Arthroscopy is a surgical procedure used to visualize ,diagnose and treat problems inside a joint.in an arthroscopic examination,an orthopedic surgeon makes an incision in the patients skin and then inserts a pencil sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint.Light is transmitted through fibre optics to the end of the arthroscope that is inserted inside the joint.By attaching the arthroscope to a miniature television camera,the surgeon is able to see the interiors of the joint through this small incision rather than making a large incision.

The television camera attached to the arthroscope displays the image of the joint on a television screen,allowing the surgeon to look around the knee .The suregon can then determine the amount or type of the injury,and then repair or correct the problem ,if necessary.

Why is Arthroscopy necessary.

Diagnosing joint injuries and diseases begins with a thorough medical history,physical examination and an X-Ray.Additional tests such as an MRI or a CT Scan may also be needed.Through the arthroscope ,a final diagnosis is made which may be more accurate than an open surgery or from X-ray Studies.

What are the Normal Joint Conditions diagnosed through Arthroscopy

Some of the most frequent conditions found during arthroscopic examination of the joint are

• Inflammation

Synovitis-Inflamed lining (synovium) of the knee ,shoulder,elbow,wrists, or ankle

• Injury:Acute and Chronic
  

Shoulder-Rotator Cuff Tendon Tears,impingment syndrome
Knee-Meniscal tears,chondromalacia (wearing or injuryof carthilage cushion) and anterior crucitae ligament tears with instability.

• Loose Bodies of bone and or/Cartilage

Although all the joints can be viewed with an arthroscope ,six joints are most frequently examined with this instrument.These include the knees,shoulder,elbow,ankle,hip and wrist.

How is Arthroscopy performed

Under suitable anesthesia ,a small incision (about the size of the buttonhole) will be made to inser the arthroscope.Several other incisions may be made to see other parts of the joints.Corrective surgery is performed with specially designed instruments that are inserted into the joints through accessory incisions.For example meniscal tears in the knee can be successfully treated with arthroscopic surgery.

Surgeons Unable to Meet Demand for Joint Replacement in the US

American Academy of Orthopaedic Surgeons annual meeting, in Las Vegas threw up some startling relevations regarding Joint Replacements .According to a report published in the meet, In 2016, nearly 200,000 patients who require hip replacement and 750,000 patients who require knee replacement will not be able to have their surgery performed, because of the shortages of orthopedic surgeons available to do the procedure," according to Dr. Thomas K. Fehring, lead researcher of the first study and an orthopedic surgeon with OrthoCarolina in Charlotte, N.C.

While Hip Replacement and Knee Replacement in the US is something that is commonplace and done quite frequently, some healthcare experts say that this might change very soon due to the mismatch between demand and supply

For the study, the retirement age of doctors performing hip and knee replacements and the number of new doctors entering the field were calculated. Using this data, the researchers calculated the number of doctors who will be available to perform these procedures in 2016.

the study shows that by 2016, there will be significantly fewer doctors available to replace those who retire. By 2016, 46 percent of patients needing hip replacements will not get them, and 72 percent of those needing knee replacements will have to wait.

"I understood that there were not as many young surgeons going into the arthroplasty field as were retiring from the arthroplasty field, but it shocked me that, if the trends continue, nearly a million patients who need hip and knee replacements in 2016 will not have access to this life-changing procedure," said Dr. Thomas K. Fehring, lead researcher of the first study and an orthopedic surgeon with OrthoCarolina in Charlotte, N.C.

One of the reasons for lesser orthopedic doctors from joining this specialty appears to be low insurance reimbursements.Reimbursement for joint replacement has decreased 60 percent in inflation adjusted dollars since 1990.

"These economic realities are not lost on our residents in training when selecting a career," Fehring said. "Unless things change, this will lead to excessive waiting times for our senior citizens requiring joint replacement. Wait times of one to two years may ensue, which will be unacceptable to the general public," he said.

by 2011, more than 50 percent of patients needing hip replacement will be under 65, and that by 2016, more than half of those needing knee replacement will be also be under 65.

According to the study,many patients needing knee replacement are between 45 and 54. In 2006, 59,077 people in this age group had knee replacements, but by 2030, that number will increase 17 times to almost 1 million, Kurtz's team found.

This trend is driven by the success of these procedures as well as by people being more active and also obesity, which can trigger arthritis at an earlier age, In addition, as the population ages, there will be a need for joint replacement in many more older people, according to the study.

Click here to know more about this study

Frequently Asked Questions on Knee Replacement

Knee Replacement surgery is bascially of two types 1)Total Knee Replacements which involves the entire replacement of the knee as opposed to only partial replacement.Traditionally these kind knee replacement involves a 7-8” incision over the knee by the surgeon and includes staying at the hospital for 4-5 days .

Partial Knee Replacement or Unicondylar Knee uses smaller implants and dues not involve making a deep incision and uses minimally invasive techniques.In partial knee replacement, the damage to the knee is limited to one part of the knee joint. The severely damaged part of the knee joint is hence replaced.

This surgery has advantage over total knee replacement. It's done through minimum invasion hence the damage to the tissue cells is far less. The patient returns to his normal lifestyle faster.

How common is knee replacement surgery?

Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

How old is the average patient?

In the U.S., the average joint replacement patient is around 65-70 years old, however patients of all ages have received knee implants.What is unicondylar arthroplaty, or partial knee replacement?

Partial knee replaces only the area of the knee that is worn out, sparing patients the more medically complicated and involved total knee replacement surgery.


What are the advantages unicondylar arthroplasty?

With a partial knee replacement, there is a dramatically shorter recovery time due to less surgical trauma, less scarring and fuller range of motion.


How is it different from total knee replacement?

During total knee replacement, surgeons typically make a 7 to 8-inch incision over the knee, patients stay in the hospital for approximately four days, and there is a recovery period of up to three months. During minimally-invasive partial knee surgery, a part of the knee to be replaced through a small, 3-inch incision. There is minimal damage to the muscles and tendons around the knee and the required hospital stay is up to two days. The recovery period is about one month.

You mentioned recovery is faster. What does that mean?

Patients often walk unassisted within a week or two of the operation. Even those who have both knees done at once are able to walk without the assistance of a walker or cane fairly quickly.

What does the surgeon do during a unicondylar arthroplasty?

When a knee replacement is performed, some bone and cartage are removed using precise instruments to create exact surfaces to accommodate a metal and plastic prostheses.

How long will knee replacement surgery last?

Knee replacement surgery has been documented to last beyond fifteen years for many patients. The overall failure rate is less than 1% per year.

How do I know if I am a candidate for this surgery?

Candidates for this surgery are generally younger, more active patients. The partial knee replacement allows for symptoms of pain or discomfort. The procedure allows younger patients to buy time before they need a full knee replacement. The procedure is also effective for older patients if they have disease localized to one half of the joint.

After surgery, is it normal for my knee to look larger than my other knee which has not had knee replacement surgery?

It is common for a post-operative total knee to be larger than the natural, native knee. That is a very common feature and finding and is not necessarily related to the parts being a different size than the amount of bone that was resurrected.

Is it normal to have numbness along the outer or lateral aspect of the incision?

It is common to develop some numbness or change in sensation over the lateral or outer aspect of the incision after surgery. The normal skin nerves run from the inner aspect of the knee, rotating to the outer aspect of the knee. Incisions that are made directly over the front of the knee oriented along the length of the leg will cut across these nerves. Generally, after four to 6 months, much of the skin sensation will return. However, in some patients, there is always a reduced degree of sensation over the outer aspect of the knee. Usually, this is of little clinical significance.

How soon can I return to normal activities after surgery?

Within six weeks after surgery, most patients are able to walk with a cane. You will probably feel well enough to drive a car within seven to eight weeks after surgery.

In most cases, successful joint replacement surgery will relieve your pain and stiffness, and allow you to resume many of your normal daily activities. But even after you have fully recovered from your surgery, you will still have some restrictions. Normal daily activities do not include contact sports or activities that put excessive strain on your joints. Although your artificial joint can be replaced, a second implant is seldom as effective as the first.

Will an implant set off a metal detector?

Since knee implants are made of metal, there’s a chance they could set off metal detectors. Patients have reported mixed experiences at airports: some detectors go off and some don’t.You may be provided with a special card to keep in your wallet explaining that you have a knee implant.

For more information of Knee Replacements proceures and FAQs check out these following websites.

Wockhardt Hospital,Bone and Joint Care
Georgetown university Hospital
Knee Replacement Guide

Orthopedic Problems in Women and their Treatement

We have with us today Dr. Sachin Bhonsle,Consultant Joint Replacement and Orthopaedic Surgeon at Wockhardt Bone and Joint Care, Mumbai, India who talks about Orthopedic problems in Women.

Dr.Bhonsle was a Lecturer in Orthopaedics in the premier and highly acclaimed institute Seth GS Medical College and KEM Hospital, Mumbai University. He was also the HOD (head of department) at the Department of Orthopaedics in Derna, Libya,before he Joined Wockhardt Hospitals

Here are some of the excerpts of his Interview with us

Are orthopedic problems dependent upon Gender

While orthodpedic problems does not make a distinction between men and women, Some research suggests that women might be prone to more bone and joint related disorder than men.Biomechanical, genetic and lifestyle differences between the genders contribute to the disparities in men’s and women’s pain. In certain cases, treatments may need to take gender-specific issues into account to deliver effective pain relief.

Medical Research suggests the following:

• Women are three times more likely than men to suffer from Carpal Tunnel Syndrome
• Women are twice as likely as men to suffer from Runner’s Knee (Chondromalacia Patella, or Kneecap Pain)…

• 41% more women than men (41 million vs. 29 million) suffer from Arthritis in general.

• Women are more likely to have Osteoarthritis of the Knee and thumbs

• women are more likely to get rheumatoid arthritis
• Women are more susceptible to footwear-induced ankle sprains than men
• Women tend to suffer more often from fibromyalgia
• Women develop osteoporosis more often as well as earlier than men

Biologically, there are several situations for women (unlike men) that demand additional care to manage today’s fast paced multi-tasking lifestyle.

What are some of the most common Bone and Joint Problems in Women

Carpal Tunnel Syndrome

is the name for a group of problems including numbness, pain, tingling, especially in early mornings and weakness in the hand. It is often the result of swelling inside the carpal tunnel, which places pressure on the median nerve

.
WHY WOMEN: Research suggests that because women’s wrists are on average, 10 % narrower due to which women can be more susceptible to crowding in the carpal tunnel passage. Hormonal changes during pregnancy and menopause can also contribute to Carpal Tunnel Syndrome and are exclusive to women. Women also suffer more often from thyroid problems which are directly linked to Carpal tunnel syndrome.

TREATMENT: wearing a wrist brace, especially at night, as one part of therapy. Treatment may also include medications, stretching and strengthening specific wrist muscles and changing the position of the wrist while in use. If symptoms persist, a physician may recommend injection or surgery. Surgery of carpal tunnel is a very simple and successful surgery which instantly and permanently cures the symptoms

Arthritis:

Arthritis means an inflammation of a joint eventually leading to wear and tear which results in painful and deformed joint. 60 % of people who have arthritis are females, and several of the more common forms are more prevalent in women. Apart from pain, stiffness in joints, redness around the joint, swelling and difficulty in performing the day to day activities are the most common symptoms.

WHY WOMEN ARE MORE SUSCEPTIBLE THAN MEN : For reasons unknown, women are most likely to get arthritis. The most common type is Osteoarthritis which is really wear and tear and essentially not a disease, mostly affecting women over 40 years. Rheumatoid Arthritis: 70 % of people with this type of arthritis are women, according to the Arthritis Foundation. It is inflammation of the synovium (lining) of the joints and can result in painful damage to the joints, affecting in the age group of 30 onwards.

TREATMENT: Early diagnosis of arthritis sets the stage for a proper treatment plan.The treatment plan may include a comprehensive diet and exercise program with best medications to lessen pain, increase movement and reduce fatigue. Role of physiotherapist is to work out correct exercise regime. Occupational therapist can help with activities of daily living. Surgery is sometimes required to reconstruct or replace a joint. Reconstruction of the joint can often be done by key hole surgery (arthroscopy). Joint replacement is a valuable tool in improving quality of life.

TREATMENT: Stretching and strengthening quadriceps and hip muscles can be helpful. Runners should run on softer surfaces, and use correct running shoes. Rest, Ice packing, splintage, patellar taping are useful. Surgical treatment is sometimes sought and it can be helped with arthroscopy.

Chondromalacia or Patella or Runners Knee:

This is characterized by pain is infront of the knee, especially while running, walking or ascending/descending stairs. This condition is caused by softening of patellar cartilage as well as mechanical alignment abnormality of patella.

WHY WOMEN: A woman’s pelvis is, on average, developmentally broader than a man’s pelvis to assist childbirth.As a result, women tend to be more “knock kneed” than men. Women may have hip weakness and excessive pronation, which may also contribute to biomechanical misalignment. These differences can put additional pressure on the patella, or kneecap, which can cause pain as the kneecap tracks up and down in its natural groove (patellofemoral groove).

WHY WOMEN: A woman’s pelvis is, on average, developmentally broader than a man’s pelvis to assist childbirth.As a result, women tend to be more “knock kneed” than men. Women may have hip weakness and excessive pronation, which may also contribute to biomechanical misalignment. These differences can put additional pressure on the patella, or kneecap, which can cause pain as the kneecap tracks up and down in its natural groove (patellofemoral groove).

Ankle Sprains: Certain types of footwear ladies favour tend to risk ankle and foot injuries.

WHY WOMEN: The higher the heel of a shoe, the more likely the ankle is to be unstable. In addition, women have a narrower heel in relation to the forefoot, and narrower feet overall. Also hormonal changes around menopause predispose relaxation of ligaments in feet.

TREATMENT: A program of strengthening and balance exercises may aid in recovery. Wearing an ankle support can reduce swelling and support the ankle ligaments.

Fibromyalgia: A condition with muscular pain through the body, specific tender points and fatigue. Often symptoms are vague. They tend to respond to certain medications lyke pregabalin and physiotherapy.

Osteoporosis: Losing calcium from the bones results in osteoporosis. Consequently the bones become weak and much more prone to fractures. Osteoporosis is best prevented rather than treated. Ladies need to act early in their life for this. There is a similar disorder called osteomalacia which is related to Vitamin.

WHY WOMEN : Menopause in late 40s or early 50s reduces the oestrogen in the body which is essential to keep the calcium in the bones. As a result after menopause there is accelerated weakening of bones.

TREATMENT : Preventive treatment includes weight bearing exercise like walking, jogging. Healthy lifestyle is important. Calcium and Vitamin D supplements are necessary for most ladies over 40. Once osteoporosis is established it can be treated with several medications but the bone strength may never return to normal. Fractures are managed best by orthopaedic surgeons once they happen.

To Know about Bone and Joint Treatements and to schedule an Consultation with Wockhardt Hospitals,Bone and Joint care,Write into enquiries@wockhardthospitals.net

courtesy

Dr. Sachin Bhonsle
Consultant Joint Replacement and Orthopaedic Surgeon
Wockhardt Bone and Joint Hospital, Mumbai, India
Qualification
MS (Orthopaedics) , FRCS (Glasgow, UK)