Meniscus Tears: Latest Non-Surgical Treatments and Recovery Options
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July 26, 2025
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Tendinitis and Overuse Injuries: Prevention and Management
By Dr. Aman Dua, Best Orthopedic Surgeon in Delhi
July 14, 2025
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Weather and Joint Pain: Is There Really a Connection?
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Customized Care: The Role of 3D Printing in Orthopaedic Implants
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Minimally Invasive Orthopaedic Surgery: Faster Recovery, Less Pain
By Dr. Aman Dua, Orthopedic Surgeon
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Exercises: Neck & Scapular region
Isometric neck side bending / Extension / Flexion
Use neck muscles for side bending, Flexion, or extension. Resist the movement of neck by applying opposite force with hand
Chin Tucks
Keep Neck straight, tuck chin inside without a moving neck.
Shoulder Streching
Hold hands together in front and raise / flex to go over head. Stretch as far as possible.
Shoulder Shrugs
Arms by side (may hold weight), pull shoulder up towards ears. Relax and Repeat
Scapular Squeeze
Start with arms by side, then bring elbows behind back as far as possible. Relax and repeat
Wall Push / Push ups
Stand with foot away from wall, palms resting on wall and arms stretched. Gradually bring chest close to wall by flexing elbows. Again go back to stretched position and repeat
Instructions:
1. Avoid Jerky movements. Hold posture for count of 10 and repeat it 10 times.
2. This Document is a rough guide, Follow Instructions from your Doctor and Physiotherapist.
3. Any inconvenience or increase in pain should be reported to the Doctor/ Physiotherapist.
Understanding the Menace of Bad Posture: A Guide by Dr. Aman Dua
In the fast-paced world we inhabit today, the prevalence of back pain, shoulder pain, and muscle stress has become increasingly common. Often overlooked, these discomforts can be attributed to a silent culprit: bad posture. As Director of Joint Replacement at Fortis Escorts Hospital, Dr. Aman Dua sheds light on the significance of maintaining good posture and its profound impact on overall health and well-being.
The Silent Agony of Bad Posture
Bad posture, characterized by the improper alignment of the body while sitting, standing, or lying down, can lead to a myriad of health issues. From back pain to shoulder stiffness and muscle stress, the consequences of poor posture extend far beyond mere physical discomfort. Dr. Aman Dua emphasizes that neglecting proper posture can result in chronic pain, reduced mobility, and even long-term spinal abnormalities.
Understanding the Culprits
In today’s digital age, where sedentary lifestyles and prolonged screen time have become the norm, the prevalence of bad posture has skyrocketed. Dr. Aman Dua points out that factors such as excessive sitting, slouching, carrying heavy bags, and improper workstation ergonomics contribute significantly to the development of poor posture. Additionally, lack of physical activity and weak core muscles further exacerbate the problem, making individuals more susceptible to musculoskeletal issues.
The Vicious Cycle: Pain and Posture
The relationship between pain and posture is symbiotic, with one often exacerbating the other. Dr. Aman Dua explains that as discomfort from poor posture increases, individuals may inadvertently adopt compensatory movements or positions to alleviate pain, further perpetuating the cycle of musculoskeletal strain. Over time, this can lead to muscle imbalances, joint misalignment, and ultimately, chronic pain conditions.
Prevention and Management Strategies
While the consequences of bad posture may seem daunting, Dr. Aman Dua reassures that proactive measures can mitigate its adverse effects. Adopting ergonomic workstations, practicing proper sitting and standing techniques, and incorporating regular stretching and strengthening exercises into daily routines can significantly improve posture and alleviate associated discomforts.
Seeking Professional Guidance
In cases where pain persists despite self-management strategies, seeking professional guidance is imperative. As an expert in joint replacement, Dr. Aman Dua emphasizes the importance of consulting healthcare professionals for accurate diagnosis and personalized treatment plans tailored to individual needs. Whether through physical therapy, chiropractic care, or other modalities, addressing underlying musculoskeletal issues is crucial for long-term relief and prevention of recurrence.
Conclusion
In conclusion, the detrimental effects of bad posture on physical health and well-being cannot be overstated. Through awareness, education, and proactive intervention, individuals can mitigate the risks associated with poor posture and lead healthier, pain-free lives. As advocated by Dr. Aman Dua, prioritizing good posture is not merely a matter of aesthetics but a cornerstone of optimal musculoskeletal health. Let us heed this call to action and stand tall against the silent menace of bad posture.
Joint Surgeon in Delhi on Joint Injury and treatment
Joint injury is common in children, sportsmen, old age people, and people who do manual labour work that involves too much physical efforts. It can happen to anyone, regardless of age or lifestyle. Injuries to the joints can be caused by a variety of factors, including sports injuries, accidents, and even simple wear and tear. In this article, One of the top joint surgeons in Delhi explains different types of joint injuries and how they can be treated.
Sprains
A sprain is one of the most common types of joint injuries. It occurs when the ligaments that connect bones to each other are stretched or torn. Sprains can occur in any joint, but they are most common in the ankle, knee, and wrist. Symptoms of a sprain include pain, swelling, and difficulty moving the joint.
Strains
A strain is another common type of joint injury. It occurs when the muscles or tendons that connect bones to muscles are stretched or torn. Strains can occur in any joint, but they are most common in the lower back, neck, and shoulder. Symptoms of a strain include pain, muscle weakness, and difficulty moving the joint.
Dislocations
A dislocation occurs when a bone is forced out of its joint. Dislocations can occur in any joint, but they are most common in the shoulder and hip. Symptoms of dislocation include pain, swelling, and deformity of the joint.
Fractures
A fracture is a break in a bone. Fractures can occur in any joint, but they are most common in the wrist, ankle, and hip. Symptoms of a fracture include pain, swelling, and deformity of the joint.
Torn Cartilage
Cartilage is a tough, rubbery tissue that cushions the joints and helps them move smoothly. A torn cartilage can occur when the cartilage is damaged or torn. This can occur in any joint, but it is most common in the knee. Symptoms of a torn cartilage include pain, swelling, and difficulty moving the joint.
Bursitis
Bursitis is a condition that occurs when the bursae, small fluid-filled sacs that cushion the joints, become inflamed. Bursitis can occur in any joint, but it is most common in the shoulder, hip, and knee. Symptoms of bursitis include pain, swelling, and difficulty moving the joint.
Arthritis
Arthritis is a condition that occurs when the cartilage that cushions the joints breaks down, causing the bones to rub against each other. Arthritis can occur in any joint, but it is most common in the hands, hips, and knees. Symptoms of arthritis include pain, swelling, and stiffness in the joint.
Why you should get a second opinion for Joint injuries
A second opinion can help confirm the initial diagnosis made by your primary healthcare provider. This is especially important if the initial diagnosis is uncertain or the injury is complex. It provides a different perspective on the injury and may offer alternative treatment options that were not considered initially. It also helps to identify other health issues that were not considered in the initial diagnosis, such as underlying medical conditions that could affect treatment options. A second opinion can help ensure that the treatment plan is appropriate for the injury and individual needs. This can include recommendations for specific exercises, physical therapy, or medications that may not have been considered initially. A second opinion can help reduce the risk of medical errors, which can occur if the initial diagnosis or treatment plan is incorrect.
Common Treatment of joint injuries
There are several common treatments for joint injuries in India, depending on the type and severity of the injury. Here are some of the most common treatments for joint injuries in India:
- Medications – Pain relievers, anti-inflammatory drugs, and corticosteroids may be prescribed to reduce pain, swelling, and inflammation.
- Physical therapy – A physical therapist may design an exercise program to help improve joint function, flexibility, and strength.
- Rest – Resting the injured joint is essential to prevent further damage and allow the body time to heal.
- Ice therapy – Applying ice to the injured joint can help reduce pain, swelling, and inflammation.
- Compression therapy – Using an elastic bandage or compression sleeve can help reduce swelling and provide support for the injured joint.
- Elevation – Elevating the injured joint can help reduce swelling and improve blood flow to the area.
- Joint injections – Injections of steroids or hyaluronic acid may be recommended to reduce inflammation and improve joint function.
- Surgery – In severe cases, surgery may be necessary to repair or replace damaged joints.
Conclusion
Joint injuries are a common occurrence that can happen to anyone. While many joint injuries can be treated with rest, ice, compression, and elevation, some may require surgery. You should always consult another trusted joint surgeon before going for a joint replacement surgery.
Symptoms and Treatment of Shoulder Dislocation in Delhi
A shoulder dislocation occurs when the head of the upper arm bone (humerus) is forced out of the socket of the shoulder blade (scapula). This can happen due to a fall, a blow to the shoulder, or a sudden twisting motion. Shoulder dislocations are relatively common injuries, especially in people who participate in contact sports or have jobs that involve repetitive overhead motions.
The most common cause of a shoulder dislocation is a traumatic event such as a fall or a blow to the shoulder. However, the injury can also occur as a result of a sudden twisting motion or from a congenital problem such as loose ligaments or a small shoulder blade. People who have previously dislocated their shoulder are at a higher risk of dislocating it again.
Common Symptoms of Shoulder Dislocation
Symptoms of a shoulder dislocation include severe pain, a popping or snapping sensation, and difficulty moving the arm. The arm may appear visibly out of place or deformed, and there may also be swelling and bruising around the shoulder. In some cases, the person may experience numbness or tingling in the arm or hand.
Shoulder Dislocation treatment in Delhi
Treatment for a shoulder dislocation typically begins with emergency care to reduce the dislocation and provide pain relief. This may involve manually manipulating the arm back into place, a process called reduction. After reduction, the shoulder will be immobilized with a sling or other device to keep it in place while it heals.
After the initial injury, physical therapy and rehabilitation will be necessary to restore range of motion, strength and stability in the shoulder. The physical therapy will typically focus on exercises to improve flexibility, strength, and stability of the shoulder. The goal of therapy is to reduce pain and inflammation, restore normal range of motion, and improve muscle strength.
In some cases, surgery may be required to repair or stabilize the shoulder joint. This can include procedures such as a Bankart repair, which involves reattaching torn ligaments to the shoulder blade, or a Latarjet procedure, which involves using a piece of bone from the person’s own body to create a new socket for the upper arm bone.
Recovery time for a shoulder dislocation varies depending on the severity of the injury and the treatment used. Most people are able to return to their normal activities within a few weeks to a few months, but it may take up to a year for full recovery. Physical therapy and rehabilitation can help speed up the recovery process and reduce the risk of re-injury.
It’s important to note that even after recovery, people who have had a shoulder dislocation may be at a higher risk of re-injuring the shoulder. Therefore, it’s essential to continue to perform exercises to maintain strength and stability in the shoulder. Consulting with a Ortho Specialist doctor can help you to develop an appropriate exercise program to reduce the risk of re-injury.
Exercises recommended for shoulder treatment
- Pendulum exercises: These exercises involve gently swinging the arm in a circular motion, using the force of gravity to help improve range of motion.
- Isometric exercises: These exercises involve contracting the muscles without moving the joint. They can help to improve muscle strength and stability in the shoulder.
- Scapular stabilization exercises: These exercises focus on strengthening the muscles that support the shoulder blade, such as the serratus anterior and the lower trapezius.
- Theraband exercises: Theraband exercises involve using a resistance band to perform exercises such as arm raises and external rotations. They can help to improve muscle strength and stability in the shoulder.
- Range-of-motion exercises: These exercises involve moving the arm through its full range of motion to help improve flexibility and range of motion in the shoulder.
- Strengthening exercises: These exercises can be done to strengthen the shoulder muscles and improve shoulder stability.
- Postural exercises: These exercises can help to improve the overall alignment and stability of the shoulder and reduce the risk of re-injury.
Note that the specific exercises recommended and progression of the exercises will depend on the individual’s condition and the stage of recovery. It’s essential to consult an orthopedic specialist surgeon to ensure that the exercises are appropriate and that they’re progressing as needed.
What to expect from a knee replacement surgery in India?
Arthritis, more particularly osteoarthritis, is the most prevalent type of knee arthritis that afflicts people, resulting in difficulty while moving, experiencing immense pain and even being disabled. The heavier the weight a person carries: the worse the symptoms and in far advanced cases, day to day tasks also become a significant challenge.
When non-surgical options don’t do much and. movement and pain become unbearable, a knee replacement surgery is a viable option.
Knee replacement surgery
A majority of individuals who have undergone knee replacement surgery abide by it and say it significantly alleviated the pain and discomfort they experienced before surgery.
There are many types of knee replacements,
total knee replacement is when the knee is replaced completely, partial knee replacement
involves replacing just the affected part of the knee and bilateral knee replacement surgery replaces both knees at the same time.
Knee replacement surgery has advanced greatly and today, the surgery is very common and success rates are invariably high for over 90 percent of all cases.
Minimally invasive Knee replacement surgery
More muscle and other soft tissue around the knee are intended to be preserved during minimally invasive surgery, which will aid in a quicker and more effective recovery. In contrast to a standard operation, which requires an 8 to 12-inch incision, a minimally invasive procedure only requires a 3 to 6-inch incision. In addition, the knee cap is frequently not moved, and several soft tissues are routinely moved aside during surgery rather than being severed.
In recent years, minimally invasive knee replacement has become less popular. Invasive surgical procedures are technically difficult and include a unique set of dangers. For instance, less intrusive operations appear to carry a higher risk of nerve injury and post-surgical alignment issues
Computer-assisted knee replacement surgery
The lack of computer-assisted knee replacement surgery in India may be due to the expense and additional time required. However, some research indicates that computer-assisted surgery might offer improved alignment and implant placing. One study comparing nearly 200 procedures discovered that five years after surgery, patients who underwent computer-assisted surgery had greater knee function.
For bowlegged patients, computer aid may be very helpful for aligning prosthesis.
Patients should think about these alternatives, but they should also keep in mind that a surgeon’s experience is still one of the most crucial considerations. For surgeons, understanding some surgical methods and technologies might be challenging. In comparison to a less skilled surgeon, an expert surgeon who employs a standard surgical approach may provide greater results.
During the Total Knee surgery procedure
You’ll be given general anaesthesia, peripheral nerve blocks, and spinal anaesthesia to keep the pain at bay along with antibiotics to tackle any risk of infection.
An orthopedic surgeon will perform the procedure, removing the bone and diseased cartilage from where the thigh bone and shin bone meet at the knee joint. A prosthetic made of metal will replace the removed parts while piece of specialised plastic is used for replacing the back of the kneecap and finally, the same plastic material is taken and between the two metal components.
This provides both bones of the knee joint smooth surfaces once again so they can move, flex and bend with complete freedom and without pain.
After knee surgery
Most patients will have to spend a few days in hospital after their knee replacement, pain medication will be administered and patients will be kept under observation.
Shortly after the pain has subsided, a physical therapist will begin therapy for weight-bearing therapy, standing and walking, physical and occupational therapy to help adapt to the new knee and these exercises will need to be done at home as well.
When you’re good enough to do your tasks by yourself, you’ll be able to go home, with a temporary cane or walker for some time
Total knee replacement recovery
Recovery and rehabilitation are primarily to be done at home and some visits to a physical therapist will be needed as well. Most people will be able to return to their normal lives by the end of 4 weeks.
Regarded as one of the best Knee replacement Surgeon in Delhi, Dr. Aman Dua has years of experience in treating knee pain and replacing knee joints, with zero infection rates, our modular OTs and post-op healing environment, will make your treatment journey with us, joyous.
Metal Allergy in Total Knee Replacement
Metal and cement component allergy is a poorly understood concept and its implications on total knee replacement surgery are also unclear. But it surely exists! What not known is how often allergic reactions cause problems for people with metal joint implants. As a Surgeon it is my duty to inform my patients about this entity in brief, simple and easily understood way, at the same time steering away from too much scientific and conflicting details that may create panic or undue anxiety.
Knee and hip implants currently available are made of metals that are durable, inert and remain in body without significant corrosion. Chromium, cobalt, Nickel, titanium and molybdenum are the commonest of metals found inside the implants in varying combinations and proportions. Sensitivity to metals is known, particularly to Nickel, which is common in several objects and substances of daily and working life. Symptoms ascribed to metal hypersensitivity may include pain, swelling, cutaneous rash, patient dissatisfaction, and loss of function.
Can we test it?
Yes. Tests are available to check the individual sensitivity to metals.
- Skin Patch Test: The most commonly used test to diagnose a metal allergy is skin patch testing. This has limited availability in India. Very small amounts of various metals are placed on your skin and then covered with a patch. After a couple of days, your doctor removes the patches. If the area is irritated, you are likely allergic to that metal. Skin patch testing is not 100% accurate, though. It is possible to have a false negative or false positive result. This means the test finds that you dont have an allergy when you actually do, or vice versa.
- Blood Tests (not available in India)
- Lymphocyte Proliferation Test for Nickel (Ni-LPT). This test has been validated against the skin patch test , but there is limited research to confirm its effectiveness.
- LTT – MELISA (memory lymphocyte immunostimulation assay). It also looks for a white blood cell reaction against the possible metal allergens. But the MELISA test has not been validated against patch testing.
Why not test everyone, before Joint replacement Surgery?
Testing before joint replacement surgery isn’t recommended for everyone
- Incidence of Metal allergy is low
- Limited geographical availability of Screening Test
- Poor sensitivity and specificity of tests
- High cost
- Risk of creating first exposure with Patch test: The same phenomenon (T-cell response) that provokes a response can theoretically induce sensitivity in people
Who should undergo sensitivity testing, before undergoing Implantation?
- If you have had a skin reaction to metal jewelry or artificial ornaments in the past, you probably should be tested.
- In a patient after TKR surgery with unexplained painful knee, if laboratory tests and radiologic findings indicate no loosening, infection, or other tissue abnormalities should the surgeon consider metal hypersensitivity
Total Knee Options in presence of Metal sensitivity
If patch testing or LPT / LTT find high reactivity, one should explore options for avoiding the reaction-producing metal or traditional Cobalt Chrome implants
Some alternative bearing surfaces currently available are
- Zirconia (oxidized zirconium) the Zirconium metal surface is transformed into a ceramic layer of oxidized zirconium or zirconia
- Titanium Nitride coated onto the surface of a titanium-alloy femoral component
- Zirconium nitride or Titanium Niobium Nitride ceramic surface coating applied to a cobalt chrome alloy Femoral component
- Delta ceramic implants (currently not available commercially).
These bearings used with an all-polyethylene or titanium alloy or zirconium nitride coated tibial component will minimize the risk of Co, Cr, and/or Nickel reaction. However, this does not preclude the risks associated with nickel and other metallic byproducts that could emanate from the stainless steel instrumentation during implantation. These components offer an added advantage of better wear resistance and may provide better longevity.
To conclude, metal sensitivity is rare and no large-scale evidence exists that implicates preexisting metal allergy as a cause of implant failure in people who received components containing metal(s) to which they are reactive. Testing should be reserved for patients with history of metal allergy and use of alternative bearing surface may be considered in positive or suspected cases.
For all Knee problems, consult the top knee replacement specialist in Delhi now
Total Knee Replacement Implant
A regular Total Knee Implant irrespective of Make or Model typically consist of 4 parts
- A metal alloy femoral component (fits lower end of thigh bone)
- A titanium / Cobalt – Chromium Tibia component (Fits upper end of leg bone)
- A Poly-ethylene plastic spacer in between these component for smooth movement
- A poly-ethylene patella button (fits back of knee cap) may not be required in some patients
Components 1,2 and 4 are fixed to bone with help of Bone cement. Movement happens between component 1 and 3.
The standard most commonly used implant consists of Cobalt – Chrome alloy femoral component (Figure 1) articulating with polyethylene surface mounted on a metal tibial tray.
These Implants have a proven track record of 15 – 20 years and have been able to provide good pain relief and functional outcomes in vast majority of patients.
Some alternative bearing surfaces currently available are
- Zirconia (oxidized zirconium) the Zirconium metal surface is transformed into a ceramic layer of oxidized zirconium or zirconia (Figure 2)
- Titanium Nitride coated onto the surface of a titanium-alloy femoral component (Figure 3)
- Zirconium nitride or Titanium Niobium Nitride ceramic surface coating applied to a cobalt chrome alloy Femoral component (Figure 3)
- Delta ceramic / PEEK (currently not available commercially).
Possible advantages
- Better wear properties (in Laboratory studies) thus increasing life of implant and some are marketed as 30 years knee with cross link polyethylene. Generally Preferred for younger patients especially less than 60 years of age.
- Safer in patients with metal allergies
- Wider range of Sizes and surface options in Newer Knee Systems.