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Knee Joint

May 8, 2024
UncategorizedMarital TherapyKnee JointShoulder InjuryJoint InjuryChild Therapy

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.

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knee replacement surgery in India
December 28, 2022
Knee Joint

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.

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Knee replacement surgeon in Delhi
July 10, 2022
Knee Joint

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.

Top knee replacement specialist near me

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

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July 10, 2022
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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
total knee replacement implant
total knee replacement implant

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.

 

 

Knee replacement surgeon in Delhi

 

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.

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