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ortho

Knee Instability & Treatment Options – When to Seek…

March 28, 2021March 30, 2024
by Eva Hospital

The painful, wobbly, and unstable feeling of a loose knee cap is commonly caused by an injury that has either sprained or torn the ligaments.

Anterior cruciate ligament or meniscus injury may also cause knee instability and pain.

The kneecap is connected to the thigh bone(femur) above and the shin bone(tibia) below.

It moves up & down in this groove as you move your knee.

Sometimes the knee ‘gives out’, or the kneecap moved out of this groove. This is called knee instability.

The most common symptom is a sensation that the knee has moved out of place.

There is usually swelling, pain, discomfort in movement, and probably a visibly deformed knee.

People who are at risk of knee instability include sportspersons and dancers. A sports injury specialist’s advice is important in such a case.

Causes

Injury to Knee Ligament

Such injuries occur due to a strong impact wherein the knee gets forcefully bent at an unusual angle, injuring the ligaments.

The kneecap is held in place via ligaments. Ligaments are the fibrous tissues that connect the bones to muscles.

An injury may make a partial or complete tear in the ligaments.

The minor tears normally heal with simpler remedies, whereas serious tears may require surgery.

There are three types of ligament tears:

ACL Tears

The ACL or the anterior cruciate ligament tear puts pressure on the injured leg and makes it difficult to walk.

The knee joint feels dislocated and there is a decreased range of motion.

A patient with an all tear can bend and flex the knee in a normal and painless way.

The treatment involves more invasive procedures.

MCL Tears

The MCL or the Medial Collateral Ligament tear is caused by a direct strike on the knee cap. there is usually swelling, redness, and pain that lasts a few hours.

A severe MCL tear makes the knee unstable and causes pain and soreness on the medial or inner part of the knee. Most MCL tears can heal without surgery unless accompanied by injuries to other ligaments.

PCL Tears

The PCL or Posterior Cruciate Ligament gets damaged usually by falling directly on the frontal knee.

As an isolated condition PCL tear can be treated non-surgically, although surgical treatment options are also there for PCL injuries.

Surgery is usually only recommended for serious tears & multiple ligament tears.

Non-Ligament Causes

It is also possible for people to experience instability symptoms owing to knee osteoarthrosis and patellar instability.

Osteoarthrosis, wears down the cartilage, inflicting pain, swelling, and stiffness.

Patellar instability can also lead to kneecap dislocation. You get a feeling as if the knee is going to pop out, leading to instability, although there is no ligament injury.

Treatment

Your surgeon diagnoses your condition by compiling your medical history and results of clinical examination.

You may also have to undergo certain tests such as X-rays, MRI or CT scans to confirm the diagnosis.

Treatment of instability depends on the severity of the injury, as established by the diagnostic reports. Both surgical and non-surgical options are there for knee instability.

Primary treatment of dislocations includes:

Resting the knee is the first step,
Ice fomentation
Compression- use of braces or compressor.
Nonsteroidal anti-histamine drugs are prescribed to relieve the pain
Targetted physiotherapy is begun after the pain subsides a little, to lend muscular strength to the muscles that hold the knee.

A sports injury specialist or a physiotherapist can design an exercise procedure to deal with knee-buckling as a treatment and also as preventive care.

The exercise program is focused on strengthening leg muscles, keeping the knee cap aligned, and improving the range of motion in the legs, and improving flexibility.

Surgical treatments largely depend on the severity of the injury.

The ACL tears are usually repaired with a procedure called ACL Reconstruction.

It involves reconstructing the damaged ligament to restore the normal structure of the knee joint.

Several other procedures are possible, as the surgeon decides, such as the lateral retinacular release, realigning the quadriceps mechanism, or tibial tubercle transfer (TTT).

A Word From Eva

Most medical treatment for instability is aimed at brace protection of the ligaments, improving the walk, range of motion, and return the patient to normal activity as early as possible.

The sooner the problem is addressed, the better it is. Instead of worrying at home and dealing with the pain, have a discussion with your doctor at Eva Hospital about your treatment options and choose what suits you best.

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Current State of the Art in Arthroplasty

January 9, 2021March 30, 2024
by Eva Hospital

Every year, hundreds of people in Ludhiana undergo Arthroplasty or joint replacement surgery.

At Eva Hospital, state of art in arthroplasty technology has made these implants easier, and faster to recover from. The joints are made from more durable materials and operated with the most advanced tools and techniques.

Let us take a look at the ways in which advancement in medical science is making a difference in the field of total joint replacement operations.

Superior Joint Materials: Art in Arthroplasty

Robust and longer-lasting materials are now being used to fashion the implants used in Arthroplasty.

A contemporary plastic compound called highly cross-linked polyethylene is now being used as a better material that doesn’t oxidize inside the body and has a longer life.

Modern combinations of plastic and ceramic components in implants are also more durable and have lesser may last much longer than previous materials, with fewer side effects.

The Increasing Number of Joint Replacements

Nowadays, more and more people in the age group of 45 to 65 years are undergoing arthroplasty.

People want more active lives. Not only knees but other kinds of joint replacement have also increased – shoulder, hip, ankle, elbow, and wrists.

At Eva Orthopedic Care Centre, the most advanced techniques, newest methods, and joint materials are applied.

The aim is to achieve pain-free, active, and long-lasting health of joints.

The minimally invasive surgery and non-surgical options can also be discussed to get the best alternative for your bone and joint health.

Kinematically Aligned Total Knee Replacement

With the traditional TKR or knee arthroplasty, a significant number of patients may complain of restricted knee flexibility or having a normal gait.

But, combining the principles of Kinematic Alignment provides a superior outcome and patient satisfaction. KA restores the three kinematic axes of the knees, namely,

Transverse axis in the femur that flexes the tibia,
Transverse axis in the femur that controls patella extension,
Longitudinal axis in the tibia, that rotates it on the femur.

The main principle of the KA method is the rehabilitation of the three axes, the JLOA( joint line orientation angle), as well as the soft tissue. It also improves the walk, and the extent of knee motion(ROM).

State of the Art Hip Replacement

Healthy joints and pain-free movement is a prerogative for life.

When your orthopedic surgeon suggests that surgical replacement of your hip joint is the best alternative for being active and pain-free, you are bound to be curious about the state of the art in hip arthroplasty.

In the minimally invasive hip replacement, the damaged ball and socket of the hip are removed and replaced with a synthetic ball & socket joint.

The new implants are attached to your own bones, with a new sliding surface in between. The outcome is a relief from pain and a quick return to a normal and active lifestyle.

Traditional hip arthroplasty involves long incisions. The recovery period is also long. In the latest method of minimally invasive hip replacement surgery, the surgeon uses special instruments to make smaller incisions.

It renders minimum or no damage to the healthy tissue and tendons around the joint. The result is reduced downtime and speedy recovery.

According to Dr. Tanveer Bhutani, another promising surgical technique is biological hip joint replacement, in which the new joint is not made of artificial material, but from donated bone and cartilage.

The current state of the art in hip replacement achieves excellent patient outcomes with minimum rehabilitation.

Hip Replacement surgery

Total Hip Replacement Surgery- Procedure, Types and Recovery

June 3, 2020March 30, 2024
by Eva Hospital

Are you finding wearing socks and shoes difficult? If you have been finding the process of walking difficult without support, or if any past fracture or arthritis has damaged the hip, you must consider a total or partial hip replacement.

First performed in the 1960s, hip replacement surgery has come a long way in helping patients get out of the pain in the hip and any immobility that arises because of hip pain.

What is Hip Replacement Surgery?

Hip replacement is the procedure in which the parts of the hip joints are replaced by artificial implants called a prosthesis. You may be advised for total hip replacement surgery or even a partial hip replacement surgery. The portions of the femur (thigh bone) and pelvis that form the hip joint are removed and replaced.

Most people between the age of 60 and 80 years must consider the process of minimally invasive hip replacement. The surgeon makes an incision in the hip after giving you anesthesia and then removes the damaged hip to replace it with the artificial joint or implant.

Hip Replacement surgery is a process of almost two hours and is known to cure pain and immobility caused by arthritis or improperly growing hip. It is a complex surgery and the success involves dexterity in the hands of the surgeon.

Dr. Tanveer Bhutani, an acclaimed orthopedic in North India, is the best at hip replacement surgery. He has performed many hip replacement surgeries successfully with complete precision and perfection.

Should you consider Hip Replacement Surgery?

If arthritis has been a cause of worry and has caused severe hip pain that is not relieved by medications and physiotherapy, the hip replacement must be considered to relieve the debilitating pain.

If you feel the pain in the hip has been interfering with the regular movement and making walking or motion difficult, you are the right candidate for hip replacement surgery.

“Osteoarthritis is the main cause of hip immobility in many patients. It is the single most important cause of over 60% of hip replacement surgeries,” says Dr. Bhutani. If you have been ailing from osteoarthritis, rheumatoid arthritis, hip fracture, or septic arthritis, your surgeon may consider hip replacement surgery after monitoring and examining you physically.

Also, read- How to make your bones stronger with increasing age.

What is Better- Cemented or Uncemented Hip Replacement Procedure?

In the process of the surgery of hip replacement, the orthopedic surgeon will replace the existing hip joints with artificial prosthesis. The prosthetic element has to adhere to the patient’s natural bone. This can be achieved in either of the following two ways:

Cemented Joint Prosthesis

This procedure uses fast-drying bone cement to help the prosthesis adhere to the bone.

Uncemented Joint Prosthesis

This is called the cementless or the press-fit prosthesis. In this process, the cementless prosthesis is textured in a way that allows the bone to grow onto it and adhere to the prosthesis over a span of time.

The orthopedic surgeon may use cemented or cementless prosthesis or a combination of the two after talking to the patient.

The choice of the component is contingent on the following:

The type of hip replacement surgery done
The psychology of the patient
The requirement is according to the acumen of the surgeon.

Weigh the Pros and Cons of the Type of Prosthesis

The cemented prosthesis is majorly a layer of cement called acrylic polymer and this forms a layer between the patient’s natural bone and the prosthetic component.

This allows the bones which have become porous from osteoporosis to heal and affix to the prosthetic joint. The application of bone cement is a process of not more than a couple of minutes and this gives the orthopedic a surety of the positioning of the prosthetic joint component.

Another advantage of the cemented joint is that it comes with an antibiotic material that helps in the quick healing of any post-surgical infection.

However, Dr. Tanveer warns that the application of the cemented joint prosthesis has to be done by a proficient orthopedic.

There are chances that the artificial joint comes loose and the whole surgical process is rendered futile; there may be a chance that cement can enter the bloodstream and be detrimental to the lungs.

Seeing the negative impact of the cemented prosthesis, Dr. Tanveer advocates cementless or press-fit prosthesis.

The expertise of the orthopedic is in fitting the prosthesis in a way that the natural bone grows in the shape and direction of the prosthesis.

A cementless prosthesis holds the prosthesis and bone in a better way and rules out the risk of any loose cement entering the bloodstream. The orthopedic will observe the bone density according to the severity of osteoporosis and accordingly administer precautions.

What is the Recovery Time of Hip Replacement Surgery?

Hip Replacement is a procedure of four to six days to stay in the hospital. The orthopedic will start the physiotherapy within a day of the surgery and you will be advised to walk with support within one or two days of the surgery.

You will be able to resume your routine activities within 3 to 6 weeks of total hip replacement surgery. There may be surgical pain for the initial one or two days but you will be relieved from the excruciating arthritis pain right away after the surgery.

Dr. Tanveer says a hip replacement is a procedure more than 50 years old and has evolved ever since. It is a safe surgery to undergo if you want to alleviate the pain and suffering in the hips and enhance your mobility.

Conclusion

Nearly 30,000 total hip replacements take place in the U.S. each year. If the pain in the hip or arthritis has been affecting your daily life and movement, hip replacement is the cure. For the most effective surgery and the genuine diagnosis and check-up, rush to the best orthopedic in Punjab, Dr. Tanveer Bhutani, EVA Hospital, and get back to the normal pain-free routine. Check out our patient testimonial for hip replacement.

Eva Hospital

What are the Pre and Post Knee Surgery Precautions?

January 30, 2020March 30, 2024
by Eva Hospital

What are the Pre and Post Knee Surgery Precautions?

With the pain in the knee and arthritis worsening it all, knee replacement surgery has now been on your charts. Soon you are going to get the damaged knee replaced with an implant and get rid of the pain.

There may be many questions running on in your mind. Is it tough to prepare? Are there a lot of precautions? What will happen after the surgery? Would I be able to manage it all alone?

Dr. Tanveer Bhutani, the best knee-replacement surgeon in Punjab, says knee replacement adds years to your life and you can live a pain-free life as you resume your daily chores. However, to make the surgery a success, there are a few precautions and exercises before and after the surgery so that the recovery happens timely.

What are the Precautions before the Surgery?

Before you get to decide upon a date for the surgery there is a list of to-dos that will help you streamline the preparations for the surgery and you will not panic:

Quit Smoking and Alcohol

You must quit smoking at least a few weeks before the surgery as smoking interferes with the medications, slows down the healing process, and increases the risk of blood clots and infection after the surgery.

The surgeon must be apprised of how many drinks you have in a week so that he may have to plan an alcohol withdrawal if need be or even monitor any alcohol-related problems that might accrue post the knee replacement surgery.

Start Exercising

A weight check is an essential parameter and you must start exercising regularly before the surgery. This will help to monitor your excess body weight and improve the recovery process.

You must ask the surgeon and startupper body conditioning exercises along with knee joint strengthening exercises. Upper body conditioning helps reduce muscle soreness and fatigue which may be caused due to walking with the use of crutches or canes.

Keep exercising until the day of the surgery to improve your strength and increase your endurance. Also, circulation exercises help in preventing clots and controlling swelling post-surgery.

Plan a Healthy Diet

Plan your meals in a way that your body gets adequate nutrition as well as helps you remain fit. Include fibrous foods like broccoli, almonds, whole wheat pasta, avocados, beans, and peas, etc. in your diet to avoid constipation. Load your plate with foods rich in Vitamin C, iron, and calcium. Start your way to include spinach, raisins, prunes, oranges, milk, cheese, yogurt, and lean red meat.

Lastly, drink loads of fluids and stay hydrated.

Diabetes Management

Surgery and stress levels before and after the surgery can affect blood sugar levels. It is very important to control the blood sugar levels before the surgery as it may aggravate risks like infection and other complications. So manage your sugar levels before the surgery so that they are maintained even after the surgery.

Prepare Your Home

This is the most important step as you prepare your home for your arrival after the surgery. Clear out the path- hindering objects like stools, rugs, or extension cords. Prepare your bathroom with a high bathing chair and maybe an elevated toilet seat.

You will also need to arrange for a chair with a firm, straight back. Secure the handrails of the stairs before the surgery. Place all the medications and other daily routine useful items within reach to avoid bending during the recovery phase.

These precautions will help in paving your way to swift recovery after the surgery.

What are the Precautions after the Knee-replacement Surgery?

You have to be careful after the surgery and adhere to all the precautions so the risks and complications of the surgery are minimal.

Dr. Tanveer is the most reputed orthopedic surgeon in Ludhiana and he suggests that after the surgery you should follow all the precautions and take medications regularly. Here is a list of precautions post-surgery so that you do not have a knee injury and recover faster:

While Bathing and Dressing Up

While bathing an anti-slip mat and a stable plastic chair are what you need after the surgery for bathing; you have to avoid bending or squatting for anything you need. You may need an elevated commode for some time.

While dressing up do not wear your lowers or pants while standing up. Take care to put on pants, socks, and underwear first on the operated leg, and while undressing, remove the clothes from the operated leg in the end.

While Sitting Or Lying Down

After the surgery makes sure you are not sitting in a single position for more than half an hour. Avoid sitting on low sofas, stools, or low chairs. Make sure you always sit on a firm chair with a straight back and armrests.

You are advised to keep your knee straight while lying down and do not bend it by keeping a pillow under the knee. You may exercise by lying flat on your back.

Use of Stairs

Avoid long flights of stairs after the surgery and ensure the handrails are secure enough. Step up first with the leg that wasn’t operated on while step down first with the leg that was operated on. This will avoid any unnecessary strain on the new knee.

Walking

The surgeon will advise you to use a walker or crutches for about 4 to 6 weeks after the surgery. Walk slowly with baby steps initially. Wear shoes that have anti-skid soles and avoid any wet and slippery surfaces.

Complete List of absolutely NOs

The surgeon will completely say a NO to jerking, twisting, or sitting cross-legged immediately after the surgery. Also, you shouldn’t be carrying heavy weights and bags after the surgery to avoid putting weight on the new knee.

A little precaution goes a long way and helps in quick recovery after the surgery, says Dr. Bhutani.

Over to You

Knee Arthroplasty or total knee replacement surgery will unleash a new life for you and you will be free from stiffness and pain in the knee for over a long time.

Make sure you adhere to the restrictions and exercises recommended by the surgeon before and after the surgery to recover faster. For any queries or consultations, do not hesitate to meet the best orthopedic surgeon in Punjab, Dr. Tanveer Bhutani at EVA Hospital, and seek genuine advice.

Knee Surgery

Endometriosis and IVF

October 24, 2019March 30, 2024
by Eva Hospital

Infertility has been a major cause of depression among women. The causes of infertility may be many but one of the most debatable and discussed cause is endometriosis.

Endometriosis has been one of the most challenging diseases for gynecologists in helping women conceive. This is typically a condition where endometrial tissue which lines the womb, starts to grow outside the womb. Not only does it cause immense pain, it is one of the leading causes of infertility. The causes of endometriosis remain oblivious yet sometimes endometriosis may be caused due to genetic predisposition, immune dysfunction or may be environmental changes.

The process of endometriosis means chronic inflammation, scar tissue, and adhesions. Women with endometriosis usually complain of pelvic pain, dysmenorrhea, dyspareunia, and the whole baggage of infertility. Endometrial deposits can cause disruption or obstruction in the fallopian tubes and can prevent fertilization. The endometrial deposits can lead to cysts and interfere with the process of ovulation.

Endometriosis has been reported to affect 6%-10% of the female population and nearly 25%-50% of infertile women suffer from this debilitating disease. What’s even more startling is that nearly 35%-50% of the women with endometriosis are infertile.

Endometriosis at all stages has been reported to affect female fertility potential. With inflammation and subsequent formation of adhesions in the pelvis, the anatomy of the pelvis is distorted and this directly affects the anatomical connection between ovaries and fallopian tubes.

Advanced stages of endometriosis may lead to tubal blockages and also the formation of hydrosalpinges. In fact even mild or minimal endometriosis adversely affects spontaneous conception.

With all said and done it can be noted that some laparoscopic surgery may be a good option for younger patients. However for patients beyond 37 years the situation is alarming.

IVF comes as a blessing to patients suffering from endometriosis and are relatively not so young in age. Various researches show that after 1-4 IVF treatments nearly 56.7% women even in stage 3 or 4 endometriosis were pregnant and a whopping 40.3% were successfully able to give birth.

IVF provides a ray of hope for patients suffering from endometriosis. Women diagnosed with endometriosis have shown favorable results for conception when treated with IVF or FET (Frozen Embryo Transfer). In IVF, women’s eggs are retrieved and fertilized with partner’s sperms under controlled conditions in a laboratory. The resulting embryos are transferred in the uterus and pregnancy is ensured. Since endometriosis does not interfere with the fetus development, the pregnancy is healthy and so are the babies after IVF.

Endometriosis is a hindrance to conception and pregnancy. However under the aegis of an experienced doctor/gynecologist, the stumbling block can be removed and pregnancy can be accomplished. Dr. Shivani Bhutani, Eva Hospital, Ludhiana is a renowned doctor specialist in infertility and has handled umpteen cases of couples suffering from endometriosis successfully. She says, “Endometriosis has a detrimental effect on pregnancy. However with proper diagnosis and IVF/FET treatment, the infertility clause can be ruled out.”

Let there be million memories with your baby as you get rid of the infertility due to endometriosis. For any query or diagnosis, seek an appointment with the best infertility expert of Punjab, Dr. Bhutani.

Knee Surgery

Post Care Tips – Arthoscopic Knee Surgery by Dr.…

September 13, 2019March 30, 2024
by Eva Hospital

Knee Surgery is synonymous with a new lease of life and renewed energy to resume work. For marking the surgery a complete success, the post-surgery instructions have to be adhered to carefully.

For relief from constant pain and stiffness due to bone damage or any deformity, the choice of knee surgery is the right option.

Coming back to the usual routine with full gusto may take about 4-6 weeks. For quick healing and recovery, the patient has to follow the discharge instructions coupled with the medicine instructions judiciously.

The health care experts and the surgeon will guide you on the exercise, rest, discharge equipment, and follow-up appointment.

A list of handy tips will help you recover without much struggle. The following list has been curated under the able aegis of Dr. Tanveer Bhutani, Punjab’s best ortho-surgeon

Exercise

Regular exercise regime must be carried on pre and post the surgery. The level of activity and exercise will be contingent on the age and status of the patient. The walk is usually the best exercise and the surgeon will guide you about the pace and distance of the walk. Gradually the patient can increase the momentum as the healing gets better. ‘Exercise is thy medicine. Muscle-strengthening exercises work in healing a patient faster.

Medications

The initial wounds must be thoroughly cleaned so that the chances of infection are decreased. To maintain suppleness, coconut oil can be externally applied. The patient will be administered antibiotics for some time so that no bacterial infection seeps in.

Pain killers and other medications will be discussed at length by the medical practitioner so that the chances of inflammation are minimized.

Body Posture

The regular walk must be carried on.

Also, strenuous workouts or fitness activities like swimming, cycling, badminton, golf, or any other activity which requires movement of the lower limbs is gradually started after 6-8 weeks.

Role of footwear

For successful knee surgery, the patient must wear comfortable, supportive, well-cushioned shoes outdoors. Heels or other fancy shoes are not advisable in the beginning.

Word of Caution

It is advisable to take care of a rugged surface so as to avoid any twisting or sudden jerk to the knee. Do not keep a pillow or any other object underneath the knee so as to avoid a permanent knee-bend. Stiffness and inflammation may take longer to settle in some patients than the others.

Make sure you are regular on the follow-ups so that the pace of healing can be monitored. Also, any untoward changes can be gauged when the patient is regular in the follow-up visits.

Dr. Tanveer Bhutani is the best knee surgeon in Punjab and he has won many accolades to his name in the recent past. His patient testimonials are a blend of his polite demeanor and professional acumen. The innumerable successful knee surgeries are a testimony to his proficiency and expertise.