FAQ's

Early onset arthritis can also be treated by many non-invasive methods. Replacement surgery is offered to patients who have a combination of pain, deformity and inability to walk or sit normally due to pain in knees. An Xray is commonly advised. Post surgery, one can expect decrease in pain, ability to walk, sit, climb stairs better and proper alignment of lower limbs. Best would be to consult with the orthopedic surgeon when your elder one has pain, inability to flex or fold the knee, difficulty in walking or climbing stairs and deformity (crooked knees).

Computers use a program that gives the surgeon real time data about the alignment of knee during surgery. One of the main aims of knee replacement surgery is to restore the alignment of the lower limbs during surgery. A computer helps achieve very high accuracy in alignment restoration and therefore is superior to conventional surgery. Robots use a similar computer program, but also execute certain steps of surgery instead of the surgeon. Robots do not have any added advantage over computer assisted surgery.

One Does Not have to undergo any bed rest after knee surgery, be it after replacement surgery for arthritis or after ligament reconstruction surgery after ligament injury. Replacement patients can walk full weight bearing on the knee the same day after surgery. Ligament reconstruction patients also do not need bed rest after surgery.

Backache can occur due to many reasons, which could be different across age groups. A clinical assessment, simple imaging and simple treatment are often all that it needs. MRI and surgery are suggested only in a few patients who have PERSISTENT pain which radiates into the legs (like sciatica) or numbness or loss of power in limbs, which is not responding to medical treatment.

In frozen shoulder, the soft tissues around the shoulder become stiff and painful. It is also called adhesive capsulitis. Movements of the shoulder become progressively stiff and restricted. It can sometimes last and give pain for 1 - 3 yrs. Physiotherapy helps keep the shoulder mobile even though it isn't therapeutic. Manipulation of the shoulder under anesthesia may sometimes be necessary if the shoulder is too stiff.

Following are some conditions when an orthopaedic surgeon will prescribe steroids:

• Rheumatoid and other inflammatory diseases
• Acute muscle spasms (local injections)
• Heel pain and plantar fascists (local injections)
• Epidural injections in disc pain
• Tendinitis, trigger finger, tender spots

Steroids in SMALL DOSES, oral or injectable, for orthopaedic problems are not only HARMLESS but also VERY EFFECTIVE pain and inflammation relievers.

MRI: (Magnetic Resonance Imaging)

• Most useful for seeing muscles, ligaments, tendons, arteries, cartilage etc.
• It's not the best for visualizing bones or fractures
• It forms, images with the use of magnetic field
• There is no radiation exposure to the body from MRI

Xray:

• Simplest and fastest way for imaging of bones
• One cannot see soft tissues with an Xray
• There is exposure to minimum radiation
• Only a 2D picture can be seen
• Xrays are often advised in various planes

CT:

• Very high resolution as compared to Xray
• Minute details of Bone can be seen even in 3D
• More radiation than Xray
• Not the best for soft tissues

These are completely different conditions and both are mostly independent of each other.

Osteoarthritis:
Osteoarthritis is an age related degenerative condition that causes loss of cartilage in mainly weight bearing joints and thereby leads to pain, difficulty in performing movements and deformity of joints. It's commonly found in knees and hips. Treatment after a certain age is joint replacement surgery and that causes significant relief from pain and also corrects deformity.

Osteoporosis:
Osteoporosis is a condition in which bones become weak and fragile with age and menopause. Patients who suffer from osteoporosis, may incur major fractures even after trivial injuries. It's common after menopause mainly due to hormonal changes in women. Regular calcium intake, daily exercise and medications for osteoporosis can stop progression of this problem.

A FRACTURE is a break in the continuity of the bone. Literally, when the bone breaks into two or more pieces. A DISLOCATION is a loss of articulation of the joint. Here the two or more bones that form the joint, lose alignment. It's commonly referred to in common language as the joint having moved out of position. A dislocation is an urgent condition and should be treated by an orthopaedist within 6 hours after the injury.

Fracture healing time in otherwise healthy individuals are different across age groups.
(In patients who have received proper treatment)

• 4 - 6 weeks: children (growing skeleton)
• 6 - 8 weeks: adults
• 8 - 12 weeks: some bones like heel bone
• 8 - 12 months: for fractured bone to get full strength

Arthroscopic surgery in orthopaedics, is the one in which only two or three Keyhole sized incisions are used to complete the full procedure. The surgeon sees the structures through a small camera. Advantages of key hole surgeries include.

• Less collateral damage to other soft tissues.
• Healing is fast.
• Very few or no stitches may be required.
• Faster rehabilitation to routine activity and sports.

It's used for diagnosis, ligament repair, cartilage repair, etc.

Tennis elbow is inflammation of the muscle origins on the outer side of your elbow near the bony prominence. It's called tennis elbow as it's common in tennis players due to repeated use of reverse hand shots. It can happen to people who don’t play tennis as well, example Cricket, badminton,volleyball players, Executives who have long desk hours on computers, Housewives, cooks, new mothers, people who deal with heavy jobs, avid gymmers etc. Treatment can range from anti inflammatory, activity modifications to injections and surgery.

Hyperuricaemia leads to gout. Excessive presence of uric acid in your blood is called hyperuricemia. When uric acid is more than normal levels in the body for a long time, it gets deposited in joints in the form of crystals. The joints swell up and are very painful. The Base of the great toe is very commonly involved. Treatment usually involves medications decrease pain and swelling and some medications to decrease uric acid in blood. We will advise such patients to decrease protein intake.

No, antibiotics and analgesics (pain killer) are different medications.

Antibiotic:
This is a medication that is used to fight infection-causing germs and organisms. These may be given to prevent occurrence of infections as well.

Analgesic:
Simply called pain killers. These are medications uses to fight pain. Various classes of medications are available which may act in different ways to ultimately decrease pain.

Both these are safe and helpful when used in the correct amount for the correct period of time. Both may be harmful if used more in terms of quantity or time.

Reducing 1 Kg Bodyweight, reduces equivalent of 6 Kgs from each knee. Weight loss definitely helps decrease knee pain and slows down process of wear and tear of weight bearing joints.

Overweight individuals are also at an increased risk for the following diseases.

• Coronary (heart) disease
• Hypertension (high BP)
• Diabetes
• Stroke (Paralysis)
• Dyslipidemia
• Gallbladder disease
• Osteoarthritis
• Sleep apnea

The trigger finger is a condition where ones finger doesn't straighten easily after making a fist (flexing). It occurs because of inflammation in a pulley across the tendon. The tendon is the tightest band which moves the finger. It's very common in people who have diabetes. Treatment may range from medications to injections to a simple surgery. Treatment usually resolves the annoying problem very easily.

Some Calcium Rich Foods:

• Milk
• Buttermilk (Chaas/Taak
• Skimmed milk
• Papaya
• Banana
• Oranges
• Almonds
• Green Leafy Vegetables
• Paneer
• Soyabean
• Cheese
• Eggs

Our knees bend to various degrees for us to be able to accomplish various activities
60 degrees:

• Climbing stairs
• Sitting in a car
• Sitting at ease

60 - 90 degrees:

• Sitting on chairs
• Climbing 2 steps at a time
• Squats
• Sitting in Indian hatch back
• Sitting on the john
• Trekking

90 - 110 degrees:

• Tying shoe laces
• Sitting on a low sofa
• Sitting cross legged
• Frog style swimming
• Pick up objects from the ground
• Cycling
• Rock climbing

110 - 135 degrees:

• Vajrasana
• Prayers
• Few forms of dance
• Indian loo
• Sitting on the floor

Contrary to popular belief, the best time to expose our skin to sunlight for Vitamin D production is from 10 am till 3 pm. 15 – 20 minutes of exposure on torso, arms and legs for 3 or 4 days a week suffice. Morning hours and evening hours are also ok, but production of Vitamin D is a maximum from 10 am to 3 pm.

Contrary to popular belief, jogging or running is NOT bad for your knees. Exercise in any form is welcome. Swimming or cycling, however, is easier on the knees and can still achieve the same physical results. It's better to swim or cycle if you have injured or arthritic knees.

The cold helps to relieve pain, reduce bleeding and decrease inflammation and swelling. Ice application is used in case of red angry swollen conditions. In these conditions the area is usually warm to our touch.

Following are some conditions where we can apply ice

• Ankle Sprain
• Injury
• Fracture
• Bursitis
• Synovitis
• After Surgeries and Invasive Procedures

PS: In case of dressing over the area, ice packs can be wrapped in a thick towel or cloth and applied, to prevent getting the area wet.

Warmth increases blood supply to the area (giving more oxygen and nutrients to the affected area), helps reduce joint stiffness and relieves muscle spasm. Hot pad application (Warm Fomentation) is used in cases of long term pain associated with stiffness and degenerative diseases.

Following are some conditions where we can apply hot fomentation.

• Arthritis of knee
• Backache
• Frozen shoulder
• Tennis elbow
• All chronic aches and pains

PS: Always wrap hot pads / hot water bottles in towels to prevent direct contact with skin and avoid burns.

Carrying a heavy shoulder bag for long hours can be the cause of your shoulder pain, neck ache, backache, headache, arm pain, tingling and numbness. Men who carry office bags or laptop bags have the same problem. Bags should be less than 5 % your body weight. They should have broad padded straps and should be worn close to the neck. Alternating the shoulder every few minutes is better than wearing it on the same side always.

Yes it provides live input during surgery to the Surgeon, robotically directs surgical devices and increases accuracy of surgery. Lesser blood loss may be expected with high accuracy in ligament balance.

No.. It does involve a small added charge, but it’s not much when viewed in context of the total cost of surgery.

Our Robot is surgeon dependent and has checks in place to avoid mishaps.. Infact the robot can only increase efficiency of the procedure and surgical outcome.

Yes.