Orthopedics and Rheumatology

Joint Replacement Surgery

Hip joint and knee joint replacements are helping people of all ages live pain- free, active lives.

Joints are formed by the ends of two or more bones connected by tissue called cartilage. Healthy cartilage serves as a protective cushion, allowing smooth and low-friction movement of the joint. If the cartilage becomes damaged by disease or injury, the tissues around the joint become inflamed, causing pain. With time, the cartilage wears away, allowing the rough edges of bone to rub against each other, causing more pain.

When only some of the joint is damaged, a surgeon may be able to repair or replace just the damaged parts. When the entire joint is damaged, a total joint replacement is done. To replace a total hip or knee joint, a surgeon removes the diseased or damaged parts and inserts artificial parts, called prostheses or implants.

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Arthroscopic Surgery

Arthroscopy is a surgical procedure during which the internal structure of a joint is examined for diagnosis and treatment of problems inside the joint. In arthroscopic examination, a small incision is made in the patient’s skin through which pencil-sized instruments that have a small lens and lighting system (arthroscope) are passed. Arthroscope magnifies and illuminates the structures of the joint with the light that is transmitted through fibre optics. It is attached to a television camera and the interior of the joint is seen on the television monitor.

Arthroscopic examination of joints is helpful in diagnosis and treatment of the following conditions:

  • Inflammation: Synovitis, the inflammation of the lining of the knee, shoulder, elbow, wrist, or ankle
  • Acute or chronic injury: Injuries to the shoulder, knee and wrist joint such as cartilage tears, tendon tears, carpal tunnel syndrome
  • Osteoarthritis: A type of arthritis caused by cartilage loss in a joint
  • Removal of loose bodies of bone or cartilage that becomes logged within the joint

During arthroscopic surgery, either a general, spinal or local anaesthesia will be given depending on the condition. A small incision of the size of a buttonhole is made through which the arthroscope is inserted. Other accessory incisions will be made through which specially designed instruments are inserted. After the procedure is completed arthroscope is removed and incisions are closed. You may be instructed about the incision care, activities to be avoided and exercises to be performed for faster recovery.

Some of the possible complications after arthroscopy include infection, phlebitis (clotting of blood in vein), excessive swelling, bleeding, blood vessel or nerve damage and instrument breakage.

Recovery

It may take several weeks for the puncture wounds to heal and the joint to recover completely. A rehabilitation program may be advised for a speedy recovery of normal joint function. You can resume normal activities within a few days.

Rheumatology

Rheumatology is a sub-specialty which is associated with the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Rheumatologists are the physicians who obtained fellowship or board certification in management of rheumatic conditions.

Rheumatologists diagnose and treat several diseases including rheumatoid arthritis, osteoarthritis, gout, systemic lupus erythematosus, back pain, osteoporosis, fibromyalgia and tendonitis. Certain rheumatic conditions are difficult to diagnose in the early stages and also to treat. It is important that diagnosis and treatment begin early, as some musculoskeletal disorders respond best to treatment in the early stages of the disease else may cause severe complications in future.

Some rheumatic diseases are complex and often change or evolve over time. In such cases rheumatologists work closely with patients to determine a diagnosis and course of treatment. They often serve as physicians, acting like consultant to advice for other doctors. Rheumatology has helped patients with rheumatological disorders lead a near normal life without any disabilities.

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