The knee joint is formed by the lower end of femur, upper end of tibia (leg bone) and patella (knee cap). The ligaments of the knee play a crucial role as they are the most important element in providing stability to the knee.

Ligaments of the Knee

The knee is stabilized by four main ligaments – two ligaments in the center of the joint (cruciate) and two ligaments on either side of the knee (collateral ligaments).The Anterior Cruciate Ligament (ACL) is in the front of the knee joint and it prevents the tibia from slipping forward. The Posterior Cruciate Ligament (PCL) is at the back of the knee and it prevents the tibia from slipping backwards.

The collateral ligaments prevent abnormal sideward movements of the tibia. The Medial Collateral Ligament (MCL) stabilizes the inner side of the knee and the Lateral Collateral Ligament (LCL) along with a few more ligaments stabilizes the outer aspect of the knee.

How ACL is damaged

Body contact sports, road traffic accidents and awkward fall are common causes of ACL injury.

How do I know

Many people can hear a “CRACK” or “POP” at the time of injury, followed by immediate swelling and pain. Players often have to be carried off the field. Later there will be pain, weakness and a peculiar looseness of knee- giving way- the most disabling problem.

What is the treatment

It depends on your disability and your activities. In brief, if you are engaged in lots of outdoor activities and heavy work and not willing to restrict your activities then you need an operation to make a new ligament. This applies to most young and active people.

What is the operation

Operation is done in general or spinal anesthesia. At first inside of knee is examined by a telescope, which is introduced through small puncture (arthroscopy). Next a new ligament is prepared by taking few fibers from the tendons around knee. Generally the hamstring or patellar tendon is used.

This newly fashioned ligament is then placed inside the knee which grows and matures to take the function of original ligament.

What if I do not get operated

Other then the disabilities like giving way, pain, swelling etc. it is said to be the “Beginning of The End of Knee.” The knee suffers repeated injuries because of its undue laxity and early arthritis sets in.

ACL Injury Tear Surgery Recovery

ACL Surgery Guideline For patients

Preparation before the operation:

1. Arrange for a leave about one month from your work.

2. DO NOT eat or drink anything after Midnight. (NBM)

3. Report to hospital 8 a.m. – Please bring your all X ray and reports with you.

4. The hospital stay is usually 2-3 days – bring your clothes accordingly.

After operation

1. Exercise: Start the static quads exercise the same day. From next day a qualified physiotherapist will take you through a detailed exercise schedule.

2 .Walking:  You can stand up next morning and start walking. You will need the help of a stick or a pair of crutches for the first few weeks. However, walk minimally for first two weeks after operation.  This reduces pain, swelling and helps healing.

3. ICE: Compress: Put some crushed ice in a plastic bag, cover it with dry towel and place it on the knee for 15-30 minutes. Do it four times daily.

4. Dressing: Will be changed in the hospital the after the operation. No further dressing is usually necessary. Keep it dry until stitches are removed.

5. Stitch removal:  Usually done 12-14 day after operation.

6. Shower: Allowed only after 2 weeks, when stitches are removed.

7. Toilet: You should use commode for 2-3 months after operation (If you do not have commode at home arrange for a chair commode)

8. Driving:  You can drive a car after two months and a two wheeler after three months, provided you have good power and control of leg.

9. Activities: During first two weeks you should mostly rest in bed with leg elevated on a pillow, and do exercise as advised. Subsequent movements depend on your muscle strength and type of operation.

Generally, after 4 weeks one can join light office duties.

After 8 weeks one can join gym, ride a bicycle or drive a car.

After 4 months light on field activities are allowed.

After 6 to 9 months games can be played provided good muscle power is achieved.

Also read:- ACL reconstruction surgery कब तक करवानी चाहिए ?

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In addition to natural, inevitable aging of the knee joints, other factors can make you more susceptible to this wear and tear. Osteoarthritis, trauma, excess body weight and lack of muscle strength and flexibility can all cause or contribute to knee problems.

SAVE YOUR KNEE in Hindi by Dr.RAJAT JANGIR

Osteoarthritis is the most common type of arthritis and other beong rheumatoid arthrtis. With this aging degenerative process, the cartilage that cushions the joints breaks down and can cause pain, immobility, and stiffness.

Whether a previous injury or repetitive stress from high impact activity jumping, running, etc., injury to the knee can also result in acute, dull, recurring or chronic pain. This trauma can eventually develop into osteoarthritis if left untreated.

Putting extra stress on weight-bearing joints like your knees puts you at risk for knee pain, as well.  This excess body weight not only accelerates joint deterioration but also increases your risk of osteoarthritis.

Weak or inflexible muscles also put undue stress on the knee joints. Without good muscular strength and flexibility to safely support your full range of motion, your knees are at a greater risk of injury.

You can help protect the health of your knees by adopting these healthy  lifestyle habits, irrespective of your age. Always consider your doctor  before starting a new exercise regimen.

Exercises for KNEE PAIN OSTEOARTHRITIS in Hindi

Strengthen your upper and lower leg muscles around knee. strenthen your hamstrings, quadriceps, gluteus muscles, hip flexors and psoas muscles.

Stretch those same leg muscles to support your full range of motion. Try incorporating yoga into your stretching routine.

Maintain a recommended weight. Extra pounds add significant stress to the knees. Even a 10-pound weight loss can make significant difference to your knee.

Choose low-impact exercises to protect the cartilage in your knees. Cardiovascular activities like cycling (on a properly fitted bike) and swimming can help keep knee cartilage healthy and prevent future damage.

See a your Doctor  right away if you have a swollen knee with pain or stiffness.

Be cautious when playing sports that require you to abruptly start, stop or direction change, like basketball or football.

Stay active every day. Physical activity everyday helps prevent stiffness and muscle atrophy and can protect your knees from future injury.

Mix up your exercise routine. Activities that put repetitive stress on your knees can increase your risk of developing a knee problem. Its better to mix up your exercises.

Exercise for Frozen Shouder in Hindi

The post Save Your Knee first appeared on My Shoulder & Knee Expert Blog.

1. Reduces stress and improves Mental Health

Cycling can ease out feelings of stress, depression, or anxiety. Focusing on the road while cycling helps develop concentration and awareness of the present moment. This may help take your focus away from the mental chatter of your day.

If you are feeling lethargic, get yourself on your bicycle for at least 10 minutes. Exercise releases endorphins in brain, which in turn help you feel better while lowering emotional stress.

2. Cardiovascular health and Blood Pressure

High blood pressure is a risk factor for cardiovascular disease in some people. Physical activity such as cycling controls your blood pressure and reduces risk of heart diseases. Use of cycling for going to office reduces the rate of heart attacks by 15 percent than with no physical activity.

3. Weight loss

Cycling is low impact exercise and can be done at moderate intensity for extended periods, it is among best exercise for anyone looking for weight loss. While diet is generally an important part of any weight loss plan, studies have shown that even without diet restrictions, individuals who were obese and cycled daily for six months lost 12% of body fat, and cycling was a more effective activity than the walking and swimming groups in the same study.

4 Low impact exercise

It is low impact form of exercise which makes it safe for older adults and people with weak or damaged joints.

Orthopedic surgeons may recommend cycling on level surfaces or indoors after surgeries such as total hip and knee replacement patients. This low impact nature of the exercise can accommodate a variety of injuries and disabilities while still allowing a person to be active.

5. Improves balance, posture, and coordination

While cycling when you try to stabilize your body and keep your bike upright, it improves your overall balance and coordination. Balance tends to decline with age and inactivity, which can be improved with cycling.

Improved balance is beneficial in the prevention of falls and fractures, which can leave you on the sidelines while you take time off from exercise to recover.

6. Boost  your immune system ?

This one is particularly important during the global corona pandemic. There is question mark in the statement. Studies suggest that immediately after intense exercise, such as an interval training session, your immune system is lowered but after adequate recovery such as eating and sleeping well it boosts your immunity.

7. Environmentally friendly

Reduce your carbon emission footprint by riding your cycle whenever possible. Cycling is a great replacement for transport options especially useful when you are going to places that are a bit too far to walk, but you still don’t want to take a car. And you don’t need to fight for a parking space in crowded areas.

Know more about sports injury in Hindi

Author is senior orthopaedic surgeon and sports injury expert at Jaipur, India

Sports Injury doctor in Jaipur

The post Seven benefits to start Cycling in Corona Pandemic first appeared on My Shoulder & Knee Expert Blog.

“Shoulder replacement, also known as shoulder arthroplasty, is the removal of portions of the shoulder joint, which are replaced with artificial implants to reduce pain and restore range of rotation and mobility. It is very successful for treating the severe pain and stiffness caused by end-stage arthritis or due to injury.”

Shoulder replacement surgery is less common than knee or hip replacements. But more than 3000 shoulder replacements are done in India every year.

Shoulder Pain Doctor in Jaipur

The Shoulder Joint 

It is ball-and-socket joint type joint. The bone in your upper arm (humerus) has a round end that acts as a ball and  fits into the curved structure (socket) on the outside of your shoulder blade.

Ligaments, tendons and muscles hold it together. A layer of tissue, cartilage keeps the bones apart, so they don’t rub against each other.

The ball and socket type joint lets you move your arm up and down, back and forward, or in a circle.

Shoulder Replacement – Why you need it !

In conditions where you have severe pain and not able to move and use shoulder joint 

• Shoulder Injury – Shattered bone around shoulder 
• Severe osteoarthritis 
• Torn rotator cuff with arthropathy 

If you have not got relief from physical therapy and pain medicine, doctor may advise you surgery.

Injection steroid in Shoulder Pain relief ?? 

What is done in surgery 

Shoulder surgeon will replace the bone in the ball and socket of your shoulder joint with a material that could be metal and plastic. You will need physical therapy the surgery.

There are three types of shoulder replacement surgeries:

Total shoulder replacement: This is the most common type shoulder replacement. Here the surgeon replaces the ball at the top of your humerus with a metal ball, which gets attached to the remaining bone. The socket of the joint gets covered with a new plastic surface.

Hemi shoulder replacement: Only the ball gets replaced at the top of your humerus with a metal ball.

Reverse shoulder replacement:

This is done mostly if they have a torn rotator cuff with arthropathy.

Nowadays due to better results also done in case of fracture around shoulder with shattered bone.  

It’s also done when another shoulder replacement surgery didn’t work.

This is called reverse because here ball get replaced with socket and socket with a ball. Here functions of the shoulder are better despite poor rotator cuff tissue. The metal ball gets attached to your shoulder bones, and a socket is implanted at the top of your arm.

Preparing for Your Surgery

Your Shoulder surgeon will do a full examination of your shoulder. X-rays, CT scan MRI or other imaging tests will be required.

Talk to your doctor about any other  medical conditions you have and any medications you take. You will have to stop taking certain drugs, especially painkillers, several weeks before surgery

The procedure takes about 2 hours.

Shoulder Dislocation doctor in Jaipur 

Recovery

You can expect to spend 2 to 4 days in the hospital after your operation.  You will be given pain medicine to reduce pain. Cold compression can help control the swelling.

At first, your arm will be kept in a brace to give rest. Within a few days your doctor will  start physical therapy to get your arm and your new shoulder started working.

You will do exercises that will gradually improve how your new joint works.

Don’t rush things:

It may take 4 to 6 weeks before you can pick up anything heavier than a glass of water .

Your arm will be in an arm sling for most of your recovery. It may be 8 to 10 weeks or more before you can drive again.

You will go for several follow-up visits with your doctor so they can see how your recovery is going.

Complications

Most people have full motion in their shoulder and return to their daily routine after shoulder replacement surgery. But as with any operation, there is a chance of complications.

Infection or bleeding: You will be given antibiotics after your surgery to lower your chances of infection.

Dislocation: This happens when the ball slips out of the socket.

Nerves around your shoulder may get damaged: They usually recover with time.

After years of use, the replacement joint may become loose or separate from the bone: You may need surgery to fix it.

Shoulder dislocation treatment in Jaipur

Author is senior Shoulder and knee orthopaedic surgeon in Jaipur, India

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