Replacing Pain with Smile

You need not feel depressed due to stiff, swollen or painful knees. Heed the advice of our panel of doctors for all possible remedies
By Amresh Kumar Tiwary

We all need some quality time for ourselves, some quality moments to spend with our families. We love to play around with our kids, go trekking with friends or enjoy long walks with our partners. We enjoy running around like never to be stopped. But have you ever thought that what happens if something stops us from doing all these things. Yes, there are people who are missing these small joys of life not because they don’t want to enjoy them but because they can’t. They suffer pain, not only of joints but also of missing special moment that life offers.
Joint stiffness & pains is one such ailment which is becoming very common amongst people. More and more cases of osteoarthritis are reported today; affecting knees and hips the most. Knees are primarily weight-bearing joints while hips not only support the weight of the body but also enable movement of your lower body; and therefore more commonly affected.
With time the severity grows leading to need for surgery for joint replacements. Such surgeries help patients lead a normal life as before. Apart from osteoarthritis, natural wearing out, rheumatoid arthritis, tumors involving or around joints and trauma with joint destructions due to road accidents, sports injury and injury of other forms leads to such processes.
With knee or hip surgery, a patient probably needs to stay in the hospital for a few days. If the person is elderly or has additional disabilities, he or she may then need to spend several weeks in an intermediate-care facility before going home.
According to Dr. Ashok Rajgopal, Chairman – Medanta Bone & Joint Institute, Gurgaon, “Knee pain usually occurs due to activities which are done often. It can also occur regardless of activity level, and is part of aging process. On the other hand, problem related to hip are usually caused due to irregular activities. Severity becomes manifolds because of unusual posture or sitting in one single position for long in office. There are several medicinal management processes available for joints related problems. One has to take these pills regularly to subside pain and to support movements.”
Says Dr S K S Marya, Chairman, Max Institute of Musculoskeletal Sciences, New Delhi, “Once the joint is damaged and the cartilage is lost the only way to recreate a painless situation is a joint replacement surgery. Medicines, physiotherapy, intra articular injections and arthroscopic debridement can be of limited assistance.”
Dr Ramneek Mahajan, Director Orthopedic and Replacement Surgery, Saket City Hospital, New Delhi, observes, “Joint replacement surgery is removing a damaged joint and putting in a new one. The doctor usually suggests a joint replacement to improve how you live as replacing a joint can relieve pain and help you move and feel better. Hips and knees are replaced most often while other joints that can be replaced include the shoulders, fingers, ankles, and elbows. These replacements are performed in different formats usually known as partial and total replacement, depending on the condition of the patient.”
The baby boomer generation is getting older and heavier which means that over the coming decades a lot of person in the young age are developing knee and hip problem.
Dr. Ashok Goel, Sr. Consultant, Sri Balaji Action Medical Institute, New Delhi, informs, “A huge number of young people are either obese or overweight, which causes more wear and tear (than normal weighing people) of bones making them osteoporotic. This can be attributed largely to today’s sedentary lifestyle. Another big reason behind bone and joint disorders largely seen in India is indoor lifestyle. A large number of Indians are vegetarians which limit their Vitamin D intake, less exposure to sunlight further reduces Vitamin D in the body hindering proper calcium deposition and making us Indian more vulnerable to bone related ailments.”
In today’s mechanical world, we tend to put ourselves in tremendous mental and physical pressure. Our ambitions make us see every possible extremity; we want to achieve everything and nothing can stop us. Long working hours, extended travels, quick or skipped meals and extreme mental pressure are part of our daily routine. While we walk on swords edge with such things, falling for sedentary lifestyle makes it more dangerous and our body starts wearing out.
Dr. Harshavardhan Hegde Executive Director, Bone and Spine Institute, Fortis Escorts Heart Institute & Research Centre. New Delhi, states, “We recommend joint replacement only when the architecture of the joint gets distorted and pain becomes constant; this may be the sequel to degenerative changes that are commonly seen secondary to aging, usage, lack of exercises, osteoporosis, deficiency in Vit D3, smoking etc. or to joint related diseases”.
One is mobilised with support after surgery within 24 hours. A walker or crutches are used for two to three weeks. Following this a cane is advised for a month. There may be some temporary pain in the new joint as muscles are weak from not being used and also as the body is healing. The pain can be helped with medicines and should end in a few weeks.
Dr. Ashok Rajgopal, adds, “In most knee cases, good amount of bending is seen on the first day itself and patients are able to walk with support within a day or two; with an approximate period of recovery being 4-6 weeks.”
“Conventionally the joint replacement is carried out in the elderly. Earlier it was preferred only in patients past sixty years of age because the average life span of the prosthesis was ten to fifteen years. With more people wanting to live for the present rather than suffer with the hope for a better tomorrow younger age groups are now opting for joint replacement surgeries” Dr. Marya., said.
Replacements are possible for both knee as well as hips; technology has also taken away the age constraints, now it can be done for the patients in their eighties also.
Dr. Hegde adds, “It depends on the extent of suffering and disability of the patient. However, as there is a limit to the survival of an artificial joint a young patient undergoing joint replacement may have to undergo a revision surgery again.”
Technology today has provided us with multiple options enhancing both quality as well as life of the implants. “Implants are sturdy and flexible. Recent advancement has increased the life of implant up to three times. The earlier implants used to last up to ten years. Now there are implants available which last for around thirty years.” Dr. Mahajan explains.
People usually are scared of such surgeries and it makes sense as joint replacement is counted amongst the major surgeries. Elaborating on the seriousness of the surgery, Dr. Goel says, “Any shortcoming can lead to serious problems like joint infection. It is therefore suggested that these surgeries should be performed by experts with a lot of experience. Patients have all the right to check the details like experience, training, education of any doctor they are getting treated with. Hospitals environment, upkeep and equipments also play a major role in such surgeries”.
Dr Mahajan, adds, “People usually ask me, how successful these surgeries are? It’s a doubt I have seen in every patient and nothing is better to address such doubts than live examples. Rakesh, chauffer by profession, lost his job and happiness because of severe arthritis. He was very depressed when he came to me. With God’s grace, I was able to give him back both his happiness and job. We performed total knee replacement for his both knees and he is perfectly fit to do anything he wants. He now drives me to work every day. Similarly, we came across a cycling enthusiast couple, they loved the sport but as wife was suffering from severe joint disorder, they were unable to pursue their interest. We operated her for knee replacement and since then they have been breaking many records and setting new milestones riding their cycles.”
Most of these surgeries are available in India now, along with the international quality implants and that too at a reasonable cost. “India is a hub of such surgeries now, we are in the age of internet and technology is not confined to any boundaries anymore. All the technology and implants are now available in India and such surgeries are performed with high standard here”, Dr. Mahajan, concludes.