Immobile Life

Knee problems crop up after years of wear and tear of the joints that are pivotal to the body’s movements and sometimes due to injuries or other causes. Double Helical takes a close look at all aspects of the disease, including treatment options
By Amresh Kumar Tiwary

The knee has the responsibility of supporting the entire weight of the body which makes it particularly prone to stress and strain. People world-wide are affected by knee problems. This problem is commonly found among people over 50 years of age and those who are overweight. Other reasons of knee pain can be health issues like bursitis, arthritis, tears in the ligaments, osteoarthritis of the joints, or infections. Each year, millions of people undergo knee surgery and how quickly they recover depends on many factors such as their age, the severity, location of the injury and pre-existing conditions, such as arthritis.
Knee surgery typically refers to total knee replacement, or knee arthroplasty. Knee surgery can be performed arthroscopically or in an open fashion. Special techniques and latest implants ensure restoration of natural movements. It covers major surgeries like total and partial knee replacement surgery and less invasive procedures like knee arthroscopy. The main aim of knee surgery is to increase the mobility and to reduce the pain associated with knee injuries and diseases.
Knee replacement is today one of the most successful operations in medicine and has improved the lives of millions of patients. Patients often ask about the correct time to have a knee replacement. One of the most effective means of treatment is physical therapy. The most effective therapy is called closed-chain quadriceps strengthening. With this therapy, the foot is planted on the floor to strengthen the large thigh muscles. This often improves the way the kneecap moves through the knee joint, decreasing pain and increasing ability to function.
Weight loss is also a very effective means of dealing with knee arthritis. When we speak about weight, we usually speak about the body mass index (BMI), which is a ratio of weight to height that can be calculated using online calculators. People with a body mass index above 30 should consider weight loss to see whether that improves symptoms before embarking on any kind of joint replacement.
In simple terms, knee replacement is a surgical procedure most often performed to relieve the pain and disability and restricted mobility arising out of degenerative arthritis. Major causes of debilitating pain include meniscus tears, osteoarthritis, rheumatoid arthritis, post trauma, ligament tears, and cartilage defects.
Knee replacement may be an option when non-surgical interventions such as medication, physical therapy, and the use of a cane or other walking aids no longer help alleviate the pain. Other possible signs include aching in the joint, followed by periods of relative relief; pain after extensive use; loss of mobility; joint stiffness after periods of inactivity or rest; and/or pain that seems to increase in humid weather.
An orthopedic surgeon helps to determine which type of knee surgery is most appropriate. He may decide that knee replacement surgery is not appropriate if you have an infection, do not have enough bone, or the bone is not strong enough to support an artificial knee.
The doctors generally try to delay total knee replacement for as long as possible in favour of less invasive treatments. With that being said, if you have advanced joint disease, knee replacement may offer the chance for relief from pain and a return to normal activities.
Knee replacement is a routine surgery performed on more than 600,000 people worldwide each year. More than 90% of people who have had total knee replacement experience an improvement in knee pain and function.
Deciding whether or not to get knee replacement surgery is difficult. Discussing your treatment options with your doctor is essential to help you choose whether this is the right option for you.
Top knee surgeons in India are not only highly qualified but also have huge experience of performing thousands of successful knee surgeries. The operations and treatments that knee specialists offer include total and partial knee replacement, arthroscopic knee surgery, and knee ligament reconstruction (including anterior cruciate ligament reconstruction).

When to go for Knee Replacement

Your pain persists or recurs over time
Your knee aches during and after exercise
You’re no longer as mobile as you’d like to be
Medication and using a cane aren’t delivering enough relief
Your knee stiffens up from sitting in a car or a movie theatre
You feel pain in rainy weather
The pain prevents you from sleeping
You feel a decrease in knee motion or the degree to which you’re able to bend your knee
Your knees are stiff or swollen
You have difficulty walking or climbing stairs
You have difficulty getting in and out of chairs and bathtubs
You experience morning stiffness that typically lasts less than 30 minutes (as opposed to stiffness lasting longer than 45 minutes, a sign of an inflammatory condition called rheumatoid arthritis)
You feel a “grating” of your joint
You’ve had a previous injury to the anterior cruciate ligament (ACL) of your knee

Top knee surgeons in India
The knee replacement surgeons in India have created a reputation for conducting groundbreaking surgeries. Medical travelers from around the world visit India every year with various knee problems. The quality that sets Indian knee surgeons aside from others is that they are not only good in communicating with the patients but are also good listeners. They provide a beforehand guide about the details and requirements of the procedure, helping the patients to be ready for the surgery both mentally and physically.
Top Indian knee surgeons like Dr Ashok Rajgopal, Dr Vikram Shah, Dr Abhay D Narvekar and Dr Sanjay Desai are highly educated and have huge work experience both in India and abroad, giving them that extra edge over other surgeons in the world.

Dr Abhay D Narvekar
Practicing as an exclusive arthroscopic surgeon for over 20 years, Dr Abhay D Narvekar, MS (Ortho), D. Ortho, Hinduja Hospital, Mumbai, has performed over 8,000 arthroscopic surgeries of the knee, shoulder, ankle and the elbow. He also runs the arthroscopic services for all the municipal hospitals in Mumbai. He has extensive experience in managing ligament injuries of the knee. With over 1,200 arthroscopic ACL reconstructions, he is vastly experienced in PCL reconstructions and articular cartilage transplants using the mosaicplasty technique as well. He has pioneered cadaveric training for arthroscopy in various training workshops.

Dr Sanjay Desai
Dr Sanjay Desai is a founder-member of the Shoulder Society of India and also Consultant, Lilavati and Breach Candy hospitals, Mumbai. He is a pioneer super-specialist in shoulder and knee surgery. Dr Desai operated on Bollywood’s superstar Shah Rukh Khan and treated actor Hrithik Roshan. Practicing in the highly specialized field of shoulder and knee surgery since the last 10 years, to him goes the credit of bringing world class arthroscopic shoulder surgery to India. Shoulder surgery is a relatively young speciality. Patients, including our sportsmen and cricketers, have had to travel abroad to undergo advanced shoulder surgery. Thanks to his expertise, this revolutionary surgical treatment is now affordable and available at our doorsteps.
Dr Desai has had a brilliant academic record studded with Gold medals throughout his orthopaedic career, including one from the University of Liverpool, while in the United Kingdom. He is still active academically, presenting his work at international conferences such as the World Shoulder Congress at Cape Town, South Africa, in April 2001. The “Young achievers Award – 2002” conferred by the Indo-American Society is a formal recognition of his contribution. Dr Desai has been invited as a faculty to Barcelona, Spain.
He is acclaimed among the medical fraternity across the globe for developing the ‘OS Needle’, a breakthrough technology which greatly reduces the time required in joint replacement.

Dr Vikram Shah
Ahmedabad-based Dr Vikram Shah has the experience of carrying out over 16,000 knee replacement surgeries and may be rightly termed as “The Knee Guru”. Dr Shah, who performed 3,000 knee surgeries in 2008, has given no leg to stand on to his closest peer in the world, a UK surgeon who carried out 1,000 surgeries in the same year.
A visionary and founder of quality health services establishments like Shalby, Dr Vikram Shah’s name is synonymous with knee replacement surgery. Inventor of OS needle used by orthopedic surgeons worldwide, Dr Shah along with his team has performed over 40,000 joint replacements. Presently they perform more than 300 primary joint replacement and 7-8 revision joint replacement surgeries every month. Dr Shah brought laminar air flow and body exhaust systems in the OT to perform joint replacement surgery in India and established the first Indian hospital with a Class 100 operation theatre making knee replacement surgeries much more safe and successful.