Frequently Asked Questions

What are the causes of knee pain?

Following could be one of the reasons for knee pain :

When one should contact the knee specialist?

If the knee pain does not get relieved with routine family doctor treatment then one should not keep pulling the knee pain rather one should show to knee specialist.

What are the treatment modalities of knee pain?

The treatment consists of non-operative and operative methods

• Non operative : physiotherapy, hot-cold fomentation, braces along with medicines
• Operative : different kind of operations for different situations:
• Arthroscopy : endoscopic procedure for knee consists of few puncture wounds especially for ligament, meniscus, cartilage injuries, some early arthritic joints.
• Total knee replacement : for Osteoarthritic joint.

Other procedures like deformity corrections, intra-articular sodium hyaluronate injections etc.

What is arthroscopy?

It is an endoscopic operation requires specialized skills to operate. It includes cleaning of joint debris and loose bodies. The torn meniscus or ligament can be repaired with small incisions. The patient gets discharge from the hospital within a day. It can help the patients suffering from rheumatoid arthritis also.

What kind of precautions should be taken to avoid knee arthritis?

• One should do required exercises on regular basis as shown by the consultant.
• Cycling, swimming and other non-loading exercise are better.
• Try to avoid putting on over-weight.
• If the knees are bent then go for deformity correction as early as possible.

What is knee replacement surgery?

It consists of opening the joint, removing the damaged portions of joint and replaced-resurfaced by artificial joint then closing the joint.

What is the postoperative protocol for patient undergoing knee replacement?

Patient usually stays in hospital for five to seven days depending upon the recovery. The dressing is changed once or twice after surgery. Patient starts walking next day after surgery in most of the cases. Initially support for walking inform of a stick or walker given for few days to two weeks.

Shoulder Problems

What is frozen Shoulder?

If you are having stiffness of shoulder in all directions then it is called frozen shoulder.

Causes for frozen Shoulder

Commonest cause is idiopathic that is the exact cause not known Second commonest is diabetes Third cause is it could be secondary to some injury or operation.

Treatment options for frozen shoulder Apart from physiotherapy, injection of steroid as well as sodium hyaluronate in the joint is one of the commonest modality to treat frozen shoulder.

If the patient does not respond to above mentioned therapy, arthroscopy ( endoscopy) is the treatment of choice. In this operation doctor puts endoscope inside the joint & cuts the stiff tissues.

Advantages of arthroscopy guided treatment of frozen Shoulder

It is precise, day care, key hole procedure which gives instant movements & pain relief.

Causes for difficulty in lifting shoulder You have to consult the doctor as it can be rotator cuff ( tissue responsible for lifting the arm) tear.

Doctor may advise for further investigations like MRI which is a very useful tool to diagnose the problem.

Treatment options for rotator cuff tear.

Arthroscopy guided repair is the gold standard. However one can go for mini-open repair which is cost- effective. It has it's own limitations that one should consult with the doctor.

What to do if cuff repair is not possible?

Doctor may advise for shoulder joint replacement. It is one of the last treatment option. The cost is the factor in country like India.

Causes for recurrent dislocation of shoulder.

The inside structures like labrum, capsule or other bony problems lead to recurrent dislocation.

Treatment option for recurrent dislocation Arthroscopy guided repair is the gold standard.

However in selected cases open surgeries may be required.

What to do after first time dislocation?

Doctor reduces the joint under short anesthesia usually it is closed procedure but in rare cases open may be required.

If you have any question about your knee & shoulder disease, you can ask Dr. Preetesh Shah. Write to Dr. Preetesh Shah on preeteshah@yahoo.co.in