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Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis?

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Orthopaedic Surgeon
Practicing since : 1994
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Hi

My mom had vaginal hysterectomy 1.5 yr ago. Post which she was asked not to sit on floor, for 6 months. But now too, she can't sit on floor - especially cross-legged. She is not bend her left knee for more than 45 degrees and feels little pain.

Is she having arthritis? What type of arthritis is it? She climbs steep stairs, up and down, everyday. Will this have any impact?
Posted Tue, 4 Dec 2012 in Arthritis
 
 
Answered by Dr. Praveen Tayal 39 minutes later
Hello,
Thanks for posting your query.
From your description it seems that both of your mother's knee joints have undergone osteoarthritic changes. These are basically age related degenerative changes in the weight bearing joints like knee and is characterized by joint pain and stiffness. Upon movement the stiffness gradually relives. Sometimes application of hot pads can make the movement possible. This is more commonly seen after menopause due to hysterectomy.
The treatment options include pain killers, hot fomentation, lubricating agents like glucosamine sulfate, chondroitin , dycerin, etc and some life style modifications and physiotherapy.
Right now she can start taking Tablet Tylenol ( Acetaminophen) Double Strength after breakfast and after dinner. It is suggested to add calcium supplements 500mg each twice daily. This will take care of her mild symptoms in 3-5 days.
She can start with walking and aerobic fitness exercises, quadriceps strengthening, patellar tapping, lateral heel wedges, etc- under the guidance of physiotherapist.
A Big No to Stair case, squatting postures, any chair which has a sitting platform lower than the knees.
Knee brace can also be used for an earlier and prolonged relief.
In severe cases intra articular injections of steroids and hyaluronic acid may be needed after consultation with an orthopaedician.
I also encourage you to consult an orthopedician for physical examination. A few blood tests, X-rays of the knee, CT / MRI scans of the knee will help us diagnose the condition and help us in choosing the best approach of treatment.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
 
Follow-up: Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis? 9 hours later
So, you mean she has osteoarthritis. Am I right? Will this lead to any other issue, in future, if left unattended?
 
 
Answered by Dr. Praveen Tayal 33 minutes later
Hello.
Thanks for writing again.
Osteoarthritis is a degenerative joint disease and if left unattended, may cause gradually increasing discomfort in daily activities.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by
 
Follow-up: Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis? 11 days later
Hi,

We went for doctor consultation and as suggested (after physical examination) hip X-ray (of both hips) was taken and is attached herewith.

Doctor said sacrosiliac joint is severely affected. I wanted to confirm (have second opinion) the same. Pl respond to my queries below per se

1) Is it confirmed that she has sacrosiliac joint arthritis? Could you elaborate on it?
2) How severe is hers, especially sacrosiliac joint dysfunction from pelvic joint arthritis?
3) What would be further course of action?

Regards,
XXXXXXX
 
 
Answered by Dr. Praveen Tayal 51 minutes later
I could not open the files attached with the query. Please re send them in a compatible format.
Sacroiliac joint arthritis is a part of osteoarthritis and needs to be treated with pain killers, calcium supplements, muscle relaxants, etc.
You must follow the advice of her orthopedician regarding the treatment.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis? 14 hours later
I have attached JPEG file again. Pl try opening and thus respond to my queries above. Also, we took some tests and abnormalities in the tests are

-------------------
Thyroid Stimulating Hormone (TSH) ( ECLIA ) 11.22 uIU/ml normal range: 0.27 - 4.20

Glucose Random( GOD POD )      154 mg / dl      < 140

LDL Cholesterol (Bad Cholesterol)
( Direct )      151 mg/dl      Desirable < = 130 Borderline 130 - 160 High Risk > 160

Cholesterol / HDL Ratio
( Calculation )      4.7     Normal L < 3.3
Low Risk : 3.3 - 4.4
Average risk : 4.4 - 7.1
Moderate Risk : 7.1 - 11
High Risk > 11.0

Urine Test impression: Bacteria is present (Protein - Trace)

X-ray impression: OsteoArthrosis on both hip joints

Packed Cell Volume( Automated )      34.2 %      Men : 40 - 54,Women : 37 - 47

and also in MCHC..
-----------------------

I have attached those reports too. Please look at them and suggest for these abnormalities in her..

 
 
Answered by Dr. Praveen Tayal 25 minutes later
I have seen all the reports.
The osteoarthritic changes in both the hip joints are of moderate nature. She can have mild pain killers with lubricating agents and calcium supplemnents for relief. Regular physiotherapy exercises are also needed after the pain subsides to retard further progression of the problem.
She needs to get her fasting blood glucose tested and start with appropriate treatment for raised TSH and glucose levels after consulting an endocrinologist.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis? 27 minutes later
1) What on the protein trace in urine?
2) How about climbing steep staircase? Should she limit or avoid climbing stairs?
3) What do you suggest on standing for prolonged time?
 
 
Answered by Dr. Praveen Tayal 14 minutes later
The trace amount of protein in urine is not worrisome since there is no infection in the urine. It does not need any active treatment.
Avoid climbing stairs and sitting on any chair lower than the level of her knees.
She can stand on her feet as long as it is not painful. Going for a short walk will help her symptoms.
Best regards.
Above answer was peer-reviewed by
 
Follow-up: Have had vaginal hysterectomy. Unable to bend knee and feels pain. Could it be arthritis? 11 minutes later
I was worried as this could be trigger for kidney or ailments related to it and also for the reason that her sibling was diagnosed to have kidney stones. Are there chances for her?

Also, what is on PCV and MCHC differing from normal range? I am done with m queries and thanks in advance, for response to this too.
 
 
Answered by Dr. Praveen Tayal 24 minutes later
Traces of protein is not suggestive of renal stones. She can be sure by getting an ultrasound done for the same.
The mild derangement of PCV and MCHC is likely to be due to iron deficiency. This can be taken care of by iron supplementation.
You can consult me again directly through my profile URL http://bit.ly/Dr-Praveen-Tayal
Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.
I wish you the very best in whatever you do.
Warm regards
Above answer was peer-reviewed by
 
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