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What Does This X-ray Report Indicate?

Posted on Wed, 19 Jul 2017

Question: My father is having a lot of pain, started from last 2 months only, while standing and walking but he is feeling fine in sitting position. Knees movement is also fine. Now from last 2 weeks, situation is worst & he is not even able to stand/walk for 90 seconds.
We consult doctor & he ask us to go for X-Ray and report said below:
1. Both knees show osteophytes.
2. Reduction of medial tibio-femoral & patella-femoral joint space.
3. Patella beaking & tibial spiking.
4. No obvious soft tissue swelling is seen.
IMPRESSION: OZsteoarthirits bilateral knee joints.
Final words from doctor was Knee replacement. My questions are as below:
1. Is it possible to have this worst situation in joints in only 2 months as he was fine till last year end?
2. As per report details, mentioned above, please suggest if knee replacement is only way?
3. What will be post effect as he is 67 Years old.

Regards,
XXXX XXXXXXX XXXXXXX

Answered by Dr. Aashish Raghu (1 hour later)

Brief Answer:
Arthritis can be mild, moderate or severe. Treatment depends on severity

Detailed Answer:
Hi there

Thanks for the query

Usually severe arthritis of the knees requires knee replacement.

If you could upload the Xray I can comment if it is severe or not.

If it is not severe then you can get it treated with joint hyaluronic acid and steroid injection and medication.

1. Yes, Because most till 2 months your father has been tolerating mild pain. But as the degeneration progresses, the cartilage also tears and the ligaments tear making the knee unstable.

2. Please upload Xray film photo for me to comment if only one replacement is the way out.

3. Side effect after surgery can be infection, loosening of the knee replacement parts, clot formation although they are not common.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr.Aashish Raghu

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Aashish Raghu (43 minutes later)

Thanks Dr. Aashish..

Could you please guide how to upload X-Ray photo?

Should I take photo and upload or there is any other way?

Regards,

XXXX XXXXXXX XXXXXXX

Hi Dr. Aashish,

I have uploaded X-Ray photo, please check and advise.

Regards,

XXXX XXXXXXX XXXXXXX

Answered by Dr. Aashish Raghu (15 hours later)

Brief Answer:
Severe arthritis. Surgery total knee replacement would be best

Detailed Answer:
Hi XXXXXXX

Thanks for the reply

I have seen the photos of the xrays that you uploaded.

There seems to be severe arthritis with the left knee affected more than the right knee.

The treatment of choice would be total knee replacement.
The other options available are hyaluronic acid injection, steroid injection into the knee joint thought they may not have predictable effect in severe arthritis.

He can preformed physiotherapy strengthen guys Quadriceps muscles of both knees. He can use hinged knee brace if there is any varus or valgus deformity of the knee.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Aashish Raghu (2 hours later)

Thank you so much.

As he is saying that pain is in both knees so will it OK fine to go for both knees replacement in one go?

What will be the cost?

How much time it will take to operate both knees?
When doctor will discharge?

Any prerequisite before going for operation like do I need to manage few units of blood etc?

After operation, how much time it will take to recover or by when he will be fine to stand/walk independently?

Could you please refer any expert here in XXXXXXX for surgery?

Regards,
XXXX XXXXXXX XXXXXXX

Answered by Dr. Aashish Raghu (5 hours later)

Brief Answer:
Answers

Detailed Answer:
If he is medically fit even both knees can be operated in one sitting.

Cost of surgery varies from hospital to Hospital between Rs. 80,000 to upto Rs.1.5 lakh to operate 1 knee.

Operating time about 1 hour in uncomplicated cases for each knee.

Doctor commonly discharges in 15 days or less.

He will need to get done blood tests, ECG, chest Xray done and once the Anaesthetist tells that he is fit for surgery you may need to arrange 1-2 units of blood per knee.

In most cases the patient is made to walk from Day 1 after surgery. He would need to strengthen the Quadriceps muscle by knee extension exercises.

You can meet Dr XXXXXXX XXXXXXX working at Fortis Hospital in XXXXXXX Kunj, XXXXXXX

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Kampana