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New orthopaedic consult

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10703 Questions
Question
New orthopaedic consult
Mon, 12 Feb 2018 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 31 minutes later
Brief Answer:
Detail below.

Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through your query in detail,you are suffering from bilateral osteoarthritis .
From your symptoms it seems that both of your 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.
The treatment options include pain killers, hot fomentation, lubricating agents like glucosamine sulfate, chondroitin , dycerin, etc and some life style modifications and physiotherapy.
You can start with walking and aerobic fitness exercises, quadriceps strengthening, patellar tapping, lateral heel wedges, etc- under the guidance of your physiotherapist.
A Big No to Stair case, squatting postures, any chair which has a sitting platform lower than your 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 your orthopaedician.



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.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by
 
Follow-up: New orthopaedic consult 4 hours later
Thank you but why is there patellar tendenessand tendon tenderness?
 
 
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
Can be stress related or due to bursitis.

Detailed Answer:
Hello.
Thanks for writing again.
The patellar tenderness and tendon tenderness is due to extra stress on tendons due to lack of joint lubricants. The joint surfaces rub on each other and tendons have to do an extra work specially in climbing. There can be an associated inflammation of tendon or bursitis. This all can be identified after an MRI scan of the knee.
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: New orthopaedic consult 2 days later
Hello thanks for the answer
1. How do we exclude a diagnosis of a runners knee?
2. And is there any differential diagnosis for my pain other then arthritis ?
3. When is a knee transplant indicated?
Can we do it prophylactically or wait till the symptoms get worse
Follow-up: New orthopaedic consult 8 minutes later
One more question please
I suffered 8 yrs Of hyperparathyroidism and high calcium. In these years there was stiffness in the knees but no pain
As soon as the parathyroid surgery is done ( September 2017) the joints feel lax, loose and started to have increased pain
Could the calcium damaged the joints or hastened the damage ?

Can calcium supplements help
And what is the role of hyluronic acid
 
 
Answered by Dr. Praveen Tayal 10 hours later
Brief Answer:
Do try to delay the transplant.

Detailed Answer:
Hello.
1. Runner's knee is usually a clinical diagnosis based on examination and the area of pain. An MRI scan will help in detecting the specific area that shows an inflammation.
2. The differential diagnosis can vary from bursitis to ITBS.
3. Knee transplant is indicated if the pain and disability due to inflammation cannot be controlled with medicines and physiotherapy and it considerably affects your quality of life.
4. It is best to get the transplant done only when no other options are left. Do try to delay it with the help of medicines and physiotherapy.
The calcium levels fluctuation can hasten the damage. Calcium and vitamin D3 supplements will help in proper bone mineralization and will reduce the symptoms.
Hyaluronic acid is a part of joint lubricant and will help in retarding the loss of joint lubricants. It will also decrease the painful movements.
Regards.
Above answer was peer-reviewed by
 
Follow-up: New orthopaedic consult 2 hours later
Ok so what are the reasons to delay transplant ?
As the person ages there are multiple heart and lung issues which complicate anesthesia and surgery ?
What is th maximum age that the surgery can be done
70,80,90 yrs ?
 
 
Answered by Dr. Praveen Tayal 5 minutes later
Brief Answer:
Depends on your own fitness.

Detailed Answer:
After a knee transplant, the life of transplanted knee is 12-15 years depending on your physical health. After that revision knee replacement is needed which is associated with more complications and leg shortening. It is best to continue with your natural knees as long as you can.
The complications associated with surgery and anesthesia will always be there- now and even after 15 years. The safety of surgery depends on your own physical health. Surgery can be done even after the age of 90 if you are otherwise healthy and fit.
Regards.

Above answer was peer-reviewed by
 
Follow-up: New orthopaedic consult 5 hours later
So an MRI can distinguish osteoarthritis vs other causes do u think ?
Ex: patellar bursitis , epicondylitis and other NO. osteoarthritic changes etc ?
That makes a lot of difference !!!
 
 
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
Yes. MRI scan will help in proper diagnosis.

Detailed Answer:
Hello.
Do get an MRI scan done for proper diagnosis.
Wishing you the best in whatever you do.
Best Regards.
Above answer was peer-reviewed by
 
Follow-up: New orthopaedic consult 33 minutes later
Last and final question
I read that taking moderate stairs is better for osteoarthritis
What do u say?

Thank you
 
 
Answered by Dr. Praveen Tayal 12 hours later
Brief Answer:
You can do that if it is not painful.

Detailed Answer:
Moderate use of stairs is not harmful if you do not have any pain in climbing them. Do go for a regular physiotherapy and strengthen your muscles first.
Regards.
Above answer was peer-reviewed by
 
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