March, 2021 | Germanten Hospital

Month: March 2021

24 Mar 2021

Knee Arthritis: Symptoms, Causes and Treatment

Spine Care: Proper Spine Postures For A Healthy Body

Inflammation of the knee joint is known as knee arthritis. The knee is the joint that gets most commonly affected by arthritis. This condition makes daily activities such as running, climbing stairs and walking very difficult. Although there are more than 100 types of arthritis, the most common forms of arthritis that affect the knee are osteoarthritis, posttraumatic arthritis and rheumatoid arthritis.The knee joint is composed of three components – thighbone, shinbone and the kneecap. The slippery, smooth substance that covers the ends of the bones forming the knee joint is called articular cartilage. It cushions and protects the bones when the knee is bent and straightened. When the cartilage wears away, bones start rubbing with each other leading to arthritis of the knee.

Symptoms


Inflammation and pain in the knee is the biggest symptom of arthritis. Apart from that,there are other symptoms as well, such as:
● Swollen and stiff knee joint
● Difficulty bending and straightening the knee
● Feeling like the knee is locking or sticking
● Grinding, clicking, snapping or creaking sound while movement
● Increase in pain with the weather change


Types of knee arthritis


● Osteoarthritis – The most common type of knee arthritis, osteoarthritis occurs when the cartilage wears away. This causes the bones to rub together, leading to painful bone spurs.
● Rheumatoid arthritis – This type of arthritis is an autoimmune disorder,wherein the body’s immune system starts attacking healthy cells. The body starts thinking that healthy tissues are harmful which causes the immune system to destroy these tissues, ultimately destroying the joint.
● Post-traumatic arthritis – This type of arthritis develops after an injury. Old injuries put extra stress on the knee joint, leading to arthritis.
● Gouty arthritis – When crystals of uric acid start depositing in the knee joint,it is known as gouty arthritis. It can cause a lot of pain, inflammation and swelling.


Causes of knee arthritis


● Osteoarthritis – This type of arthritis is caused by the daily wear and tear of the knee joint.
● Rheumatoid arthritis – It is not known what causes this type of arthritis,however, genetic factors might be at play.
● Post-traumatic arthritis – As mentioned above, this type of arthritis is caused by previous injuries such as a cartilage tear or sprains.
● Gouty arthritis – This type of arthritis can be caused by various factors such as obesity, old age, family history of gouty arthritis or using certain medications.


Diagnosis


Germanten Hospital is the number one centre for orthopaedics in Hyderabad. The team of doctors at Germanten Hospital is led by Dr.Mir Jawad Zar Khan, a veteran of 20 years in the field of orthopaedics. A gold medalist of Osmania University, he has received advanced training in this field from Germany and the USA.To celebrate his achievements and effort, he was awarded the title of Best Doctor by
the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.At Germanten Hospital, a team of the best doctors will first perform a physical exam of the knee area. After that, imaging tests such as a CT scan, an MRI or an X-ray also might be performed, for better identification of damage to the tissues. Lab tests and uric acid tests are also performed to diagnose rheumatoid arthritis as well as gouty arthritis.


Treatment


There are various methods to lessen the pain caused by knee arthritis. These include:
● At-home treatment methods – A few things that can be followed to reduce the pain, at home are:
● Losing extra weight
● Engaging in low-impact exercises instead of high-impact ones
● Physical therapy
● Wearing a knee bandage or brace
● Applying ice or heat
● Over-the-counter pain relief medication
● Non-surgical options – There are a wide variety of non-surgical options for knee arthritis. Some of these approaches include:
● Viscosupplementation- This procedure works by injecting hyaluronic acid into the joint. The thick fluid helps reduce swelling and pain in your arthritic joint.
● Radiofrequency (RF) ablation- It is a minimally invasive and non-surgical procedure and works by destroying the nerve fibers that carry the pain signals to the brain.
● Stem cells therapy- In this procedure, stem cells are used to reduce pain. It is a natural form of treatment wherein no anesthesia is required.
● Surgery – If at-home remedies and non-surgical options don’t work, the last option to consider is knee surgery. Various procedures can be performed, such as:
● Cartilage transplant – In this procedure, the damaged knee cartilage is replaced with tissue grafts that would help regain the normal function of the knee. This procedure might also eliminate the need for knee replacement surgery.
● Partial knee replacement – In this procedure, only the damaged cartilage is removed and the ligaments are kept intact. This technique
helps patients gain a better range of motion and also recover faster.There is minimal loss of blood in this procedure.
● Total knee replacement – In this procedure, the knee joint is completely replaced with a prosthesis or an implant.

At Germanten Hospital, knee replacement surgery is performed using a robotic arm.This technology is precise to the nearest half millimetre and makes the surgery much safer and advanced. Our hospital is the first one in India to have acquired robotic arm
technology for minimally invasive knee replacement surgeries.Germanten Hospital is NABH-accredited, has over 200+ beds and each operation theatre has a laminar airflow for total infection control. In 2019, Times of India graded it as the Best Emerging Orthopedic Hospital. It was also named the Best Orthopedic Hospital in South India by Economic Times 2021.

24 Mar 2021

Spine Care: Proper Spine Postures For A Healthy Body

Spine Care: Proper Spine Postures For A Healthy Body

The position of our body when we are standing up or sitting is called posture. Ideally, the spine should be in a neutral position such that the joints, ligaments and muscle groups are aligned to maintain balance, keep the body flexible and reduce fatigue.In today’s lifestyle, a bad posture is quite common. Leaning over or slouching in a chair can lead to neck, shoulder and back pain as well as an injury during work or exercise and other such activities.

Types of poor spine posture


Most commonly, there are four types of bad postures:
● Kyphosis – Also known as a hunchback, the upper back is extremely curved and the shoulders are rounded forward in this position. It may occur to diseases such as Scheuermann’s disease or polio, infections and radiation or
chemotherapy in younger people. In older people, especially women,osteoporosis causes the shoulders to round forward due to weak spinal bones.
● Flatback – In this position, there is very little curvature of the spine. The back looks flat and it may seem like the person is stooping forward. A flatback can be present at birth or it may result from degenerative conditions of the spine such as ankylosing spondylitis, vertebrae compression or disc degeneration. It can also occur due to back surgery.
● Swayback – Also known as hyperlordosis, the lower back is curved inwards to an extreme level. The stomach and rear stick out and it may seem like the person is leaning back. This condition may develop if one sits a lot which leads to tightening of the muscles in the back. Obesity, neuromuscular conditions,spinal and vertebral abnormalities or an injury might also cause swayback.Apart from these bad postures, a few other types of bad postures include military-style posture, poking chin posture and uneven hips or shoulders.


Effects of bad posture


Poor posture can lead to various long term effects such as:
● Back pain
● Neck pain
● Shoulder pain
● Varicose veins
● Negative impact on digestive organs and system
● Impact on the cardiovascular system
● Change in the spinal curve

Apart from these effects, muscular stress caused due to poor spinal posture can also lead to the following conditions –
● Change in spinal curvature – Our spine is designed to make an “S” shape.When poor posture is practised, the natural curvature of the spine gets affected and this, in turn, impacts the spine’s ability to maintain the body’s balance and act as a shock absorber. This makes us more prone to spinal injuries.
● Nerve constriction – Due to poor posture, the shape of the spine changes. This puts pressure on the spinal nerves leading to neck pain, back pain as well as pain in other areas of the body.
● Blood vessel constriction – The blood supply to the cells of the spinal muscles can get cut off due to poor posture. This leads to a deficit of oxygen and nutrient supply to the cells. The chances of blood clots and deep vein thrombosis also increase.
● Vertebral subluxations – Due to alteration in the spinal curvature, vertebral subluxations occur, leading to chronic health issues.
● Stenosis – In this condition, the spinal canal becomes narrow. This causes pain and other symptoms such as numbness and weakness through the body, as the stenosis might press on the spinal cord and nerves.


What is the ideal posture?


A good spinal posture is when the three natural curves of the spine i.e. the curves at the neck, lower back and the mid-back, are maintained. Apart from that, the head should be above the shoulder and the top of the shoulder should be over the hips.
Benefits of good posture
● Good posture helps prevent backache and neck pain
● Reduced wear and tear of joints
● Reduced strain on spinal ligaments
● Joints and bones stay in alignment
● Prevention of spine getting fixed in an abnormal position
Tips to improve posture
● While sitting –
● Ensure that you sit at the end of the chair
● The back should be straight
● Shoulders should be pulled back
● Bodyweight should be evenly distributed on both hips
● Feet should be kept flat on the floor
● Instead of bending forward at the waist, while standing up, move to the front of the chair and straighten your legs to stand up

● While driving –
● Knees should be at par with your hips
● To support the curve of the back, the seat should be pulled closer to the steering wheel, in such a manner that the knees can be bent and the feet can reach the pedals

● While lifting –
● Avoid lifting objects heavier than 30 pounds
● Have a firm footing
● Instead of bending from the waist, keep your back straight and bend from the knees to lift an object
● Tighten the stomach muscles while lifting the object
● While sleeping or lying down –
● While sleeping, the best position is lying on the back. Put a pillow under your head, but not your shoulders
● Avoid sleeping on the side or on the stomach
● While standing –
● Feet should be shoulder-width apart
● The head should not be pushed out forward, rather it should be on top of the spine
● Stand tall and straight
● Keep shoulders upright
● Shift weight from one foot to another, if you are standing for a long period

If your posture is bothering you or appears to be problematic, you should come to Germanten Hospital, Hyderabad. It is accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and is the number one centre for the diagnosis and treatment of all spinal issues. Germanten Hospital has over 200+ beds and a high-advanced laminar airflow in every operation theatre for total infection control. In 2019, Germanten Hospitals was ranked as the Best Emerging Orthopaedic Hospital by the Times of India. It has also been named the Best Orthopaedic Hospital in South India, by the Economic Times, in 2021.At Germanten Hospital, we have a team of the best orthopaedic doctors led by Dr Mir Jawad Khan, a pioneer in the field of orthopaedics with experience of more than 20 years. An expert in spinal surgery, he has been awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu Shri Roshaiah Guru,in 2018. He has also been honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

The position of our body when we are standing up or sitting is called posture. Ideally,the spine should be in a neutral position such that the joints, ligaments and muscle groups are aligned to maintain balance, keep the body flexible and reduce fatigue.In today’s lifestyle, a bad posture is quite common. Leaning over or slouching in a chair can lead to neck, shoulder and back pain as well as an injury during work or exercise and other such activities.

Types of poor spine posture


Most commonly, there are four types of bad postures:
● Kyphosis – Also known as a hunchback, the upper back is extremely curved and the shoulders are rounded forward in this position. It may occur to diseases such as Scheuermann’s disease or polio, infections and radiation or chemotherapy in younger people. In older people, especially women, osteoporosis causes the shoulders to round forward due to weak spinal bones.
● Flatback – In this position, there is very little curvature of the spine. The back looks flat and it may seem like the person is stooping forward. A flatback can be present at birth or it may result from degenerative conditions of the spine such as ankylosing spondylitis, vertebrae compression or disc degeneration. It can also occur due to back surgery.
● Swayback – Also known as hyperlordosis, the lower back is curved inwards to an extreme level. The stomach and rear stick out and it may seem like the person is leaning back. This condition may develop if one sits a lot which leads to tightening of the muscles in the back. Obesity, neuromuscular conditions, spinal and vertebral abnormalities or an injury might also cause swayback. Apart from these bad postures, a few other types of bad postures include military-style posture, poking chin posture and uneven hips or shoulders.


Effects of bad posture


Poor posture can lead to various long term effects such as:
● Back pain
● Neck pain
● Shoulder pain
● Varicose veins
● Negative impact on digestive organs and system
● Impact on the cardiovascular system
● Change in the spinal curve

Apart from these effects, muscular stress caused due to poor spinal posture can also
lead to the following conditions –
● Change in spinal curvature – Our spine is designed to make an “S” shape.When poor posture is practised, the natural curvature of the spine gets affected and this, in turn, impacts the spine’s ability to maintain the body’s balance and act as a shock absorber. This makes us more prone to spinal injuries.
● Nerve constriction – Due to poor posture, the shape of the spine changes. This puts pressure on the spinal nerves leading to neck pain, back pain as well as pain in other areas of the body.
● Blood vessel constriction – The blood supply to the cells of the spinal muscles can get cut off due to poor posture. This leads to a deficit of oxygen and nutrient supply to the cells. The chances of blood clots and deep vein thrombosis also increase.
● Vertebral subluxations – Due to alteration in the spinal curvature, vertebral subluxations occur, leading to chronic health issues.
● Stenosis – In this condition, the spinal canal becomes narrow. This causes pain and other symptoms such as numbness and weakness through the body, as the stenosis might press on the spinal cord and nerves.


What is the ideal posture?


A good spinal posture is when the three natural curves of the spine i.e. the curves at the neck, lower back and the mid-back, are maintained. Apart from that, the head should be above the shoulder and the top of the shoulder should be over the hips.
Benefits of good posture
● Good posture helps prevent backache and neck pain
● Reduced wear and tear of joints
● Reduced strain on spinal ligaments
● Joints and bones stay in alignment
● Prevention of spine getting fixed in an abnormal position
Tips to improve posture
● While sitting –
● Ensure that you sit at the end of the chair
● The back should be straight
● Shoulders should be pulled back
● Bodyweight should be evenly distributed on both hips
● Feet should be kept flat on the floor
● Instead of bending forward at the waist, while standing up, move to the front of the chair and straighten your legs to stand up

● While driving –
● Knees should be at par with your hips
● To support the curve of the back, the seat should be pulled closer to the steering wheel, in such a manner that the knees can be bent and the feet can reach the pedals

● While lifting –
● Avoid lifting objects heavier than 30 pounds
● Have a firm footing
● Instead of bending from the waist, keep your back straight and bend from the knees to lift an object
● Tighten the stomach muscles while lifting the object
● While sleeping or lying down –
● While sleeping, the best position is lying on the back. Put a pillow under your head, but not your shoulders
● Avoid sleeping on the side or on the stomach
● While standing –
● Feet should be shoulder-width apart
● The head should not be pushed out forward, rather it should be on top of the spine
● Stand tall and straight
● Keep shoulders upright
● Shift weight from one foot to another, if you are standing for a long period

If your posture is bothering you or appears to be problematic, you should come to Germanten Hospital, Hyderabad. It is accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and is the number one centre for the diagnosis and treatment of all spinal issues. Germanten Hospital has over 200+ beds and a high-advanced laminar airflow in every operation theatre for total infection control. In 2019, Germanten Hospitals was ranked as the Best Emerging Orthopaedic Hospital by the Times of India. It has also been named the Best Orthopaedic Hospital in South India, by the Economic Times, in 2021.At Germanten Hospital, we have a team of the best orthopaedic doctors led by Dr Mir Jawad Khan, a pioneer in the field of orthopaedics with experience of more than 20 years. An expert in spinal surgery, he has been awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu Shri Roshaiah Guru,in 2018. He has also been honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

24 Mar 2021

Common Shoulder Related Issues

Common Shoulder Related Issues

Our shoulders are one of the most movable joints in our body. With the help of our shoulder, we can move our arms across the body, reach up and behind. The shoulder joint is mainly made of three bones – the humerus, the clavicle and the scapula. It is anchored by tendons, muscles and ligaments to hold it in a stable position. Since the ball of the upper arm is bigger than the socket holding it, the shoulder can be unstable and is prone to problems and injuries. There can be many reasons behind shoulder pains – strains, falls, blows, accidents, daily wear and tear, repetitive motion and medical conditions.

Some common shoulder injuries are-

1. Dislocations – When the top of the arm bone comes partially or completely out of the shoulder socket, it is called a shoulder dislocation.This can happen if the shoulder is hit hard or if there is a tear or a stretch in the ligaments that keep the shoulder bones stable.
2. Fractures – A crack or break in the bone is called a fracture. It can be along the bone's length or across the bone. Shoulder fractures can occur from an impact such as a sports injury or an accident, in younger people.For older people, shoulder fractures can occur due to taking a fall. When someone has a shoulder fracture, they can face some difficulty moving their arm. They might also experience swelling or bruising around the shoulder.
3. Arthritis – When the cartilage between bones breaks down, the bones rub together causing wear and tear. This leads to pain and stiffness in the shoulder joint. This condition is called arthritis. The most common form of arthritis is osteoarthritis. Another type of arthritis called rheumatoid arthritis is a condition where the body's immune system attacks the protective lining in the joints.
4. Strains and sprains – When the ligament gets pulled in the wrong way, it can get torn or stretched causing a sprain in the shoulder.
5. Tendinitis – When the rotator cuff tendons get inflamed and irritated, that condition is called tendinitis. Sometimes, when a certain activity is performed again and again, like golfing or pitching, or due to the usual wear and tear, small tears develop in the tendons. It might hurt when someone with tendinitis tries to lift their arms.
6. Separations – The acromioclavicular joint is the joint where the shoulder blade and collarbone come together. A hard blow to the shoulder or a fall can tear the ligaments that hold the AC joint together. When the collarbone pops out of the place, this injury is called separation.
7. Bursitis – When we move, our tendons slide over our bones. To make this easier, small sacs of fluid called bursae are present in our shoulders.When the shoulder joints are overused, the bursae become inflamed and swollen. This condition is called bursitis. It is painful to use the shoulders even for the most basic tasks.
8. Impingement – When the tendons of the rotator cuff get pinched in the shoulder's bones, it is called impingement. It is painful and can cause swelling. This happens when the arms are lifted over the head a lot.
9. Cartilage tear – A tear in the cartilage also occurs when a certain motion is performed over and over again. It can also get hurt due to a fall or when the shoulder absorbs a great amount of force. When you feel like your shoulder is locking, catching or grinding, then you can suspect a tear in the cartilage.
10. Frozen shoulder – When adhesions (abnormal tissue bands) form in the joint, they don't allow the shoulder to move freely. This can happen when due to some reason, you're not able to move your shoulder. This
condition is called a frozen shoulder. The common symptoms of shoulder problems include swelling, inflammation,pain, stiffness and bruising.


Treatment


Depending upon the type of shoulder problem or injury, your doctor may use a sling, suggest rest, ice or heat and medicine for the pain, or surgery. When the injuries are severe, at-home treatments don't work. At Germanten Hospital, we have a dedicated team of physicians, orthopaedic surgeons and physiotherapists, led by Dr Mir Jawad Khan, who is an expert in the diagnosis and surgical as well as non-surgical treatment of the shoulder. He has over two decades of experience in the field. To celebrate his achievements and effort, he has been felicitated with the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019,he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

At Germanten Hospital, each operation theatre has a high-advanced laminar airflow for total infection control. With over 200 beds, Germanten Hospital has earned the title of Best Emerging Orthopaedic Hospital in India, awarded by the Times of India in 2019. It has also been named the Best Orthopedic Hospital in South India by the Economic Times 2021. We use our shoulders for the smallest movements, hence it is important to protect them.
● If a large part of your day involves working at a desk, then you need to ensure that your chair offers proper support for the back.
● Maintain a good posture.
● You should also take a break and move and stretch once every hour.
● Whenever you need to lift something heavy, the proper technique should be used. Instead of bending from your waist, you should bend your knees for the power and keep your back straight.
● If you need to reach for something heavy over your head, using a ladder or a stool is a better option to prevent any shoulder injuries.

24 Mar 2021

Hip Replacement Surgery Anterior Approach

Traditionally, hip replacement surgery is done either with a lateral approach or a posterior approach. In both techniques, the muscles and tendons need to be detached from the hip, for replacing the joint. It can be very painful and the recovery period can last for a few months to a few years. There is also a risk of hip dislocation, which leads to failure of hip replacement. The anterior approach for hip replacement is a newer, minimally invasive technique.

What is the anterior approach for hip replacement surgery?

In this procedure, instead of making an incision behind or on the side of the hip, an
incision is made in front of the hip. Since 1980, this approach has been opted more by surgeons since it is less invasive as compared to the other ones. By using this approach, the damage caused to the surrounding tendons and muscles is less, which contributes to a faster recovery period as well.


Advantages of anterior approach for hip replacement surgery

There are various advantages of an anterior approach for hip replacement surgery,
such as –
● Less damage to surrounding muscles – With an anterior approach, there is no need to cut into major muscles, since there are fewer muscles in the front of the hip. Thus, instead of detaching the muscles from the bone and then repairing it after surgery, the surgeon works between the fewer muscles in the front itself.
● Fewer complications post-surgery – As compared to a posterior approach or a lateral approach, there are very few complications post-hip surgery performed with an anterior approach.
● Faster recovery period – Since an anterior approach is used, the recovery period is faster as no major muscles or tendons have been cut through during surgery.
● Less pain post-surgery – Patients require very less medication for pain relief after hip replacement surgery performed with this approach.


Procedure

A hip replacement surgery, also known as hip arthroplasty is a procedure wherein a patient’s hip joint is completely replaced with an artificial joint. First, the patient is put under general anaesthesia. The surgical site is cleaned and any hair from that area is removed. Next, the surgeon makes an incision in the front of the hip joint and separates the muscles from the hip joint. The damaged bone and cartilage from the pelvis and the upper part of the femur are then removed. The acetabulum as well as the head, neck and part of the shaft of the femur is replaced with an artificial joint. To ensure that the joint has been placed correctly, the surgeon will take an X-ray.


Recovery

After the procedure, the patient is gradually allowed to eat and drink. Mostly, patients can go home a day or two after the surgery. Initially, you may find that you would need canes or crutches to walk. Physical therapy is also suggested for patients.Usually, patients regain their strength and mobility within four to six weeks of the surgery.

Risks

With every surgery, some risks are always associated. Similar to risks of other hip replacement approaches, a few risks of an anterior hip replacement surgery include:
● Complications due to anaesthesia
● Bleeding from the incision
● Deep vein thrombosis
● Pulmonary embolism
● Hip joint infection
● Hip bone infection
● Dislocation of the hip joint
● Loose joint
● The difference in length of legs
● Injury to nearby nerves and muscles

Outlook

Recovery after an anterior hip replacement surgery is quicker, as compared to the posterior and lateral approaches. Patients can regain their strength and range of motion quicker.With any approach, artificial hips need to be replaced after a few years if they get loose or wear out. However, the anterior hip replacement is an effective approach and
the patients quality of life is improved significantly.At Germanten Hospital, we have a team of the best Arthroplasty as well as physiotherapists, led by Dr.Mir Jawad Zar Khan. It is the number one centre for hip replacement surgeries. With more than 200 beds, each operation theatre at Germanten Hospital has high-advanced laminar airflow for total infection control. For its highly advanced technology and minimally invasive surgical procedures, Germanten Hospital has been graded as the Best Emerging Orthopaedic Hospital by the Times of India in 2019. It has also been named the Best Orthopaedic Hospital in South India, by the Economic Times in 2021. Dr.Mir Jawad Zar Khan is at the forefront of Germanten Hospital. A gold medalist from Osmania University, Dr.Mir Jawad Zar Khan has an experience of more than 20 years in the field of orthopaedics. Having received advanced training from Germany and the USA, he has performed more than 10000 surgeries. To celebrate his achievements and efforts, he was awarded the title of Best Doctor by the ex-CM of
Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

06 Mar 2021
ACL-Injuries

ACL Injuries: Causes, Symptoms and Treatments

ACL Injuries: Causes, Symptoms and Treatments
An ACL (anterior cruciate ligament) tear is one of the most common knee injuries. It is more common in athletes who engage in high-demand sports such as basketball, soccer and football.
Anatomy of the knee joint

The knee joint is composed of three bones – the thigh bone, kneecap and shinbone. The kneecap is situated in front of the joint for protection. These bones are connected by four primary ligaments to hold the knee stable. The two types of ligaments that are located in the knee joint are collateral ligaments and cruciate ligaments. The collateral ligaments are located on the sides of the knee. These ligaments are responsible for protecting the knee from unusual movement. On the inside, the ligament is called medial collateral ligament whereas the ligament located on the outside is called a lateral collateral ligament. The sideways motion of the knee is controlled by the collateral ligaments.

The ligaments found inside the knee joint are called cruciate ligaments. These ligaments form an “X” shape. The posterior cruciate ligament is located in the back and the anterior cruciate ligament is located in the front. The back and forth motion of the knee is controlled by the cruciate ligaments. The anterior cruciate ligament provides rotational stability to the knee and prevents the tibia from sliding out in front of the femur.

Injuries in the anterior cruciate ligament are called “sprains” and are graded on a scale of severity of the injury.

  • Grade 1 Sprains – A mild injury of the ligament is known as Grade 1 sprains.In this type of injury, the ligament has been slightly stretched but it is still able to keep the knee joint stable.
  • Grade 2 Sprains – Also known as a partial ligament tear, in this type of injury,
    the ligament gets stretched to the point where it becomes loose.
  • Grade 3 Sprains – A complete tear of the ligament where it gets split into two
    pieces is called a Grade 3 sprain. With this kind of injury, the knee joint
    becomes unstable. This is the most common type of ACL injury.

Causes

There are various reasons behind an ACL tear:

  • Collision or direct contact, such as a football tackle
  • Stopping suddenly
  • Rapidly changing direction
  • Suddenly slowing down while running
  • Incorrect landing from a jump

Female athletes are more prone to get ACL injuries, as compared to male athletes while playing certain sports. Studies say that this is due to the differences in muscular strength, neuromuscular control, physical conditioning, increased looseness in ligaments, the effect of estrogen on ligament properties and pelvis and lower leg alignment.
Symptoms of ACL injury

The most evident symptom of an ACL tear is a popping sound. You would feel your knee giving out from under you. A few other symptoms of an ACL injury include:

  • Pain
  • Swelling within 24 hours of injury
  • Loss of mobility
  • Discomfort while walking
  • Tenderness along the joint line

If the pain and swelling are ignored, it might resolve on its own. However, if an individual tries to return to sports immediately after an ACL injury, the meniscus of the knee might get damaged.
Diagnosis
treatment. During your first visit to Germanten after an ACL tear, the doctor will first talk to you about your medical history and symptoms. Then, your doctor will perform a physical exam wherein he or she will check all the structures of your injured knee and compare it with your non-injured knee. Most of the time, a physical exam is enough to diagnose a ligament injury. To confirm this diagnosis, the doctors at Germanten might perform imaging tests such as an MRI or an X-ray.

Treatment
Usually, a torn ACL cannot be repaired without surgery however in some cases, nonsurgical treatments might be effective. Nonsurgical treatments include bracing and physical therapy. These methods are suggested for patients who have a very low activity level or are older.

Surgical treatment for an ACL tear includes reconstruction of the ligament, as ACL tears cannot be repaired by suturing the ligament back together. The torn ligament is replaced with a tissue graft, on which the new ligament grows. This tissue graft is generally extracted from the patellar tendon or the hamstring tendons. An arthroscope is used to perform the surgery as it is a minimally invasive technique. At Germanten Hospital, the most advanced and sophisticated medical equipment and technologies are used to perform minimally invasive surgeries. Each operation theatre has a highly advanced laminar airflow for total infection control. Germanten Hospital has been accredited with NABH (National Accreditation Board for Hospitals & Healthcare). With more than 200 beds, we aim to provide excellent care and service to our patients. Germanten Hospital was named the Best Orthopedic Hospital in South India by Economic Times in 2021. In 2019, Times of India graded it as the Best Emerging Orthopedic Hospital. Create a balance between strength and flexibility.
Reconstructive surgery at Germanten Hospital is performed by a team of expert doctors, led by Dr.Mir Jawad Zar Khan. A veteran of more than 20 years in the field of orthopaedics, he has performed more than 10000 surgeries. Dr.Mir Jawad Zar Khan was awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

03 Mar 2021

How to prevent knee pain?

As we get older, our knees become weaker due to the constant motion and stress on them, resulting in knee pain. Some other factors such as injuries, weak muscles, lifting heavy objects improperly, excess amount of body weight as well as beginning your workout without a proper warm-up can cause inflammation in the knees, resulting in pain. Structural issues such as ligament injuries, arthritis and torn cartilage may also cause knee pain.

Not only older people, but people of all age groups also complain of knee pain from time to time. When the knees are visibly swollen or it isn’t possible to squat with the knees at a 90-degree angle, then it is more of structural damage. If the knees can be straightened without pain, it is typically inflammation in the knees, a less serious condition.


How to prevent knee pain?

Prevention is better than cure – we have heard this saying since we were kids. Here are a few ways to prevent knee pain –


1.Warm-up – Starting your workout routine without warming up first makes you prone to knee injuries and ultimately pain and inflammation. Always make sure to stretch your thigh muscles. This helps to relieve pressure on the knees. Hamstring curls, step-ups and straight-leg lifts are some stretches that can protect the knee and help prevent knee pain.
2.Weight-training – Working out with weights can help strengthen your leg muscles, which would result in better knee support and fewer injuries.
3.Wearing the right shoes – For correct leg balance and alignment, you should wear shoes that are suitable for the activity that you’re going to engage in. Shoes that fit improperly can lead to knee injuries and pain. Our thigh muscles do more work, trying to hold the knees steady when we wear shoes such as high heels. This leads to knee pain. Shoes such as low pumps or flats are better options to prevent knee pain since the heel in such shoes is closer to the ground. So you should avoid wearing heels regularly.
4.Maintaining weight – It is important to lose the extra weight if you have any since excess weight puts a lot of stress on your knees. Most people with arthritic knees experience a loss of pain when they lose the extra weight.
Maintaining your posture – Slouching and leaning forward while walking is an absolute no-no if you are looking to prevent knee pain. To avoid strain on your knee joints, your head, shoulders, abdomen and pelvis need to be in alignment and centred. A strong core helps achieve a better posture, ultimately leading to no knee pain. Exercises such as planks, Pilates and yoga are essential for strengthening your core.
5.ow-impact exercises – Activities like swimming and cycling are essential to protect the knee cartilage and prevent pain.

Chronic knee pain can point to structural damage and if left untreated, you might need to get knee replacement surgery. Germanten Hospital in Hyderabad is the number one centre for knee replacement surgery in India. In this surgery, the damaged surfaces of the knee are replaced with a prosthesis made of metal and plastic. Depending on the amount of damage to the knee cartilage, a partial or a total knee replacement surgery may be performed.

The team of highly efficient and experienced doctors at Germanten Hospital is led by Dr. Mir Jawad Khan, a renowned orthopaedic surgeon with experience of two decades in the field. He is a gold medalist from Osmania University, Hyderabad and has received advanced training from the USA and Germany. He has been awarded the title of Best Doctor by the ex-CM of Joint Andhra Pradesh and former Governor of Tamil Nadu, Shri Roshaiah Garu, in 2018. He has also been honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shri Etala Rajendra.

Dr. Mir Jawad Khan introduced robotic arm and computer navigation knee replacement surgery in India. The team of surgeons at Germanten Hospital scan and model each patient’s knee in 3D, for detailed observation, with the help of this technology. After that, a tailor-made implant is designed to fit every different patient to achieve the best results.

As a NABH accredited hospital, Germanten Hospital has the most modern, carefully prepared Laminar flow operation theatres, to minimise the chances of any infection. It is the go-to centre for knee replacement surgeries and other orthopaedic procedures. The hospital has over 200+ beds and is well-maintained with a highly sterile-environment. Due to this advanced technique, knee replacement surgeries at Germanten Hospital take no more than 25 minutes and are painless. There is minor blood loss and fewer incisions since the procedure is minimally invasive. After the surgery, patients experience less pain and can get back on their feet very quickly.
 

In 2019, Germanten Hospital was graded as the Best Emerging Orthopaedic Hospital by Times of India. It has also been named the Best Orthopaedic Hospital in South India by the Economic Times, in 2021. For all your knee problems, visit Germanten Hospital, Hyderabad to receive the best patient care and outcome.
 

02 Mar 2021

Most Advanced and Safest Knee Replacement for Your Loved Ones

Knee replacement or knee arthroplasty is a surgical procedure used for resurfacing a knee that is damaged by arthritis. Plastic or metal parts are used for capping the ends forming the joint and the kneecap. It is the best procedure for someone who has severe knee injury or severe arthritis and hasn’t gotten any relief from any other form of treatment.

There are different forms of arthritis that might affect the knee joint. In middle-aged and older adults, the most common form of arthritis is osteoarthritis, a degenerative joint disease that breaks down the adjacent bone and joint cartilage in the knees. Another form of arthritis is rheumatoid arthritis that causes synovial membrane inflammation resulting in an excessive amount of synovial fluid that leads to stiffness and pain. The aim of the knee replacement surgery is to resurface the parts of the joint that have been affected and relieve the pain that is unmanageable by other treatments. Here are some other medical treatments that can be used for treating a degenerative joint disease:


● Anti-inflammatory medications
● Assistive devices for walking
● Cortisone injections into the knee joint
● Glucosamine and chondroitin sulfate
● Limiting painful activities
● Pain medications
● Physical therapy
● Viscosupplementation injections
● Weight loss

There are two types of spine surgeries – open or conventional and keyhole or minimal access
surgery. Some spinal conditions like tumours and disc problems can be treated using minimally
invasive spine surgery or spine keyhole surgery.


If none of the above-mentioned treatments work, the doctor will recommend a knee replacement surgery.

Before the procedure, the doctor will perform a physical examination to make sure that you are in proper health before the procedure. These might also include diagnostic tests like X-rays and blood tests. Make sure that you ask all questions that you have regarding the procedure. Also, notify the doctor about any allergy or sensitivity to certain medications, anesthetic agents, or latex tape. You need to inform your doctor if you are taking any blood-thinning medications, prescribed or over-the-counter medications, herbal supplements, etc. Based on your specific medical condition, the doctor might request some specific preparation.

The knee replacement procedure requires you to stay in the hospital, depending on your condition and the procedure. Here are the steps that will be involved in your procedure:


● The nurse will ask you to remove your clothing and give you a gown to change.
● Next, an intravenous (IV) line will be placed in your hand or arm and you will be
asked to lay down on the operating table.
● The doctor will insert the urinary catheter. The excessive hair present at the
surgical site will be clipped off.
● An anesthesiologist will monitor your blood pressure, blood oxygen, and heart rate
during the procedure.
● An antiseptic solution will be used for cleaning the skin over the site of surgery.
● The doctor will make a small incision in the knee area and remove the knee joint’s
damaged surfaces.
● The damaged surfaces will be resurfaced with the prosthesis. This prosthesis will
be made up of plastic and metal. A cemented prosthesis is the most common kind
of artificial knee prosthesis. Uncemented prosthesis are not usually used anymore.
When the doctor uses a cemented prosthesis, it is attached to the bone using
surgical cement whereas an uncemented prosthesis is attached to the bone through
a porous surface. Sometimes, the 2 types are combined for replacing the knee.
There are three components of a prosthesis. The first one is the tibial component
that is used for resurfacing the top of the shin bone or tibia. The second one is the
femoral or thigh bone components that resurface the thigh bone's end. The last one
is the patellar component used for resurfacing the kneecap’s bottom rubbing
against the thigh bone.
● Once the prosthesis is in position, the doctor will close the incision using surgical
staples of stitches. A drain will also be placed at the incision site for removing
fluid.
● Lastly, a sterile dressing or bandage will be applied at the incision site.

Once the surgery is completed, you will be kept under observation until your breathing, pulse, and blood pressure are stable. After that, you will be shifted to your hospital room. You will have to stay at the hospital for a couple of days after your knee replacement procedure.
 

It is important that you start moving your new joint after the procedure. You have to consult a physiotherapist soon after the surgery and have them create an exercise program for you. Physical therapy can be started by using a Continuous Passive Motion (CPM) machine that moves the new joint through its range of motion. You will be given some pain medications to help you with pain so that you can start exercising. After you have been discharged, you need to continue physical therapy until you have a good range of motion and regain muscle strength.

At Germanten Hospital, we ensure that our patients have access to the safest and most advanced knee replacement procedure. Germanten is the largest hospital in Hyderabad that focuses on orthopedics trauma, joint replacements, sports injuries, and spine surgeries. We offer a wide range of operative and nonoperative treatment options. In 2019, Times of India graded it as the Best Emerging Orthopedic Hospital. It also was named the Best Orthopedic Hospital in South India by Economic Times 2021.

Germanten Hospital is a 200+ bedded NABH-accredited hospital and is equipped with German Precision Technology. We follow strict protocols to ensure that you and your loved ones have access to the highest quality healthcare facilities in the country. An example of this includes our high advanced Laminar flow Operation Theatres that ensure zero infection. Special anesthesia will be used during the procedure so that you remain free of pain. We also have special DVT pumps for preventing blood stasis-related complications. All patients undergoing the knee replacement procedure will have access to our expert physiotherapy team that will help them get early mobility. Through our stringent protocols and German standards, we assure that our patients have a successful and safe knee replacement procedure the results of which lasts for life.
 

The orthopedic team at the hospital is led by Dr. Mir Jawad Khan who has more than 20 years of experience in the field. He was awarded the title of Best Doctor by Shri Roshaiah Garu (Ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu) in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.


So, if you have chronic knee pain and haven’t gotten any relief from nonsurgical treatments, you need to book a consultation appointment at Germanten Hospital to know if the knee replacement procedure is the right option for you or not.

02 Mar 2021

Radiofrequency (RF) Ablation: Procedure, Effectiveness, and Recovery

 Radiofrequency (RF) ablation, a minimally invasive procedure, is used for destroying the nerve fibers that carry the pain signals to the brain. By doing so, it can provide long-lasting relief for people suffering from chronic pain, specifically for people with neck, lower back, and arthritic joints issues. If you have recurrent pain and have good experience with a nerve block injection, RF Ablation might be the treatment for you.

Also known as rhizotomy, RF ablation is a minimally invasive and non-surgical procedure that uses heat for reducing or stopping the pain transmission. The RF waves “burn” or ablate the nerve responsible for the pain which eliminates the possibility of pain signals transmitted to the brain. It is usually used for treating chronic pain and conditions like spondylosis (arthritis of the spine), and sacroiliitis. However, it can also be used for treating back, neck, knee, peripheral, and pelvic nerve pain. There are several other benefits to this procedure as well, such as immediate pain relief, avoiding surgery, improved function, minimal recovery time, quicker return to the normal routine, and decreased dependency on pain medications.

This treatment is the perfect option for someone who has experienced pain relief after a pain receptor/diagnostic nerve block injection. It is performed using X-ray (fluoroscopic) guidance and must not be performed on people with infection, bleeding problems, or ones who are pregnant.

The treatment will begin with the doctor reviewing the medical history and imaging studies to determine the best location for the procedure. If you are taking a blood-thinning medication, you will have to stop taking it before the procedure. Make sure that you tell your doctor about all the medications that you have been taking. This is an outpatient procedure that lasts for about 15 to 45 minutes.

During the procedure, you will need to lay down on an X-ray table. The doctor will use local anesthesia for numbing the treatment area. Then, they will use a special X-ray called a fluoroscope for directing a thin hollow needle into the area that is responsible for pain. Through the fluoroscope, the doctor will be able to see the needle in real-time and ensure that it goes to the right location. There will be some discomfort, but you will feel less pain and more pressure.

Once the needle is put in place, you will receive a numbing medication. After that, an RF current will be passed through the needle for creating a small, precise burn known as a lesion. This current will destroy the nerve or a portion of it that is transmitting the pain and disrupt the signal that is producing it. Each site will take about 90 seconds to get burned. Doctors can burn multiple nerves at the same time.

Most of the patients are able to walk immediately after the procedure. There might be some pain because of muscle spasms or residual effects of nerve ablation, but it will only last for about two weeks. The pain relief from this procedure can last somewhere between 9 months to 2 years. In some cases, the nerve regrows through the burned lesion. If needed, the procedure can be repeated.

If you think that this procedure might be right for you, then you need to get help from the best. Germanten Hospital is the largest hospital in Hyderabad dedicated to Orthopaedics Trauma, Joint Replacements, Spine Surgeries, and Sports injuries. Germanten offers advanced treatments that cover operative as well as nonoperative management. In 2019, Times of India graded it as the Best Emerging Orthopedic Hospital. It was also named as the Best Orthopedic Hospital in South India by Economic Times 2021.

Germanten is a 200+ bedded NABH-accredited hospital with HEPA suite laminar operation theatres for total infection control. You can get diagnostic facilities like imaging, radiology, pathology, and laboratory services in the hospital itself. Apart from critical care facilities and highly-advanced ICU, we also offer post-operative rehabilitation services as well.

The reason behind the success of Germanten hospital is Dr. Mir Jawad Khan, who leads the orthopedic team at the hospital. He has been committed to providing the highest quality of medical services to the people for more than 20 years. To celebrate his achievements and effort, he was awarded the title of Best Doctor by Shri Roshaiah Garu (Ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu) in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra.

So, if you have been suffering from chronic pain for quite some time and haven’t had any luck with other nonsurgical treatments, the RF Ablation procedure from Germanten Hospital is your best bet. To know more about the procedure, book an appointment at Germanten Hospital.

02 Mar 2021

How to Prevent Back Pain and Neck Pain?

Most of us in our lives have experienced falling asleep in a weird position and then waking up with the most annoying stiff neck. If you try to move your neck, it hurts so bad! Sometimes, other events such as injuries to the neck can also result in neck pain.

Similarly, at times we think of ourselves as superheroes and end up lifting something too heavy or we take a fall. There comes in our back pain. It can be short-term or chronic, depending upon various factors such as a sprain, a fracture, a medical condition such as spinal stenosis or arthritis and excess body weight. A sedentary lifestyle is also a great contributor to back pain. Nowadays, even younger people complain of back pain, which is a result of longer screen hours and incorrect posture.
What can we do in our daily lives to prevent pain in our necks and backs?

Here are a few tips to avoid neck pain –

1.A new pillow – Most of the time, our pillows are the reason behind our stiff necks. You may not even realise that you’re using the incorrect pillow. The pillow that supports your natural neck curve and keeps it aligned throughout the night is the best. With some trial and error, you’ll find the pillow that is best for you.
2.Correct sleeping position – We all love to sleep in varying positions that we find comfortable, but the best sleeping position is the one where your head, neck and body is in alignment. Try sleeping on your back and to take the strain off of your neck, place some pillows under your arms. You can also elevate your thighs by placing pillows under them. This position helps relieve neck pain, as well as prevent it.
3.Computer screen at eye level – To prevent neck pain, try to adjust the computer monitor’s height in such a way that you don’t have to look down. With laptops, this is difficult, so you can use a book to place beneath it, to raise the height to your eye level.
4.Use earphones or headphones – Everyone loves to multitask. Oftentimes, we’re busy cooking, using both our hands and talking on the phone simultaneously. Putting your phone between your ears and shoulders and tilting your head sideways can cause extreme neck pain, over time. Instead, use headphones or put your phone on speaker.
5.Correct posture while texting – All of us look down on our phones each day, every day and that strains our necks too much. Try to raise the phone to your eye level and ultimately, minimize screen time. It is beneficial, not just for the neck but also the wrists, spine and eyes.
6.Regular exercise and stretching – Exercising regularly is beneficial for the whole body, even the neck! It helps maintain a good posture and ultimately relieve the tension from our neck. Exercises such as the chin tuck help strengthen the neck muscles tremendously.

To prevent back pain, follow these tips –

1.Maintain your weight – When you gain excess weight, your centre of gravity shifts and that strains your lower back. Hence, it is very important to maintain your ideal weight.
2.Sleeping position – The correct sleeping position is not only beneficial for the neck but also for the back. Sleeping on your stomach is one of the worst positions and can cause a lot of back pain.
3.Avoid lifting heavy objects – We tend to lift objects by bending over the waist, which is an invitation for back pain and injuries. Instead, bend your knees and sit in a squatting position whenever you want to lift something.
4.Maintaining the correct posture – While standing up, keep your abdomen tucked in and your head should be held up. Try to pull your shoulders down from your ears. This posture is essential in avoiding back pain.
5.Strengthen your back – Doing back as well as abdominal exercises can help strengthen the muscles and minimise the chances of any back injuries and pain.
6.Improving bone health – Weaker bones lead to osteoporosis later in life, which causes back pain, especially for women. So, increase your intake of vitamin D and calcium by consuming items such as milk, cheese, yoghurt and green leafy vegetables for strengthening your spinal bones.
7.Stop smoking – People who smoke are more prone to back pain as compared to non-smokers. Blood flow to the spinal disks is restricted due to the consumption of nicotine. Smoking also weakens the back muscles, making it prone to injuries. Thus, to avoid back pain, one should stop smoking.

When all these remedies fail, consulting a doctor might be necessary. At Germanten Hospital, Hyderabad, various back and neck conditions such as sciatica, spinal stenosis, vertigo and spondylosis are treated non-surgically.

The team of doctors at Germanten Hospital consists of the finest neurosurgeons, orthopaedic spine surgeons, physical therapists as well as neuro physicians. Spinal surgeries and procedures are performed in a minimally invasive way here, to make it less painful for our patients. Our NABH-accredited hospital has over 200+ beds and the most advanced medical technology available. Germanten Hospital has been awarded the title of the Best Emerging Orthopaedic Hospital in India, by the Times of India in 2019. It has also been named as the Best Orthopaedic Hospital in South India by the Economic Times in 2021.  

The spinal surgery team at Germanten hospital is led by Dr Mir Jawad Khan, a well-known orthopaedic surgeon. He has over two decades of experience in the field. To celebrate his achievements and effort, he has been felicitated with the title of Best Doctor by the ex-CM of Joint Andhra Pradesh & Former Governor Tamilnadu, Shri Roshaiah Garu in 2018. In 2019, he was honoured with the Vaida Ratna Award by the Honourable Health Minister of Telangana, Shree Etala Rajendra. Germanten Hospital, Hyderabad is your go-to place for all spine-related problems!

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