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Message of Dr Sharma

Degenerative Arthritis is the fate of mankind; only the extent of involvement differs from one individual to other. Its severity varies with the advancing age. It affects different individuals differently. Arthritis is a reality, which needs to be understood and accepted. Effects of age are visible as changing skin texture, greying of hair and diminishing sight. Similar changes are taking place in our joints. The difference is that changes in joints are taking place without being visible to our eyes; hence accepting them is little difficult. The cartilage of the joint, which is well congruent in younger years, becomes eroded and irregular as the age progresses. This may also happen because of the rheumatic disease or as a result of fracture through the joint. The body reacts to this change and thus excess bone formation takes place, thus Osteophytes are formed. These are soft eburnated bony spicules within the joint, synovial fluid is collected and joint becomes swollen.

Knee joint is affected more as 1) while walking knee suffers with maximum stress bearing, 2) in our population varus or inward bending deformity of knee is common due to genetic predisposition. Thus more forces are concentrated on inner part of the knee while bearing weight. This damages the cartilage of the inner part of the knee faster.

If you are taking painkiller tablets, not able to walk well, are not able to perform your daily routine activities comfortably, denying that you have a problem, is not a solution. Painkillers of Ayurvedic, Homeopathic or Allopathic origin are not the answer. These are temporary methods. Their excess intake exposes you to the risk of gastric ulcers and a much serious problem of kidney damage. Singh et al have reported in American Journal of Medicine (105) 1998 that 1,07000 patients are admitted annually for medicine related intestinal complications as a result of pain medicine intake. All pain-relieving tablets cause kidney damage for sure and prolonged use may damage kidneys irrepairably, thus forcing one to go for repeated dialysis and kidney transplant.

Common symptoms for arthritis are painful knee or hip joint and disturbed walking and limping. Common symptoms of knee arthritis are Pain, Swelling, Locking and Instability of knee joint. Stretching of ligaments causes pain. Commonly encountered arthritis is Degenerative Arthritis, Rheumatoid Arthritis, Sero-negative Arthritis, Gouty Arthritis and posttraumatic arthritis.

The non-operative treatment of arthritic knees starts with awareness about arthritis, use of wedges in shoes and only occasional pain relieving medicines. Amongst pain relieving medicine NSAIDs (brufen, voveron, nimulid, etc) are best avoided. Paracetamol is a safer pain medicine, First step methods are weight reduction and pursuing precautions like avoiding squatting, kneeling or sitting on floor. Stair climbing should be minimized. Weight reduction is an important strategy.

Physiotherapy is important as strong knee muscles reduce the strain on the joint cartilage. Heat therapy and IFT/ultra sound are methods of physiotherapy, which help reducing swelling of the inflammed joints. You need to take arthritis seriously when discomfort starts in walking or taking stairs, when you need to accept regular pain medicines, when you become overweight, when pain shuffles from one knee to other.

You should consider surgery when arthritis is moderate to severe and when joint wear is demonstrable by X rays. This is visible by weight bearing X rays of knee joints. The final decision for surgery has to be taken by you, your family and your surgeon. Our vision needs to be broadened, reality of aging has to be accepted and if needed treatment must be undertaken. Our mission should be to make aging graceful for all. Arthritis is a manageable challenge, a planned & judicious treatment is important and early initiation is key to success.

Under our care we promise you the safe and successful treatment for your arthritic hip or knee, using the latest techniques of high flexion mobile bearing joints and computer navigation, which definitely improve results.

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With Best Wishes

Dr Rajeev K Sharma

M.S. (Orth) Goldmedalist, D.N.B. (Orth), M.Ch. (Orth)

Chairman, Institute of Orthopaedics, Joint Replacement & Sports Medicine

Moolchand Medcity, Lajpat Nagar, New Delhi



President Elect, Indian Arthroplasty Association