Author Archives: jointsurgery

Cemented hip replacements may fail after 10 to 15 years, or occasionally sooner due to loosening, wear or breaking of parts. A hip revision operation also known as revision hip arthroplasty is thus needed to replace the hip replacement that has worn out, loosened or has developed a problem.

If you have unrelieved pain in the hip that was replaced, your orthopedic surgeon can detect and determine whether you need a hip revision procedure using regular X-ray examinations. If a problem is detected, i.e. if the X-rays show damage has occurred to the hip replacement causing its failure, you may need to have a revision surgery before a major problem develops.

Component failure- The most common reason for hip implant failure is the wearing down of the plastic insert in the hip socket. In some other cases, the hip implant may shift slightly after surgery leading to unbalanced weight distribution and premature implant failure. Depending on the the kind of failure and the extent of the wear, only the plastic component or the entire implant together with the metal components will be replaced.

Osteolysis- The wearing down of the plastic component leaves tiny plastic particles in your body that are attacked by your body’s immune system, and this immune response also attacks the healthy bone around your implant. This leads to a condition called osteolysis, in which the bone in the area around the joint implant softens as it is absorbed by the body, thus making your implant unstable and in need of revision.

Hip Dislocation- Some patients do experience dislocation of the implant after surgery. In approximately half of these cases, your physician may be able to put your hip implant back in place without surgery. However, if your surgeon determines the implant was damaged, certain components of the ball-and-socket joint may need to be replaced in a revision procedure.

Fracture- If the bone next to your primary implant is fractured in an accident, revision surgery may be required in order to provide a safe, stable joint. In this case, the original implant may need to be removed, the fracture addressed and a revision joint implanted.

Infection- In a low percentage of cases, your hip may become infected after surgery. Although it may be successfully treated with antibiotics, there are severe cases where a follow-up revision surgery may be required.

Asceptic loosening- Aseptic loosening occurs when the hip implants become loose within the bone. A loose hip implant tends to be painful, and usually requires revision hip replacement. Reconstruction is possible through different methods including cemented or cementless components, with or without bone grafting, and the use of additional metalware such as screws, plates and cages to reinforce fixation.

In revision hip arthroplasty, compared with primary total hip arthroplasty, the environment of the hip joint is poor, and therefore, an implant appropriate for the purpose of the revision should be selected.

The total revision hip implant is comprised of four parts:

• A metal hip stem that is inserted into the top of your thighbone
• A metal cup which holds the cup liner
• A cup liner which holds the femoral head
• The femoral head or ball which is attached to the top of the hip stem and is inserted into the liner to form the ball-and-socket joint.

Hip revision implants are not one-size-fits-all, therefore your surgeon will choose the right hip implant for your body. Depending on the type of revision surgery needed (e.g. acetabular cup revison), different implants and components may be used (e.g. special cup, augment, reinforcement). The revision stem  like the S-ROM is the most commonly used. Your surgeon will determine which of the four component’s design options will work best together to restore your accurate leg length, while minimizing the risks of post-operative dislocation and premature implant wear.

Postoperative care for revision hip surgery is the same as that for total hip replacement surgery. Patients receive a combination of home health care, physical and occupational therapy home health care and other forms of rehabilitation.

You should have near-normal range of motion and adequate strength in your hip to perform most daily activities after completing the post-operative hip rehabilitation process. Many patients have less pain and better mobility after revision hip surgery. They have successfully returned to activities such as walking, driving, swimming, golf and stationary cycling. However, you should avoid running, jumping, heavy lifting, crawling and climbing.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Hemiarthroplasties are favored as a treatment for hip fractures in the following situations:

1) The fracture has disrupted the blood supply to the femoral head: in this case even if the fracture heals, the head of the femur will crumble. This is known as avascular necrosis and will lead to the hip joint failing.

2) Severe osteoporosis: if the bone is too brittle, other methods of fracture treatment will not be successful

3) A fracture that has been present for several days

Some tests that may be ordered to check that you’re fit for surgery include:

• Blood tests
• Chest X-Ray
• Urine test
• ECG

The anaesthetic team will see you and decide the type of anaesthetic that’s best for you. The different types of anaesthesia include:

General Anaesthetic: This type of anaesthetic puts you asleep during the whole procedure and a machine controls your breathing.

Spinal Anaesthetic: An injection is placed into your back to numb your hip and legs. You will be awake during the procedure, however a sedative can be given to you to help you doze off.

Nerve Blocks: This special injection is used to help with your pain after the operation and often used in conjunction with a general anaesthetic.

Patients are usually able to go home after spending 4 – 7 days in the hospital. You are ready to go home when you can safely get in and out of bed, walk up to 20 meters with your crutches or walker, go up and down stairs safely, and understand your hip precautions. Patients who still need extra care may be sent to a different hospital ward for further rehabilitation before they go home.

• Breathing: To avoid lung problems after surgery, you will be asked to breathe deeply and cough frequently. This will help avoid pneumonia and lung collapse.
• Walking: Walking and light activity are important to your recovery and will begin the day of or the day after your surgery. Most patients who undergo total hip replacement begin standing and walking with the help of a walking support and a physiotherapist the day after surgery.

The physiotherapist will teach you specific exercises to strengthen your hip and restore movement for walking and other normal daily activities.

It is important to keep your wound as dry as possible. Most patients are discharged home with a waterproof dressing, which can be left on for showering. During the first 24 hours, it is normal to have some minor bleeding. After being discharged home, there should be no discharge, redness or bleeding around the wound. If there is redness, discharge or a foul odour, please seek medical attention as soon as possible.

There are a number of ways your wounds may be closed those include either with the non-absorbable stitches, absorbable stitches or surgical staples. The stitches or staples are usually removed 10-14 days after surgery.

There are usually no specific diet or extra vitamins / nutrients needed to recover from a total hip operation. It is important to have a normal healthy, balanced diet and plenty of nonalcoholic fluids.

One of the possible complications of hip replacement surgery is dislocation. Dislocation is most common during the first year after surgery, but can occur at any time.

There are certain positions and precautions that must be avoided.

• Do not cross your legs.
• Do not bend your hips more than a right angle (90°).
• Do not turn your feet excessively inward or outward.
• Do not twist on your operated leg when turning
• Do not bend down to pick things up off the floor

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

You should consult an Urologist or a General Physician.

It cannot be completely cured. But it can be prevented by administering medication which can prevent further damage.

If you eat a lot of foods that are rich in purines, you may get gout. Some of these foods are salmon, sardines, liver and herring. You may get gout if you’re

overweight, drink alcohol, or have high cholesterol. Men have gout more often than women do. Women are more likely to have gout after menopause. Some medicines may cause gout, such as certain diuretics (water pills), niacin (a B-complex vitamin), aspirin (taken in low doses), and some drugs used to treat cancer.

Change your diet plan. Avoid the intake of red meats, shellfish, beer, red wine and salt. First, pain relievers such as acetaminophen/Tylenol or other more potent analgesics are used to manage pain.

Secondly, anti-inflammatory agents such as nonsteroidal anti-inflammatory drugs (NSAIDS), colchicine, and corticosteroids are used to decrease joint inflammation.

Common side effects of NSAIDS include irritation of the gastrointestinal system, ulceration of the stomach and intestines, and even intestinal bleeding. Patients who have a history of allergy to aspirin or nasal polyps should avoid NSAIDS because of the risk of an intense allergic (anaphylactic) reaction.

Always take the medication after food or with a glass of milk.

Gout is a painful type of arthritis that develops when uric acid builds up in the body, leading to the formation of uric acid crystals in the joints. The big toe is a common site affected by gout, but it can also affect other joints, including the knees, ankles, heels, or toes. Affected joints are painful, red, swollen, and warm.

Gout is nine times more common in men than in women. It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.

Uric acid. Uric acid crystals that build up in the joints, causing inflammation, are the cause of the characteristic symptoms of gout. Uric acid deposits can also occur beneath the skin (called tophi), and uric acid can also form kidney stones.

Because alcohol interferes with the body’s ability to remove uric acid, people with gout should avoid drinking alcohol. Alcoholic drinks, drugs, an illness, or even a stressful event can trigger an attack of gout. Attacks usually last for 3-10 days. Another attack may not occur for months to years, but many people with gout experience more frequent and longer attacks over time.

Symptoms of gout generally include the following: Warmth, pain, swelling, and extreme tenderness in a joint, an very red or purplish skin around the affected joint, which may appear to be infected. As the gout attack subsides, the skin around the affected joint may peel and feel itchy.

The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in the big toe. Gout attacks also appear in feet, ankles, knees, fingers, heels, and elbows.

Family history.Gout tends to run in families; between 20-80% of those affected have a family history of the disease. Diets high in purines, male gender, overweight, lead exposure, and alcohol consumption are other risk factors.

In severe gout, dietary changes are usually not enough to prevent repeated attacks, and medications are needed to lower the uric acid. However, if you are not taking medication for your gout, and even if you are, it is reasonable to limit your intake of foods high in purines. For the first six months after starting allopurinol for gout, your diet is especially important in helping to prevent attacks. For more information, send us your query by filling up our free consultation form.

That depends on the type and severity of your gout and how your doctor is treating it. Some patients just have one or two gout attacks; they may be treated only when attacks occur and take no medications when they are doing well. However, many patients need long-term medications, which work only while you are taking them. For example, if your doctor has prescribed colchicine to prevent gout attacks, the attacks will return if you stop the drug. If you are given allopurinol to reduce the uric acid in the blood (to reduce gout attacks) or to reduce the uric acid in the urine (to reduce the risk of uric acid-related kidney stones), the risk returns if you stop the drug. So many patients need to take gout treatments for the rest of their lives. For more information on the different drugs prescribed for gout and how they work, send us your query by filling our form.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

For the most part, routine laboratory testing reveals nothing. However, upon physical examination, patients will be sensitive to pressure in certain areas of the body, called tender points. To meet the diagnostic criteria (set forth for research purposes), patients must have widespread pain in all four quadrants of their body for a minimum duration of three months and at least 11 of the 18 specified tender points. The 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee, and elbow regions (more than 90% of these areas are myofascial trigger points). However, if a person has widespread pain, at least six or more tender points and many of the commonly associated symptoms of fibromyalgia (such as disturbed sleep, irritable bowel syndrome, frequent headaches, fatigue, and memory problems), they should still be diagnosed and treated for fibromyalgia. Roughly 75% of chronic fatigue syndrome (CFS)- diagnosed patients will meet the fibromyalgia criteria. If you have been diagnosed with fibromyalgia or chronic fatigue syndrome, but you are unsure about the diagnosis, or you are concerned you have something else that mimics these conditions.

Traditional treatments are geared toward reducing pain and improving the quality of sleep, meaning that a sleep study may aid with individualizing your therapy. Deep level (stage 4) sleep is crucial for many body functions (such as tissue repair, antibody production, and the regulation of various neurotransmitters, hormones, and immune system chemicals). Therefore, the sleep disorders that frequently occur in fibromyalgia patients should probably be treated first because they may aggravate the symptoms of this condition. Ambien, Lunesta, clonazepam, and trazodone are just a few of the medications that may be used to aid sleep. For addressing the pain and the symptoms in general, medications that boost serotonin and norepinephrine (neurotransmitters that modulate sleep, pain, and immune system function) are commonly prescribed in low doses, such as amitriptyline, cyclobenzaprine and Cymbalta. Ultram may help with the pain, although stronger opioids may be needed. Muscle relaxants, anti-epileptics (such as Neurontin and Lyrica) and other drug categories may be prescribed as well.

In addition to medications, most patients will need to use other treatment methods, such as trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture, acupressure, relaxation/biofeedback techniques, osteopathic manipulation, chiropractic care, therapeutic massage, or a gentle exercise program.

Long term follow-up studies have shown that fibromyalgia is chronic, but the symptoms may wax and wane. The impact that fibromyalgia can have on daily living activities, including the ability to work a full-time job, differs among patients. Overall, studies have shown that fibromyalgia can be as disabling and life-impacting as rheumatoid arthritis.

Lifestyle modifications may help you conserve energy and minimize pain. Learn what factors aggravate your symptoms and avoid them when possible. Many patients find warm water (hot tub or shower) to be soothing. Hot wraps for particularly painful areas are also beneficial. Maintaining a rigid sleep schedule (e.g., ensuring that you receive at least eight hours of sleep per night and that you have a routine for easing you into sleep) is one method endorsed by patients to help minimize daytime fatigue and reduce nighttime sleep difficulties. Gentle movement and stretching exercises will help you maintain your function, which is essential when the body is tired and the muscles hurt.

No, but there are researched treatments that have been shown to be helpful for reducing the symptoms. Patients need to beware of the many bogus cures that are being promoted on the Internet and in the media. Many businesses count on people who are desperate to get rid of chronic, unrelenting pain (such as that produced by fibromyalgia). If a remedy sounds too good to be true, it probably is.

Doctors cannot “see” and may not understand the sources of your pain or fatigue. However, what they do observe is your anxiety and frustration with having to deal with these symptoms around-the-clock, which may wrongfully lead them to conclude that your symptoms are of a psychological nature. Also, the old school of thought regarding pain is that it is produced by tissue injury, and there is no obvious source of tissue injury in patients with fibromyalgia. Regardless, if your doctor does not believe that your symptoms are real, you owe it to yourself to find another doctor who believes in you and will work with you to help reduce your symptoms.

Although some degree of regular exercise is essential for maintaining function, and if done in warm water, it can improve circulation. Yet, exercise alone will not be enough to treat your fibromyalgia. Many studies on the use of exercise to treat fibromyalgia have been published over the years, and while the documented benefits are minimal, these studies are heavily promoted at medical conferences and widely publicized in the medical journals. Exercise is easy to prescribe and doesn’t cost anything, so it tends to be one of the first therapies that a doctor recommends for fibromyalgia. Yet, you have to be careful because over-working any one muscle will cause others to hurt more.

The pain of fibromyalgia has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning, and you may hurt more in muscle groups that are used repetitively. Read more about muscle stiffness and repetitive activity in fibro.

This symptom can range from mild to incapacitating. The fatigue has been described as “brain fatigue”—patients feel totally drained of energy. Many patients say that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating (i.e., brain fog). Fibromyalgia fatigue is definitely not just being tired!

Most fibromyalgia patients have an associated sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine that recorded brain waves of patients during sleep. Researchers found that most fibromyalgia patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Patients appeared to spend the night with one foot in sleep and the other one out of it.

If you wake up feeling as though you’ve just been run over by a Mack truck—what doctors refer to as “unrefreshing sleep”—it is reasonable for your physician to assume that you have a sleep disorder. However, to pinpoint the types of sleep disturbances present, an overnight sleep study may be warranted. In addition to the alpha-EEG finding, other sleep disorders have been identified in fibromyalgia patients, including sleep apnea (as well as the newly discovered form of interrupted breathing called upper airway resistance syndrome, or UARS), bruxism (teeth grinding), periodic limb movements during sleep (jerking of arms and legs), and restless legs syndrome (difficulty sitting still in the evenings).

Irritable Bowel Syndrome (IBS), which can include constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea is found in roughly 40 to 70% of fibromyalgia patients. In addition, Gastrointestinal Esophageal Reflux Disease (GERD), is equally common in people with fibromyalgia. This can include heartburn, chest pain, regurgitation, indigestion, and a chronic cough, among other symptoms.

Recurrent migraine or tension-type headaches are seen in about 70% of fibromyalgia patients and can pose a major problem in coping for this group. For some people, aggressive treatment of the migraines also provides tremendous relief of the overall pain of fibromyalgia. Myofascial trigger points, or those knots in your neck and shoulder muscles, are the primary cause of your headaches and they can be treated.

Changes in weather, cold or drafty environments, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety, infections (flu or a cold), and over-exertion can all contribute to symptom flare-ups. Repetitive use of the same muscle group can strain the muscles and lead to more pain.

Fibromyalgia does run in families and there appears to be a strong genetic component. If one parent has this condition, the odds that a child will develop, it is estimated to be 50%. Many research studies are under way to look at the genetic abnormalities that might be linked to various neurotransmitters involved in both pain and sleep regulation.

The best doctor to see is one who has lots of experience treating fibromyalgia patients. There is no specific medical specialty that “owns” this condition, so it is important to inquire about a physician’s level of experience and their general philosophy for treating fibromyalgia.

Studies show that roughly 25% of patients get worse over time, but another 25% get better. Some patients may be likely to improve because they have a good doctor willing to work with them to find which therapies they respond to. Also, as people age, other medical conditions can aggravate the symptoms of fibromyalgia, so it is imperative that patients seek aggressive treatment for age-related conditions, such as arthritis. A preventive medicine program with maintenance exercises and a healthy diet may prove worthwhile.

Balancing work and chronic illness is always a challenge, but most patients with fibromyalgia are able to remain employed. The answer to this question really depends upon one’s job and whether job accommodations can be made to ease the symptoms. Also, the development of other medical conditions may make fibromyalgia symptoms more severe and lead to the need to consider early retirement or disability. Studies show that roughly 25% of fibromyalgia patients receive some form of disability compensation at any given time. If you are experiencing difficulties with work, check out our disability-related articles in the Coping Resources section.

Only a few studies have been conducted on this topic, and most indicate that variations in barometric pressure (which occur when a storm front moves in) may worsen the symptoms. In addition, extreme cold weather and cool drafts can cause you to shiver and this will make your tight, knotted muscles more sore.

No, but a diet full of fruits and vegetables may supply your body with antioxidants, which are known to be useful for protecting your tissues and to minimize the development of “other” sources of pain. Irritable bowel syndrome and acid reflux are both common in people with fibromyalgia, so it is wise to avoid foods that irritate these conditions. Click here to read about how your diet can be affecting your symptoms.

You will need to be in the hospital 1-2 days.

Absorbable suture are mainly used. If staples are used they will be removed at your 2 week post operative appointment.

You will return to see the physician 2 weeks after your surgery.

You will have a back corset brace for 6 weeks. It will need to be worn for sitting, standing and walking.

You will have a dressing until your first post operative visit (2 weeks). Your dressing will need to be changed daily using dry gauze. No ointments.

You may shower after 48 hours but keep your incision dry. Make sure you change your dressing after you shower.

You will have Physical Therapy by Home Health and will graduate to outpatient therapy at 6 weeks.

You will not need to be on blood thinners.

You will not be able to drive while you are taking medication. You will be advised when you can start driving by your physician. When you do start driving we suggest you start with short trips. You will need to make sure you can apply the brakes and gas easily.

Approximately 4-6 weeks. How long you will be out of work depends on the type of work you do.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The clavicle lies above several important nerves and blood vessels.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

We accept different methods of payment like, cash, plastic cash, via net banking, etc.

• To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

Clinical data show that woman are actually as much as ten times more likely to develop carpal tunnel syndrome than men are. This is largely due to the fact that women tend to have smaller hands and thus a narrower carpal tunnel.

If needed, it is possible to address both hands in one operation. Doing so does not generally have any effect upon recovery time, but can increase the discomfort and pain experienced after surgery. The choice to treat both hands separately or at once is left to each individual patient’s discretion.

Carpal tunnel release surgery can be performed under local anesthesia. This makes it a fairly simple, outpatient operation. This means that patients can return home on the day of surgery without requiring overnight care.

Endoscopic surgery is a minimally invasive approach performed using an advanced surgical tool called an endoscope. The endoscope is composed of a thin tube with a miniature light and a camera on the end. In an endoscopic carpal tunnel release, the endoscope is inserted through a small incision in the palm. The area to be operated upon is then magnified and projected on a screen. The surgeon uses the images on the screen to guide the surgery, which is performed using a small instrument inserted through another small incision.

Minimally invasive or endoscopic surgery for treatment of carpal tunnel syndrome can dramatically increase the risk for complication. It can also make for a faster recovery, less pain and less scarring. One must of course bear in mind are risks involved in any form of surgery. Your surgeon can and will inform you these before your surgery.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

• We accept different methods of payment like, cash, plastic cash, via net banking, etc.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

• After obtaining medical evaluation from your primary care provider you are admitted to the hospital for elective surgery. An anesthetic is placed and the ankle joint is exposed by careful separation of the tendons, vessels and nerves in front of the joint. The diseased portion of the ankle is precisely removed and the replacement is impacted into position. The layers are closed and a dressing is applied. Additional procedures may be performed at the same time as necessary. The procedure lasts 2 to 3 hours.

When compared to the other major joints, arthritis of the ankle is uncommon. Many people know of someone who has found pain relief from hip or knee replacement, but few know someone who has had an ankle replacement. It is true that ankle replacement is not as common as hip and knee replacement, but the number of procedures is growing fast.

• As with any surgical procedure, experience matters. Ankle replacement is a complex procedure, and is best performed by a surgeon who specializes in foot and ankle surgery, and not just knee and hip replacement.

The typical patient spends one or two nights in the hospital after ankle replacement. However, the length of the hospital stay can depend on many other factors. Your surgeon will advise you on what he/she believes is likely for your specific situation.

A foot and ankle surgeon who is experienced in ankle replacement surgery can evaluate your particular situation and determine whether you are a candidate for the procedure. All patients must exhaust other non-surgical treatment methods prior to proceeding with ankle replacement. No age limits have been established for the ankle replacement, but the performance of a prosthetic joint and how long it will last depends on many factors, including the type of implant used, your physical condition, bone quality, activity level and lifestyle.

It is very important that your surgeon be aware of all medications that you are taking, especially, steroids and blood thinners. You will be advised if you need to make any changes in your medication schedule. Generally, patients are advised to stop taking prescription or over the counter anti-inflammatory medication, including aspirin or ibuprofen five days before surgery. These medications thin the blood and can lead to excessive bleeding during surgery.

The arthritic ankle is expected to be less swollen but not completely normal. Also, there will be a visible scar on the front of the ankle from the incision.

There are several components that make up the ankle replacement device. All of the parts are made from highly biocompatible materials, including titanium and cobalt chrome metals on the tibial and talus sides of the joint. Between those two components, a third component made of a biocompatible plastic called polyethylene is attached to the tibial component to help the components glide against each other. These are identical materials to those used in hip and knee replacements. All of the materials have a long and successful track record for use in human joint replacements.

Advances in technology and materials have made ankle replacement more and more reliable. An increasing number of foot and ankle surgeons are using ankle replacement surgery with confidence to relieve pain and restore mobility in patients with compromised ankle function.

Although still a small niche segment, the ankle replacement market is growing rapidly. In 2009, about 2,300 procedures were performed in the US alone.

How long an ankle replacement lasts depends on many factors, including the type of implant used, and the patient’s physical condition, activity level and lifestyle.

While prosthetic joints can provide increased mobility and pain relief for many years, it is a fact that they are mechanical bearings and may not last for the rest of the patient’s life. Most patients can expect their ankle replacement to last 10-20 years.

The components used for ankle replacement are not different for men and women specifically; what differs is simply the size of the components based on the patient’s anatomy. During the procedure, the surgeon carefully chooses the components that best match your ankle joint. The implants are available in a range of sizes and combinations for a customized fit.

Sedentary patients may be better served by an ankle fusion. Increased body mass index (BMI) is just one factor that will be carefully considered by your surgeon. Increased BMI can be associated with mechanical failure of the implant.

As with any surgery, there is always a risk of complications. Risks include nerve injury, vessel injury, tendon injury, bone injury, infection, failure and persistent pain.

All patients will experience some level of pain after surgery. Many patients are off prescription pain medication five to seven days after surgery. After the initial pain from the surgery subsides, you should not have any chronic pain as a result of the implant. You may have some soreness, but that will begin to improve in the weeks and months following surgery. Call your physician if you have any increased pain, swelling, fever or abnormal incision drainage.

Although the recovery program varies by patient and surgeon preference, many patients are in the hospital for 1 to 3 nights. The stitches used to close the incision are removed between 10 and 21 days after surgery. Once stitches are removed the patient is allowed to move the ankle. Bearing weight on the ankle is allowed 6 weeks after surgery, at that time, physical therapy is started to accelerate the resolution of swelling, pain and stiffness and to eventually improve strength and coordination. Protective devices such as a cast boot or brace, along with physical therapy, are discontinued 12 weeks after surgery. Your physician will schedule regular follow-up appointments with you during that time.

Physical therapy is critical to the success of your new ankle. Your rehabilitation program often begins as early as the day of your surgery, when your health care team advises about the rehabilitation process. You will be instructed in the exercises to perform at home, which are designed to gradually increase the use of your ankle. It is important to follow your doctor’s instructions exactly and do your exercises regularly. In general, initial therapy involves stretching to help regain the normal ankle range of motion. Later, strengthening exercises are added if necessary. Your surgeon will provide you with any specific restrictions based upon your individual situation. It is important to follow those restrictions closely.

Most people are able to return to normal everyday activities such as dressing themselves and grooming within the first 2 weeks after successful ankle replacement surgery. Your ambulation will be restricted for 6-8 weeks until you start your rehabilitation therapy. Your doctor will advise you on specific limitations, including the amount of walking you can do on the ankle that was operated on. Many surgeons restrict their patient’s ambulation for a period of time. Your doctor will also let you know when you can begin ambulating more freely, and when you can return to other activities. Contact sports may be restricted in the long term.

• Once you return home, it’s a good idea to have a family member or friend available to help you with daily activities such as washing, dressing and preparing meals.

This is especially important during the first week or two following surgery. If you do not have home support, ask your health care provider about an agency or facility that may be able to provide the help you need.

You must be off all pain medication before you consider returning to driving. Patients with minimal discomfort and access to a vehicle with an automatic transmission can usually return to driving about two months following surgery.

The decision to return to work is individualized and is influenced by your job, your employer and your post-operative course. In most circumstances, patients can return to office work in 2 to 3 weeks if accommodations are made for transportation, parking, office access, rest and foot elevation. Patients that perform physical work may return to work once they recover endurance for standing and walking, this is at least three to four months after surgery.

The recovery of full ankle function may take up to 6 months, provided you followed the recommended physical therapy regimen. Most improvements are maximized by six months after surgery and residual swelling persists for 6 to 12 months.

People who have had an ankle replacement are generally advised to avoid contact sports and to refrain from repetitive impact activities that will accelerate wear of the implant, as these can place too much strain on your ankle implant. Consult your physician about the specific activities that might affect your new ankle.

It is impossible to state how much motion will recover after ankle replacement. However, patients with severely restricted motion that has been present for many years may be unable to achieve full motion despite a properly performed operation and dedicated physical therapy.

Ankle replacement surgery can help you return to normal daily activities that were previously limited by the ankle disease. Even though the ankle replacement addresses the most likely pain source, other sources of pain remain in the ankle and foot. Pain is likely to be reduced but it is not always eliminated.

When ankle arthritis pain begins limiting your daily activities, causing you to lose sleep, and is not responding to other treatment alternatives, it may be time to consider ankle replacement surgery. By waiting too long, your range of motion can become severely limited, making the surgery more difficult and the results less certain. It is a good idea to discuss your condition early on with a foot and ankle surgeon, and learn about the options and timing that might be right for you.

Early recommendations for arthritis treatment may include rest, walking with a cane in the opposite hand, over the counter or prescription anti-inflammatory medications, and medication for pain relief. Physical therapy may be prescribed in the early stages, although this can become less effective and even damaging as the arthritis advances. Cortisone injections can provide temporary relief of pain, although this is not generally considered a long-term solution. Occasionally, arthroscopic surgery is used to remove bone spurs and debris from the joint. When these solutions are not effective, your foot and ankle surgeon may discuss surgical alternatives with you, such as ankle fusion or ankle replacement surgery.

One of the surest ways to sustain excessive damage or develop a chronic condition is to continue to use an injured body part as you normally would. With this in mind, it is important to recognize the symptoms of Achilles tendonitis so it does not evolve into a long-term problem.

The primary symptom of this condition is pain above your heel or in the back of your lower leg. This typically starts as a mild ache, but then progressively becomes worse, especially following prolonged physical activity. Sprinting, stair climbing, and even simply running contribute to increasing pain.

Other symptoms of Achilles tendonitis include stiffness and tenderness in the tendon, particularly in the morning. This will typically improve with mild activity as the tendon stretches.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Your doctor can tell if you have an Achilles tendon problem by asking questions about your past health and checking the back of your leg for pain and swelling. If your symptoms are severe or don’t improve with treatment, your doctor may want you to get an X-ray, ultrasound scan, or MRI.

Treatment for mild Achilles tendon problems includes rest, over-the-counter pain medicine, and stretching exercises. You may need to wear well-cushioned shoes and change the way you play sports so that you reduce stress on the tendon. Early treatment works best and can prevent more injury. Orthotic shoe devices can also help reduce stress on the tendon.

Even in mild cases, it can take weeks to months of rest for the tendon to repair itself. It’s important to be patient and not return too soon to sports and activities that stress the tendon.

Treatment for severe problems, such as a torn or ruptured tendon, may include surgery or a cast, splint, brace, walking boot, or other device that keeps the lower leg from moving. Exercise, either in physical therapy or in a rehab program, can help the lower leg get strong and flexible again. The tendon will take weeks to months to heal.

The following are the risk factors for the achilles tendon disorders:

1) Sports and physical activity.

2) Sports training errors.

3) Age

4) Weight

5) Footwear