FAQ

Osteoporosis means porous bone. Osteoporosis is often called a silent disease because there are no symptoms. It may come to your attention only after a fracture develops –a fracture can occur very easily with a simple slip or fall or even with no injury at all. Due to low density and poor quality of bone, you will be at high risk for fractures, particularly at hip, spine and wrist.

Factors responsible for osteoporosis include:

• Age
• Menopause
• Low body mass index
• Low bone density
• Previous fractures
• Cigarette smoking
• Alcohol consumption
• Family history
• Low dietary calcium and vitamin D intake
• Prolonged bed rest/ physically inactivity
• Certain medications like steroids, anti-thyroid drugs
• Certain illnesses (Rheumatoid arthritis, Hyperthyroidism)

Osteoporosis can be detected by your doctor through clinical observation and / or bone mineral density (BMD) measurement.

There are many things you can do to lower your chances of developing osteoporosis. Lifestyle changes may be the best way of preventing osteoporosis. Here are some tips:

• Get enough calcium in your diet or through supplements (nearly 1200mg/day)
• Get enough Vitamin D (800 -1000|U/ Day)
• Exposure to sunlight for 10 -15 min at least 2-3 times a week is important for a healthy bones as sunlight is a very important source of vitamin D
• Avoid Excess of alcohol
• Stop smoking
• Engage in regular weight- bearing excercises throughout life
• Prevent Falls
• You should get treatment for underlying medical problem that can cause osteoporosis. If you are on a medication that can cause osteoporosis, ask your doctor if you can lower the dose or take another type of medicine.

The main indication of joint replacement is when osteoarthritis reaches the advanced stage. Osteoarthritis is an age related wear and tear of the joints that happen after the age of 35 -40. After the age of 40, stage I arthritis happens when the cartilage between the joints starts to degenerate. The initial stages can be managed by tablets, physiotherapy and regular exercise. When it reaches stage II, the joint lubrication becomes lesser over time, just like in the engine of a car. Patients can be benefited from an injection in the joint called viscous supplement. When it reaches stage III, Patients have continuous pain throughout the day and their quality of life is severely impacted. In such conditions, we do a key-hole surgery and address cartilage damage.

In India, the most common joint replacements are done for the knee joint, followed by hip and shoulder. Knee replacement largely depends on the age and degree of arthritis. When patients come in at a very early stage, only one half of the knee is affected Actually the knee has three compartments, an inside compartment, outside compartment and knee cap compartment. When one component alone is affected, that can be replaced and is called as unicompartmental knee replacement. The other joint replacements include elbow, wrist, joint and ankle but they are very rare. These are age related but more hereditary.  It is usually following an injury or weight related. When overweight people come in for surgery. I advice them to first optimize their weight before going ahead with the replacement. We recently did a surgery on a 88year old man from Jodhpur, so age is not a barrier. The whole idea is that even if the patients is going to live only for a few years after the surgery, he should be as self –reliant and independent ad possible.

The latest implants that are in the market today give a good bending capability in the knee and are called high flexions knee replacements. There is advancement in design by making a cut in the back of the knee. This cut helps achieve130- 145 degree flexibility. However, patients should have realistic expectations. They can’t expect to be as flexible as they were in their 20s.

These are artificial implants that comprise of two parts, metal and plastic. The joint space becomes narrow so we make cuts in the bone and replace it with a metal and put in a very high quality polyethene. Most of the current replacements are expected to last a life time. The implants normally outlive the patient unless in rare circumstances where people start doing aggressive sports and wear out the replacements. Both pre and post surgery physiotherapy are very important as it helps to strengthen quadriceps and takes off the load from the knee. The physiotherapy usually lasts for a month. Some patients with very positive mindsets even start walking 10 14 days! They can go back to office in 3weeks and driving within 2 months time.