Rajesh Bhalla

Frequently Asked Questions

Q. 1 - Does an Orthopaedic Doctor treat problem related to knee/foot/ankle?

Yes, one can approach an Orthopaedic Doctor. As they are well-versed in the musculoskeletal system, they can provide treatment for common Arthritis, ankle sprains, and sports injuries. He is the best person to tackle the situation. An orthopaedic surgeon further having vast experience in such joint preserving procedures are even in more commanding position.

Q. 2 - What will be the qualification of an orthopedic surgeon?

He will be a medical practitioner holding a degree of MS (Master of surgery, Latin – Magister chirugiae) or DO (Doctors of Orthopaedic Medicine)/ DNB (Diplomate of national board) Throughout the surgical residency period of these courses, in-depth knowledge of different musculoskeletal conditions and treating techniques will be provided. The candidate is trained under senior teachers and evaluated in the end before being honoured with the degree.

Q. 3 - Why my knee started with pain?

With age as the hair turns grey, eyes turn weak, teeth turn loose, and wrinkles start on face and etc. Similarly aging do happen to knees. They start with insidious grumbling pain around knee while or after long standing. Squeaking pain while climbing stairs or while squatting.

Q. 4 - What happens in aging?

Here the cartilage at the end of the long bones of the joints degenerates. Cartilage is a white semi-rigid, flexible tissue providing cushion-like support to them. The articular cartilages of knee joints wear away with age. It is a degenerative knee condition affecting everyone with growing age.-This we call Knee Arthritis. The natural regeneration power of the cartilage dwindles with age.

Q. 5 - how can we prevent aging?

Prevention of early degeneration is the best tool for long healthy knee life. Caution should start from early life. Young enthusiastic people start practicing wrong gymming and other activities for early muscle building. There should be an understanding that this follows a long term program to achieve desired results. This should be under proper coach/guide supervision. Healthy life style, protein rich diet, weight control, proper footwear adds to the age of the valuable knee.

Q. 6 - What do you mean by healthy life style?

This comes with respecting knee. There should not be any activity to trouble knee to its extremes. After certain age ~30 years or so, floor work should be caution. The routine habit of unnecessarily stressing the knee should be monitored. Certain work which require floor sitting should turn intelligently to desk work (at a comfortable height). This will off load the knee. The body weight on knee ranges from one to 25 times when from standing to squatting.
Its ranges 5 to 7 times from standing to walking, 10 to 15 on brisk walking and 20 to 25 times on running.

Q. 7 - Why age 30?

Human life expectancy in India is 69 to 70 years as studied on 2020, while USA 79.11years. Age 30 in Human physiology has a water shed time. Particularly female’s body, they start heading toward menopause, they are termed elderly in gynecology with certain complication associated with the age. From Orthopaedic point, the body is now entering elderly phase from youth. Repairing and regeneration is slowing down. Female body starts losing calcium and organic tissues from bones. This we call osteoporosis. Middle age starts from 40 onward. This is a general rule which vary from body to body and environment. So the person should learn this phase and behave accordingly.

Q. 8 - I am in trouble. What shall I do?

You please learn every problem has a solution. So relax and calm down. You need to see your orthopaedic surgeon trained in knee preserving techniques. And start with healthy life style till then

Q. 9 - What are knee preserving techniques?

These are the surgical techniques which are used to recondition and repair the damaged cartilage, Realign the leg, strengthening of muscle, conditioned braces and footwear. These are to prevent chopping out your knee (TKR, Total Knee Replacement). They follow same operative protocol but you save your knee. This prolongs knee productive and pain free life.

Q. 10 - What is Total Knee Replacement?

Here the damaged knee cartilage along with the bone ends are chopped off and prosthesis is replaced. Namely femur (thigh bone), Tibia (leg bone), Patella (knee cap). Though this a successful old tested surgery. I personally keep it a reserve till end. As this comes with lots of limitations and restrictions.

Q. 11 - What are the limitations and restriction of TKR?

This is an implant. SO Not going to regenerate in itself as here in our native knees. Thus has a life ranging 10 to 15 years and sometimes 20. So will require a repeat surgery accordingly. With modern medicine life expectancy of individual is increasing. If someone got operated at 50 years of age, he will have to go through another surgery at 60 or so. This time the bone is in bad conditions along with the soft tissues and advanced age. Post surgery you are not advised to squat as this will accelerate wearing of the prosthesis.

Q. 12 - Why Joint or Knee preserving surgeries?

As we are mending the god gifted natural knee and prolonging their life. This gives you the liberty to repeat this procedure again and again till we get the desired results. These are not major surgeries as is TKR. These are keyhole surgeries that even many times under local anesthesia or opd procedures. These carry bare minimal risk. These are to stimulate the mesenchymal cells to grow a fresh cartlage regeneration or to replace the lesion with healthy afresh cartlage.

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