[jeepbug]

Hi nice thread started by dr Tejas . I am a micro dentist (microscope assisted precision dentistry ) mainly retreatment of faulty root canals , caps, bridges an dental implant complications


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[Abhi_abarth]

Originally Posted by Pferdestarke

If you are experiencing any stiffness in the early hours of day, it could be a rheumatological disorder which needs further clinical and radiological evaluation. Let us try with simple medicine and exercises. Start this tablet (Diclofenac+serratiopeptidase) twice daily for 5 days and whenever the pain becomes intrusive, apply hot fomentation. Start doing these exercises. If the pain doesn't subside in a week, please don't hesitate to consult an orthopaedician. Hope this relieves your backpain.

Thank you for this Doc. I will start the medication and exercises right away and keep you posted.

[ankan.m.blr]

My nephew in Bangladesh recently met with a bike accident. He had major fractures on his leg which required screws to be fitted. He also has ligament torn. Unfortunately I do not have much details of the injury. I was informed that after the screws 'set' the fractured bone (which will take 4-5 months), the torn ligament needs to be operated upon. There's no reliable orthopedic facility in Dhaka that can perform this kind of operation. So I am thinking of bringing my nephew to Bangalore. Can anyone please let me know whether there is any good hospital for this type of procedure (ligament surgery).

[SS-Traveller]

Originally Posted by ankan.m.blr

...after the screws 'set' the fractured bone (which will take 4-5 months)...

An orthopedic surgeon would be in a better position to say, but 4-5 months for a fracture to heal sounds much too long. The usual is 6-8 weeks.

Kolkata has some good hospitals and orthopedic surgeons (and a lot closer to Dhaka). Unless Bangalore is the choice because of convenience.

[chotu_r]

I am a 25 year old guy, 6'2'' and slightly overweight at 105 kilos. A couple of months ago, i enthusiastically tried to include exercise in my daily regimen and started doing jogging and playing badminton vigorously for a month. Towards the end of the month, i could feel the left knee was a wee bit loose at times but any discomfort was too small to notice and i attributed it to the usual pains of exercise. A week after i took the break, one fine morning my left knee started feeling like the knee cap was loose and about to fall off. My right knee also started feeling weird shortly thereafter, leading to a sense of discomfort but strangely no pain at all. I shrugged it off at the time as i had a similar experience a few years ago and it had gone back to normal after a few days. An X-ray revealed nothing and an Ultrasound for left knee showed swelling in ACL and slight swelling in PCL. An MRI of the same knee showed likely grade I knee sprain and some reduction in medial aspect of tibio-femoral joint space associated with minimal joint effusion. The words 'Grade I knee sprain' and some general reading about it on the web induced a sense of security in me and i carried on wearing knee caps till now. Worried about the persisting 'looseness' in my knees i finally went back to the ortho for some closure only to be told to decide on a possible date of surgery! Apparently my ACL is torn and knee may get damaged if left alone for a year or more. I was shocked and couldn't ask my doctor for more details. I still feel that i might have been misdiagnosed as i have never felt pain in my knees. The fact that my doctor beamed a huge smile after seeing my Ultrasound and declared that i required surgery doesn't help!

Im worried whether surgery is required and if any alternatives like physiotherapy might feasible. More importantly, i have been told that i should not use my beloved bike for 3 months after surgery. The horror!! Would i still be able to go to the gym/jogging/walking before surgery? Currently i am avoiding any movement, hoping that resting my knee will help it heal faster. However, if surgery is required, i think that having some fitness will help in rehabilitation. Requesting advice from the doctors or experienced members here.

[sagarpadaki]

Is there any treatment for snoring? I feel my neighbours are disturbed a lot because of my snoring problem. Can it be cured through medicine and is some kind of surgery required?

[alphadog]

Originally Posted by chotu_r

Im worried whether surgery is required and if any alternatives like physiotherapy might feasible. More importantly, i have been told that i should not use my beloved bike for 3 months after surgery. The horror!! Would i still be able to go to the gym/jogging/walking before surgery? Currently i am avoiding any movement, hoping that resting my knee will help it heal faster. However, if surgery is required, i think that having some fitness will help in rehabilitation. Requesting advice from the doctors or experienced members here.

Hi

I am an Orthopaedic Surgeon with a special interest in sports injuries and key hole surgery ( arthroscopic surgery), based in Cochin, Aster Medcity. I was previously in the UK.
It is natural that you are feeling frustrated and anxious about your knee. Can I please provide some advice.
First of all,if you have not had a significant trauma/injury to your knee, either recently or in the past, its highly unlikely that you have torn your ACL. It is an injury that needs a significant amount of trauma. If you have narrowed joint space and a feeling of knee being 'loose' its quite likely that you possibly have either an unstable knee cap or a meniscal cartilage injury.
It is always good to try out non-surgical measures like a good focussed physiotherapy programme, with particular emphasis on strengthening the Quadriceps (the muscles in front of thigh) and the hamstrings ( muscles at the back) and also improve the coordination or proprioception through exercises. You can then gradually build up your activity level as pain allows.
A good warm up and stretching before and after any kind of physical activity is essential as well. I do not personally think that you need to stay away from your bike.
If these measures do not work even after a period of physio etc for 6-8 weeks, then an arthroscopic (key-hole) assessment of the knee might be warranted.
I am more than happy to provide you with a second opinion or further advice if needed, off the forum, through email (for reasons of confidentiality). I will need to eyeball your scans and reports as well please, if you are interested. Please let me know.
Hope this helps.

regards

Dr Vinod Kumar

Originally Posted by ankan.m.blr

My nephew in Bangladesh recently met with a bike accident. He had major fractures on his leg which required screws to be fitted. He also has ligament torn. Unfortunately I do not have much details of the injury. I was informed that after the screws 'set' the fractured bone (which will take 4-5 months), the torn ligament needs to be operated upon. There's no reliable orthopedic facility in Dhaka that can perform this kind of operation. So I am thinking of bringing my nephew to Bangalore. Can anyone please let me know whether there is any good hospital for this type of procedure (ligament surgery).

Hi

I am an Orthopaedic surgeon, based in Cochin, Aster Medcity.
Sorry to hear about your nephew, but glad that he has been treated. 3-6 months to heal up is quite within the normal range of time taken to heal for certain bones and certain types of high energy fractures, which this seems to be.
Dealing with the ligament injuries after the bones heal up is the right thing to do.
It is important that you get the ligament injuries look at and treated at a reputed centre, with the expertise and facilities. Are you decided about Bangalore?

Regards

Dr Vinod Kumar

Originally Posted by Abhi_abarth

I have been riding bikes since 2000 and this problem has started only from 2012. Maybe I am growing old or immunity levels falling down.

My daily commute is 56 KM.

Please suggest

Hi

I am an Orthopaedic Surgeon, based in Cochin.
What you are suffering from sounds like what we call 'Mechanical Back pain'. But before confirming this and to rule out any serious causes of back pain, you will need certain investigations. At the very least an X ray of your back and some blood tests, especially looking at CBC, Calcium, uric acid levels etc. If you have pain radiating to one or both legs, you may need a MRI scan, no need for scan otherwise.
Once this has been done and other causes ruled out, what you need is a short term course of anti-inflammatory medications and muscle relaxants for 2-3 weeks. You need to combine this will regular practice of exercises for the back. In fact the back exercises are the most important thing, more than medicines, to keep the muscle spasm at bay and to give you relief.
The pain and stiffness in your back is due to muscle spasm,which happens due to prolonged sitting on your bike, bad roads might not help. The muscles on either side of the spine has to work extra hard and repeated straining causes them to over compensate and then go into spasm. This usually is worst first thing after walking up and in the evenings at the end of the day.
You might not see immediate benefits with exercises, hence it needs to be done religiously for atleast 3 weeks or more, twice a day, and then continue this and make it a part of your daily routine.
I am sure you will start seeing the difference if you do this.
I am more than happy to give links and more information regarding specific exercises for the back if you want me to.
Hope this helps.

Regards

Dr Vinod Kumar

[shashi63]

Originally Posted by chotu_r

Im worried whether surgery is required and if any alternatives like physiotherapy might feasible. More importantly, i have been told that i should not use my beloved bike for 3 months after surgery. The horror!! Would i still be able to go to the gym/jogging/walking before surgery? Currently i am avoiding any movement, hoping that resting my knee will help it heal faster. However, if surgery is required, i think that having some fitness will help in rehabilitation. Requesting advice from the doctors or experienced members here.

If you need a second opinion I would recommend Dr.Mangal Parihar.

His contact details can be had from

http://www.parihar.com/about-us/dr-mangal-parihar.html

God Bless!

Take Care!

[Ironhide]

Originally Posted by alphadog

Hi

I am an Orthopaedic Surgeon with a special interest in sports injuries and key hole surgery ( arthroscopic surgery), based in Cochin, Aster Medcity. I was previously in the UK.
Dr Vinod Kumar

Doc,

Came across your advice on the knee injury and since I too have a knee injury I felt maybe you would be able to offer some guidance on managing it. Here goes..

I had injured my left knee (no direct injury/trauma - blunt or otherwise) in 2007. I was 29 then and had participated in a competition that required me to run long distances in hilly terrain, up and down roads, trails and foot tracks with significant amount of weight on our backs. On the first day we ran about 24 km with about 23kgs. The knee was fine then. The second day was a rest day and on the third day we ran a smaller (20km) distance with just about 5 kg on our backs. The run was routine, but in the last 5 km or so, when I was descending along a hilly road there was a pain in my knee, behind the knee cap which progressively increased. I somehow finished the run and after some recuperation, participated in an obstacle competition too a day after.

The competition finished with some more runs over the course of next few days and I managed to keep running. The pain was present, but with some warm compresses and painkillers, kept under control.

After the competition, the pain was always present, but lesser in intensity. As part of my job, I needed to trek long distances, often in hills. The pain reduced and often it was no more than a footnote. I even played a lot of games, and the knee was okay, save for the occasional pain, which didn't need painkillers.

I showed the knee to a physiotherapist in 2010 and asked him if a surgery would get the knee back to its original state. He said that a surgery may not make the knee as good as new, and suggested that I first try a few exercises, which I did religiously for 3 months. The condition improved only slightly. All this while the routine of games and runs continued.

Now I am in a desk job and have eased off on the games for the past year and only walk 4-5 kms daily (though I intend to start cycling and swimming too). There is pain (not a shooting variety, but more of a really bad ache), especially when I walk up stairs or run (only for the first 10 minutes or so, then it seems to ease up, though it is present during the run). My weight has always been and continues to be in the right range. Presently my BMI is 24.3. What I have been meaning to ask you sir, is:-

• What might the cause of this pain behind the knee cap, which now sometimes radiates downwards towards the outside of the knee?
• Is a surgery required?
• Will my knee be 100% functional post surgery? I love trekking and running and will I be able to continue these pastimes post surgery? Seeing the way pain re emerges going up a flight of stairs, will I be able to trek up trails, with some weight in the rucksack?
• Is there an alternative (Ayurved/Physiotherapy/Homeopathy/Accupuncture) that can help?
• While walking on level ground doesn't aggravate the pain, will these two pursuits of walking and cycling damage the knee further? Is swimming beneficial?

Apologies for the long-ish post.

(PS : Was wondering if any other member has been afflicted with a similar injury, and what was the corrective action taken - just curious)


Cheers !

[alphadog]

Originally Posted by Ironhide

Doc,

Came across your advice on the knee injury and since I too have a knee injury I felt maybe you would be able to offer some guidance on managing it. Here goes..

Hi

Thank you for asking me.
It does sound like you are suffering with this knee quite a bit and I get the impression that you are keen to get back to running, cycling or other fitness activities.
Reading about your past knee problems and going by your current symptoms, I can localize the problem to the knee-cap.
The backside of the knee cap, normally has a lining of smooth cartilage tissue (the thickest in the body). It is this that allows a smooth gliding of joint surfaces and keeps the knee moving. It is quite possible that you have a softening or damage to this cartilage at the back of the knee-cap or damage to cartilage of the trough in which this knee cap sits. This usually causes ache and pain especially on stair climbing or going up an incline and also in positions that involve prolonged bending of the knee. Swelling and increased fluid in the joint as a response to this may also develop.
The treatment of this in the first instance in reducing strain on the knee cap by modifying your activities and trying out physiotherapy to strengthen muscles around the knee with pain killers as and when needed. You have been through this bit already.
If there is no respite, then there is a surgical option available wherein, the damaged cartilage is shrunken / excised with special instruments and the surfaces cleaned up in order to try and generate new cartilage which may give you relief. This is done through arthroscopy (key-hole) surgery. the recovery after surgery will take approx. 6-8 weeks.
Try and avoid placing stress on your knee-cap by indulging in activities like strenuous uphill climbs, trekking etc. Swimming and cycling are good alternatives to maintain your fitness level. There are some more finer points regarding techniques in swimming and cycling which will reduce strain on your knee. This forum may not be the best place to enumerate all that information.
You can always try adjuvant therapies like ayurveda, acupuncture etc (anything that may help is welcome i suppose!), but these will not sort out the root cause of the problem.
It would have been nice to see your X rays / scans etc. As far as my opinion goes, if you have exhausted all non-surgical avenues, then surgical intervention by the right surgeon is the way forward. With emphasis on the 'right' surgeon.
Please feel free to ask if you need any further info.

Regards

Dr Vinod Kumar
Aster Medcity, Cochin

[Ironhide]

Originally Posted by alphadog

Hi
Thank you for asking me.
It does sound like you are suffering with this knee quite a bit and I get the impression that you are keen to get back to running, cycling or other fitness activities.
Reading about your past knee problems and going by your current symptoms, I can localize the problem to the knee-cap...........With emphasis on the 'right' surgeon.
Please feel free to ask if you need any further info.

Regards

Dr Vinod Kumar
Aster Medcity, Cochin

Thanks a lot Doc -that indeed cleared up a lot of confusion! Appreciate the quick reply and the inputs ! If the fog of doubt crops up again, will take the liberty of troubling you !

Cheers !

[chotu_r]

Originally Posted by alphadog

Hi

I am an Orthopaedic Surgeon with a special interest in sports injuries and key hole surgery ( arthroscopic surgery), based in Cochin, Aster Medcity.

Thanks for the quick reply doc. That lifted a load of anxiety from my heart! I am sending you a quick mail for further advice.

Originally Posted by shashi63

If you need a second opinion I would recommend Dr.Mangal Parihar.

Thank you for your kind recommendation. I am trying to find a good doctor in Hyderabad at present so i may visit in person.

[slicvic]

Physicians, Cardiologists on the forum, kindly comment http://www.team-bhp.com/forum/shifti...ly-misled.html

[deepclutch]

Doctors here(Neurosurgon, Orthopaedics), what is your opinion on "Ozone therapy for Lumbar-disc problems?
I have a relative facing these symptoms: muscle cramps/pain in lower/upper knee due to referred pain in left leg?(Sciatic pain). my relative had done a MRI scan of the disc and shown to multiple Orthopaedics in Kerala most of them are saying there is no disc problem and some says it is referred pain. but, all agrees there is no significant disc problem looking at the scans.

later another Ortho in Amrita Hospital,Cochin checked and confirmed there is no disc problems except perhaps swellings in the (L5S1?) pressing nerves to cause the muscle cramps and pain in the left leg. someone did ozone therapy at MOSC Medical college Kolenchery and he is happy about that. but, I want to know how effective this is in reducing the swellings on the disc(L5 S1 or so). Ortho from Amrita recommended Corticosteroid injection(Lumbar-disc something) while I heard about this Ozone therapy recently only. any reviews.

[SILVERWOOD]

Originally Posted by chotu_r

Thank you for your kind recommendation. I am trying to find a good doctor in Hyderabad at present so i may visit in person.

Dr Vijay Rama Rao @ Vijaya Health care, opp Passport Office, Secunderabad is a great Orthopedic Surgeon.He has been practicing for last 3 decades and is a gentleman par excellence.

Waseem.