Knee Arthritis|Knock Knees|Virtual Knee Surgery

It is not unusual for a person who finds out that he or she (or a loved one) needs a pacemaker to feel suddenly isolated and alone. There is not a great deal of information online, either. But here's a surprise. Pacemakers have helped literally millions of people all over the world for the past five decades.

But you probably do not know a lot about pacemakers. There isn't a lot of information about them, even online.

First of all, pacemakers may seem like some futuristic, bionic device, but they've actually been around for over 50 years. That's right, I Love Lucy was not yet in re-runs when the first pacemakers were implanted.

Second, pacemakers have proven themselves to be a safe, effective technology. The pacemaker is implanted in your upper chest; an insulated wire is passed through a vein into your heart. The wire is plugged into the pacemaker, which then delivers electricity (not drugs or artificial ingredients) to your heart. They send the heart tiny amounts of electricity.

A healthy heart produces electrical impulses on its own. If you need a pacemaker, it is likely because your heart does not produce these electrical impulses fast enough or conduct the electricity through the heart muscle quickly enough to keep your heart going at the right rate. The pacemaker just "fills in the missing beats" by sending electricity to the heart. Electricity is electricity, after all.

Pacemakers are tiny devices about the size of a pocket watch. They are made of titanium, a lightweight metal that doctors call "biocompatible." This means it is compatible with the human body; the body does not react to it or reject it.

It is hermetically sealed and runs on a battery. In fact, most of the interior real estate of a pacemaker is taken up by a lithium-iodide battery.

Your pacemaker is designed to run for years on that battery! How long the device actually lasts depends on many factors but the doctor can help you predict it. Pacemaker patients go for checkups at least twice a year, and part of the checkup will tell you how the battery is doing.

The miracle of the pacemaker battery is that it does not just suddenly conk out like a flashlight battery. Instead, it operates at full capacity and can signal the device (and the doctor will know how to get this information) when it is starting to wear out. You will have some "grace" time to schedule your replacement.

When a pacemaker wears out, you don't replace the battery. First of all, most of the device is the battery and it's hermetically sealed. Instead, doctors go back and remove the old pacemaker and replace the new one. The leads or wires are unplugged but left in place. When the new pacemaker is implanted, the old leads are plugged into the new device.

Replacement surgery or "pacemaker revision" as it sometimes called is a much faster procedure than the first implant. In fact, it is often done on an outpatient basis.

Surgery to implant a pacemaker may seem scary, but for your hospital team it is a fairly simple procedure. In medical terms, it's called "minimally invasive" because the incision needed is quite small. It is typical for a pacemaker to be implanted in a cardiac catheterization or electrophysiology lab rather than a full-blown operating room.

As the patient, you may be surprised to find out that the doctors prefer you to be awake. You will be draped (that is, you won't be able to see where they make the incision) and given some sedatives to relax you, but most pacemaker recipients do not require full anesthesia.

You will get some numbing medicine for your chest. A small incision is made and a spot is created just under the skin and tissue for the pacemaker. A tiny incision is made in a vein and the insulated wire is passed through the vein and into your heart.

This wire is called a "lead" and you may get one, two or even three of them, depending on the type of pacemaker you get.

Interestingly, it is the lead that takes most of the time during your implant procedure. The doctor gently advances the lead through the vein. He and the rest of the implant team (you'll have several people in the room with you besides the doctor) will observe what's happening on monitors. They use a large device called a fluoroscope to get video X-rays which show how the lead is navigating its way into your heart.

Once in the heart, the doctor needs to get it to attach or "fixate." It is not very hard to fixate the lead, but some parts of the heart conduct electricity better than others. This is highly individual, so the doctor is going to want to test the first landing site to see how good it is. This is done using a small hand-held device that sends a small amount of electricity through the heart to force it to beat.

You will not feel this at all. However, you may notice when this is going on, because it can be quite loud. The doctor is busy looking at where the lead is fixated while some member of his team is busy testing the lead. People are going to be calling out numbers, even shouting across the room. Somebody else is probably watching the EKG (that's another monitor) and may shout out more numbers. If you don't know what's going on, it can be confusing or even disconcerting.

Once the doctor fixates the lead(s), the other end of the wire is plugged into the pacemaker, the pacemaker is placed in the little space in your chest, and the incision is sewn up. The whole procedure can take up to two or three hours (depending on how many leads are used and your individual case) but it may be less.

Most pacemaker patients need a few days to recover and then a few weeks before they can resume their old activities. While there may be a few restrictions on pacemaker patients, most people feel better than they did before and report that they can actually do more even with a few restrictions.

Right after your implant, you will likely be asked to see your doctor a few times. This is to check on the surgical incision and run some preliminary tests and make adjustments to your pacemaker.

Once the initial phase is completed and your system is stable, the doctor will give you a plan for regular checkups, typically once a quarter or every six months. Please make every effort to keep these appointments, even if all the doctors end up telling you is that you're doing just fine.

That's because your pacemaker can report or communicate to the doctor about how it is doing, suggest adjustments that may help it to work better, and will tell you how much service life is in the battery.

Millions of people have pacemakers. You may even know some people who have them that just never mentioned them. That's because many pacemaker patients report that after a while, they "forget" about the device. With no pills to remember and only occasional doctors' appointments, it's pretty easy to forget about this silent servant.

Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. Osteoarthritis (OA) is the most common joint disorder.

As part of the aging process, joint fluid decreases. With wear and tear, the cartilage becomes thinner. If the muscles and tendon protecting the joint become weakened, if there is overweight, or if there is persistent abnormal posture or activities such as squatting or sitting on low stools, the condition would become worse.

Most of the time, the cause of OA is unknown. It is mainly related to aging, but metabolic, genetic, chemical, and mechanical factors can also lead to OA.

Symptoms Osteoarthritis include:

o The most common symptom of osteoarthritis in any joint is pain that worsens during activity and gets better during rest. As the disease advances, the pain may occur even when the joint is at rest.
o Grating of the joint with motion
o Pain seems to increase in humid weather
o Joint swelling
o Limited movement
o Morning stiffness

A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness. An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.

The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). Injections of steroids into the joint can relieve pain but it would aggravate the arthritis. It should not be used unless absolutely necessary.

Surgery may be required for certain severe cases of deformity. These include arthroplasty and knee replacement therapy.

India healthcare are globally developed with best medical facilities & world class treatment by internationally certified Surgeons.

There are dedicated specialized hospitals in India achieved accreditation from Joint Commission International ( JCI ) standard. JCI is gold standard in global healthcare standard like Indraprastha Apollo Hospital (New Delhi - located in North India), JCI Accredited Apollo Hospitals (Chennai - located in coastal South India), Wockhardt Hospital, Mumbai. They availed high quality and cost effective advanced surgery in India.

The Hopsitals is best in the world in terms of

o State of the art diagnostics.
o World class operating theaters & Intensive care unit.
o Highly Qualified & experience doctors & surgeons may be trained abroad.
o English speaking highly trained paramedical staff.

A price range of 5000- 7000 US dollars is quoted for a Knee replacement depending upon the type of implant chosen and the class of accommodation.

Doctors have found that RA of the hands is not the only cause of worry for patients. Walking can be really painful to many of them if they are affected by RA of the knees. Researches have not been able to detect the exact causes of the disease. Nonetheless, there are certain factors which are responsible for RA in the knee.

One of the main causes for RA in the knees is if you have any precious injury. If you have hurt yourself badly in the knees previously, chances are that you will develop RA in no mean time. These wounds are obviously the ones which are grave and deep. The joints can be badly infected and you can develop this disease.

Heredity can also be responsible for this disease. If you have a defective gene, there are chances that you can have this disease since these genes can be responsible for cartilage production in your body. In these instances, you can be highly susceptible to RA.

Weight loss is a must for you if you want to get rid of this disease. If you develop too much weight in your hips, then there are chances of extra pressure on the knees, which can in turn lead to rheumatoid arthritis.

Too much crystal deposits like uric acids in the gout can lead to this disease. Excess of crystal degenerates joints and they can cause RA. Also if you overstress yourself and put constant pressure on knees, even then you might develop rheumatoid arthritis in your knee joint.

Rheumatoid arthritis of the knee is mostly seen in people who are over 50 years of age, especially, women. It can affect either one or both sides of the knee joint. Nevertheless, it mostly occurs on the inner (medial) aspect of the knee.

People who are into rigorous sports training and activities, especially those playing football, tend to develop rheumatoid arthritis in the knee. You will not be able to detect the disease since the symptoms start developing over a number of years.

Knee Anatomy

The knee joint itself is made up of the shin bone (tibia) and the thigh bone (femur). The articular cartilage is located on the surface of each of these bones. This cartilage allows flexibility to the joint. Additionally, the knee has two separate layers of cartilage which is known as menisci. This adds to the stability of our knee. Rheumatoid arthritis leads to deterioration of the knee cartilage. This causes swelling, pain and it stiffens the functionality of the knee. If the cartilage breaks, it leads to meniscal or ligament trauma.

For all you rheumatoid arthritis patients out there, it is to inform you that there is a want of a complete cure for rheumatoid arthritis. However, there are various treatments for this disease which can prevent the progress of rheumatoid arthritis. Valgus unloader braces have been found to reduce pain in few cases of medial compartment rheumatoid arthritis. It diminishes the load on that compartment. NSAID's- Non-Steroidal Anti-Inflammatory Drugs such as ibuprofen is also found to provide some temporary pain relief to your pains.

Muscle relaxants are normally detected in low doses. This can relieve you of pains which arise in your muscles. However, the most advanced process of curing the knee pain of rheumatoid arthritis is knee replacement.

The benefits of low-impact aerobic exercises in helping knee problems are huge. There are multiple benefits in using aerobics for knee strengthening exercises including building up the muscles round the knee, weight loss and stimulating the body to release its natural painkillers, endorphins. Here is some brief information on each of these benefits.

MUSCLE STRENGTHENING

There are muscle groups around the knee that help to support the knee joint by absorbing a lot of the shock that would otherwise be transferred to the knee joint. Toning and strengthening these muscles using low-impact aerobics helps these muscles take a lot of stress away from the knee.

WEIGHT LOSS

Another benefit of an aerobic exercise routine in your knee exercise program is weight loss. Being overweight is one of the biggest causes of knee pain and knee problems. It has been shown that when walking, the knee is subjected to impact equivalent to three times your body weight. Just imagine what this would be if you were running. Keeping your weight down therefore reduces this shock on the knee joint.

ENDORPHINS

When we exercise using aerobics, the body releases its own natural painkillers called endorphins. These help to reduce pain in the knee joint.

WHAT TO DO BEFORE AND AFTER EXERCISING

To ensure proper function of our bodies, including the heart and lungs, we all should do some sort of aerobic exercise. What we need to avoid when exercising is putting the weight bearing joints. knees, ankles and hips, under a lot of stress. Avoiding high impact exercises and using low impact exercises, like low impact aerobic exercises, will assist in preventing knee and other joint problems and in ensuring knee and joint pain is minimised.

Before starting an aerobic exercise session, it is important warm up properly. A few minutes of walking and some stretching exercises will allow a gradual warm up. Important muscles to stretch are the hamstrings and quadriceps, the knee supporting muscles.

Don't "over-exercise". When muscles get tired, their shock absorbing capabilities are dramatically reduced. This means that the joints, ligaments and tendons take the extra stress thus making them more susceptible to injury.

Allow your body to repair itself by exercising only every other day. "Over use" injuries are common and so easily avoided.

If you are pregnant it is important to check with your medical practitioner or physiotherapist on the safety of your exercise routine. When pregnant, the body releases hormones that causes tendons and ligaments to become looser and increases the flexibility of the pelvic bones. This can increase the risk of exercise related injuries to joints, especially if doing high impact exercises.

THE BEST LOW-IMPACT AEROBIC EXERCISES

If you have any knee problems or knee pain, check with your medical professional or physiotherapist before commencing aerobics to ensure the exercises are safe.

WALKING - Walking is a great low-impact exercise but there are some guidelines you must follow.

Walk at a slower pace for a few minutes when you first start, to warm up.
Only walk on even and level surfaces.
Wear proper shoes that provide cushioning in the soles and support.
Slowly increase the intensity of the walking and gradually build up to around 45 - 60 minutes.
Be careful to not over exert yourself.

SWIMMING - Swimming is a great aerobic exercise because it puts no impact stresses on the joints and gives the muscles an excellent workout. Highly recommended.

OTHER WATER BASED EXERCISES - Water based exercises are recommended as the water's natural buoyancy properties supports most of your body's weight, taking load off the knee joints. Exercising in water is excellent for strengthening muscles as they must work harder to overcome the resistance of the water.

CROSS TRAINERS OR ELLIPTICAL TRAINERS - These provide intense cardio exercise with low impact on the knees. They also exercise most of the body's main muscle groups, including those that support the knee joint, and can be an excellent method to lose weight.

EXERCISE BIKES (Stationery) - These provide excellent low-impact cardio workouts like the cross trainers but there are a few important points to know about.

Set the seat height so your knees do not bend more than 90 degrees.

When the pedal is at its furthest point from you, your knee should be slightly bent.

If you suffer from lower back problems, a recumbent bike may be the answer. These usually offer cushioned support for the back and better seating. However, a recumbent bike will give a lower intensity workout than a conventional exercise bike.

Low-impact aerobic exercises can provide huge benefit in preventing knee injuries and knee problems and also in providing knee rehabilitation exercises following knee surgery or knee pain treatment.

Always consult with your medical professional before commencing any exercise routine.

For instance how your hips might be rotating during your swing, where your hands are on the golf club or maybe even how your knees are bent before you get into your swing. All of these seemingly little things factor in when trying to develop a perfect golf swing, but most of them are overlooked.

Almost everyone who has ever attempt this game has failed miserable the first couple of times out on the golf course, mostly because their ego gets the best of them and they believe it is an easy sport to master. On TV the pros like Tiger Woods and Phil Mickelson make hitting 300+ drives down the fairway and 50 foot puts look easy, but that is as far from the truth as can be.

Playing the game of golf takes a lot of skill and concentration, especially around huge crowds like the pros are used to, but it all starts with a good, solid swing. A lot of people who just start off playing golf usually come up to the tee and try knock the ball into next week much like a baseball player would when he is up to bat, but developing a perfect golf swing takes a mixture of fitness and power, but more so control and concentration.

There are a few simple golf tips you can use when you are just starting out on the links. One is to never take your eye off the ball during your swing or you will hit the ball into God knows where. Keep your eyes fixed on the ball, shoulders square, arms straight with your left arm being like your cross hairs for the ball if you are right handed. Now that you have the form down when you swing you don't want to twist your wrists during the swing until after impact. Once you have made contact follow through with the swing motion until the club is behind your back and the ball is headed down the fairway.

The most common form of arthritis is osteoarthritis (OA). It affects almost 30 million Americans and the incidence is expected to rise with the graying of the Baby Boomers.

OA is a disease that affects the hyaline articular cartilage of joints. The exact mechanism of disease development is still being researched but there appears to be a trigger that causes a metabolic abnormality to occur. Cells, called chondrocytes, inside the cartilage begin to elaborate destructive enzymes which cause the surrounding matrix to degrade. In addition, inflammatory changes involving the synovium- the lining of the joint- contribute to further cartilage damage.

OA affects primarily weight-bearing joints such as the neck, low back, hips, and knees. I will focus on the knee.

Treatment for OA of the knee is primarily symptomatic. This involves the use of exercise, weight loss if indicated, patient education, analgesic medications, non-steroidal-anti-inflammatory drugs (NSAIDS) - either oral as well as topical, and injections.

The most common type of injection given for OA of the knee is a corticosteroid ("cortisone") injection. These are effective for reducing pain short-term and also helping to improve quadriceps muscle strength by reducing the inhibition of quadriceps reflex due to the presence of inflammation and swelling. Usually fluid is withdrawn from a swollen joint at the time of corticosteroid injection.

Corticosteroid injections are usually given to patients who are already taking oral medications such as NSAIDS. These injections may be given as often as three times a year. More often and they can actually cause more cartilage damage.

The second type of injection is hyaluronic acid. These types of injections are often referred to as viscosupplements since they are used to reduce pain but also provide a lubricating quality as well. Some preparations are derived from rooster combs and others are synthetically manufactured. There are many different formulations available. Despite claims that one product is superior to others, there is no concrete data that one preparation is superior to others.

These injections are often used as a last-ditch effort to help patients avoid having to undergo knee replacement surgery. As with corticosteroid injection, withdrawal of joint fluid always precedes injection of the viscosupplement.

Whether the injection is corticosteroid or hyaluronic acid, each needs to be administered using ultrasound needle guidance in order to ensure proper delivery of the medication to the joint space. Reports of inadequate response to these preparations probably are more related to poor injection technique rather than to the shortcoming of the medication.

If you have injured your ACL these are often the symptoms you will experience. The anterior cruciate ligament restricts the tibia from sliding in front of the knee. When you tear this ligament there are several symptoms that will almost always accompany this injury. They include...

1. Pop or Snap Sound When Injury Occurs

One of the most common ways to tell if you have injured your ACL is from the injury itself. If when you injured your knee you felt a snap or pop and then collapsed it is possible you have torn your ACL.

2. Swelling

ACL injuries especially tears are often accompanied by significant swelling in the knee shortly after the injury. This is not always the case, from my personal experience both times I tore my ACL there was minimal swelling, however most people experience a lot of swelling.

3. Knee Instability

After you have injured your ACL you will likely notice knee instability this is due to your ACL no longer supporting and stabilizing your knee. If you are not in to much pain immediately after the injury you will likely notice the "funny" feeling you have walking where your knee no longer feels stable.

4. Loose Knee

Similar to the instability issue above, a common way to determine if you have an ACL injury is by testing your knees looseness. To do this sit in a chair with your leg relaxed and foot flat on the ground. Keeping your leg relaxed push place one hand on top of your injured knee and with the other push on the back of your calf. If both knees feel the same than you may not have injured your ACL. However, if you feel like the injured knee is loose and there is nothing stopping you from pushing the back of your calf forward than you could have an ACL injury.

5. Clicking/Popping While Walking

The final symptom of an ACL injury is clicking/popping while walking. Now this isn't actually a symptom of an acl injury it is a symptom of meniscus damage which can often accompany an ACL injury. This symptom by itself is not enough to say you have an ACL injury but if you have this symptom along with the 4 above than you have likely injured your ACL and meniscus.

How to fix and ACL injury?

Surgery is often the recommended choice of recovery for an ACL tear. The recovery process for ACL surgery can be long and time consuming but there are advanced recovery techniques that can greatly reduce the recovery time.

ACL Surgery Recovery Experience and Timeline

The knees are among the most vulnerable joints of the human body. This vulnerability mostly stems from frequent use as we constantly engage them daily when walking and exercising. Knee pain is a very common condition that affects as much as 19% of the population. While knee pain tends to be more common in women, its occurrence increases steadily with age in both genders.

Some of the common causes of knee pain often come in the form of sprains, strains, and fractures, most of which can be avoided. To prevent knee pain or injuries from some of the most common causes, here are a few tips:

• Wear good shoes that provide adequate support for your arches. Ill-fitting shoes increase the incidence of pronation which puts extra stress on your knees and may eventually result in pain and even injury.


• Carrying heavy objects puts a lot of stress on your knees; ask for help if you suspect that an object may be too heavy for one person to move.


• It is important to maintain a healthy weight. Not only does extra weigh put a lot of stress on your knees, it also increases your risk of developing osteoarthritis.


• Exercises like walking or swimming can strengthen your knees; however, controlling your intensity level and alternating days with other exercises is good practice to avoid hurting yourself in the process.


• Weight training is also a good way to strengthen your knees, and there are several low impact exercise machines in the gym that will engage your knees and keep them strong, making them less prone to injury.


• Protect your knees by wearing guards during recreational sports like soccer, and don't forget to stretch before engaging in physical activities. Be mindful of the correct techniques and positions when exercising, and always use them.

Engaging in exercises that improve strength and flexibility is one of the surest ways to prevent the common causes of knee injuries. Some of the benefits that come with such exercises are mentioned below:

Strengthening exercises: Strengthening exercises engage your hamstrings and quadriceps. Strengthening them will reduce stress and aid your knees in absorbing shock.

Flexibility exercises: Flexibility exercises stretch the muscles that support your knees, while strengthening them in the process. Gentle stretches improve flexibility and reduce soreness, while vigorous stretching can cause pain and muscle tightening.

Keeping your knees healthy and preventing injury starts with developing strong and flexible supportive muscles. A qualified physician can give you a customized exercise plan as well as specific tips to help keep your knees in good condition.

Osteoarthritis is the most common form of arthritis. The Communicable Diseases Center in Atlanta estimates that OA affects more than 27 million Americans. Other estimates tend to run higher. Almost all agree that the incidence is going to climb as a result of the Baby Boomer "epidemic."

There are many symptomatic treatments for OA. These include analgesic medications, topical and oral non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy, exercise, lifestyle modification, bracing, and injections of glucocorticoid or viscosupplements. However, once these fail, there is little else to offer than operative treatment. This is not acceptable.

Recently, there has been increasing interest in the use of mesenchymal stem cells (MSCs) to potentially slow down or even possibly regrow lost cartilage. Animal experiments have been promising and a few anecdotal reports in the literature along with short series have confirmed a possible benefit for humans as well.

Mesenchymal stem cells are sometimes referred to as mesenchymal "stromal" cells because their differentiation is along the lines of stroma or connective tissue.

Among the various tissues, mesenchymal stem cells can evolve into are skin, muscle, bone, cartilage, tendon and ligament, fat, and nerves.

Mesenchymal stem cells are relatively easy to obtain since they are abundant in both the bone marrow as well as adipose fat. MSCs have the ability to differentiate as well as replicate, given the proper environment. This last point is critical to understanding the biology of MSCs.

It is still not known what type of protection MSCs require when exposed to the hostile environment of a joint like the knee, where weight-bearing is such an important task.

It is important to know that a proper stem cell procedure done for OA of the knee involves more than just harvesting stem cells and injecting them into the joint. Selective injury administered to the area requiring repair is absolutely essential. Injury is the first step in healing and is required for stimulation of stem cell differentiation. The extent of injury required is still a subject of conjecture.

Combining ultrasound imaging as well as arthroscopy in order to visualize the area of disease and allow access to it can make the difference between a successful versus an unsuccessful procedure.

On a separate note, MSCs may find usefulness in OA since they do have immunomodulatory effects as well. It is now known that OA is an inflammatory disease that requires disease modification much the same way that RA does. This may be an important component that explains how MSCs work in OA.

Knee replacements are made to complete replace worn-out or damaged knee joints. It is a major surgery and involves taking out a section of the lower and upper leg bones, taking out the kneecap in its entirety, and replacing each with hardware that has been specially designed to fit you specifically. The change in pain and function are immediate. The recovery and rehabilitation are tough, but the relief and return of activity a replacement knee provides is worth it. Before surgery, you'll be able to find out answers to many questions, including how long knee replacements last.

You may be experiencing a lot of should I or shouldn't I moments. However, if like many patients before you, whose knees have reached the point of no good return; knee reconstruction surgery is the only option available that can lead them back to a normal, active, lifestyle. While there will be many questions associated with the prospect of surgery, one of the most oft-asked questions, as mentioned above, that you may have, as well, is how long do knee replacements last? Like most patients, you will want to know the outcome is worth the surgery and recovery period you are facing.

The implants contain materials, like plastic and metal, which over the years begin to thin. However, the news is not all that bad. While no one can give you the exact length of time of how long your replacements will last, chances are good it's going to be many, many years. In fact one study done a few years ago found that 96% of knee reconstruction recipients were still getting along well with their knee implant 20 years after replacement surgery. However, keep in mind that the majority of people who have this surgery are over age 50. If you are younger and active, the replacement knee may wear out more quickly.

When considering how long knee replacement hardware will last, it will depend, as well, on factors such as over health, size, weight, you strength level, ability to tolerate pain, and various other conditions. In general, it really varies from person to person; although again, the more active you are after knee replacement, the more stress will be placed on the joint. It's important to remember that while the join needs to remain active to work properly, overuse will only serve to wear it down much more quickly. Because of this, a happy medium must be determined.