Knees and the Lumbar Spine bear maximum weight of our body, making them most vulnerable towards wear and tear. Indians have an affinity to sit on the ground for many household chores putting these joints at a greater risk of wear and tear. This prolonged wear and tear causes deformities in the knees due to loss of cushioning (cartilage) in the joint. That is why we commonly see people walking with bowed legs, literally waddling from side to side (resulting from advanced Osteoarthritis/wear and tear). Similarly, people with Lumbar Spondylitis or Sciatica (back problems) develop crampy pain in their back and legs that compels them to sit down after standing for even 5-10 mins.
The real problem begins when a person who is always outdoors, becomes homebound due to pain and deformity. They avoid going out of their homes and are mostly confined to their rooms, leading to a sedentary lifestyle. A major chunk of their problems arises out of loss of activity and:
- Weight gain
- Loss of muscle strength and stamina
- Decrease in bone mass
- Increase in gut related problems such as Constipation
- Weight gain, which worsens blood sugars, blood pressure and Uric Acid parameters
These health problems are progressive and become almost irreversible with advancing age. Most of these patients suffer from Depression and have to consume pain killers and/ or sedatives to sleep.
Here’s a golden example, there were two individuals with advanced Osteoarthritis, and both had been advised Total Knee Replacement (TKR) surgery at the age of 60yrs. One opts for surgery and the other does not because of fear of surgery. Their parameters like weight, bone strength, stamina and endurance when checked 5years later, it showed that the person who opted for surgery took lesser painkillers, was a regular walker, had lesser weight gain, had better bone &muscle strength as well as endurance. His metabolic parameters like Blood Sugar & Blood Pressure were also better. This individual’s quality of life was vastly different from the person who did not undergo the surgery.
It is important for patients to understand that when the pain is debilitating, intolerable and affecting their day to day activities, and if they have been advised surgery, prolonging the illness is only going to aggravate the condition. Also, the risks of complications of surgery increases manifold with advancing age, so undergoing the surgery at the right time, as prescribed by the doctor, is of paramount importance! With current advances in medical science, it is possible to detect most orthopedic ailments such as Osteoarthritis and Lumbar Canal Stenosis early. As per the doctor’s advice, patients will need to seriously undertake major lifestyle changes such as performing regular exercises and avoid sitting, squatting and kneeling on the ground.
Regular orthopedic screening includes a DEXASCAN for evaluating bone strength, and blood parameters such as Serum Calcium, Vitamin D, Vitamin B12 and Serum Uric acid; this is a must for all people above 60yrs of age to undergo this check every year. Recent advances in orthopedic surgery are minimally invasive and more focused on the addressing the disease locally. For example if a patient has Osteoarthritis in only one compartment of the knee, he can opt for a Unicompartmental Knee Replacement instead of a traditional total knee replacement. Recent advances like MISS (minimally invasive spine surgery) are better done in recently diagnosed spine ailments. The advantages of these techniques are –they are less invasive, also they:
- Promote early mobilization and have shorter recovery time
- Have lesser complications
- Reduced hospital stay
(Disclaimer: The writer is Dr Manish Sontakke, Consultant Joint Replacement Surgeon, Hiranandani Hospital, Vashi-A Fortis Network Hospital. Views expressed are a personal opinion.)