Friday, January 4, 2013

ortho questions part 2: Patients queries answered

Please find some of the questions asked regarding the problems affecting the bones and joints [Ortho Problems]

 I will share few questions in each blog and i will be pleased to answer any if you have queries.

Disclaimer: This sharing is only to educate the public and not taken as an advice to your or someone else's present problem

Question # 6

My father is 71 yrs old and met with an accident a year ago. His left knee was injured and after medication, the wound subsided. Since then he suffers from severe swelling in the knee till the ankle within very few metres of walking. Swelling gets reduced if he takes rest or uses creep bandage. Is there any solution for this without going for surgical procedures, considering his age?

He has mild Filariasis due to heredity and consumes Eofil Forte 5 times a month.


Your father needs to see an Ortho Surgeon who will be able to differntiate the pain due to arthritis from other causes. The swelling may be due to blockage of veins called deep vein thrombosis or as a result of it. He may need a compression stocking if it is due to the thrombosis.

Question # 7
Dear Sir,
Around first week of Jan 2012 I had undergone Arthroscopically treatment on replacement of the completely teared ligament in my left knee and which was corrected by replacing a tissue from the knee with 2 biodegradable screws drilled and fixed to the upper and lower part of the left knee.
Even almost a year of completion I am presently unable to restore my original activities  like a normal human of 32 years of age having pains around the surgical area if I stand or sit or walk or climb contionously for a period of more than 2 hours of time. Please clarify me when I will become a completely normal human of those at this age.
Thanks and Regards,


Cruciate Ligament reconstruction surgery of the knee will result in a stable knee and should not leave you with pain. If pain is the problem, the possibilities are meniscal tear or early arthritis or chondral damage. It would be best you go back to the surgeon who operated on you and discuss the reasons for the pain and the treatment of the same.

Question # 8
Dear Sir,
First of all thank to you for such a noble initiative, and greetings to Chockalingam Sir. I have following problem. I am 31 years old. I had some pain in my lower back since the age of 17 years but it was so mild that I seldom paid attention to it. 3 years back during some stretching exercise I got stiff neck and shoulder which got worsened by neck exercise. Later when I visited doctor they diagnosed me with Spinabifida Oculta and sacrolisatic L1. (uneven growth at lower joint and improper formation of backbone) My pain alleviated with the help of some medicine and warm water application.
Also, Doctor told me that it is not very uncommon deformity and gave an injection in my sole for the pain. Also he told that if pain increases he will do surgery for the same.  Now, at present my lower back pain is negligible but I still I have some stiffness in my neck and sometimes there is tingling sensation in my left hand. Please suggest.


I am unable to understand the problem you have. Spina Bifida Occulta will not result in pain. Sacralisation of L5 and not L1 is probably what you mean. Sacralisation will not result in pain if the adjacent discs and facet joints are normal. Injection in my sole for the pain, you have mentioned, sole means the foot, but you have not mentioned any symptoms in your sole or a diagnosis to go with it.

Question # 9
My mother was suffering from chronic arthritis. Her legs were not upright they were tilted. As per advice of GSVM medical college Kanpur doctor, we went for her surgery and a pin was inserted in her legs, in 2002.After that her pain still continued. Doctors continued to say that everything will become normal. Seeing her worsening condition and pain we went for her total knee replacement in 2009 after having 1.5 years of research and suggestions of doctors. But her woes still continues. Let me put in points
1.     She is having stiffness and pain in portion below the knee and above knee in both the legs.
2.     The doctors have advice not to use any ointments or creams in the stiching scars of both her legs.
3.     Scars are creating itching and she is helpless
4.     We have one physiotherapist regularly coming for exercises.
5.     Eating so many pain killer medicines, some pain killers advised by doctor created reaction ,
now she is not taking any medicine unless, pain makes her restless.
Suggestions required for.
1.     Can she use any pain relief ointment, for below knees pain?
2.     Which ointment she can use for getting relief from itching feeling from scars.
3.     Which exercises you suggest for her side pains
4.     Can she use any pain killers any safe medicine you can advise?
5.     The knee, sometimes swells if she walks to much any advice for this.
I have tried to put some points which comes to me during my discussions with my mother , request you to please suggest what else shall I ask her. (Which may be important for medical requirement?)
She is now 67 years of age.


Total knee replacement surgery will result in painless joint which would enable your mother to be able to walk distances without pain. If she is experiencing pain in the knee then you need to consult the surgeon who operated on her to ensure that everything is fine with her new joint. Itching of the skin is not uncommon in the first year but rarely after three years. She should not be on any painkillers nor should she need a physiotherapist after this long. Swelling is not uncommon. Kindly have her leg and knee checked by the surgeon.
Kindly read through my blog to know what to expect.

Question # 10
Dear    Dr. M.K
This is a very good initiative which has been introduced in Ashok Leyland.  Dear Dr S. Chockalingam,
I am 38 years female with intermittent low back pain and left knee pain since 1 year. All my reports, viz., CRP, Uric Acid, ASO titer, RAF, CBC, TSH, are within normal limits. I had shown orthopedic doctor here and for knee he said I had chondromalasia patella. I took calcium, calcibest sachet, Vit D injection which gave relief to my back pain. I got relief from knee pain after taking Diacerin-GM. I have been told I can take Diacerin intermittently and that I may be suffering from nonspecific arthritis. 
I have noticed that my knee pain is aggravated on prolonged sitting for more than 2 hours. If I am standing I am pain free, but I cannot sit in one place for long time. At present I am taking Diacerin intermittently with calcium tablets.
I have this weird phenomena which has been going on since 6-7 months where in once in every 1-1 Ω months I will have low grade fever 99 F associated with severe low back ache with left or right knee pain which is unbearable as well as upset stomach semisolid stool. It will last for 2 days and then it goes away on its own. After which I am absolutely fine. No pains, no weakness, malaise or fever or lose stool etc.  
At present I am pain free and waiting for my next bout of above mentioned phenomena. Kindly guide what I should do or whom I should show or any other tests if you recommend. I have already seen a Internal medicine physician, two orthopedics.     
Thanks & Regards,
Ans: An opinion from a Rheumatologist may complete your assessment. Back pain is very common in general population and you may be one of the patients who have mechanical back pain and knee pain secondary to Chondromalacia patella or early patellofemoral arthritis. At your age, you should have routine exercises to your back and knee to strengthen your muscles. Please refer to the following sites.