Sunday, 1 July 2012

Surgery is no "magic wand", but it does get disabled people back on their feet again

‘Surgery makes you walk but it’s no magic wand’

Priyangi Agarwal, TNN Jun 26, 2012, 05.55AM IST
    "When I recall my pre-surgery days, I feel that life was as difficult as living with a disability!" This is how, Premlata Devi, an elderly who underwent knee replacement surgery described her pain. But what is it that actually leads to such acute crippling of the knees? Experts blame arthritis as the chief cause of trouble. According to the Arthritis Foundation of India (AFI), "Most forms of arthritis can be divided into osteoarthritis, rheumatoid arthritis and gout."
    AFI literature shows that osteoarthritis typically strikes the weight bearing joints such as knees, hips and back joints besides hands and spine. It is a progressive disease that mostly affects the knee. Rheumatoid Arthritis is an autoimmune disease (a condition in which body's own immune system becomes its enemy and tends to cause a disease). It causes chronic inflammation of the joints and sometimes the tissues around the joints. Gout, which is also known as the crystal induced arthritis, is an arthritic condition that occurs when uric acid crystals accumulate over the joints. Gout can affect joints in the big toe, ankle, foot, hand, wrist and elbow besides the knee. In rare cases, it may affect shoulders, hips or spine. "Problems such as pain and disability arise in all the three conditions mainly due to degeneration of joints," explained, Prof RN Srivastava, faculty, orthopaedic department, CSMMU. "Pain induced by damaged ligaments and parts of the knee is most felt in case of knees, which bear the maximum body weight," he stated adding, "The painful destroyed knee affects a person's day to day living in simple activities such as standing, sitting, walking, and others."

    Before Surgery - Disabled
    The worn, diseased or damaged surfaces of the knee joint can be removed and replaced with artificial surfaces in a surgical procedure known as Total Knee Replacement (TKR). "The surgery has helped many people return to a normal life," said Dr Srivastava. In the words of Premlata, "Knee replacement surgery made me walk after years, but it is no magic wand." Her observation is extremely important. "Patients should not aspire for overnight changes in their lifestyle. The surgery may make them walk but after sustained sessions of physiotherapy. Pre-operative counselling plays an important role here. It helps in setting up realistic targets for patients," said Dr Sanjai Srivastava, who regularly takes up arthroplasty.
    After Surgery - able to walk

    Experts suggest that disease can surely be delayed if not totally prevented. "Ageing, lack of nutrition and physical activity, vitamin D deficiency, obesity, hereditary and socio-economic factors are some causes behind degeneration of cartilage," they said.

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