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Author Archives: Dr. Rachit Sheth

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Author Dr. Rachit Sheth Categories Treatments Leave a comment

Stages of AVN or Avascular Necrosis

What is AVN or Avascular Necrosis?

Cellular death in the hip area has nothing to do with your mobile phone, but it does have everything to do with mobility. An interruption of the blood supply to bone components, particularly the shoulders, knees and hips, is what causes cellular death. Bone is alive, but without blood tissue it dies.

And ultimately, this leads the bone to collapse. This disease is known medically as Avascular Necrosis (AVN), and has aliases the include osteonecrosis, bone infarction, aseptic necrosis or ischemic bone necrosis.

AVN is not life-threatening, but it is debilitating. If it isn’t treated, AVN can cause the bone to collapse. AVN most often affects your hip. Anyone can be affected, but the condition is most common in people between the ages of 30 and 50.

SEE ALSO: SYMPTOMS & RSIK FACTORS OF AVN

Stages of AVN

Avascular necrosis develops in stages. It may take several months or even over a year for the disease to progress; therefore, it is important to diagnose AVN early. Early treatment is directly linked to better outcomes. The stages of AVN are:
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Stage 1: Primarily hip pain. X-rays may show the beginning of necrosis.
This stage is characterized by sclerosis of the superior central portion of the joint head and/or osteopenia and/or subchondral cysts.

Stage 2: Bone death can be seen on x-ray but the femoral ball is intact.
In this stage, the articular surface is depressed so that the round contour is compromised, without being significantly deformed. This leads to a joint space narrowing.

Stage 3: Shows bone death with collapse on x-ray, also shows signs of cartilage damage and osteoarthritis.
This stage is characterized by a wide collapse of the subchondral bone and destruction if the underlying trabecular pattern. This can lead to secondary arthritis.

Stage 4: Shows collapse of the femoral head with severe osteoarthritis.
The final stage where both articular surfaces are affected, which leads to a dysfunctional joint.

Avascular necrosis treatment

There are several good options for treating AVN, depending on the patient’s health, age, level of activity, condition of the bone and pre-existing health conditions.

Non-surgical treatment of AVN includes: medications and therapy like rest, exercises and electrical stimulation.

If you catch avascular necrosis early, treatment may involve taking medications to relieve pain or limiting the use of the affected area. Because most people don’t develop symptoms until avascular necrosis is advanced, your health care provider might recommend surgery. Surgical treatment of AVN includes:

  • Core decompression
  • Bone transplant (graft)
  • Bone reshaping (osteotomy)
  • Joint replacement
  • Regenerative medicine treatment

When avascular necrosis of the hip is diagnosed at the onset stage, core depression can sometimes successfully prevent the collapse of the femoral head. Treatment goals for AVN are to improve the joint, stop the bone damage, and ease pain.

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Author Dr. Rachit Sheth Categories Orthopedic Trauma/Fractures, Treatments Leave a comment

Recovery From a Hip Fracture Surgery

What is a hip fracture?

A hip fracture is a break of the top part of the femur or thigh bone. These fractures usually result from high energy injuries such as car accidents in younger patients and most often from falls in the elderly patient.

Fact is hip fractures are among the most common types of broken bones, and once over the age of 65, a broken hip is the most common reason why people need a hip surgery.

Recovery process after a hip fracture surgery is something the person who sustained the injury and the family members of the patients are concerned majorly. Few questions they have, such as:

Is this major surgery worth doing?
What are the chances of recovery?
Is there any alternative way to treat the broken hip in elderly patient?

Read more to get answers for all these concerns.

Treatment of a broken or fractured hip

Almost all people who break or fracture their hip will require surgery to fix the problem. One of option could be hip replacement surgery, also known as total hip arthroplasty, a surgery to replace a worn-out or damaged hip joint. The treatment option varies depending on the location of the fractured bone and the patient who is injured.

Sometimes patients’ family prefer to go for nonsurgical treatments for these surgeries. While nonsurgical treatment for hip fracture may be an option for very sick or frail patients. But most all hip fractures of the femur bone will require surgery.

Optimal recovery from hip fractures

The best way to recover from a hip fracture is to get moving as soon as possible. Immobility opens the door to the possibility of significant complications. There are number of ways to accomplish hip surgery without any complications.

Most importantly, the surgery should be performed soon after the injury. Thanks to medical advancements, hospitals are getting better equipped at getting these patients with broken hips to an operating room on either the day of or the day after their injury.

Depending on the conditions of the patients or any medical issues, the surgery may be delayed. One such common situation is when an individual on blood-thinning medication fractures their hip. The blood-thinning effects may need to be reversed prior to safely performing surgery.

SEE ALSO: IT’S TIME FOR A HIP REPLACEMENT SURGERY – ARE THESE THE WARNING SIGNS?

Hip fracture surgery recovery

In order to get recovery, patient have to regain the following:

Mobility
In order for all joints to function properly, they need to move. Without proper movement, joints and the muscles cannot function properly.

Strength
Restoration of muscle strength is critical after breaking one’s hip. It is critical to get the muscles working as soon as possible after surgery to prevent potentially permanent atrophy of the muscle tissue

Balance
Recovery of balance is not only important to regain function but also to prevent further potential injuries. The use of ambulatory aids (canes or walkers) can be helpful.

Full healing of a broken hip can take many months. Usually, hip fracture takes 10-12 weeks for healing and much longer to regain muscle strength and mobility. Typically, within 6 months of the surgery, patient can get close to full recovery.

That said, one should not wait or delay for months or longer to be active in their recovery therapy. As time passes, the likelihood of regaining function declines. The strongest recovery are made early in the initial recovery process.

Wrapping up…

Hip fractures are serious injuries, and while full recovery is possible. For that reason, timely surgery, early rehabilitation, and patience for a long recovery are important, and hopefully, you or your loved one will be able to get back to all of the activities you enjoy!

Looking for a hip fracture surgery in Ahmedabad?

Dr. Rachit Sheth is a Consultant Orthopedic Surgeon in Ahmedabad, specializing in hip replacement surgery.
For more information or appointment, contact us.

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Author Dr. Rachit Sheth Categories Knee/Hip Replacement Leave a comment

Myths And Facts About Knee Replacement Surgery

Knee replacement surgery involves replacing the worn-out or diseased knee joint with an artificial joint called a prosthesis.  Knee replacement surgery is beneficial in relieving pain and restoring your lost disabilities. It has a 95% success rate.

Despite the fact that the knee replacement surgery can be a good treatment option, many people still have many misconceptions regarding it and it prevents many from getting the treatment on time.

Myth 1: Knee replacement surgery has very low success rate

Fact: Total knee replacement surgeries have a success rate of 95% in most cases. It is the best surgical treatment for those who can not perform their minor routine activities due to extreme knee pain.

Myth 2: Knee replacement surgery should be avoided as long as possible

Fact: It is absolutely not correct. It is not advisable to wait for the surgery until the pain becomes intolerable. Unnecessarily waiting for surgery and delaying it, is technically more challenging for the surgeon and it causes patients’ health to deteriorate overtime.

SEE ALSO: When is the time for knee replacement surgery?

Myth 3: Bending of the knee or sitting on the floor is difficult even after the replacement surgery

Fact: This is the most spread misconception but the fact is different. It totally depends on the quality of the knee surgery, prosthesis used and post-operative recovery of the patient. Some prosthesis allow the range of knee movements same as the normal knee joints.

Myth 4: If the surgery fails or knee implant fails, there is no chance for a repair

Fact: If surgery fails for any reason, your doctor may perform a second surgery, called revision knee replacement surgery. This is performed after evaluating the reasons of failure for the first surgery.

Myth 5: It is not possible to drive after knee replacement surgery

Fact: Driving is easier after the surgery. Most of the people start driving within 6-8 weeks of surgery.

Myth 6: Old aged people cannot undergo knee replacement surgery

Fact: Age is not a limiting factor when it comes to knee replacement surgery. The patient can undergo surgery at whatever age he is at, be it 45 or 65. All it requires a clinical fitness of the patient and a nod from the knee surgeon or an orthopedic surgeon.

Myth 7: It takes months and months to recover after a knee replacement surgery

Fact: The recovery period after a knee replacement surgery totally varies from patient to patient depending on their health conditions and post-surgery care. Some patients tend to recover within a few weeks of their knee replacement surgery and gradually resume their normal routines.

Final takeaway

With most of the myths surrounding total knee replacement surgery debunked, now you must have a clear understanding that knee replacement surgery is a wise decision to make. Unnecessarily waiting for surgery and delaying it is not a wise decision.

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Author Dr. Rachit Sheth Categories Treatments Leave a comment

Shoulder Arthroscopy for Shoulder Pain – Know the Benefits

What is shoulder arthroscopy?

Shoulder arthroscopy is a surgical procedure used to visualize, diagnose, and treat various problems inside the shoulder joint and in the space surrounding the rotator cuff. This is done through small incisions that allow the insertion of specialized instruments.

Arthroscopic shoulder surgery is used to treat a variety of common shoulder problems, including bursitis, tendonitis, arthritis, impingement, rotator cuff tears, labral tears and shoulder instability.

Reasons your shoulder is in pain

If you met with an accident and hurt your shoulder, you probably know why your shoulder hurts. But if you are like many people who are experience unexplained shoulder pain. Your shoulder is pretty resilient but with the growing pain and you overdo tasks like – throw, lift, twist and reach, it could end up with injuries like:

  • Labral tears
  • Shoulder impingement
  • Frozen shoulder
  • Rotator cuff injury
  • Dislocation

What are the benefits of arthroscopic shoulder surgery?

You may have shoulder arthroscopy instead of open surgery (with a larger incision), depending on your specific concern. Compared to open surgeries, arthroscopic surgeries have less risk of infection and a shorter recovery time. Shoulder arthroscopy also tends to cause less joint stiffness and pain than open surgeries.

More reasons to choose shoulder arthroscopic surgery:

  • Less tissue damages
  • Reduced pain
  • Lower chance of infection
  • Less blood loss
  • Faster recovery time

FAQ by Patients: When can I go back to work/school/drive/eat?

When you can return to your everyday life depends on the complexity of your surgery. If you’ve had a minor procedure, you may be able to return to work or school in a few days. You’ll need longer to recover from more major procedures. Your orthopedic surgeon will give guidance suitable for your recovery.

Looking for a shoulder arthroscopy surgery in Ahmedabad?

Dr. Rachit Sheth is a Consultant Orthopedic Surgeon in Ahmedabad, specializing in knee and shoulder arthroscopy surgeries.
For more information on: shoulder arthroscopic surgery or you can contact us.

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Author Dr. Rachit Sheth Categories Knee/Hip Replacement Leave a comment

Avascular Necrosis (AVN) of Hip – Why Early Detection is Necessary

What is Avascular Necrosis?

Avascular necrosis (AVN) is the death of bone tissue due to a loss of blood supply. You might also hear it called osteonecrosis, aseptic necrosis, or ischemic bone necrosis. If it isn’t treated, AVN can cause the bone to collapse. AVN most often affects your hip.

Anyone can be affected, but the condition is most common in people between the ages of 30 and 50.

Causes and Risk Factors for Avascular Necrosis

Things that can make avascular necrosis more likely include:

  • Alcohol consumption
  • Medical treatments like radiation therapy for cancer (as it weakens bones)
  • Long term usage of steroid drugs
  • Trauma (breaking or dislocating a hip)
  • Certain medications
  • Blood clots, inflammation, and damage to your arteries. All of these can block blood flow to your bones.

Symptoms of AVN

Many people have no symptoms in the early stages of avascular necrosis. As the condition worsens, your affected joint might hurt only when you put weight on it. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock.

You may have severe pain if the bone and surrounding joint collapse making it unable to use your joints. The time between the initial symptoms and bone collapse can range from several months to more than a year.

Why early detection is necessary with AVN

Primary concern is if the disease progresses to the stage in which the bone dies and collapses, then the only option is a hip replacement.

When avascular necrosis of the hip is diagnosed at the onset stage, core depression can sometimes successfully prevent the collapse of the femoral head. If your hip, knee, or ankle is affected, you may need crutches to take weight off the damaged joint. Untreated avascular necrosis also causes bone to lose its smooth shape, potentially leading to severe arthritis.

Treatment goals for AVN are to improve the joint, stop the bone damage, and ease pain.

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