 Hi again and welcome to Ni Ki Baat. Today from KMC Hospital Mangalore and our specialist center for knee and hip surgery, myself Dr. Yogesh Kamath and our team that's Dr. Nabil here who's an orthopedic surgeon and Dr. Bishwa our rehab specialist. We are going to collectively tell you a little bit trying to bust some myths about knee pain. So as you know we have a specialist knee and hip clinic and many times a majority of our patients of course are senior citizens. When the children accompany their parents and we've advised surgery it's not uncommon that a 30-40 year old professional son or daughter would ask me, my mother has got this arthritis, am I likely to be like her when I'm 60 years old? So what I would advise strongly is yes bone shapes are genetically transmitted but if your mother or father or your grandmother has suffered from bad arthritis it doesn't mean that you are going to get arthritis. There's no doubt that arthritis or rather the prevalence of arthritis is increasing in recent times and this is more because we are definitely getting used to less activity than our yester generations did. Putting on weight would definitely increase the chances of arthritis. A lot of us are getting pains and joint pains out of stress which is no doubt a part of modern life. Having said that if you are developing knee pains it does not mean that you would have surgery at some time in future. A lot of early knee pain can definitely be traced to bad postures, bad lifestyles, bad diets. Having said that it doesn't mean that any kind of knee pain or especially pain that you get following injuries or something that is consistent despite whatever you do should be ignored. A lot of doctor colleagues too have this thing in the mind, I'm getting knee pain. I will probably be advised surgery if I go to this knee specialist surgeon. A lot of knee pain like I said can be managed without surgery but because of the fear of surgery when we avoid taking opinions and avoid taking remedial measures we can actually sometimes make arthritis worse which over time does predispose us to severe arthritis and severe arthritis might mean replacement surgery. What I want to highlight here is there are different forms of surgery which can prevent you from having bad arthritis. So, niggly pains though they can be managed by exercise certain pains can be due to early cartilage issues. We've got a lot of new treatments in place which can actually help reverse early arthritis changes. There are treatments with your own bone marrow derived stem cells. There are treatments with injections like TRP. These treatments can often be done on a daycare basis with good investigative modalities like MRI which can help us point to the specific problem. There are various small procedures which help us preserve the natural joint which we offer by means of being a comprehensive knee care specialty. These procedures if you have at the right time can help prevent major surgery. What do you think about this Dr. Nabeep? Yes, so many times we see patients who have deteriorated into worse or knee problems when many times they could be managed with their mild to moderate knee problems by very well by exercises very well by they're changing their work ergonomics or changing into a more balanced diet. So, there are more commercialization on fat diets where there is no scientifically proven evidence. There is no documented evidence that this will actually reverse knee arthritis. If patients are obese, we definitely need to cut down on their calorie intake. We definitely need to add a good amount of vegetables, a good amount of fruits into their diet, a good amount of vitamin C and ask them to get into a more healthy fat intake diet. So, many patients fail to realize their knee problems until they go into injury phase or they haven't get into any kind of arthritis. So, over my years of training period, I've come across many patients being forced into what is called as emergency knee surgeries. So, let's go on to Dr. Yogish to discuss about is knee surgery really? Yes, Dr. Naveel, that's right. It is very common that arthritis goes into flare ups. And when an arthritis is in a flare up, the patient is most troubled. Automatically, family members who are obviously feeling bad, think of an immediate solution. In our culture, it is more of a thing to act at that time rather than to plan things in advance. Now, this is something that doesn't work with planned knee surgery. Particularly, if an arthritis is in a flare up, there is a lot of inflammation within the joint. And if a joint replacement is done at that time, the patient is likely to take a lot more time to adjust to the new joint. With joint surgery, it should almost always be planned. Therefore, when one is planning the whole outcome of surgery, one can automatically make logistic and realistic expectations about the rehabilitation as well, which we surgeons when we advise should explain to the patient as well. Similarly, when patients have injuries, particularly on the sports field, they lose their confidence and there's a lot of anxiety associated. Many times, they are advised about having ligaments reconstructed in the urgent situation. That is also extremely rare unless there is a dislocation to have a ligament reconstructed early. In fact, what we should be doing in the emergency situation following an injury is rehabilitation with the right exercise. I'd love our rehab expert, Dr. Bishwa, to enlighten us on this. Yes, you can start with your exercises even after injury. Yes, you can start with your exercises even after injury, as one has to continue their day to day activities just like walking or going to toilet even after injury. So those things cannot be stopped. However, doing simple exercises could take the fear away. So it is always advisable to start with simple exercises so that the muscle doesn't get wasted. The knee doesn't get painful or stiff. It's always advisable to seek opinion from a specialist knee surgeon or a specialist physiotherapy before you start your intense exercises. The same way, even a surgery is an injury to the knee. Be it a replacement surgery or sports injury related keyhole surgery, 100% of our patients walks and does their exercises pretty much from the same day of surgery. When you are planning to go back to your sports, it is always advisable to start with milder form of exercises and avoid heavy impact exercises initially and gradually build it up once the pain reduces. Great, thank you, Dr. Bishwa. If you want to refer to our previous videos, you have actually would see Dr. Bishwa demonstrating these basic exercises which each and every one of you can do when you need pain. Those will actually even help reduce the pain and prevent further damage. Anyway, thank you so much for patient listening and we will look forward to seeing you again at the end of June, the 25th of June, where we are going to talk to you a little bit at how at our specialist knee and hip center, we have been managing planned surgeries during the COVID epidemic. We have a lot of precautionary measures in place so as to conduct your planned surgeries in a safe environment, especially because many of you are working from home and have the means to undergo these at this time. So look forward to seeing you again on the 25th of June. Bye.