Bone of Contention, No More: Dr Nishikant at a Health Talk : Jaipuria School, Patna
The degree and occurrence of osteoarthritis can be checked by lifestyle changes, said Dr Nishikant Kumar, Consultant (Orthopaedics).
Move aside diabetes, hypertension, cancer and HIV, the known ‘kings of diseases’ in this country, for India has a much bigger ailment to worry about now – Osteoarthritis.
“Osteoarthritis (OA) is a condition in which the cartilage that acts as a cushion between bones in joints begins to wear out, causing inflammation and pain in joints, thereby restricting movement,” said Dr Nishikant Kumar, Consultant (Orthopaedics) at Paras HMRI Hospital. He was speaking on ‘Myths and facts about Urban Lifestyle Diseases – An insight into osteoarthritis’ at Jaipuria School, Patna.
OA is also known as degenerative arthritis or degenerative joint disease. “In India, OA is the most prevalent form of arthritis and the leading cause of disability, with around 180 million Indians suffering from it. It affects over 15 million Indians each year,” informed Dr Nishikant.
Types of osteoarthritis
OA is of two types, primary and secondary. Explained Dr Nishikant, “Primary OA is degenerative, and occurs mostly in people above 55-60 years of age. Secondary OA, however, is largely genetic and may occur in younger age groups. The alarming thing is that, due to lifestyle choices, primary OA is increasingly occurring in younger age groups now.” OA typically affects weight bearing joints, i.e. hip and knee. According to him, while Western countries witness more cases of primary hip-OA and secondary OA, in India there is a wider occurrence of primary knee-OA.
Impact of urban lifestyle
Primary OA does not have a genetic bearing. “It can be attributed to several reasons besides this, including lack of exercise, improper diet, improper posture, obesity, sedentary lifestyle, dependence on unhealthy and junk food, popular squatting position, lack of sleep, and inadequate exposure to sunlight leading to vitamin D deficiency,” pointed out Dr Nishikant. Also, long hours of standing through the day and wearing high heels put women at greater risk. “Sample this,” said the orthopaedician, “for every one pound of weight added on to the body, there is 3 pounds of additional stress on the knees!,” Thus, barring genetic occurrences of OA, it is majorly in the domain of lifestyle diseases.
Symptoms of osteoarthritis vary, depending on which joints are affected and how severely they are affected. Said Dr Nishikant, “The most common symptoms are pain and stiffness. Anterior knee pain, difficulty in climbing up stairs or in standing up from a sitting position, these are the first tell-tale signs of OA. Thereafter, affected joints may get swollen, especially after extended activity. These symptoms tend to build over time rather than show up suddenly.”
A diagnosis of osteoarthritis may be suspected after a medical history and physical examination is done. The following tests may help confirm it: Joint aspiration, X-rays and/or MRI.
Management & treatment
There is no cure for chronic OA, but treatments are available to manage symptoms. Explained Dr Nishikant: “There are two ways to manage OA: conservative and surgical. Conservative management includes effecting lifestyle modifications, incorporating an effective exercise regimen, physical and occupational therapy, and select medicines and injections. However, the efficacy of said medicines is undocumented yet. Surgical management, on the other hand, comprises high tibial osteotomy (HTO)in younger age group and involves single compartment, while in advanced stage replacement surgery is a viable option.”
According to him, knee replacement can be either unicompartmental (partial) or total knee replacement (TKR). Busting myths on TKR, he said: “TKR is a fully safe procedure that hardly requires 45-60 minutes. It can be done through conventional technique, or through computer assisted System (CAS), which promises higher accuracy. It can be done though Patient Specific instrumentation (PSI) or Custom Made Implants which is another step further in accuracy and effectiveness.”
Solution at the doorsteps
As our lifestyle choices take a toll on our health, we see the patient spectrum moving towards younger age groups. Recounted Dr Nishikant, “We conducted TKR on a 19-year-old girl, and thanks to that intervention, she is able to walk and go about her daily activities without any problems. A TKR recommendation generally depends upon the level of morbidity and the degree to which the OA is hampering one’s day-to-day life.”
Patna, fortunately, has progressed by leaps and bounds in OA management. “We at Paras HMRI Hospital in Patna conduct TKR through all recent techniques. We have integrated orthopaedic solutions that comprise an optimum mix of conservative and surgical management,” said the orthopaedician. He signed off by adding, “It is our belief that the implant should significantly enhance the quality of life and outlive the patient!”
To know more about Dr Nishikant refer to Dr Nishikant Kumar