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Knee surgeries rising among younger population

Statesman News Service |

New Delhi, 13 October
Over the last few years, the volume of joint replacement procedures has increased dramatically and the percentage of joint replacement in patients younger than 65 years has seen a marked increase, say orthopaedic experts who believe that obesity is a major problem in India and is partly to blame for the rise.
“More knee replacements are being performed in the younger population than before due to obesity, sedentary lifestyles & other forms of arthritis," said Dr Brajesh Koushle, Senior Joint Replacement and Arthroscopic Surgeon, Fortis Hospital Noida.
Dr Koushle said it is a common misconception that autoimmune diseases (AIs) affecting joints, such as rheumatoid arthritis (RA), only affect the elderly. Statistics show that the young and active can also suffer from these debilitating conditions.
"Patients must not lose hope. Treatment has improved significantly and newer therapies and methodologies including the very exciting biologic disease modifying drugs and procedures like arthroscopy and joint replacements have made a tremendous impact on our ability to treat the various arthritis. With the help of these therapies, patients are now able to live a fuller, healthier and more active life no matter what their age. They can still reach for the stars and realise their dreams," said Dr Koushle.
“I am willing to do low-impact exercises, but not give up my active lifestyle, that is why I agreed to undergo knee replacement surgery so that I could stay active without being dependent and I’m doing it," said a 50 year-old woman, who has undergone knee replacement recently at Fortis Hospital, Noida.
 As the number of younger patients with arthritic knees increases, emphasis should be on prevention, and improvements in surgical techniques and implants will lead to better long-term outcomes when joint replacement is performed, said Dr Koushle.
Dr Bimlesh Pandey, rheumatologist at Fortis Hospital, Noida, said: “Nowadays arthritis of the knee and other joints is striking at younger ages but shedding a few pounds if you’re overweight may reduce your risk.”
Dr Pandey said as people become more aware of the facts around joint pain they are more inclined to seek help. "Many people believe that only the elderly suffer from arthritis but I treat patients of all ages in my practice. Often they are misdiagnosed because some doctor&’s rule out the possibility of a patient having some form of arthritis as they are too young, and the elderly don’t seek treatment as they believe there is nothing that can be done," he explained.
There is a lot of misconception about arthritis and treatment chiefly; for instance people feel there is no treatment in allopathy or modern medicine, which is totally incorrect, arthritis is treatable to a great extent.
“If we could identify the disease early, the outcome is gratifying. There should be emphasis of a patient-centric approach which includes rheumatologist, orthopedic surgeon and physiotherapist, occupational therapist. One has to know a very good referral policies and building team of experts in arthritis management,” he said.
"The diagnosis of knee osteoarthritis is occurring much earlier. Obesity and knee injuries may be helping to drive the increase in knee Osteoarthritis among younger people… Injuries to the knee have been linked with an increased risk of knee arthritis.”
According to Dr Surender Singh, Head of Physiotherapy Department, a programme of exercise & taking precautions has reduced pain and improved mobility by as much as 50 per cent in those with knee arthritis. An effective self-management plan should include a plan to stay active, as well as medication, balance between rest and recreation, a healthy diet, and joint protection techniques.”
Early diagnosis and aggressive treatment are critical to help to minimise the devastating effects of these diseases. Evidence suggests that disease control as soon as possible after onset determines the subsequent disease course and long term outcomes, which suggests there is a therapeutic window of opportunity.
 "The treatment for arthritis varies from patient to patient depending on the type of arthritis they suffer from as well as their individual profile. We use a combination of symptomatic treatment such as anti-inflammatory drugs and disease modifying drugs to treat these diseases. We also recommend exercise to help improve a patient’s general health, improve mobility and to strengthen muscles. The type of exercise will vary according to the patient and the type of arthritis they are suffering from. The daily stresses of life may also aggravate, and can trigger a flare of symptoms, so patients are encouraged to reduce stress,” opined Dr Pandey.