Joint Replacement Surgery – Dr. Swapnil Zambre Explains How Can You Avoid It



I am Dr. Swapnil Zambre and I have recently joined Currae Hospitals, as primarily a Spine and Endoscopy Specialist with Arthroscopy Sub-speciality interest, and Joint Replacement as my primary area of management.

I have started just a few weeks ago now. And to give you a bit of background about myself, I have done my MS Orthopaedics from KEM Hospital, and after that pretty much straightaway, I have gone to UK. About 13 years, I was over there and I have got exposure to various areas of orthopaedics. I did my sub-speciality training and fellowship training over there and I have come back and started practicing in India, recently.

Main area that I really like to focus upon are joint preserving techniques and joint preserving surgeries, which try and avoid you having a joint replacement. Today’s topic which is how to avoid a joint replacement is very near to my heart and that is what I would love to talk to you guys about.

I get a lot of patients who ask me this question quite commonly that, “ammi kay karaycha amche joints Changle rahatil anni replacement karavi lagnar nahi?” So, I tell them that the two main things that you have see is, “tumsa joint atta normal ahe ka ki atta already thoda far arthritis zala hai ka,” if it is still normal then the main thing you do is exercise. Whether you lose weight, “agar apka wajan kam nai ho raha hai to koi farak nai padta” but you have to exercise. If you don’t lose weight, no issues. A normal joint which gets exercise regularly will stay normal even if you don’t lose weight, yeah. Now, of course, it is preferable that you lose weight but it is not important, so if you are not losing weight, don’t get disheartened, keep exercising. And what is the best form of exercising? For a normal knee, the best form of exercise is pretty much anything really: running, skipping, jumping, walking, lunging, swimming, cycling. The easiest thing for most of my patients I tell is power walking, brisk walking is very good.

I personally feel, my opinion that anybody below 60 years, walking is not really an exercise. Above 60, if you do walking, that’s a form of exercise but below 60, you are so young, firstly and secondly, you have more functional demands of your body, you are working, you are taking care of your family, so you need a more fitter body in order to deal with those demands. So, I think running or skipping or cycling is far better than just walking. At the very least, you should be brisk walking or power walking. You can start slowly where you start by just walking but you have to gradually build it up if you are below 60. So, exercise wise that is important if you have a knee that is completely normal, but if you have a knee which is already starting to become a little arthritic then losing weight becomes very important, simply because apka ghutna agar already ghis gaya hai aur usme upar se aur weight ja raha hai to wo jaldi ghisenga. So exercise is important when you have arthritis but also losing weight is very important. Losing weight is not easy but it is if you want to keep your knees preserved or replacement karwana nahi hai to you have to lose weight. And there are various ways in which you can lose weight and there are various diets and various other health groups that you can go to but important thing is weight loss. Exercise carries some importance there as well but mainly weight loss.

Now, another thing is that kafi sare patients, in fact majority of my patients are vitamin D deficient, so your bones become weak and that also affects your joints. Especially, jo log metros mein ya cities me rahate hai, they don’t go out in the Sun much and everybody is vitamin D deficient, so you should regularly take vitamin D supplements to keep your bones healthy, so that you don’t have any problems with your bones and your joints, necessarily.

Another thing is never ignore an injury to your joint, never ignore it, simply reason being that if you go to a specialist early, they can do something to prevent further damage to the joint and that joint can end up being preserved. For example, I’ll tell you that if you go play cricket and you get a twisting injury to your knee, you can get a cartilage tear. Now, if you sit on a cartilage tear, slowly over a period of time, aapka dard kam ho jayenga and uske baad me you will find that knee is not too bad, it is never perfect, it is not too bad. What do I mean by a cartilage tear? Now, a cartilage tear is something like this, you know, agar aap ghutne ka x-ray nikalte hai to log apko bolenge gap kam ho gaya hai. Actually, body mein kahi gap nahi hoti but gap dikti hai. Gap kyon dikti hai? Kyonki yahan pe dono haddiyon ke beech me ek meniscus naam ki cartilage lagi hui rahati hai jo ek shock absorber ka kaam karti hai. Agar apke knee ko agar twisting injury ho gayi to kabhi kabhi isme chota tear ah sakta hai, wo tear agar apne waqt pe dikha ke agar hum log agar keyhole surgery karke usko trim kar dete hai to apka ghutna safe rahata hai aur accha function karta rahata hai, lekin agar samjho wo fata hua ka fata hua raha gaya to it can start damaging your knee. Imagine karo ki agar ye apka ghutna hai, normal day-to-day life me movement kar raha hai, agar kisi ne kholke idhar andar ek chota foreign body, chota tukda daal diya aur uske upar aapke to chalne ko bola to kya honga? And that is what exactly the tear does. So the same way, ligaments hoti hai, ghutne ke andar. Commonly, anterior cruciate ligament tear hoti hai jiske wajah se ghutna apka unstable ho jata hai. Aisi kuch injuries hui to kabhi kabhi keyhole surgery se apke ghutne ko bachaya ja sakta hai jiske wajah se apka joint replacement aage jake avoid ho sakta hai.

Another aspect is certain kind of joint injections that we have. There are multiple types of joint injections. This can work in people who have mild-to-moderate arthritis and they can give a long-lasting pain relief without having the side effects that tablets give you and they are extremely safe and they are very effective as well, far more effective than tablets are.

So basically, seek help early is what I am saying. If you have a normal knee joint, exercise regularly, whether you lose weight or not, doesn’t matter. If you have a knee that is already starting to become arthritic then you must not only exercise but also lose weight in order to preserve that knee. If you get an injury, seek help early because small treatment might make your knee completely normal and you might prevent further damage to the knee. Also, regularly take vitamin D supplements, especially if you are an indoor person and if you don’t indulge in too much Sun lit activity. These are the important things.

Of course, I am sure you might have further queries about what you might want to know about how to prevent a joint replacement. If you have any queries, feel free to post them below and I’ll do my best to try and then answer them as soon as possible. I am normally available in Currae from Monday to Saturday in the evening between 6 and 7. If you want, you can book up an appointment by calling the hospital and I’ll be more than happy to see you.

Thank you so much.

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