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Patellofemoral Pain

Anterior Knee Pain – or pain at
the kneecap - is a very common
complaint. Most anterior knee pain
is from the joint between the
kneecap (patella) and the thigh bone (femur), known as the patellofemoral joint. This article looks at the assessment and treatment options of anterior knee pain.

Articular Cartilage Injuries in the Knee FAQs

Articular cartilage is the white
shiny covering over the ends of the
bones in a joint – it is the
substance which makes a joint a
joint, rather than two pieces of bone rubbing together. Articular cartilage injuries in the knee usually come from a twist or a fall. Articular cartilage defects can often be difficult to diagnose. Most commonly they cause vague pain. Other symptoms include swelling, and mechanical symptoms, such as popping, catching, giving way and even locking.

Lumbar Disc Replacement FAQs

The ‘intervertebral discs’ are
the shock absorbers between the
bones of the spine. Unfortunately,
they often degenerate – tearing,
bursting, or just wearing out. They can cause back or neck pain. The low back is known as the ‘lumbar’ region. The usual treatment is rest and painkillers, followed by core muscle (Pilates) exercises. If pain is a problem despite this treatment, one option is to have an operation. Fusion operation is the conventional approach. In a fusion, some or all of the disc is removed and replaced with bone, which joins to the bones above and below the disc together. It is the gold standard for comparing all other operations, including the new operation of lumbar disc replacement.

Diagnosis of Low Back Pain FAQs

Accurate diagnosis of back pain
isn’t always easy. The human
spine is very complex, so it can be
difficult to pinpoint the exact
cause of low back pain or other symptoms. Additionally, other factors, like depression, anxiety, or stress, can contribute to the symptoms of back pain. MRI scanning is safe and produces outstanding images of the spine, but, unfortunately, it doesn’t show ‘pain’, therefore, in more complex cases of back pain it can often be very helpful to inject X-ray dye and local anaesthetic into the back to identify, and in some cases, treat, the painful structures.

Rotator Cuff Tear FAQs

The rotator cuff is the joined-up
of tendon of four of the muscles
which move the shoulder, mainly to
control the stability and
coordinated movement of the shoulder joint. Tears can vary hugely in severity from small partial thickness tears which may not cause any problems to massive full thickness tears which are difficult to treat. The longer a tear has been present, the weaker the shoulder and the larger the tear, the poorer the eventual outcome after treatment. Small partial thickness tears can commence non-operative treatment, and proceed to operation if non-operative treatment fails.

Meniscus FAQs: Tears, Repairs & Transplants

The menisci are two rubbery
crescent moon shaped flat pieces of
cartilage in each knee. The main
purpose of the meniscus is to act
like a washer – spreading load on the articular cartilage. Because the menisci are subjected to huge forces in everyday life, the menisci can tear simply standing up from sitting or climbing a step. Before arthroscopic surgery was developed in the 1970s, the only treatment for a meniscus tear was to remove the meniscus, which will eventually develop arthritis. Now, depend on the severity, a torn meniscus can be repaired, trimmed, or replaced.

Colonoscopy FAQs

A colonoscopy is an examination of
the inside lining of the large
bowel. Any abnormalities will be
visualised on the monitor screen.
Small polyps are usually removed at the same time, or biopsies of large polyps, tumours or inflammation will be taken for further evaluation. It is recommended to undergo colonoscopy at age of 50, or if you have symptoms like bleeding from the back passage, persistent abdominal pain, change in bowel habits, unusual diarrhoea, etc.

Haemorrhoids: Management update and a word of caution

There are three cushions present in
the normal anal canal, which
contribute 10 15-20% anal closure
pressure and are important for both
flatus and faecal continence. Haemorrhoids occur when these vascular cushions become congested and swollen, and when the condition becomes severe, they can prolapsed out of the anal canal. There are various treatments to Haemorrhoids, in which stapled haemorroidopexy is commonly used nowadays.

Minimally Invasive Surgery in the Foot & Ankle

There are numerous surgical
treatment methods to foot & ankle
illnesses, but many of them are
replaced by minimally invasive
surgery (MIS), for example, Percutaneous Distal Chevron Osteotomy to treat hallux valgus, Percutaneous Cheilectomy for hallux rigidus, distal metatarsal minimally invasive osteortomy for metatarsalgia, and endoscopic plantar fascia release to treat plantar fasciitis. There are many advantages of MIS over other methods, including minimal injury to adjacent tissue, reduction of post-operative complications & morbidity, enhancement of rehabilitation progress, cosmetically more acceptable scars. Arthroscopic and endoscopic applications have also become a standard procedure during diagnosis to give a far superior view, and treat some tendon conditions.

Bunions FAQs

Hallux valgus is the medical term
for “bunions”, which refers to
the abnormal angulation of the big
toe towards the second toe. Severe
hallux valgus can lead to recurrent inflammation and pain over the bunion due to the repeated friction with shoe wear, difficulty in fitting shoes, second toe or other lesser toe deformities due to overcrowding, and calluses on the sole. There are more than a hundred hallux valgus operations described in the medical literature, but no one operation has proved itself to be the best. The exact operation performed depends on an individual’s particular combination of problems.