Knee Pain


Anterior patella-femoral syndrome presents as pain on the front of knee particularly during stair climbing caused by cartilage softening on undersurface of patella in young patients Exercises to strengthen the overlying muscles and cycling exercises to improve the cartilage health along with avoidance of overloading activities like squatting and stair climbing form the mainstay of treatment.

In elderly the above mentioned problems increase in severity and involve the load bearing part of knee joint between femur and tibia leading to degeneration of cartilage cap.

Habbits like squatting, sitting on ground and lack of exercises along with contributory factors like osteoporosis and vitamin D deficiency lead to progressive inward bowing of tibia which in turn leads to eccentric loading of inner surface of knee thereby accentuating the deformity. Neglected disease at this stage leads to progression and eventual involvement of outer compartment of knee and advanced osteoarthrosis leading to increase in pain and limitation of movements

Conservative treatment in form of exercises for strengthening the muscles and of knee and mobilization exercises such as cycling can lead to improvement in early stages.

Advancement of disease can be arrested in the moderate stages of disease by realignment surgery known as high tibial osteotomy where in medial bowing of tibia is corrected along with reduction of patellar overload leading to healing of eccentrically loaded cartilage. Late stages require knee replacement surgery

Several patients of osteoarthritis who have benefited by High tibial osteotomy or total knee replacement surgeries performed by Dr Devendra Dave bear testimony to his competence and experience in dealing with these cases. He prefers to do the realignment surgery more in suitable patients as it is more biological and better suited to our indian lifestyle relieving pain without compromising on abilty to sit crosslegged and squat.