The Dumbbell Squat - Build Mass Without The Risks

As I'm sure you already know, squatting is often referred to as 'the king of exercises' for building mass. Many assume that this title is earned in reference to the squat's ability to build huge leg muscles. However, as well as being the #1 exercise for building the quads & glutes, squats also help stimulate growth in all the major muscle groups.

I could go on about the numerous reasons why every bodybuilder should include squats in their routine but hopefully you don't need convincing.

If you want to get big - squat- it's as simple as that.

However, for some, loading a heavy bar onto the shoulders and squatting till you feel dizzy can present a bit of a safety issue. For those that train at home or indeed without a training partner then squatting can be viewed as somewhat dangerous.

There's significant risk of running out of steam and struggling to rerack the bar.

For the lone trainer, heavy barbell squats are something that should only be attempted with a good quality power rack with safety bars. Too many times in the gym I've witnessed some poor guy struggling to get the bar back onto the rack after completing one rep too many.

Even with suitable equipment, if you fail to make the squat and drop the bar, there's still a risk it could go wrong and you end up inuring yourself. At the very least, you're gonna have to unload, lift the bar back onto the rack and reload. If that's ever happened to you then you'll know how much this can knock the steam out of the preceding squats sets.

A fantastic and much underrated alternative to the barbell squat is the dumbbell squat. It's often seen as the poor cousin to the barbell 'king' but for some, it can actually be the superior exercise.

For the newbie, home trainer or the experienced trainer without access to a spotter or suitable power rack, the dumbbell squat makes a superb alternative to the barbell squat.

With the dumbbell squat, you have pretty much all of the mass building aspects of the barbell squat minus the safety issues. The exercise begins and ends with the weights on the floor, a far safer alternative to the' top loaded' barbell squat.

With the dumbbell squat, if you find yourself struggling to make the final rep then it's far easier and safer to simply end the rep and return the weights to the floor.

Performing The Dumbbell Squat

• Take a pair of medium weight dumbbells and align them in parallel, either side of you


• Position your legs a little over shoulder width apart


• Point feet directly forward or slightly out


• Kneel down and take a grip of each dumbbell


• Once you're happy with your grip, push up with your legs, keeping you back straight


• Once completely upright, pause momentarily before lowering back to the start position

I've scoured the net to find you a video that best demonstrates the dumbbell squat and found the short demo below. I'm a little camera shy myself but perhaps one day I'll do my own video demonstration.

http://www.youtube.com/watch?v=bJqnATFga7Y

Tips

• Ensure your back remains at a constant angle to your body during the squat. You want the power to come from your quads (and hip flexors) not your back.


• When lowering, your knees shouldn't extend ahead any further than the end of your toes.


• Make sure your feet point either directly ahead or slightly outwards but never inwards. In inward turn can place disproportional stress on your knees


• Whatever foot angle you find most comfortable, it's imperative that you maintain the same angle for both feet. Different angles can place uneven load on one knee - not good.


• Rather than try to lift the bar, focus on pushing your legs down into the ground. You'll find this actually makes the lift 'seem' easier. Plus, this approach also help you maintain proper form with a straight back by thinking about your legs pushing rather than your body lifting.


• Given the similarity with the deadlift, you may feel a tendency to lean back slightly at the top of the movement as many people deadlifitng do. Please don't do this. Arching backwards places unnecessary stress on the lower back. Arching back is performed by power lifters in competition to satisfy the judges that a full standing position was reached. Unless you're a competitive power lifter, please don't lean back.

I hope this article has revealed to you the many safety advantages of the dumbbell squat over the traditional barbell squat, especially for lone trainers. Remember, when it comes to weight lifting, your ability to avoid injury is one of the biggest factors in determining your progress.

Understanding Knee Replacement Surgery For the Elderly

Knee surgery can be needed by anyone but it is more often perform in older people than younger people. There are many reasons for one to go for knee surgery, such as sport injuries, arthritis and pain associated with cartilage deterioration and the wearing out of bones.

When to Consider Knee Replacement Surgery

Knee surgery can be prevented sometimes and these methods should be explored first. Losing weight, medication, surgery or physical therapy can sometimes solve certain knee problems. If none of these worked, knee replacement might be your only option. The healthier you are, the less risks there is and recovery would be sooner. People with diabetes or high blood pressure can still go for a knee replacement surgery as long as their illness is under control.

What is Knee Replacement?

Knee replacement can be done partially or as total knee replacement. During the knee surgery, the damaged joints will be replaced with plastic or metal components, shaped to allow better motion in the knee. The operation will last around two hours for different types of knee replacement surgery. The minimal invasive procedures require shorter incisions and thus less scaring. The process is very technical and should only be performed by a highly skilled surgeon.

Recovery after Knee Replacement Surgery

Patients usually stay in the hospital for between 3 and 5 days after the surgery. During the stay, they will start their rehabilitation program immediately. A physical therapist will start working on the mobility with the patient, while the occupational therapist will assist the patient on preparing for usual daily activities such as dressing and washing.

All patients won't recover at the same rate as certain factors would have an influence. Strength, body weight and pain tolerance level of an individual all make a difference to the speed of the recovery.

If the doctor is not satisfied with the rate of recovery in the hospital, patients might still be able to return home after about 5 days and it can be arranged for a therapist to assist them with further sessions at home.

Some patients might need to get extra help at home during the first few weeks. This doesn't have to be done by a trained caregiver, but anyone that can assist with meals or helping the person to get dressed and occasionally go out.

To walk unassisted again will take up to six weeks in certain instances. After two to four weeks the patient might be able to use a cane or walker.

Senior Citizens Rheumatoid Arthritis, Osteoarthritis, and Arthritis - Causes and Treatments

"Arthritis" does not mean only that someone has stiff, aching joints. Many types of arthritis exist, each with its own symptoms and treatments. Most types are chronic, meaning that they can be a source of discomfort for an extended period of time. Arthritis can afflict joints almost anywhere in the body and may cause changes you can see and feel, including swelling, warmth, and redness in the joints. It can last for a short time but be very painful or continue for a long time with less pronounced results while still damaging the joints.

Arthritis is extremely common in the United States, especially among senior citizens. Still, there are many steps they and those providing care for the elderly can take to relieve the different types of arthritis. The most common types in this population are osteoarthritis, rheumatoid arthritis, and gout.

Osteoarthritis.

Osteoarthritis (OA) is the most common form of arthritis in senior citizens and begins when cartilage, the type of tissue that pads joints, begins to wear away. This can eventually cause all the cartilage between bones to wear away, forming painful rubbing of bones against each other. This type of arthritis is most common in the hands, neck, lower back, knees, and hips.

Symptoms of OA can range from stiffness and mild pain that accompanies exercise or bending to severe pain in the joints even in times of physical rest. OA can also cause stiffness during times in which you haven't used specific joints in a while, like when you're on a long car ride, but this stiffness usually goes away when you move your joints again. OA can eventually lead to problems moving joints and sometimes to developing a disability if the areas affected are the back, knees, or hips.

Aging is often the greatest risk factor for developing OA. Other factors depend on the area of the body afflicted-for instance, OA in the hands or hips may be caused by genetic factors; OA in the knees may be caused by being overweight; and injuries or overuse of joints in the knees, hips, and hands may lead to OA.

Rheumatoid arthritis.

Rheumatoid Arthritis (RA) differs from OA in that it's an autoimmune disease, meaning that your immune system attacks and damages the lining of a joint as if it were an injury or disease. RA leads to inflammation of the joints, which causes pain, stiffness and swelling, sometimes in multiple joints at once. It may be severe enough to prevent you from moving a certain joint. Senior citizens with RA may often experience fatigue or fever. You can develop RA at any age, and it's more common in women. 

RA can afflict almost any joint in the body and is often symmetrical, meaning that if you have RA in a specific joint on one side of your body, you probably experience RA in the same joint on the other side of your body. RA can damage not only joints, but also the heart, muscles, blood vessels, nervous system, and eyes.

Gout.

Senior citizens with gout experience the most severe pain relative to many other arthritis patients. An attack begins when uric acid crystals form in the connective tissue or joint spaces, leading to swelling, stiffness, redness, heat, and pain in the joint. Attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Drinking alcohol, being overweight, and taking certain medications may worsen the symptoms. In senior citizens, using certain medications to lower blood pressure may also be a risk factor for a gout attack.

Gout is most common in the big toe, but it can occur in other joints such as the ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause discoloration and tenderness due to skin stretching tightly around the joint. If you see a doctor during an attack, he or she may take a sample of fluid from the affected joint.

Other forms of arthritis.

Other forms include psoriatic arthritis  in patients who have psoriasis; ankylosing spondylitis, which mainly affects the spine; reactive arthritis, which occurs as a reaction to another illness in the body; and arthritis in the temporomandibular joint, the point at which the jaw attaches to the skull.

Arthritis Symptoms and Warning Signs.

Senior citizens and those providing their elder care should look out for the following symptoms as they may be indications of arthritis:

• lasting joint pain


• swelling in a joint


• stiffness in a joint


• tenderness or pain when touching a joint


• difficulty in using or moving a joint normally


• warmth and redness in a joint

Any of these symptoms lasting longer than two weeks should be addressed by a physician. If you experience a fever, feel physically ill, have a suddenly swollen joint, or have problems using a joint, a doctor should be contacted sooner. You will have to answer questions and go through a physical exam. Before suggesting treatment options, your doctor may want to run lab tests and take X-rays.

Arthritis Treatment.

Some common treatment options exist even though each type of arthritis is treatedsomewhat differently. Rest, exercise, eating a healthy diet, and becoming educated about the right way to use and protect the joints are key to minimizing the effects of arthritis. Proper shoes and a cane can minimize pain the feet, knees, and hips while walking, and some technology exists for helping open jars or bottles, turn doorknobs more easily, and otherwise improve quality of life in senior citizens with arthritis. 

Additionally, some medications can lower the pain and swelling. Acetaminophen (in Tylenol) and some NSAIDs are sold over-the-counter and can ease pain. Other NSAIDs must be prescribed. It is important for senior citizens and those providing their in home care to pay attention to the warnings on both prescribed and over-the-counter drugs and to ask a doctor about how to properly and best use over-the-counter medicine to treat arthritis. The FDA also has information about many medications.

Some treatment options are specialized for individual types of arthritis.

Osteoarthritis Treatment.

There are medicines to help senior citizens with pain associated with OA, and rest and exercise may ease movement in the joints. Managing weight is also important. If one experiences OA in the knees, a doctor can provide shots in the knee joint, which can help to move it without as much pain. Surgery may also be an option to repair or replace damaged joints in senior citizens.

Rheumatoid Arthritis Treatments.

Treatment can diminish the pain and swelling associated with RA and cause joint damage to slow down or stop. One will feel better overall, and it will be easier to move around. On top of pain and anti-inflammatory medications, a doctor might prescribe DMARDs, which are anti-rheumatic drugs that can slow damage from RA. Corticosteroids, including prednisone, can minimize swelling while waiting for DMARDs to kick in. Additionally, biogenic response modifiers block the damage inflicted by the immune system and help people with mild to moderate RA when other treatments have failed to work properly.

Gout Treatment.

If you've gone through a gout attack, talk to a doctor to discuss possible causes and future prevention of attacks. Work together with your doctor and other elder care providers to plan and execute a plan for prevention. Commonly, NSAIDs or corticosteroids are recommended for an acute attack. This treatment diminishes swelling, allowing you to feel better fairly shortly after treatment. Usually, the attack fully stops within a few days. If one has experienced multiple attacks, a doctor may be able to prescribe medication to prevent further attacks.

Exercise can help Arthritis.

In addition to taking the proper medication and allowing your joints to rest, exercise can help senior citizens to stay in shape, maintain strong muscles, and control symptoms of arthritis. Daily exercise like walking or swimming keeps joints moving while lessening pain and strengthening the muscles around joints. Before starting any new exercise program, it is important to discuss options with your physician. 

Three types of exercise are the best for senior citizens with arthritis:

• Range-of-motion exercises reduce stiffness, improve flexibility, and keep joints moving. Activities like dancing fit into this category.


• Strengthening exercises strengthen muscles, which improves support and protection to your joints. Weight training fits into this category.


• Aerobic or endurance exercises improve health in the heart and arteries, prevent weight gain, improve how your body works overall, and may decrease swelling in some joints. Riding a bike fits into this category.

Other things to do to manage Arthritis.

On top of exercise and weight control, a number of other methods may help senior citizens ease the pain around joints. Applying heat or cold to joints, soaking in a warm tub, or swimming in a heated pool may help you feel better and move your joints more easily.

Surgery may be an option when damage has become disabling or when other treatment options have not adequately diminished pain. With surgery, joints can be repaired or replaced with artificial ones. Commonly, arthritic knees and hips are replaced.

Unproven remedies.

Many senior citizens with arthritis try treatments that have not been tested or proven to help. Some are harmful, like snake venom, while others are harmless yet unhelpful, like copper bracelets.

Here are a few ways to determine whether a treatment is unproven:

• The remedy is said to work for all types of arthritis and other diseases


• Scientific support is from only one research study


• The label doesn't include directions or warnings of use

Areas for further research.

Studies suggest that acupuncture could ease OA pain in some senior citizens. Dietary supplements such as glucosamine and chondroitin are also under investigation and may reduce OA pain. More research is needed to determine whether these types of treatments actually work to reduce symptoms and damage to joints.

Talk to your doctor and others involved in your elder care.

Try not to make light of your symptoms by telling yourself that joint pain or stiffness is simply caused by aging normally. Your doctor and other elder care providers can discuss possible treatment options with you to safely minimize your pain and stiffness and prevent more serious joint damage.

What Is Outpatient Knee Replacement and Can It Help You?

Outpatient knee replacement is a method utilizing fairly recent advances in orthopedic knee arthroplasty (whether total or unicompartmental), that signals itself to be significant in the future of knee replacement procedures. Customarily, this was a variety of prosthetic operation that needed to be performed in a hospital setting. However, advances in techniques like minimally invasive surgery and anesthetics, originated by Dr. Robert Berger, have prominently shortened hospital times, and within the last ten years, have even made it feasible for an increasing number of patients to be discharged on that very day, and actually walk out of the clinic or hospital with no walker, cane, nor any crutch being required. With a steadily rising rate of knee surgery patients being scheduled for same day outpatient procedures today, the usual hospital wait for a total knee arthroplasty has been astonishingly dropped from two weeks just a few decades ago, to about a week by 1998, 4 or 5 days by 2003, and presently it is abnormal even for knee recipients using more traditional techniques to stay more than 3 days in the hospital.

An outpatient procedure of this variety needs everything to be done perfectly by the most qualified surgery team, which should include some knee specialists. Any omission, delay or other mistake on the team's behalf can cause an extended stay to be required for the patient. Not all facilities or doctors will be ready for same day surgery, as this depends on the modern technology together with the most experienced team. In April 2011, Dr. Kevin Stone, a California orthopedic surgeon, finished a knee replacement operation in faster than two hours hospital time, utilizing state of the art robot mechanisms.

The advantages of outpatient operating portend a major lowering in expenses to both patient and hospital, in addition to an accelerated recovery time allowing artificial knee recipients to start doing physical therapy the day after operating. The danger is regarded as minimal; Dr. Berger shows his research concluding a 94% rate of success in same day knee surgery. He has indicated that his minimally invasive method entails a solitary incision between the joint line and the knee cap, avoiding making dislocations or cuts on the quadriceps tendon and muscles.

Another crucial consideration is the presence of a complete team to help the patient in deriving benefit from the optimal therapeutic methods. The popularity of this improved method may signify that nearly all knee replacements will be capable of being finished in a matter of minutes or hours not so far in the future. Dr. Berger is moreover famed for his recent criticism of an artificial knee called the Zimmer knee, manufactured by his former firm, the Zimmer company, that he claimed has a greater danger of post-surgery knee failure; this has ended up in suits and recalls clustered around the Zimmer knee.

Likewise, outpatient hip arthroplasties have been done by Dr. Berger's team beginning in 2001, with the first such outpatient hip replacement in Virginia being done in July 2010 by Dr. Mark McFarland of the Newport News Orthopedic and Spine Center.

What Is Osteoarthritis of the Knee And What Is the Treatment?

Articular cartilage is the gristle that caps the ends of long bones. It consists primarily of a matrix of proteoglycans which are complex arrangements of proteins and glycogen molecules. The proteoglycans exist within a framework of tough collagen fibers. Within the proteoglycan matrix are cells called chondrocytes. These cells are the ones that are responsible for the synthesis of proteoglycans. In fact, the normal maintenance of cartilage integrity is highly dependent on the normal metabolic function of these chondrocytes.

Healthy cartilage can withstand the usual loads that accompany the activities of daily living. Cartilage, when loaded, acts as a shock absorber. It will partially deform but springs back to its normal shape under normal circumstances. It also provides a gliding surface which is enhanced by a small amount of synovial fluid, produced by the joint lining, that acts as a lubricant.

Osteoarthritis is a degenerative disease of articular cartilage. It arises as a result of the inability of cartilage to keep up with excessive breakdown. The first step is a disturbance in the matrix. This causes loss of cartilage resiliency. In addition, proteins that promote inflammation (called inflammatory cytokines) are produced by the joint lining. These cytokines activate destructive enzymes, called proteases. The proteases degrade the matrix and cause the chondrocyte to malfunction.

The inflammatory cytokines cause the production of other bad chemicals including nitric oxide and matrix metalloproteinases. These cause further cartilage breakdown.

Over time, cartilage wears away, underlying bone is exposed, and joint deformity occurs. Pain and disability are the end result.

The knee is a particular target of osteoarthritis.

With the aging demographic as well as the increasing incidence of obesity, knee osteoarthritis (KOA) is a significant public health problem. Significant disability can result and health care dollars are being spent at an astonishing rate for total knee replacement. The 2003 National Institutes of Health Consensus Statement on Total Knee Replacement estimated that the mean total cost of a knee replacement in the United States was $35,000. That figure is obviously higher now. And the dollar cost does not factor in the potential for complications.

More than half a million knee replacements occur annually and that figure will continue to rise.

Non-surgical treatments by and large are palliative. These include education, weight loss, analgesics, non-steroidal anti-inflammatory drugs (NSAIDS), braces, physical therapy, exercise, and injections of glucocorticoids and viscosupplements (lubricants).

Investigational therapies aimed at either increasing the production of matrix and/or collagen or reducing the amount of inflammatory cytokines are being scrutinized but so far, there is little cause for optimism.

More recently, the use of autologous stem cells, have been shown to have promise for KOA.

(Wei N, et al. Guided mesenchymal layering technique for treatment of osteoarthritis of the knee. J Applied Research. 2011; 11)

Knee Pain - The Causes and Symptoms

The knees are extremely prone to getting injured. This is mainly because they have extremely complex structures, and are made up of tendons, bone, cartilage and ligaments. They often experience quite a lot of rough treatment, just by our daily actions. They bear weight and often get injured when we fall over.

The following are the main symptoms and causes of knee pain:

Symptom: The knee is extremely sore, also swollen and painful when you move it.

Cause: This can often be due to the soft tissue below the knee cap having softened. Also, you could have a tear in your cartilage or ligaments.

Symptom: Pain when stretching your legs, or at the back of the knee.

Cause: You may have torn your hamstring.

Symptom: The knee always seems to be sore; it is hard to move and cannot carry much weight without becoming unstable.

Cause: You may have torn the cushioning cartilage at the end of the bones in the knee. It is called the meniscus.

Symptom: A constant but not extremely painful ache in the knees. Swelling also occurs.

Cause: You may have damaged your articular cartilage. This can be caused by an injury, or just everyday wear and tear.

Symptom: The knee being unstable, and giving way with any amount of weight being placed on it. If the knee makes a popping sound, swells or is sore when standing which may make it give way and prevent you from standing or very much movement.

Cause: It is possible that you have had an injury in your anterior cruciate ligament, otherwise known as ACL, or your posterior cruciate ligament, otherwise known as PCL. This is quite a common injury in dogs, and it is more common to injure your ACL.

Symptom: The knee shape has changed

Cause: You may have fractured the knee, or torn a ligament.

Symptom: The knee has swelled, is painful or is unstable when you put weight on it. Your mobility is reduced.

Cause: Over extension of the knee joint. It is a common injury if you do sports that involve jumping or turning, and the knee joint extends beyond being straightened like it usually is. It usually happens because of weakening bodily contact, or just awkward landings.

Symptom: Pain, stiffness or swelling throughout the knee joint in the long term. The pain increases throughout winter.

Cause: These are the symptoms of osteoarthritis.

Symptom: Swelling towards the back of the knees.

Cause: You may have Bakers Cyst.

Symptom: You are aged between twelve and eighteen, and the kneecap is sore to the touch.

Cause: It is possible that you have Osgood-Schlatter Disease. A lot of teenage males experience this, often when they have growth spurts.

Symptom: Sharp pain between the kneecap and the shinbone, especially during and after harder activities, such as jumping or running.

Cause: This is often a symptom of Tendinitis, which is an injury in the tendon that joins the kneecap and shinbone. It is caused by overdoing strenuous activities.

Symptom: The knee sometimes locks up, and is unable to move. Excessive pain felt throughout the knees, and a grinding feeling when you do move it.

Cause: You have probably torn a cartilage.

These are the most common knee injuries, and although none of them may seem life threatening, they are not to be ignored. If you find yourself suffering any of these symptoms, I would strongly recommend seeing your Doctor.

Alternative Surgery to Prevent Knee Arthritis

Osteoarthritis, the commonest form of arthritis affects the knee joint most often in India. Elderly afflicted by this chronic painful disease need joint replacements as a permanent solution to improve their quality of life and put an end to disabling pain. However it is increasingly common to see many young people also suffer from the earlier manifestations of the disease. In this group alternate solutions have to be recommended considering the age, increased demands like participation in sports and work. Joint replacements cannot obviously be a solution to young men and women.

Osteoarthritis is a age related wear of Articular cartilage which covers the end of the long bones in a joint. It is smooth, elastic, shining tissue. It is responsible for lubrication, shock absorption, and pain-free movements. Unlike other tissues of the body, it has limited capability of regeneration and repair as it has no blood supply and nerve supply. This limited repair capacity decreases with aging and leads to depletion in the arthritis knee. Pain and stiffness ensue, necessitating medication or surgery.

Osteoarthritis does not involve the whole of the joint to begin with. A localized area of cartilage damage called a lesion is the precursor and harbinger of the disease. If left untreated, lesions greater than 1. 5 cm will lead to arthritis after 15 years.

Some generalized and local conditions predispose to early cartilage damage. These are mechanical, chemical, and biological. Occupations, Obesity, mal-alignment or structural damage can predispose to cartilage damage.

Ligaments and menisci stabilize the knee. Menisci dissipate stresses, help in lubrication, increase joint conformity and confer additional stability. The ligaments inside the joint are called the cruciate ligaments. These are torn in many sports, or two wheeler accidents. An ACL injury is the commonest ligamentous injury. Unrepaired ACL's lead to further tearing of the menisci and both in association can lead to osteo-arthritis.

Meniscal tears can occur in isolation in sports or domestic accidents. After the importance of the menisci was realized and arthroscopic surgery came into vogue, attempts are made to resect and remove only the damaged portion of the menisci and preserve the rest. However, it is not always possible to do so as the damage is beyond repair and a total or subtotal Menisectomy is necessary. Such knees are also predisposed to develop secondary osteoarthritis (occurring in younger persons at an earlier age) cf Primary osteoarthritis which occurs in the elderly.

Some people have deformities around the knee. These may be situated in the thigh bone or leg bone. Normally in the standing position, there should be no gap between the inner side of the knee and ankle joint. If a gap exists between the knees, then the person has bow legs (Genu varum) and if a gap exists between the ankles, then the legs diverge at the ankle, causing knock knees (Genu valgum). Both these deformities can lead to one sided wear of the knee joint and arthritis in one half of the knee.

Surgical solutions are available to prevent or treat early arthritis. These alternatives avoid knee pain from arthritis.

These knee reconstructive procedures attempt to restore the anatomy of the joint and are mainly of a biological nature. They do not involve joint replacement. Examples are

1) Knee ligament reconstruction- ACL reconstruction is possible through tiny key-hole incisions (arthroscopic surgery). Graft is taken from the patient's own body (autograft) or from a brain dead person, (allograft). This tendon graft is threaded through bony tunnels in the leg and thigh bones and is fixed with screws, buttons or other devices.

2) Meniscal suture- This is a procedure in which attempt is made to suture a torn meniscus if situated in a suitable position. Concomitant ACL reconstruction is required if there is an injury to this ligament also. This is done through arthroscopic surgery.

3) Meniscal transplant- This procedure is to be introduced shortly. In this menisci are harvested from the knee joints of brain dead living donors or non heart beating donors. These are preserved and then grafted into the damaged knee.

4) Reparative cartilage procedure are available to salvage localised cartilage defects and prevent their progression to extensive involvement. These are microfracture wherein small holes are made in the raw area to generate a super clot and in growth of fibro cartilage. In mosaicplasty, cartilage plugs are harvested from non weight bearing portion of the knee and re-implanted into the lesions.

5) Corrective osteotomy- Mal-aligned joints can be corrected by an osteotomy (division of bone). After this surgery, stresses across a joint are distributed more evenly excess wear from one half of the joint is minmized. This again prevent rapid progression of osteoarthritis and can postpone the need for a replacement.

These surgical alternatives are available in Chennai to treat painful knees in young people and prevent progression to arthritis. By availing these alternate surgical procedures where one is indicated, one can preserve and continue with natural cartilage and postpone or avoid joint replacement by a decade or more.