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GOVERNMENT:
PM'S US VISIT
Doing
The Kneedful
Walking,
as the Prime Minister now knows, is a complex act. It appears easy because
the human knee is so well designed. Osteoarthritis, which reportedly wrecked
the prime minister's knee, disrupts this design through "wear and
tear"-severely enough for renowned surgeon C. Ranawat to suggest
knee replacement surgery.
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A semi-hard
cartilage cushions the thigh and shin bones on either side. The cartilage
must be smooth for bones to move without friction. |
In a healthy
knee, the thigh and shin bones rest comfortably cushioned on either side
of a semi-hard substance called cartilage. Cartilage is smooth so the
bones effortlessly glide over it when we move. A liquid called synovial
fluid further acts as a lubricant on the joint.
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The
cartilage is damaged and rough, thereby exposing the bones. The friction
of bones moving over the rough cartilage surfaces results in severe
pain, swelling and stiffness. |
Smooth cartilage
is crucial for movement. In osteoarthritis, the cartilage is damaged and
gets rough. The synovial fluid dries up. The bones grinding across the
cracked, bumpy cartilage send excruciating, chronic pains. The joints
swell up and stiffen. Little wonder, of late Vajpayee has found it difficult
to speak standing up.
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The
cartilage is replaced with an artificial knee. Two metal pieces are
fitted to the bones with bone cement. A plastic plate acts as a bearing
between them. |
According
to Dr A. Rajagopal, a leading orthopaedic, osteoarthritis is a common
age-related degenerative disease. Several factors can trigger the disease:
genetic disorders, knee injuries, fractures, obesity, gout or other arthritic
conditions. "Obesity," stresses Rajagopal, "is a major
factor." At 83 kg, Vajpayee is overweight.
Osteoarthritis
has no cure. Treatment is limited to relieving the pain. Knee-replacement
surgery, as in Vajpayee's case, is usually the last resort. The cartilage
is removed and replaced with an artificial knee. Called a prosthesis,
it is made of metal and plastic. Two metal pieces are fitted into the
thigh and shin bones, with a plastic plate acting as a bearing between
them. The prosthesis either fits into the bone or is "cemented"
by a substance called polymethymethyacrylate. Ranawat specialises in this
kind of surgery.
After the
surgery, rigorous physiotherapy prevents stiffness in the knee joint.
Recovery takes between four and six weeks. Artificial knees are said to
last up to 20 years. So after surgery the prime minister may well be spared
this problem at least.
-Supriya
Bezbaruah
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