Friday, October 19, 2018

Recurrent Shoulder Instability

The shoulder is considered as the most complex joint. Therefore, the elements contributing to the stability of the shoulder are no less intricate. Recurrent Shoulder Instability is the persistent inability of the ligaments, tendons and the muscles around the shoulder bone to keep the arm centered in the shoulder socket.

Shoulder Anatomy:

The shoulder is a complex anatomical structure made up of 3 bones:

•    Upper Arm or Humerus
•    Shoulder Blade or Scapula
•    Collar Bone or Clavicle

It is a ball and socket joint that allows multidirectional mobility of hand. The Humerus Head fit into a shallow socket in your shoulder bone called Glenoid. Stability of the shoulder is established by a special harmony between Humerus Head, Glenoid, Labrum, Glenohumeral Ligaments, Rotatory cuffs, Deltoid muscles, and other soft tissue components.


The three main causes of Recurrent Shoulder Instability are listed below:
  • Severe Injury or Trauma:
Severe injury during an accident may lead to initial shoulder dislocation. This can damage Labrum, Glenoid or Humerus Head which results in continued dislocation, commonly known as Bankart Lesion.
  • Repetitive Strain:
Physical activities such as Swimming, Volleyball, Tennis which involves repetitive overhead motions can damage shoulder ligaments leading to shoulder instability.
  • Multidirectional Instability:
Patients who have naturally loose ligaments can have shoulder instability without any history of injury or strain. Such patients are susceptible to instability in multiple directions.

Clinical Evaluation:

A careful evaluation and a clear understanding of the patient’s history is the primary step of treatment plan. The Recurrent Shoulder Instability correlates to the type of injury, age at the time of the first dislocation, duration, degree, and direction of instability, hyperlaxity, activity leading to recurrence of dislocation etc. Imaging tests such as X-Ray, MRI Scan, Scapular Y View Image are the primary radiographic evaluations to identify the problem. While X-Ray identifies the injury to the bones, MRI Scan provides a detailed image of soft tissues which helps in identifying the injuries to ligaments and tendons surrounding the shoulder joint.

Treatment Options:

Depending upon the patient’s condition the doctor will develop a treatment plan to relieve your symptoms. Doctors recommend both surgical and non- surgical treatment plans for patients.
  • Non-Surgical Treatments:
Activity modification, Non-steroidal anti-inflammatory medications, physical therapy etc. are some of the non-surgical treatment options. Making some changes in daily activities by avoiding activities that aggravate symptoms is of great help. Physical therapy helps in strengthening the shoulder muscles thereby increasing the stability of the shoulder.
  • Surgical Treatments:
When there is damage or wear and tear in the ligament doctors opt for surgical treatments. Mainly two types of surgical procedures are carried out:



Arthroscopy is a minimal invasive surgery in which soft tissues are repaired through a small incision. During this procedure, an instrument called Arthroscope with a light source and video camera is inserted through a cut into the affected area which provides the surgeon a clear picture to analyze the problem. The surgeon can sometimes correct the problem simultaneously with an additional thin surgical instrument inserted through an additional incision.

Open Surgery:

In some cases, doctors opt for open surgery. This involves larger incision that requires more healing time.


After the recovery period, patients are directed to do therapies or exercises to strengthen the ligaments and improve the range of motion in their shoulder. Your commitment to these therapies and exercises play an important role in reviving the strength and mobility of your shoulder.


Shoulder Pain Treatment in India

Dr. Biren Nadkarni, Senior Orthopedic and Joint Replacement Surgeon with 15 years of unparalleled service, provides high-quality patient care with ardent dedication and commitment. Currently working in Sitaram Bhartia Institute of Science and Research, New Delhi, Dr. Biren Nadkarni is rendering his distinguished service to Holy Family hospital and Cygnus Orthocare Hospital in New Delhi.
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Saturday, September 15, 2018



The term PRP stands for platelet-rich plasma therapy. It is a new treatment method that works with one's own body's natural systems that are needed to accelerate healing. PRP therapy is the preparation of supplying patient's own blood that is injected at the injured site which ultimately promotes faster healing of sports injuries like sprains, mild arthritis and tendinitis. This method is mostly preferred by sports personalities. Because, when there is an injury; they need a speedy recovery when compared to normal people. PRP therapy could definitely reduce the healing process from months to weeks.

Who is benefitted the most with PRP?

Mainly, the sports personalities, who wanted the injury to be healed within the stipulated timeframe to go back to the next game or tournament. Hence, they prefer the most. Some of the most important injuries that can be treated with this PRP therapy are quadriceps, Achilles tendon, and tennis elbow injuries, where we need to resolve the issue as early as possible to avoid further serious injuries or any permanent disabilities or surgeries.

How PRP therapy is done?

It begins with the collection of 30 ml of the patient's blood. The collected blood sample was processed in a centrifuge (tube-like container) to separate the platelet-rich plasma from the blood. Once done, under ultrasound guidance, the doctors inject the platelets into the injured site. This therapy takes an approximate 20 minutes to complete.
In this method, the platelets function as a natural reservoir for the growth of the injured tissues which actually stimulate the flow of blood and make the tissue tight and flexible. After the therapy, there is a significant improvement in the tissue repair. So, surgery can be avoided by using this therapy.

Benefits of PRP Therapy treatment

The more significant benefit of PRP Therapy is; it can be administered in a normal medical office without any general anesthesia. There is no need for hospital stays and there is no prolonged recovery period.  The only condition is the patient should be a good candidate for Platelet-rich Plasma Therapy. Depends on the severity of the injury, the doctor may proceed with the therapy one or more times.
The major benefits of this therapy are, it is a non-invasive method. It uses the patient's own blood, which boosts the natural growth of tissues. It has a very low risk. It has long-term healing instead of quick and temporary relief.

How safe the PRP therapy is?

PRP injections are proved to be extremely safe. It has no known side effects. Since the patient’s own blood is used; there will be no allergic reaction or side effects and no possibility of risk of infection or bleeding.

PRP therapy in Delhi

In Delhi, Joint and Bone Solutions provides PRP therapy with utmost care and there is a team of specialists who are working round the clock. Dr. Biren Nadkarni is a Senior Orthopedic surgeon who is a specialist in all kinds of orthopedic related issues, where they do the therapy with extreme care and with very good results. 

Monday, June 25, 2018

How can you treat sports injuries?

Sports injury treatments vary depending on the type of injury, severity, and location. Some sports injuries may need physiotherapy or surgical intervention, others may resolve simply that require only over-the-counter pain relievers and rest. Understanding the right treatment option is a strong step towards recovery.

The most common sports injuries are 
Elbow injury, Groin injury, Ankle and Feet injury, Head injury, Hip injury, Shoulder injury, knee injury, leg injury.
A Groin injury is the most common sports injury faced by athletes which are caused by a groin strain or pulled the groin muscle. Complete rest with painkillers is provided to the person.

Ankle sprain generally occurs in athletes when the foot turns inward. This turning may cause tears or stretches of the ligaments on the ankle’s outside. A physiotherapist may teach some exercise to prevent the loss of flexibility and strength.

Knee injury: The anterior cruciate ligament (ACL) holds the leg bone to the knee. Sudden cuts, hits can tear or strain the ACL.  If you hear a POP sound it means there is a complete tear in ACL. An entirely torn ACL requires a surgical intervention to remain physically active.
The posterior cruciate ligament, (PCL) is the strongest ligament located inside the knee. The injury in PCL may occur due to a hard blow to the shin bone. Arthroscopic procedure, open surgery is done for PCL tear.

Meniscal injury: Meniscus is a tough cartilage tissue found at the end of the bones that form joints. Degenerative and acute tears happen in the meniscus. Based on the area and type of the tear the treatment is provided. If a patient is not recovering from Rest and pain medicines, finally surgery has opted.

Tennis Elbow (Epicondylitis): Repetitive use of the elbow in sports like tennis, golf, the action makes tiny tears in the tendons of the elbow. This condition usually happens outside of the elbow. Until the pain reduces, rest is advised for the players.

When the patient does not recover from Rest, pain medicines and he does continuously have excessive swelling, deformities in joints, skin color change, mild bruising, and then he should consult an orthopedist about his condition.

Dr. Biran Nadkarni from Joint & Bone Solutions, New Delhi is the best orthopedic surgeon and with his many years of experience, he treats all kinds of orthopedic issues especially he is a famous sports medicine specialist in India.

Tuesday, June 5, 2018

Cryotherapy after Orthopaedic Surgery/ Total Knee Arthroplasty

Physiotherapy treatments helps to restore movement and function to anyone affected by disability, injury or any health condition. This practice helps to reduce pain, medications and based on the severity of the condition, the person is treated with various physiotherapy treatments. One such is Cryotherapy (or) Cold therapy.

physiotherapy treatments in delhi

In Cryotherapy, the low temperatures are used either generally or locally to treat conditions such as inflammation, injury in ligament/muscle, swelling, pain etc. This therapy heals benign and malignant lesions. Since 17th-century Cryotherapy has been in the usage.

The main goal of cold therapy is to decrease the cells’ metabolism, increase survival of the cells, decrease pain, spasm, encourage constriction in blood vessels and destroy the cell through crystallizing the cytosol. Cryotherapy improves healing process, alleviates muscle spasm, swelling, and promotes blood circulation.

If any injury occurs, the first treatment is RICE, Rest, Ice, Compression and Elevation in which “I” stands for Ice. Cryotherapy is used to relieve pain in the conditions such as sprains, low back pain, tendonitis, arthritis pain, pain and swelling after a knee/hip replacement.
physiotherapy treatments in delhi

The major types of Cryotherapy are:

Localized Cryotherapy: This procedure is performed by applying ice on the injury like a sprained ankle or using a freezing agent and treating skin disorders such as skin warts, cancer.

Whole body Cryotherapy (WBC): In this procedure, all most the patient’s body is exposed to subzero temperature. WBC is used to treat various issues such as pain, insomnia, muscle and joint pain, itching, psoriasis, Rheumatism.

Internal Cryotherapy: A surgeon uses freezing agents to treat an internal part of the body. Internal Cryotherapy is usually administered in laparoscopic surgery and to treat some of the cancer forms. Cryotherapy for prostate, kidney, lungs, and heart surgery are some of the famous treatments.

Benefits of Cold therapy:

  • Faster muscle recovery
  • Faster recovery after surgery
  • Reduces depression symptoms
  • Chronic pain management
  • Weight loss (Cryolysis)

Best Physiotherapist in Delhi

Dr. Biren Nadkarni is a senior orthopaedic surgeon at Joint and Bone solutions, New Delhi. He provides all kinds of bone and joint treatments with advanced technologies. His team of physiotherapists are well experienced and they are the best physiotherapists in Delhi.

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Monday, May 21, 2018

Now, You may Move your Hands and Legs Smoothly

Nobody wants his hands and legs to be tied down by anyone. This restricts his mobility and individual freedom. Likewise, an ortho pain also makes you unable to move anywhere as you want. There are people born with movement disabilities while there are others who are down with disability owing to various circumstances such as accidents, lifestyle, sprain, prolonged sitting postures etc. Some consult an Ortho Specialist and get things sorted out while a few directly move to a Physiotherapist.

physiotherapy treatments

The physiotherapy center of Joint and Bone Solutions is also one such a hospital offering physiotherapy treatments apart from giving away other services such as arthritis care, trauma and fracture surgery and even conditions related to sports injury under the special care and attention of Orthopaedic and Joint Replacement Surgeon, Dr. Biren Nadkarni. The testimonials, his cured patients have to say out are incredible and call out the expertise of the best physiotherapist in Delhi, Dr. Nadkarni in this field.

What is Physiotherapy?

Physiotherapy in India has been on practice since time immemorial. During the ancient times, there were physicians practicing it and as years turned down the line, it became a very formal practice of medicine. Physiotherapy is a healing procedure through which the physical mobility of the individual can be made more flexible and relaxing. It helps to make the soft tissues of the muscles very stronger and aids to reduce the pain to a certain extent.

Why Physiotherapy is Required?

It is one of the restorative techniques in order to help maintain the functional process of the body and helps restoring the flexibility of the body back to normalcy. After the treatment of orthopedic disorders, stimulation of muscles and tendons become mandatory. It is then, an Ortho Specialist recommend the patient for physiotherapy. Sportsmen suffering from sports injuries and people with Parkinson’s disease, arthritis and spinal Stenosis should make of this primitive cum modern technique.

Physiotherapy Treatments

The techniques chosen for each patient are in accordance with the muscoskeletal condition of him:

physiotherapy treatments


  • Cryotherapy or Cold Therapy

The inflammation and the pain that follows because of injuries.
  • The Range of Motion Exercises

The stiffness of the body is reduced to the optimum level so that the degrees of motion is easily restored.
  • Electrical Stimulation

Electrical signals are used for the muscles to be moved to and fro.
  • Heat Therapy

The flow of blood is increased in order to enhance the healing process.

  • TENS- Transcutaneous Electrical Nerve Stimulation is helpful to relieve the pain to the maximum.
  • Soft Tissue Mobilization

Many a lot of techniques are used to help mobilize the soft tissue for a reason that it helps in reduction of pain and swelling.

Best Physiotherapist in Delhi

Every physiotherapist and physiotherapy techniques are different. A patient’s health, health issues and requirements have to be put into consideration while looking for physiotherapy treatments. At Joint and Bone Solutions, the clients/patients can have excellent physiotherapy treatments offered by the best physiotherapist in Delhi

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Saturday, March 10, 2018

Remove That Damaged Hip With Total Hip Replacement

Damaged Hip Joint??? Looking for a perfect solution???? No worries....Perfect solution is here....!!!

Dr. Biren Nadkarni at Joint & Bone Solutions offers safe and effective Minimally Invasive Hip replacement in Delhi with well-advanced technologies. Dr. Biren Nadkarni, well known as the best hip replacement surgeon Delhi, also practices in Apollo Spectra Hospital New Delhi.

hip replacement

Hip Replacement is done when the hip joint is severely damaged, which affects our daily routines. By Hip replacement procedure, the damaged hip is replaced with an artificial one (known as a prosthesis).

When a Hip Replacement is needed

Hip Replacement is needed when the hip joint is damaged or worn out to the extent that the mobility of your Hip joint is reduced and you experience severe pain even while resting. Osteoarthritis is the most common reason for Hip replacement Surgery. Other reasons for Hip Replacement are rheumatoid arthritis, a hip fracture, septic arthritis, ankylosing spondylitis or any disorders that cause unusual bone growth.

hip replacement

Minimally Invasive Hip Replacement Procedure

Two small incisions are only needed for a minimally invasive hip replacement procedure so that the wound will be healed fastly. The surgeon makes use of X-ray images to visualize the organs that he is operating and for fixing the artificial hip in its position.

According to the condition of the patient, age and activity level of the patient, hip replacement will be carried out as, Total Hip Replacement, Bipolar(partial) Hip Replacement and Ceramic Total Hip Replacement.

Bipolar Hip Replacement - Bipolar hip replacement is usually recommended for older patients and for patients with poor health, as the rubbing of metal ball in the bone socket in unipolar hip replacement will not be suitable for them.

Ceramic Hip Replacement - Ceramic Hip Replacement is the most suitable method for younger people in 40 – 50 age group. Because they last longer and the complicated revision hip replacement surgeries are not necessitated in this case.

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Wednesday, February 21, 2018

Restore Knee Activity With Knee Ligament Surgery

Ligaments are tough connective tissues that surround a joint and give support, limit the movement of joint. When there is damage to the ligaments, the knee joint becomes unstable. Sports injury will be the main cause of knee ligament damage. A torn ligament limits knee movement drastically. When other medical treatments become vain, then the surgery is recommended.

The major ligaments are

Anterior cruciate ligament (ACL), Posterior cruciate ligament (PCL), Medial collateral ligament (MCL) and Lateral collateral ligament (LCL).

Anterior cruciate ligament surgery

ACL is located in the centre of the knee. Excessive twisting during sports damages the ACL. The damaged ligament is rebuilt with new ligament during the ACL reconstructive surgery. The Orthopedic surgeon makes many minor incisions around the knee area. An arthroscope is inserted into the incision and camera in the arthroscope provides a clear view of the inner knee. After removing the damaged ligament, small holes are drilled into the lower and upper leg bones adjacent to the knee joint. The holes form tunnels and the new tissue is anchored. The new tissue is accurately placed in the place of the removed ACL. The Surgeon attaches the new ligament to the bone with screws. Once the wound starts to heal, the new ligament is formed.

Posterior cruciate ligament surgery

This is the strongest ligament located in the knee joint. Hard blows, falls will cause the damage to the PCL. The PCL surgery mostly requires a graft. Generally damaged PCL with hamstring tendons segments are grafted. Using some procedures the PCL surgery is performed.

Arthroscopic procedure

In this procedure, a small incision made in the skin. The arthroscope is inserted into the incision and with the help of video camera, the damaged joint is thoroughly analyzed. Few more incisions are made on the skin for inserting thin surgical instruments to graft and repair the damaged ligament. The procedure is performed as an outpatient procedure and it takes normally two hours to perform the surgery.
Open PCL surgery: Open surgery is advised when the injuries are more intricate. When compared to the Arthroscopic procedure, open surgery will take a longer time for recovery. However, an expert orthopedic surgeon will do the open surgery as good as possible.

Joint and Bone Solutions is one of the best hospitals for Knee ligament surgery in Delhi. Dr. Biren Nadkarni is an expert in treating all orthopedic problems with his vast experience.

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