Mr. Marvin, a 54yr old gentleman came to MIOT on 19th Feb, 2018 with severe pain in both knees and difficulty to walk. Mr. Marvin was a Military officer and a passionate rugby player. He has never missed a weekend without playing rugby with his 2 sons. In the year 2000, he met with a road traffic accident. Luckily, he did not have any open injuries, just mild body pains.

But in a few months time, he started experiencing back pain. He did not know whether to associate it with his accident or his nature of job. He ignored it, thinking he would be fine in a few days. But as months passed, he started experiencing pain even in his knees. He visited a Doctor nearby. The Doctor prescribed him painkillers and told him that he will get well.

For the next few years, he had mild episodes of pain but it did not bother him much. In 2010, he again started experiencing severe pain in his spine and knee joint. He went to several doctors for his pain, but he could not get any relief. As time passed, he started noticing that, he was unable to put weight on his left leg and walk. As a result, he was not able to serve in the military field and got transferred to an administrative job. Mr. Marvin said “that was one of the hardest decisions I had ever taken. But, I had a family to take care of now and they needed me”.

Mis- Diagnosis:

By the year 2017, Mr. Marvin was not able to walk normally. He was limping. Completely disheartened by his condition, he thought that he had to find a solution somehow to this problem or he feared it would become worse.  He came to a multispecialty hospital in Delhi where the Doctors prescribed him an array of Investigations. With the results, they told him that he had developed Deep vein Thrombosis in his left leg and should undergo Venous stripping to get it treated.

DEEP VEIN THROMBOSIS (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but also can occur with no symptoms. VEIN STRIPPING is used to remove or tie off a large vein in the leg.

The pain did not subside even a little after the treatment. His limping had worsened and walking had become very difficult. Mr. Marvin said “Sitting in the same ground watching my boys play without me brought me more pain than my leg. I had to definitely do something about it.” It was only at that time, a friend referred him to MIOT.

Approach to MIOT:

Once at MIOT, he met the Knee replacement specialist. After investigations, he was Diagnosed with morbid OBESITY WITH ARTHRITIS (Joint swelling) OF BOTH KNEES. The Doctor advised him for Total Knee Replacement but as he was very obese and had breathlessness, the Doctor wanted to get the Opinion from the Cardiologist, Endocrinologist and Pulmonologist as well.

Routine blood investigations were taken, his HbA1c was 7.6. The Endocrinologist advised medications accordingly and told that he was fit for surgery. Cardiologist advised Stress thallium, report were within normal limits so was recommended fit for surgery. Pulmonologist advised him for investigations which were suggestive of mild hypoxemia and moderate obstructive sleep apnoea.

Hypoxemia is an abnormally low level of oxygen in the blood. More specifically, it is oxygen deficiency in arterial blood. Obstructive sleep apnoea causes breathing to repeatedly stop and start during sleep. This type of apnoea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnoea is snoring.

Back on Foot:

On 26th Feb, with all the necessary precautions, Mr. Marvin was taken up for Total Knee Replacement of Left knee. His post-operative period was uneventful. From the next day post surgery, he was actively mobilized with physiotherapy. In a week’s time he started walking with crutches. He is now able to walk normally, without limping. Mr. Marvin said “I am eagerly waiting to walk by myself. I want to go back home and start playing rugby with my sons, which I thought is never going to happen again. And for this life, I wholeheartedly than MIOT”.

KNEE REPLACEMENT SURGERY can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.

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