Current clinical evidence is promising

“I am really impressed with how young Sri Lankan orthopedic surgeons are trying to improve their knowledge and surgical skills” – Dr. Gurupal Singh
Dr. Gurpal Singh, Senior Consultant Orthopedic Surgeon at Mount Elizabeth Novena Hospital and Parkway East Hospital in Singapore, in an interview with The Sunday Observer, discusses life extension in joint replacement surgery, the latest treatments for arthritis, and the impact of sports injuries. Learn more about new research into treatments. Correct use of weight machines and gym equipment.
Dr. Singh was recently invited by the Parkway Patient Support Center, Colombo to discuss the evolution of orthopedic oncology as a subspecialty and musculoskeletal tumors at a panel hosted by the Sri Lanka College of Singapore, Parkway Cancer Center, Singapore. I came to this country to give a speech on the development of science. Oncologist and Orthopedic Association of Sri Lanka.
excerpt
Q: I read that you are involved in research into prolonging the life of joint replacement surgery, new materials for joint replacement surgery, prevention of infection and premature failure in joint replacement surgery. Could you elaborate on this?
![]() Dr. Gurupal Singh |
A: I have spent two years in Germany on an advanced clinical fellowship and developing collaborative research. During this time, I was also heavily involved in research (clinical and basic science). In fact, I spent much of my free time in the lab, during which I discussed the findings with the students and orthopedic trainees I was supervising. , retrieval analysis of failed implants, effects of implant wear on tissue, use of sonication in periprosthetic joint infections, and surgical techniques for orthopedic oncology. It was a very fulfilling time not only to deepen my knowledge of orthopedic surgery, but also to gain a deeper understanding of the biomechanical, engineering and biological aspects of tumor biology and joint failure.
Q: Is the use of new materials in joint replacement a successful method?
A: The materials used for joint replacement are the basis for rigorous quality checks and are well characterized. However, it is true that even the best joint replacement surgery is not as good as a young, healthy joint. When a joint replacement surgery fails, a second surgery is required to remove the failed implant component and place a new implant. Become. This is a longer and more technically complex operation than primary surgery. One of the factors limiting the longevity of joint replacement surgery is the wear/bonding of the bearing surfaces of the implant. Therefore, companies around the world are constantly working to further improve implant materials. Strong supporting evidence is provided by lab data, and current clinical evidence is encouraging, but it is ultimately understood that only the test of time can confirm the success of new materials. I’m here.
Q: What is Arthritis? What are the main causes? How to diagnose it at a very early stage?
A: Arthritis is a common condition that causes joint pain. The most common type of arthritis is osteoarthritis, which is often described as “wear and tear of the cartilage that covers the joint surfaces” and basically refers to degenerative changes throughout the joint that eventually lead to It causes joint pain, stiffness and limb deformity. Despite being very common, the exact cause of osteoarthritis is still not fully understood. Risk factors include older age, female sex, obesity, previous joint injury/ These include repetitive stress, genetics, limb deformities, and certain metabolic disorders. Arthritis is diagnosed by a combination of clinical and radiological findings. Regarding imaging, X-rays are usually sufficient for advanced osteoarthritis. In the early stages, magnetic resonance imaging (MRI) may be recommended.
Q: Are there non-surgical treatments for arthritis?
A: Yes, there are several non-surgical treatment options for arthritis. In fact, surgery is only a last resort. In general, it is recommended to try less invasive methods first, such as activity modification, physical therapy, and medication. In some cases, injections may be considered. Surgery may be considered if symptoms do not improve or worsen with the above treatments.
Q: Why is arthritis more common in women than men? What are the early signs of arthritis?
A: Literature suggests that women are generally more susceptible to osteoarthritis than men. This may be due to gender differences in both the presence of some risk factors and relative risk. In particular, body mass index (BMI), a modifiable risk factor, appears to affect women more than men.
Early signs of osteoarthritis include joint stiffness and pain that is exacerbated by physical activity (climbing stairs, getting out of a chair, etc.). Some patients may also experience joint swelling on and off.
Q: Is there substantial evidence that unplanned use of exercise equipment or training without proper training guidance has led to an increase in orthopedic injuries?
A: Although exercise has many well-documented fitness and health benefits, it also comes with a risk of exercise-related injuries. Several military studies have investigated possible risk factors, and it is possible that specific parameters of exercise contribute to the overall risk of injury, roughly proportional to their contribution to the total amount of activity performed. To my knowledge, there is little documented data on potential hazards associated with exercising on fitness equipment/machines. and must be stored securely. Proper training and safety advice is always recommended. When in doubt, patients are advised to undergo a physical examination by a trusted physician and work with a certified physical therapist or experienced personal trainer before beginning an exercise plan.
Q: You recently gave a CME lecture on the development of musculoskeletal oncology as a subspecialty in Sri Lanka at the College of Surgeons Auditorium. Could you briefly tell us about the content? What is Musculoskeletal Oncology?
A: Musculoskeletal oncology is a branch within orthopedic surgery focused on the diagnosis and management of benign (noncancerous) and malignant (cancerous) tumors of bone and soft tissue. This includes patients with cancer that has spread to bone from other organs.
Q: Do you lead/collaborate with the Sri Lanka Orthopedic Association and the Sri Lanka Oncology Society?
A: Yes, I have been visiting Sri Lanka for nearly 10 years for educational purposes and am fortunate to have had long standing relationships with many orthopedic surgeons in Sri Lanka. The Annual Meeting of the Sri Lanka Orthopedic Association has a particular focus on training and is also a forum for international cooperation promoting the exchange of practice. This is all part of our desire to improve orthopedic care. These conferences are a unique opportunity for clinicians, scientists, industry professionals and relevant medical professionals to share their experiences. I have attended many educational courses for orthopedic trainees in Sri Lanka and have been really impressed with how young Sri Lankan orthopedic surgeons seek to improve their knowledge and surgical skills.
I am so passionate about orthopedic oncology that I also contacted the College of Oncology, Sri Lanka and recently gave a talk on the evolution of orthopedic oncology for a local medical oncologist in Colombo, Sri Lanka. Due to the rarity of musculoskeletal tumors, close collaboration between different specialties is critical to achieving the best outcomes for patients.
Q: Regarding your specialty, what are the latest treatments available at Parkway Hospital Group in Singapore?
A: Parkway Hospital Group in Singapore offers the latest technology for a wide range of orthopedic conditions. This includes robot-assisted surgery for patients suffering from arthritis. State-of-the-art imaging equipment (including magnetic resonance imaging, computerized scans, and positron emission tomography-computed tomography) is provided to patients. A new mode of radiotherapy, proton therapy, is also now available for oncology patients. Drugs such as conventional chemotherapy, targeted therapy, and immunotherapy are commonly available, and the quality of the drugs used is ensured by rigorous audits. But most importantly, doctors from different specialties can work together to make patient decisions on a case-by-case basis.
Q: What are common orthopedic sports injuries? Please comment on your expertise in this area.
A: Sports injuries are very common in orthopedic outpatients. In my practice, I see many patients with ligament injuries such as meniscus injuries and anterior cruciate ligament (ACL) injuries due to sports accidents. These injuries usually affect young, highly active patients with a strong desire to return to high-level sports. I routinely perform keyhole surgery (arthroscopy) for these patients. Surgically speaking, there are various techniques that can be used to repair sports injuries. The key is to clearly identify the problem, determine if surgical intervention is necessary, and if surgery is recommended, share the rehabilitation program up front to teach the patient how to optimize their outcome. That’s it. In fact, physical therapy plays a very important role for all sports injury sufferers. These injuries usually heal very well and the patient returns to full sport.
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