Dealing with osteoarthritis

QI am 58- years- old and I am suffering from osteoarthritis in both knees. My doctor has advised knee surgery. Which surgery is advisable — osteotomy or knee replacement? — Anonymous

Each surgery has its own set of indications. If it is a case of advanced osteoarthritis, joint replacement may be advisable, particularly to protect the other knee from further damage. It is a definitive procedure with a life of 15 to 20 years if performed by an experienced surgeon. High Tibial Osteotomy ( HTO) will not address the arthritis but it will give you temporary relief by correcting the alignment of the knees. But total knee replacement will be required after 6 to 8 years, and a previous HTO makes knee replacement more challenging. An arthroscopy will actually help you buy some time before either of these other surgeries are planned. Combining it with an HTO may improve your chances of pain relief. However, an unpredictability in outcome persists. — Dr Praveen Mereddy, senior consultant orthopaedic surgeon

QI am 22- year- old and recently underwent a routine urine examination. The results indicated the presence of traces of protein and pus cells ( 25- 30/ HPF). Am I at risk of developing kidney stones? I experience a burning sensation and slight abdominal pain while urinating. — Swathi P

The presence of protein or pus cells in one urine sample is not significant. You must repeat the urine test after obtaining advice on the proper way to collect a sterile urine sample. Retract the foreskin and collect mid- stream urine. If you’re experiencing a burning sensation, you should send a sample for a urine culture test. And if there is abdominal pain, you should have an ultrasound of the abdomen done to rule out stone disease.

— Dr P. Vamshi Krishna, senior consultant urologist