Diagnosis and Management of Arthritis in Joints
Associate Director, Centre for Orthopaedics
BLK-Max Super Speciality Hospital, New Delhi
February 2, 2025
Dr. Mannu Bhatia, Associate Director, Centre for Orthopaedics at BLK-Max Super Speciality Hospital, New Delhi, explains how joint arthritis develops, why X-rays remain the first and most informative diagnostic test, and when medicine and physiotherapy give way to hip, knee, shoulder or elbow replacement. The session includes real patient cases from Cameroon, Ethiopia, Gambia and Yemen, along with a direct discussion of surgical cost and safety for international patients.
Questions Doctors Asked Dr. Mannu Bhatia
Real questions from the live masterclass, answered by Dr. Mannu Bhatia, Associate Director, Centre for Orthopaedics.
What is the definitive treatment for osteoarthritis?
Asked by Dr. Sunday
The definitive treatment is that the patient should be visiting the doctor regularly. If the condition is detected and treated at an early stage, that is the definitive treatment. A patient who ignores an ACL injury, skips the recommended MRI, skips the recommended surgery and skips the medicines is the one who progresses to osteoarthritis and eventually needs a knee replacement. Patients with a problem in one knee who don't get it treated often go on to develop the same problem in the other knee, then the hips, then the spine. The definitive treatment is listening to the doctor and following through, whether that means physiotherapy or treatment for rheumatoid arthritis.
Answered by Dr. Mannu Bhatia
I have a patient with intermittent elbow pain, treated with oral and topical NSAIDs followed by PRP injections. What is the outcome of PRP for this patient in Ethiopia?
Asked by Moderator
I am not a strong advocate for PRP. Once the joint surface and the cartilage are already gone, PRP cannot regenerate them, so I don't believe it delivers a real result. I would want to see the patient's X-rays, and an MRI if needed, before deciding what should actually be done.
Answered by Dr. Mannu Bhatia
What are the absolute contraindications for joint replacement?
Asked by Moderator
As surgical techniques progress, more countries are attempting these surgeries, but two things need to be in place regardless: a genuinely sterile operating theatre, and excellent post-operative facilities, since that is what actually gets the patient the benefit of the surgery. There are no absolute contraindications beyond the patient having a poor overall medical condition, for example a cardiac condition that would make operating on them risky.
Answered by Dr. Mannu Bhatia
Is it possible to do a bilateral hip replacement in a patient with a slipped hip joint?
Asked by Moderator
Bilateral hip replacement can always be done, either in the same sitting or with a gap between the two sides, depending on the patient's condition. If the body can tolerate it, both sides can be done together. If the body, or the finances, don't allow that, there can be a gap in between, but rehabilitation and the expected result need to be planned accordingly.
Answered by Dr. Mannu Bhatia
What is the best NSAID to use for osteoarthritis?
Asked by Moderator
I would not advise continuous use of NSAIDs, since they can have a harmful effect on the kidneys over time. Short-term use for pain relief is fine.
Answered by Dr. Mannu Bhatia
How affordable are these surgeries at your facility?
Asked by Moderator
They are very affordable in India, around half the cost of the same surgery in Nigeria, and much less than the cost in Europe or the US, with better results.
Answered by Dr. Mannu Bhatia
Read the Full Article Series
- 1.Diagnosis and Management of Arthritis in Joints: A Complete Guide
- 2.What Is Arthritis? Understanding Its Main Types and Causes
- 3.Who Is at Risk of Osteoarthritis: Age, Weight, Occupation and Injury
- 4.Recognising Joint Arthritis: Pain, Swelling, Crepitus and Instability
- 5.Diagnosing Joint Arthritis: Why X-Rays Come Before an MRI
- 6.Non-Surgical Management of Arthritis: Weight, Physiotherapy and Mobility Aids
- 7.Medicines and Joint Injections for Arthritis: What Works and What Doesn't
- 8.When Arthritis Needs Surgery: Hip, Knee, Shoulder and Elbow Replacement
- 9.Recovery After Joint Replacement: Rehabilitation and Activity Limits
- 10.Joint Replacement Case Studies: Patients Who Travelled From Africa for Surgery
- 11.The Cost of Joint Replacement Surgery in India for International Patients