Risk and Complications You Must Be Aware of Hip Replacement Surgeries

The number of replacement surgery in India has increased in the past few years. Due to the complication related to hip joints and knee joints patients are visiting doctors for the replacement surgeries. Hip joint replacement becomes important in case you suffer from arthritic hip or face an accident. In order get a long lasting relief from the arthritic pain, patients usually go for hip replacement surgeries. However, there is very little chance of error in this operation but still as like any major surgery it has also certain risks. In the post, I am going to discuss about the risks and the complications related to common hip replacement surgery in India that patients must be aware off. 

The complications can be divided into two different categories such as general complications and specific complications. The general complications are such as allergic to the given medication, loss of blood during transfusion, heart attack, organ failure or nerve blocking etc. These are very general complications, which are related with most of the major operations. However, there are certain specific complications are related with the hip replacement surgeries. These are discussed below.

Blood clots: During or later the surgery it has been seen that patient can come up with the complication of the blood clotting in deep veins of leg that resulting into pain or swelling. If the clot will not be cleared off, it can causes future complications also. In different ways, these complications can be handled. Doctors can give medications or in case of emergency can go for another operative process to get the clot out.

Pulmonary embolism: Sometimes it happens that the clots of blood passes through the veins and reach the lungs through the veins and can be stuck. In such cases, the patient can be detected with breathlessness, chest pain that may result into collapse. In order to get rid of these, doctors prescribe blood thinning medicines or oxygen therapy.

Infection: Infection can happen at any major operations. In order to avoid the infections operation theatres are especially equipped with systems that pump fresh air within it. The infection in case of hip replacements can be dealt with the medicines but the replaced joints have to be removed until that. After an interval of 6 to 12 weeks, new hip components are being planted again.

Dislocation: A study suggests that one in a 20 cases it has been found that the artificial joint may get dislocated. In such cases, the patient has to go through the operations again in order to put the joint back in the position. In case, it is occurring for more than once, the patient may have to gone through surgeries again or has to put and braces in order to stabilise the joints. Thus in order to stay protected it is necessary that the patient must not bend the joints more than 90 degree. It is also advised to them that not to cross the legs more than the midline of the body.

Wear: It has been seen that people operated and replaced with the plastic socket are facing the problem of inflammation and the worn plastic eat away hipbones. In order to get rid of the problem people are more often prone to the ceramic on ceramic or metal on metal joints. The reason is that these joints are wear less. However, it comes with the risk as metal on metal joints releases metal ions, which can have other adverse effects on the bones. Advanced hard wearing plastics are also developed and used in order avoid this risk.

Inequality in leg length: Due to the artificial replacement sometime, an inequality of leg length is recorded within the patients after operation. However, doctors take ample precautions in order to avoid the problem. Due to the muscle weakness it is also been found that the height of the leg gets unequal. However, in order to resolve the issue a shoe raise is necessary in the shorter part.

Loosen replacement: One of the common causes of the failure of hip replacement is found due to the loosen up of the artificial replacement. However, it can occur at any point of time but generally, it has been seen to occur after the 10 or 15 years of the operation. In case the bone got thinner, the artificial joint may get loosen. In these cases, the only option is to undergo the surgery again in order to fix the problem.

In order to conclude I can say that surgery at any age is not a pleasant experience for anybody. However, at some point of time we have to choose between living a normal life and life in a incapacitating conditions. Therefore, we have to choose the surgical process in order restore the normal functionalities our life.

Do You Know The Common Causes Shoulder Injuries?

Many people used to think that knee and hip joints are the most vulnerable joints of our body. However, it is also true that shoulder is a vital joint in human body. Therefore, an orthopedicsurgeon in India mentioned that people must also concentrate on the issues of shoulder injuries. At least they must know the common reasons of shoulder injuries. Here are some common causes of having shoulder injuries.

In all developments of the shoulder, especially those above shoulder stature, the deltoid muscle contracts to raise the arm, and in doing as such, powers the leader of the humerus upwards into the attachment. The rotator sleeve muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) balance this activity, by keeping the head of humerus moving upwards.

Impingement happens when the space between the humerus and shoulder attachment is limited, causing torment, swelling and wounding of the rotator sleeve ligaments. This can prompt bursitis and tearing of the ligaments, and perhaps caused by:
i) degenerative changes of the bones (i.e. goads on the humerus or acromion).
ii) irritation of the rotator sleeve ligaments (i.e. tendonitis), because of abuse or overload.
iii) inordinate upward development of the humerus, because of muscle awkwardness between the deltoid and rotator sleeve muscles.

The ligaments wind up plainly excited and prompt further unevenness of solidness. Treatment can incorporate ice application, calming prescription and particular activities to recapture quality and coordination of the rotator sleeve muscle action.

Rotator Cuff Muscle Dysfunction (counting Tendonitis)

The competitor with rotator sleeve tendonitis whines of agony with overhead action, for example, tossing, swimming and overhead shots in racquet sports, and there is regularly delicacy outwardly of the shoulder. Exercises performed at not as much as shoulder stature are typically torment free.

Physiotherapy administration includes evasion of the disturbing exercises, neighborhood day by day utilization of ice (15 minutes) and delicate tissue muscle discharges. The utilization of hostile to inflammatories, either topical (i.e. Voltaren gel) or solution (i.e. as recommended by your neighborhood specialist) will enhance the recuperating rate of the ligaments. For powerful and dependable help of manifestations, the rotator sleeve muscles should be reinforced and the fundamental muscle irregular characteristics should be rectified. These activities should be particularly intended for you by a physiotherapist and will include the utilization of theraband and weights. Reinforcing these muscles can take half a month to accomplish and should be a continuous piece of your day by day schedule. Before you coming back to your favored game, any biomechanical variations from the norm or preparing issues will be amended, to limit the danger of your indications returning later on.

Shoulder Instability/Dislocation

Shoulder flimsiness happens while amid day by day or brandishing exercises, the body can't guarantee that the humerus bone (upper arm) stays firmly inside the shoulder glenoid (attachment). On the off chance that there is over the top development of the humerus, rotator sleeve muscle weakness and torment may happen, that prompts the advancement of shoulder impingement and tendonitis (as talked about above). This precariousness can be either:

Atraumatic: Happens when the body's defensive component (i.e. joint container, tendons and rotator sleeve muscles) turn out to be logically extended. This can be hereditary, where a few people have more noteworthy tendon flexibility all through the body (i.e. hypermobility), or it can be created after some time, because of rehashed "extending" of the joint in extremes of development. This is especially basic in sports requiring dreary exercises i.e. baseball pitchers, spear hurlers, swimming/water polo and tennis players.

Traumatic: Happens because of a fall on an outstretched arm or if the arm is pulled in reverse, while over the competitors' head, for example, amid a handle.

Results in the shoulder location, the ball (humerus bone) and attachment (scapula bone and glenoid labrum) turn out to be incidentally isolated. The patient may portray a sentiment the shoulder 'flying out'. Is ordered into either a "foremost" (advances) disengagement, that is extremely normal, or a "back" (in reverse) separation, that is far less normal. Disengagements should be "moved" when essentially conceivable (restoring the humerus to its normal position). An accomplished physiotherapist or games doctor finishes this. In the event, neither one of the professionals is accessible; this patient must be made agreeable and taken quickly to healing facility.

Therefore, it has been seen that there can be several reasons of getting injury to the shoulder. Therefore, one must remain always careful about these injuries and consult a doctor in case of any need.

Have You Asked These Vital Questions To Your Doctor Ever?

A patient must remain frank to the doctors all the time. As it will always help the doctor in order to sort the different issues if the patients clarify the problem in front of the doctor. However, when it comes to any orthopaedic doctor it becomes more important to share all the things.

Will incessant blood coagulating issues obstruct getting mended rapidly? – If your blood does not tend to cluster effortlessly, advise the orthopedic specialist about the same before the operation. On the off chance that you have a past filled with blood contaminations – ensure that the specialist knows about that also.

What is the nature of the prosthetic(s) to be utilized? – Request the specialist to utilize transported in, top-quality manufactured joints for knee substitutions. Prosthetics of nearby make largely bear somewhat bring down sticker prices, however their adequacy and unwavering quality after some time stays suspect. You ought not need to get the prosthetic supplanted before 12-15 years (at the most punctual).

To what extent would the knee be in a defensive cast? – For a couple days after a total knee joint substitution surgery, the appendage would be encased in a cast. For fractional substitutions as well, such throws would be utilized – but for a lesser number of days. Discover for to what extent the cast must be held, and ensure that the joint is not presented to sudden, solid yanks meanwhile.

Would you require a blood-diminishing specialist? – keeping in mind the end goal to forestall diseases, orthopedic authorities generally suggest utilizing a blood more slender, directly after a fake knee joint has been embedded. Ask in insight about the kind of blood more slender you would require (if by any means). You ought to likewise know about the length for which the more slender must be utilized.

Will lung issues be an issue? – Yes they can – and that is precisely why you ought to say such issues (if present) to the orthopedic specialist. In the event that you have lung clusters and additionally ceaseless asthma, intense respiratory issues can be experienced after the use of anesthesia. Regardless of the possibility that it is a generally minor custom fit knee surgery you are going for, lung issues ought to never be overlooked.

Would strolling helps be required? – As you resume developments after a knee substitution surgery, you would likely be encouraged to utilize props, sticks or knee supports for the initial 2-3 weeks. Ensure that you take after the exhortation, to minimize odds of falls (which can bring on additional harms to the delicate joint). In specific cases, exceptional restorative leggings may likewise must be worn, to keep the knee joint legitimately packed.

What can be the likely delayed consequences of a knee surgery? – Most knee specialists have the ability and expertise to finish joint substitution operations in the most ideal way – yet the dangers of tricky delayed consequences can't be discounted by and large. Get some answers concerning the irritations, upgraded bone delicacy, as well as intense agonies that may be experienced after the surgery. Ensure that you can reach the specialist, in the event of any such crisis.

What might be the drugs you need while recovering? – Post-agent prescriptions after knee substitutions are not just about painkillers. You will, more then likely, need to take vitamin pills, mitigating pills, and other supplementary pharmaceuticals. Get a careful thought of the courses of these prescriptions, with the goal that disarrays do not emerge later.

Which knee restoration activities would be perfect for you? – To get back the lost versatility in your knee joint, you will step by step need to begin taking after a standard practice plan. Use of warmth and ice is essential for the initial 6-7 days after a knee joint substitution surgery. In the event that there are no entanglements, you can continue to light joint extending works out (as exhorted by the orthopedic specialist).

Will arthroscopic methods be utilized for the surgery? – Advanced knee substitution surgeries are for the most part done with arthroscopic helps. This includes the inclusion of a little camera-piece inside the joint – to give a continuous encourage about whether the joint is being embedded and set in the right way. In the event that your knee specialist is agreeable to utilizing this method, see if it would add to the general costs (and by how much).

To what extent do you have to hold up, before continuing your expert life? – If you are professionally utilized, you have to know the length for which you ought to remain on therapeutic leave. Contingent upon whether you have experienced a partial or complete knee substitution along with whether yours is a work area work or not – a resting time of one to two months is prescribed. Attempting to rejoin work too early may arrive you back at a healing center!

Therefore, if you are visiting the doctor next time, you must ask these questions to your doctor for sure.

Know These Early Signs of Arthritis to Stay Fit and Healthy

One must understand that it is important to stay fit. However, nowadays arthritis has become a very common problem. It is not anymore a disease of old age. Therefore, people must know the signs of arthritis as knowing the signs in prior can help them to take precaution from further problems. A hip joint replacementspecialist doctor mentioned that one of the early sign of arthritis is to feel tired. In the present post, several other signs of arthritis are being discussed.

You may feel strangely exhausted well before whatever other manifestations wind up plainly self-evident. Weariness can go before the onset of different indications by weeks or months. It might travel in complete disorder from week to week or everyday. Weakness is now and then joined by a general sentiment sick wellbeing or even sorrow. The exhaustion of rheumatoid joint inflammation that outcomes in absence of vitality can unfavorably influence feelings and state of mind, occupation, associations with individuals, sex drive, profitability, mindfulness, inventiveness, and joy. Weakness from rheumatoid joint pain can likewise be related with poor craving and weight reduction.

Solidness in at least one of the littler joints is a typical early indication of RA. This can happen whenever of day, regardless of whether you are dynamic or not. Normally, firmness starts in the joints of the hands. It as a rule goes ahead gradually, in spite of the fact that it can go ahead all of a sudden and influence numerous joints throughout maybe a couple days. Morning firmness is regularly an early indication of joint inflammation. Firmness that goes on for a couple of minutes is typically an indication of a degenerative type of joint pain. Firmness that goes on for a few hours is for the most part a side effect of provocative joint pain and is common of RA. You may likewise feel firmness after any time of delayed idleness like resting or sitting.

Aggravation of ligaments can make weight on your nerves. This may bring about deadness, shivering, or a consuming feeling in your grasp alluded to as carpal passage disorder. The joints of your hands or feet may even create a squeak or crackling commotion as harmed ligament grinds against joints when you move.

Mellow aggravation of the joints is run of the mill right off the bat, making your joints seem greater than typical. This swelling can likewise make joints feel warm to the touch. Flare-ups can last anyplace from a couple days to half a month, and this example can be required to increment with time. Resulting flare-ups might be felt in similar joints or in different joints.

Joint solidness is frequently trailed by joint delicacy or agony amid development or while very still. This likewise influences both sides of the body similarly. Joint agony from rheumatoid joint pain is created by the irritation show in a joint when the sickness is dynamic. Joint agony can likewise happen when the sickness is dormant or controlled if the joint has been harmed by rheumatoid joint inflammation before. In early RA, the most widely recognized locales for agony are the fingers and wrists. You may likewise encounter torment in your knees, feet, lower legs, or shoulders. Solid joints are average of rheumatoid joint inflammation. Joints that are influenced by dynamic rheumatoid joint inflammation are excited and distinctively stiffer in the morning than later in the day. Specialists utilize the span of the morning firmness as a measure of the seriousness of the dynamic joint aggravation. As rheumatoid joint inflammation reacts to treatment, the length of the morning joint firmness lessens.

Swollen joints are exceptionally normal in rheumatoid joint pain. Once in a while the joint swelling is negligible and can be hard to appreciate. Different circumstances the joint swelling is exceptionally evident. Mostly, individuals who are influenced by rheumatoid joint pain can without much of a stretch tell when their joints are swollen. The joint swelling can prompt loss of scope of movement of the joint. Joint swelling in the fingers can make it difficult to get rings now and again effectively.

Warmth of the joints influenced by rheumatoid joint inflammation is an indication of dynamic aggravation. Specialists search for joint warmth as they screen the action of the infection. As rheumatoid joint pain reacts to treatment, joint warmth settles. At times joint warmth is available without obvious joint swelling or redness.

As a rule, however not generally, rheumatoid joint pain influences many joints. Traditionally, RA influences the little joints of the hands and wrists and chunks of the feet. Furthermore, usually, knees, elbows, hips, lower legs, and shoulders can be excited. Once in a while, just a couple joints are included. Less as often as possible, a particular joint is included. Both of these situations are more typical in adolescence incendiary joint pain. Whenever at least four joints are aggravated, the condition is alluded to as poly arthritis. At the point when just a couple joints are aggravated, it is alluded to as oligoarthritis. At the point when a solitary joint is kindled, it is alluded to as mono arthritis.

Therefore, going through the overall post one thing is clear that there are several changes of body, which indicates towards arthritis. Therefore, if you are feeling any of these issues, at once you must visit a reputed orthopedic else in future this can make you suffer for sure.

5 tips to follow in order to avoid knee injuries

Have you stopped by holding your knee in the middle of walk? Have you felt a strong pain in knee? If the answers are yes then, it is your time to think again about your knee. Knee is most important joint our body and it takes all the pressure of the upper body on it. If one is going to ignore the pain for a long time, it is possible that they will face a lot of issues in the future. Even ignoring the pain for a long time can result in knee joint replacement. Here are 5 of the tips following which one can easily avoid the knee pains.

Warm Up: In order to get protected from injuries to knee, one must do warm up properly before walking. In addition, one must do a dynamic warm up which will increase the blood flow in the veins and muscles around the knee and legs.

 The dynamic warm will focused on the knee and hip joints, and thus if any blockage or anything will be there, it will be come under the notice of the person while doing the stretching or the exercise. Diagonal walking, high kicks are some of the example of warm up properly.  

Make Lower Muscle Strengthen: As being mentioned, it is important that the person needs to strengthen the muscles around the knee joints as it protects the knee from being injured. In addition strengthening the muscle will protect the bones not to get spilt in any different direction. However, in order to protect the knee it is not the only the setup but doing exercises which strengthen the muscle attached to legs and hips. These exercises will help the quadriceps, hamstrings and groin muscles to get stronger.

If the calves, dorsiflexors or the plantarflexors will be strong, then it will help the person in order to protect the ankles and knees from getting injured. In order to make these muscles strong one can do running and walking beside any other exercises with gym equipments. However, in order to protect one self, it is advisable that the person must also do the exercises under the supervision of trainer.

Put right armour: Ok, I know that you are not going for any war, but while any one is preparing for exercise or even performing daily works must wear the right gears. If the person will not wear right things could end up with affecting the valuable parts. There are many instances where the persons get injured due to not wearing the proper items for exercising and hurt the selves. If one is involved in workout then he must wear right shoes, which will protect the him from the impact.

Do not Force: Another problem, which brings the knee to injury, is over pushing one self as by over pushing oneself one may hurt himself as well as the knees. It is true that one must push the limits as it helps in order to achieve more while working out. However, if one forcing more than the limit can bring harm to one self. Thus one must stop at once when he found that that the work out is harming one self must stay away from it. Running on the harder surface is very bad thus one must avoid this especially. One must also avoid the trainings such as jumping, lunging, skating etc. The main reason behind avoid such things is the impact it has on the knees.

It also prevents the inflammatory issues in the knees. However, if someone got hurt through this he must put an ice pack or a wet towel on the knees in order to avoid the discomfort level. In order give a comfort to the knees, one must also try to stop the exercise for few days as the impacts can harm the knees more. However, one can go for other exercises such as stagnant biking or swimming as it will help you to burn out your sweat as well as put the knees to rest.

Performing stretches regular: it looks that kicking, jumping and other activities are completely dependent on the knees. Yes, it is true but in addition to this, the muscles such as hamstring, gluteal muscle, calf muscles and quadriceps muscles also play important role while the knees are performing those duties. In addition to that one must understand that it is not that knee or supportive muscle are the only thing whose mal function can injure you, but it is also the other parts of body, if they mal functions it can also harm the knee alternatively. Thus stretching of full body parts is an important exercise that must be done the people in order to avoid the injuries.

Therefore, here are some of the tips that are being given to the people in order to avoid different injuries related to knees. Apart from that, people must also use different protective gear in order to protect the knee from being injured. There are guards, braces, pads and other modern equipments, which can protect the knees from getting injured. Therefore, it is advisable to all the people in order to protect them from the knees injuries they must use proper preventive measures. 

Do want to avoid hip pain? Follow these steps

Nowadays joint problems are not remaining the problems of an old age but even young people are also suffering from these problems. However, doctor plasticising hipreplacement surgeries in India mentioned that there are certain steps that people can include in their life style to avoid the hip related issues. Doctors also mentioned that the people who are not taking the hip pains seriously might suffer bigger problems like hip replacements in the future. Therefore, along with the old people, young people can also follow the ways to make sure that they can avoid the serious knee pains too. Here are some of the easy ways that can be followed by the people.

The first and foremost thing that a person must do is to do a proper diagnosis. The reason is that a proper diagnosis can help the doctors to understand the reason behind the pain or the suffering that the person is facing. It is important that a person must visit the doctor before he or she will start doing different exercises. The reason is that the pain could be because of different reasons such as arthritis, bursitis or even due to some of injuries. Thus, it becomes more important to take the advice of the doctor before going for any kind of exercise as it may harm one instead of giving relief.

Another very common way of avoiding hip related pain is by putting ice on the inflammatory area. It provides an instant relief to the pain that the person is suffering. One must put an ice pack available in the market for at least 15 minutes on the place of pain for at least three or four times in a day. In a situation where the person is feeling that the pack is too cold to be put on, he can wrap the ice in a towel and place it over the affected place.

In several cases, it has been found that heating the right place could be also a soothing experience. In order to get relief one can take shower in a hot water or if the person is having a bathtub, he or she can soak for hours to get relief. However, if the pain is because of the bursitis, in such case one must not heat the place as it could increase the pain. Therefore, as mentioned earlier it is important to visit the doctor before applying any of such home remedies.

In order to get relief of the pain one can also use a technique of hot and cool. In such technique, one can use the method of heating and cooling on a repetitive manner. One must place an ice pack on the place for suppose fifteen minutes and then to remove it. Cleaning the place with a dry towel, one must put heat pack on the particular place. One must continue this cycle for few hours as it can help the person to avoid the hip pain.

If the intensity of the pain is higher, then a patient can take drugs, which are non-steroidal and anti-inflammatory. These types of drugs help in order to sooth the pain and give a relief to the person suffering from it. However, it is always advisable that one must consult the doctor before they start to take any sorts of drugs, as over dose of any drugs could have adverse effect on the body.

If someone is already suffering from hip pains, they must avoid doing any sorts high impact activities. These activities include jump, sprint etc, as these activities puts a lot of pressure on the joints. Such impacts might harm the joints too. One can take a brisk walking instead of running as it has much lower impact on the joints than running. Additionally, one can focus on the kits that they are using in order to doing the physical exercises, especially the shoes. A good shoe can helps a lot in order reduce the pressure of the foot as well as of the joints.

Most of the doctors usually used to advice that prevention is always a better option than of cure. In order to take a proper prevention one must focus on strengthening the muscles such as of the inner thighs, backs etc. Swimming is a very good exercise, which helps the back muscles to get strengthen as well as the hip muscles and inner thigh muscles. Additionally performing daily exercise can help the person in order to avoid sudden crunches or aches.

Therefore, one who follows these basic issues can easily avoid the pains related to hip in future. Additionally, doing proper exercise can also helps the person in order to have a much-fit body that can help the person to avoid problems like hip replacement and other bone related issues.

To Control Joint Pains Take Preventive Measure From Earlier Age

In my long-term career, I have seen that most of the people come with the problems of arthritis or joint pains after the age of 50 years or more. However, I am sure that if those people would take proper care of the bones from an earlier age they could avoid such issues. Joints usually connect two bones such as knee joint, shoulder joints or hip joints and take the weight to allow you move in a fluent manner. Trauma, strains and sprains, bursitis are some of the causes of the joint pain. Here I am going to mention certain tricks, following which they can avoid arthralgia in the later age.

Ice Therapy: In order to reduce the tissue from swelling, the flow of blood is needed to be reduced. Ice temperature helps to decrease blood flow thus whenever you feel pain you must put an ice pack on the place in an interval of every hour for duration of 15 minutes time. Apply the same process even on next day at least for four or five times for the same duration. The process helps you to heal the pain. The process is also known as cryotherapy. However, in order to shun the ice burn it is advised to not place the ice directly on skin rather to apply it by wrapping it in wash clothes or towels.

Hydrotherapy: Pouring warm water can also does wonder in case of getting relieved from joint pains. Having a bath in mild warm water or immersed the area in the water can bring relief to you by stimulating the flow of blood.

Massage: Giving a proper massage to the area of pain can also help you in order to get relieved from pain and further knee joint replacement. Proper massage can help you to get over the joint pain of knee and hips. You can go for it by both own or professional. If you are doing it by own remember to keep the direction of the stroke to the upward. A topical menthol rub massage can also help to reduce the pain.

Medication: However, it is the least option that is suggested, but in case the pain is acute, ibruphen can be a good relief for the joint pain. Non-steroidal drugs can help to relieve from the joint swelling as well as stiffness of the muscle. However, it is recommended that to visit the doctor before you take the medicines.

Exercise: Doing regular exercise helps you to avoid the joint pains and later to avoid the joint replacing surgeries. Therefore, it is important to choose the proper exercise, which let you to stay within the limit and not cause further pain. Exercise extends the limits of you muscle and strengthens the joints thus it prevents the joint aches. Further doing the exercise helps you to control body weight. It helps the joints such as knees and the joints to get relieved from taking the extra burden. As example you are 10kg weighing extra it put pressure equivalent to 30 kg extra on your knee joints.

Adapting right technique: it is always advisable that you must sit, work or lift heavy things in the proper technique as it helps your joint to be protected from the external injuries. People who are associated with the sports must use different protecting gears that would help them from being injured or hip joint replacement.

Finally, the best possible way to keep the joint pain away is by having a plenty of time by taking rest. It helps you to reenergise yourself and to repair the body damages in a natural way.

These few tricks can be used in order to avoid the joint related problems. However, causes like aging or family history cannot be avoided all the time. Thus, it is advisable to stay in touch of the doctor to avoid the joint problems. Keep the joint pains away and stay happy.