Avoid Knee Replacement? Ultimate Guide with Dr. Turab Syed

Knee Arthritis
With us we have Dr. Turab Syed a consultant Trauma and Orthopaedic Surgeon in Scotland in the NHS. We will discuss the following topics about these conditions:
What ages do these develop?
How can we treat them?
Physio, conservative or Surgery.
Recovery from Surgery.
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Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only.
Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.
Dr / Mr. Turab Arshad Syed
MBBS MRCS DipSICOT DipSEM MFSEM FRCS (Tr & Orth) MSc (Sports Medicine) MFST (Ed) MAE (UK)
Consultant Trauma & Orthopaedics Surgeon (Hip & Knee Replacement and Foot & ankle Surgery) & Expert Witness
Forth Valley Royal Hospital, Larbert, Stirlingshire, Scotland
Kings Park Hospital, Stirling, Scotland
Profile / Bio Data
Mr Turab Syed is a consultant Trauma & Orthopaedic Surgeon in Scotland in the NHS (Forth Valley Royal Hospital - old Falkirk Royal and Stirling Royal Infirmaries) with Private practice in Scotland at BMI Kings Park Hospital, Stirling, Manchester and Harley Street (at the Harley Health Village) in London.
He teaches (as Academic Tutor) and examines for the Masters in Trauma & Orthopaedic Surgery at the University of Edinburgh and is an Examiner for Final Year MBBS in Surgery and Senior Clinical Lecturer at Glasgow Medical School.
He is a founding member of the Diabetic Foot Surgeons Forum (U.K.) and faculty of the Diabetic Foot Reconstruction Cadaveric Workshop (U.K.). He is passionate about increasing awareness about surgical management of Diabetic Feet, reducing amputation rates and improving the quality of life of this sub-strata of diabetics.
Before moving to Scotland, he was a Consultant at the Royal Free London Hospital where he was also a Lecturer and examiner for UCL (University College London) London Medical School 3rd to final years, for surgery.
He has been PI (Principal Investigator) of two RCTs and is currently co-investigator for the FAME trial. He has published and presented at learned societies extensively and lectured/taught at learned societies including SICOT (International Orthopaedic Society) and Royal Society of Medicine, Charing Cross and Imperial College Orthopaedic Courses. He has over 90 posters and podium publications.
Mr Turab Syed has done a masters in Sports and exercise Medicine and has been the team doctor for England Football Team C, England UEFA Regions Cup Squads, MKDONS Academy doctor, Guernsey National Football Team doctor, ECCA (English Cross Country Athletics) Official Doctor, Motor Sports Association official doctor and Jersey Derby Doctor.
He is fellowship-trained in Trauma, Lower Limb Joint replacements (Hip and Knee replacements) and Foot and ankle Surgery.
www.turabsyed.co.uk
www.bmihealthcare.co.uk/consu...
www.turabsyed.co.uk
www.drturabsyed.co.uk
www.orthopaedicsurgeonstirling.co.uk
www.footandanklepain.co.uk
www.footdoctor.co.uk

[@jmc8076]

@9:24 valuable for most Ortho surgeries.

[@9111logic]

Excellent talk, thank you both for such a comprehensive description and for the multiple solutions ❤🙏

[@mik71]

My bone doctor taught me an important lesson that has helped me threw the years of arthritis,and that is. ( it’s only pain ) now when it gets bad I break into insane laughter and have developed Tourette’s syndrome in that I swear uncontrollably in inappropriate places.

[@jmc8076]

What??

[@sincin9935]

Lol 😂

[@9111logic]

😂😍

[@laveraparato258]

Great topic

[@cyberbob4111]

thank you, very interesting talk, looking forward to the next ones.

[@TheAtt22]

THIS IS AN EXCELLENT VIDEO. THANK YOU!

[@anuradhasrivastava9368]

Amazing conversation

[@CountryStrong2309]

I have stage cancer stage 4 and seriously my knee hurts me sooo bad I'm so glad I caught this video! I was a very active cheerleader for year's I assumed that it finally caught up with me. I think it has to be that and bone and cartilage damage

[@nycgorodok]

Sending you sincere wishes for a full recovery 🙏🏼🙏🏼🙏🏼

[@laurelroebuck8271]

Thank you for this video. I'm facing replacements of knees & hip - this was so helpful for me. (Although I still don't want any of it! 😉) I look forward to watching the next video on hip replacement. Thanks.

[@leonardchecchio1655]

In terms of reducing pain and perhaps preventing osteoarthritis body weight is also very important. There is tremendous stress on weight bearing joints which can be reduced by maintaining ideal body weight. Unfortunately this is not emphasized early on in life. The obesity epidemic will keep orthopedic Drs busy forever.

[@xcast1]

Overweight is associated with osteoarthritis, but I doubt that the weight itself is a big factor. The real culprit is the sedentary inactive lifestyle associated with overweight and the resulting inflexibility (particularly in knees and hips) + reduced avascular nutrient supply to cartilages and tendons: If you have e.g. 20% more weight, that is not much, actually ridiculous, compared to the g-forces (2 - 5 G = 2x - 5x body weight force in knees and ankles) arising with jogging, running, jumping in active people and the even higher leveraged forces inside tendons and joints - let alone forces occurring in elite sports. However, recreational sports people have by far the lowest OA prevalence (e.g. PMID 22572082) compared to sedentary people and elite athletes. Non-overweight, low-inactive people still have a rather high OA prevalence. (Elite athletes obviously get OA via direct damage from the extreme forces during sport, but despite their OA being radiologically visible, it's with less pain and immobility compared to that of sedentary inflexible people. Elite athletes are mostly not seriously disabled.) Also note, the ankle joint has to bear even higher forces compared to knee and hips (near 100% of OA cases) in usual walking and lifestyle patterns of low-active people as the ankle operates continuously around 90° (requires additional Achilles muscle force pulling over the ankle with a multiple of the body weight force) compared to a nearly 180° operation of knees and hips where muscle operation hardly adds more than 50% body weight force. But ankle OA is rather rare! The body would easily compensate some 20% extra body weight by muscle, tendon and cartilage adaption - but the other effects of a chronic sitting and low-activity pattern does: The typical sedentary lifestyle and chronic sitting pattern first results in shortening of the hip flexor muscle-tendon units, mainly the psoas muscles, and (less critical) in the units pulling over the back of the knee, particularly gastrocnemius. (The process is similar to the formation of joint contractures in immobile and hypertonic patients due to whatever reason, and in immobile home care people. Just the process is slower.) From what I have seen, this is the major cause of OA (exception: elite sportsmen) : The shortened hip flexors result in anterior pelvis tilt during standing and walking. And this also induces a chronically bent knee in these postures as a compensation. The extreme end stage of that pattern is visible in older people walking bent over a rollator with permanently flexed hips and knees, forming a kind of Z-shape or duck style walking pattern instead of an economic erect posture. If you ask them to try standing erect, it is hardly possible; and they have to apply extreme forces in the antagonist muscles (glutes for hip, quads for knee) in the effort to counter the shortened muscle - unproductive extreme forces which do not produce motion but cause about 2x that force pressing into the joint and cartilages for no good reason. The ankle joint is not affected anyway nearly as seriously in this chain of forces due to the 90° geometry and missing shortening during sitting, and that is why ankle OA is rare - despite the ankle transferring the body weight maximally. These extreme grinding forces in knees and hips due to unproductive double forces in both agonists and antagonist, and also the ever lower avascular nutritional transport in the synovial fluid are the main paths for synovitis, OA onset and aggravation. A minor factor is that excessive adipose tissue also increases the general inflammation throughout the body. Natural prophylaxis and therapy should first and foremost focus on lengthening the hip flexor / psoas and gastrocnemius muscles by efficient stretching of these muscle-tendon units; and on habitually re-learning an optimally erect posture in standing / walking / jogging as soon as it is possible by the re-lengthened 'hardware'. And then it is possible to do more (moderate) exercises in a comfortable manner for creating growth stimulus and avascular nutrient supply to the joints and tendons.

[@jellybean6582]

My mother who is now 79 was told she had osteoarthritis of her knee when she developed pain and weakness practically overnight following her second covid jab. She had been previously able to walk the five miles into town very comfortably and now cannot walk without pain. Is there a possible mechanism where the vax could trigger this?

[@laveraparato258]

Great topic! PRP is available in the US but not covered by insurance. I had it for my elbow. I started with a steroid injection. It only lasted 6 weeks. I know that repeated steroids don't result in healing. I heard about PRP. It's not cheap. I had to take out a personal loan that won't be paid off until April 2025. I had a series of 5 injections over 5 months. I have been pain free for almost 2 months vs not being able to sleep from the pain and having excruciating pain while mixing something in a bowl or pouring from a teapot.

[@333robsta]

There are a few surgeons in the US who apparently have high rates of success, using growth hormone injections in the knee.

[@lyw7645]

Megadose niacinamide, Dr Kaufman’s protocol

[@tompoole007]

One would never twist the good Dr's Arm for extra steroids. But if you did, hed know what to do with the sprain i think.

[@bestcomment3589]

stem cell? ?????????

[@nipagandhi7251]

Role of BORON....

[@jmc8076]

Just search internet for bal of evidence thru good dbl blind randomized studies. Any natural treatment incl supplements depends on actual dx (RA vs OA), causes, person’s diet, etc. Also get levels checked first as any large isolated dose nutrient can over longer term can cause depletion with others plus other risks.

[@smokecurl9437]

My knee pain got worse with boron

[@grizzlymartin1]

Just starting my own investigation, but any literature support for dietary administration of Collagen for related conditions? Thx.

[@grizzlymartin1]

Sidebar: Genomics. Why in the world has “arthritis” (inflammation) not been “solved?” It is literally the root of all anatomical/physiological/pathology evil. Very perplexing. I’ve been in healthcare more than three decades and not seen any real progress. I really am placing hope in genomics to undo that otherwise very disappointing human medicine history.

[@xcast1]

Osteoarthritis (OA) and rheumatoid arthritis (RA) are very different. Almost all OA cases are in knees and hips. OA can mostly be avoided. >90% of the original cause is the sedentary lifestyle, particularly the chronic sitting posture itself. This then leads to: shortened hip flexor muscle-tendon units (psoas mainly); anterior pelvis tilt and subsequent chronically excessive knee bending for compensation in standing & walking; grinding forces in the joint by activation of both agonists and antagonist muscles pulling over these joint at the same time with high forces in the desperate attempt to override the shortened muscle-tendon units; more and more non-erect posture in standing & walking; less and less comfort in sports exercise / more and more physical inactivity; ever lower avascular nutrient supply to the joint cartilages and tendons; overweight; more inflammation from excess fat tissue; ... more sitting / vicious circle. First and foremost natural prophylaxis and therapy: At least balance the sitting posture by frequently stretching the psoas / hip flexors and gastrocnemius efficiently - 2x or more per day; Regular moderate exercise for supplying nutrients to the joints and for conditioning - particularly walking / jogging / (non-extreme) jumping, followed by stretches. Exposure to near infrared light (from sun or artificial) helps regeneration. Avoid vitamin D deficiency. RA / psoriatic arthritis / lupus inflammation occurs more widespread through the body, rather independent of shortened and overloaded muscles. And as with other autoimmune diseases, the original causation is complex and less clear. Natural prophylaxis & alleviation: Avoid inflammatory and low-fibre ('processed') foods. Foremost avoid animal based foods, particularly red meat (Neu5Gc), processed meat, unfermented dairy; replace with plant-based whole foods and targeted supplements (B12, D3, I, Zn, outside US: Se, women: check Fe). Add turmeric and sufficient omega-3 to food. Regular moderate exercise and stretching - same as for OA. Get enough exposure to near infrared light from sun and / or artificial IR / red-light & heat in the affected joints. Avoid vitamin D deficiency. Prof. Dr. Cicero G. Coimbra states, that his rather new "Coimbra Protocol", a supervised high-dose D3 protocol with vigilant observation of Ca and PTH blood levels, puts 95% of autoimmune patients in permanent remission. Promising, many confirmations by cases and fellow therapists. Meanwhile, there is a safety study for this protocol in PMC9033096, discussion of mechanism in PMC8058406. Potentially a breakthrough in therapy. Big RCTs missing.