Osteoarthritis of the knee is a global scourge. Treatment ranges from cumbersome conservative measures with too many drugs with undesirable side effects, to aggressive knee replacements which still remain elusive to an average Indian. Can we provide hope to these patients and offer them a dignified existence?. In a study conducted over 100 patients in my hospital since 1998, I have devised a very effective treatment option, a new integrated therapy incorporating Yoga and a few alternative systems. Apart from offering to combat associated problems like diabetes, hypertension, obesity, osteoporosis etc it has lessened the amount of medications used for their treatment

Patient History. This patient is a 59-year-old female who presents with right side hip pain which has gradually progressed over the last 2 years. She describes activity related pain in the right groin radiating down the anterior thigh to the knee. There is also a moderate amount of posterior pain in the ischial region. She is now having pain at night as well as occasional back pain. The patient works as a landscape designer and historically has been quite active participating in yoga, snow skiing, and hiking. These activities have become more limited over the last 12 months. She denies any significant right knee pain and has no radicular complaints. Prior treatment has consisted of physical therapy on two separate occasions over the last year both for 6-week periods without relief. She uses anti-inflammatories daily but otherwise has not had any injections or surgery on the right hip. A cane is used for long distances and her maximum ambulatory capacity is 2 blocks. She is unable to negotiate stairs easily and has difficulty donning socks and shoes. Overall she describes her activity level as light labour. She has no significant past medical or surgical history and takes no medications. The patient is allergic to sulfa drugs. She denies tobacco use. By physical exam she stands 5 feet 4 inches and weighs 150 pounds. Lumbar spine exam shows no tenderness to palpation with negative straight leg raise bilaterally. Right hip exam is consistent with 95 degrees of flexion and 10 degrees extension. Abduction and adduction are 20 degrees and 10 degrees, respectively with 5 degrees of both internal and external rotation. Groin pain is reproduced with passive hip range of motion. Hip flexion and abduction strength are 5/5 with mild tenderness along the greater trochanteric region. Leg lengths are symmetrical. Right knee exam shoes full range of motion with neutral alignment and stability in both the coronal and sagittal planes. Right foot and ankle exam is consistent with normal sensory motor function and palpable dosalis pedis and posterior tibial pulses. X-ray examination demonstrates advanced degenerative changes in the right hip with complete joint space obliteration and early erosive changes in the femoral head. Bone quality shows mild osteoporosis. Impression: Osteoarthritis Right Hip. Plan: Anterior Approach Right Total Hip Arthroplasty

Aims

Physician burnout and its consequences have been recognized as increasingly prevalent and important issues for both organizations and individuals involved in healthcare delivery. The purpose of this study was to describe and compare the patterns of self-reported wellness in orthopaedic surgeons and trainees from multiple nations with varying health systems.