Dr Pankaj Walecha, Orthopedic and Joint Replacement Surgeon

31/12/2025

500,000 people became part of this community by showing up, learning, and trusting the information shared here.
Reaching this milestone felt like the right moment to give something meaningful back.
There are people living with severe hip pain who need surgery to walk freely again, but cost stands in the way. As a way of supporting this community, two patients who genuinely need hip replacement surgery and financial assistance will be supported.
This is about care, dignity, and restoring movement.
If you or someone you know may qualify, please watch the full video on YouTube for details.
This is for you.

30/12/2025

NAME THE DEVICE!

29/12/2025

Can Congenital Hip Dislocation Be Corrected Successfully in Adults?

Yes, congenital hip dislocation can be corrected successfully in adults, but the treatment approach is very different from what is done in childhood. When a hip dislocation present since birth or early childhood is not treated properly, the joint does not develop normally. Over time, this leads to pain, limp, stiffness, and early arthritis in adulthood.

In many cases, the problem may not have been a true congenital dislocation alone. Sometimes, a hip injury or trauma during childhood that was missed or not treated correctly can also lead to abnormal hip development. As the person grows, the hip adapts in a faulty position, which eventually starts causing problems in adult life.

By adulthood, the socket is usually shallow, the femoral head may be deformed, and surrounding muscles are tight or imbalanced. Because of these changes, simple correction is not possible. Most adult patients with symptomatic congenital or childhood-related hip dislocation require a total hip replacement. The surgery is more complex than routine hip replacement and requires careful planning to restore leg length, stability, and hip function.

With modern implants, advanced surgical techniques, and proper rehabilitation, adults can achieve excellent pain relief and functional improvement. Early evaluation and correct surgical planning are key to successful outcomes.

28/12/2025

27/12/2025

Can Steroids Cause AVN?

Yes, steroids can increase the risk of avascular necrosis (AVN), especially when they are taken in high doses or over long periods of time. Steroids can affect blood flow to the bone, and when the blood supply to areas like the femoral head is reduced, the bone can weaken and slowly collapse. This is how AVN develops.

Steroids are often prescribed for valid medical reasons, sometimes even from childhood. Conditions like asthma, autoimmune disorders, kidney problems, or inflammatory diseases may require long-term steroid use. In these cases, the medication may be necessary and life-saving, but prolonged exposure can still increase the risk of AVN. Many patients are not aware of this risk until hip pain or stiffness begins later in life.

Steroids taken without medical supervision also pose a serious risk. In gym culture, some people use anabolic steroids or injectable substances to gain muscle or improve performance. These are often taken in unregulated doses and combinations, which can significantly increase the chances of AVN, liver damage, hormonal imbalance, and joint problems.

What this really means is that steroids are not inherently bad, but they must be used responsibly. If you have a history of long-term steroid use, whether for medical treatment or otherwise, and you develop hip pain, stiffness, or limping, it is important to get evaluated early. Early detection of AVN can help preserve the joint and delay or avoid major surgery.

26/12/2025

By two weeks after hip or knee replacement, your wound is usually healing well and your body is ready to move a little more. This phase is important because what you do now sets the base for long-term recovery.

Physiotherapy should be done regularly and exactly as advised. The focus at this stage is on gentle range of motion, improving walking pattern, and retraining muscles that may feel weak or stiff. Movements should be controlled and pain should not be pushed through. Consistency matters more than intensity.

Cold packs play an important role in this phase. Ice application helps reduce swelling, controls pain, and allows you to exercise more comfortably. Ice can be applied for 10 to 15 minutes after physiotherapy or walking, usually two to three times a day, as advised.

Muscle strengthening also starts becoming important around this time. Exercises for the thigh, hip, and core muscles help improve stability and confidence while walking. Strength is built gradually, not in one day. Avoid sudden or jerky movements and focus on correct form rather than speed.

Walking should be regular but limited to comfortable distances. Use a walker or stick if advised and avoid overconfidence. Fatigue and swelling are signs that you may be overdoing it.

Pay attention to warning signs like increasing pain, redness around the wound, fever, or sudden swelling. If anything feels unusual, it is better to check early rather than wait.

Recovery is not a race. Two weeks is about building control, strength, and confidence step by step, with guidance from your surgeon and physiotherapy team.

25/12/2025

Prepping robot for surgery!

24/12/2025

Potential Early Signs of Chondromalacia

Chondromalacia refers to softening and early damage of the cartilage under the kneecap. In the early stages, symptoms can be subtle and are often ignored or mistaken for routine knee strain.

One of the earliest signs is dull pain in the front of the knee, especially while climbing stairs, squatting, or getting up from a sitting position. Many people notice discomfort after sitting for a long time with the knees bent, such as during driving or office work.

Another common early symptom is a feeling of stiffness or tightness around the kneecap, particularly in the morning or after prolonged rest. The knee may take a few steps to feel normal again.

Some patients report a grinding or crackling sensation when bending or straightening the knee. This sound, often called crepitus, usually happens without severe pain in the beginning but can increase over time.

Mild swelling around the knee after activity is also an early warning sign. This swelling is often activity related and settles with rest, but it signals irritation inside the joint.

A sense of instability or weakness while walking downhill, using stairs, or during light exercise can also appear early. The knee may feel unreliable even though it does not give way completely.

What this really means is that early chondromalacia does not usually cause sharp or constant pain. Symptoms tend to come and go and worsen with overuse. Identifying these signs early allows timely treatment with activity modification, physiotherapy, and strengthening, often preventing progression to more serious cartilage damage.

23/12/2025

GUESS THE INSTRUMENTS USED HERE!

22/12/2025

Trial implants are temporary components used during knee replacement surgery before the final implant is fixed. Think of them as a rehearsal step. They allow the surgeon to check whether the size, alignment, and balance of the knee are correct before committing to the permanent implant.

This step is critical because every knee is different. Trial implants help the surgeon fine tune implant size, thickness, and positioning so the final knee feels natural and functions well. Once everything feels right, the trial components are removed and replaced with the final implants.

21/12/2025

CAN KIDNEY PATIENTS HAVE JOINT REPLACEMENT SURGERY?

20/12/2025

A helping hand indeed