Frequently Asked Questions
What are your business hours?
Our practice hours are from 8:00am to 5:00pm, Monday through Friday.
What is your contact phone number?
(02) 4229 9116
What is your practice location?
Practice Location
Loftus St (main entrance)
Wollongong 2521
Who do I call for appointments?
For all appointments and enquiries, please contact us on (02) 4229 9116.
Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here
Where do I park for appointments?
Free parking is available onsite via the practice driveway off London Drive.
What if I need to cancel an appointment?
Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.
What should I bring with me when I come for an appointment?
When you come for your appointment remember to bring the following:
-
Driver’s License or a valid ID -
Insurance information -
Referral Letter (if required) -
Reports, X-Rays, MRI’s, CT scans and any other relevant medical information -
List of medications (if any)
Does Dr Bhimani usually run on time?
We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.
Should I make an appointment?
-
Do you have pain in your knees, hip or groin? -
Is the pain restricting your daily activities? -
Is the pain not relieved on taking medications? -
Do you have swollen knee? -
Do you limp while walking? -
Does pain makes you stop when you walk more than a few blocks? -
Are you having pain when lying or sitting down? -
Are you getting pain for about 3 to 4 days per week? -
Do your knees hurt when climbing or descending stairs? -
Do you feel pain when walking for long time? -
Does pain disturbs your sleep? -
Do you find difficult to put your socks and shoes? -
Do you have a sensation of instability or the knee is going to give out when you are physically active? -
Do you need crutches, cranes or walkers to help you while walking? -
Do you have tightness or limited range of hip motion?
What if I need imaging?
What can I do if am happy with the service I have received?
Am I likely to require surgery?
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.
Will physical therapy be required after surgery?
Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.
Does Dr Bhimani see public and private patients?
Yes, Dr Bhimani sees both private and public patients.
What are Dr Bhimani's fees?
General
Acute Knee Clinic
What are your business hours?
Our practice hours are from 8:00am to 5:00pm, Monday through Friday.
What is your contact phone number?
(02) 4229 9116
What is your practice location?
Practice Location
Loftus St (main entrance)
Wollongong 2521
Who do I call for appointments?
For all appointments and enquiries, please contact us on (02) 4229 9116.
Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here
Where do I park for appointments?
Free parking is available onsite via the practice driveway off London Drive.
What if I need to cancel an appointment?
Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.
What should I bring with me when I come for an appointment?
When you come for your appointment remember to bring the following:
-
Driver’s License or a valid ID -
Insurance information -
Referral Letter (if required) -
Reports, X-Rays, MRI’s, CT scans and any other relevant medical information -
List of medications (if any)
Does Dr Bhimani usually run on time?
We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.
Should I make an appointment?
-
Do you have pain in your knees, hip or groin? -
Is the pain restricting your daily activities? -
Is the pain not relieved on taking medications? -
Do you have swollen knee? -
Do you limp while walking? -
Does pain makes you stop when you walk more than a few blocks? -
Are you having pain when lying or sitting down? -
Are you getting pain for about 3 to 4 days per week? -
Do your knees hurt when climbing or descending stairs? -
Do you feel pain when walking for long time? -
Does pain disturbs your sleep? -
Do you find difficult to put your socks and shoes? -
Do you have a sensation of instability or the knee is going to give out when you are physically active? -
Do you need crutches, cranes or walkers to help you while walking? -
Do you have tightness or limited range of hip motion?
What if I need imaging?
What can I do if am happy with the service I have received?
Am I likely to require surgery?
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.
Will physical therapy be required after surgery?
Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.
Does Dr Bhimani see public and private patients?
Yes, Dr Bhimani sees both private and public patients.
What are Dr Bhimani's fees?
Non-surgical treatment
What are non-surgical orthpaedic treatments?
Many orthopaedic conditions have many non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.
Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating the injury and managing pain. We also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.
Non- pharmacological Treatments
Physical and Occupational Therapy
Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.
Weight reduction and physical exercise
The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.
Thermotherapy
Thermotherapy involves application of hot or cold packs to the affected area. It is contraindicated in individuals with thermoregulatory impairments. Individuals having peripheral vascular disease, diabetes, cardiovascular disease and hypertension, or who are pregnant should use it with caution.
Orthotics
Orthotics involves the use of devices such as splints or braces to correct an injury. These devices need to be properly designed by a qualified orthotist to fit the patient’s body and their specific injury.
Pharmacological Treatments
Platelet-rich plasma therapy (PRP)
This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.
Steroid injections
These injections of steroids are given directly into the affected joint for severe pain when use of Non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.
Medications
To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.
Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them.
They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.
Preparing For Surgery
What are non-surgical orthpaedic treatments?
Many orthopaedic conditions have many non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.
Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating the injury and managing pain. We also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.
Non- pharmacological Treatments
Physical and Occupational Therapy
Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.
Weight reduction and physical exercise
The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.
Thermotherapy
Thermotherapy involves application of hot or cold packs to the affected area. It is contraindicated in individuals with thermoregulatory impairments. Individuals having peripheral vascular disease, diabetes, cardiovascular disease and hypertension, or who are pregnant should use it with caution.
Orthotics
Orthotics involves the use of devices such as splints or braces to correct an injury. These devices need to be properly designed by a qualified orthotist to fit the patient’s body and their specific injury.
Pharmacological Treatments
Platelet-rich plasma therapy (PRP)
This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.
Steroid injections
These injections of steroids are given directly into the affected joint for severe pain when use of Non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.
Medications
To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.
Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them.
They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.
Anaesthesia
What types of anaesthesia are there?
The type of anaesthesia used will depend on the nature and duration of the procedure, your general medical condition, and your preference, your and those of your anaesthetist and surgeon or other doctor performing the procedure.
What is an anaesthetist?
A specialist anaesthetist is a fully qualified medical doctor who, after obtaining their medical degree, has spent at least two years working in the hospital system before completing a further five years of training in anaesthesia.
What is anaesthesia?
Relieving pain and suffering is central to the practice of anaesthesia, which involves administering medications to eliminate sensations, including pain.
How do I prepare for anaesthesia?
Make sure that you leave plenty of time to get to the hospital and the admissions area prior to your designated arrival time. There can often be a considerable waiting period at hospitals, so bring something to read or listen to and try to remain relaxed – as difficult as this may be! Your anaesthetist and the hospital staff are there to look after you.
Remember, if you have any concerns or questions please contact your anaesthetist prior to coming to hospital.
Depending on the type of operation, hospital or facility, this may not occur until immediately before your procedure. The anaesthetist will want to know:
1. How healthy you are and whether you have had any recent illnesses, with a particular focus on heart or respiratory problems.
2. What previous operations you have had and whether there were any problems with anaesthesia.
3. If you have had any abnormal reactions to any medications and whether you have any allergies.
4. Whether you have a history of reflux or heartburn, asthma, bronchitis, heart problems or any other medical conditions.
You may be given questionnaires to complete, or be asked questions by nurses, before seeing your anaesthetist. Your anaesthetist needs to have the best possible picture of you and your present condition so that the most suitable anaesthesia can be planned. Answer all questions honestly – it is really all about minimising risk to you.
1. Get a little fitter – regular walks will work wonders.
2. Don’t smoke – ideally, you need to stop six weeks before surgery. However, stopping for even 24 hours can help. Your GP may be able to assist.
3. If you are overweight, make a serious attempt to reduce your weight before your procedure.
5. Continue to take any medications which have been prescribed but remember to let your anaesthetist and surgeon know what they are.
If you don’t follow this rule of fasting, the operation may be postponed in the interests of your safety. Your surgeon, anaesthetist or the hospital will advise you how long to fast.
What about anaesthesia for joint replacement surgery?
The anaesthetist will consider several factors when planning your anaesthesia, including:
What are the risks and complications of anaesthesia?
Nevertheless, some patients are at an increased risk of complications because of health problems e.g. heart or respiratory disease, diabetes or obesity, age, and/ or because of the type of surgery which they are undergoing.
Infrequent complications include: bruising, pain or injury at the site of injections, temporary breathing difficulties, temporary nerve damage, muscle pain, asthmatic reactions, headaches, the possibility of some sensation or awareness during the operation (especially with caesarean section and some emergency procedures), damage to teeth and dental prostheses, lip and tongue injuries, and temporary difficulty in speaking.
Nausea and vomiting are quite common after certain types of surgery, and rare after other types. The type of anaesthesia used may also be a factor. Even with the use of modern medications, a small percentage of patients may experience nausea and vomiting that is difficult to control. If you have had difficulties in the past, please let your anaesthetist know.
There are also some very rare, but serious complications including: heart attack, stroke, seizure, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage, paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection from blood transfusion. Remember that these more serious complications, including death, are quite remote but do exist.
We urge you to ask questions. Your anaesthetist will be happy to answer them and to discuss the best way to work with you for the best possible outcome.
Your anaesthetist is aware of these risks and only uses blood transfusions when absolutely necessary. For major surgery, your anaesthetist may supervise a system of collecting your blood during or after your operation, processing it and returning it to you. This is called blood salvage and sometimes this can avoid the need for a transfusion.
Post-operative CARE
What is Osteoarthritis?
Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.
What causes Osteoarthritis?
With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.
What are the symptoms of Osteoarthritis?
Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.
Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
How is Osteoarthritis diagnosed?
Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.
X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.
What are non-surgical treatments?
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.
Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.
What are surgical treatments?
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.
Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).
Joint Replacement Surgery
What types of anaesthesia are there?
The type of anaesthesia used will depend on the nature and duration of the procedure, your general medical condition, and your preference, your and those of your anaesthetist and surgeon or other doctor performing the procedure.
What is an anaesthetist?
A specialist anaesthetist is a fully qualified medical doctor who, after obtaining their medical degree, has spent at least two years working in the hospital system before completing a further five years of training in anaesthesia.
What is anaesthesia?
Relieving pain and suffering is central to the practice of anaesthesia, which involves administering medications to eliminate sensations, including pain.
How do I prepare for anaesthesia?
Make sure that you leave plenty of time to get to the hospital and the admissions area prior to your designated arrival time. There can often be a considerable waiting period at hospitals, so bring something to read or listen to and try to remain relaxed – as difficult as this may be! Your anaesthetist and the hospital staff are there to look after you.
Remember, if you have any concerns or questions please contact your anaesthetist prior to coming to hospital.
Depending on the type of operation, hospital or facility, this may not occur until immediately before your procedure. The anaesthetist will want to know:
1. How healthy you are and whether you have had any recent illnesses, with a particular focus on heart or respiratory problems.
2. What previous operations you have had and whether there were any problems with anaesthesia.
3. If you have had any abnormal reactions to any medications and whether you have any allergies.
4. Whether you have a history of reflux or heartburn, asthma, bronchitis, heart problems or any other medical conditions.
You may be given questionnaires to complete, or be asked questions by nurses, before seeing your anaesthetist. Your anaesthetist needs to have the best possible picture of you and your present condition so that the most suitable anaesthesia can be planned. Answer all questions honestly – it is really all about minimising risk to you.
1. Get a little fitter – regular walks will work wonders.
2. Don’t smoke – ideally, you need to stop six weeks before surgery. However, stopping for even 24 hours can help. Your GP may be able to assist.
3. If you are overweight, make a serious attempt to reduce your weight before your procedure.
5. Continue to take any medications which have been prescribed but remember to let your anaesthetist and surgeon know what they are.
If you don’t follow this rule of fasting, the operation may be postponed in the interests of your safety. Your surgeon, anaesthetist or the hospital will advise you how long to fast.
What about anaesthesia for joint replacement surgery?
The anaesthetist will consider several factors when planning your anaesthesia, including:
What are the risks and complications of anaesthesia?
Nevertheless, some patients are at an increased risk of complications because of health problems e.g. heart or respiratory disease, diabetes or obesity, age, and/ or because of the type of surgery which they are undergoing.
Infrequent complications include: bruising, pain or injury at the site of injections, temporary breathing difficulties, temporary nerve damage, muscle pain, asthmatic reactions, headaches, the possibility of some sensation or awareness during the operation (especially with caesarean section and some emergency procedures), damage to teeth and dental prostheses, lip and tongue injuries, and temporary difficulty in speaking.
Nausea and vomiting are quite common after certain types of surgery, and rare after other types. The type of anaesthesia used may also be a factor. Even with the use of modern medications, a small percentage of patients may experience nausea and vomiting that is difficult to control. If you have had difficulties in the past, please let your anaesthetist know.
There are also some very rare, but serious complications including: heart attack, stroke, seizure, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage, paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection from blood transfusion. Remember that these more serious complications, including death, are quite remote but do exist.
We urge you to ask questions. Your anaesthetist will be happy to answer them and to discuss the best way to work with you for the best possible outcome.
Your anaesthetist is aware of these risks and only uses blood transfusions when absolutely necessary. For major surgery, your anaesthetist may supervise a system of collecting your blood during or after your operation, processing it and returning it to you. This is called blood salvage and sometimes this can avoid the need for a transfusion.
Arthroscopic Surgery
What are your business hours?
Our practice hours are from 8:00am to 5:00pm, Monday through Friday.
What is your contact phone number?
(02) 4229 9116
What is your practice location?
Practice Location
Loftus St (main entrance)
Wollongong 2521
Who do I call for appointments?
For all appointments and enquiries, please contact us on (02) 4229 9116.
Our practice hours are from 8am to 5pm Monday to Friday (excepting public holidays). Or request an appointment here
Where do I park for appointments?
Free parking is available onsite via the practice driveway off London Drive.
What if I need to cancel an appointment?
Telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.
What should I bring with me when I come for an appointment?
When you come for your appointment remember to bring the following:
-
Driver’s License or a valid ID -
Insurance information -
Referral Letter (if required) -
Reports, X-Rays, MRI’s, CT scans and any other relevant medical information -
List of medications (if any)
Does Dr Bhimani usually run on time?
We recognise that your time is valuable, and we make every effort to run on time. Occasionally emergencies or patients require a little more time, and these cause scheduling delays beyond our control. We apologise if we keep you waiting.
Should I make an appointment?
-
Do you have pain in your knees, hip or groin? -
Is the pain restricting your daily activities? -
Is the pain not relieved on taking medications? -
Do you have swollen knee? -
Do you limp while walking? -
Does pain makes you stop when you walk more than a few blocks? -
Are you having pain when lying or sitting down? -
Are you getting pain for about 3 to 4 days per week? -
Do your knees hurt when climbing or descending stairs? -
Do you feel pain when walking for long time? -
Does pain disturbs your sleep? -
Do you find difficult to put your socks and shoes? -
Do you have a sensation of instability or the knee is going to give out when you are physically active? -
Do you need crutches, cranes or walkers to help you while walking? -
Do you have tightness or limited range of hip motion?
What if I need imaging?
What can I do if am happy with the service I have received?
Am I likely to require surgery?
As a dedicated orthopedic surgeon Dr Bhimani always make sure his patients fully understand their condition, the treatment options available to them, as well as any risks or potential complications of a particular treatment. However it is crucial that patients understand that the decision to have any kind of orthopedic surgery is always theirs to make.
Once Dr Bhimani understands your diagnosis, you can both plan and agree on a sensible and holistic approach to treatment and rehabilitation for your best long-term results.
To accomplish these objectives for patients Dr Bhimani is extremely dedicated to ensuring he is at the forefront of developments in hip and knee surgery to provide patients with the best possible orthopaedic care.
Will physical therapy be required after surgery?
Dr Bhimani will choose the least invasive surgical procedure suited to your condition to minimise your recovery period. Dr Bhimani will ensure you understand what procedure you are having, how to prepare for surgery and what recovery program you need to follow. Physiotherapy is an essential part of this education, preparation and recovery process and will help you obtain a better surgical outcome.
Does Dr Bhimani see public and private patients?
Yes, Dr Bhimani sees both private and public patients.
What are Dr Bhimani's fees?
Anterior Cruciate Ligament (ACL) Injuries
What types of anaesthesia are there?
The type of anaesthesia used will depend on the nature and duration of the procedure, your general medical condition, and your preference, your and those of your anaesthetist and surgeon or other doctor performing the procedure.
What is an anaesthetist?
A specialist anaesthetist is a fully qualified medical doctor who, after obtaining their medical degree, has spent at least two years working in the hospital system before completing a further five years of training in anaesthesia.
What is anaesthesia?
Relieving pain and suffering is central to the practice of anaesthesia, which involves administering medications to eliminate sensations, including pain.
How do I prepare for anaesthesia?
Make sure that you leave plenty of time to get to the hospital and the admissions area prior to your designated arrival time. There can often be a considerable waiting period at hospitals, so bring something to read or listen to and try to remain relaxed – as difficult as this may be! Your anaesthetist and the hospital staff are there to look after you.
Remember, if you have any concerns or questions please contact your anaesthetist prior to coming to hospital.
Depending on the type of operation, hospital or facility, this may not occur until immediately before your procedure. The anaesthetist will want to know:
1. How healthy you are and whether you have had any recent illnesses, with a particular focus on heart or respiratory problems.
2. What previous operations you have had and whether there were any problems with anaesthesia.
3. If you have had any abnormal reactions to any medications and whether you have any allergies.
4. Whether you have a history of reflux or heartburn, asthma, bronchitis, heart problems or any other medical conditions.
You may be given questionnaires to complete, or be asked questions by nurses, before seeing your anaesthetist. Your anaesthetist needs to have the best possible picture of you and your present condition so that the most suitable anaesthesia can be planned. Answer all questions honestly – it is really all about minimising risk to you.
1. Get a little fitter – regular walks will work wonders.
2. Don’t smoke – ideally, you need to stop six weeks before surgery. However, stopping for even 24 hours can help. Your GP may be able to assist.
3. If you are overweight, make a serious attempt to reduce your weight before your procedure.
5. Continue to take any medications which have been prescribed but remember to let your anaesthetist and surgeon know what they are.
If you don’t follow this rule of fasting, the operation may be postponed in the interests of your safety. Your surgeon, anaesthetist or the hospital will advise you how long to fast.
What about anaesthesia for joint replacement surgery?
The anaesthetist will consider several factors when planning your anaesthesia, including:
What are the risks and complications of anaesthesia?
Nevertheless, some patients are at an increased risk of complications because of health problems e.g. heart or respiratory disease, diabetes or obesity, age, and/ or because of the type of surgery which they are undergoing.
Infrequent complications include: bruising, pain or injury at the site of injections, temporary breathing difficulties, temporary nerve damage, muscle pain, asthmatic reactions, headaches, the possibility of some sensation or awareness during the operation (especially with caesarean section and some emergency procedures), damage to teeth and dental prostheses, lip and tongue injuries, and temporary difficulty in speaking.
Nausea and vomiting are quite common after certain types of surgery, and rare after other types. The type of anaesthesia used may also be a factor. Even with the use of modern medications, a small percentage of patients may experience nausea and vomiting that is difficult to control. If you have had difficulties in the past, please let your anaesthetist know.
There are also some very rare, but serious complications including: heart attack, stroke, seizure, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage, paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection from blood transfusion. Remember that these more serious complications, including death, are quite remote but do exist.
We urge you to ask questions. Your anaesthetist will be happy to answer them and to discuss the best way to work with you for the best possible outcome.
Your anaesthetist is aware of these risks and only uses blood transfusions when absolutely necessary. For major surgery, your anaesthetist may supervise a system of collecting your blood during or after your operation, processing it and returning it to you. This is called blood salvage and sometimes this can avoid the need for a transfusion.
What is Arthritis?
Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.
What causes arthritis?
Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.
Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.
What is osteoarthritis?
The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.
It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.
What is rheumatoid arthritis?
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.
What is post-traumatic arthritis?
What is septic arthritis?
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.
What is psoriatic arthritis?
What is gouty arthritis?
Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.
What is Lyme arthritis?
Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.
What is Lupus arthritis?
Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.
What is Juvenile arthritis?
Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.
How is arthritis diagnosed?
Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:
-
Weakness (atrophy) in the muscles -
Tenderness to touch -
Limited ability to move the joint passively (with assistance) and actively (without assistance) -
Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis) -
A grating feeling or sound (crepitus) with movement -
Pain when pressure is placed on the joint or the joint is moved
How is arthritis treated?
There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.
What are the non-surgical treatments of arthritis?
Medications
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee.
What are the surgical treatments of arthritis?
In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.
There are a number of surgical procedures. These include:
-
Removing the diseased or damaged joint lining -
Realignment of the joints -
Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain -
Replacing the entire joint (total joint replacement)
How is arthritis managed long-term?
In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.
In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.
Arthritis
Osteoarthritis
What is Osteoarthritis?
Osteoarthritis, also known as "wear and tear" arthritis, occurs when the cartilage that cushions and protects the ends of your bones gradually wears away. This leads to pain and stiffness that worsens over time, making it difficult to do daily activities.
Osteoarthritis is the most common form of arthritis. It develops slowly and most often occurs during middle age.
Although there is no cure for osteoarthritis, there are many treatment options available to help manage pain and keep people staying active.
What causes Osteoarthritis?
With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that allowed the bones to glide easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.
Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis.
What are the symptoms of Osteoarthritis?
Osteoarthritis can affect any joint in the body including the joints of the spine. Symptoms may range from mild to disabling.
A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other as the joint moves. This causes the pain and inflammation. Pain or a dull ache develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.
The joint may stiffen and look swollen, enlarged or "out of joint." A bump may develop over the joint. Joint movements such as bending, straightening and rotation may become more difficult and loss of motion may follow.
Loose fragments of cartilage can interfere with the smooth motion of a joint. The joint may lock or "stick." It may creak, click, snap, or make a grinding noise (crepitus). An arthritic joint may weaken and weight bearing joints such as a knee or ankle may buckle and give way.
Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
How is Osteoarthritis diagnosed?
Although osteoarthritis cannot be cured, early diagnosis and treatment can help maintain joint mobility, relieve pain and improve function.
When you visit Dr Bhimani, a complete medical history, physical examination, x-rays, and possibly laboratory tests will be done.
Medical History
Dr Bhimani will want to know if the joint has ever been injured. Dr Bhimani will want to know when the joint pain began and the nature of the pain. Is the pain continuous, or does it come and go? Does it occur in other parts of the body? Is it worse at night? Does it occur only with activity or at rest as well?
Physical Examination
Dr Bhimani will then examine the affected joint in various positions to see if there is pain or
restricted motion. Dr Bhimani will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction. muscle loss (atrophy), and signs that other joints are involved. Dr Bhimani will look for signs of injury to muscles, tendons, and ligaments.
X-rays
X-rays can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help Dr Bhimani distinguish various forms of arthritis.
Laboratory Tests
Sometimes laboratory tests, such as blood tests, can help rule out other diseases that cause
symptoms similar to osteoarthritis.
What are non-surgical treatments?
Lifestyle Changes
Dr Bhimani may recommend rest or a change in activities to avoid provoking osteoarthritis pain. This may include modifications in work or sports activities. It may mean switching from high-impact activities (such as aerobics, running, jumping, or competitive sports) to low-impact exercises (such as stretching, walking, swimming, or cycling). A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle)
Medications
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, Dr Bhimani may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide short term relief of pain and swelling.
Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from
osteoarthritis.
Physical Therapy
A balanced fitness program, physical therapy, and/or occupational therapy may improve flexibility, increase range of motion, reduce pain, and strengthen the joint. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.
What are surgical treatments?
considered. The decision to treat surgically depends upon the age and activity level of the patient, he condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, osteotomy, joint fusion, and joint replacement.
Arthroscopy
Dr Bhimani uses a pencil-sized, flexible, fiberoptic instrument (arthroscope) to make two or three small incisions to remove bone spurs, cysts, damaged lining, or loose fragments in the joint.
Osteotomy
The long bones of the arm or leg are realigned to take pressure off of the joint.
Joint replacement
Dr Bhimani removes parts of the bones and creates an artificial joint with metal or plastic
components (total joint replacement or arthroplasty).
Rheumatoid Arthritis
What types of anaesthesia are there?
The type of anaesthesia used will depend on the nature and duration of the procedure, your general medical condition, and your preference, your and those of your anaesthetist and surgeon or other doctor performing the procedure.
What is an anaesthetist?
A specialist anaesthetist is a fully qualified medical doctor who, after obtaining their medical degree, has spent at least two years working in the hospital system before completing a further five years of training in anaesthesia.
What is anaesthesia?
Relieving pain and suffering is central to the practice of anaesthesia, which involves administering medications to eliminate sensations, including pain.
How do I prepare for anaesthesia?
Make sure that you leave plenty of time to get to the hospital and the admissions area prior to your designated arrival time. There can often be a considerable waiting period at hospitals, so bring something to read or listen to and try to remain relaxed – as difficult as this may be! Your anaesthetist and the hospital staff are there to look after you.
Remember, if you have any concerns or questions please contact your anaesthetist prior to coming to hospital.
Depending on the type of operation, hospital or facility, this may not occur until immediately before your procedure. The anaesthetist will want to know:
1. How healthy you are and whether you have had any recent illnesses, with a particular focus on heart or respiratory problems.
2. What previous operations you have had and whether there were any problems with anaesthesia.
3. If you have had any abnormal reactions to any medications and whether you have any allergies.
4. Whether you have a history of reflux or heartburn, asthma, bronchitis, heart problems or any other medical conditions.
You may be given questionnaires to complete, or be asked questions by nurses, before seeing your anaesthetist. Your anaesthetist needs to have the best possible picture of you and your present condition so that the most suitable anaesthesia can be planned. Answer all questions honestly – it is really all about minimising risk to you.
1. Get a little fitter – regular walks will work wonders.
2. Don’t smoke – ideally, you need to stop six weeks before surgery. However, stopping for even 24 hours can help. Your GP may be able to assist.
3. If you are overweight, make a serious attempt to reduce your weight before your procedure.
5. Continue to take any medications which have been prescribed but remember to let your anaesthetist and surgeon know what they are.
If you don’t follow this rule of fasting, the operation may be postponed in the interests of your safety. Your surgeon, anaesthetist or the hospital will advise you how long to fast.
What about anaesthesia for joint replacement surgery?
The anaesthetist will consider several factors when planning your anaesthesia, including:
What are the risks and complications of anaesthesia?
Nevertheless, some patients are at an increased risk of complications because of health problems e.g. heart or respiratory disease, diabetes or obesity, age, and/ or because of the type of surgery which they are undergoing.
Infrequent complications include: bruising, pain or injury at the site of injections, temporary breathing difficulties, temporary nerve damage, muscle pain, asthmatic reactions, headaches, the possibility of some sensation or awareness during the operation (especially with caesarean section and some emergency procedures), damage to teeth and dental prostheses, lip and tongue injuries, and temporary difficulty in speaking.
Nausea and vomiting are quite common after certain types of surgery, and rare after other types. The type of anaesthesia used may also be a factor. Even with the use of modern medications, a small percentage of patients may experience nausea and vomiting that is difficult to control. If you have had difficulties in the past, please let your anaesthetist know.
There are also some very rare, but serious complications including: heart attack, stroke, seizure, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage, paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection from blood transfusion. Remember that these more serious complications, including death, are quite remote but do exist.
We urge you to ask questions. Your anaesthetist will be happy to answer them and to discuss the best way to work with you for the best possible outcome.
Your anaesthetist is aware of these risks and only uses blood transfusions when absolutely necessary. For major surgery, your anaesthetist may supervise a system of collecting your blood during or after your operation, processing it and returning it to you. This is called blood salvage and sometimes this can avoid the need for a transfusion.