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Bio Medical Waste Report For Shalimar Bagh

Month Red Autoclave(Infected Plastic Waste) Yellow- Incineration(AnatomicalWaste & Soiled Waste) Blue Autoclave (Glass- Bottles) Black Cytotoxic- Incineration( Cytotoxic Contaminated Items) White- Sharp Total Bags Total Weight(In KG's)
  No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's)    
Apr-17 924 2963.50 954 2994.10 239 1017.30 103 279.20 1645 606.40 3865 7861.00
May-17 1175 4624.12 1028 3498.40 276 1524.34 87 195.01 1803 823.85 4369 10665.71
Jun-17 1060 4511.45 902 2886.66 293 1324.05 76 194.00 2057 1100.69 4388 10016.85
Jul-17                     0 0.00
Aug-17                     0 0.00
Sep-17                     0 0.00
Oct-17                     0 0.00
Nov-17                     0 0.00
Dec-17                     0 0.00
Jan-18                     0 0.00
Feb-18                     0 0.00
Mar-18                     0 0.00
YTD 3159 12099.065 2884 9379.155 808 3865.69 266 668.705 5505 2530.94 12622 28543.555

Orthopaedics and Joint Replacement

Home >> Taxonomy >> Orthopaedics and Joint Replacement

Clinical Directorate

For more info please call 8744 888 888 (Delhi – NCR) & 9988 422 333 (Chandigarh Tri-city), or mail at homecare@maxhealthcare.com

At Max Institute of Orthopaedics & Joint Replacement Surgery, our primary objective is "early mobilisation, minimal discomfort". This state-of-the-art specialised health care facility is designed to provide the highest levels of professional expertise and patient care. Here, every patient is tended to by a multi-disciplinary unit.

Tips for a Healthy Back

June 11, 2015 0 76 2 minutes, 17 seconds read

Back pain problems are endemic in today’s world. Many of these are lifestyle related – sedentary life, obesity, long hours of sitting. Fortunately, these are easily resolved.

How do we prevent back problems and stay healthy? Here are some tips.


  • The normal spine is a balanced construct with a double S curve; the head is supported on top of these curves. When the spine is unbalanced, muscles, ligaments and joints have to work harder. Fatigue and pain are inevitable.
  • Avoid prolonged sitting.
  • Walk around from time to time.
  • Raise and rest one foot on a block about six or eight inches high when standing.
  • If you have been bending forwards, stretch and bend backwards.
  • Crouch periodically to relax your back.


  • Sleep in a comfortable position; a pillow under the knees helps.
  • Mattress should be firm and supportive.
  • Remember mattresses have a limited life span and need replacing periodically.
  • Sleep adequate hours.


  • Maintain the weight that is ideal for your height.
  • Eat a balanced diet and drink plenty of water.
  • Drink adequate fluids to maintain proper hydration.
  • Take a calcium rich diet.
  • Expose your bare skin to the sun for 20 minutes to manufacture vitamin D.


  • Start with a daily brisk walk and with basic PT exercises taught in school
  • Specific back exercises for the back are extension and flexion exercises. Extension exercises are done by lying on the tummy and raising one leg and thigh and holding it for six seconds each time. One can also raise the upper body while keeping the pelvis on the couch. Each time the body is put to maximum contraction and held for six seconds to have the best toning of the muscles.
  • Flexion exercises are done by lying on the back and raising the straight leg; this stretches the nerve root and conditions the nerve. In this position, bend the legs fully, raise the pelvis to maximum height, and hold for six seconds. Lastly, in standing position raise the arms in front and half squatting and holding there for six seconds.
  • All exercises should be done in gradual, gentle manner to start and become tougher as the body gets conditioned. It may be wise to take the guidance of a physiotherapist while doing exercises.


  • Most of the back problems arise as result of unprotected bending forward. This is avoided by working on a workstation at the correct height.
  • Be especially cautious when making beds!
  • When sitting, the spine should be well supported, in the chair; the knees are at the same level as the hips and the feet rest flat on the ground.
  • The table should be at the correct height.

Pain, numbness, weakness, disability, associated fever, unexplained weight loss are reasons to see your doctor.

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Bone Disease in Women : Essential Facts !

June 11, 2015 0 68 4 minutes, 4 seconds read

Bone disease is a silent, disabling condition that develops through a woman’s life as age progresses.

Osteopenia refers to early signs of bone loss that can turn into osteoporosis. With osteopenia, bone mineral density (thickness) is lower than normal. However, it is not yet low enough to be considered osteoporosis.

It is important to remember that not everyone who has osteopenia develops osteoporosis. But osteopenia can turn into osteoporosis. Osteoporosis can result in easily fractured bones and other very serious bone problems. It can also cause disfigurement and lead to loss of mobility and independence.

With ageing, your body absorbs back the minerals from your bones, leading to weaker bones and making them vulnerable to fractures and other damage.

How is Osteopenia Diagnosed?

Bone health is measured in two ways.

The first is bone density. Bone density defines the thickness of your bone.

The second is bone mass. Bone mass means how much bone you have. Bone mass, or the amount of bone you have, usually peaks around age 30. Then bone mass begins to decline. Your body starts to reabsorb bone faster than new bone can be made.

To find bone density, blood tests are done to measure the levels of minerals in your bones like:

  • Calcium
  • Phosphate
  • Vitamin D and its analogues

The denser the content of your bone mineral is, the stronger your bones are.

What are some risk factors for Osteopenia and Osteoporosis?

Risk factors for developing osteopenia are the same as those for developing osteoporosis. They include:
  • Being female
  • Being thin and/or having a small frame
  • Getting too little calcium in the diet
  • Smoking
  • Leading an inactive lifestyle
  • A history of anorexia nervosa
  • A family history of osteoporosis
  • Heavy alcohol consumption
  • Early menopause

Most people with osteopenia don't know they have it. In fact, the first sign may be a broken bone. A broken bone may mean that the condition has already become osteoporosis.

How can my Doctor Test for Osteopenia and Osteoporosis?

The most accurate way to diagnose osteopenia and osteoporosis is through bone mineral density testing. This is usually done with a dual-energy X-ray absorptiometry (DEXA) scan.

DEXA scan results are reported as T-scores:
  • Normal bone: T-score above -1
  • Osteopenia: T-score between -1 and -2.5
  • Osteoporosis: T-score of -2.5 or lower

Other tests can be done to help diagnose osteoporosis and osteopenia. Quantitative ultrasound is one such test. It measures the speed of sound in the bone to assess bone density and strength. However, DEXA scans are usually still needed to confirm results from ultrasound and other tests.

Who should get a Bone Density Test?

It is recommended that that you receive screening bone density scans if:

  • You are a woman 65 or older
  • You are a woman 60 or older with certain risk factors that put you at increased risk of fracture

The Female Athlete Triad and Osteopenia

The female athlete triad is a combination of three medical conditions that are becoming increasingly common in young female athletes. These conditions are eating disorders, amenorrhea -- or lack of menstrual periods, and osteopenia or low bone mass. These issues are of growing concern mainly because of the media's increased pressure on teens to maintain a "perfect" body weight and be thin.

Female athletes who compete in gymnastics, dancing, swimming, skating, and running are at high risk for the female athlete triad as they strive to appear lean and fit.

We know that more female athletes lack a menstrual period than women in the general population.

Not having a period is associated with decreased estrogen levels. Decreased estrogen levels may also be the cause of low bone mass or osteopenia.

Low-calorie diets are usually the first predictor of eating disorders. Excessive exercise or exercise obsession can be another sign of an eating. Each of these three problems must be medically evaluated and treated to ensure a good outcome for the woman.

How can I prevent Osteopenia and Osteoporosis?

Osteopenia is every woman's concern -- no matter what your age or health status. That's because osteopenia is the first step to full-blown osteoporosis or severe bone loss.Moreover, fractures don't wait until you have osteoporosis. The risk of fractures increases as your bone density decreases. Once you have just one fracture, you are at a greater risk for more fractures. The good news is that osteopenia can be prevented or reversed before fractures occur.

Here are some prevention tips:
  • Eat a balanced diet. Include plenty of calcium and vitamin D. You'll find these nutrients in foods like milk, yogurt, cheese, and broccoli.
  • Exercise regularly. Choose weight-bearing exercise like walking or running. Also do strength training using weights or resistance bands.
  • Avoid smoking.
  • If you drink, do so in moderation.
  • If you have gone through menopause, talk to your doctor about the newer osteoporosis.
  • medications. Depending on your individual health and risk factors, he or she might recommend an osteoporosis medication.

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Save yourself from Arthritis

July 1, 2014 0 81 2 minutes, 20 seconds read

Let's save our Generation Next from arthritis pain, says Dr Manuj Wadhwa, Director and Head, Max Elite Institute of Orthopedics and Joint Replacement Surgery. Arthritis affects over 15% approximately 180 million people in India, which is higher than many well-known diseases.

While much has been said about the high incidence of Diabetes, Hypertension, Cancer and HIV in India, recent studies suggest that Osteoarthritis beats them all to claim the no. 1 slot among ailments in the country.

Contrary to the misconception that arthritis only impacts the elderly, this disorder is increasingly found in the younger population. Age is not a factor for arthritis; it can affect young and old alike. Earlier, arthritis patients would be around 65 years or so, but now the younger lot in the age group of 40-45 yrs which is normally considered to be in their golden years are increasingly turning up for surgery. Higher levels of stress coupled with modern day lifestyles are increasing the incidence of Arthritis. The best way to beating Arthritis is by staying active.

The key to arthritis management is finding a balance between activities and rest-exercising, as too much may stress sensitive joints while being too sedentary can cause stiffness and immobility. Stretching and gentle movements such as Yoga are easy on the joints and keep them fluid and supple.

Exercises such as riding a bike, swimming and water aerobics keep the heart healthy and muscles strong while putting too much pressure on the joints. Low impact exercises allow you to work your muscles without stressing your joints.Stretching often increases muscle tone and can help boost the range of motion of your joints. Just make sure you warm up your muscles and joints before stretching before warming up can further aggravate joint pain and even strain your muscles. By varying activities and following a well-rounded exercise routine with variety can help to maintain strength and protect your joints.

Maintaining a healthy weight can reduce stress on your joints, especially weight-bearing joints like your hips and knees. In addition, this can slow down the wear on your joints during daily activities such as walking.

When you have experienced a joint injury, protecting that joint will lower the chances of developing arthritis later. By taking care not to injure the joint again, you may also decrease the intensity of symptoms should arthritis develop later. Remember always listen to your body, Stop exercising if you experience sharp pain and don't try to work through joint discomfort.

Find activities that are gentle on the body and take them at a comfortable pace. Lastly but not the least, Drinking enough water keeps the cartilage in joints lubricated so bones don't rub up against each other. By eating foods rich in vitamin C and E and calcium, you'll help build a musculoskeletal system that can outlast degenerative conditions.

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Dr. Kutbuddin Akbary

Dr. Kutbuddin Akbary
Consultant Spine Surgeon –MIMS & Orthopedics
Dr. Kutbuddin Akbary
  • AO Spine
  • Association of Spine Surgeons of India (ASSI)
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Work Experience: 
  • Consultant Spine and Endoscopic Spine Surgeon, Wockhardt Hospital, Mumbai Central, 2019-2020
  • Senior Clinical Fellow in Spine Surgery, National University Hospital, Singapore, 2018-2019
  • Minimally Invasive and Endoscopic Spine Surgery Fellowship, Seoul St Mary’s Hospital at the Catholic University, Seoul, South Korea, 2017-2018
  • Consultant (Spine Surgeon), GBH American hospital, Udaipur, 2016 – 2017
  • Spine Foundation Fellowship at Breach Candy, Wockhardt, Lilavati and VN Desai Municipal Hospitals, Mumbai, 2014 - 2016
Education & Training: 
  • M.S Orthopedics (2013), University of Delhi
  • M.B.B.S (2008), University of Delhi
Awards Information: 
  • Master Class Training Course for Full Endoscopic Surgery of the Lumbar Spine at the Catholic International Bioskills Education Centre, The Catholic University of Korea and Seoul St. Mary’s Hospital, 5th & 6th July 2019
  • National University Hospital Spinal workshop 15th Advance cervical spine course, in Singapore- 3-4 Nov 2018
  • World Endoscopic Spine society Annual Conference and Cadaveric workshop on Endoscopic  Spine surgery with Dr Jean Destandau in New Delhi,1-3 Sep 2017.
  • C1-C2 Fixation Techniques cadaveric workshop  at the 29th ASSICON Goa, Nov 2015
Duration Of OPD: 

       Max Super Specialty Hospital, Gurgaon

  • Monday - 4 PM - 6 PM
  • Tuesday – 12 PM – 4 PM
  • Wednesday - 9 AM – 12 PM

       Max Smart Super Speciality Hospital, Saket

  • Wednesday – 4 PM – 7 PM
  • Thursday – 9 AM – 12 PM
Research & Publication: 
  • Akbary K, Quillo-Olvera J, Lin GX, Jo HJ, Kim JS. Outcomes of minimally invasive oblique lumbar interbody fusion in patients with lumbar degenerative disease with rheumatoid arthritis. J Neurological Surgery- A (Central European Neurosurgery). 2019 May ;80(3):162-168
  • Akbary K, Kim JS, recent technical advancements of Endoscopic Spine Surgery with disparate or disruptive technologies and patents, World Neurosurgery, 2020 Jul 17 ;S1878-8750(20)31579-5
  • Akbary K, Kim JS, Park CW, Jun SG, Hwang IC. The Feasibility and Perioperative Results of Bi-Portal Endoscopic Resection of The Facet Cyst Along with Minimizing Facet Joint Resection in The Degenerative Lumbar Spine. Operative Neurosurgery 2019 Sept 24. PII: opz262

How to maintain bone and joint health during winters?

December 4, 2020 0 1 minute, 29 seconds read

Motion is life and you need stronger bones and flexible joints to do that. With the onset of winter, the problems of bones and joints ought to increase. It is usually due to restricted absorption of Vitamin D (sunlight) in your body during winter or due to decreased blood flow to bones to increase body temperature or due to restricted mobility to conserve energy which allows accumulation of inflammatory markers or toxins in joints. This leads to stiffness and pain in joints. Ignoring problems related to bones and joints which can lead to further deterioration.

These are few tips to keep your joints and muscles healthy during this winter

1) A balanced diet is key to overall healthy living. Eat a diet which comprises of fruits, vegetables, cereals, dairy products and pulses.

2) Eat foods rich in Vitamin K, D and C.

Examples of some foods rich in Vitamin D are fatty fish, egg yolks, milk and cheese. Some foods rich in Vitamin K are green leafy vegetables like broccoli, spinach, cabbage and kale. Some foods rich in Vitamin C are oranges, lemons, strawberry and kiwi.

3) Physical activity is also important. Exercising strengthens the muscles and maintains weight.

4) Do not over eat and reduce weight

5) Take shower with warm water

6) Dress warmly: Depending on the climate in your city, choose to wear warm winter clothes or dress in layers. Always ensure that you cover your hands, knees, legs and all arthritis prone area

7) Stay hydrated, 3ltr a day a is good way to go.

8) Increase your intake of omega-3 fatty acids which include avocado, flaxseeds, walnuts and fish in your diet.

Enjoy winter while taking the above precautions for Arthritis. If you are facing extreme discomfort in your joints due to arthritis, do consult experts for Bone and Joint.

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Knee Injuries

October 16, 2020 0 4 minutes, 4 seconds read

Anatomy of the knee

Bony Anatomy:The knee joint is the point where three bones meet. The thigh bone (femur), leg bone (tibia) and knee cap or patella. The thigh and leg bone glide over each other facilitating loading of the knee (bearing weight) and movement of the knee joint. The knee cap (patella) is convex on the part that glides over a groove (concave portion) on the thigh bone called the trochlea.

Muscular Anatomy:The knee cap has the thigh muscles (quadriceps mechanism) attached to it on its upper aspect and a rope like structure(tendon) that attaches it to the leg bone. This mechanism acts as a lever and facilitates movement of the knee joint. The effort being the quadriceps muscle, the patella the fulcrum and the patellar tendon bearing the load which is the movement of the leg bone over the thigh bone during bending of the knee.

Soft Tissue Anatomy: All three bony surfaces are covered with a 1cm thick layer of polish called cartilage. This facilitates very little friction during movement. Apart from this there are two ‘C’ shaped cushions between the thigh and leg bone, one on the inside of the knee and the other on the outside. These act as shock absorbers reducing the load that is directly transmitted to the cartilage and bone, much like shock absorbers in a bike. To keep both the thigh bone and leg bone together facilitating them to be stable are four ropes called ligaments.

Ligaments: One on the inside: medial collateral ligament (MCL)

One on the outside: lateral collateral ligament

Two in the centre crossing each other: Anterior and posterior cruciate ligaments


These can be broadly classified into:

1. Bony

2. Soft Tissue

Bony Injuries: These refer to fractures of the femur, tibia or patella. Bones break either into two pieces (simple fractures) or multiple pieces (comminuted fractures). They may be associated with a wound of varying size that communicates with the fracture making it an open fracture. If not they are called closed fractures. Bone may break at points where ligaments or tendons are attached to them, these injures are called avulsion injuries. If the pieces have not moved much from their original location, the fractures are called minimally displaced/undisplaced , if they have moved away from their original location they are called displaced fractures. Fractures that communicate with the joint are called intra articular fractures and those that do not extra articular fractures

Diagnosis: The patient typically will have an antecedent injury followed by pain inability to move the limb, swelling and deformity. Diagnosis is confirmed by doing x rays of the part including the joint above and below the injury. Sometimes fractures may not be visible on an Xray clearly, eg: an undisplaced crack fracture. Then doing a CT scan helps.

Treatment: Treatment largely involves the nature of the fracture, location and displacement.

Soft Tissue Injuries

Ligament Injuries:

ACL/PCL Tear: The anterior cruciate ligament prevents the leg bone from moving forward on the thigh bone. It has a tendancy to get injured when the knee goes into hyperextension or twists during a sporting activity/ two wheeler accident. The ligament can tear off its attachment on the thigh bone, through its middle or through its attachment on the leg bone.

Treatment: Low key persons can be treated conservatively with rehabilitation. However if there is an associated meniscus tear or the individual wants to lead a sporting/active lifestyle, the ligament needs to be repaired/ reconstructed.

This is done by keyhole (arthroscopic) surgery. Spare tendons in the body like the patellar tendon/hamstring tendons are harvested and prepared into new ligaments. These are placed into the knee by drilling tunnels into the thigh and leg bone. The new ligament is fixed with a button on the thigh bone and a screw (plastic) on the leg bone.

Sometimes if the ligaments is avulsed from the thigh or leg bone, it can be fixed back using arthroscopic techniques.

MCL/LCL Tear: these ligaments lie external to the knee joint, preventing the knee from moving sideways. They can be injured by excessive sideward movement of the leg bone that causes these ligaments to break. They can break through their mid substance and attachments at either ends.

Treatment: Ligament injuries through the substance or attachments through the thigh bone have a better tendancy to heal without surgery. However persistent instability warrants repair/ reconstruction of the same. When associated with another ligament injury meniscus injury operative treatment is imperative.

Meniscus Injuries

The meniscus have a tendancy to tear in isolation or in association with ligament tears.

Sometimes they spontaneously tear (degenerate) as the patient ages.

Treatment: Injury related tears can be treated by either partially removing the meniscus or repairing it via keyhole (arthroscopic) techniques. Degenerative tears are usually treated without surgery unless they produce mechanical symptoms like something is getting stuck in the knee /locked.

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Dr. Aditya Sharma

Dr. Aditya Sharma
Senior Consultant - Orthopaedics Sports Injury and Joint Replacement
Dr. Aditya Sharma
  • Life Member, Indian Orthopaedic Association
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Work Experience: 
  • Senior Consultant Orthopedics & Chief of Sports Injuries at PRIMUS Super Speciality Hospital (2013-2020)
  • Consultant (Orthopaedic) at Medanta the Medicity (2012-2013)
  • Fellow (Joint replacement and sports injuries) at Medanta The Medicity (2011-2012)
  • Fellow (Navigation assisted Joint replacement surgeries) with joint masters at Breach Candy and Lilavati Hospital, Mumbai (Feb-Jun 2011)
  • Senior Resident at Lokmanya Tilak General Hospital, Mumbai (June 2010-Jan 2011)
  • Orthopaedic Surgeon in Lokmanya Tilak General Hospital, Sion, Mumbai
Education & Training: 
  • MBBS - MGM Medical College Indore (2007)
  • MS (Orthopaedic Surgery) - Lokmanya Tilak General Hospital, Mumbai (2010)
Duration Of OPD: 

       Max Super Speciality Centre, Noida

  • Wednesday : 1pm – 4 pm
Research & Publication: 
  • Advanced arthroscopic knee procedures training at Singapore
  • Advanced shoulder arthroscopic procedures at Japan
  • Advanced shoulder arthroscopic procedures at South Korea
  • AO Trauma Fracture Management – 2014
  • Ipsilateral multiple costovertebral joint dislocation: Case report and review of literature (Journal of Surgery and Allied Sciences, April-June, 2020)
  • Teriparatide for rapid healing of osteochondral defect with Mosaicplasty (Case study newsletter of Virchow April 2016)

Dr. Ashok Kumar

Dr. Ashok Kumar
Dr. Ashok Kumar
  • Life Member IOA (Indian Orthopedic Association)
  • Life member IMA (Indian Medical Association)
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Work Experience: 
  • 10 years in Max Super Speciality Hospital, Gurgaon.
  • Worked for 3 years as Sr. Resident in DDU Hospital Delhi.
Education & Training: 
  • MBBS PGIMS Rohtak Haryana.
  • Diploma in Orthopaedics PGIMS Rohtak Haryana
Duration Of OPD: 

       Max Super Speciality Hospital, Gurgaon

  • Sun: 10:00AM-2:00PM
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