Max Institute of Musculoskeletal Sciences & Orthopaedics

ACL is also known as Anterior Cruciate Ligament, which refers to an injury in this specific ligament that runs diagonally across the middle of your knee. The major role of this ligament is to protect the tibia from sliding out in front of the femur and also aids in rotational knee stability. During an ACL injury, other cartilage and ligaments that are surrounding it are also affected. In most cases, the tear is partial but there are many causes of a complete tear as well.This is one of the most common injuries to the knee and is often experienced by people involved in serious sports activities. Specifically, basketball, soccer, and football athletes are the ones who face this knee injury. In fact, it is more frequent in women majorly because of the difference in physical conditioning, muscular strength, and neuromuscular control.

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An aneurysmal bone cyst (ABC) is a benign, blood-filled lesion that can develop within bones. Despite its name, it is not a true cyst but rather a bone tumour that can cause bone expansion and thinning. ABCs are most commonly found in the long bones, such as the tibia and the spine, though they can occur in any bone, including the jaw. These cysts are often discovered in individuals under the age of 20, but they can also be present in adults. Symptoms of an Aneurysmal Bone Cyst Symptoms of an aneurysmal bone cyst depend on the location and size of the cyst: Pain: The most common symptom, often worsening with activity. Swelling: A noticeable lump may form over the affected bone. Limited mobility: ABCs in the spine or joints can restrict movement. Fractures: Weakened bones may lead to fractures, especially with larger cysts. In some cases, an aneurysmal bone cyst in the spine can cause neurological symptoms due to compression of the spinal cord. Causes of Aneurysmal Bone Cysts The exact cause of aneurysmal bone cysts remains unknown. However, several factors may contribute to their development: Genetic mutations: Some cases of ABCs have been linked to genetic mutations that lead to abnormal blood vessel formation within the bone. Trauma: Although not a direct cause, trauma to a bone may trigger the development of an ABC in susceptible individuals. How is an Aneurysmal Bone Cyst Diagnosed? Diagnosis typically involves imaging studies and sometimes a biopsy: X-ray: A common first step, x-rays can reveal the characteristic "soap bubble" appearance of ABCs. MRI and CT scan: These advanced imaging techniques provide detailed views of the cyst's size, location, and impact on surrounding tissues. Biopsy: In certain cases, a biopsy may be required to confirm the diagnosis and rule out malignancy. What Surgery Treats Aneurysmal Bone Cysts? Surgery is often the treatment of choice for aneurysmal bone cysts, especially in symptomatic cases. The surgical approach depends on the cyst's size, location, and potential complications: Curettage: This is the most common procedure where the surgeon scrapes out the cyst from the bone. Often, the cavity is filled with bone grafts or bone cement to stabilise the area. Resection: In cases where the cyst is large or located in a critical area, complete resection of the affected bone segment may be necessary. Embolization: For ABCs in complex locations, like the spine, pre-surgical embolization (blocking blood flow to the cyst) may reduce bleeding during surgery. What Happens During Curettage for Aneurysmal Bone Cysts? During curettage, the surgeon: Makes an incision to access the bone. Scrapes out the cystic tissue from the bone cavity. Fills the cavity with bone grafts, bone cement, or other materials to promote healing and bone strength. Closes the incision, allowing the bone to heal over time. Outlook The prognosis for individuals with aneurysmal bone cysts is generally favourable, especially with prompt treatment. The recurrence rate after surgery varies, with curettage alone having a higher recurrence rate than when combined with other treatments like bone grafting. In rare cases, untreated or recurrent ABCs can lead to significant complications, including bone deformities or fractures. Frequently Asked Questions What age is aneurysmal bone cyst common?  Aneurysmal bone cysts are most common in individuals under 20, but they can occur at any age. How long does it take to recover from an aneurysmal bone cyst?  Recovery time varies depending on the treatment method. Most patients can expect to recover within a few months to a year. How do you treat aneurysmal bone cysts without surgery? Sclerotherapy is a minimally invasive method for treating aneurysmal bone cysts. Rather than opting for surgical removal, doctors administer specific chemicals directly into the cyst to stimulate the formation of scar tissue. Over time, this scar tissue matures and solidifies into bone, effectively resolving the cyst without the necessity of open surgery. What are the complications of an aneurysmal bone cyst?  Complications may include bone fractures, deformities, and, in rare cases, neurological symptoms if the cyst compresses nearby nerves or the spinal cord. Do aneurysmal bone cysts grow?  Yes, if left untreated, aneurysmal bone cysts can grow and expand, leading to further bone weakening and potential complications. How Can I Prevent an Aneurysmal Bone Cyst? There is no known method to prevent aneurysmal bone cysts, as their exact cause remains uncertain. However, early detection and treatment can prevent complications like fractures and severe pain. Review  Reviewed By  Dr L Tomar - Principal Director and Unit Head department of Orthopaedic and Joint Replacement on 03 Sept 2024.

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Arthritis is inflammation of joints, which refers to diseases that affect joints and connective tissue around joints. The most common form, osteoarthritis (a degenerative joint disease), is a result of joint trauma, joint infection, or age. Some other forms of arthritis include rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Arthritis Symptoms There are different types of arthritis, so the symptoms also vary. The symptoms range from mild to severe and may be intermittent or remain throughout life. The most common symptoms of arthritis are: Joint pain Joint swelling Redness of the skin around a joint Decreased range of motion Stiffness, especially in the morning Limited movement Warmth Tenderness Pain while moving. Arthritis Causes The cause of arthritis depends on its type. Following are some of the major causes of arthritis: Faulty immune response in which immune cells damage the body’s own cells. Metabolic disturbances such as an increase in uric acid. Obesity Repetitive movements History of injury Different Types of Arthritis  Osteoarthritis- The most common type of arthritis, osteoarthritis is also known as Degenerative Joint Disease (DJD)/wear-and-tear arthritis. Most commonly, it affects weight-bearing joints such as the knee. Rheumatoid Arthritis (RA)- Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the body’s own cells, resulting in joint pain and swelling. Childhood Arthritis- It is also known as Juvenile Idiopathic Arthritis. As the name suggests, it is inflammation of joints in children, and it can permanently damage joints, making it difficult to walk. Fibromyalgia- Fibromyalgia is a disorder that causes musculoskeletal pain and is often accompanied by altered sleep, fatigue, and mood issues. It is generally triggered by physical or emotional stress. Gout- It is caused due to an increase in uric acid in the body. Excess uric acid converts into crystals that cause pain and inflammation of joints. Lupus- Lupus is a condition in which a faulty immune response leads to damage to body cells, and it can affect joints, blood cells, skin, heart, lungs and brain.  Risk Factors for Arthritis Family history- Arthritis can run in families and be passed on from one generation to another. Age- With advancing age, the risk of arthritis increases. Your sex- Most arthritis affects women more than men, but some types of arthritis, such as gout, affect men more than women. Previous joint injury- A history of injury increases the risk of arthritis. Obesity- Obesity can affect weight-bearing joints and may be one of the more significant risk factors for arthritis. How is Arthritis Diagnosed?  Arthritis is diagnosed with the help of the following modalities: Physical examination- The doctor checks for redness, swelling and warmth. Laboratory examination- The following lab tests may be used to diagnose arthritis: - Antinuclear antibody - Complement tests - Arthrocentesis - Complete blood count - C-reactive protein - Creatinine - Erythrocyte sedimentation rate - Rheumatoid factor - Urinalysis - Uric acid test - Haematocrit Imaging techniques - X-Ray- It helps identify bone damage and deformities. - Ultrasound- Ultrasound helps to assess ligament, tendon and synovial tissue. - Magnetic Resonance Imaging (MRI)- Magnetic Resonance Imaging (MRI) are better than X-Ray as they give a better picture of damage and deformities. - Arthroscopy- Arthroscopy is a procedure used to see the inside of a joint using a small camera called an arthroscope. It requires a small incision to allow the insertion of a camera and helps detect bone diseases and tumours. Arthritis Treatment Arthritis is treated with medications and physiotherapy. But when conservative treatment does not provide relief, surgery may be advised. Medications- The following medications may be used to treat arthritis: - NSAIDs- Certain over-the-counter pain-relieving medications can provide pain relief. Doctors may suggest stronger medications that are available only on prescription. - Topical ointments- The doctor may advise the patient to apply ointments containing capsaicin or menthol for pain relief. - Corticosteroids- Injection of corticosteroids may be given directly into the joint, and it is sometimes combined with local anaesthesia to provide pain relief. - Disease-modifying antirheumatic drugs (DMARDs)- It is given to treat the underlying cause of arthritis and provide pain relief. It is given to patients with autoimmune diseases such as rheumatoid arthritis. Physical therapy- The doctor may refer the patient to a physiotherapist who will help the patient with strengthening exercises. The physiotherapist may also use ultrasound and TENS to provide pain relief. Surgery- One of the following surgeries may be advised:  Osteotomy- In Osteotomy procedure, the damaged bone piece is removed, and joint surfaces are scraped and smoothened. Joint replacement- Joint replacement surgery involves the replacement of the joint with an artificial joint. Joint fusion- It is a treatment modality most commonly used for smaller joints such as the ankle and wrist. The doctor may use rods, wires, plates or pins to join the two bones and make a continuous joint. Review Reviewed by Dr. Vikas Gupta, Director - Orthopaedics and Head - Hand & Shoulder Surgery, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury.

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Back pain is one of the most common medical conditions affecting young and old people across the globe. The common causes of back pain can include: Mechanical back pain: The pathology lies in the muscles or the bones of the lower back region or the intervertebral disc. Non-mechanical back pain: There is a progressive loss of sensation or any weakness in muscle power, which may be due to long-standing comorbidities such as diabetes or neuropathy. The causes of back pain can be either due to an injury, exaggerated activity, or any medical condition which affects the lumbar spine, the intervertebral disc, or the hip.

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Carpal tunnel syndrome can significantly impact individuals, causing pain, numbness, and weakness in the hand and wrist. The discomfort associated with this condition can extend beyond physical symptoms, affecting daily activities, work performance, and overall quality of life. Seeking prompt and effective treatment is crucial to alleviate these challenges and prevent potential complications. With our expertise in orthopaedics and neurology, at Max Hospitals, Delhi, we offer comprehensive care for individuals facing carpal tunnel syndrome. From accurate diagnosis to personalised treatment plans, we prioritise patient well-being. Our multidisciplinary approach involves non-surgical interventions such as splinting, physical therapy, and lifestyle modifications. In cases where surgical intervention is necessary, we provide advanced and minimally invasive procedures to ensure optimal outcomes. With a commitment to patient-centric care, Max Hospitals aims to improve functionality, relieve pain, and enhance the overall hand health of individuals dealing with carpal tunnel syndrome.

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The disc is soft material placed between two vertebrae, which serves as a cushion and permits mobility of the neck.

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Finger joint pain can be caused by various reasons including injury or infection, arthritis of the hand, carpal tunnel syndrome, and more. Finger joint pain makes it difficult for anyone to perform daily life tasks. The hand is composed of different bones, muscles, and ligament that helps with movement and agility. Some of the finger joint pain may go away with over-the-counter drugs or some physical therapy, though some may need medical attention.

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Juvenile idiopathic arthritis, previously titled juvenile rheumatoid arthritis, is the most common form of arthritis present in children under the age group of 16 years. This can result in constant joint pain, swelling, and stiffness around various joints. Some children may experience symptoms lasting only for a few months, while others have symptoms that continue to persist for many years. This is a chronic disease that can target any joints in the body. Certain forms of juvenile idiopathic arthritis can create serious complications, like growth issues, joint damage, and eye inflammation. Treatment is based on the reduction of pain and inflammation, improving function, and preventing damage. JRA is an autoimmune disorder in which the body mistakenly identifies some of its own cells and tissues as foreign matter. The immune system, which fights off bacteria or viruses, starts to target healthy cells and tissues. The result is inflammation marked by redness, heat, pain, and swelling.

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Knee ligaments are short bands of fibrous connective tissue that hold the knee together. The most common cause of its tear is trauma by accidents or sports injuries. The knee has four major ligaments that connect bones. They give the joint stability and strength. The four knee ligaments that connect the thigh bone (femur) to the shin bone (tibia) are: Anterior cruciate ligament (ACL) - This ligament is in the centre of the knee. It controls the movement of the shin bone to permit rotation and forward motion. Posterior cruciate ligament (PCL) - This ligament is in the back of the knee. It controls the backward movement of the shin bone. Medial collateral ligament (MCL) - This ligament stabilises the inner knee. Lateral collateral ligament (LCL) - This ligament stabilises the outer knee.

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Knee pain is a common condition involving people of all age groups. Several factors contribute to knee pain, like a ruptured ligament or damaged cartilage. Certain medical conditions, including arthritis, gout, and infections, also result in knee pain. Pain around the knee can generate in any structures like femur, tibia, fibula patella, or associated structures like ligaments, tendons, and cartilage (meniscus) of the knee. Many kinds of minor knee pain respond well to self-care and preventive measures. Physical therapy and knee braces or splints also help ease the pain. In chronic cases, however, the knee may require surgical intervention. Surgeons often use minimally invasive arthroscopic surgery to repair the extent of damage to the knee, like torn tendons or ligaments and meniscal injuries resulting in instability and pain around the knee joint. In severe cases, doctors may recommend knee replacement surgery. Knee pain can be exaggerated by physical activity, as well as obesity.

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The knee joint is the most complicated joint of the body. It consists of three components junction of three bones: the patella (knee cap), distal femoral condyles (thigh bone), and the proximal tibial plateau (leg bone). The ends are covered with articular cartilage- an elastic material that allows the knee to move freely. If damaged, the cartilage cannot repair itself. In such a case, a knee replacement surgery is done. Max Institute of Musculoskeletal Sciences & Orthopaedics, is equipped with a state-of-the-art Digital Orthopaedic Operating Suite. We offer comprehensive care for several orthopaedic afflictions, including knee, hip, and joint problems. The joint implants are planned pre-operatively for perfect size and positioning as per the anatomy of the patient, thereby safeguarding their health. Our wide range of offerings has made us rank among the best hospitals in India. We focus on providing the highest level of patient care with professional expertise for early mobilization and have taken orthopaedic treatment to a world class level. a) TOTAL KNEE REPLACEMENT Total Knee Replacement or 'Arthroplasty' is relining of the joint (bone end surfaces) with artificial parts called prostheses. There are three components used in the artificial knee. The femoral (thigh) component is made of metal and covers the end of the thigh bone. The Tibial (shin bone) component, made of metal and UHMWPE (medical-grade plastic), covers the top end of the Tibia. The third component, the patella or kneecap, is made up of polythene. The surgeon decides at the time of operation if it should be replaced in a particular situation or not. Patients with severe arthritis of both knees can be offered replacements of both knees together after a thorough medical evaluation. Joint replacement is also done using computer assistance which improves implant alignment and surgical precision. Before a total knee replacement surgery is performed, Orthopaedics evaluate the medical history, conduct a physical examination, X-rays, and other tests like MRI and blood tests. The doctor then reviews the results and discusses with the patient if total knee replacement surgery is the best option in their case to improve function and relieve pain. b) UNICONDYLAR KNEE REPLACEMENT In some patients, only one half of the knee joint is worn out. In these situations, only one side of the knee is replaced. This is termed as Unicondylar Knee Replacement. It can be done in specific conditions, which only the surgeon can judge and advice. This surgery is comparatively economical, and since the operation is less extensive, the post-operative recovery is faster.

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Neuromuscular diseases are a group of disorders that affect the nerves and muscles in the body. The nervous system, consisting of the brain, spinal cord, and nerves, works in conjunction with the muscular system, comprised of skeletal and smooth muscles, to control movement and other bodily functions. These diseases can arise from various causes, including genetic mutations, infections, injuries, or environmental factors.

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Osteoporosis is a major global health problem that is increasing dramatically as the population ages. It has been defined as a progressive systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. The World Health Organization (WHO) estimated that 200 million people worldwide have osteoporosis. Hip and spine fractures are the most severe consequences of osteoporosis. The condition mostly affects women in their post-menopausal stage. There are two major types of osteoporosis: Primary osteoporosis can be: Postmenopausal Senile osteoporosis Secondary osteoporosis: In this type, there can be underlying causes which can be: Hyperparathyroidism Hyperthyroidism Malabsorption Chronic liver disease Chronic kidney disease Rheumatoid arthritis Prolonged bed rest

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A rotator cuff is the muscle group that makes up the shoulder joint. It holds the upper arm bone within the socket of the shoulder. Its injury or tear results in a dull ache in the shoulder. This pain often worsens at night time. These tears are normal and increase with age and commonly occur in people who perform sports. In addition, they also affect people in certain occupations, such as painters and carpenters. Physical therapy helps improve the flexibility of the shoulder joint muscles. It also strengthens the muscles. In addition, these exercises help manage the symptoms of rotator cuff injuries for many people. But, if the muscles tear, they require immediate medical attention. Most cases of rotator cuff tear need surgery. Rotator cuff tears can affect anyone. This includes people of all ages and genders. However, the issue is more commonly seen in adults.

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The shoulder is a ball-and-socket joint and a significant part of the skeletal system. It resembles a golf ball put on a golf tee. A shoulder ligament tear is an injury to the soft tissues that obstruct the joint's stability and range of motion. A tear may occur in the tendons, the muscles, or the labrum, a rim of fibrous tissue that lines the glenoid. A tear may be partial or sever the tendon, muscle, or labrum entirely. With time, minor tears in the tendon can lead to a more significant tear. Shoulder tears can happen due to repetitive use or sudden trauma. Long-term repetitive arm motions performed during sports, chores, or jobs can lead to a tear. For instance, athletes who play sports that require repetitive movements like throw ball, tennis, and baseball may experience a shoulder tear. The ligament may also tear, breaking a fall with an outstretched arm. A shoulder gets dislocated when the humerus becomes dislodged from the glenoid, pulling muscles and tendons out of place and causing a tear.

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Disc disease comes with a spectrum of treatment options for a patient today. Non-surgical treatment options are as follows: Physical therapy or Physiotherapy Chiropractic manipulative therapy (CMT) and other chiropractic treatments Osteopathic manipulation Anti-inflammatory medications such as non-steroidal anti-inflammatory drugs, or spinal injections epidural often provide adequate relief from the troubling symptoms. Surgery may be recommended if the conservative treatment options do not provide relief. Patient has increasing weakness or has bowel, bladder involvement.

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Spinal fractures are different than a broken arm or leg. A fracture or dislocation of a vertebra can cause bone fragments to pinch and damage the spinal nerves or spinal cord. Most spinal fractures occur from car accidents, falls, gunshot, or sports injuries. Injuries can range from relatively mild ligament and muscle strains, to fractures and dislocations of the bony vertebrae, to debilitating spinal cord damage. Depending on how severe an injury is, one may experience pain, difficulty walking, or be unable to move arms or legs (paralysis).

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Spondylitis is one of the most common causes of back and neck pain and is essentially the result of an inflammation of the vertebral joints. The problem with detecting the condition is that it develops silently and comes to prominence once the condition has fully developed. Pain in spondylitis is usually concentrated around the cervical region of the neck, shoulder and lower spine with the instances and stings of pain flowing further downwards.

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Upper back pain is a pain in the area between the base of the neck and the bottom of the rib cage. The upper back provides stability to anchor the rib cage and protect internal vital organs. The upper back is relatively resistant to injury and pain. So when upper back pain occurs, commonly it is due to long-term poor posture or major injury. Severe upper back pain can limit physical activities; it feels like sharp burning pain at one spot on the back or general achiness that can spread to the neck, shoulder, and other body parts. Types of Upper Back Pain Upper back pain has two types. They are Muscular irritation: The shoulder girdle is attached by large muscles to the shoulder blade and back of the rib cage. These large muscles are prone to develop tightness and strain that can cause pain. Muscular irritation in the upper back occurs due to overexertion or deconditioning (lack of strength) Joint dysfunction: Joints of the thoracic spine can become dysfunctional due to ageing or sudden injury. This functionality can result in upper back pain Symptoms of Upper Back Pain Symptoms for upper back pain may differ from person to person. For some people, upper back pain can be mild and go away within days, and for others, the pain may worsen and interfere with daily activities. Common symptoms of upper back pain include: Sharp and excruciating pain in the back Throbbing sensation or discomfort Soreness or stiffness Reduced mobility of upper back muscles Radiating pain in arm, neck, shoulder, or any part of the body Numbness or tenderness Weakness Severe back pain can affect day-to-day activities, such as the ability to sit comfortably, lift moderately heavy objects, or stand for a long duration. When to see a doctor? In case of serious and persistent symptoms such as radiating pain, tingling sensation in the abdomen, and reduced coordination, consult the upper back pain doctor immediately. Causes of Upper Back Pain Other causes of upper back pain include: Poor posture: This can cause structural changes to the back and neck. The muscles may become weak and deconditioned Improper lifting posture: Lifting heavy objects without the correct posture can put stress on the upper back Accident: Vehicular accident, falling from a height, or any other kind of accident that can injure spinal bone or muscles and cause upper back pain Upper Back Pain Diagnosis Diagnosis for back pain includes: Patient's history: The doctor may ask about the complete medical history of the patient, including family history, onset of symptoms, the severity of back pain, lifestyle, and habits that may influence back pain Physical exam: Physical exam helps the doctor to evaluate the exact source of pain. The doctor may observe the back and the posture for anything unusual. He may also check for any tenderness, abnormality or rib instability Diagnostic tests: Imaging tests such as X-rays and MRIs can be performed. X-ray creates an image of the bones, while MRI creates a cross-section image of soft tissues and bones. This test helps the doctor to identify the exact source of pain Blood tests: Blood samples can be collected to test in a laboratory for infections or any abnormality that may point out to diseases such as arthritis or bone cancer Upper Back Pain Treatment The most common medical treatments for upper back pain include: Physical therapy: A physiotherapist can design a customised physical therapy program, including exercises and stretching, as per patients' specific needs. Physical therapy for back pain mostly focuses on stretching and strengthening the back, neck, and core muscles. This therapy can last for a few weeks or months Prescribed medication: In case of persistent pain, the doctor may advise prescribed medications. Commonly prescribed medications are nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, which prevent the pain signals from reaching the brain Injections: Spinal injections may be given to block the spinal pain. Epidural steroid injection is commonly given to reduce upper back pain. Such injections give short-term relief from the pain Surgery: Back Pain Surgery is rarely used for upper back pain. It is recommended if the spinal cord or nerve roots are at risk Thoracic spine surgery is of two types: Vertebral augmentation: This method is minimally invasive and uses artificial bone cement to stabilise the fracture and stop damaged bone's movement Spinal decompression: This surgical procedure removes any structure, such as a herniated disc or bone overgrowth, that presses against the nerve or spinal cord. It relieves the pressure on the spinal cord An alternative treatment available for upper back pain is complementary alternative medicine (CAM). Most people find alternative treatments effective that relieve the pain to some extent. Complementary alternative medicine treatment includes: Acupuncture: Acupuncture is a treatment method in which thin needles are placed on the pain points to alter the energy waves, ease muscle tension and reduce pain Electrotherapy: Electrotherapy is a treatment method that elevates pain by sending small electric pulses to the pain points. Transcutaneous electrical nerve stimulator ( TENS) is a common electrotherapy that uses adhesive pads to place electrodes on the painful body part. This electrode creates a shooting and tingling sensation that reduces pain Risk Factor of Upper Back Pain Lack of physical fitness or exercise can increase the risk of upper back pain. Other risk factors for upper back pain include Gender: Back pain is more common in women than in men Overweight: Being overweight can stress the back. Belly fat, particularly, can strain the soft tissues in the back, which can cause severe upper back pain Smoking: Smoking can reduce blood flow to the spine; this prevents the back from getting the necessary nutrients to stay healthy. It can cause the disc in the spine to degenerate, resulting in upper back pain Prevention of Upper Back Pain In most cases, upper back pain can be managed at home by taking a few preventive measures. Self-care, such as a good amount of rest, appropriate sitting posture, applying heat or ice on the back, and exercising, can help relieve the back pain. It is also important to take regular breaks between work to stretch and walk around. Muscle strain from setting address can add to the poor posture, resulting in upper back pain. Complication of Upper Back Pain Upper back pain can lead to complications such as permanent nerve damage and physiological and psychological responses to chronic back pain. Prognosis The prognosis for lower back pain in terms of pain relief depends on the cause of the pain. Most patients recover faster with medications and physiotherapy. Upper back pain gets better with time and exercise. Review Reviewed by Dr. Karan Baveja, Consultant, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury and Dr. Yashpal Singh Bundela, Director - Neurosurgery, Neurosciences.

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