KNEE ARTHRITIS AND JOINT PAIN

CAUSES OF KNEE PAIN Knee injury Arthritis Infection

ARTHRITIS: DEFINITION INFLAMATION OF THE JOINT AND SOFT TISSUE SURROUNDING IT. Various Types.

TYPES OF ARTHRITIS DEGENERATIVE INFLAMMATORY - OSTEOARTHRITIS - RHEUMATOID ARTHRITIS - GOUT. - PYOGENIC / TUBERCULOSIS.

OSTEOARTHRITIS KNEE – DEGENERATIVE Age related Weight bearing joints like knee MORE COMMON IN FEMALES AND OBESITY Cartilage destruction Resulting in pain and deformity

KNEE Arthritis Commonest complaint in Indian population in the elderly Could be because of social habits like sitting cross legged or squatting Knee Arthritis more common than hip Arthritis

SYMPTOMS Pain, swelling. Difficulty Deformity - bowed legs in walking in climbing stairs in getting up from sitting position. in squatting & sitting cross-legged. Deformity - bowed legs Restriction of movements

PROGRESSIVE JOINT ARTHROSIS STAGE 1 STAGE 2 STAGE 3 STAGE 4

RHEUMATOID ARTHRITIS RA IS AN IMMUNO-INFLAMATORY DISEASE INVOLVING THE ARTICULAR CARTILAGE, SUBCHONDRAL BONE, SYNOVIUM & EXTRA ARTCULAR TISSUES.

RA : SYMPTOMS PAIN EXACERBATION AND REMISSION MORNING STIFFNESS POLYARTHRALGIA MORNING PAIN SWELLING

HAMMER TOES HALLUX VALGUS SWAN NECK DEFORMITY BOUTONIEER DEFORMITY

LAB INVESTIGATIONS Arthritic profile : Haemogram R.A. Factor Serum Uric Acid C-Reactive protein

DEXA SCAN Bone densitometry by : Dexa scan Classified as - Normal - Osteopenic - osteoporotic

TREATMENT Preventive Curative

TREATMENT Non surgical - medications, - braces - physiotherapy 2. Surgical - Arthroscopy - Osteotomies - Replacement Surgery 3. Alternative Medicines

MEDICAL - TREATMENT Allopathic Ayurvedic Homeopathic

ALLOPATHIC DRUGS 1.ANALGESICS (PAIN KILLERS) 2.DISEASE MODIFYING DRUGS 3.INTRA-ARTICULAR INJECTIONS

VARIOUS NSAIDS Diclofenac Paracetamol Ibuprofen Etoricoxib

CARTILAGE REGENERATORS SUPPLEMENTS IN OA What new Drugs? CARTILAGE REGENERATORS CONTENTS Glucosamine and Chondroitin Sulphate Given long term enough evidence that it is helpful or not helpful ??

MEDICAL TREATMENT Analgesics and anti inflammatory drugs Cartilage regeneration tablets i.e. glucosamine sulphate chondroitin sulphate Intra articular steroid injections

INTRA-ARTICULAR INJECTION INJ.DEPOMEDROL 80 mg.

Inj. HYLASE Inj. Supplements depleted Hyaluronic acid in arthritic Joint. Recently single dose inj. Hyaluronic acid has been introduced.

SURGICAL HTO ARTHROSCOPY JOINT REPLACEMENT

HTO CORRECTION OF MECHANICAL AXIS

ARTHROSCOPY DAY CARE SURGERY MINIMAL INVASIVE TECHNIQUE MENISCAL TEARS,LAVAGE ARE EFFECTIVELY MANAGED.

REMOVAL OF LOOSE BODY

CRITERIA FOR KNEE REPLACEMENT SURGERY PAIN Activities of Daily Living WAIKING DISTANCE IRRESPECTIVE OF ANY X-RAY PICTURE

ULTIMATE SOLUTION TOTAL KNEE REPLACEMENT To replace damaged joint. Aims of joint replacement surgery Provides painless, stable, mobile joint.

TOTAL KNEE REPLACEMENT

KNEE JOINT REPLACEMENT

SEVRELY DEFORMED KNEE

AFTER SURGERY

FEW EXAMPLES

CASE - 54 yrs RA

POST OP X RAYS

CASE – 71 yrs OA

CASE – PRE OP XRAY & GAIT

CASE – POST OP

PREVENTION IS BETTER THAN CURE

Balanced Diet Proper exercises Regular Habits Change of life-style PREVENTIVE MEASURES Balanced Diet Proper exercises Regular Habits Change of life-style

BALANCED DIET PROTEINS : 10% TO 15% OF THE TOTAL CALORIES CARBOHYDRATES : 55% TO 65% OF THE TOTAL CALORIES FAT : 15% TO 30% OF THE TOTAL CALORIES

SOURCES OF CALCIUM CALCIUM RICH DIET – Vegetable: Green leafy Veg., rajgira, nachani, fruits. Poultry & dairy: milk, cheese, paneer, Tofu Fruits

SANCHETI INSTITUTE: KNEE CLUB ORTHO SURGEON Weight Loss Education KNEE CLUB PHYSIO DIETICIAN Lifestyle Exercise

Knee Club Group Therapy approach Allopathy, Homepathy, Naturopathy, Hydrotherapy, Ayurvedic & others Physiotherapy Combination of exercises, yoga & pranayam

TIPS TO REMAIN HEALTHY REGULAR MEDICAL CHECK UP AROUND THE AGE OF 50 IS COMPULSORY - Bone Densitometry - BLOOD TEST - Arthritic profile - X-ray Knee Joint - Prevent Osteoporosis Change in Life Style

TREATMENT OF OSTEOPOROSIS 1.Oral Calcium Supplement. 500 mg. calcium – 2 times a day 2.Calcitriol (active form of Vit. D) to increase calcium absorption and deposition 3.Vit. D. Injections 4.Proper supervised exercises

PREVENTION OF OSTEOPOROSIS 1. Regular exercises 2. Daily calcium intake after menopause 3. Hormone replacement therapy for post menopausal and post hysterectomy patients

CARRY HOME MESSAGE HEALTHY EATING REGULAR EXERCISES PREVENTIVE CHECK UP CHANGE OF LIFE-STYLE

THAT ULTIMATELY MATTERS! CONCLUSION NOT JUST LIFE BUT THE QUALITY OF LIFE THAT ULTIMATELY MATTERS!