2. KNEE ARTHRITIS AND JOINT PAIN

3. CAUSES OF KNEE PAIN
Knee injury
Arthritis
Infection

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

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

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

7. 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

8. 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

9. PROGRESSIVE JOINT ARTHROSIS
STAGE 1
STAGE 2
STAGE 3
STAGE 4

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

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

12. HAMMER TOES
HALLUX VALGUS
SWAN NECK DEFORMITY
BOUTONIEER DEFORMITY

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

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

15. TREATMENT
Preventive
Curative

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

17. MEDICAL - TREATMENT
Allopathic
Ayurvedic
Homeopathic

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

19. VARIOUS NSAIDS
Diclofenac
Paracetamol
Ibuprofen
Etoricoxib

20. 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 ??

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

22. INTRA-ARTICULAR INJECTION
INJ.DEPOMEDROL 80 mg.

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

24. SURGICAL
HTO
ARTHROSCOPY
JOINT REPLACEMENT

25. HTO
CORRECTION OF MECHANICAL AXIS

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

27. REMOVAL OF LOOSE BODY

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

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

30. TOTAL KNEE REPLACEMENT

31. KNEE JOINT REPLACEMENT

32. SEVRELY DEFORMED KNEE

33. AFTER SURGERY

34. FEW EXAMPLES

37. CASE yrs RA

38. POST OP X RAYS

39. CASE – 71 yrs OA

40. CASE – PRE OP XRAY & GAIT

41. CASE – POST OP

42. PREVENTION IS BETTER THAN CURE

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

44. 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

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

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

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

48. 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

49. 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

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

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

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