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WORLD ARTHRITIS DAY. 12.10.14.
WEBSITE: HTTP://RAMSONIORTHOSURGEON.COM/
DR R K SONI. MS ORTHO. LRCP EDINBURGH. LRCP&S GLASGOW.M.CH ORTHO & TRAUMA . LIVERPOOL .UK
Consultant Orthopaedic arthroscopy and Joint replacement surgeon.. Bhopal. MP J K Hospital.Website: http://ramsoniorthosurgeon.com/
“Our Focus is your health”.
World Arthritis Day 2005
Arthritis – Quality of life , living without Pain.
World Arthritis Day: "Small Things Matter”
12.10.07
World Arthritis Day in 2011
Move to
Improve
Find relief for aches and painsWorld Arthritis Day
12 October 2014
Healthy Living .
Physical activity Healthy eating Lifestyle choices, including alcohol
and smoking Emotional wellbeing Self management and motivation
If you have confidence and believe you can do some thing you are much more likely to succeed.
Arthritis
Has been present in Humans since 4500 BC
S No All Men Women
1 Osteoarthritis 2.7 1.0 3.9
2 Hypertension 1.3 0.4 1.9
3 Slipped disc 1.3 0.3 1.9
4 Diabetes 1.1 1.5 0.8
5 Spondylosis 1.1 0.5 1.5
6 Migrain 1.0 0.2 1.5
7 Asthma 0.7 0.3 1.0
8 Rheumatoid 0.5 0.3 0.7
9 Hypothyroidism 0.5 00 0.9
10 Dyslipidaemia 0.4 0.3 0.5
Osteoarthritis affects about 10% of population above 55 years of age. Osteoarthritis is India’s number one ailment: Diabetes is ranked 4 th.% of total affected by the disease.
NICOLAS ANDRY . ( 1741) FRENCH PHYSICIAN.
( ART OF PREVENTION AND CORRECTION OF DEFORMITIES IN CHILDREN.)
Arthritis symptoms
1. pain. 2. swelling . 3. stiffness. 4Morning stiffness . 5. deformity. 6. gradual reduction in walking
distance. 7. sleep disturbed `
Arthritis and deformity
Excessive calcium and joint pain 1.Hyperparathyroidism:
2. one of the feature is joint pain due to hypercalcaemia.
3. High serum ca level is ass with high systolic and Diastolic blood pressure.
4. High serum calcium is highly predictive of MI.
Serum ca level is predictive of cardiovascular disease in men.
Increased uric acid level and joint pain.
Gout attack can be precipitated Dehydration Injury Fever Heavy eating Heavy drinking Recent operation
Lemon and arthritis
No relation . If any thing it is helpful in pt with arthritis.
Yogurt / and joint pain.
Yogurt is good for joint pain.
Alcohol and Arthritis.
. Known Risk factor: 1- for Gout. 2. Osteoporosis. 3. Obesity. And obesity increases risk
of OA three fold. 4. Memory loss. 5. Contra indication for many Drugs , Alcohol and drug interaction.
Smoking and Arthritis .
Smokers are twice more likely to develop Rheumatoid Arthritis.
Osteoporosis . Delayed fracture healing . Degenerative disc disease.
Diet and Arthritis
1.More Fruits and vegetables. 2.Omega 3 fatty acids, 3.Olive oil . 4.Vit c . 5. Avoid high cooking temperature 6.Vegetarian diet . 7. Avoid food containing additives
and preservatives.
Weight / Obesity/ Arthritis
Wt
BMI;- 25-to 30. ---Overweight > 30. ----- Obese > 35 . ---- Morbidly obese
Obesity trends in UK / India
UK Low
socioeconomic status
India Higher
socioeconomic status.
Bigger is not always better.
Prevention of Arthritis/ Arthroscopy
Focal femoral condyle resurfacing.
Total knee replacement.
Not Pt specific instruments or cutting blocks
Pt Specific Knee implant
Enhanced arthroplasty recovery Programme. 1. Pre Op Pt Education. 2. Pre and Post op Hb level. 3. Pre op neutrition.: Low Albumin
and transferrin levels are predictors of longer
Recovery. Preemptive analgesia. Gabapentin and Cox 2 inhibitors
from 1st day of op upto 7 days.
Risk and Benefit of joint replacement
Risk. Infection. DVT . PE. Stiffness, Residual pain
BENEFIT No Pain . Deformity
correction . No Medication . Psychososial
benefit. Mood Life span
Longevity of the knee replacement.
Fear of operation .
Fear of operation
Anecdotal Surgeon , Qualification, Training and
experience. Financial aspect Pt
Surgeon
Gov/ MCI Rules/ Regulation. Accountability.
Chances of failure after two stage revision ( THR)
Prognostic factors. Elevated BMI Smoking . Anaemia Connective tissue disease .
Exercise and
Arthritis
Does exercise and physical activity helps or hurt arthritis.
Exercises
Exercise ( Contd)
Increases strength and flexibility. Reduces joint pain. Reduces fatigue Helps in maintaining healthy wt. Make u feel better & improves
sense of well being. Decreases depression and
elevates Mood.
Exercises for Arthritis
1. Range of motion exercises .
2. Strengthening exercises .
3. Aerobic or endurance exercises .
Arthritis ( osteoarthritis) Age related or wear and tear
arthritis. Inflammatory: - RA. , Gouty, Ca PD, Traumatic. Infective.
Prevalence of arthritis ( Wt) 16% of under or normal wt adults. 22% of over wt 31% of obese adultsHave doctor diagnosed arthritis
Over all 66% of Over wt or obese adults
53% of normal adults.
Benefits of fish-derived fat Japan ; fish consumption is higher
than USA, UK the prevalence of RA is lowest 0.4%.
Drugs
1. Corticosteroids. Prednisolone etc
AVN of femoral head, Humeral head. Talus etc2. Diuretics; increase the risk of gout3. Drug induced Lupus;-
Procainamide, hydralazine
The relation between total joint arthroplasty and risk for serious cardiovascular events in pt with moderate – severe OA .
BMJ 2013 347
Objective : whether THR & TKR reduces the risk for serious cardiovascular events in pt with severe OA
2200 adults with OA hip and Knee aged 55 or more followed until death / 7 yrs .
Factors that exacerbate the risk of CVD
Hypertension. Diabetes . Smoking. High BMI. Increased stress . use of NSAID underlying inflammation. Physical inactivity.
40 % of adults aged over 65 are physically inactive due to OA
18% of adult American have OA
Reasons for Increased all cause mortality due to cardiovascular causes.
Functional limitation due to OA. NSAID use. Increased psychosocial stress.
Proven benefits of total joint arthroplasty for improving
1. pain. 2. mobility 3. gait. 4. quality of life, 5.Overall function.
Benefits of total joint arthroplasty Improvement in 1.pain. 2. mobility. 3. gait. 4. Quality of life 5. walking distance. 6. mood.
Total joint arthroplasty is associated with 40 % reduction in subsequent risk of serious cardiovascular event
Choose Wisely.
AVOID: 1. Routine Post op DVT U/S in pt with THR and TKR.
2. arthroscopic knee wash out for OA knee for long term relief.
Do NOT 3. use Glucosamine and chondroitin to treat OA Knee.
4. use Lat Heel wedge for Med Compartment OA .
5.Syn Visc or Hyalgan for OA Knee. 6. Post op Splinting of wrist after CTR