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all about arthritis

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all about arthritis

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    1. All About Arthritis Kambiz Behzadi, M.D. Orthopedic Surgeon San Ramon, Pleasanton, Livermore

    3. Arthritis 40 Million Americans have arthritis 20 Million people suffer from Osteoarthritis Osteoarthritis most common form of arthritis

    4. Synovial Joints Bone ends --> Articular Cartilage Cartilage cushions bones-->allows bones to move without pain Synovium--> covers joints, produces fluid that reduces friction

    5. Synovial Joints Ligaments connect bones--> stability Muscles and Tendons power joints--> movement

    6. Arthritis Arthritis is Inflammation Body’s normal reaction to injury Chronic inflammation in arthritic joint--> long lasting disability

    7. Osteoarthritis Loss of cartilage and joint surface Second most common cause of disability in adults 7 million physician visits per year 3 million hospitalizations $2655 per person

    8. Osteoarthritis Weight bearing joints Hips, knees, feet Fingers Spine

    9. Osteoarthritis

    10. Osteoarthritis Pain in affected joints Pain worse with prolonged use Pain better with rest Stiffness relieved by flexing and movement

    11. Osteoarthritis-Xray

    12. Osteoarthritis Causes Primary Osteoarthritis Most Common Thought to be result of Aging Decreased ability to withstand stress Ligaments supporting joints weaken

    13. Secondary Osteoarthritis

    14. Goals of Treatment To Relieve pain Increase motion Improve strength

    15. Medication- NSAIDs NSAIDs are nonsteroidal anti-inflammatory drugs Aspirin Ibuprofen Naproxen

    16. Medication Cox-2 inhibitors offer the benefits of other NSAIDs with a decreased incidence of gastrointestinal side effects. Vioxx, Celebrex, Bextra

    17. Medication Injections Liquid cortisone Hyaluronate Supartz Synvisc Hylagan

    18. Vitamins Anti-oxidants A,C,D,E may help prevent Osteoarthritis No Clinical trials No clear proof

    19. Nutritional Supplements Glucosamine Chondroitin Sulfate Some Positive results Mild to moderate pain relief If not seen within eight weeks, not likely to benefit

    20. Alternative Medicine Complimentary approaches may: Ease symptoms Improve outlook and attitude

    21. Alternative Medicine Complimentary approaches will not: Cure acute illness Replace proven medical treatment for osteoarthritis

    22. Alternative Medicine

    23. Joint Protection

    24. Exercise Gentle exercise in moderation Strengthen muscles Prevent stiffness Decrease weight Promote endurance Right program for you

    25. Surgery Arthroscopy Least Invasive Arthroscope Remove partially damaged cartilage Portals Remove dead cartilage and enzymes that cause inflammation

    26. Abrasion / Drilling Abrasion and Drilling Healing response Fibrocartilage= Scar Cartilage Inferior mechanical properties to articular cartilage Less advanced OA Focal arthritis

    27. Osteotomy Realignment of Joints Transfer Weight to less involved part of joint 60s and 70s Less popular Does not provide good long term results

    28. Mosaicplasty / OATS Localized focal arthritis/defect Traumatic arthritis Small to medium Transferring healthy plug of bone and cartilage to defect in weight bearing area

    29. ACI Articular Cartilage Implantation “Pot hole in the road” Two operations Cartilage harvested and sent to Lab, to grow in Culture Cartilage cells transplanted into the defect In future may be applicable to large lesions/primary OA

    30. Total Joint Replacement Considered last Solution for Arthritis Improved Ambulation Decreased Pain Increased ROM 90%+ good to excellent results

    31. Total Joint Replacement Removal of diseased joint Replace with a prosthetic joint

    32. Minimally Invasive Surgery Continuous advances in joint replacement procedures MIS= Minimally Invasive Surgery

    33. MIS 8-12 inches --> 3 to 5 inches Same implants Minimal trauma to Muscles and Tendons Quadriceps muscle and tendon not cut Unassisted walking at 2 to 4 weeks Back to Activities/Work Sooner

    34. Summary Osteoarthritis affects in excess of 20 Million Americans Accurate Diagnosis important Understand the nature of this Problem Many treatment Options available Benefits and limitations Choose the right treatment for you Get back into the game

    35. Arthritis www.nih.gov/niams/

    36. THANK YOU

    37. MIS THR

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