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KNEE ARTHRITIS AND JOINT PAIN

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 - OSTEOARTHRITIS INFLAMMATORY

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KNEE ARTHRITIS AND JOINT PAIN

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  1. KNEE ARTHRITIS AND JOINT PAIN

  2. CAUSES OF KNEE PAIN • Knee injury • Arthritis • Infection

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

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

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

  6. 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

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

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

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

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

  11. HAMMER TOES HALLUX VALGUS SWAN NECK DEFORMITY BOUTONIEER DEFORMITY

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

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

  14. TREATMENT • Preventive • Curative

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

  16. MEDICAL - TREATMENT • Allopathic • Ayurvedic • Homeopathic

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

  18. VARIOUS NSAIDS • Diclofenac • Paracetamol • Ibuprofen • Etoricoxib

  19. 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 ??

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

  21. INTRA-ARTICULAR INJECTION • INJ.DEPOMEDROL 80 mg.

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

  23. SURGICAL • HTO • ARTHROSCOPY • JOINT REPLACEMENT

  24. HTO • CORRECTION OF MECHANICAL AXIS

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

  26. REMOVAL OF LOOSE BODY

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

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

  29. TOTAL KNEE REPLACEMENT

  30. KNEE JOINT REPLACEMENT

  31. SEVRELY DEFORMED KNEE

  32. AFTER SURGERY

  33. FEW EXAMPLES

  34. CASE - 54 yrs RA

  35. POST OP X RAYS

  36. CASE – 71 yrs OA

  37. CASE – PRE OP XRAY & GAIT

  38. CASE – POST OP

  39. PREVENTIONISBETTER THANCURE

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

  41. 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

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

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

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

  45. 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

  46. 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

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

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