Arthritis

arthritis

What is Arthritis? What is its prevalence?

Arthritis is one of the most common chronic conditions, affecting millions of people worldwide. The term arthritis encompasses over 100 conditions that primarily affect a body’s joints. The percentage of adults with arthritis varies considerably from country to country, ranging from 11.2% to 32.7%. Prevalence rates of arthritis are projected to increase year by year, with older people, women at greater risk.

What are the types of arthritis?

Although you may be most familiar with osteoarthritis, there are actually many different types of arthritis and other rheumatic diseases that can affect the body. The most common types of arthritis include

  • Osteoarthritis.
  • Rheumatoid arthritis.
  • Ankylosing spondylitis.
  • Psoriatic arthritis.
  • Juvenile arthritis.
  • Gout.
  • Reactive arthritis.
  • Secondary arthritis.

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Knee Osteoarthritis: Normal Healthy cartilage (solid arrow) & completely worn out cartilage exposing the underlying bone (broken arrow)

What is Osteoarthritis?

Osteoarthritis (OA) is a form of arthritis that features the wear and tear of the cartilage of one or more joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints.

Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.

The most common symptoms of osteoarthritis are pain, swollen joints, joint stiffness. Pain usually increases during activity and decreases with rest. Symptoms are often worse toward the end of the day.

Osteoarthritis affects most people at the later stages of life.

Osteoarthritis is most common in large weight bearing joints such as the knees or hips. It can also affect other joints such as shoulder joint and small joints of fingers.

What is Rheumatoid arthritis?

Rheumatoid arthritis (RA) is joint inflammation caused by an overactive immune system. It usually affects many joints throughout the body at the same time.

Rheumatoid and other types of arthritis are much less common than osteoarthritis.

Advances in treatment strategies have resulted in ever-improving outcomes and quality of life for those suffering from rheumatoid arthritis.

What are the early symptoms of arthritis?

A dull pain or discomfort in one or both the knees while trying to get up from sitting position or while going up/down the stairs is the usual early symptom in knee arthritis. Some may experience early morning stiffness in their knees after getting up from bed which gets better after a little while or after a warm shower. Pain while walking, sitting cross-legged or squatting are few other symptoms of arthritis.

In an effort to prevent this, surgeons are constantly searching for ways to ensure that the implants are properly positioned. CAS is one additional check to confirm proper placement of the implants.

Most patients are concerned about the type of implant when considering TKR, however, probably the most important consideration should be is, how well these implants are positioned.

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Knee pain while trying to stand from sitting position & while trying to climb up or down the staircase are early symptoms of arthritis
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Activities which can lead to knee osteoarthritis when repeated frequently over a period of time.

How to prevent osteoarthritis?

Although it is difficult to avoid getting osteoarthritis as we age the following may help:

  • Trying not to overuse any joints.
  • To avoid activities that requires repetitive movement.
  • Maintaining an ideal body weight.
  • Doing strengthening exercises to keep the muscles around your joints strong. This is especially important for weight-bearing joints, such as the hips, knees, and ankles.
  • Trying and avoiding or minimizing stair climbing, squatting and cross leg sitting.

What are the treatment options for early osteoarthritis?

The treatment options for early osteoarthritis includes

a) Physical activity

It’s important to stay as active as possible. When joints hurt, people tend not to use them as much. Then the muscles get weak. This can cause the joint to work less effectively, and it can make it harder to get around. This causes more pain, and the cycle begins again. Hence try to stay as active as possible and avoid this problem.

Exercise keeps your muscles strong and helps you stay flexible. Swimming, stationary cycling, cross trainer exercises are good for people who have arthritis. Avoid activities that make your pain worse such as jogging, skipping, jumping and long walking.

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Swimming and hydrotherapy are some of the best exercises for osteoarthritis

b) Special devices

Special supportive devices such as canes, crutches & walkers can help people who have arthritis stay independent. These devices help protect your joints and keep you moving.

c) Medicine

Medicine should be used wisely. You only need the amount that makes you feel good enough to keep moving. Using too much medicine may increase the risk of side effects.

d) Injections

Reliable benefits can be obtained in some patients through knee injections such as PRP (platelet rich plasma ) or Stem cell injection

What are the treatment options for late stage knee arthritis?

Disability in late stage arthritis is because of

  1. Pain limiting day to day activities.
  2. Difficulty in knee bending.
  3. Deformities such as Bow Legs & Knock Knees.
  4. Change in the gait (manner of walking).

Computer Assisted Total or Partial Knee Replacement is the only proven long term cure for arthritis in its late stage. However short term benefits can be obtained with knee injections such as

  • PRP (platelet rich plasma ) injection.
  • Stem cell injection.
  • HA (Joint fluid) injection.

What is PRP Injection?

PRP is Platelet-Rich Plasma therapy, although an emerging technology it is currently used in wide range of orthopaedic disorders including osteoarthritis, avascular necrosis, ligament injuries and other sports injuries. PRP therapy, which takes approximately 20 minutes to complete, begins with collection of 15 milliliters of the patient’s blood.

The blood sample is placed in a centrifuge to separate the PRP from the other components of whole blood. Doctors then inject the concentrated platelets into the joint.

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PRP injection used for treating knee arthritis
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Stem cells injection used for treating knee & Hip disorders

What is stem cell injection (stem cell therapy)?

There is a lot of debate around stem cell treatment, and its use in arthritis. What makes stem cells special is that they can:

  1. Divide and duplicate themselves, and
  2. Develop into different types of cells such as a cartilage cell or a bone cell.

Most research indicates that younger patients who have relatively mild arthritis or cartilage damage see the most benefit. The most common type of stem cells used for treating arthritis are mesenchymal stem cells. Mesenchymal stem cells are usually collected from the patient’s fat tissue, blood, or bone marrow. Stem cell therapy is done as a day care procedure, where patients can go home on the same day and need not stay overnight.