Posted by: wockhardthospitals | July 14, 2009

All about Joint pain, Joint Replacement Surgery, Arthritis: FAQ`s

Total joint replacement surgery, especially of the knee, has long been used to treat severe arthritis in elderly patients. However, concerns arise when a patient in his 40s or 50s has severe knee arthritis that is not relived with conservative treatments. Some patients with crippling arthritis in their third or fourth decade have a new ray of hope with this surgery. One reserved for elder patients, joint replacement surgery is becoming more common in the younger, active population.

How Young is to Young? The benefit of surgery far outweighs the risk of surgery in a young patient with severe arthritis. The benefits are primarily Quality of life, pain reduction. And maintaining proper fitness. By accomplishing these goals, patients may also reduce the risk of developing other problems associated with poor fitness such as cardiovascular disease.

Click image to know more about Bone & Joint Care @ Wockhardt Hospitals

Click image to know more about Bone & Joint Care @ Wockhardt Hospitals

The concern of performing such a surgery in young is that the wear out of the implant. Developments in manufacturing have sought to reduce the magnitude of this problem. The use of highly cross kinked polyethylene, and ceramic on ceramic bearing surfaces has significantly reduced the wear of the artificial joint.

The young patients with joint replacement should be cautious, and will be able to do activities like Cycling, Swimming, low-resistance Rowing, Walking & Hiking, Low-resistance weightlifting. Activities to be avoided are high impact sports like Football, Hockey, Gymnastics, Jogging and Power lifting.

The replacement surgery is required in young patient suffering from sever arthritis of hip in conditions like osteonecrosis , developmental dysphasia of hip , Perthes disease , post fracture arthritis , Rheumatoid arthritis , Ankylosing spondylytis , or as a sequelae of infection . Joint replacement is a very rewarding surgery to alleviate pain, improve mobility and restore function.

A joint replacement should be performed after conservative methods have failed and if a patient’s quality of life and ability to perform activities of daily living is significantly affected. Many different non-operative modalities should be tried first. These include anti-inflammatory medications, physical therapy m weight loss and walking assistance devices.

The Centre for Joint Replacement (CJR), Wockhardt Hospitals is routinely performing such technically demanding joint replacement surgeries. The computer navigatioi0n has further helped the operating surgeon in precise placement of the artificial joint, which has a bearing on the longevity of the prosthesis.

With advances in technology, improvement in implants, better operating facilities, and safer anesthesia, the younger patient with severe, crippling arthritis have a new ray of hope in their life.

What are the symptoms of arthritis in young patients?

There are more than 150 different forms of arthritis. Symptoms vary according to the form of arthritis. Each form affects the body differently. Arthritic symptoms generally include swelling and pain or tenderness in one or more joints for more than two weeks, redness or heat in a joint, limitation of motion of joint, early morning stiffness, and skin changes, including rashes.

How can a doctor diagnose arthritis in young patient?

Doctors diagnose arthritis with a medical history, physical exam and x-rays of the hip, blood test.

What you can do?

  • Consult a doctor who will determine the type of arthritis you have.

  • Rest the joint until the pain subsides to prevent further inflammation.

  • To ease the pain or stiffness of the joint, apply heat on the joint for about 15 minutes once or twice a day using a hot water bottle, towel or an infrared lamp.

  • Take painkillers or anti-inflammatories, as recommended by your doctor.

  • If you are overweight, try to reduce weight to lighten the load on weight-bearing joints.

  • Participate in regular exercise.

What your doctor can do for you?

There is no cure for arthritis, so beware of ‘miracle cures’. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested, such as a hip or knee replacement. The type of surgery will depend on your age and severity of the disease. In the elderly with severe arthritis, joint replacement can give good results.

Treatment Options

Initial treatment for osteoarthritis of the hip or knee is conservative, consisting of rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesic and or anti inflammatory medications. With worsening symptoms a cane or a knee brace may be helpful. For more severe symptoms, an injection of cortisone into the joint is frequently advised and can be quite helpful. When conservative measures have been exhausted and are no longer helpful, and the arthritis has become disabling, surgery may be recommended.

Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:

  • Exercises to keep joints flexible and improve muscle strength

  • Many different medications are used to control pain, including corticosteroids and NSAIDs.  Glucocorticoids injected into joints that are inflamed and not responsive to NSAIDS.

  • For mild pain without inflammation, acetaminophen may be used.

  • Heat/cold therapy for temporary pain relief

  • Joint protection to prevent strain or stress on painful joints

  • Surgery (sometimes) to relieve chronic pain in damaged joints

  • Weight control to prevent extra stress on weight-bearing joints

Does exercise really help those who have arthritis?

Exercise is very important because it increases lubrication of the joints and strengthens the surrounding muscles, putting less stress on joints. Exercise in heated swimming pools-hydrotherapy-can brings enormous relief from pain and stiffness. Also studies have shown that exercise helps people with arthritis by reducing joint pain and stiffness and increasing flexibility, muscle strength and energy. It also helps with weight reduction and offers an improved sense of well-being.

Can special diets treat arthritis?

But what if you have arthritis – are diet and nutrition still such a simple matter? Can what you eat cure your arthritis? Can food prevent it from occurring? Are there foods that can cause your arthritis to ‘flare’ or go into remission? What role do vitamins and nutritional supplements play in the treatment of arthritis? Will lose (or gaining) weight help ease your symptoms? Will taking powerful anti-arthritic medications affect your appetite or your ability to eat certain foods?

These are the sorts of questions that people with arthritis often ask, and they’re valid questions. Some questions “Can what you eat cure your arthritis?” have simple answers “No”. Some questions “Are there foods that can cause your arthritis to ‘flare’ or go into remission?” aren’t so straightforward. “Perhaps…”

Most of what you need to know about diet and nutrition is common sense; healthy eating is pretty much the same for anyone, whether you have arthritis or not. But there are exceptions.

Predisposing factors to Osteoarthritis of hip in young patients

Some conditions may predispose the hip to osteoarthritis; it tends to affect people as they get older and particularly affects joints that have to take a lot of stresses and strains.

  • A previous fracture that involved the hip.

  • Growth abnormalities of the hip (such as a shallow socket) may lead to premature arthritis.

  • Some childhood hip problems later cause hip arthritis (for example, a type of childhood hip fracture known as a Slipped Epiphysis; also Legg-Perthe’s Disease).

  • Inactive lifestyle- Obesity (overweight) your weight is the single most important link between diet and arthritis, as being overweight puts an additional burden on your hips, knees, ankles and feet.

Predisposing factors to Osteoarthritis of Knee young patients

Abnormalities of knee joint function resulting from fractures of the knee, torn cartilage and torn ligaments can lead to degeneration many years after the injury. The mechanical abnormality leads to excessive wear and tear – just like the out-of-balance tyre that wears out too soon on your car.



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