osteoarthritis management

Dr. A.MOHAN KRISHNA M.S.ORTHO, MCh ORTH(U.K)

Consultant Orthopaedic surgeon ,Trauma, Arthroscopy, Arthroplasty Surgeon Apollo hospitals, Hyderabad

Consultant Orthopaedic Surgeon at

www.drmohankrishna.comwww.healthyjointclub.comwww.bonesandjointsclinic.com

www.drmohankrishna.comwww.healthyjointclub.comwww.bonesandjointsclinic.com

OA is a disease of joints that affects all of the weight-bearing components of the joint:•Articular cartilage•Menisci•bone

Wearing of cartilage lining

Exposure of underlying bone

Swelling of joint lining

Bone at edges of joint grows outwards

forming osteophytes

Articular cartilage is the main tissue affected OA results in:•Increased tissue swelling•Change in color•Cartilage fibrillation•Cartilage erosion down to subchondral bone

As the degeneration progresses

1. Analgesics: - Tramadol + paracetomol Combination - Plain paracetomol as on need basis2 . Local antiinflammatory gels 2 to 3 times application.3. NSAID’s : reserved for acute exacerbations of pain for week to 10

days.4. Weight reduction if one is heavy5. Physiotherapy: exercises are taught to patient once or twice Patient needs to do them regulary - It strengthens the periarticular muscles around the knee - Further helps to maintain the tone of the muscles

Treatment methods of stage I 1,2,3,4,5 and 1.Nutraceuticals : a. Glucosamine 1500mg + chondrotin 1200mg in divided doses for a period of 3 months b. Dycerin 50mg twice a day ( warn about red urine/irritable bowel) c. Collagen peptide II : 10gm per day given for a period of 2-3 months 3 to 4 months break and restart for the complaints

It is a viscosupplementation injection that lubricates and cushions your joint.

Can provide pain relief

upto 9 months

- Reserved for relief of pain from acute exacerbations of arthritic pain.

- If patient with knee pain want to buy some time for surgery.- In patients not fit for surgery

1. Extraarticular steroid injection: many bursa around the knee joint can get inflamed in OA knee and may mimic acute exacerbations.

- Local steroid shots will be helpful2. Arthroscopic lavage: - When there are mechanical symptoms like locking of knee,

feeling of foreign body sensation which is due - Loose bodies - Torn degenerative menisci

Arthroscopic wash out can give relief from these symptoms.

Osteoarthritis: articular cartilage thins out and becomes irregular exposing the underlying bone. Some times loose pieces of worn out cartilage and synovial tissue move inside the knee joint producing locking and secondary inflammation.Joint wash using arthroscope to wash out this debris can be done . This procedure can reduce mechanical symptoms like locking and also aids pain relief.

Dr.A.MOHAN KRISHNAM.S.Ortho., MCh Ortho(U.K).,Consultant Orthopaedic Surgeon,Apollo Hospitals,Hyderabad.Appointments: Secretary : 09441184590 08332936085 www.drmohankrishna.comwww.healthyjointclub.comwww.bonesandjointsclinic.comEmail: healthyjointclub@gmail.com