What is arthritis? It's causes and treatment options
Dr. Kalyan Srungavarapu, Specialist, Orthopaedics, Aster Royal Hospital
Arthritis is a medical condition characterized by inflammation of the joints. The term "arthritis" is derived from the Greek words "arthro," meaning joint, and "itis," meaning inflammation. Joints are the connections between bones that allow movement and flexibility. They are lined with cartilage, a tough and elastic tissue that cushions the bones and prevents them from rubbing against each other. The joint is also enclosed by a synovial membrane, which produces synovial fluid that lubricates the joint and helps to reduce friction during movement. Ligaments and tendons attach to the bones and provide support and stability.
Arthritis can be caused by a malfunction of the immune system, which attacks the joints, leading to the breakdown of the cartilage and other tissues. Over time, this can cause the bones to rub against each other, leading to pain and stiffness. There are more than 100 different types of arthritis, all falling under the umbrella of rheumatic diseases. Anyone can develop arthritis, including children, and its causes are not fully understood, making it an autoimmune disease.
Arthritis can have a significant impact on a person's quality of life, as it can cause chronic pain, stiffness, and reduced mobility. Although there is no cure for arthritis, symptoms can be managed through medication, physical therapy, and lifestyle changes.
What is the treatment for arthritis?
There are many different drugs used to treat arthritis. These include aspirin, non-steroids anti-inflammatory drugs (NSAIDS), gold salts, antimalarial drugs, cortico steroid and anticancer drugs in a very low dose. Each drug tries to contain the affect of attack of the immune system, but may work on some and not on others. Each drug has its own side effects and care must be taken to consult a doctor and take the drugs recommended by him under his supervision and follow up.
In addition to medication which helps to ease the pain, regular exercise is very important. Proper exercises help keep joints flexible, build and preserve muscle strength and help protect the joint from further deterioration. Physiotherapy can help. Though many persons who suffer from arthritis, feel better in a warmer climate, it does not necessarily cure or improve the disease itself.
People with arthritis, like everyone else need well balanced diets, to stay as healthy as possible. Overeating and overweight will put an unnecessary burden on the system and joints and therefore should be controlled.
Surgical Treatment
- Hospital Visit
During the hospital visit, doctor will take a careful history, examine you and review x-rays of your knees. He will discuss your general condition, allergies and the medications you are taking. Our surgical assistant will schedule a date for your operation.
- Medical Clearance
Before proceeding with surgery we want to be sure that any medical problems you have, are under control. Please be sure to bring any medical problems you have, to our attention. This includes medications you ONLINEd any allergies you may have. Prior to surgery you should correct any dental problems. You should continue to take blood pressure, heart and other medication right up to the time of your surgery. Take any heart or blood pressure medication with a small sip of water on the morning of surgery before coming to the hospital. If you are taking arthritis medications or any blood thinning medications such as Coumadin, please ask your doctor for guidance about when to stop taking these medicines. If you are diabetic and take insulin every morning, you must discuss this with your physician. also.
Approximately two weeks prior to surgery, all of your laboratory studies should have been completed and the results returned to your doctor. This allows time for any problems, such as a bladder infection, to be evaluated and treated. It is important that this laboratory evaluation be completed on time so that your surgery will not be delayed or postponed.
- Exercising Before Surgery
It is important for you to improve your general medical condition prior to surgery. With this in mind you should continue to eat nutritious well-balanced meals. Make every effort to stop smoking one week prior to surgery. While your knee pain will make it difficult, we would like you to work on those muscles which will be used right after surgery to stand and walk.
- Surgery
Most patients are given a general anesthetic but a spinal or epidural anesthetic technique is also very satisfactory. During surgery, the joint surfaces are resurfaced and the joint is realigned. The decision whether to resurface the kneecap, is made during surgery. The entire operation lasts about an hour and a half after which you are taken to the recovery room to be monitored while coming out of anesthesia. After about an hour, you will be taken to your room.
Most knee replacement patients will have a tube similar to an IV line coming from their knee to drain excess blood. If used, this drain is generally discontinued the day after surgery.
You and your surgeon may decide that a catheter should be placed in your bladder to assist in monitoring urine flow. If this catheter has been placed, it is usually removed in a couple of days when you become more active.
- Physiotherapy And Recovery
The day after surgery, physical therapists will begin to help you get up and move around. Exercises will begin to help you bend your knee. To help bend the knee, most patients use a continuous passive motion (CPM) machine which gradually and slowly increases the flexibility of the joint.STAR CARE has a physio programme for 3-4 weeks for all patients.
Range Of Motion Exercise
Almost every patient develops an area of numbness on the outer side of the knee following knee replacement. This is due to the position of the incision and the nerves in the skin. This numbness is permanent but becomes less noticeable with time and causes no disability.
Mild swelling is common in the operated leg after going home. This usually improves with elevation and the ankle exercises.
Living With Your New Knee
After discharge from the hospital, you will be encouraged to perform your exercises and to walk at home. It is common for patients to utilise the service of a homecare physiotherapist for the exercise programme for 1 or 2 weeks. Your sutures will still be in place and this area should be kept clean and dry. If there are any problems with your incision such as redness or drainage, please notify the hospital. You should take your temperature twice a day and for any temperature elevation above 100.5 degrees F, contact the hospital. When you come to the hospital two weeks after surgery, sutures will be removed and new x-rays of the knee obtained. We will monitor your progress on a regular basis until you have resumed normal activities. Most patients usually walk on crutches for about four weeks after surgery and are able to resume most normal activities such as driving a car by about six weeks after surgery.
Who needs surgery?
A joint replacement is essential in individuals suffering from a painful disabling arthritis pain which persists in spite of medical treatment. The procedure is, therefore, indicated for painful arthritic joints with or without deformity - in-patients suffering from rheumatoid arthritis, osteoarthritis, traumatic arthritis and certain other non-septic arthritis.
High Flexion Knee Replacement
High flexion rotating platform knee replacement surgery, also called mobile bearing high bending knee is thee latest and most modern advancement in the field of knee replacement surgery. The various types of knee replacement implants available in the market do not allow one squat or sit cross-legged, with high flex cross rotation platform knee replacement surgery, one can do this. Rotating Platform High Flexion is one very few implants, at the moment that gives the combination of high knee flexion and rotation. The advantage of rotation is that it gives movement in two planes, similar to normal knee, being minimally invasive, and the incision in the skin is much smaller and recovery is faster.
The benefits of rotating platform high bending knee replacement surgery are:
- Deep flexion ranging from 120 to 140 degrees, as a normal knee with reduced wear.
- Rotational Freedom in deep flexion.
- Allow kneeling, squatting and sitting cross legged, praying on the floor.
- Excellent, bending & rotation.
- Active lifestyle with long implant
Writer Bio
Dr Kalyan Srungavarapu is one of the best Orthopaedician who manages arthritis in Muscat Oman. He completed his MBBS, MS (Orthopaedics), Fellowship in advanced joint replacement surgery and MCh Orthopaedics (UK). He has been trained in advanced arthroscopic surgeries for sports injuries in Royal College of surgeons England. A member of the Royal college of Physicians and Surgeons of Glasgow (MRCS) and American Academy of Orthopaedics Surgeons (MAAOS). He is also a fellow of American college of surgeons (FACS) and fellow of Royal college of of physicians and surgeons of Glasgow (FRCS).
