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Osteoarthritis (Knee Pain Clinic)

Are you looking for effective way to manage and cure Osteoarthritis? You are at the right place. Stop your Knee Pain today! Call us at +65 6471 2744 or SMS to +65 92357641 to schedule for an appointment.

The most common form of arthritis, Osteoarthritis (OA) affects an estimated 40% of the adult population. Of these, only 10% seek medical advice and only 1% are severely disabled.

Knee Osteoarthritis

Knee Osteoarthritis

Causes

Osteoarthritis (OA) means inflammation of the joints although it is better known as a degenerative disease due to the inflammation of the joints with thinning of the articular cartilage. The cartilage in our joints allows for the smooth movement of joints. When it becomes damaged due to injury, infection or gradual effects of ageing, joints movement is hindered. As a result, the tissues within the joint become irritated causing pain and swelling within the joint.

Symptoms

In OA, you will have no problem in the morning on arising but as the day progresses your discomfort will increase.

In the evening, there will be a dull ache in the area of the affected joint.

Other symptoms include:

  • Pain
  • Swelling of the affected joints
  • Changes in surrounding joints
  • Warmth – The arthritic joint may feel warm to the touch
  • Crepitation – A sensation of grating or grinding in the affected joint caused by the rubbing of damaged cartilage surfaces
  • Cysts – In OA of the hand, small cysts may develop, which may cause the ridging or dents in the nail plate of the affected finger

The changes associated with degenerative arthritis tend to involve similar joints. Whereas in post-traumatic degenerative arthritis where there is a history of acute or chronic trauma, the changes tend to be isolated to the specific joints injured.

Risk Factors

Old age
As a person grows older, it becomes more likely that the cartilage may be worn away. OA is uncommon in people below 40 years of age.

Gender
Women are more likely to suffer from OA, especially after menopause.

Previous joint injury
Someone with a previous injury to the cartilage within the joint, e.g. after a fracture involving the joint or after a sporting injury to the joint will have a higher risk of developing OA later in life.

Weight
A greater than normal body weight puts more stress on the weight-bearing joints such as the hip and knee, increasing the likelihood of developing OA in these joints.

Bone deformities
People born with deformed joints or abnormal cartilage have an increased risk of OA.

Other diseases that affect the joints
Bone and joint diseases that increase the risk of OA include other arthritic conditions such as rheumatoid arthritis and gout.

Genetics
Genetic factors may predispose to the development of OA.

Diagnosis

The specialist will begin by taking a detailed history of your problem and past medical problems, followed by a physical examination. He may then proceed to other tests, such as:

X-rays
This is the most commonly performed test to evaluate the status of the affected joint and the alignment of the joint. Normal x-rays are safe, simple and pain-free.

Blood tests
Depending on the clinical findings, blood may be drawn for special testing, to rule out other causes of joint pain, e.g. due to rheumatoid arthritis, gout or infection.

Joint aspiration
Occasionally, especially when the joint is very swollen, the doctor may choose to suck some fluid out of the swollen joint for special testing. Removal of joint fluid also sometimes relieves pain.

Treatment Options

The goals for treatment for osteoarthritis are:

i. Pain relief
ii. Maintenance of function
iii. Prevention of associated deformities
iv. Patient education

The treatment for OA depends on the severity of the disease and the patient’s own lifestyle expectations.

Early cases of OA can generally be treated with:

  • Rest and lifestyle modification, such as weight loss and cessation of smoking
  • Use of aid (e.g. a walking stick). Use of good shoes is also helpful for relieving symptoms in some
    cases of OA
  • Exercise and physiotherapy to strengthen muscles and improve joint flexibility
  • Medication

In OA of the hand, rest can be accomplished by selectively immobilising the joint in a splint. Splinting is initially done for a period of 3 – 4 weeks, during which the splint is worn continuously.

This is usually combined with non-steroidal anti-inflammatory medication (NSAIDs) taken at the same time. If there is improvement in symptoms, use of the splint during the day is progressively diminished over the course of the coming month/s.

Use of NSAIDS
Gastrointestinal intolerance remains one of the major factors limiting the prolonged use of NSAIDs and may require temporary or permanent discontinuation of the anti-inflammatory agent. Concomitant use of H2 blockers, omeprazole, or misoprostol, a prostaglandin analogue that counteracts the mucosal effects of NSAIDs, may mitigate some of the gastrointestinal effects. Nephrotoxicity is a well-known complication of NSAIDs, and patients with pre-existing renal insufficiency should not take NSAIDs for extended periods.

Types of medication
There is presently no medication that can cure OA or regrow the cartilage in osteoarthritic joints.

The most commonly prescribed medications are painkillers. The type of painkiller prescribed depends on
the severity of the pain. For early disease with mild and occasional pain, simple painkillers, although more severe pain may require the use of non-steroidal anti-inflammatory drugs (NSAID’s) for relief. Analgesic (painkillers) creams and adhesive patches can also be used.

Glucosamine, with or without chondroitin, has also become a popular drug treatment in recent
years. It can be purchased without a doctor’s prescription.

However, it is ineffective in many patients, especially those with severe OA. The duration of its symptomatic relief also tends to be temporary. There is no evidence that glucosamine or chondroitin is able to result in cartilage repair.

Injections
For the treatment of OA, your doctor may sometimes recommend a lubricant injection to coat the cartilage and stimulate the healing process.

Surgery
Surgery is usually only offered for severe disease that has not responded to conservative treatments mentioned. Both the type of surgery and the decision for surgery are made following careful discussions between you and your doctor.

For many joints in the hands, arthodesis or fusion of the joint is the method of choice. In joint fusion, the arthritic surface is removed and bones on either side of the joint are fused to eliminate movement from the problem joint.

There may be some loss of movement but the pain ablation and stability may functionally improve the joint that is severely affected by the degenerative joint disease.

STOP YOUR KNEE PAIN TODAY. CALL US AT +65 6471 2744 Or SMS TO +65 92357641 FOR APPOINTMENT

Patient Guide to Knee Pain

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

Symptoms

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully straighten the knee

When to see a doctor
Call your doctor if you:

  • Can’t bear weight on your knee
  • Have marked knee swelling
  • Are unable to fully extend or flex your knee
  • See an obvious deformity in your leg or knee
  • Have a fever, in addition to redness, pain and swelling in your knee
  • Feel as if your knee is unstable or your knee “gives out”

Causes

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries
A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

  • ACL injury. An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.
  • Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
  • Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
  • Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical problems
Some examples of mechanical problems that can cause knee pain include:

  • Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.
  • Iliotibial band syndrome. This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
  • Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. In some cases, the kneecap may stay displaced and you’ll be able to see the dislocation.
  • Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can place more stress on your knee joint. In some cases, problems in the hip or foot can refer pain to the knee.

Types of arthritis
More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

  • Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
  • Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
  • Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
  • Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
  • Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. There’s usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other problems
Chondromalacia patellae (patellofemoral pain syndrome) is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight misalignment of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Risk factors

A number of factors can increase your risk of having knee problems, including:

  • Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
  • Biomechanical problems. Certain structural abnormalities — such as having one leg shorter than the other, misaligned knees and even flat feet — can make you more prone to knee problems.
  • Lack of muscle flexibility or strength. A lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don’t absorb enough of the stress exerted on the joint.
  • Certain sports. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball’s jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury.
  • Previous injury. Having a previous knee injury makes it more likely that you’ll injure your knee again.

Complications

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you’ll have similar injuries in the future.

Preparing for your appointment

You’re likely to start by seeing your family doctor. Depending upon the cause of your problem, he or she may refer you to a doctor specializing in joint diseases (rheumatologist), joint surgery (orthopedic surgeon) or sports medicine.

What you can do
Before your appointment, you may want to write a list of answers to the following questions:

  • When did you begin experiencing symptoms?
  • Did a specific injury make your knee start to hurt?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • What medications and supplements do you take regularly?

What to expect from your doctor
Your doctor may ask some of the following questions:

  • Do you exercise or play sports?
  • Do you experience any swelling, instability or locking of the knee?
  • Are you experiencing symptoms in other areas, or just in your knee?
  • Have you ever had knee pain before? If so, do you know what the cause was?

Tests and diagnosis

During the physical exam, your doctor is likely to:

  • Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
  • Check to see how far you can move your lower leg in different directions
  • Push on or pull the joint to evaluate the integrity of the structures in your knee

Imaging tests
In some cases, your doctor might suggest tests such as:

  • X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
  • Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body. CT scans can help diagnose bone problems and detect loose bodies.
  • Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee, and how they are working. Your doctor may want to maneuver your knee into different positions during the ultrasound, to check for specific problems.
  • Magnetic resonance imaging. MRI uses radio waves and a powerful magnet to create 3-D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Lab tests
If your doctor suspects an infection, gout or pseudogout, you’re likely to have blood tests and sometimes arthrocentesis, a procedure in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Treatments and drugs

Treatments will vary, depending upon what exactly is causing your knee pain.

Medications
Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Therapy
Strengthening the muscles around your knee will make it more stable. Training is likely to focus on the muscles on the front of your thigh (quadriceps) and the muscles in the back of your thigh (hamstrings). Exercises to improve your balance are also important.

Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.

Injections
In some cases, your doctor may suggest injecting medications directly into your joint. Examples include:

  • Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that lasts a few months. The injections aren’t effective in all cases. There is a small risk of infection.
  • Supplemental lubrication. A thick fluid, similar to the fluid that naturally lubricates joints, can be injected into your knee to improve mobility and ease pain. Relief from one or a series of shots may last as long as six months to a year.

Surgery
If you have an injury that may require surgery, it’s usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what’s most important to you. If you choose to have surgery, your options may include:

  • Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage, and reconstruct torn ligaments.
  • Partial knee replacement surgery. In this procedure (unicompartmental arthroplasty), your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed with a small incision, and your hospital stay is typically just one night. You’re also likely to heal more quickly than you are with surgery to replace your entire knee.
  • Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

Lifestyle and home remedies

Over-the-counter medications — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) — may help ease knee pain. Some people find relief by rubbing their knees with creams containing a numbing agent, such as lidocaine or capsaicin, the substance that makes chili peppers hot.

Self-care measures for an injured knee include:

  • Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time.
  • Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don’t use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin.
  • Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that’s lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.
  • Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.

Alternative medicine

  • Glucosamine and chondroitin. Study results have been mixed about the effectiveness of these supplements for relieving osteoarthritis pain. People who have moderate to severe arthritis pain appear to get the most benefit from these supplements.
  • Acupuncture. Research suggests that acupuncture may help relieve knee pain caused by osteoarthritis. Acupuncture involves the placement of hair-thin needles into your skin at specific places on your body.

Prevention

Although it’s not always possible to prevent knee pain, the following suggestions may help forestall injuries and joint deterioration:

  • Keep extra pounds off. Maintain a healthy weight; it’s one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.
  • Be in shape to play your sport. To prepare your muscles for the demands of sports participation, take time for conditioning. Work with a coach or trainer to ensure that your technique and movement are the best they can be.
  • Get strong, stay limber. Because weak muscles are a leading cause of knee injuries, you’ll benefit from building up your quadriceps and hamstrings, which support your knees. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts.
  • Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.

STOP YOUR KNEE PAIN TODAY. CALL +65 6471 2744 OR SMS TO +65 92357641 FOR APPOINTMENT

Patient Guide to Osteoarthritis

Osteoarthritis is the most common form of arthritis, affecting millions of people around the world. Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over time.

While osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, neck, lower back, knees and hips.

Osteoarthritis gradually worsens with time, and no cure exists. But osteoarthritis treatments can slow the progression of the disease, relieve pain and improve joint function.

Symptoms of Osteoarthritis:

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

  • Pain. Your joint may hurt during or after movement.
  • Tenderness. Your joint may feel tender when you apply light pressure to it.
  • Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
  • Loss of flexibility. You may not be able to move your joint through its full range of motion.
  • Grating sensation. You may hear or feel a grating sensation when you use the joint.
  • Bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint.

When to see a doctor
If you have joint pain or stiffness that lasts for more than a few weeks, make an appointment with your doctor.

Causes of Osteoarthritis

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints deteriorates over time. Cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. In osteoarthritis, the slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone.

Risk Factors of Osteoarthritis:

Factors that increase your risk of osteoarthritis include:

  • Older age. The risk of osteoarthritis increases with age.
  • Sex. Women are more likely to develop osteoarthritis, though it isn’t clear why.
  • Bone deformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
  • Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
  • Obesity. Carrying more body weight puts added stress on your weight-bearing joints, such as your knees.
  • Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
  • Other diseases. Having diabetes, underactive thyroid, gout or Paget’s disease of bone can increase your risk of developing osteoarthritis.

The complication of Osteoarthritis:

Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make daily tasks difficult. Some people are no longer able to work. When joint pain is this severe, doctors may suggest joint replacement surgery.

Stop the Pain and Cure your Osteoarthritis Today! Call +65 6471 2744 or SMS to +65 92357641 for Appointment

Total Knee Replacement

A Guide to Understanding Total Knee Surgery

Why Does My Knee Hurt?

Your knee joint is made up of three bones. Your thigh bone (femur) sits on top of your shin bone (tibia). When you bend or straighten your knee, the rounded end of your thigh bone roll and glides across the relatively flat upper surface of your shin bone. The third bone is often called the kneecap (patella), which is attached to the muscles that allow you to straighten your knee. Your kneecap provides leverage that reduces strain on these muscles.

In a normal, healthy knee, the bone surface that come together at the joint are smooth and hard. A cushioning layer of tissue, called cartilage, prevents direct contact among these bones. This tough layer of tissue allow the three bones to move without creating friction or wear on the bone surfaces.

KneeHowever, when this cartilage is damaged or worn away, your bones rub together causing friction, pain and, eventually deterioration of the bone surfaces. The most common causes of damage to your cartilage are the various types of arthritis. There is no medication or treatment that will make damaged cartilage grow back.

 What is Total Knee Replacement?

In total knee replacement surgery, the parts of the bones that rub together are resurfaced with metal and plastic implants. Using special, precision instruments, your surgeon  will typically remove the damaged surfaces of all three bones. The replacement surfaces will then be fixed into place.

The surface of the upper bone is replaced with a rounded metal component that comes very close to matching the curve of your natural bone. The surface of the lower bone is replaced with a flat metal component with a piece of ultra-high-molecular weight polyethylene plastic to serve as the cartilage. The undersurface of the kneecap may also be replaced with a round disc made of the same polythylene plastic.

Knee Replacement

How Will I Know If I Should Have Knee Replacement?

Our orthopaedic surgeon will perform a very thorough examination of your knee. This will include a test of your range of motion-how far you can bend and extend your knee. Our surgeon will also look for deformities in your legs which may show up as conditions commonly called bowlegged or knock-kneed. You will be asked to walk, sit, and perhaps go up and down a few steps.

Our surgeon will also ask you many important questions to determine our medical history. Answering these questions thoroughly helps the surgeon accurately evaluate your individual circumstance. You will be asked about current medications, as well as past injuries, infections and other disorders you may have experienced. And, of course, you will be asked to describe the pain in your knee.

Finally, our surgeon will take X-rays which will be used to further assess the condition of your knee joint. If you decide on total knee replacement surgery, these X-rays will also be used to help our surgeon select the best type and size of artificial knee.

Based on this examination, your surgeon will determine whether your are a candidate for total knee replacement. Although widely practiced, total knee replacement is a major surgical procedure and should only be considered when all other treatment methods have failed.

There are more conservative alternatives which you and our surgeon may want to consider. These include medications or injections for pain and inflammation, physical therapy, or other types of surgery.

The final decision about whether or not to have total knee surgery will be yours, so you will want to understand the risks involved. There are potential complications both during and after surgery. Generally, these include infection, blood clots, pneumonia, prosthesis loosening, and nerve damage. Our surgeon can answer your specific questions about these risks.

What Is It Like To Have Knee Replacement Surgery?

Before Surgery

If you and our surgeon decide that total knee replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery.

Because blood transfusions may be needed during your surgery, you may want to donate one unit of your own blood, or possibly two units if your surgeon feels it is needed. You can donate one unit per week before your surgery.

During Surgery

On the day of surgery, a small tube (intravenous line) will be inserted into your arm. This tube will be used to administer antibiotics and other medication during your surgery. You will then be taken to the operating room and given anesthesia.

After the anesthesia takes effect, your knee will be scrubbed and sterilized with a special solution.

The surgery will begin with an incision over the knee that will expose the joint. When the bones are fully visible to the surgeon, special, precision guides and instruments are used to remove the damaged surfaces and shape the ends of the bones to accept the implants.

The implants are then secured to the bones. It might also be necessary to adjust the ligaments that surround the knee in order to achieve the best possible knee function. When the surgeon is satisfied with the fit and function of the implants, the incision will be closed.

A special drain may be inserted into the wound to drain the fluids that naturally develop at the surgical site. A sterile develop at the surgical site. A sterile bandage will then be applied, and you will be taken the recovery room, where you will be taken to the recovery room, where you will be closely monitored. Your surgery will take between two to three hours, depending on your individual circumstances.

After Surgery

As your anesthesia wears off, you will slowly regain consciousness. A nurse will be with you, and may encourage you to cough or breath deeply to help clear your lungs. You will also be given pain medication. When you are fully awake, you will be taken to your hospital room. Your knee will remain swollen and tender for a few days.

What Can I Expect After Surgery?

When you are back in your hospital room, you will begin in a rehabilitation program designed specially for you. This program will help you regain strength, balance, and get you back to the activities you enjoy. It may include a machine, called a continuous passive motion machine, that automatically moves your leg.

Your physical therapist will help you perform appropriate exercises. About 24 hours after surgery, you will probably be asked to stand. Within the next 24 hours, you will begin to walk a few steps with the help of a walker.

You will be discharged as soon as our surgeon determines that you have recovered sufficiently. You can expect to stay in the hospital for about three days after your surgery. You may or may not be transferred to a nursing facility for a few more days, as determined by our surgeon. Your bandages and sutures will usually be removed before you leave the hospital.

At home, you will need to continue your exercises. Your physical therapist will instruct you about proper home care, and may continue to work with you.

Within six weeks after surgery, most patients are able to walk with a cane. You will probably feel well enough to drive a car within seven to eight weeks after surgery.

In most cases, successful total knee replacement will relieve your pain and stiffness, and allow you to resume many of your normal daily activities. But even after you have fully recovered from your surgery, you will still have some restrictions. Normal daily activities do not include contact sports or activities that put excessive strain on your knees. Although your artificial knee can be replaced, a second implant is seldom as effective as the first.

Tags: Osteroarthritis, Knee Pain, Synvisc Injection, Knee

Synvisc – Visco-Supplementation

What is Synvisc?

The joints of people with osteoarthritis or other degenerative joint diseases are different in several ways from those of healthy people. They contain less synovial fluid (the oily liquid which lubricates joints), and that fluid is thinner and therefore less able to lubricate nicely.

Synvisc is Visco-Supplementation entails the supplementation of the defective matrix of the joint with material of high viscosity and elasticity, namely Sodium Hyaluronate. When injected into the joint, it provides protection, lubrication, shock absorption and restoration of the viscosity of synovial fluid.

By supplementing the patient’s natural lubricants, Synvisc injection may reduce pain and stiffness in the treated joints for easier, more comfortable movement. A number of studies in Canada and Europe have shown the beneficial effects of Visco-supplementation in the management of osteroarthritis.

Osteoarthritis Synvisc

 

 

 

 

 

 

 

What is Sodium Hyaluronate?

Sodium Hyaluronate is an important component of synovial fluid and provides it with its lubricating properties. It also acts as a shock absorber during movement such as walking down the staircase.

Sodium Hyaluronate is injected intra-articularly into the synovial cavity of a joint.

What makes me a good candidate for Synvisc?

Synvisc is  particularly useful for patients in relatively early stages of osteoarthritis, where physical damage has not progressed very far.  It can also be used as an alternative or supplement to therapy with non-steroidal anti-inflammatory drugs (NSAID’s) or analgesics, the medications most often prescribed for arthritis patients.

If you are unable to tolerate or you do not wish to take NSAID’s , Synvisc may be an appropriate therapy.  If you have recently been diagnosed as having osteoarthritis, Synvisc may be appropriate if your doctor has decided that your current therapy needs to changed or enhanced.

How is Synvisc injection administered?

Synvisc injection is given to the knee. More than one joint may be treated at the same time.

More injections may be given in chronic conditions. It is available only through a healthcare professional. Dr. Kevin Yip specialises in joint injection.

How long will the benefits of Synvisc last?

This form of treatment appears to be effective in more than 75% of patients after one course, and in 84% of cases after the second course of therapy. The effectiveness of therapy was evaluated by assessment of patient activity, and decreased use of concomitant therapy. Majority of patients experience clinical benefits lasting from 6 to 12 months. The clinical outcomes also depend on the severity of symptoms. Those with more severe condition would benefit from additional injections.

What are the advantages of Synvisc?

Sodium Hyaluronate (Hyaluronic Acid) is the natural substance of the joint. It is injected to the joint space and works only locally within the joint, thus there have been no reported systemic reactions related to the treatment. This is different from those medication such as pain-killer known as Nonsteroidal anti-inflammatory drugs (NSAIDs) which can cause gastro-intestinal bleeding or ulcer.

Recent studies also shown that Synvisc decreased the use of concomitant therapy such as pain-killer or analgesics. Synvisc injection is effective in relieving the symptoms of osteoarthritis, and may also slow down the progression of the diseases.

Visco-Supplementation is one of the recommended choice for Osteoarthritis treatment according to the American College of Rheumatology Subcommittee on Osteoarthritis Guidelines of the Knee year 2000.

Is Synvisc injection painful?

Naturally, as with all injections, there may be a mild and short-lasting discomfort during the actual procedure., but aside from this it is virtually painless.

Often your doctor may use a topical anaesthetic to reduce the discomfort. If there is considerable inflammation around the joint, the doctor may remove some of the excess fluid (exudate) prior to an injection of Sodium Hyaluronate. Visco-Supplement injection is only administered when joint swelling disappeared.

What precautions should I take after Synvisc?

You should rest and avoid strenuous weight-bearing activities for 1-2 days after an injection.

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