Knee Osteoarthritis

Knee osteoarthritis is a degenerative joint disease that results in the breakdown of [...] No related posts.]]>

Knee Osteoarthritis

Knee osteoarthritis is a degenerative joint disease that results in the breakdown of the cartilage between the joints in the knees. This leads to pain, loss of range of motion and bone damage. There appears to be several origins of knee osteoarthritis including joint deformity, repeated injury, or excess weight. There is no cure for osteoarthritis so the focus is on treatments for the pain and reduction of continued damage to the joint.

And this is where leeches come in. Leeches secrete morphine, a potent pain killer. Leeches also secrete an anticoagulant which improves blood flow to the area where the leeches are applied and an anti-inflammatory. Since inflammation is responsible for the symptoms of osteoarthritis, researchers believe that leeches might relieve pain in patients with osteoarthritis.

The U.S. Food and Drug Administration (FDA) classify leeches as medical devices and has approved them for microsurgery. The FDA is also involved in the regulation of the transport and sale of leeches. In Germany there has been an estimated 70,000 treatments a year over the last few years with four to five used for each treatment. Most of these treatments have been aimed at pain reduction in knee osteoarthritis.

Several studies have been conducted regarding the use of leeches for treating knee osteoarthritis.

One study, reported in the Annals of the Rheumatic Diseases, focused on 16 patients with an average age 68. These patients had experienced persistent knee pain for more than six months. None had suffered any knee injuries and all had x-ray evidence of osteoarthritis. These patients were already treating their knee osteoarthritis with physical therapy, relaxation, diet and exercise.

In this study, part of the group was provided traditional treatment and the rest were treated with leeches. Four leeches were applied to the knee for 80 minutes. Pain levels were measured three days before and 28 day after the treatment. The results were rapid. Treatment with leeches resulted in pain relief after three days and continued through the 28 day test period. The patients who received traditional treatment did not experience relief. There were no side effects noted from the leeches and the patients reported that the initial leech bite was mildly painful.

A larger study was conducted involving 51 patients age 40 and above with knee osteoarthritis with high pain. Four to six leeches were applied to the affected knee and were allowed to remain until they detached themselves, which took about 70 minutes. Then the patients rested the knee for 12 hours. Researchers then measured the patients pain, stiffness and range of motion after 3, 7, 28, and 91 days.

The results were similar to the smaller study. The patients receiving leech therapy reported less pain, less stiffness, better function, and fewer total osteoarthritis symptoms through the full 91 days that the researchers followed them.

These studies give hope for alternative treatments of knee osteoarthritis for reducing pain and increasing mobility. In order to properly validate these studies additional research needs to be conducted over a longer period of time. But it appears that leeches do provide relief to knee osteoarthritis sufferers.

Originally posted 2010-02-01 07:00:47. Republished by Blog Post Promoter

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Arthritis literally means joint inflammation. Most of the cases of arthritis involve the body joints but joints are not the only body parts to be affected by arthritis. In its various forms arthritis can also affect other parts of the body. [...] No related posts.]]> If you suffer from severe osteoarthritis, surgery may be in store for you.

Arthritis literally means joint inflammation. Most of the cases of arthritis involve the body joints but joints are not the only body parts to be affected by arthritis. In its various forms arthritis can also affect other parts of the body. It is one of the most commonly occurring diseases affecting people of all ages. However most of the victims are able to go about their business as usual.

At a body joint, ends of two bones come together. The ends of the bones are covered with cartilage which makes the surfaces of bone ends smooth for sliding against each other. The smoothness of surfaces makes it possible to carry out the joint movement easily and painlessly with minimum friction thousands of times in a day. The two bones of a joint are held together firmly in place by ligaments which also form a capsule around the joint. The surface of ligaments is lined with synovial membrane which secretes synovial fluid for lubricating the joint.

Osteoarthritis, one of the more common types, results when cartilage wears out. When this happens the ends of the bones in contact with each other lose their protective cover as well as the smooth gliding surface. The bone ends then directly rub against each other. The joint becomes stiff and starts paining. This osteoarthritis involves joints which are exposed to frequent wear and tear such as fingers, big toes, knees, hips, lower spine.

Surgery is no small choice, and doctors and the surgeons they work with are naturally reluctant to operate unless you meet criteria that they consider important.

Hand Arthritis Surgery

Two of the key factors that all surgeons probably consider are the life-expectancies of the artificial joint and of you. Historically artificial joints last about 15 to 20 years. New technologies may extend this, but there’s really no one offering a guarantee that this will be so. For the new technologies, the long-term data just isn’t there yet. (That’s why it’s called “new.”)

Doctors call the replacement of an artificial joint gone bad a “revision.” And revisions are sometimes more difficult than the original operation. This also forms one more cause for reluctance in treating younger patients.

There seem to be two models that doctors and the surgeons they work with go by.

Model #1: Age and pain intensity.

In this model, the age is a critically important factor. If you’re expected to live, on average, to age 75 or 80, and the joint is only going to last 15 years, surgeons using this model will be reluctant to operate until you’re 65 years old.

The other parameter is pain intensity. No matter how old you are, if you need the replacement because the pain is just unbearable, many (most?) physicians will agree to operate.

Model #2: Add “life style”

In this model, the factors of the first model are still considered, but to them is added the question of whether you’re sacrificing your life right now in order to have some kind of “ideal state” when you’re 65.

This is clearly a subjective area for both the patient and the doctor, but in many cases, the evidence is so overwhelmingly clear that the call for a replacement of the joint is considered very reasonable.

And there are clear advantages to getting the artificial joint while you are younger.

• Generally, you’re better able to withstand surgery when you’re younger than when you’re in your latter years.
• Assuming the operation and recovery go well, you’ll have years of a better life that you can look back on when you’re older – even if at that time you get sidelined because a revision isn’t possible.
• Technology is improving all the time. By the time you need a revision (assuming that the newer materials do wear out in 15 to 20 years), the procedures may be in place to make revisions much easier to successfully perform.

Concluding Remarks

This article is a clarion call for osteoarthritis patients to be advocates on their own behalf and to have a discussion of the effects that your osteoarthritis is having on your life. If you are severely restricted in what you can do, if your family is suffering so as to compensate for your pain, and if you can imagine what it would be like for you to see your loved ones in pain and know that this is what they feel about you right now, then it may be past due for you to have this conversation.

And if your physician and surgeon will not take lifestyle as an important factor, seek out a second, third and fourth doctor who will.

This is NOT a call for unnecessary or ill-advised surgery. It is a call for a very important discussion that you should have with your doctor.

Originally posted 2010-01-04 07:00:13. Republished by Blog Post Promoter

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A current form of treatment for osteoarthritis damaged cartilage is by harvesting cartilage cells from healthy joints and transplanting these cells into the damaged area. The main drawback [...] No related posts.]]> Osteoarthritis is a condition which affects millions around the world. There is continual research into treatments to relieve the symptoms or prevent the disease all together.

A current form of treatment for osteoarthritis damaged cartilage is by harvesting cartilage cells from healthy joints and transplanting these cells into the damaged area. The main drawback is the limited amount of cells available.

Now, scientists in Britain believed that they have identified a potential treatment for osteoarthritis by use of stem cells.

Researchers at Cardiff University have discovered stem cells that are located in the articular cartilage in adults. These stem cells do not have the capability to become any cell in the way that full stem cells can. However, they do have the ability to become chondrocytes, which are the only cells found in cartilage, and in a large enough quantity to potentially treat osteoarthritis.

In their presentation at the UK National Stem Cell Network Annual Science Meeting n Edinburgh, the research team explained that they had identified a progenitor stem cell in bovine cartilage which they were able to turn into a chondrocyte cell in a culture. Their big breakthrough was being able to identify a similar cell in human cartilage.

Lead researcher Professor Charlie Archer from the Cardiff School of Biosciences said: “We have identified a cell which, when grown in the lab, can produce enough of a person’s own cartilage that it could be effectively transplanted. There are limitations in trying to transplant a patient’s existing cartilage cells but by culturing it from a resident stem cell we believe we can overcome this limitation.”

Trials are currently underway using goats and if successful, could lead to a small clinical trial involving 20 human patients.

If the research follows current expectations it is possible that treatment could be widely used in less than 5 years.

Originally posted 2008-04-09 19:59:20. Republished by Blog Post Promoter

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There are some concerning side effects from oral NSAIDs which includes stroke, heart attack, and bleeding or ulceration on the stomach or [...] No related posts.]]> Non-steroidal anti-inflammatory (NSAID) medication, such as ibuprofen and diclofenac, and a newer one called celecoxib (which we wrote about yesterday, have been prescribed as oral medications for the treatment of arthritis pain.

There are some concerning side effects from oral NSAIDs which includes stroke, heart attack, and bleeding or ulceration on the stomach or intestines.

The United States Food and Drug Administration has now approved a topical NSAID for treatment of osteoarthritis pain. Voltaren® Gel is the first approved topical treatment which is applied directly to the area of the osteoarthritis pain.

Over-the-counter remedies, like Bengay and Icy Hot, work primarily by generating heat or numbing the area. Voltaren® Gel contains diclofenac which is the most commonly used NSAID in the world and the second most commonly used NSAID in the U.S.

Two randomized, double-blind, placebo-controlled studies were conducted involving over 900 patients. The first, on patients with osteoarthritis of the hand, showed a 46% reduction in pain after 6 weeks of treatment. The other study was on patients with knee osteoarthritis. After 12 weeks these participants reported a 51% reduction in pain.

This type of topical NSAID pain reliever has been available in other countries for some time. These have provided additional supporting research.

The British Medical Journal reviewed 13 clinical trials of topical NSAIDs and found that in the first week they were less effective than a comparable oral treatment but were equivalent in pain reduction from the 2nd to 4th weeks.

Tests have also shown that there is less drug absorption throughout the body than oral medications. For example, there is 94% less absorption than with a comparable oral diclofenac treatment.

Patients with osteoarthritis pain in multiple locations will most likely still need to use an oral NSAID.

Over-the-counter remedies, like Bengay and Icy Hot, work primarily by generating heat or numbing the area.

Novartis, the maker of Voltaren® Gel, indicates that it should not be taken by patients with a known hypersensitivity to diclofenac, or who have experienced asthma or allergic type reactions to aspirin of other NSAIDs. They also say that it should not be used in combination with aspirin or other oral NSAIDs due to potential side effects.

This report is not intended to be an endorsement of Voltaren® Gel. Rather, it is intended to provide information about an alternative treatment for osteoarthritis pain. You should always consult your physician before beginning any new prescription treatment.

Originally posted 2007-12-18 19:46:20. Republished by Blog Post Promoter

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