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All About Arthritis Kambiz Behzadi, M.D. Orthopedic Surgeon San Ramon, Pleasanton, Livermore San Ramon, Pleasanton, Livermore.

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Presentation on theme: "All About Arthritis Kambiz Behzadi, M.D. Orthopedic Surgeon San Ramon, Pleasanton, Livermore San Ramon, Pleasanton, Livermore."— Presentation transcript:

1 All About Arthritis Kambiz Behzadi, M.D. Orthopedic Surgeon San Ramon, Pleasanton, Livermore San Ramon, Pleasanton, Livermore

2 Arthritis and You Musculoskeletal Conditions affect millions of people Musculoskeletal Conditions affect millions of people $254 billion per year spent $254 billion per year spent

3 Arthritis 40 Million Americans have arthritis 40 Million Americans have arthritis 20 Million people suffer from Osteoarthritis 20 Million people suffer from Osteoarthritis Osteoarthritis most common form of arthritis Osteoarthritis most common form of arthritis

4 Synovial Joints Bone ends --> Articular Cartilage Bone ends --> Articular Cartilage Cartilage cushions bones-->allows bones to move without pain Cartilage cushions bones-->allows bones to move without pain Synovium--> covers joints, produces fluid that reduces friction Synovium--> covers joints, produces fluid that reduces friction Articular Cartilage Bone Synovial Membrane Synovial Fluid

5 Synovial Joints Ligaments connect bones--> stability Ligaments connect bones--> stability Muscles and Tendons power joints--> movement Muscles and Tendons power joints--> movement

6 Arthritis Arthritis is Inflammation Arthritis is Inflammation Bodys normal reaction to injury Bodys normal reaction to injury Chronic inflammation in arthritic joint--> long lasting disability Chronic inflammation in arthritic joint--> long lasting disability Inflammation Swelling Pain Stiffness

7 Osteoarthritis Loss of cartilage and joint surface Loss of cartilage and joint surface Second most common cause of disability in adults Second most common cause of disability in adults 7 million physician visits per year 7 million physician visits per year 3 million hospitalizations 3 million hospitalizations $2655 per person $2655 per person Cartilage Healthy KneeOsteoarthritic Knee

8 Osteoarthritis Weight bearing joints Weight bearing joints Hips, knees, feet Hips, knees, feet Fingers Fingers Spine Spine

9 Osteoarthritis Most of us by our 60s & 70s More women than men All races equally 40 million by 2020 Burden of Disease

10 Osteoarthritis Pain in affected joints Pain worse with prolonged use Pain better with rest Stiffness relieved by flexing and movement

11 Osteoarthritis-Xray

12 Osteoarthritis Causes Primary Osteoarthritis Most Common Primary Osteoarthritis Most Common Thought to be result of Aging Thought to be result of Aging Decreased ability to withstand stress Decreased ability to withstand stress Ligaments supporting joints weaken Ligaments supporting joints weaken

13 Secondary Osteoarthritis Obesity Trauma Surgery Abnormal jointsGoutDiabetes Hormone disorders Causes

14 Goals of Treatment To Relieve pain To Relieve pain Increase motion Increase motion Improve strength Improve strength

15 Medication- NSAIDs NSAIDs are nonsteroidal anti-inflammatory drugs NSAIDs are nonsteroidal anti-inflammatory drugs Aspirin Aspirin Ibuprofen Ibuprofen Naproxen Naproxen

16 Medication Cox-2 inhibitors offer the benefits of other NSAIDs with a decreased incidence of gastrointestinal side effects. Vioxx, Celebrex, Bextra

17 Medication Injections Liquid cortisone Hyaluronate Supartz Synvisc Hylagan

18 Vitamins Anti-oxidants A,C,D,E may help prevent Osteoarthritis No Clinical trials No clear proof

19 Nutritional Supplements Glucosamine Glucosamine Chondroitin Sulfate Chondroitin Sulfate Some Positive results Some Positive results Mild to moderate pain relief Mild to moderate pain relief If not seen within eight weeks, not likely to benefit If not seen within eight weeks, not likely to benefit

20 Alternative Medicine Complimentary approaches may: Complimentary approaches may: Ease symptoms Ease symptoms Improve outlook and attitude Improve outlook and attitude

21 Alternative Medicine Complimentary approaches will not: Complimentary approaches will not: Cure acute illness Cure acute illness Replace proven medical treatment for osteoarthritis Replace proven medical treatment for osteoarthritis

22 Alternative Medicine PainStiffnessFatigueInflammationAnxiety/ Depression Biofeedback uuu Visualization u u Hypnosis u u Relaxation u u Yoga uuu u uuu u Acupuncture uu uu Magnets uu u Vegetarian Diet uu u Herbs & Supplements uuuuu TherapySymptoms

23 Joint Protection

24 Exercise Gentle exercise in moderation Gentle exercise in moderation Strengthen muscles Strengthen muscles Prevent stiffness Prevent stiffness Decrease weight Decrease weight Promote endurance Promote endurance Right program for you Right program for you

25 Surgery Arthroscopy Arthroscopy Least Invasive Least Invasive Arthroscope Arthroscope Remove partially damaged cartilage Remove partially damaged cartilage Portals Portals Remove dead cartilage and enzymes that cause inflammation Remove dead cartilage and enzymes that cause inflammation Arthroscope Portals Damaged cartilage

26 Abrasion / Drilling Abrasion and Drilling Abrasion and Drilling Healing response Healing response Fibrocartilage= Scar Cartilage Fibrocartilage= Scar Cartilage Inferior mechanical properties to articular cartilage Inferior mechanical properties to articular cartilage Less advanced OA Less advanced OA Focal arthritis Focal arthritis Focal, localized lesion

27 Osteotomy Realignment of Joints Realignment of Joints Transfer Weight to less involved part of joint Transfer Weight to less involved part of joint 60s and 70s 60s and 70s Less popular Less popular Does not provide good long term results Does not provide good long term results

28 Mosaicplasty / OATS Localized focal arthritis/defect Localized focal arthritis/defect Traumatic arthritis Traumatic arthritis Small to medium Small to medium Transferring healthy plug of bone and cartilage to defect in weight bearing area Transferring healthy plug of bone and cartilage to defect in weight bearing area SmallLarge

29 ACI Articular Cartilage Implantation Articular Cartilage Implantation Pot hole in the road Pot hole in the road Two operations Two operations Cartilage harvested and sent to Lab, to grow in Culture Cartilage harvested and sent to Lab, to grow in Culture Cartilage cells transplanted into the defect Cartilage cells transplanted into the defect In future may be applicable to large lesions/primary OA In future may be applicable to large lesions/primary OA

30 Total Joint Replacement Considered last Solution for Arthritis Improved Ambulation Decreased Pain Increased ROM 90%+ good to excellent results

31 Total Joint Replacement Removal of diseased joint Replace with a prosthetic joint + + + Knee Hip

32 Minimally Invasive Surgery Continuous advances in joint replacement procedures Continuous advances in joint replacement procedures MIS= Minimally Invasive Surgery MIS= Minimally Invasive Surgery

33 MIS 8-12 inches --> 3 to 5 inches 8-12 inches --> 3 to 5 inches Same implants Same implants Minimal trauma to Muscles and Tendons Minimal trauma to Muscles and Tendons Quadriceps muscle and tendon not cut Quadriceps muscle and tendon not cut Unassisted walking at 2 to 4 weeks Unassisted walking at 2 to 4 weeks Back to Activities/Work Sooner Back to Activities/Work Sooner

34 Summary Osteoarthritis affects in excess of 20 Million Americans Osteoarthritis affects in excess of 20 Million Americans Accurate Diagnosis important Accurate Diagnosis important Understand the nature of this Problem Understand the nature of this Problem Many treatment Options available Many treatment Options available Benefits and limitations Benefits and limitations Choose the right treatment for you Choose the right treatment for you Get back into the game Get back into the game

35 Arthritis www.nih.gov/niams/ www.aboutarthritis.com American Academy of Orthopaedic Surgeons www.aaos.org Arthritis Foundation www.arthritis.org www.behzadisportsdoc.com

36 THANK YOU

37 MIS THR TWO INCISION CO-AXIAL PATH SINGLE INCISION POSTERIOR APPROACH


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