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San Ramon, Pleasanton, Livermore

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Presentation on theme: "San Ramon, Pleasanton, Livermore"— Presentation transcript:

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

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

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

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

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

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

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

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

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

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 Thought to be result of Aging Decreased ability to withstand stress Ligaments supporting joints weaken

13 Secondary Osteoarthritis
Causes Trauma Obesity Surgery Abnormal joints Gout Diabetes Hormone disorders

14 Goals of Treatment To Relieve pain Increase motion Improve strength

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

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

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

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

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

22 Alternative Medicine Therapy Symptoms Pain Stiffness Fatigue
Pain Stiffness Fatigue Inflammation Anxiety/ Depression Biofeedback u Visualization Hypnosis Relaxation Yoga Acupuncture Magnets Vegetarian Diet Herbs & Supplements

23 Joint Protection

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

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

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

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

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

29 ACI Articular Cartilage Implantation “Pot hole in the road”
Two operations Cartilage harvested and sent to Lab, to grow in Culture Cartilage cells transplanted into the defect 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 MIS= Minimally Invasive Surgery

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

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

35 American Academy of Orthopaedic Surgeons
Arthritis Arthritis Foundation American Academy of Orthopaedic Surgeons



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