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Report: Self-management, strength training can benefit sufferers of osteoarthritis


January 14th, 2010 by Formosa Medical Travel

Self-management programs and strength training regimens can help patients suffering from the early stages of osteoarthritis, says a new report titled Multidimensional Intervention for Early Osteoarthritis of the Knee.


The study, conducted at the University of Arizona Arthritis center over the course of 24 months, had 273 participants. The trial compared the effects of strength training regimens, self-management programs, and a combination of the two.


All participants were between the ages of 35 and 65, diagnosed with osteoarthritis, and had been sufferers of knee pain for less than five years. The first group of participants underwent a strength training regimen over the course of nine months, focusing on improving muscle strength, range of motion, flexibility, and balance. The second group concentrated on developing long-term exercise habits, with professional education and treatment advice. The third group participated in both strength training and self-management.


201 of the 273 participants completed the full two-year trial. There was little difference in the outcomes of the three groups, but all three showed marked improvement in many categories. Self-reported pain was decreased across the board, and physical function test scores improved for all three groups. The lack of a difference between the three groups suggests “similar benefits for all three over a two-year period,” said Patrick McKnight, lead author of the study.


These results suggest that sufferers of osteoarthritis should make an effort in the early stages of the disease to undergo strength training or some method of self-management program. By taking a proactive approach to the affliction, sufferers of osteoarthritis may be able to delay the need for total joint replacement surgery.



Knee transplants may be treatment for knee pain


January 11th, 2010 by Formosa Medical Travel

As osteoarthritis continues to afflict more and more Americans, sufferers turn to different treatments to ease the pain and regain mobility. Although knee replacement surgery is considered the most effective and long-lasting treatment to knee pain, an advanced procedure is being pursued by some younger patients: knee cartilage transplantation.


Osteoarthritis causes the deterioration of the cartilage in the knee. The cartilage serves as a load bearing zone and allows for flexion of the joint. Unfortunately, cartilage has poor regenerative qualities and, once afflicted by osteoarthritis, can degenerate quickly. Once osteoarthritis has progressed to an advanced stage, simple tasks such as walking can prove very painful or even impossible.


In performing a cartilage transplant, doctors first must perform a biopsy. In this minor surgery, surgeons take a sample of knee cartilage from the non-essential area — that is, the zone that does not bear weight. The biopsy is then taken to a lab, where it is cultured and grown into millions of cartilage cells.


The cultured cells are then used to replace the damaged knee cartilage, in a more-invasive surgical procedure. Once the undeveloped cartilage cells have been re-inserted, a period of about three months is necessary for them to continue the healing process and replace the damaged area of the knee.


Younger patients are more suited for cartilage transplants than older ones. Some doctors recommend that the operation only be pursued by patients in their 20s, 30s, and early 40s, while older patients should consider either partial or total knee replacement surgery.



Running shoes could exacerbate osteoarthritis


January 10th, 2010 by Formosa Medical Travel

A study published in the December 2009 issue of PM&R: The journal of injury, function, and rehabilitation concluded that the use of modern running shoes could cause damage to knee, hip, and ankle joints. The study, conducted on 68 healthy adult runners, showed surprising results.


For the study, subjects were observed using a treadmill with a motion analysis system. None of the participants had any history of musculoskeletal injury, and each was in the habit of running 15 miles per week. Each participant was required to run both barefoot and wearing typical running shoes. The results showed that running with shoes may increase the stress on knee joints by up to 38%. “There is an increase in joint torque that may be detrimental,” said D. Casey Kerrigan, MD, the author of the study.


This may serve as a call for shoemakers to redesign their products, making them more safe for runners. The study pointed to the attributes of the shoes as the possible cause of the problem, including elevated heels and raised arches. The added material in running shoes may counteract the body’s natural response to running, in the end doing more harm than good.


The increased stress on knee joints may lead to osteoarthritis if continued over a long period of time, it is theorized. However, Bruce Williams, a spokesman for the American Podiatric Medical Association, doubts this claim. “It’s much ado about nothing,” said Williams, concluding “there was an increase in joint forces, but that’s it.” The study was not designed to show a link between running shoes and osteoarthritis.



Arthritis and Medical Tourism


January 6th, 2010 by Formosa Medical Travel

Osteoarthritis, the most common cause of knee and hip pain, afflicts an estimated 40 million Americans.  With the population of the United States aging every day, many predict that osteoarthritis will afflict as many as one out of every five Americans by the end of the decade.


Osteoarthritis causes the degeneration of the cartilage in both the knee and hip joints, causing those afflicted to experience severe pain and decreased mobility. While the condition is not life-threatening, it does have severe implications for the quality of life of those who suffer from osteoarthritis. If the condition is allowed to progress to an advanced stage, patients can find themselves very limited in their daily activities.


The only long-term solution to osteoarthritis of the knee or hip is total joint replacement surgery. Artificial joints can replace the deteriorated cartilage, and allow patients to return to their normal lives, usually with greatly increased mobility and reduced pain. Unfortunately, total joint replacement surgery is a costly procedure, especially in the United States. Patients without health insurance can expect to pay upward of $45,000 for a single knee or hip replacement surgery in the United States.


For Americans who cannot afford the cost of knee replacement or hip replacement surgery, there are options. Medical tourism, the practice of leaving one’s country for medical care, can offer patients significant savings. Many countries offer joint replacement surgery for a fraction of the cost of the same procedure in the United States. In Taiwan, both knee replacement surgery and hip replacement surgery can be obtained for under $12,000, at world-class hospitals accredited by the Joint Commission International.



Ontario attempting to reduce hip, knee replacement wait times


December 19th, 2009 by Formosa Medical Travel

An agency in eastern Ontario is launching an effort to bring down the long wait times for knee and hip replacement surgery in Ontario, Canada.


Currently, wait times for knee replacement and hip replacement surgery can be almost a year in many parts of eastern Ontario, compared with a provincial average of under 200 days. To help reduce this wait time, the Champlain Local Health Integration Network plans to launch a “Regional Hip and Knee Replacement Program” in early 2010, which is aimed at improving the quality of care offered to residents of the region.  ”The idea is to try and reduce wait times” and “improve efficiencies,” said Dr. John Gordon, the lead physician for the program.


Wait times are a common theme for patients with debilitating osteoarthritis. While some methods are available to delay the need for knee replacement and hip replacement surgery, most patients with severe osteoarthritis of the hip or knee must, sooner or later, pursue joint replacement surgery to treat the problem. The long waiting lists in many parts of Canada require many patients to suffer pain and reduced mobility in the months leading up to surgery.


There are concerns that, if the United States adopts a healthcare system similar to that in Canada, there will be similar issues related to waiting lists. Since osteoarthritis is not considered a life-threatening condition, joint replacement surgery is often put off until it has reached a very advanced stage, which has large implications for the quality of life of those afflicted by osteoarthritis.



Common misconceptions about total hip and total knee replacement surgery


November 23rd, 2009 by Formosa Medical Travel

Osteoarthritis is the most common cause of knee and hip pain, afflicting an estimated 40 million Americans. Also known as degenerative joint disease or degenerative arthritis, osteoarthritis can cause the deterioration of both the knee and hip. As the US population continues to age, it is estimated that osteoarthritis will affect as many as one in five Americans by the year 2020.


Although osteoarthritis is not life-threatening, it does have significant effects on the quality of life of those who suffer from it. While non-surgical treatments such as anti-inflammatory drugs – i.e. Naproxen, Aleve, Proxen, etc., and joint fluid injections (such as Hyaluronan, Synvisc, and Synflex) can delay the need for surgery, the only long-term solution is total joint replacement surgery.


There are a number of misconceptions about total hip replacement and total knee replacement surgery. The most common is that total knee replacement and total hip replacement are highly-dangerous procedures. In reality, total knee replacement and total hip replacement surgery have the highest success rates of any elective surgeries performed today.


Currently, the vast majority of knee and hip replacement surgeries are performed in minimally-invasive fashion. This allows for minimal scarring and faster healing times, while maintaining the same success rate. While some believe that minimally-invasive procedures may result in different outcomes, the data show that these procedures are equal to their more-invasive counterparts – the only difference being the size and appearance of the incision.


Another misconception is the idea that joint replacements can only last as long as twenty years. This is not necessarily the case. The reason for this is, of course, that the data being used for this assumption is based on knee and hip replacements that were performed twenty years ago. Research is constantly being done to increase the performance of joint replacement devices, and a great deal of time has gone into developing improved models. New production methods and materials will likely increase the lifetime of hip and knee replacements in the future.



Treatments available for osteoarthritis of the knee


November 18th, 2009 by Formosa Medical Travel

Because the cause of osteoarthritis is not known, there is no immediate cure, say experts. The only option to permanently get rid of the disease is by removing it, via total joint replacement. Osteoarthritis can be the direct cause of knee stiffness, knee pain, loss of movement, and inflexibility. There are, however, treatments which can help reduce pain and delay the need for total knee replacement or total hip replacement.


Some anti-inflammatory drugs, such as Naproxen – marketed under names such as Aleve, Anaprox, Naprosyn, Proxen, and Synflex – can be used in pain reduction and to reduce inflammation in the short term. These drugs can be a relatively safe alternative to surgery, although they are not without their risks.


Some treatments that are growing in popularity are joint fluid therapy and hyaluronan therapy, in which injections are made into the afflicted area to help restore movement and reduce pain. These treatments – which go under a number of names, including Synvisc, Supartz, Hyalgan, Euflexxa, chicken shots, rooster juice, and viscosupplementation – can often delay the need for a knee replacement  by months, or even years. Cortisone shots are also sometimes administered as treatment. However, while some patients experience improvements in their condition, others report little to no benefit.


For younger, more active patients, a procedure known as knee osteotomy is sometimes used to shift the patient’s weight to the non-arthritic side of the knee. This is a less-invasive procedure, which can often delay the need for a total knee replacement for up to ten years.


For many patients, total joint replacement surgery is often the only long-term cure for osteoarthritis. In knee replacement surgery, surgeons replace the weight-bearing portions of the bone with artificial devices. This procedure, developed in the 1960s, has evolved over the years into one of the safest surgeries performed – although complications can occur in a small minority of patients. Knee replacements can last as long as 20 years in many patients, although the life of the device is dependent on many factors, such as the patient’s activity level.


For the millions of Americans suffering from debilitating knee pain and loss of mobility as a result of osteoarthritis, there are treatments. Anti-inflammatory drugs, joint fluid therapy, and knee osteotomy are all options that patients should consider when attempting to reduce knee pain caused by osteoarthritis. However, total knee replacement remains most successful treatment for curing osteoarthritis.



Knee Replacement Alternatives


November 3rd, 2009 by Formosa Medical Travel

Knee Replacement Alternatives

There are a number of alternatives to knee replacement surgery that sufferers of osteoarthritis should consider before getting a total knee replacement. As the cost of knee replacement surgery increases in the United States, many people are exploring new methods for arthritis relief.

 

Most knee replacement alternatives focus on limiting pain, rather than treating the cause. Some options include anti-inflammatory medications, lifestyle changes, and other treatments – which can often reduce the pain caused by osteoarthritis, and delay the need for a knee replacement. In the intermediate stages of osteoarthritis, many patients are given joint fluid therapy, also known as “chicken shots” or “rooster juice“.  Chicken shots for knee pain relief are a currently a very popular alternative to total knee replacement surgery.

 

Cortisone shots and Synvisc injections are also often succesful in limiting knee pain in the short term. However, in many cases, patients who are seeking a long-term solution to osteoarthritis should consider surgical treatment.

 

Before getting total knee replacement surgery, consult your doctor about some of these less-expensive alternatives.






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