World arthritis day 12 10-2014 by Dr. Ram Soni

1. WORLD ARTHRITIS DAY.
12.10.14.
WEBSITE: HTTP://RAMSONIORTHOSURGEON.COM/

3. DR R K SONI. MS ORTHO.
LRCP EDINBURGH. LRCP&S
GLASGOW.
M.CH ORTHO & TRAUMA .
LIVERPOOL .UK
Consultant Orthopaedic arthroscopy
and Joint replacement surgeon..
Bhopal. MP J K Hospital.
Website: http://ramsoniorthosurgeon.com/

4. “Our Focus is your health”.

6. World Arthritis Day 2005
Arthritis – Quality of
life , living without
Pain.

7. World Arthritis Day:
"SmallThings Matter”
12.10.07

8. World Arthritis Day in 2011
Move to
Improve

9. Find relief for aches and pains
World Arthritis Day
12 October 2014

10. Healthy Living .
 Physical activity
 Healthy eating
 Lifestyle choices, including alcohol and
smoking
 Emotional wellbeing
 Self management and motivation

11.  If you have confidence and believe you can do
some thing you are much more likely to
succeed.

12. Arthritis
 Has been present in Humans since 4500 BC

13. S No All Men Women
1 Osteoarthritis 2.7 1.0 3.9
2 Hypertension 1.3 0.4 1.9
3 Slipped disc 1.3 0.3 1.9
4 Diabetes 1.1 1.5 0.8
5 Spondylosis 1.1 0.5 1.5
6 Migrain 1.0 0.2 1.5
7 Asthma 0.7 0.3 1.0
8 Rheumatoid 0.5 0.3 0.7
9 Hypothyroidism 0.5 00 0.9
10 Dyslipidaemia 0.4 0.3 0.5
Osteoarthritis affects about 10% of population above 55 years of age.
Osteoarthritis is India’s number one ailment: Diabetes is ranked 4th.
% of total affected by the disease.

15. NICOLAS ANDRY . ( 1741)
FRENCH PHYSICIAN.
( ART OF PREVENTION AND
CORRECTION OF DEFORMITIES
IN CHILDREN.)

24. Arthritis symptoms
 1. pain.
 2. swelling .
 3. stiffness.
 4Morning stiffness .
 5. deformity.
 6. gradual reduction in walking distance.
 7. sleep disturbed
 `

25. Arthritis and deformity

34. Excessive calcium and joint
pain
 1.Hyperparathyroidism:
2. one of the feature is joint pain
due to hypercalcaemia.
3. High serum ca level is ass with high systolic
and Diastolic blood pressure.
4. High serum calcium is highly predictive of
MI.

35.  Serum ca level is predictive of cardiovascular
disease in men.

36. Increased uric acid level
and joint pain.

37. Gout attack can be
precipitated
 Dehydration
 Injury
 Fever
 Heavy eating
 Heavy drinking
 Recent operation

39. Lemon and arthritis
 No relation . If any thing it is helpful in pt with
arthritis.

40. Yogurt / and joint pain.
 Yogurt is good for joint pain.

41. Alcohol and Arthritis.
 . Known Risk factor:
 1- for Gout.
 2. Osteoporosis.
 3. Obesity. And obesity increases risk of OA
three fold.
 4. Memory loss.
 5. Contra indication for many Drugs ,
Alcohol and drug interaction.

42. Smoking and Arthritis .
 Smokers are twice more likely to develop
Rheumatoid Arthritis.
 Osteoporosis .
 Delayed fracture healing .
 Degenerative disc disease.

43. Diet and Arthritis
 1.More Fruits and vegetables.
 2.Omega 3 fatty acids,
 3.Olive oil .
 4.Vit c .
 5. Avoid high cooking temperature
 6.Vegetarian diet .
 7. Avoid food containing additives and
preservatives.

44. Weight / Obesity/ Arthritis

45. Wt
 BMI;- 25-to 30. ---Overweight
 > 30. ----- Obese
 > 35 . ---- Morbidly obese

47. Obesity trends in UK / India
UK
 Low socioeconomic
status
India
 Higher socioeconomic
status.

48. Bigger is not always
better.

49. Prevention of Arthritis/
Arthroscopy


51. Focal femoral condyle
resurfacing.

57. Total knee replacement.

62. Not Pt specific instruments or
cutting blocks
Pt Specific Knee implant

63. Enhanced arthroplasty
recovery Programme.
 1. Pre Op Pt Education.
 2. Pre and Post op Hb level.
 3. Pre op neutrition.: Low Albumin and
transferrin levels are predictors of longer
 Recovery.
 Preemptive analgesia.
 Gabapentin and Cox 2 inhibitors from 1st day
of op upto 7 days.

67. Risk and Benefit of joint
replacement
Risk.
 Infection.
 DVT . PE.
 Stiffness,
 Residual pain
BENEFIT
 No Pain .
 Deformity correction .
 No Medication .
 Psychososial benefit.
 Mood
 Life span

68. Longevity of the knee
replacement.

69. Fear of operation
.

70. Fear of operation
 Anecdotal
 Surgeon , Qualification,Training and
experience.
 Financial aspect Pt
 Surgeon
 Gov/ MCI Rules/ Regulation.
 Accountability.

71. Chances of failure after two
stage revision ( THR)
Prognostic factors.
 Elevated BMI
 Smoking .
 Anaemia
 Connective tissue disease .

72. Exercise
and
Arthritis

73. Does exercise and
physical activity
helps or hurt
arthritis.

74. Exercises

75. Exercise ( Contd)
 Increases strength and flexibility.
 Reduces joint pain.
 Reduces fatigue
 Helps in maintaining healthy wt.
 Make u feel better & improves sense of well
being.
 Decreases depression and elevates Mood.

76. Exercises for Arthritis
 1. Range of motion exercises .
 2. Strengtheningexercises .
 3. Aerobic or endurance exercises
.

80. Arthritis ( osteoarthritis)
 Age related or wear and tear arthritis.
 Inflammatory: - RA. , Gouty, Ca PD,
 Traumatic.
 Infective.

81. Prevalence of arthritis (
Wt)
 16% of under or normal wt adults.
 22% of over wt
 31% of obese adults
Have doctor diagnosed arthritis
Over all 66% of Over wt or obese adults
53% of normal adults.

82. Benefits of fish-derived fat
 Japan ; fish consumption is higher than USA,
UK the prevalence of RA is lowest 0.4%.

83. Drugs
 1. Corticosteroids. Prednisolone etc
AVN of femoral head,
Humeral head.Talus etc
2. Diuretics; increase the risk of gout
3. Drug induced Lupus;- Procainamide,
hydralazine

84. The relation between total
joint arthroplasty and risk
for serious cardiovascular
events in pt with moderate –
severe OA .
BMJ 2013 347

85. Objective : whether THR & TKR
reduces the risk for serious
cardiovascular events in pt
with severe OA

86.  2200 adults with OA hip and Knee aged 55 or
more followed until death / 7 yrs .

87. Factors that exacerbate the
risk of CVD
 Hypertension.
 Diabetes .
 Smoking.
 High BMI.
 Increased stress .
 use of NSAID
 underlying inflammation.
 Physical inactivity.

88.  40 % of adults aged over 65 are physically
inactive due to OA
 18% of adult American have OA

89. Reasons for Increased all
cause mortality due to
cardiovascular causes.
 Functional limitation due to OA.
 NSAID use.
 Increased psychosocial stress.

90. Proven benefits of total joint
arthroplasty for improving
 1. pain.
 2. mobility
 3. gait.
 4. quality of life,
 5.Overall function.

91. Benefits of total joint
arthroplasty
 Improvement in
 1.pain.
 2. mobility.
 3. gait.
 4. Quality of life
 5. walking distance.
 6. mood.

92.  Total joint arthroplasty is associated with 40
% reduction in subsequent risk of serious
cardiovascular event

93. Choose Wisely.
 AVOID: 1. Routine Post op DVT U/S in pt with
THR andTKR.
 2. arthroscopic knee wash out for OA knee for
long term relief.
 Do NOT 3. use Glucosamine and chondroitin
to treat OA Knee.
 4. use Lat Heel wedge for Med Compartment
OA .
 5.SynVisc or Hyalgan for OA Knee.
 6. Post op Splinting of wrist after CTR