Welcome To www.LupusMCTD.com
December 15, 2018, 01:36:38 pm *
Welcome, Guest. Please login or register.

Login with username, password and session length
 
   Home   Forum Help Search Calendar Login Register  
Pages: « 1 2   Go Down
  Print  
Author Topic: Ortho & Arthritis  (Read 55455 times)
0 Members and 1 Guest are viewing this topic.
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #30 on: January 30, 2007, 11:50:30 am »




New hip treatment for younger boomers
Patients don't have to wait until 60 for alternative to replacement

Jan 30, 2007
WASHINGTON - Doctors are beginning to offer a new alternative to hip replacement — one aimed at younger, athletic baby boomers who have worn out their joints too soon. Now they no longer have to wait until they hit their 60s for a fix.

A baby boomer is someone born in the years after the end of World War II. Many of them, such as President George W. Bush and former President Bill Clinton, are starting to reach their 60s.

The new alternative is called hip resurfacing, covering a damaged hip’s ball and socket with smooth metal rather than cutting away worn bone and replacing it.

The operation hit the U.S. market last spring with Food and Drug Administration approval of the British-designed Birmingham Hip Resurfacing System. Competitors are in clinical trials here, and expected to get FDA approval later this year.

It is not the first time orthopedic surgeons have tried resurfacing worn-out hips. But where earlier attempts failed, data from Europe suggest this latest approach uses longer-lasting materials — with the additional promise of a joint that may hold up to the heavy recreation of today’s 40- and 50-somethings better than traditional hip implants.

“I do have people that call me and say, ‘My father had hip resurfacing in 1970 and it didn’t work. Why are we doing that now?”’ says Dr. Michael J. Anderson, an orthopedic surgeon who estimates that about 15 percent of his hip implants now are resurfacings.

His response: Comparing today’s resurfacing with yesteryear’s is like comparing a modern car to a Model T Ford.


Not everyone’s a good candidate, specialists caution. Resurfacing is not for patients with thinning bones — part of the joint could break — or those who have poorly functioning kidneys that can’t eliminate microscopic metal particles produced when the joint’s reinforced pieces rub together.

Moreover, while patients typically recover quickly, resurfacing is harder to perform than a hip replacement, and only a small fraction of U.S. orthopedic surgeons so far are trained to do it.

Growing demand
But interest is growing, as evidenced by a focus on hip resurfacing at next month’s annual meeting of the American Academy of Orthopaedic Surgeons — and a growing demand for hip repair from ever-younger patients.

Until now, “you might have told someone to soldier on for as long as you possibly can,” because a standard hip replacement before age 60 is itself likely to wear out, explains academy spokesman Dr. Scott Rubinstein, of the Illinois Bone and Joint Institute.

With the new resurfacing option, “people may be a little more aggressive” in treating younger creaky joints, he adds.

More than 400,000 total or partial hip replacements are performed each year in the United States, a number growing as the population ages.

Typically, surgeons replace a hip by cutting off the femoral head, the joint’s ball, and replacing it with a metal ball mounted on a rod implanted deep in the thigh bone. A plastic socket replaces the original. Those artificial hips can bring tremendous relief to people crippled by hip pain.

But the metal-on-plastic friction means the implants can begin wearing out in about 15 years, sooner if sports or other activities increase pressure on the joint. For the average 65-year-old, that’s no problem. A 50-year-old, in contrast, could very well wear out an initial replacement and have little thigh bone left to fit another.

“You’re dealing with Swiss cheese,” is how hip replacement pioneer Dr. Mitchell Sheinkop describes the remaining bone.

Enter resurfacing. Surgeons lightly shave the damaged femoral ball and fit a metal ball snugly over it. That ball rolls in a metal cup reinforcing the socket. The idea: Metal-on-metal shouldn’t wear out as fast, and if patients do need another replacement in 15 or 20 years, the thigh bone is largely intact.

“This resurfacing initiative has interest because we’re sparing bone,” explains Sheinkop, a Rush University professor and joint replacement director of the Neurologic and Orthopedic Institute of Chicago.

Higher cost
What is the evidence? The FDA cited studies showing the Birmingham Hip resurfacer lasted at least five years, approving its sale on condition that manufacturer Smith & Nephew Inc. continue tracking its endurance for 10 years.

Doctors differ on what age is the cutoff for resurfacing, somewhere between 60 and 65, largely dependent on the patient’s bone strength. Nor do all insurers cover it. The implant costs about 20 percent more than a standard artificial hip, adding to the $35,000 tab.

Complicating the choice is that surgeons call newer artificial hips — ceramic-on-ceramic balls and sockets, or tougher plastic designs — good options for even the most active person just turning 60.

So resurfacing is emerging as a niche for the younger sports enthusiast. Dr. Marc Wiener, a Chicago-area internist, chose resurfacing when his own hip degenerated in his 40s, because it came with few restrictions on his activity. Wiener exercised before surgery to be in prime condition for physical therapy afterward — and played 18 holes of golf a month after his resurfacing, hit the basketball court at seven weeks and the tennis courts in three months.

www.LupusMCTD.com
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #31 on: September 10, 2007, 03:56:32 pm »

Treatment of arthritis begins with patient education

September 10, 2007
 
Dr. T. Glenn Pait, associate professor of neurosurgery and orthopedic surgery at the University of Arkansas for Medical Sciences and director of the Stephens Spine and Neurosciences Institute at UAMS, thinks the treatment for arthritis should be multi-pronged.

According to the Arthritis Foundation, more than 42 million Americans have been diagnosed with arthritis of some form; another 23.2 million people live with chronic joint symptoms but have not been diagnosed by a doctor.

Contrary to popular belief, arthritis isn't a disease that affects only older adults. More than half of the cases involve people under 65, including nearly 3 million children.

The term arthritis is used to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues that surround the joint and other connective tissue. The pattern, severity and location of symptoms can vary depending on the specific form.

Some forms of arthritis include:



Osteoarthritis


Rheumatoid arthritis


Gout


Ankylosing spondylitis


Juvenile arthritis


Systemic lupus erythematosus


Scleroderma


Fibromyalgia

Osteoarthritis is the most common form of arthritis, a chronic disease that causes a breakdown of the cushioning cartilage in joints and the formation of new bone at the margin of joints. Osteoarthritis is frequently called degenerative joint disease. About half the nation's population over 65 will have this type of arthritis; by age 70, almost all individuals will have some form of osteoarthritis.

Treatment for osteoarthritis typically begins with patient education. It's important that a patient understands the "dos and don'ts" of his or her daily activities. Weight loss is extremely important to those osteoarthritis patients since decreased weight placed on arthritic joints means less stress placed on the joints.

Treating osteoarthritis typically beings with a non-steroidal anti-inflammatory drug (NSAID); the non-prescription forms of these drugs include aspirin, ibuprofen, naproxen and ketoprofen. Some other over-the-counter drugs include glucosamine and chondroitin sulfate, both of which help patients control their pain but cannot help grow new cartilage.

Medications, however, cannot do the job alone. They need to be accompanied by lifestyle changes that include exercise, which is important to maintain joint and overall body mobility.

Any treatment for osteoarthritis should involve physical and occupational therapies to provide exercise for the joints that are affected. Water aerobics and swimming are good examples since water supports the body and muscles can be exercised without stress or straining joints. Usually, the benefits of therapy will be seen in three to six weeks.

If medications and physical therapy fail to bring about improvement in the quality of life for an osteoarthritis patient, surgery may be recommended. Surgery is intended to replace or repair damaged joints in severe situations for which medical treatment options have failed.

As indicated earlier, there are many forms of arthritis and each one affects individuals differently. The outcome of each case cannot be totally predicted. It is important not to ignore early symptoms and signs of the disease. A physician should evaluate any aches and pains in any joint, especially the spine, that do not go away within a reasonable time.

Early diagnosis, testing and treatment are the best ways to promote continued health while living with arthritis.

Barbara Hanson is director of community resource development for the Southwestern Vermont Council on Aging. For information about senior services, call the Senior Helpline at 800-642-5119 or 786-5991 or visit www.svcoa.org.
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #32 on: October 18, 2007, 12:52:50 pm »

Low Back Pain
High-sensitivity C-reactive protein in chronic low back pain with vertebral end-plate modic signal changes



Abstract

Objective
To assess high-sensitivity C-reactive protein (hsCRP) level as a measure of low-grade inflammation in relation to Modic vertebral end-plate marrow signal change on magnetic resonance imaging (MRI) in patients with chronic low back pain.

Methods
All patients hospitalized for chronic low back pain in our institution were prospectively enrolled in this pilot study. Serum hsCRP concentration was measured by immunoturbidimetric assay. MR images were evaluated independently by a panel of 2 spine specialists and a radiologist. Recording of clinical parameters, MRI evaluation, and hsCRP level of each patient was blinded.

Results
Three groups of 12 consecutive patients (Modic 0, Modic I, and Modic II signal changes on MRI) were prospectively selected. Serum hsCRP level was significantly different in the 3 groups (P = 0.002) and especially high in the Modic I group (P = 0.002 compared with Modic 0 and II groups): mean ± SD 1.33 ± 0.77 mg/liter in the Modic 0 group, 4.64 ± 3.09 mg/liter in the Modic I group, and 1.75 ± 1.30 mg/liter in the Modic II group. The only difference in clinical parameters among the 3 groups (P = 0.001) was that the worst painful moment during the previous 24 hours occurred during the late night and morning for all Modic I patients (P = 0.001 compared with Modic 0 and P = 0.002 compared with Modic II).

Conclusion
Low-grade inflammation indicated by high serum hsCRP level in patients with chronic low back pain could point to Modic I signal changes. This result could help physicians predict the patients with Modic I signals to more precisely prescribe the correct imaging procedure and local antiinflammatory treatment in such patients.

François Rannou 1 *, Walid Ouanes 1, Isabelle Boutron 2, Bianca Lovisi 1, Fouad Fayad 1, Yann Macé 1, Didier Borderie 1, Henri Guerini 1, Serge Poiraudeau 1, Michel Revel 1
1Assistance Publique-Hôpitaux de Paris, Université René Descartes, Groupe Hospitalier Cochin, Paris, France
2Assistance Publique-Hôpitaux de Paris, Université Paris VII, Groupe Hospitalier Bichat-Claude Bernard, Paris, France

 


*Correspondence to François Rannou, Service de rééducation, Hôpital Cochin, 27 rue du faubourg Saint-Jacques, 75014 Paris, France
Keywords

Chronic low back pain • High-sensitivity CRP • Microinflammation • Modic • Vertebral end-plate signal • Magnetic resonance image

« Last Edit: October 18, 2007, 12:57:22 pm by Admin » Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #33 on: January 05, 2008, 10:33:05 am »

46 Million Americans Suffer From Arthritis
By 2030, 40% of U.S. adults will have the condition, experts say


Jan. 5, 2008- Arthritic disease is the most common cause of disability in the United States and now affects 46 million Americans, or more than 21 percent of the adult population, a major new report finds.

That number is expected to rise even higher as baby boomers age, so that by 2030, 40 percent of American adults will suffer from some form of arthritic disease, the researchers said.

Today, almost two-thirds of people with arthritis are under 65, and more than 60 percent are women. The disease hits whites and blacks equally, but the rate is lower among Hispanics, according to the report.

"Arthritis remains a large and growing problem," said lead researcher Dr. Charles G. Helmick, an epidemiologist with the U.S. Centers for Disease Control and Prevention. "Cases of osteoarthritis has risen, while rheumatoid arthritis has gone down since our last estimate," he added.

Rheumatoid arthritis is a painful autoimmune disorder of uncertain origin leading to chronic inflammation at the joints. Osteoarthritis is a more common illness caused by a gradual breakdown of cartilage in the joints.

The reasons why there are now fewer cases of rheumatoid arthritis is unclear, Helmick said. One reason may be that experts have changed the way they estimate the number of cases. Today, they use a more specific and restrictive definition of the condition, he said. But there has been a real decreases in cases of rheumatoid arthritis worldwide, and no one is sure why, Helmick added.

The main reason that osteoarthritis is increasing is an aging population, Helmick said. "As more people age, there will be more people with osteoarthritis. That's what's driving the numbers upward," he said.

Also, the obesity epidemic in the Unites States is taking its toll, Helmick noted. "Obesity is a risk factor for knee osteoarthritis, one of the most common types of arthritis," Helmick said. "We don't have any cures, we treat the symptoms and, when it gets bad enough, we do knee replacements, which are very expensive," he said.

As more people suffer from arthritis, the costs associated with the disease will also keep going up. Currently, the costs to the country from arthritis top more than $128 billion a year in lost earnings and medical care, Helmick said.

The researchers, from the National Arthritis Data Workgroup, used data from the U.S. Census Bureau, national surveys, and findings from community-based studies across the United States to determine the prevalence of arthritis in 2005 and beyond. The results were published in two papers in the January issue of Arthritis & Rheumatism.

Key findings in the report include:

    * By 2030, almost 67 million people will have arthritis -- an increase of 40 percent. Osteoarthritis, the most common type of arthritis, affects almost 27 million Americans. That's a big increase from 1990, when 21 million suffered from the condition.
    * The prevalence of rheumatoid arthritis has declined to 1.3 million Americans, from 2.1 million in 1990.
    * The prevalence of gout, a form of inflammatory arthritis, has risen in 2005 to about 3 million up, from 2.1 million in 1990.
    * Currently, juvenile arthritis affects some 294,000 children between infancy and age 17.
    * An estimated 59 million Americans have suffered an episode of low back pain over the past three months, the researchers said, while 30 million have suffered neck pain over the same time period.

In addition, the report includes estimates for related conditions such as fibromyalgia, spondylarthritides, systemic lupus erythematosus (lupus), systemic sclerosis, Sjögren's syndrome, carpal tunnel syndrome, polymyalgia, and rheumatic/giant cell arteritis.

One expert advised staying active and keeping your weight under control to help prevent or treat arthritis.

"We know that cases of osteoarthritis are likely to grow, because it's age-related," said Dr. Patience White, chief public health officer at the Arthritis Foundation. "In addition, weight plays a big role in risk, as well as lack of physical activity, in keeping your muscles strong," she said.

Losing weight and keeping physically active can help to reduce pain and keep the disease at bay, White said. "If you lose as little as 10 pounds, you can decrease pain in the knees and hips by 50 percent," she said. "With exercise, you can decrease progression."
~More information

For more information on arthritis, visit the Arthritis Foundation.
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #34 on: May 13, 2008, 07:30:52 am »

New Advice for Surgery on the Knees

For years, people with worn-out knees were told to wait as long as possible before opting for replacement. Wait until you are older, the thinking went, so the joint will outlive you.

But medical experts say doctors and patients are pushing the limits of their old joints too far. Improvements in artificial joint technology and surgical techniques mean replacements are lasting longer than ever — often 20 years or more. But doctors are still advising candidates for replacement to “wait until you can’t stand it.” As a result, some patients wait until the cartilage in their knees wears out completely, leaving them housebound and with painful bone-on-bone rubbing in their knees.

The problem is that patients who wait too long become so debilitated that recovery is harder and function is often not fully regained. “There’s definitely a point where there’s a diminishing return if you wait too long,” said Lynn Snyder-Mackler, a professor in the department of physical therapy at the University of Delaware. “You end up trading one set of impairments for another.”

About one in five adults has arthritis or chronic joint pain. As people age, cartilage begins to wear, and the resulting inflammation causes swelling, pain and stiffness. Jobs and sports that involve repetitive motion on a particular joint can increase the risk of developing arthritis in that joint. Family history and weight gain also play a role.

Joint replacement is not inevitable once arthritis sets in. Treating the pain and inflammation early on can help people maintain function longer. Over-the-counter and prescription pain relievers as well as supplements like glucosamine and chondroitin may offer relief. Maintaining a healthy weight lowers risk for arthritis in the knees. Moderate exercise can also help.

As for surgery, women appear more likely than men to wait too long before opting for it. It may be that they are more inclined to accept the limits of weakened knees. Doctors may discourage women from surgery because they typically live longer than men.

In research published last fall in The Journal of Bone and Joint Surgery, Dr. Snyder-Mackler and colleagues studied 95 men and 126 women who were to have knee replacements. They found that even after controlling for gender differences in strength and agility, the women had far higher levels of impairment before choosing surgery than the men had.

And earlier this year, The Canadian Medical Association Journal reported that doctors recommended surgery more often for men than for women. University of Toronto researchers selected one man and one woman, both 67, who had identical levels of knee osteoarthritis. They each went on separate visits to 29 orthopedic surgeons and 38 family doctors. Although they both described similar symptoms, two-thirds of the doctors recommended knee replacement for the man, while only a third thought it appropriate for the woman.

After years of suffering, Craig Mason, 65, of Whittier, Calif., insisted that her doctor refer her for a knee replacement. Ms. Mason could get around only using a walker. She said that when she was “truly incapacitated,” her doctor still wanted her to postpone surgery.

“My primary physician kept putting it off and putting it off, and finally I almost had to threaten and say, You’ve got to do something about this,” she said. “He just wanted me to get older.”

Last year, Ms. Mason underwent surgery. Recovery was painful, she said. But unlike the chronic pain associated with her knee, the pain of surgery and physical therapy eventually disappeared. “When I woke up from surgery I said, This was a big mistake,” she said. “But they say it’s like childbirth — you forget the pain. I should have had it done a long time ago.”

Total knee replacements are not for everyone, and doctors say patients in their 40s and 50s may still want to consider partial knee replacements or other interim surgical procedures.

Sometimes patients themselves insist on delaying surgery because they worry about long recoveries and giving up favorite activities that they now suffer through with braces and medication. Doctors say, however, that many patients can resume normal activities, although it depends on the person’s fitness and disability levels before the surgery.
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #35 on: May 13, 2008, 07:35:24 am »

Think of Your Poor Feet

The average person walks the equivalent of three times around the earth in a lifetime. That is an enormous amount of wear and tear on the 26 bones, 33 joints and more than 100 tendons, ligaments and muscles that make up the foot.

In a recent survey for the American Podiatric Medical Association, 53 percent of respondents reported foot pain so severe that it hampered their daily function. On average, people develop pain in their 60s, but it can start as early as the 20s and 30s. Yet, except for women who get regular pedicures, most people don’t take much care of their feet.

“A lot of people think foot pain is part of the aging process and accept it and function and walk with pain,” said Dr. Andrew Shapiro, a podiatrist in Valley Stream, N.Y. Though some foot problems are inevitable, you can slow the progress of many problems.

The most common foot conditions that occur as you get older are arthritic joints, thinning of fat pads cushioning the soles, plantar fasciitis (inflammation of the fibrous tissue along the sole), bunions (enlargement of the joint at the base of the big toe), poor circulation and fungal nails. If you have the following risk factors, take more preventive steps as you age.

Are you overweight? The force on your feet is about 120 percent of your weight. “Obesity puts a great amount of stress on all the supporting structures of the foot,” said Dr. Bart Gastwirth, a podiatrist at the University of Chicago. It can lead to plantar fasciitis and heel pain and can worsen hammertoes and bunions. It’s also a risk factor for diabetes, leading to the next question.

Are you diabetic? Being farthest from the heart, the feet can be the first part of the body to manifest complications like poor circulation and loss of feeling, both of which can lead to poor wound healing and amputation. Diabetics should have their feet examined annually by a doctor and avoid shoes that cause abrasions and pressure.

Do you have poor circulation? If you’re suffering from peripheral artery disease — a narrowing of veins in the legs — your feet are more susceptible to problems, said Dr. Ross E. Taubman, president of the American Podiatric Medical Association. Smoking also contributes to poor circulation.

Do your parents complain about their feet? Family history is probably your biggest clue to potential problems.

Do you have flat feet or high arches? Either puts feet at risk. A flat foot is squishy, causing muscles and tendons to stretch and weaken, leading to tendinitis and arthritis. A high arch is rigid and has little shock absorption, putting more pressure on the ball and heel of the foot, as well as on the knees, hips and back. Shoes or orthotics that support the arch and heel can help flat feet. Those with high arches should look for roomy shoes and softer padding to absorb the shock. Isometric exercises also strengthen muscles supporting the foot.

Are you double-jointed? If you can bend back your thumb to touch your lower arm, the ligaments in your feet are probably stretchy, too, Dr. Gastwirth said. That makes the muscles supporting the foot work harder and can lead to injuries. Wear supportive shoes.

Do your shoes fit? In the podiatric association’s survey, more than 34 percent of men said they could not remember the last time their feet were measured, and 20 percent of women said they wore shoes that hurt weekly; 8 percent wore painful shoes daily. Feet flatten and lengthen with age, so if you are clinging to the shoe size you wore at age 21, get your feet measured (especially mothers — pregnancy expands feet).

Do you wear high heels? “The high heel concentrates the force on the heel and the forefoot,” Dr. Gastwirth said. Heels contribute to hammertoes, neuromas (pinched nerves near the ball of the foot), bunions and “pump bump” (a painful bump on the back of the heel), as well as toenail problems. Most of the time, wear heels that are less than two and a half inches high.

Do your feet ever see the light of day? Fungus thrives in a warm, moist environment. Choose moisture-wicking socks (not cotton), use antifungal powders, and air out your toes at home.

Have you seen a podiatrist? Minor adjustments — using drugstore foot pads or prescription orthotics — can relieve the pressure on sensitive areas, rebalance the foot and slow the progress of a condition.

Do you walk? Putting more mileage on your feet is the best way to exercise the muscles and keep them healthy.
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #36 on: June 12, 2008, 02:04:38 pm »

Centocor arthritis drug golimumab meets goal in 3 trials; FDA application expected this month

http://money.cnn.com/news/newsfeeds/articles/apwire/c9573a54672eddecbaba48b7117bf60d.htm
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #37 on: July 03, 2010, 08:42:39 pm »

Getting a New Knee or Hip? Do It Right the First Time
By LESLEY ALDERMAN

THERE is nothing like a new hip or knee to put the spring back in your step. Patients receiving joint implants often are able to resume many of the physical activities they love, even those as vigorous as tennis and hiking. No wonder, then, that joint replacement is growing in popularity.

In the United States in 2007, surgeons performed about 806,000 hip and knee implants (the joints most commonly replaced), double the number performed a decade earlier. Though these procedures have become routine, they are not fail-safe.

Implants must sometimes be replaced, said Dr. Henrik Malchau, an orthopedic surgeon at Massachusetts General Hospital in Boston. A study published in 2007 found that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years.

The percentage may sound low, but the finding suggests that thousands of hip patients eventually require a second operation, said Dr. Malchau. Those patients must endure additional recoveries, often painful, and increased medical expenses.

The failure rate should be lower, many experts agree. Sweden, for instance, has a failure rate estimated to be a third of that in the United States.

Sweden also has a national joint replacement registry, a database of information from which surgeons can learn how and why certain procedures go awry. A registry also helps surgeons learn quickly whether a specific type of implant is particularly problematic. “Every country that has developed a registry has been able to reduce failure rates significantly,” said Dr. Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn.

A newly formed American Joint Replacement Registry will begin gathering data from hospitals in the next 12 to 18 months.

Meanwhile, if you are considering replacing a deteriorating knee or hip, here are some ways to raise the chances of success and avoid a second operation.

EXPERIENCE COUNTS Choose — or request a referral to — an experienced surgeon at a busy hospital. “The most important variable is the technical job done by the surgeon,” said Dr. Donald C. Fithian, an orthopedic surgeon and the former director of Kaiser Permanente’s joint replacement registry.

Ask for recommendations from friends who have had successful implants and from doctors you know and trust. When you meet with the surgeon, ask how many replacements he or she does each year.

VOLUME MATTERS A study published in The Journal of Bone and Joint Surgery in 2004 found that patients receiving knee replacements from doctors who performed more than 50 of the procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.

The researchers documented a similar trend when it came to hospital volume. Patients at hospitals that performed more than 200 knee replacements a year fared better than patients at hospitals that performed 25 or fewer.

ADJUST EXPECTATIONS Not everyone with joint pain will benefit from a joint replacement.

An implant can help reduce pain and improve mobility if the joint surface is damaged by arthritis, for instance. But a new joint will not help pain caused by inflammation of the surrounding soft tissue, said Dr. Berry, who is also vice president of the board of the American Academy of Orthopaedic Surgeons.

Some people with mildly arthritic joints, for instance, can manage well with the judicious use of medication. “Surgery comes with complications and risks, and should not be approached lightly,” Dr. Berry said.

Joint replacement is not a minor operation. If you have uncontrolled high blood pressure or another serious chronic condition, a joint operation may simply be too risky for you.

NARROW YOUR OPTIONS “There is no one best joint,” Dr. Berry said. “A successful replacement depends on selecting the right implant for the patient.”

A good surgeon will recommend an implant that makes sense for your age, activity level and the shape of your joint. Younger or very active people who place more physical demands on the implant, for instance, may benefit from newer hard-on-hard bearing surfaces, like those made of ceramic, said Dr. Joshua J. Jacobs, chair of orthopedic surgery at Rush University Medical Center in Chicago.

In general, be wary of the latest, most advanced new joint. There is little evidence to support the use of more expensive designs over basic ones, said Dr. Tony Rankin, a clinical professor of orthopedic surgery at Howard University. One recent study found that premium implants fared about as well as standard implants over a seven- to eight-year period.

Be skeptical, too, of advertising gimmicks. “I had a 78-year-old patient with a perfectly good knee replacement come in and ask if she should have gotten the ‘gender knee,’ which she had seen advertised on TV,” Dr. Rankin recalled. “She was doing well, but was swayed by the idea of a knee made just for women.”

GATHER THE DATA Once you have a recommendation or two from a surgeon, find out how well the joint has performed in others and if there are known complications. The newer metal-on-metal hip implants, for instance, are somewhat controversial and may cause tissue and bone damage in certain patients.

Ask if the hospital has a registry that tracks joint replacements. If so, ask to see the data on the implants you are considering.

It is also helpful to understand what the operation involves, including the materials that will be used and how the surgeon plans to fix the joint to the bone. You can learn more about your operation at the American Academy of Orthopaedic Surgeon’s patient information Web site, orthoinfo.org.

If you want to delve deeper, look at a large national registry from another country, like Australia (which can be found at dmac.adelaide.edu.au/aoanjrr/publications.jsp). The annual report of Australia’s registry lists knee and hip implants that had a “higher than anticipated revision rate.”

A caveat: the information can be difficult to parse for a layperson. “A surgeon can provide perspective on information that, taken out of context, could be misleading,” Dr. Rankin said. So discuss it with your surgeon.

PLAN YOUR RECOVERY To avoid complications during your final stage of recuperation, discuss with your doctor in advance the support you will need when you return home, Dr. Berry advised.

Recovery takes a different course for each patient, depending on the type of procedure and implant. In general, expect mild to moderate pain for the first few weeks. Some patients are able to return to work in one to two weeks, but full recovery can take six to 12 months, Dr. Jacobs said.

Make sure you have the help you need in the initial stages of recuperation. Since you may have difficulty getting around and won’t be able to drive right away, you may want to have a friend or family member stay with you. You may even need to hire an aide or visiting nurse.

Follow your doctor’s orders, and don’t rush your recovery. You don’t want your new joint to fail because you couldn’t resist carrying loads of laundry up and down stairs, or felt compelled to rearrange the patio furniture.

If the new joint is given time to heal, you will find plenty of opportunities for all that in the future.


Source NYTimes
Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Adminஐﻬ
"Pay It Forward" ஐﻬ
Site Owner
******
Offline Offline

Gender: Female
Posts: 10407


LupusMCTD Founder ஐﻬ


WWW
« Reply #38 on: December 13, 2011, 11:30:26 am »

Diagnosing Infectious Arthritis
This dangerous type of arthritis has symptoms similar to other joint problems like gout. Because it can affect joint function in a matter of days, it's important to get the right diagnosis quickly.

By Madeline Vann, MPH
Medically reviewed by Cynthia Haines, MD

The idea of inserting a needle into your painful, swollen wrist or ankle may not be appealing — but it is the best method of getting the joint fluid necessary to diagnose infectious arthritis (also known as septic arthritis), a type of rheumatic disease.

The reason: The symptoms of infectious arthritis, which include fever, swelling, pain, and redness, often resemble the symptoms of other types of joint problems, particularly crystal-induced arthritis conditions like gout and pseudogout. But infectious arthritis can do considerable damage to your joint, and quickly. So even if you suspect you have gout rather than infectious arthritis, call your doctor immediately.

Infectious Arthritis: The Need to Diagnose Quickly

Infectious arthritis develops when bacteria such as staphyloccocus or streptococcus spread through the bloodstream and infect a joint, usually in the knee, ankle, or toe. This condition is very dangerous to your joint structure and possibly to your health, says Kevin Deane, MD, assistant professor of medicine in the division of rheumatology at the University of Colorado Health Sciences Center in Denver.

“It can take a week for an infection to destroy a joint,” observes Dr. Deane — in sharp contrast to other types of arthritis, which may take years to wear down a joint. So time is of the essence in diagnosing infectious arthritis.

Diagnosing Infectious Arthritis: Health History, Physical Exam

There are several steps your doctor will take to diagnose infectious arthritis. The first step will be to take a health history in order to highlight any risk factors.

Some people are at increased risk for infectious arthritis. Make sure you tell your doctor if you have any of these problems, which can increase the risk of joint infection or make it more difficult to treat infectious arthritis:

Weakened immune system (due to HIV, for example)
Diabetes
Heart or kidney disease
Other forms of arthritis, especially rheumatoid arthritis or osteoarthritis
Recent joint surgery
Prosthetic joint
Injection drug use
Recent infections of any kind
In addition, it's important to discuss any recent events that could have led to infectious arthritis, such as an animal or insect bite, damage to your joint, skin infection, or hospitalization. Your doctor may also ask you whether you have traveled recently, because infectious arthritis can be a sign of Lyme disease, transmitted by ticks in certain parts of the country.

Next, he will perform a physical exam of the affected joint or joints as well as any other areas on your body that may indicate symptoms of the underlying problem or causes, such as rashes, injuries, or bites.

Diagnosing Infectious Arthritis: Other Tests

X-rays. Your doctor may order an X-ray of the joint if he thinks that you have another condition, such as pseudogout. An X-ray can show the build-up of calcium crystals that characterize this form of arthritis and help distinguish it from infectious arthritis. However, notes Deane, infectious arthritis can occasionally cause pseudogout, so the two may be diagnosed at the same time.

Joint fluid aspiration. The definitive test for infectious arthritis, which will help distinguish it from other possible causes of a swollen, painful joint, is a needle aspiration of synovial fluid. This means that your doctor will use a needle to take a sample of fluid from inside your joint. Your joint may be numbed before this simple procedure.

This joint fluid can be analyzed under a crystal-detecting microscope. The fluid can also be cultured, which means that it will be prepared in a special way to allow any bacteria in it to grow. Based on the culture results, your doctor will be able to make recommendations about which antibiotics you should take if you have an infection.

Blood tests. Your doctor will also order a blood test to establish your white blood cell count, which rises when your body is fighting an infection. He may also order a blood culture, to see if the suspected infection has spread into the bloodstream.

While you may see your primary care provider or rheumatologist to diagnose infectious arthritis, in emergency or hospital situations you could also be working with an orthopedic surgeon to manage the diagnosis and treatment of your infectious arthritis.

Diagnosing infectious arthritis is not a lengthy process — just don’t delay seeking medical help if you think you may have a joint infection.[/b]


http://www.everydayhealth.com/arthritis/inflammatory-arthritis/infectious-arthritis-diagnosing-treating-and-preventing.aspx?xid=aol_eh-arth_3_20111212_&aolcat=AJA&icid=maing-grid7%7Cmain5%7Cdl13%7Csec1_lnk3%7C119571
« Last Edit: December 13, 2011, 11:31:53 am by Adminஐﻬ » Logged


I look normal, as I have an "Invisible Illness". You can not catch it, you can not see it. It's called Lupus.My body is attacking itself on the inside.
www.LupusMCTD.com Represents:
1) We are patients helping researchers build a future for the lives of others...
2) Where HOPE is a WORK In Progress
3) Pay It Forward~Giving Back To The Future Lupus/MCTD Patients
Pages: « 1 2   Go Up
  Print  
 
Jump to:  


© Page Contents, Layout, Graphics and Design All Copyrighted by Credited Artists and are Not Public Domain.



LupusMCTD Founder & Patient
Former Domestic Violence SURVIVOR
Kathy A. Patterson

Author of the Upcoming Memoir Book:
"Fighting From The Inside Out"..
A lupus patient fights the beast within her immune system and the beast at home....

e-Booklet filled with photos and videos of what abuse was, signs to look for,
where to turn to for help, and much more to help others like me...


For more information
Call the National Domestic Violence Hotline at 1−800−799−SAFE(7233)



"The Meaning of the Words in the Second Amendment .... "That the people have a right to freedom of speech, and of writing, and publishing their sentiments;"

PRIVACY NOTICE: Warning--any person and/or institution and/or Agent and/or Agency of any governmental structure including but not limited to the United States Federal Government also using or monitoring/using this website or any of its associated websites, you do NOT have my permission to utilize any of my profile information nor any of the content contained herein including, but not limited to my photos, and/ or the comments made about my photo's or any other "picture" art posted on my profile. You are hereby notified that you are strictly prohibited from disclosing, copying, distributing, disseminating, or taking any other action against me with regard to this profile and the contents herein. The foregoing prohibitions also apply to your employee(s), agent(s), student(s) or any personnel under your direction or control. The contents of this profile are private and legally privileged and confidential information, and the violation of my personal privacy is punishable by law
Photobucket
© 2008 LupusMCTD Foundation of America - All Rights Reserved
Est.November 11, 2005
"We Understand What You Are Going Through"™
Powered by EzPortal

Powered by MySQL Powered by PHP Powered by SMF 1.1.21 | SMF © 2015, Simple Machines
Twitter Mod created by 2by2host.com - a web hosting company