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Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Liberty From Aches and Pain
Dr. Kevin M. H. Yip Singapore Orthopaedic Surgeon
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Causes of knee osteoarthritis
Diagnosis Prevention Conservative treatment Medication Surgical treatment
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Natural progression Of OA
Acute inflammation phase–Intermittent
Loose bodies Osteophytes Loss of Cartilage and Meniscus
Deformity-accelerated
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Causes of early knee degeneration
age, recurrent inflam Sports is better or worse for the knee?
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Inflammation damages Joints Rheum Arthritis, Gouty Arthritis, Haemophilia
ACL Deficient knee
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Causes of early knee degeneration
Cruciate ligament tear Meniscus tear Cartilage Damage Immobilization
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Other Causes of Knee Pain
Bursitis Tendinitis Mal Tracking Patella Gouty Arthritis
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Diagnostic Arthroscopy GoutyArthritis Patella Mal-Tracking Plica
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Meniscus Repair Importance of the meniscus - an important cushioning mechanism
Need early repair to prevent extension of the tear
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Cartilage Injury Osteochondral lesions - Fixation or removal of loose bodies
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Do we need to treat OA Knee? Suffering the symptom of pain
Morbidity Quality of life Treatment depends of the symptoms
and XRNeed to explain the pros and cons of
the treatment options and to help the patient to make a correct
option.
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Treatment for OA knee Medication
Arthroscopic washout Knee joint Injection Bone realignment Joint replacement
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Treatment of OA knee
Medication
synovitiscartilage erosion
Arthoscopy washout
Loose bodies,Osteophytes
H. Tib Osteotom yJoint Replacem ent
deform ity
recurrent knee inflam recovered knee
Acute Knee
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Acute phase - Rest, Ice, Compression, Elevation, Medication
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Anti-Inflammation Medicine
eg Vioxx, Arcoxia (MSD) Celebrex, Bextra(Pfizer) Cox 2 Safe and effective Low GI effect
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Miacalcic Nasal 2000 (Calcitonin)-Novartis
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
• 3 injections, one week apart
• Multicenter
• Prospective
• Randomized
• Controlled (arthrocentesis)
• Double-blind
• All patients received arthrocentesis
• Intent-to-treat populationhylan G-F 20: 31 kneesNSAID 34 kneesNSAID + hylan G-F 20 : 37 knees
Hylan G-F 20 vs. Continuous NSAID Therapy
Adams et al. (1995), Osteoarth Cartil 3
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Initial Treatment of Knee inflam
Aspiration, Physiotherapy Arthroscopic Washout of loose bodies
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Arthroscopic washout Recovery is faster and less invasive.
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Cartilage - Abrasive therapySoft tissue - shaving, synovectomy
Surgical Procedures
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Joint Replacement Remarkable pain relief
Range of motion is good Lasts for 20-25yrs
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Treatment of OA knee
Medication
synovitiscartilage erosion
Arthoscopy washout
Loose bodies,Osteophytes
H. Tib Osteotom yJoint Replacem ent
deform ity
recurrent knee inflam recovered knee
Acute Knee
Singapore Orthopaedic Surgeon, Tel: +65 64712674Email: [email protected]
Discussion Degen Arthritis is treatable. Recurrent inflammation can damage cartilage
Arthroscopic washout and debridement for moderate OA
Joint replacement has good long term results
