Latest on Osteoarthritis Knee Joint

The technique of "Unmasking and treating the underlying problem":

This technique is being explained for the first time. It is a source of new hope for the patients, and gives promising results. It also gives us the clue and the knowledge of a new etiology for the symptom of Pain Knee Joint. Clinically our work has proved that the pain knee is due to lesions that are outside the joint and the aging process has nothing to do with it. These lesions may appear as early as 35 years of age and are invariably found in all those cases of Osteo-arthritis knee joint that clinically present with Pain Knee. Why these lesions develop is a question yet to be answered, but anyway they are well demarcated, identifiable and severely tender on deep palpation. These lesions when treated give complete relief to the symptom of Pain Knee, thus certain other treatment modalities would be required to be postponed, till the time that the patient escapes any benefit from this new technique.

However a big task is still lying ahead. This new algorithm needs to be authenticated and standardized by designing bigger treatment models. Their results evaluated and follow-ups carried out. Till date this new algorithm only gives us a clue of the etiology of pain knee and a new possible treatment technique.
Trigger spots identified around knee joint are as under:

1. Above the joint on the medial side it is on the Adductor Tubercle, possibly the insertion of Adductor Magnus (Fibro Osseous Junction).

2. Higher up on the tendons and ligaments in the same line on the medial side. May be these are tendonitis or with associated underlying Bursitis.

3. On Lateral side it is on the origin of the Gastronemius lateral head (Fibro Osseous Junction).

4. Higher up on the tendons and ligaments in the same line on the Lateral side. May be these are tendonitis or with associated underlying Bursitis.

5. Underneath the upper border of Patella (this is very rare).

6. On the medial aspect of the joint upon Tibial Collateral Ligament ( Pes anserine bursa).

7. On the Dorsum above the popliteal fossa.
The first and the third points are invariably found in all the cases presenting with Pain Knee joint. Rarely a patient may have only one of them. These points are basically causing the main symptom of pain as we clinically see in our everyday practice. Why these sites are more prone to develop these pathological changes is a very important question that needs to be answered.

However other questions that are looking forward towards us for explaining the etiology and pathogenesis of this disease are:

What in particular is the pathology at these sites?
Why are certain people more prone to develop these changes while others are not?
Can these be prevented?
Are these posture related?
Having identified them what are the most effective options to treat them?

Dog Arthritis - The Three Warning Signs

How do you know if Your Dog Has Arthritis?

Strictly speaking, dogs don't have 'symptoms'. A symptom is subjective - it is only appreciated by the patient and in people, symptoms are what the person experiences about the illness, disease or injury.

Symptoms include pain or discomfort, fever, chills, cold, heat, vertigo, nausea, and more. They are usually the reason for the patient seeking medical advice or attention. So, although it is reasonable to assume our dogs will experience these things as well, they do not communicate them. What we see in dogs with arthritis are signs such as stiffness, less energy on walks, lameness, spending more time in their basket and so on.

Veterinary clinicians tend to talk about clinical signs - the things we pick up on a clinical examination such as lameness, joint swelling, heat, and fluid around or in a joint. We all know what we mean by symptoms and so I am going to use the terms 'signs and symptoms' in this article.

The Three Warning Signs in Dog Arthritis

1. Lameness and stiffness
These signs are variable and clinical arthritis in dogs usually starts as a mild stiffness after rest. The stiffness getting up is usually more severe if your dog's rest period was preceded by vigorous activity. The first time you notice some subtle stiffness in your pet when they get up from the floor or out of their bed may be after a particularly vigorous or long walk the day before.

As the condition progresses, the periods of stiffness and lameness will become more severe or more prolonged. So instead of being a little bit stiff for a few seconds when they get out of their basket or bed, your dog may be walking stiffly for a few minutes. In time the signs can progress to a more or less permanent lameness that is most intense after rest.

Arthritis in the dog usually starts in a joint subsequent to another problem in that joint such as hip dysplasia, elbow dysplasia or ligament damage. Therefore in a large proportion of patients there will have been a previous lameness that could have subsided months or years ago.

Does arthritis in dogs always cause joint pain?
Osteoarthritis may or may not progress to a point where we become aware of it. If it does start to cause a problem for the patient, this is when it progresses to a point where the signs or symptoms of osteoarthritis are detected. It is at this point that veterinary help is usually sought and further tests are performed to diagnose the problem and assess how severe it is.

We are likely to take steps at this stage to reduce signs and symptoms and take some preventative action, perhaps involving lifestyle modifications. The aim of these interventions is to make your dog more comfortable and to gain the best possible quality of life for your pet.

2. Joint Swelling
In dogs with arthritis, over time the supporting soft tissues around the joint will become thicker. This increase in what is essentially scar tissue will make the joint stiffer, with a reduced range of motion. If the joint is visible then you may notice that it is bigger than the joint on the other side of the body. In many cases, osteoarthritis can affect both knees or both elbows in dogs, and so a discrepancy between the two sides may not be present.

3. Crepitus or grating in the joint
Crepitus is a noise or a vibration produced by rubbing irregular surfaces of bone or cartilage together. It is similar to the sensation you will get by rubbing your hair between your fingers. As osteoarthritis progresses, crepitus becomes a fairly consistent feature. However, it is important to realise that this is not a specific sign for osteoarthritis and mild crepitus may have no clinical significance. It is also not possible to judge how painful your dog's arthritis is by the degree of crepitus in the joint, although joints with severe, audible crepitus will usually be causing discomfort for your pet.

In summary, dog arthritis will typically cause a gradual onset stiffness and lameness. This is often most severe immediately after rest. If the affected joint can be seen, it may appear thickened. The joint may feel stiff with a reduced range of motion and crepitus may be heard or felt in the affected joint.

Although these signs are typical of arthritis in dogs, they are not specific and can be present in other conditions that may require very different treatment. Diagnosis requires a thorough examination by a veterinary professional and a skilled clinical investigation.

Health Tourism in Thailand

Private healthcare in the West is notoriously expensive, for some, prohibitively so. Commonplace medical items like dentistry or health check ups are high-priced, while surgery and major operations can completely bankrupt many individuals. Thus, the rapidly-growing practice of traveling across international borders to obtain healthcare.

Many have found their solutions in Thailand, spurring a trend in "health tourism" within the country. Why Thailand? Because the Thai medical profession is one of the most advanced in the region. Thailand's hospitals and clinics are world class. Investments in equipment and management standards are so high that major hospitals are "internationally accredited".

The following are some "ball park" cost comparisons. The cost of surgery can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the US costs around $500. A knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the US. Lasik eye surgery worth $3,700 in the US is available for around $730. In the US cataract surgery for one eye runs around $8,000, but at a prestigious International hospital in Thailand cataract surgery can be performed on both eyes for around $2,500. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the US runs about $1,200. A thorough dental cleaning and checkup runs around $10.00.

Tourists are drawn to Thailand for many reasons - tropical beauty, splendid beaches, and a fascinating culture. Now however, health is yet another reason that lures visitors to the kingdom. Thailand has become the spa capital of Asia. The country abounds in health clubs and spas, and offers an incredible amount of sporting activities, everything from golfing to scuba diving, and from biking to cave exploring.

Thai Airlines features what is known as Royal Orchid Holidays. Medical checkups, has become so important, Royal Orchid Holidays has added medical checkups to its package tours. It's an unusual theme for a package tour, perhaps, but a very practical one, giving travelers the opportunity to have a comprehensive medical checkup while they are in Thailand for business or pleasure. Quality healthcare combined with a tourism holiday at a low price attracts patients from all over the world.

On the medical side, an Internet search of the International hospitals in Bangkok will provide all the information necessary regarding medical procedures available and the related costs. While the list is long, to start, your search should include the popular Bumrungrad Hospital, Bangkok Hospital, Samitivej Hospital, and Bangkok Nursing Home Hospital. They are all internationally accredited hospitals.

On the tourism side, Thailand is known as The Land of Smiles. It is often referred to as the most exotic country in Southeast Asia. In Bangkok a visit to the Grand Palace is a must see. Trips to a floating market or to the Bridge on the River Kwai, or other popular destinations, are easily arranged and inexpensive, even with a personal driver. A short flight or overnight train trip and you can be enjoying the pristine beaches in the Southern Islands or the Northern mountains with its waterfalls, elephants bathing in mountain streams, and Hill Tribe villages.

Consider Health Tourism in Thailand. You will readily see that you can have a medical procedure, and a wonderful holiday, all at less cost that you would have paid for the medical procedure alone in the West.

The 3 Most Impressive Job Fields For 2010 and Beyond

College students and other people looking to reinvent themselves should really consider looking for a place to fit into one of the three fastest growing and most promising career fields for the near future. These career fields hold the most promise for job advancement due to the expected demand for them.

The first and most popular field is nursing. With all of these baby boomers reaching the age where they start experiencing health problems, there is bound to be a strong demand for people in the health care industry. You should start seeing record numbers of operations for things like knee replacement or hip replacement surgery. There will be more people in hospitals for general ailments than in past years just because the demographic is so enormous. These are highly skilled high paying jobs as well. You can get a sense of satisfaction knowing that you have really helped someone when at work.

The second really popular field is engineering. The world is flat. High tech gadgets are everywhere. There is no doubt that our civilization is going to continue this massive trend toward computerizing and automating all forms of communication. Who knows what kind of useful or useless devices this generation of engineers will invent. We can be sure that they will make a great living inventing them though. Math and science are two subjects that only a certain type of person can easily excel in. If you are one of them, then you already have an advantage over a huge percentage of the population. I doubt we will be seeing any time in the near future where there are huge numbers of skilled engineers unemployed.

The third field to consider is the field of education. In America there is a drastic shortage of quality teachers. In some states teachers are paid exceptionally well compared to other careers that demand a similar education. That is of course if you take into consideration the amount of time a typical teacher has off during the summer months. Few career choices will give you as much time off as well as holidays throughout the rest of the working year. Plus, it is a career that you can really be proud of. Teachers are typically pretty darn nice people. They are well respected in their communities. They also make exceptionally good parents because of their insight into helping their children succeed academically.

There you have it. Those are three of the top fields for people to consider getting into in 2010 and the years shortly thereafter. Those who do are bound to make a decent living while enjoying their jobs. Those people who are ambitious enough to want to climb the ranks in those professions should have ample opportunity to do so.

Ten Non-Surgical Alternatives to Total Knee Replacement Surgery to Treat Osteoarthritis in the Knee

Knee osteoarthritis is often a painful and disabling condition. Many people consider total knee replacement surgery as a way to treat osteoarthritis of the knee but it is important to know that there are a number of non-surgical options to consider.

If you are struggling with knee osteoarthritis, before undergoing surgery like total knee replacement, learn more about the top 10 ways to treat osteoarthritis of the knee WITHOUT undergoing knee replacement surgery. You should always talk to your doctor or orthopaedic surgeon for further information and medical advice. Here are 10 non surgical options you might consider trying to treat knee osteoarthritis before undergoing total knee replacement surgery:

1. Exercises specific for knee arthritis and these include: water aerobics, floor exercises, yoga and weights


2. Supplements: glucosamine with chrondrotin 1500 mg per day. Make sure you are not allergic to shellfish. Check the label some glucosamine has shellfish in the supplement. Fish oil is an omega 3 and it is good for joint health. It should be taken at least 1000 mg per day.


3. Oral NSAIDs: over the counter vs. prescription. Check with your doctor to see if you are a candidate. Another option is the use of aspirin or Tylenol (acetaminophen) both of these medications are over the counter.


4. Hyaluronic acid (HA) injection: the normal knee has hyaluronic acid (HA) with a thick and viscous consistency. As the knee becomes arthritic the composition of the HA changes. The injection replaces a fluid similar to the healthy fluid found in a normal knee. There are many brands on the market. They can be given as a single dose injection or a series of injections ranging from 3 to 5 based on the brand. Examples of the different brands are: hyalgan, orthovisc, synvisc, supartz, and euflexa.


5. Cortisone injection: cortisone is like a strong Motrin/Eleve, in the sense that it is able to slow down or reduce the inflammatory process that is produced by the knee osteoarthritis. The injection can be given every three months. If given more than every three months if does not work as well. Cortisone does not destroy the knee joint, the bones in the knee or the knee ligaments/ tendons. There are a lot of myths about cortisone. The bottom line is that cortisone will not damage an arthritic knee joint. Cortisone given in the knee joint does not cause the person to gain weight. Cortisone can temporarily raise a person's blood sugar if they are a diabetic.


6. Unloader knee braces: a special brace that is used for patients that have knee pain with activity. The concept behind the unloader knee brace is that it forces the person to put more weight on the non arthritic side of the knee. Most people with arthritis have one side that is less affected by the arthritis and cartilage loss. Some of the different brands of the unloader custom braces are: Berg and Donjoy. They can be ordered through your doctor. The arthritic leg must be measured so the brace fits properly and then the braces built to fit each individual knee. Most insurance plans will cover the brace.


7. PRP also known as platelet rich plasma: there are enzymes in PRP that may help reduce the progression of knee osteoarthritis and decrease the symptoms. PRP is produced by withdrawing blood from the person and separating out the highly concentrated plasma and injecting it into the arthritic knee joint


8. Weight loss: the less weight on the arthritic knee typically will help to reduce the pain from the arthritis and may slow down the progression. Morbidity obese patients have a higher incidence of knee arthritis at a younger age.


9. Capsaicin: this is a topical cream made out of red peppers that can help reduce the pain of knee arthritis. It can be purchased over the counter at most grocery or drug stores (for example, Walgreens, Kroger, Costco or Walmart)


10. Simple slip on knee brace: an over the counter knee brace that slips over the knee made of neoprene with Velcro straps. The brace can help give a sense of more support to the knee and it provides warmth to the knee with can help ease arthritic pain.

If you are suffering from knee osteoarthritis, before you decide on major surgery like total knee replacement surgery, it is beneficial for you to learn about your non surgical alternatives. There are a number of things you can try first including unloader knee braces or platelet rich plasma (PRP) before undergoing total knee replacement. For more information about your options to treat knee osteoarthritis, contact a board certified and experienced orthopaedic surgeon like Orthopaedic Specialists in Louisville, Kentucky.

Custom Fit Knee Replacement

Custom Fit Knee Replacement In South Florida

From standing and walking to running a marathon, the knee joint plays a vital role in most forms of mobility. But when it becomes damaged or suffers from the deteriorating effects of arthritis, any movement can become painful. When knee damage progresses to this point, total knee replacement surgery may be the best option. The success of the artificial replacement joint depends largely on how well it fits into the existing bone structure. Custom fit knee replacement procedures are designed to ensure that the new replacement joint can function as closely to a natural knee joint as possible.

Knee Anatomy

The knee is made up of three main components: the patella (kneecap),femur (thighbone), and tibia (shinbone). Tendons and ligaments that run through and around the joint connect muscle to bone and provide strength and support. The meniscus, a wedge of cartilage, is located in the middle of the joint, serving as a buffer between the femoral head and the top of the tibia. The meniscus also serves as a shock absorber and has a stabilizing effect by helping keep the upper and lower bones in place. A thin, gel-like layer of cartilage covers the femoral head and the top of the tibia to prevent friction between the bones.

Knee Replacement Surgery

During a total joint knee replacement procedure, surgeons remove damaged portions of the femoral head and the top of the tibia. The natural knee joint is replaced with an artificial implant made of metal alloy, plastic, and ceramic components. Metal stems attached to the implant components are inserted into the center of the femur and tibia and are cemented in place. The new artificial joint is designed to closely mimic the form and function of a natural knee joint.

Custom Fit Knee Replacement

Custom fit knee replacement procedures take the fitting of the artificial joint one step further. Using 3D imagery and computer modeling technology, the surgical team takes precise measurements of the remaining healthy bones of the knee joint. In order to create a perfect fit for the artificial knee joint, these extremely precise measurements are used to create custom cutting guides that are then used to trim back the healthy bone. By matching the artificial joint to the exact contours of the remaining healthy bones, surgeons are able to install an implant that feels and reacts exactly as the original one did. This innovative procedure produces more effective results compared a traditional knee replacement surgery.

What Is Baker's Cyst?

Also known as a Popliteal cyst or "Bulge-knee", a Baker's Cyst is caused by an abnormal collection of the synovial fluid that normally lubricates the knee joint. The cyst is formed because of an increase in the amount of synovial fluid, resulting in increased pressure in the joint. After time, this excess of fluid will bulge toward the back of the knee, forming a cyst.

Often, a Cyst occurs because of another injury or disease process that is occurring in the knee, which causes the increase in synovial fluid. Some of the most common causes are Osteoarthritis, Rheumatoid Arthritis and Meniscal Tears, but they can be seen with other conditions.

A person may have a Cyst and never report any symptoms. More often, stiffness and swelling in the back of the knee are reported, causing discomfort and a decrease in activity. It may be possible to feel the cyst underneath the skin. Occasionally, a Baker's Cyst may rupture, which will result in swelling, bruising and pain behind the knee and calf. Most people find that having a Baker's Cyst is an annoyance, but not something which needs medical attention.

If the Baker's Cyst is causing concern, it is always a good idea to have a medical examination to rule out more serious conditions. Your Orthopaedic physician will look for a balloon-like sac in the back of the knee. A major consideration for your physician will be to differentiate a Baker's Cyst from a DVT (deep venous thrombosis) or blood clot. Blood clots can be life-threatening and require urgent medical attention.

X-rays of the knee will be performed to look for conditions such as arthritis and to rule out other issues. An MRI is sometimes performed to confirm meniscal tears or other soft tissue injury. Usually, the patient will be diagnosed with a primary condition, such as arthritis, that is causing the secondary Baker's Cyst. The Orthopaedist will probably treat the primary condition and the Baker's Cyst will improve concurrently, without any other intervention. If that fails to be the case, the cyst can be drained by needle aspiration. The cyst is surgically removed only if very large, painful or does not resolve with any other treatment. Cysts can recur after removal and the surgery may cause more problems than intended.

As with any other health concern, it is important to consult with a qualified physician who can treat the condition appropriately. Baker's Cysts might be an aggravation, but they can primarily be treated with nonsurgical care.