Rheumatoid - Ain't No Rumour

Rheumatoid arthritis (RA) is a systemic disease that affects the entire body and is one of the most common forms of arthritis. It is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining, the synovium, can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement. The disease usually begins in middle age, but can start at any age. It affects two to three times more women than men.

The cause of rheumatoid arthritis is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage.

Researchers suspect that agent-like viruses may trigger RA in some people who have an inherited tendency for the disease. Many people with RA have a certain genetic marker called HLA-DR4. Researchers know that there are other genes that influence the development of RA.

It is important to diagnose RA early in the course of the disease because with the use of disease-modifying drugs, the condition can be controlled in many cases. Physicians diagnose RA based on the overall pattern of symptoms, medical history, physical exam and lab tests including a test for rheumatoid factor. Rheumatoid factor is an antibody found in the blood of about 80 percent of adults with RA. However, the presence or absence of rheumatoid factor does not indicate that one has RA.

Early in the disease, people may notice general fatigue, soreness, stiffness and aching. Pain and swelling may occur in the same joints on both sides of the body and will usually start in the hands or feet. RA can also affect wrists, elbows, shoulders, neck, knees, hips and ankles. Other features include lumps called rheumatoid nodules under the skin in areas that receive pressure, such as the back of the elbows.

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Sneak Peek at Knee Anthroscopy

Knee arthroscopy is a surgical procedure in which a small camera is used to examine tissues inside the knee joint. Additional instruments may be inserted to repair the knee.

Arthroscopic surgery on the knee involves inserting a small camera, less than 1/4 inch in diameter, into the knee joint through a small incision. The camera is attached to a video monitor, which the surgeon uses to see inside the knee. In some facilities, the patient can choose to watch the surgery on the monitor as well.

For a simple surgical procedure, a local or regional pain-killing medicine (anesthetic) is given to numb the affected area. You will remain awake and able to respond. For more extensive surgery, general anesthesia may be used. In this case you will be unconscious and pain-free.

After the camera is inserted, salt water (saline) is pumped in under pressure to expand the joint and help control bleeding. Some surgeons also use a tourniquet to prevent bleeding.

After looking around the entire knee for problem areas, the surgeon will usually make 1-4 additional small surgical cuts to insert other instruments. Commonly used instruments include:

• A blunt hook to pull on various tissues
• A burr to remove bone
• A shaver to remove damaged or unwanted soft tissues

A heat probe may also be used to remove inflammation (synovitis) in the joint.

At the end of the surgery, the saline is drained from the knee. The incisions are closed, and a dressing is applied. Many surgeons take pictures of the procedure from the video monitor to allow the patient to see what was done.

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Knee Replacement -Its Implications

Knee replacement surgery (arthroplasty) involves replacing a damaged, worn or diseased knee joint with an artificial joint.

Knee replacement is a routine operation for knee pain when the knee joint has been severely damaged, most commonly by arthritis. It's as effective and reliable as hip replacement. There are two main types of surgery, depending on the condition of the knee: total knee replacement and half (partial) knee replacement.

A replacement knee will not last forever, but your artificial knee will probably last you at least 10-15 years, depending on how active you are and the type of replacement you have.

As new technology continues to be developed, this figure is likely to increase.

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Knee Microfracture Surgery

Knee microfracture surgery is a common technique used to repair damaged knee cartilage, the material that helps cushion bones at the joints. It is frequently performed on athletes.
The surgeon makes a tiny, quarter-inch incision on the affected knee and inserts a long thin scope (arthroscope). This scope allows the surgeon to work directly on the joint area. The surgeon uses an ice pick-like tool called an awl to drill very small holes (“microfractures”) into the bone near the defective cartilage. The injury prompts the body to make new, replacement cartilage. Bone marrow seeps out of the holes, creating a blood clot that releases cartilage-building cells.
Microfracture surgery can help a patient prevent a partial or total knee replacement. It is also used to treat pain in the knee from cartilage injuries, as well as:

• Early arthritis of the knee
• Lesions on the kneecap
• Degenerative chondral lesions of the knee
• Traumatic injuries to the cartilage

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Housemaid's Knee

Prepatellar bursitis, also known as housemaid's knee, is a common cause of swelling and pain above the patella (kneecap), and is due to inflammation of the prepatellar bursa. This structure is a superficial bursa with a thin synovial lining located between the skin and the patella. The bursa develops within the first years of life as a result of mechanical pressure and friction, and it serves the purpose of reducing friction on underlying structures and allowing maximal range of motion in the knee. Aseptic prepatellar bursitis is commonly caused by repetitive work in a kneeling position, hence the name "housemaid's knee".

Inflammation of the prepatellar bursa may be aseptic (most common) or septic (e.g. bacterial infection), the septic variants being most common in children and immunocompromised individuals. Prepatellar bursitis is more common in men than women.

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Knee Replacement Surgery – Method

In total knee replacement surgery, the parts of the bones that rub together are resurfaced with metal and plastic implants. Using special, precision instruments, the surgeon will typically remove the damaged surfaces of all three bones. The replacement surfaces will then be fixed into place.

The surface of the femur is replaced with a rounded metal component that comes very close to matching the curve of your natural bone. The surface of the tibia is replaced with a smooth plastic component. This flat metal component holds a smooth plastic piece made of ultra-high-molecular-weight polyethylene plastic that serves as the cartilage. The undersurface of the kneecap may also be replaced with an implant made of the same polyethylene plastic.

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Plan for a perfect Knee Replacement Surgery

Knee replacement surgery means a specialist who cuts and removes the injured part of the knee cartilage from our body and replace into that part and joins it with an artificial metal. The ends of another part are smoothly reshaped and accommodated into that place. In an artificial joint knee replacement surgery, the affected part is replaced with that of bone cement and some uncemented devices.

For this kind of knee replacement surgery, first choose an extensive variety of devices which accounts your age, weight, activity level and an overall health. 90 percent of patients who have undergone knee replacement surgery have fast recuperating than those who haven’t. After a period of 10 years there should be again a surgery done to make the knee fit for future. Knee replacement has another name is known as knee arthroplasty.

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