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Archive for November, 2010

HIgh Tibial Osteotomy

HIgh Tibial Osteotomy

High Tibial Osteotomies (HTO) are surgical procedures used to treat unicompartmental osteoarthritis of the knee.

Osteonecrosis is one of those complications.  It is “bone death” caused by poor blood supply to the affected area.  Though osteonecrosis is mst common in the hip and shoulder, in high tibial osteotomies it usually presents in the bone fragment above the surgical site.

There aren’t any symptoms in the early stages of this condition.  But as it gets worse you may feel pain in the joint that increases over time, pain at rest, limited range of motion, and limping.

Bone grafts and joint replacement are the usual treatment options for osteonecrosis.



Knee Surgery

Knee Surgery

Deciding to have surgery is never easy.  You need to consult with your surgeon and discuss your medical history.

High tibial osteotomies are most successful in patients who understand exactly what they are getting into.  Patients should not be overweight, they should be active, and have a high tolerance for pain.  Also patients need to be able to take several weeks if not months off of work.

This surgery is not a treatment option for everyone who suffers from osteoarthritis of the knee.



Happy Thanksgiving!

November 25, 2010
Enjoy Your Turkey!

Enjoy Your Turkey!

Everyone at “osteoarthritis blog” wishes you a healthy and happy Thanksgiving.



High Tibial Osteotomy

High Tibial Osteotomy

There are two different types of high tibial osteotomy surgeries to treat knee osteoarthritis.

A “closing wedge” osteotomy cuts out a wedge of bone to change the angle of the knee joint.

An “opening wedge” cuts the bone and fills the gap with a graft to change the angle of the knee.

Either surgical procedure is significant because the bones supporting your body weight are fractured, and then fixed.  You will be off your feet for up to 6 weeks and a return to full activity can take as long as six months.



Osteoarthritis of the Knee

Osteoarthritis of the Knee

Unicompartmental Osteoarthritis is the primary indication for a high tibial osteotomy.  Unicompartmental means that only one side of the knee is affected by the arthritis.

Once the cartilage between the femur and tibial plateau starts eroding the angle at the knee joint begins changing.  If the inside of the knee wears away the result is a “bow-legged” deformity.  If the outside of the knee wears away then the angle makes the legs appear “knock-kneed”.

The goal of a high tibial osteotomy is to realign the bones and restore a more normal angulation.



High Tibial Osteotomy

High Tibial Osteotomy

A high tibial osteotomy (HTO) is a surgical procedure often associated with osteoarthritis of the knee.

“Osteo” means bone.  “Otomy” means to cut.  So an osteotomy is a cutting of the bone.  Osteotomies are usually used to correct angulations of bones.  In the case of unicompartmental osteoarthritis, the surgery requires that a wedge of bone is removed from beneath the affected compartment.



NSAIDs

NSAIDs

Non-steroidal anti inflammatory drugs (NSAIDs) relieve the pain associated with knee osteoarthritis on a chemical level.

Enzymes called Cox-1 and Cox-2 are a contributing factor in the creation of prostaglandins.  Prostaglandins are responsible for swelling and the sensation of pain.  NSAID’s block Cox enzymes, so your body does not produce as many prostaglandins.

So NSAID’s reduce pain and swelling by blocking Cox-1 and Cox-2 enzymes, thus your body doesn’t produce as many prostaglandins, and pain and swelling is reduced.



Attention!

Attention!

NSAIDs are commonly prescribed and recommended to treat the pain associated with osteoarthritis of the knee.  This series of posts is about the side effects associated with nonsteroidal anti-inflammatory drugs.  Some of the problems that these medications cause are very serious and can adversely effect your health much worse than the pain in your knee caused by OA.

  • Liver Failure
  • Kidney Failure
  • Heart Attack
  • Stroke
  • Death

NSAID use has been linked to all of the above conditions.  It is important you talk to your doctor and know all of the risks associated with any medication you take.  With NSAIDs, know all of the precautions you must take to safely treat your knee pain.

Think about a conservative treatment option for your knee OA.  Nobody has ever died from wearing a knee brace.



Clotting Problems

Clotting Problems

NSAID use can interfere with the clotting of blood.  This series of blog posts is about the possible side effects associated with non-steroidal anti-inflammatory drugs used to treat knee osteoarthritis.

If the efficiency of your body’s ability to clot blood is affected you may bruise easily or have trouble stopping bleeding if you are cut or lacerated.

A study published in the Journal of Bone and Joint Surgery concluded that neoprene knee sleeves can reduce pain and increase function in a knee with osteoarthritis more effectively than NSAIDs.



Fluid Retention

Fluid Retention

Observable swelling from fluid retention in the tissues of your body is called edema.  Edema is a possible side effect from using nonsteroidal anti-inflammatory drugs to treat the osteoarthritis in your knee.  The swelling is most common in the feet and ankles.

Swollen ankles can also be a symptom of heart, kidney, and respiratory problems.  Edema can be the sign of a serious medical condition.  Since NSAID use can also result in serious heart, kidney, and respiratory problems, consult your physician immediately is your ankles swell unexpectedly.