Frequently Asked Questions

Categories

 

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





General

 

Acute Knee Clinic

What are non-surgical orthpaedic treatments?


Many orthopaedic conditions have many non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.

Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating the injury and managing pain. We also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.

Non- pharmacological Treatments

Physical and Occupational Therapy

Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.

Weight reduction and physical exercise

The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.

Thermotherapy

Thermotherapy involves application of hot or cold packs to the affected area. It is contraindicated in individuals with thermoregulatory impairments. Individuals having peripheral vascular disease, diabetes, cardiovascular disease and hypertension, or who are pregnant should use it with caution.

Orthotics

Orthotics involves the use of devices such as splints or braces to correct an injury. These devices need to be properly designed by a qualified orthotist to fit the patient’s body and their specific injury.

Pharmacological Treatments

Platelet-rich plasma therapy (PRP)

This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.

Steroid injections

These injections of steroids are given directly into the affected joint for severe pain when use of Non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.

Medications

To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.

Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them.

They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.

Stem cells These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament. Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing - bone, muscle, ligament, and cartilage. Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program. Stem Cell Harvesting: There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells. The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process. Stem Cell Donation: Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.





 

Non-surgical treatment

What are non-surgical orthpaedic treatments?


Many orthopaedic conditions have many non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.

Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating the injury and managing pain. We also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.

Non- pharmacological Treatments

Physical and Occupational Therapy

Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.

Weight reduction and physical exercise

The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.

Thermotherapy

Thermotherapy involves application of hot or cold packs to the affected area. It is contraindicated in individuals with thermoregulatory impairments. Individuals having peripheral vascular disease, diabetes, cardiovascular disease and hypertension, or who are pregnant should use it with caution.

Orthotics

Orthotics involves the use of devices such as splints or braces to correct an injury. These devices need to be properly designed by a qualified orthotist to fit the patient’s body and their specific injury.

Pharmacological Treatments

Platelet-rich plasma therapy (PRP)

This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.

Steroid injections

These injections of steroids are given directly into the affected joint for severe pain when use of Non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.

Medications

To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.

Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them.

They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.

Stem cells These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament. Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing - bone, muscle, ligament, and cartilage. Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program. Stem Cell Harvesting: There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells. The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process. Stem Cell Donation: Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.





 

Preparing For Surgery

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

Anaesthesia

What are non-surgical orthpaedic treatments?


Many orthopaedic conditions have many non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.

Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating the injury and managing pain. We also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.

Non- pharmacological Treatments

Physical and Occupational Therapy

Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.

Weight reduction and physical exercise

The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.

Thermotherapy

Thermotherapy involves application of hot or cold packs to the affected area. It is contraindicated in individuals with thermoregulatory impairments. Individuals having peripheral vascular disease, diabetes, cardiovascular disease and hypertension, or who are pregnant should use it with caution.

Orthotics

Orthotics involves the use of devices such as splints or braces to correct an injury. These devices need to be properly designed by a qualified orthotist to fit the patient’s body and their specific injury.

Pharmacological Treatments

Platelet-rich plasma therapy (PRP)

This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.

Steroid injections

These injections of steroids are given directly into the affected joint for severe pain when use of Non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.

Medications

To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.

Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them.

They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.

Stem cells These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament. Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing - bone, muscle, ligament, and cartilage. Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program. Stem Cell Harvesting: There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells. The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process. Stem Cell Donation: Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.





 

Post-operative CARE

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

Joint Replacement Surgery

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

Arthroscopic Surgery

TACK-CLOTH WAX


INSERT DESCRIPTION FORMULATION: {Insert Image Here} DATA SHEETS: Technical Data Sheet Safety Data Sheet





 

Anterior Cruciate Ligament (ACL) Injuries

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





Arthritis

 

Osteoarthritis

What is Arthritis?


Arthritis is inflammation of one or more of your joints that causes pain and stiffness. While arthritis is mainly an adult disease, some forms affect children.
There are many types of arthritis. Some of these include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, septic arthritis, and psoriatic arthritis.
While each of these conditions has different causes, the symptoms and treatment are often thesame. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in weight-bearing joints such as the knee and hip.
Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep patients staying active.




What causes arthritis?


Arthritis may be caused by wear and tear on the articular cartilage through the natural aging process (osteoarthritis), or may develop following an injury (post-traumatic arthritis).
Other types of arthritis, such as crystalline arthritis, may come from an inflammatory process.
Still others, such as rheumatoid arthritis or lupus arthritis, are the result of a systemic disease
throughout the body.

Regardless of whether the cause is from injury, normal wear and tear, or disease, the joint becomes inflamed, causing swelling, pain and stiffness. Inflammation is one of the body's normal reactions to injury or disease. In arthritic joints, however, inflammation may cause long-lasting or permanent disability.




What is osteoarthritis?


The most common type of arthritis is osteoarthritis. Also known as "wear and tear" arthritis,
osteoarthritis occurs when the cartilage that cushions and protects the ends of your bones gradually wears away.

It results from overuse, trauma, or the natural degeneration of cartilage that occurs with aging.
Osteoarthritis is often more painful in joints that bear weight, such as the knee, hip, and spine. However, joints that are used extensively in work or sports, or joints that have been damaged by injury may show signs of osteoarthritis.
In many cases, bone growths called "spurs" develop at the edges of osteoarthritic joints. The bone can become hard and firm (sclerosis). The joint becomes inflamed, causing pain and swelling meaning continued use of the joint is painful.




What is rheumatoid arthritis?


Rheumatoid arthritis is a long-lasting disease. Rheumatoid arthritis affects many parts of the body, but mainly the joints. The body's immune system, which normally protects the body, begins to produce substances that attack the body. In rheumatoid arthritis, the joint lining swells, invade surrounding tissues. Chemical substances are produced that attack and destroy the joint surface.
Rheumatoid arthritis may affect both large and small joints in the body and also the spine. Swelling, pain, and stiffness usually develop, even when the joint is not used. In some circumstances, juvenile arthritis may cause similar symptoms in children.




What is post-traumatic arthritis?


Post-traumatic arthritis results from an injury to the joint. If a broken bone or fracture extends into a joint it will damage the smooth cartilage that covers the joint surfaces. The surface becomes uneven and causes friction as the joint moves. Over time, the joint breaks down and becomes arthritic.




What is septic arthritis?


Septic arthritis is an infection of the joint. Most often bacteria reach the joint through the
bloodstream from an infection in another part of the body, such as the urinary tract. Infected joints are typically warm, red, and acutely tender. They are often swollen due to pus in the joint. An infected joint often needs surgical drainage in addition to antibiotics.




What is psoriatic arthritis?


Psoriatic arthritis is associated with the skin disease psoriasis. While it may involve larger joints such as the knees it often presents with symptoms in smaller areas such as the distal joints at the tips of the fingers and toes.




What is gouty arthritis?


Gouty arthritis develops as the result of uric acid build up in the bloodstream. The uric acid forms crystals which cause acute inflammation in a joint. The big toe, ankle, knee, and elbow are the most common joints affected. A gout attack can be acutely painful. The inflamed joint becomes red and very sensitive to touch. Gout attacks are most often treated with medicine rather than surgery. Long term, many patients develop soft tissue masses (tophi) over the affected joints.




What is Lyme arthritis?


Lyme arthritis can be one of the side effects of Lyme disease, a systemic infection caused by a tick bite. Lyme arthritis can present acutely as pain and swelling in early stages of the disease. Lyme disease is treated with antibiotics. Left untreated, Lyme disease can lead to chronic arthritis.




What is Lupus arthritis?


Lupus is an autoimmune disease that affects multiple organs including the kidneys, skin, blood, and the heart. Lupus arthritis can be systemic and cause chronic pain in multiple joints.




What is Juvenile arthritis?


Juvenile arthritis is the most common type of arthritis in children. There are several types of the disease and most are different from rheumatoid arthritis in adults.




How is arthritis diagnosed?


Arthritis is diagnosed through a careful evaluation of symptoms and a physical examination. X-rays are important to show the extent of any damage to the joint. Blood tests and other laboratory tests may help to determine the type of arthritis. Some of the findings of arthritis include:

  • Weakness (atrophy) in the muscles
  • Tenderness to touch
  • Limited ability to move the joint passively (with assistance) and actively (without assistance)
  • Signs that multiple joints are painful or swollen (an indication of rheumatoid arthritis)
  • A grating feeling or sound (crepitus) with movement
  • Pain when pressure is placed on the joint or the joint is moved




How is arthritis treated?


There is no cure for arthritis, but there are many treatments to help relieve the pain and disability that it can cause.




What are the non-surgical treatments of arthritis?


Medications Over-the- counter medications can be used to control pain and inflammation in the joints. These medications, called anti-inflammatory drugs, include aspirin, ibuprofen, and naproxen. Acetaminophen can be effective in controlling pain.
Prescription medications also are available. Dr Bhimani will choose a medication by taking into account the type of arthritis, its severity, and your general physical health. Patients with ulcers, asthma, kidney, or liver disease, for example, may not be able to safely take anti-inflammatory medications.
Injections of cortisone into the joint may temporarily help to relieve pain and swelling. It is
important to know that repeated, frequent injections into the same joint can cause damage and undesirable side effects.
Viscosupplementation or injection of hyaluronic acid preparations can also be helpful in lubricating the joint. This is typically performed in the knee. Exercise and therapy Canes, crutches, walkers, or splints may help relieve the stress and strain on arthritic joints. Learningmethods of performing daily activities that are the less stressful to painful joints also may be helpful. Certain exercises and physical therapy may be used to decrease stiffness and to strengthen the weakened muscles around the joint.




What are the surgical treatments of arthritis?


In general, Dr Bhimani will perform surgery for arthritis when other methods of nonsurgical
treatment have failed to relieve pain and other symptoms. When deciding on the type of surgery, Dr Bhimani will take into account the type of arthritis, its severity, and your loss of normal function.

There are a number of surgical procedures. These include:

  • Removing the diseased or damaged joint lining
  • Realignment of the joints
  • Fusing the ends of the bones in the joint together, to prevent joint motion and relieve joint pain
  • Replacing the entire joint (total joint replacement)




How is arthritis managed long-term?


In most cases, persons with arthritis can continue to perform normal activities of daily living.
Exercise programs, anti-inflammatory drugs, and weight reduction for obese persons are common measures to reduce pain, stiffness, and improve function.

In persons with severe cases of arthritis, orthopaedic surgery can often provide dramatic pain relief and restore lost joint function.
Some types of arthritis, such as rheumatoid arthritis, are often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.





 

Rheumatoid Arthritis

What is Rheumatoid Arthritis?


Aching joints are common in arthritis. In rheumatoid arthritis, the joint lining swells, invades
surrounding tissues, and produces chemical substances that attack and destroy the joint surface.

People of all ages may be affected. The disease usually begins in middle age.
Rheumatoid arthritis usually affects joints on both sides of the body in the hands and feet, as well as the hips, knees, and elbows. Without proper treatment, rheumatoid arthritis can become a chronic, disabling condition.




What causes Rheumatoid Arthritis?


Rheumatoid arthritis is not an inherited disease. Researchers believe that some people have genes that make them susceptible to the disease. People with these genes will not automatically develop rheumatoid arthritis. There is usually a "trigger", such as an infection or environmental factor, which activates the genes. When the body is exposed to this trigger, the immune system responds inappropriately. Instead of protecting the joint, the immune system begins to produce substances that attack the joint. This is what may lead to the development of rheumatoid arthritis.
Ligaments and joint capsules become less effective supporting structures. Erosion of the articular cartilage, together with ligamentous changes, result in deformity and contractures. As the disease progresses, pain and deformity increase.




What are the symptoms of Rheumatoid Arthritis?


Pain, morning stiffness, swelling, and systemic symptoms are common. Other rheumatoid symptoms include:

  • Swelling, pain, and stiffness in the joint, even when it is not being used
  • A feeling of warmth around the joint
  • Deformities and contractures of the joint
  • Symptoms throughout the body, such as fever, loss of appetite and decreased energy
  • Weakness due to a low red blood cell count (anemia)
  • Nodules, or lumps, particularly around the elbow
  • Foot pain, bunions, and hammer toes with long-standing disease
Patients with severe rheumatoid arthritis typically have multiple affected joints in the hands, arms, legs, and feet. Joints of the cervical spine may be involved as well.




How Is Rheumatoid Arthritis Diagnosed?


Rheumatoid arthritis is diagnosed using a medical history and a physical examination. Some of the conditions Dr Bhimani looks for include swelling and warmth around the joint, painful motion, lumps under the skin, joint deformities, and joint contractures (inability to fully stretch or bend the joint).
A blood test may reveal an antibody called rheumatoid factor. This is an indicator of rheumatoid arthritis. X-rays can help show the progression of the disease. The American College of Rheumatology requires at least four of the following seven criteria to confirm the diagnosis:

  • Morning stiffness around the joint that lasts at least 1 hour
  • Arthritis of three or more joints for at least 6 weeks
  • Arthritis of hand joints for at least 6 weeks
  • Arthritis on both sides of the body for at least 6 weeks
  • Rheumatoid nodules under the skin
  • Rheumatoid factor present in blood testing
  • Evidence of rheumatoid arthritis on X-rays




How Is Rheumatoid Arthritis Treated?


Although there is no cure for rheumatoid arthritis, there are a number of treatment options that can help relieve joint pain and improve functioning. The treatment plan is tailored to the patient's needs and lifestyle. Rheumatoid arthritis is often treated by a team of health care professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.
Medication
Medications used to control rheumatoid arthritis fall into two categories: those that relieve
symptoms and those that have the potential to modify the course of the disease. Often, they are used together. Aspirin and ibuprofen can help reduce the pain and inflammation of rheumatoid arthritis. Disease-modifying drugs include methotrexate and sulfasalazine and gold injections.

Researchers are also working on biologic agents that can interrupt the progress of the disease. These agents target specific chemicals in the body to prevent them from acting on the joints.
Exercise and Therapy
Exercise is an important part of a treatment program. The physician and physical therapist may work with patients to develop an exercise program that helps strengthen the joints without stressing them. In some cases, a splint or corrective footwear may be required.

Surgery
Joint replacement surgery is also an option and is often effective in restoring function.





Dr. Aziz Bhimani

Hip and Knee Surgeon

For appointments please call

 

(02) 4229 9116

Wollongong Orthopaedics

54 Princes Hwy West

Wollongong NSW 2500

e reception@wollongongorthopaedics.com.au

f  02 4227 4361

  • Black Facebook Icon
  • Black YouTube Icon
  • Black LinkedIn Icon

Dr Aziz Bhimani Hip and Knee Surgeon West Wollongong NSW

Royal Australian College of Surgeons logo
International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine
International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine
Austraian Orthopaedic Association
Austraian Orthopaedic Association