The arthritis clinic has been set up to deal with all types of arthritis and to treat all aspects of arthritis. The arthritis clinic is run by a team comprising of Orthopaedic surgeons, Rheumatologists, Physicians and Physical medicine specialists. The treatment of arthritis is actually a team work, requiring different modes of treatment for different types and stages of arthritis. This is known as the multimodal approach.
What is arthritis?
Arthritis refers to inflammation of joints, leading to pain, swelling and stiffness of joints.
What are the causes of Arthritis?
There are more than 100 forms of arthritis caused by various reasons. The following are the major types of arthritis seen commonly.
Osteoarthritis (wear and tear)
This type of arthritis is caused by wear and tear of the joint due to age or injury to the joint.
Rheumatoid arthritis
In rheumatoid arthritis, the body immune system becomes hyperactive and destroys multiple joints. It leads to arthritic involvement of various joints of the body, including small joints of the hand, feet and major joints of the body.
Gout
A body metabolite called uric acid accumulates in the body due to a metabolic error. The uric acid crystals get deposited in various joints and causes arthritis.
Infective arthritis
Some infections caused by pus forming bacteria and tuberculosis cause arthritis.
Psoriatic arthritis
Some skin diseases like psoriasis leads to arthritis which is called as psoriatic arthropathy.
What are the symptoms of arthritis?
- Pain, swelling & stiffness of the joints
- Difficulty in moving the fingers, especially in the morning, known as morning stiffness
- Difficulty in climbing stairs & getting up from chair
See your doctor if:
- Your joint pain persists beyond 3 days
- You have severe unexplained joint pain
- The affected joint is significantly swollen
- You have a hard time moving the joint
- Your skin around the joint is red or hot to the touch.
- You have a fever or have lost weight unintentionally
How is arthritis diagnosed?
The doctor will perform a physical examination and ask about your medical history. Blood tests and joint x rays are often done to identify the type of arthritis. A sample of joint fluid may also be sent to lab for investigation.
How is arthritis treated?
Medical Treatment
If the arthritis is diagnosed early, it can be managed with drugs. Different drugs are available for different types of arthritis like rheumatoid arthritis, gouty arthritis, psoriatic arthritis, seronegative arthritis etc.
Physiotherapy
Physiotherapy is very useful in early stages of arthritis. Different physical modalities are available to relieve the pain of arthritis. The muscles around the arthritic joint are strengthened by physical exercises. Life style modification programmes are taught to the patients to live with arthritis in a healthy way.
Arthroscopic surgery
Arthroscopic surgery is done in the early stages of the arthritis when the disease is limited to the covering of the joint called synovium. This stage of arthritis is called synovitis. Arthroscopy is done to remove the diseased synovium and the debris inside the joint caused by arthritis.
Surgical Correction of Deformed Joints
Arthritis can lead to deformities of various joints like the knee joints, joints of the fingers, feet, wrists etc. These joint deformities are corrected by various surgeries. The deformities of the knee joint are corrected by an operation called Osteotomy. In Osteotomy, a piece of bone is removed from the deformed side of the joint and the bone is then aligned straight. The deformities of fingers and toes are corrected by release of tendons and capsule. The deformed small joints of the feet are sometimes fused into proper alignment by an operation called arthrodesis.
Total Joint Replacement
Total joint replacement is done for severely damaged joints. The damaged joint surfaces are removed and replaced by an artificial joint called prosthesis. This is commonly in the knee and hip joints. Joint replacement surgery is also done in the shoulder, elbow and the ankle joints.
Lifestyle Changes
Lifestyle changes are the preferred treatment for osteoarthritis and other types of arthritis. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program that is best for you.
What is total knee replacement?
A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The artificial components of a total knee replacement are referred to as the prosthesis.
Which patients should consider a total knee replacement?
Total knee replacement surgery is considered for patients whose knee joints have been damaged by progressive arthritis. Regardless of the cause of the damage to the joint, patients with progressively increasing pain and stiffness and decreasing daily activities require total knee replacement.
What happens in the postoperative period?
Physiotherapy is an extremely important part of rehabilitation and requires full participation by the patient for optimal outcome. Patients can begin physical therapy 48 hours after surgery. A unique device that can help speed recovery is the continuous passive motion (CPM) machine. Patients will start walking using a walker and crutches. Eventually, patients will learn to walk up and down stairs and grades. A number of home exercises are given to strengthen thigh and calf muscles.
How does the patient continue to improve as an outpatient after discharge from the hospital?
It is important for patients to continue in an outpatient physiotherapy program along with home exercises for optimal outcome of total knee replacement surgery. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring (contracture) and maintain muscle strength for the purposes of joint stability.