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Archive for June, 2010

knee-ice-treatment

Ice Your Arthritis

Often times physicians will recommend cold therapy to treat the pain and swelling  associated with knee osteoarthritis.  Something as simple as an ice pack wrap can make your stiff and swollen joints feel a lot better.

Ice packs reduce swelling by constricting blood vessels and decreasing fluid build-up.  They can be uncomfortable when first applied, but in a short matter of time they can numb the deep aches by reducing the ability of nerve endings to conduct impulses.

An ice pack knee wrap is a great treatment option for osteoarthritis because you can strap an ice pack to your knee, allowing a degree of mobility while icing.



knee surgery

Anterior Cruciate Ligaments (ACL) or meniscal tears in the knee repaired by arthroscopic surgery does not decrease the odds that you will develop osteoarthritis.  This new data will be published in the August edition of the Journal Radiology.

Kasper Huetink, M.D. is the lead author of the study.  He said, “This study proves that meniscal and cruciate ligament lesions increase the risk of developing specific types of knee osteoarthritis.  Surgical therapy does not decrease that risk.”

The study examined 326 patients who were seen between 1996 and 1997 for a previous study.  The pervious study looked at the diagnostic value of knee MRI’s in regards to patients with knee pain considering arthroscopy.  Ten years later those patients were looked at again.  Localized knee osteoarthritis was evident in patients whether their injuries were surgically repaired or not.

Dr. Huetink also said, “There is a higher risk of developing knee osteoarthritis at specific sites after tearing a meniscus or cruciate ligament.  We showed a direct relationship between injury and long-term consequences, and showed that surgery has no impact on long-term outcomes.”

Huetink, Localized Development of Knee Osteoarthritis Can Be Predicted from MR Imaging Findings A Decade Later.  Journal Radiology, August 2010.



PT for OA

Physical Therapy has been proven to relieve pain and stiffness as effectively as knee surgery.  A recent study published in the New England Journal of Medicine can be added to the laundry list of science that supports physical therapy has an effective osteoarthritis treatment.

Physical Therapy will generally provide a series of exercises to help improve strength, flexibility, and range of motion.  Patients learn how to take care of their entire body in relation to their arthritic knee so they can minimize symptoms and perform activities of daily living with less pain.

Kirkley, BIrmingham, Litchfied, et al: A Randomized Trial of Arthroscopic Surgery for OSteoarthritis of the Knee.  New England Journal of Medicine, 2008.  Vol 359: 1097-1107.



knee acupuncture

An article published in the Annals of Internal Medicine reports that the effect of acupuncture for reducing pain in knees with osteoarthritis remains vague and open to interpretation.

1007 patients with knee osteoarthritis (experiencing chronic pain for at least 6 months) were seen at 315 primary care practices with experience in traditional chinese acupuncture.  This was a randomized controlled trial.

Patients were given real acupuncture and “sham” acupuncture over the course of six weeks.  No statistically significant difference was reported between the two acupuncture therapies.  This suggests any difference could be a placebo effect.

In short, acupuncture was proven to be ineffective at reducing knee pain associated with osteoarthritis.  Other osteoarthritis treatment options should be explored.

Hanns-Peter Scharf, MD; Ulrich Mansmann, PhD; Konrad Streitberger, MD; Steffen Witte, PhD; Jurgen Kramer, MD; Christoph Maier, MD;Hans-Joachim Trampisch, PhD, and Norbert Victor; PhD Acupuncture and Knee Osteoarthritis, Annals of Internal Medicine, July 4, 2006 Vol 145 no. 1 12-20


cancel study

Pfizer suspended clinical trial of their new infusion therapy drug, Tanezumab.  Apparently some patient’s condition became worse.

The worldwide program was cancelled after the FDA reported the osteoarthritis in some patients became so bad so quickly that they needed to have their knees replaced!

Pfizer is no longer accepting new patients into their trials of Tanezumab and has suspended dosing of existing patients in the OA program.

The FDA is demanding that Pfizer present information on the problems associated with Tanezumab reported in their other clinical studies.



obese man walking

small steps - big results

University of Massachusetts – Biomechanics and Energy Metabolism Laboratories:  Associates at the lab note that being overweight is the one risk associated with osteoarthritis that a patient can most easily change.  The lab is working on a walking program for obese people that increases the amount of energy a person uses (promoting weight loss) and minimizes the wear and tear on arthritic knees.

The idea is to walk with short, fast steps.  The results compared to “normal” walking is a small but significant increase in energy usage.  This may be beneficial for obese people in losing weight and managing their knee osteoarthritis.

Think about this, what if patients in the study used knee braces while walking?  Could they walk even farther and expend more energy?  Maybe the next study will look at this….

Russell EM, Braun B, Hamill J. Does stride length influence metabolic cost and biomechanical risk factors for knee osteoarthritis in obese women?  Clin Biomech (Bristol, Avon). 2010 Mar 1; [Epub ahead of print].



Too many drugs

Pfizer is developing a new biotech drug for reducing knee pain associated with osteoarthritis.  A later stage trial shows the drug is a more effective osteoarthritis treatment than a placebo.

Tanezumab is an infusion therapy.  It is taken every eight weeks and might be the first biotechnology drug for helping people with osteoarthritis in their knees.

Phizer’s recent study had close to 700 patients involved.  All of the patients were unable to take standard pain killers like NSAIDs (aspirin, ibuprofen).  The trial did not include patients wearing bio mechanical knee braces or unloading type orthotic devices.  Drugs only.

Pfizer is the same company responsible for Celebrex.  Celebrex a COX II Inhibitor is marketed as a pain reliever that is safe for the stomach.  Over 18 million prescriptions were sold in the first year of Celebrex’s release.  That is more than Viagra and Lipitor combined!  It was one of the most aggressive marketing campaigns in pharmaceutical history.

Since that time Celebrex has been reported to the FDA for strokes, sudden cardiac death, heart attacks, and heart failure.  In February of 2005 there were 116 cases reported of serious side effects for the month.

Dr. David Graham, a safety reviewer for the FDA was asked about drugs like Celebrex increasing heart attack risk.  He said, “There is no question in my mind that there is risk from the first tablet”.



Stride-OA-Knee-Brace

There are few products available to treat osteoarthritis that offer immediate pain relief.  Custom knee braces make that short list.  These knee braces offer a bio-mechanical solution to a bio-mechanical problem.  Unloading knee braces actually shift your body weight from the damaged cartilage in your knee.  The hinge and shells absorb some of the pressure, and the rest is transferred to the healthy cartilage on the opposite side of your knee.  These braces work.  And for most patients the results are immediate!  Knee braces for OA have been available for over twenty years and there is a lot of valid science proving their efficacy.  Medicare, Medicaid, and most major HMO’s and PPO’s pay for this type of medical device.  Be sure to be fit by a certified orthotist.  Custom arthritis knee braces should not be ordered over the internet.



stethoscope

Glucosamine is naturally occurring in cartilage. Glucosamine’s primary function is to lubricate joints and help rebuild cartilage.  Glucosamine  does not have serious side effects and is safe for the treatment of osteoarthritis.   Glucosamine is made from shellfish so those allergic should take precaution.

There are non-shellfish glucosamine products available.

Chondroitin is regularly used in conjunction with Glucosamine.   Chondroitin, like glucosamine is found in cartilage.  Chondroitin improves elasticity in cartilage and helps protect the  joint from injury. Chondroitin has no serious side effect.  Though sometimes mild gastrointestinal issues can occur.



Arthritis Report

Hello Readers.  I am hoping for some feedback from our loyal audience.  How often should we be posting on our blog?  Monthly, weekly, daily?  Please let us know how often you would like to hear from us.  We are here for you.  Our blog is designed to help you find and understand the conservative treatments available to provide your arthritic knees with pain relief.  Please reply to this post and let us know what you think!

Osteoarthritis Treatments are our business.  Specifically knee osteoarthritis.