Archive for January, 2012
The United States Chapter of the International Society of Prosthetics and Orthotics held its bi-annual meeting in Honolulu this week. Dr. Frank Gottschalk presented a half hour lecture titled, “Amputation Following Failed Infected Knee Arthroplasty”. Dr. Gottschalk stressed the fact that total knee arthroplasty is a safe and common procedure, and explained that only less than 1% of patients succumb to infections. However he believes that this problem could become more prevalent by 2030.
Dr. Gottschalk quoted statistics that there are approximately 500,000 knee replacements performed in the United States each year. That number will swell to 3.5 million annual surgeries by 2030. His research indicates that there are specific risk factors that lead to infections post surgery. Diabetes, morbid obesity, smoking, rheumatoid arthritis, steroids, and revision surgeries are the primary culprits. Knee replacement surgeries for these osteoarthritis patients are usually a last resort.
The infections are of the staph, MRSA, and Gram Negative varieties. Approximately 90% of the patients who succumb to infection post knee replacement surgery are treated successfully, but some conditions will deteriorate to the point where a limb will have to be amputated. Dr. Gottschalk informed the audience of prosthetists about what types of patients will be successful candidates for prosthetic restoration. He stressed that when a patient is motivated they can have the potential to accomplish anything.
His statistics show that younger patients who lose limbs following an infected knee replacement will have a good chance of becoming active community ambulators. Dr. Gottschalk explained that elderly and morbidly obese patients will often times not be candidates for artificial legs and will most likely be confined to wheelchairs. He concluded by saying that the more surgery a patient is exposed to, the more scar tissue will develop. Scar tissue decreases functionality. So it is in the patient’s best interest to keep the revisions to a minimum.
Frank Gottschalk, M.D. is a professor at the Department of Orthopaedic Surgery at the University of Texas Southwestern Medical Center at Dallas. Dr. Gottschalk serves on the Board of United States Member Society, International Society of Prosthetics & Orthotics.
Studies have shown that knee osteoarthritis is 4 to 5 times more prominent in obese individuals. Knee osteoarthritis is caused by the breakdown of cartilage in a joint. By losing weight and reducing the stress placed on the joint, it is possible to slow the cartilage destruction. For every 10lbs of weight lost it is possible to reduce the strain on the joint by 30-50lbs. Weight loss can cause a staggering reduction in pressure and can decrease knee pain immensely.
Low impact exercise routines reduce the joint stress associated with body weight, while allowing you to lose weight. Start slow with a workout that challenges you, yet does not cause pain. Proper diet and exercise can provide the necessary jumpstart to a knee pain free lifestyle.
You don’t have to spend money and time on a gym membership to exercise if you have knee osteoarthritis. A seated pillow squeeze is a simple workout which can be performed at home without the use of complicated equipment. This exercise uses a pillow and a chair!
Using a sturdy chair (not one with wheels), sit upright with your feet firmly placed on the ground. Place a pillow folded in half in between your knees, and squeeze slowly counting to 5. You should feel your muscles contract in your inner thighs. Repeat this for 12 times taking 20 second breaks in between sets.
Leg extensions are great exercises for people suffering from knee osteoarthritis. This simple exercise can strengthen your leg and increase joint flexibility. Leg extensions can be performed in the comfort of your home, without spending money on a gym membership. Leg extensions strengthen your quadriceps. This can increase overall knee joint stability, while reducing pain in osteoarthritic knees.
Sit tall in a chair, keep your torso straight while raising your right leg parallel to the floor. For a more advanced move, point your toe to the ceiling to fully engage your quadriceps. Lower your right leg, touching your heel to the floor, and repeat for 10-15 repetitions before switching legs.
Exercising in the water is great for osteoarthritis because it allows for resistance training while reducing the overall stress on the joint. Studies have shown large reductions in inflammation and knee pain, along with improved joint mobility as a result of aquatic activities.
By using varied water depths you can limit the effects of joint pressure by reducing contact with the pool floor. Floatation devices may be used to stabilize your midsection while allowing extremity movement. By including water aerobics in your exercise plan you can ease knee pain and allow your joints to decompress while getting a great workout.
Exercise might be the last thing you think you’re capable of with osteoarthritis, however it is one of the most beneficial treatment options for knee pain relief. Exercise will increase your joint’s range of motion and improve blood-flow, while promoting weight loss.
A functional exercise such as a wall squat provides a controlled movement of the joint. This allows the knee to be isolated while providing adequate support. A wall squat is performed by placing your back against a wall, bending your knees 30°, sliding down the wall, then returning to a vertical position. Place your hands on the wall for balance and remember slow controlled movements are key. Keep your feet and legs parallel. Try to avoid letting your knees extend past your toes.
Wall squats should be repeated 5-10 times, allowing for adequate rest between sets.
TENS Units or transcutaneous electrical nerve stimulation units are often used by physical therapists. Sometimes they are called TENS machines. Regardless of what the nerve stimulators are named, they work the same way. Electrodes are placed on the skin and an electrical current is used to stimulate the nerves within a certain section of your body.
Physical Therapists often incorporate nerve stimulation with TENS Units into their treatment programs for patients suffering from osteoarthritis of the knee. TENS units have been proven in scientific research to be an effective treatment option for knee pain.
So what’s your resolution this year? How about you get control of the knee pain that is interfering with your life? We can help. Come visit us to learn about conservative treatments for your knee osteoarthritis.