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Archive for December, 2012

The diathesis stress model was originally introduced as a way of explaining why some people developed mental disorders and others did not.  Mental disorders could not be fully explained by genes or by experience, and so the diathesis stress model effectively described the contributions of both components.  Essentially, the diathesis stress model states that some combination of environmental and genetic can lead to pathology.  If the environmental stress (the oil in the glass) is added to the genetic vulnerability (the water in the glass) and it reaches a threshold, then the individual will develop the pathology.

This model can easily be applied to osteoarthritis.  Each person has a specific genetic make-up that can affect their vulnerability to osteoarthritis; they might have dense bones, weak cartilage, or a predisposition for obesity.

What is important here, is to understand the relationship between a genetic predisposition and environmental stress.  Since genetic code cannot be altered, the only thing within our power is to minimize the risk factors we develop.  If we act to stay light, fit, active, and healthy, onset of osteoarthritis may be delayed or even avoided entirely.



The KineSpring system unloads the medial compartment throughout a broad range of motion.

Moximed’s KineSpring system was developed as a surgical intervention for osteoarthritis of the knee that is not as severe as a joint replacement.  If the medial compartment of the knee is under abnormal stresses, it can lead to extreme knee pain.  This pain, and the osteoarthritis that causes it, is often treated with anti-inflammatories, rest, diet, exercise, and ultimately a partial or total knee replacement.  This final stage of treatment, the joint replacement surgery, is highly traumatic.  Joint replacements involve the removal of entire sections of bone to be replaced by metallic prosthetics.

Instead of removing damaged bone, the KineSpring system offers an implantable spring that could let the injured tissue heal.  The spring unloads the medial compartment of the knee throughout a broad range of knee motion, allowing high user function while promoting tissue repair.  This is especially important because knee motion is crucial to bone and cartilage growth.  If you are considering a medial compartment knee joint replacement, the KineSpring may be a less severe and similarly effective alternative.

But do not mistake this post as an endorsement of the KineSpring system for osteoarthritis of the medial compartment.  The KineSpring is a surgical replication of an orthotic solution.  In other words, a knee brace for osteoarthritis offers all of the benefits of the KineSpring system without the needless risk of undergoing surgery.  So if you suffer from osteoarthritis of the knee, ask your doctor about orthotic solutions before you move on to surgical ones.  Braces are safer, less expensive, and far more easily removed than surgical implantations.



Corticosteroids are often injected into arthritic joint spaces to reduce symptoms

Osteoarthritis of the knee often includes severe inflammation.  This inflammation and osteoarthritis related knee pain can be treated with an injection of corticosteroids.  These injections reduce inflammation and pain, and increase healthy function.  Unfortunately, these injections only alleviate pain for a short time, and subsequent injections are decreasingly effective.  This means that corticosteroid injections may be very useful in treating acute osteoarthritis, but are less helpful for people with chronic knee pain.

Recent developments by Flexion Theraputics inc. may reduce the limitations of steroid injections.  A new product, the FX006, offers sustained release of steroids after a single intra-articular injections.  This lets the FXoo6 reduce knee pain and inflammation for patients with osteoarthritis for much longer after each treatment.  The increased effectiveness of this injection makes it a reasonable treatment option, that should be considered alongside alternative therapies.

So if you suffer from osteoarthritis and are thinking about a knee injection, ask your doctor about the FX006.  Don’t settle for a standard treatment without discussing your options.  A sustained release injection can improve your function without any additional risk.



Cartilage reduces friction in the knee during normal motion.

 

Osteoarthritis is caused by damage and inflammation of the bony aspects of the joint surface.  Cartilage is a joint’s first line of defense.  It is not surprising then to learn that people with healthy cartilage have less osteoarthritis, and that unhealthy cartilage makes osteoarthritis worse.  It is important to protect and maintain cartilage in order to avoid severe osteaorthritis.

In order to preserve your cartilage, you must understand how it recieves its nutrients.  Unlike bone, which recieves its nourishment from its blood supply, cartilage is very poorly vascularized.  Instead of getting nutrients from the blood stream, cartilage collects nutrients from the synovial fluid.  This is crucial, because it means that increasing motion can push nutrients out of the synovium and into the cartilage.

While it is undisputed that exercise can reduce osteoarthritis, it has been considered to be a mixed blessing; it was thought that losing weight would help osteoarthritis, but exercise might damage joints in the process.  This is not the case!  Exercise encourages healthy cartilage, which protects and insulates the joint surfaces.  So exercise with no reservations.  Athletic activity will improve your osteoarthritis.



OA and knee surgery

December 2, 2012

Knee surgery is highly traumatic, and can lead to osteoarthritis later in life.

One common risk factor for knee osteoarthritis is a history of severe knee injury.  The connection between injury and osteoarthritis is often associated with direct damage to the cartilage or bones of the knee.  This is not the only way that osteoarthritis can develop after injury.  Any trauma to the knee can lead to inflammation, which increases pressure in the joint space and lead to osteoarthritis.  Severe trauma often has secondary effects like inactivity and obesity, which are well-documented risk factors.

There is extensive evidence suggesting that injury to a ligament (like the ACL) can lead to osteoarthritis.  Only recently, however, have we begun to understand the connection between osteoarthritis and ACL reconstruction surgery.  Research at the University of Queensland examining the long term health of patients with ACL reconstruction surgeries found that, not only were they more likely to develop knee osteoarthritis, but they were also far more likely to need knee joint replacements.  In fact, people who underwent knee surgery developed osteaorthritis up to 15 years earlier than those who had not.

So remember that surgery is not a miracle cure.  It is a controlled application of extreme trauma.  It certainly has applications in which it can provide life-changing help, but it is not a blanket solution for all.  So before undergoing elective surgery, check all of your options, and try a non-invasive treatment first.