Showing posts with label osteoarthritis. Show all posts
Showing posts with label osteoarthritis. Show all posts

Tuesday, 22 July 2014

NEMEX-TJR neuromuscular training program



Neuromuscular training seems to gain ground in the therapeutic interventions for almost all the musculoskeletal disorders. It gradually becomes clear to everyone that the neuromuscular adaptations are much more profound and important for our body and its effort to heal itself. Recently, one more study showed the immediate efficacy of neuromuscular exercise in patients with severe osteoarthritis of the hip or knee - See more at Physiospot.

A very nice guideline for the NEMEX-TJR training program presented in this study can be found here.

Tuesday, 11 February 2014

Using stem cells from hip replacements to help treat ageing adults




The tissue normally discarded during routine hip replacements could be a rich new source of adult stem cells for use in regenerative medicine, UNSW-led research has found.

With tens of thousands of hip replacement surgeries performed each year, this tissue could have “profound implications” in clinical use, the scientists say.

“In hip replacement surgery, the femoral head and part of the neck are resected to accommodate the neck of the implant,” explains study leader Professor Melissa Knothe Tate, the Paul M Trainor Chair in Biomedical Engineering at UNSW.

“Typically this tissue is discarded, yet it may provide an untapped source of autologous stem cells for ageing adults who were born a generation too early to benefit from banking of tissues like umbilical cord blood at birth.”

The study, published in the latest issue of STEM CELLS Translational Medicine, was led by the UNSW Graduate School of Biomedical Engineering and involved orthopaedic surgeon Dr Ulf Knothe of the Cleveland Clinic in Cleveland, scientists from Ludwig Maximilians University in Munich and Case Western Reserve University in Cleveland.

The researchers wanted to determine the feasibility of using the patient’s own tissue removed during routine joint replacement to potentially heal and/or repair failing organs and to treat diseases.

The team collected periosteum derived stem cells (PDCs) from patients with rheumatoid arthritis or osteoarthritis, ranging in age from 30 to 72 years, who had undergone joint replacements. They compared them with commercial bone marrow stem cells derived from prenatal donors in patients up to 72-years-old.

Based on the results, the PDCs exhibited “remarkable similarities” to the bone marrow cells cultured under identical laboratory conditions. They also showed “no significant differences” in their ability to differentiate into other cells due to the donor’s age or disease state,” Professor Knothe Tate and her team said in their paper.

“The use of periosteum tissue that is discarded with the femoral neck in replacing the hip is highly novel, as it represents an unprecedented and to date unstudied source of stem cells from rheumatoid arthritis or osteoarthritis patients,” they said.

Dr Ulf Knothe, the leading clinician on the study, concluded: “Use of stem cells from periosteum may open up unprecedented opportunities for the treatment of disease and tissue/organ failure in a population of osteoarthritic patients born around four decades too early to bank their own cord tissue or blood.”

The full article, “Arthritic periosteal tissue from joint replacement surgery: A novel, autologous source of stem cells,” will be available online after the embargo lifts: http://www.stemcellstm.com.

Media contact for Professor Knothe Tate: Fiona MacDonald, UNSW Media Office, +61 (0) 403 664 438, fionajmacdonald@gmail.com. Images available plus more on Professor Knothe Tate.

Thursday, 11 July 2013

Kevin Stone: The bio-future of joint replacement



Arthritis and injury grind down millions of joints, but few get the best remedy -- real biological tissue. Kevin Stone shows a treatment that could sidestep the high costs and donor shortfall of human-to-human transplants with a novel use of animal tissue.

Inspired by www.thestudentphysicaltherapist.com.

Wednesday, 29 May 2013

Osteoarthritis grading system - Kellgren and Lawrence


X-ray of knee with grade 1 osteoarthritisX-ray of  knee with grade 2 osteoarthritis
X-ray of knee with grade 3 osteoarthritisX-ray of knee with grade 4 osteoarthritis

Top Left - Grade I
Top Right - Grade II
Bottom Left - Grade III
Bottom Right - Grade IV

Photos source: synoviscone.com

The Kellgren and Lawrence system for grading osteoarthritis is based on xrays and consists of Normal, Grade I, Grade II, Grade II and Grade IV.

It measures the presence of typical features of osteoarthritis:

Joint space narrowing - bone is visible on xray but the articular cartilage that covers it is not. A normal joint therefore appears to have a space between the bones. Any decrease in space implies a reduction in cartilage cover.

Osteophytes - small bony projections that form around joint margins. Thought to be a result of the body trying to increase joint surface area to decrease pressure. They are responsible for limiting range of motion and can cause pain.

Sclerosis - this means 'hardening' and is a sign of osteoarthritis, seen as increased white areas in the bone at the joint margins.

• Grade I: doubtful narrowing of joint space and possible osteophytic lipping
• Grade II: definite osteophytes, definite narrowing of joint space
• Grade III: moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bone contour
• Grade IV: large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone contour

You can read more here. A very nice blog dedicated to knee osteoarthritis.

A very nice pdf file with some general guidelines for assessment and treatment publishes by the Brigham and Women's Hospital can be found here.

(these sources were suggested to me by my classmate Bita Lotfaliei)

Friday, 24 May 2013

Physiotherapy after dynamic hip screw (DHS)



After a fractured hip a dynamic hip screw (DHS) is used to hold the bones in place while the fracture heals.  It allows you to start walking straight after surgery, preventing the complications that can occur if you stay in  bed for long periods.

Physiotherapy is vital to make the most of your surgery and is essential to ensure the success of the operation.

Ream more and find the guidelines for physiotherapy after dynamic hip screw, posted by the The Royal Free London Orgnanization.

Monday, 20 May 2013

Total hip replacement rehab protocol



Ellis & Badenhausen Orthopaedics, PSC
Ellis & Badenhausen Orthopedics, PSC is dedicated to providing the Louisville community with the highest quality of orthopaedic service. We will ensure that patient care remains the focus of our medical practice by maintaining an experienced staff and by keeping on the forefront of medical technology and research.

The following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance.

Sunday, 19 May 2013

Osteoarthritis



A nice educational video on osteoarthritis. You can also find two treatment guidelines here and here. Below you can see a patient with difficulty of walking due to severe osteoarthritis.


Wednesday, 15 May 2013

Treatment guidelines: osteoarthritis of the hip and the knee 2



I have already posted the KNGF's guidelines for osteoarthritis of the hip and the knee. You can also find the American Physical Therapy Association's (APTA) guidelines for osteoarthritis here.

Monday, 13 May 2013

Nordic walking and osteoarthritis



For the aftercare stage of patients with osteoarthritis operation in the hip or the knee, the physical therapist should advise the patient on maintaining the targets they have achieved, for instance by giving them tips on engaging in healthy physical activity behavior in their everyday life or, if useful, by helping patients enter regular community exercise or sports programs, or supervised group exercise programs, such as tai chi, Nordic walking or other exercise programs (KNGF Guidelines for osteoarthritis of the hip and knee).

Monday, 4 February 2013

Assessment & treatment guidelines_1



Physiotherapy assessment and treatment in Physical Therapy education is something that you will start doing from day 1.

I believe that there is only one way to be good in that - by organizing all this information in nice documents and have them in your portfolio to access them anytime.

Here is a small file I have created with assessment and treatment guidelines for the following cases:

Osteoarthritis of the hip
Knee trauma
Acute ankle sprain
Thoracic outlet syndrome
Olecranon fracture
Carpal tunnel syndrome
Low back pain (non-specific, sub-acute phase)
Shoulder pain
Tennis elbow
Colles fracture


Treatment guidelines: osteoarthritis of the hip and knee



The Royal Dutch Society for Physical Therapy has created some really state of the art guidelines documents for physio therapeutic treatment of some major pathologies. I have presented that before, but I thought it would be useful for students to have access to each treatment guideline separately in this blog.

So, here is the guideline for osteoarthritis of the hip and knee.