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OSTEOARTHRITIS

OSTEOARTHRITIS. Osteoarthritis is the result of mechanical and biological events. Destabilization of the normal process of degeneration and synthesis of articular cartilage chondrocytes , extracellular matrix and subchondral bone.

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OSTEOARTHRITIS

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  1. OSTEOARTHRITIS Osteoarthritis is the result of mechanical and biological events. Destabilization of the normal process of degeneration and synthesis of articular cartilage chondrocytes, extracellular matrix and subchondral bone. Changes include increased water content, increased proteoglycans and altered collagen matrix, all leading to articular cartilage deterioration. Prevalence(based on TNS report) Estimated to be around 80% in age group of > 55 Male:female <45 yrs- M>F >45 yrs- F>M

  2. An Arthritic Joint • Cartilage loss • Meniscal wear • Bone loss • Varus(95%) ––bow leg more common • Valgus (5%) ––knock knee

  3. Varusmalalignment of knee is either cause or effect of unicompartmental OA Knee (Devas 1969) Normal wt. bearing 60% from medial side 40% from lateral side 4 deg varus – 95% from medial side BIOMECHANICS

  4. Osteoarthritis Treatment Pharmacological Therapy Topical ( rubifacient) therapies Oral Analgesics therapies DMAODs Intra- articular therapies Dietary supplements Non-pharmacological Therapy Education Exercise, physical activity Weight loss Nutrients, herbal remedies Pulsed EMF TENS-transcutaneous electrical nv stimulation Orthotic devices

  5. Arthroscopy Osteotomy UKR TKR Chondrocyte transplantation SURGICAL METHODS

  6. Illizarov fixator Coventry staples Cervical H plate Spacer plate Cancellous screw and K-Wires Small LCP Tomofix My Experience since 1995

  7. CASE : Small LCP Name – Najeeb shah 60years/male, Right Knee Date of operation – 30.08.2007 Procedure – medial open wedge high tibialosteotomy secured with small LCP and autograft Pre op FT angle - 4°VR, Post op FT angle – 7°VL Address -98/191, Beganganj, kanpur Phone no – 9936581057

  8. PRE OPERATIVE X- RAYS POST OPERATIVE X- RAYS IMMEDIATE POST OP R AT 8 WEEKS

  9. PRE OPERATIVE CLINICAL PHOTOGRAPHS POST OPERATIVE CLINICAL PHOTOGRAPHS AT 8 WEEKS FOLLOW UP

  10. Name –ARUNA • 58 years/female, B/L knee[rt>lt] • Date of operation –22-2-2010 • Procedure- medial open wedge high tibialosteotomy secured • by LCP and autograft (R) • Pre op FT angle – 3°VR(rt), Post op FT angle - 7°VL(rt) • Address - goviondnafgar KANPUR • Phone no - 9415050888 Case : Tomofix

  11. PRE OP PHOTOS POST OP PHOTOS N

  12. PREOP XRAYS POST OP XRAYS G

  13. Name –KAUSHALYA • 79 years/female B/L knee[RT>LT] • LT-medial open wedge HTO fixed with TOMOFIX RT- TKR • Pre op FT angle – 4°VR[LT] 7[RT] Post op FT angle - 4°VL B/L • Address- UDHAM SINGH NAGAR ,UTTRANCHAL • Phone no -9756608247 Case : HTO WITH TKR

  14. PREOP PHOTOS POST OP PHOTOS O

  15. PREOP XRAYS P0ST OP XRAYS N

  16. Name –PRAVEEN • 62 years/male LT>RT knee • Date of operation –3-1 10 • Procedure- medial open wedge high tibialosteotomy secured by LCP ® and autograft (L) • Pre op FT angle – 5°VR(L) Post op FT angle - 6°VL(L) • AddreSS SHIMLA ,HIMACHAL PRADESH • Phone no – 8954622468,9336469699 Case : HTO IN GRADE IV

  17. PRE OP PHOTOS POST OP PHOTOS O

  18. PREOP XRAYS POST OP XRAYS O

  19. OBSERVATIONS

  20. Total patients operated = 253 Small LCP fixation=90 TOMOFIX = 143 Other fixation modalities used in 20 Maximum follow up = 15 years Minimum follow up = 2 months TOTAL PATIENT DETAILS

  21. THANK YOU

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