Total Knee Replacement, partial knee replacement MJRC India

Rheumatoid arthritis

Rheumatoid arthritis is a chronic form of arthritis that involves joints, the sheath of tendons and blood vessels. It ultimately leads to joint destruction. The cause of this disease is an immune mechanism, in which the body does not recognise some of its own tissues and considers them foreign. The symptoms may come and go. The typical picture of a person with this disease is the relatively young person who has crippling deformities of the joints of the hand.

Symptoms
Early morning stiffness, which lasts more than half an hour. .Pain and swelling in many joints in the limbs. The joints involved are the fingers, wrists, elbows, shoulders, knees and neck. .There may be symmetrical involvement of other joints. .There are nodules felt under the skin especially near the elbows .There is a generalized fatigue. .In later stages, the knees are bent and moving about becomes very difficult.
Risks and age groups affected

Women in the age group 20- 50 are more prone to the disease. Another type of involvement is in the elderly age group( Late onset) If another family member is affected then there is an increased risk as the disease is genetically transmitted. The doctor makes the diagnosis based on the history . Some blood tests are required. These are the latex test to determine the presence of the rheumatoid factor and the ESR (erythrocyte sedimentation rate. X-rays of the involved joint may show the presence of soft tissue swelling.

Treatment
Anti-inflammatory drugs are prescribed as the first line of treatment. The aim is to reduce the inflammation inside the joints to halt the pace of joint destruction. If the disease is not responding then other drugs like chloroquine, gold, cortisone injections, penicillamine and anti-metabolites may be used. Etanercept is another drug introduced recently. Gene therapy to decrease the effects of some of the harmful factors is gaining popularity in America. When the swelling in the lining membrane of the knee joints fails to resolve then it can be destroyed by a medical or surgical synovectomy. Surgical synovectomy is done when the joint damages is not advanced and the synovitis persists. When joint destruction has occurred, then the only way to mobilise the patient is joint replacement. Joint replacements of knees, elbows, shoulders and some of the finger joints may be required.