Janice’s painful knee

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Janice’s painful knee
  1. Janice 55 she is philippine Nurse
    1. she suffered from Intermittent pain in her left knee
      1. Exacerbated by walking, standing , going up and down the stairs
        1. Least painful in the morning
          1. No trauma
            1. History of osteoarthritis
              1. 1)Swelling 2) Tenderness 3) Absence of fluid 4)Reduced ROM 5)Crepitus
                1. Diagnosed with osteoarthritis
                  1. Knee joint replacement
                    1. TREATMENT MODALITIES
                      1. Non- pharmacological treatment
                        1. Education
                          1. Life style
                            1. Exercise
                              1. Avoid Prolonged loading Activities that cause pain Contact sports High impact sports eg running
                              2. Walking instead of running,
                                1. low-impact aerobic fitness exercises.
                                2. Weight Management
                                1. Glucosamine is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids Joints are cushioned by the fluid and cartilage that surround them. In some people with osteoarthritis, the cartilage breaks down and becomes thin. This results in more joint friction, pain, and stiffness.
                                2. JOINT KNEE REPLACEMENT
                                  1. Knee joint replacement is a surgery to replace a knee joint with a man-made joint. The artificial joint is called a prosthesis.
                                    1. WHEN IS IT RECOMMENDED ?
                                      1. You are having pain from knee arthritis that keeps you from sleeping or doing normal activities-----You cannot walk and take care of yourself-----Your knee pain has not improved with other treatment---- You understand what surgery and recovery will be like.
                                        1. SIDE EFFECT:
                                          1. Infection Blood clots in the leg vein or lungs Heart attack Stroke Nerve damage.
                                        2. Stem cell injection
                                          1. THIS PROCEDURE IS NON-INVASIVE, EASIER, NO REJECTION!
                                            1. Super Concentrated Platelet Rich Plasma Procedures
                                              1. SIDE EFFECT: CANCER
                                      2. Osteoarthritis, also called degenerative joint disease (DJD), is a chronic disease characterized by progressive degeneration, destruction, and loss of articular cartilage. It can either be primary or secondary.
                                        1. PATHOLOGY
                                          1. RADIOLOGY
                                            1. NORMAL
                                              1. OSTEOARTHRITIS
                                                  1. The hallmarks of knee osteoarthritis :
                                                    1. joint space narrowing: usually asymmetric, typically of the medial tibiofemoral compartment and/or patellofemoral compartment ----subchondral sclerosis----- osteophyte formation: patellofemoral osteo-phytes are more associated with pain
                                    2. PAIN
                                      1. Signs and symptoms that sometimes accompany knee pain include:
                                        1. •Swelling and stiffness
                                          1. •Redness and warmth to the touch
                                            1. •Weakness or instability
                                              1. •Popping or crunching noises
                                                1. •Inability to fully straighten the knee
                                                2. CAUSES OF PAIN
                                                  1. 1-Injuries:
                                                    1. -ACL injury (ANTERIOR CRUCIATE LIGAMENT)
                                                      1. EXCULDED BY:ACL insufficiency results in deterioration of the normal physiologic knee bending culminating in increased anterior tibial translation and increased internal tibial rotation.
                                                      2. -Fractures
                                                        1. EXCLUDED BY: SHE WONT BE ABLE TO MOVE AT ALL! IN THIS CASE SHE WAS ABLE TO MOVE BUT WITH PAIN.
                                                        2. -Torn meniscus (FIBRO-CARTILAGE)
                                                          1. EXCLUDED BY: IN ADULTS: BY TWISTING OR SQUATING IT CAN CAUSE TEAR. BUT IN OLD PEOPLE IT HAPPENS AS SECONDARY TO OSTEOARTHRITIS
                                                            1. TYPES OF CARILAGE:
                                                              1. Hyaline
                                                                1. has a glassy appearance. numerous chondrocytes each located within found in the nasal septum, at the ends of the ribs, and in the tracheal rings.
                                                                2. Elastic Cartilage
                                                                  1. occurs in the epiglottic, external ear and the auditory tube. contains a dense network of delicately branched elastic fibres.
                                                                  2. Articular Cartilage
                                                                    1. divided into several zones:
                                                                      1. Tangential layer
                                                                        1. Chondrocytes are rather small and flattened parallel to the surface.
                                                                        2. Transitional zone
                                                                          1. The chondrocytes are slightly larger, are round.
                                                                          2. Radial zone
                                                                            1. Fairly large chondrocytes form radial columns the stacks of cells are oriented perpendicular to the articulating surface.
                                                                            2. Calcified cartilage layer
                                                                              1. It rests on the underlying cortex of the bone. The matrix of the calcified cartilage layer stains slightly darker (H&E) than the matrix of the other layers.
                                                                            3. lubricated, wear-proof, slightly compressible surfaces, which exhibit very little friction. is not surrounded by a perichondrium and is partly vascularise
                                                                      2. -Knee bursitis
                                                                        1. EXCLUDED BY: BURSITIS HAPPENS AS SECONDARY TO ARTHRITIS
                                                                      3. 2-Mechanical problems:
                                                                        1. -Loose body
                                                                          1. -Iliotibial band syndrome
                                                                            1. -Dislocated kneecap
                                                                        2. 3-Arthritis:
                                                                          1. -Osteoarthritis
                                                                            1. -Rheumatoid arthritis
                                                                              1. -Gout
                                                                                1. EXCLUDED BY: URIC ACID TEST AND BLOOD TEST AND DEVELOPMENT OF TOPHI.
                                                                                2. EXCLUDED BY: IT IS BILATERAL (BOTH SIDES) AND THERE IS MORNING STIFFNESS, IN OUR CASE ITS NOT.
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