Patient awareness kolkatta new
-
Upload
rajeshmultiplier -
Category
Business
-
view
65 -
download
1
Transcript of Patient awareness kolkatta new
Osteoarthritis
Dr A V Gurava ReddyDNB, M.Ch, F.R.C.S(Ed), F.R.C.S(Glas)
Chief joint replacement surgeonManaging director
Sunshine hospitals hyderabad
Osteoarthritis
• Typically affects
• Knees
• Hips
• Spine
• And small joints of fingers
• Mostly commonly affects knees in Indian
population
OSTEOARTHRITIS KNEE
• Chronic, degenerative disorder
• multifactorial aetiology
• loss of articular cartilage
• periarticular bone remodelling
• large weight-bearing joints
• Common in older patients but can occur in
younger patients ( genetic mechanism , previous
joint trauma )
• hinge joint
Incidence
• Incidence increases with age
• In india - 80-90% above 65 suffer with primary OA
• After age 55 years, the prevalence increases in women in
comparison with men
prevalence
• Equivalent prevalence occurs in men and women
aged 45-55 years (↑dramatically after the age of
50 years in women)
• Most adults older than 55 years show radiographic
evidence of osteoarthritis
• No significant correlation exists between incidence
of OA and race
Causes
Primary OA
• Idiopathic
• Defective gene
• AGE RELATED WEAR AND TEAR
Causes
Secondary OA
– Obesity
– Repetitive use (ie, jobs requiring heavy labor
and bending)
– Previous trauma (ie, posttraumatic OA)
– Infection
Causes
– Crystal deposition
– Acromegaly
– Previous rheumatoid arthritis (ie, burnt-out
rheumatoid arthritis)
– Heritable metabolic causes (eg, alkaptonuria,
hemochromatosis, Wilson disease)
Causes
– Hemoglobinopathies (eg, sickle cell disease,
thalassemia)
– Underlying orthopedic disorders (eg, congenital
hip dislocation, slipped femoral capital
epiphysis)
– Disorders of bone (eg, Paget disease,
avascular necrosis)
History
• Insidious throbbing arthralgias with activity
• Initially, resting relieves the pain
• Eventually, the pain occurs even at rest
• Morning stiffness ≥ 30 minutes
• Intermittent joint swelling
Symptoms
• Pain
• Stiffness
• swelling
• Instability
Signs
• Pain
• Tenderness
• Swelling
• Effusion
• Crepitus
• Limitation of movement and muscle
wasting
Deformities
Imaging
• Plain radiographs
• Bone scans may be helpful in early
diagnosis of OA of the hand
• The space between the bones of the upper and lower leg is smaller
• Bony spurs (osteophytes)
• Increase bone density at the margin of the joint
x-ray
findings– Joint space narrowing
– Osteophytes
– Subchondral sclerosis : ↑ bone density,
frequently found adjacent to joint space
– Subchondral cysts : fluid-filled sacs which
extrude from the joint
Radiographs
Diagnosis
• On the basis of the initial history
and examination
• X-rays
Manage
ment
Goals of
managing OA
• Pain control
• Prevent stiffness and secondary deformities
• Limiting functional impairment
Treatment
• Education and behavioural intervention
• Weight loss
• Physiotherapy
• Splints
Treatment
• Analgesics
- Acetaminophen (Tylenol®) is a mild pain
reliever with few side effects
- Anti-inflammatory medication, such as
ibuprofen and aspirin
- COX-2 inhibitors
- Glucosamine and Chondroitin sulfate
Treatment
• Intra-articular injection
- Glucocorticoids injection
- Hyaluronic Acid (HA) and similar
hyaluronan preparations (eg, Synvisc)
………. Debatable
Treatment
• Surgery
- Arthroscopy (including debridement,and lavage/irrigation)
- Proximal Tibial Osteotomy
- Total Knee Replacement
Case 1
CASE 2
Case 3
CASE 4
MOBILE BEARING KNEE- RESULT
HI-FLEX
KNEE
Young –19 /m
All four joints replaced in a young patient with ochronotic arthropathy
MOTTO
Achievements
• Established as a patient friendly hospital in 2009
• The second largest Joint replacement center in Asia
• Well equipped and biggest trauma care facility in the state of Andhra Pradesh
• Availability of all Super specialists under one roof
PATIENT FIRST
Sunshine Hospitals is South East Asia’s 2nd largest joint replacement centre to a
pioneering multi-super specialty hospital
3000+ successful joint replacements every year
A state-of-the-art healthcare destination unrivaled for its service, quality of
deliverables and empathy
Investing relentlessly in people, equipment, technology and research
PATIENT FIRST
About Sunshine Hospitals
• 400 Bed Facility
• Centrally Located at Paradise circle Secunderabad
• Exceptional Ambience
• Spacious Parking area
• Well trained Patient care Coordinators
• Choice of occupancy(Royal Suite… General ward)
PATIENT FIRST
About Sunshine Hospitals
• 40 critical care beds with central monitoring systems
• Dedicated floor and In House critical care team to handle all Emergencies
• 1:1 Nursing ratio in critical care areas
• Treatment and patient care protocols as per international standards and
guidelines
• Specialized equipment and expertise Consultant team to handle complex
procedures
PATIENT FIRST
About Sunshine Hospitals
• 14 World class operating Theatres having global quality standards with laminar
airflow, Hepa Filters, High end microscope and other latest surgical equipments.
• Well equipped patient centered central monitoring systems ICCU’s with special
trained staff and consultants 1:1 Nursing staff
• 2 Flat panel digital catheterization lab
• 150 seat Auditorium with latest AV system
• 2 Digital 7900 flurostar C-Arm
• 1.5 Tesla MRI and Spiral CT
• Dedicated floor for OT with pre and post operative ICU care
PATIENT FIRST
• State of art Radiology services( MRI, CT, ECHO, Ultrasound, Doppler, TMT,
digital x-ray etc)
• Fully automated laboratory services( Pathology, Microbiology, Biochemistry,
Genetics)
• Special Health checkup packages
• Continuous learning programs for doctors and paramedical staff( internal and
external)
PATIENT FIRST
CT / MRI 1.5 Tesla
PATIENT FIRST
PATIENT FIRST
PATIENT FIRST
20
09
Our VisionTo create a world-class medical facility where patients are treated with compassion.
Our MissionTo create a world-class medical facility where patients are treated with compassion .To offer qualitative and comprehensive services in a patient-friendly environment focused on clinical excellence, safety, dignity and transparency, while staying affordable and accessible to every patient in need.
Our Values• Compassion• Teamwork• Transparency• Process-driven
PATIENT FIRST
AUGUST,
SUNSHINE HOSPITALS: The beginning
Arthroplasty surgeries
PATIENT FIRST
96 3
1
2010: A promising start..
5 Beds
321
0
210
5 Shoulder, Arthroscopy & Shoulder
surgeries 500
Trauma surgeries
Arthroplasty surgeries
PATIENT FIRST
27 7
1
2013: The Journey till now..
0 Beds
603
1
040
5 Shoulder, Arthroscopy & Shoulder
surgeries 500
Trauma surgeries
2014: Well placed to grow..
PATIENT FIRST
2ASIA’s LARGEST
Joint replacement Centre
nd
2014: Well placed to grow..
PATIENT FIRST
1stRanked
Worldwide Achievers & Headlines Today
HEALTHCARE EXCELLENCE AWARD 2013
Other specialities
• Trauma
• Arthroscopy and sports medicine
• Orthopedic oncology
• Spine
• Hand surgery
• Pediatric orthopedics
• Ilizarov and reconstructive surgery
Trauma team
Spine unit
Hand surgery
Arthroscopy and sports medicine
Orthopedic oncology
Pediatric orthopedics
Reconstructive and ilizarov
surgery
Our Anaesthesia Team
Our Physiotherapy Team
Our Support Team
PATIENT FIRST
PATIENT FIRST
THE SUNSHINE ADVANTAGE Sunshine Big hospitals without Specialty focus
Single Specialty hospitals
Volumes3000 joint replacements in a year
✔
Round the clock availability of Specialists, Resident in
the campus 24 X 7
DM Cardiologists ✔
MS Orthopedics doctors ✔MD Anaesthesiologist ✔MD General Medicine ✔Intensive care Specialists ✔
Infrastructure
Cardiac cath labs ✔CT Scan ✔MRI ✔Dialysis Machines ✔Modular theatres Laminar airflow with HEPA filters
✔
Support Services
Dedicated Pain Control Nurses working under a Consultant Anaesthesiologist
✔
Exclusive Infection control team headed by Consultant Microbiologist
✔
Is the time out?