Mapping Your News

Hampstead Heath this morning was beautiful but treacherous and all of a sudden, as is usual with such things, I fell over on the ice. One minute I was walking along chatting and the next minute I was on my bottom as my wrist, forearm, shoulder and buttock took a bash. I slid sideways fast in the fall, thereby distributing the blow to several parts of my body and reducing its impact, entirely by luck. So I escaped joining the legions of people who, over the UK Christmas festivities, suffered a fall as the weather managed to concoct a particularly tricky combination of sub-zero temperatures and sharp showers.

Falls are an increasing concern as the population of many countries gets older and not just in periods of cold and frosty weather. Our ability to maintain balance is something we take for granted since we learned to walk but it relies on a series of complex skills and abilities which are subject to the changes which come with age. In elderly people falls can become a significant problem, causing injuries and fractures which need costly medical and surgical care and eventually threatening independence. Medical systems all over the world are feeling the expense and the clinical load which results from falls.  Read more...

Populations across the world suffer from osteoarthritis (OA), the most common degenerative joint condition in world, causing large amounts of pain, disability and expense. Western developed populations are ageing and as the incidence of OA rises with each decade of life the impact of this condition will be felt ever more strongly. Less developed countries such as China will soon be joining the countries with ageing populations so the need for effective OA treatment will increase greatly. One of the approaches to managing OA is to perform joint replacement.

Medical interventions can be rated on a scale which calculates the improvement in quality of life which results and here hip replacement comes out top of all treatments. The 1960s saw its development into a standard treatment for hip arthritis but the 21st century has seen the technique evolve into a complex and predictable approach to many hip conditions, with excellent fifteen year plus results. Once conservative treatments have been exhausted due to a worsening joint then joint replacement becomes the standard choice.  Read more...

The Aircast Cryocuff is a useful, portable and flexible device for the management of knee injury, pain and swelling. Used commonly by physiotherapists, it can be an important tool in knee injury and post-operative management of knee operations, where the application of cold therapy is difficult with traditional methods.

Sports and energetic activities cause large numbers of knee injuries which need prompt and appropriate treatments from physiotherapists for the best and speediest outcome. Physios manage a wide variety of knee injuries and conditions including: meniscal (cartilage) injuries, medial ligament injury, lateral ligament injury, anterior cruciate rupture, knee replacement, dislocation of the patella and more general injuries to the knee capsule.

The knee is a hinge type joint, vulnerable to sporting and other injuries, and it is classified as a synovial joint, lined with synovial membrane. When the knee is injured inflammation occurs, increasing the supply of blood and the metabolism of the surrounding tissues. The synovial membrane secretes amounts of synovial fluid which cause a knee effusion (water on the knee) and this interferes with the muscle control of the knee and can be tight and painful. An effusion can slow recovery if allowed to.  Read more...

Major joint replacement is one of the success stories of the late twentieth century, providing the greatest changes in quality of life measurements of all medical treatments or operations. Total knee replacement has now developed from a less predictable operation to a routine procedure with good long-term results for severely osteoarthritic joints. Populations in developed countries are rapidly getting older and total knee replacement is set to overtake total hip replacement as the most performed joint replacement.

Osteoarthritis is a degenerative joint condition which is more common the older a person becomes, and is the most prevalent joint condition in human populations. The most affected joints vary, with some people having spinal and finger changes whilst other suffer OA of the major joints such as the hips and the knees. Major joint disease is more disabling as it tends to compromise normal mobility and so reduce independence. The patient can suffer from loss of knee movement, reduction of knee power, grating and crunching of the joint and pain, for which weight loss, muscle strengthening, painkilling medication and physiotherapy can be useful. If normal therapies are not successful then knee replacement is the remaining option.  Read more...

Patients recover very quickly from this abdominal operation and it is rare to suffer serious side-effects. Cholecystectomy produces a number of minor post-operative complications so it is important to understand these as well as the rare potential for more critical complications.

About Gall Bladder Removal

The gall bladder is a small sac lying underneath the liver which stores bile produced in the liver. Whatever we eat, bile is released into the gut to help the body digest fats in the food. Small stones of various sorts can develop within the gall bladder which are known as gall stones. Many people, particularly from middle age onwards, develop gallstones which produce no symptoms whatsoever and do not need to be removed.

Sometimes the stones can lead to pain or inflammation with the gall bladder. In some patients stones may escape from the gall bladder and get into the main bile duct (the main tube connecting the liver to the gut) where they can cause an obstruction leading to jaundice (yellow pigmentation of the skin). In these cases it may be necessary to perform a cholecystectomy (surgical removal of the gall bladder).

Is Gall Bladder Surgery Harmful?  Read more...

Flat foot is common in the population and classed either as congenital flat foot which is not a pathology as such and may not give symptoms, and acquired flat foot which develops in adult life from a foot problem. There are many potential causes of flat foot acquired in adulthood which include arthritic diseases, neurological conditions, foot abnormalities and dislocations or foot fractures. In the acquired form of flat foot the most frequent type is secondary to a dysfunction of one of the foot tendons, the tendon of the tibialis posterior muscle. Tendon changes can occur from inflammatory, degenerative or traumatic conditions.

Pathological changes in the tendon of the posterior tibial muscle have been shown to occur more commonly in patients who take steroids, have high blood pressure, are overweight or diabetic and have had injuries or operation to their midfoot. In the group of joint conditions known as spondyloarthropathies the incidence of tendon dysfunction is higher, patients usually having a family history of joint problems. Since older people without particular medical problems can also suffer this condition, degenerative mechanical causes may also be important. In 10% of patients with rheumatoid arthritis this tendon pathology may occur.  Read more...