Mapping Your News

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...

The foot has a complex anatomy designed to bear the weight of the body and to propel the body forward in walking and running. The talus or ankle bone sits in the ankle mortise and is the top link of the main longitudinal arch of the foot. The longitudinal or medial arch is the largest and is on the inside of the foot, absorbing the loads in standing postures and aided in its elastic recoil by the spring ligament. The outside of the foot has a smaller arch known as the lateral arch and the front of the foot has a transverse (across) arch between the first and fifth metatarsal heads.

The foot arches have a very important role in the function of the foot and without them it would not be the dynamic propulsion system that it is. They absorb the energy and forces involved when body weight is applied to the ground, store it to some degree and release it as the next step is taken. If you watch someone walk with very flat feet and no spring you will be struck by the lack of dynamic movement, the slowness of gait and the lack of balance. Maintaining the health of the foot arches should be an important part of keeping fit and able as we age.  Read more...

Instability of the shoulder in multiple directions is moderately often encountered, occurring normally on both sides of the body and is not related to accident or injury. The underlying difficulty is the laxity of the capsule of the shoulder and the deficiencies of these stabilising ligamentous structures. This ligament laxity shows itself in excessive joint mobility in all anatomical directions. Patients may describe joint instability as the shoulder may sublux (partial dislocation) or wholly dislocate from time to time. However, the patient may not suffer such obvious symptoms and complain only of pain.

The mainstay of treatment is conservative management, with physiotherapists working on increasing the strength of the stabilising muscular systems such as the rotator cuff muscles and the scapular stability muscles. If conservative rehabilitation is not successful then surgical intervention can be undertaken to stabilise the more static stabilisers such as the shoulder capsule, tightening up so that stability is increased. Open surgery is the typical technique but arthroscopic techniques are developing rapidly.

How common this pathology is in the overall population is not clear and it is much more common to have instability of the shoulder from traumatic events such as incidents which lead to shoulder dislocation. In this field there are several different classifications, TUBS stands for:  Read more...

Patients report widely diverging levels of disability and pain in response to neck problems, with some have almost no disability and little pain and others with severe interference with normal life and high pain report. There may be different neurological and pathological events which underlie this variety which reflect the neck syndrome present. Initially most work was on finding an anatomical site of injury or damage to explain the symptoms but this has led to limited success in explaining the clinical syndromes. The pain mechanisms which may be responsible for the reported symptoms are now increasingly investigated.

One way to allow more accurate whiplash treatment to be identified is to clarify which diagnosis and which pain syndrome in present in an individual patient’s neck pain problem. Neck injury can consist of long term postural abnormality, repeated small trauma in activity or an obvious event such as whiplash injury. Any inflammation which is present in these cases in known to significantly change the ways pain is processed both in the central nervous system of the brain and the spinal cord and in the locally damaged area. Even though most research has been performed on animals this can be taken seriously when considering pain in humans.  Read more...

Our modern habit of confining our feet into the prisons of our shoes may be partly responsible for some of the problems we face. Our feet have evolved to manage the changing levels and types of surfaces as the toes grip the ground and reinforce the arches. With the universal use of shoes almost all of the time we have given our feet a much reduced role and they do not have to be able to manage the ground surface, being given a smooth firm plastic or leather one instead. The small intrinsic foot muscles weaken and lose function as they are deprived of their natural job, reducing the foot’s effectiveness.

The arches of the foot and the function of the toes alter as the intrinsic muscles of the foot weaken as the toes lose the ability to hold themselves straight when gripping the surface. Due to this they start to bend or claw, and as this progresses the muscles which extend the toes can shorten in sympathy, drawing the toes up in a flexed position. This takes the pads of the toes away from any possible contact with the ground, obliging them to take force on the tips perhaps. Overall the foot becomes less functional and the arches decrease in height.  Read more...