If you are suffering from arthritis, you are not alone. It is estimated that more than 150 million people in India alone suffer from this dreaded condition. Although it was known earlier to be prevalent only in people at their advanced age, these days it has been reported to strike people even in their prime age of 22 – 45. Stiffness, swelling and pain are the daily complaints of these people.

Everyone knows that Arthritis attacks the joints. In the human body where two bones meet, you have a joint. Joints hold the bones together and help the bone skeleton to move. In short, the joints provide stability while the body is in motion. In a normal joint (where two bones come together), the muscle, bursa and tendon support the bone and aid movement. The synovial membrane (an inner lining) releases a slippery fluid into the joint space. Cartilage covers the bone ends, absorbing shocks and keeping the bones from rubbing together when the joint moves.

In a person with an arthritic joint , the cartilage covering the bones at the joint is damaged due to disease or is degenerated over the years, causing symptoms like pain, stiffness, swelling and even joint fever. The free movement of the joint is affected forcing the person to walk with great pain and difficulty. This condition is called ARTHRITIS. These symptoms can occur at different intervals depending on the condition and age of the individual and the extent of the damage.

Types of Arthritis

To date, about 160 types of arthritis have been reported. Here is a list of the common types of arthritis:
Rheumatoid arthritis
Gouty arthritis
Rheumatic arthritis
Lupus
Tuberculosis arthritis
Diabetic arthritis
Septic arthritis
Osteoarthritis or degenerative arthritis due to aging of joints

Of all the types of arthritis, the most common and feared is Rheumatoid Arthritis. Earlier it was more prevalent in the western countries, but now it has been reported in large numbers in India as well.

Diagnosing Rheumatoid arthritis

The normal tests for any kind of arthritis is to do an X – ray of the Chest, X – ray of the joint, blood tests – glucose tolerance ( for diabetics), blood urea, serum creatinine ( to see if the kidney is affected), serum bilirubin, haemoglobin, coagulation test ( to see if the clotting is normal). ESR is the most important test for arthritis, for it helps to track the recovery of the patient.

But for Rheumatoid arthritis, the patient will be recommended for examination of more clinical features:
Test for Rheumatoid factor
Scan- CT/MRI
Joint fluid analysis

Treatment

Before beginning the treatment, the physician will assess the progress of the condition. Those with mild symptoms will be treated as outpatients. Only severe cases will be admitted inside.
The first priority would be to give pain relief to the patient. He will be advised bed rest and treated to arrest the spread of the disease. Treatment involves giving pain relief medication like Brufen, Voveron, and Indomethacin. Drugs like Methotrexate, Hydroxy chloroquine, Sulphasalazine will be given to stop the progression of the disease. In extreme cases, steroids may also be given.

Recent advances in the treatment of Rheumatoid arthritis

Recent successes in the treatment of Rheumatoid arthritis have revolutionized the disease process. These include:
Biologic agents:
Etarnecept: It is a fully human soluble drug injected subcutaneously
Infliximab: It is given as an IV injection
Monoclonal Antibody:
Adalimumab: Can be used on alternate weeks
Recombinant Receptor Antagonist:
Anakinara – Recombinant IL – 1 receptor antagonist can be given as daily subcutaneous injections.

Advantages to the recent treatment:

There are many advantages to the new line of treatment. Long-term intake of medication is no longer required. There are relatively fewer side effects. They are mostly acting selectively on organs. And they are more effective than conventional drugs and can be used in combination with them.
There is one disadvantage: cost

Surgical solutions

The various options include soft tissue release, tendon transfer and joint replacement. Surgical options can give long-term relief.
Joint Replacement is one of the greatest advances in medicine. It has rescued a person crippled with arthritis to resume the life as he had before. Any individual with severe arthritis which cannot be treated with normal medicine can go in joint replacement. These days, joint replacement is being done regularly by making small openings on the skin. This reduces the pain and heals quicker. This treatment is called as minimally invasive joint replacement. More recently, Computer Navigated Joint Replacement is being carried out with big success. Here computers are used to place the replacement components exactly at the places required without any difficulty. This increases the life span of the new joint.

Among all the joint replacements that is being done today, the most successful is the total knee replacement. Here the worn out knee surfaces are replaced with artificial implants that restore excellent movement without any pain to the sufferer. Normally, these replacements are done under regional anaesthesia. Patients are known to stand and walk slightly even the same day. By the time they leave the hospital which is on the 10th day generally, they will have regained 90 degrees movement in the knee. The sutures are removed on the 12th day. And in a month the patients can get back to even their full functions as before. They can even play tennis with their new knees!

The relief from the dreaded arthritic pain and restoration of normal function is so deep and complete that joint replacement has become a readily accepted procedure by patients suffering from arthritis everywhere. It is surely one of the great wonders of this century.

MIOTS Hospitals, Chennai has been doing pioneering work for managing patients suffering from severe arthritis since long. By interacting with other world class orthopaedic centers, they have successfully introduced the latest techniques and treatment for degenerative arthritis from around the world. Today it is only one of the 3 hospitals in the world that is performing the minimally invasive computer navigated high flex knee replacement procedure with great success.

P.S. My sincere thanks to the doctors and lab technicians at MIOTS Hospitals, Chennai, for providing me the information produced here. Their documented literature was exhaustive and revealing.