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OSTEOARTHRITIS –
DIAGNOSIS, TREATMENT
AND SURGERY
Edited by Qian Chen
Osteoarthritis – Diagnosis, Treatment and Surgery
Edited by Qian Chen
Published by InTech
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Copyright © 2012 InTech
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Publishing Process Manager Vana Persen
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team
First published February, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechweb.org
Osteoarthritis – Diagnosis, Treatment and Surgery, Edited by Qian Chen
p. cm.
978-953-51-0168-0
Contents
Preface IX
Part 1 General Treatment of OA 1
Chapter 1 Long-Term Treatment of Osteoarthritis Pain:
Achieving a Balance Between Efficacy and
Tolerability for a Successful Chronic Therapy 3
Mila Etropolski
Chapter 2 Characterization of Live and Experimentally
Degenerated Hyaline Cartilage with Thermal Analysis 27
Gellért Sohár, Piroska Szabó-Révész,
Kálmán Tóth and Zoltán Aigner
Chapter 3 Topical and Regional Treatment for Osteoarthritis 47
Leena Patel and Charles Mackworth-Young
Chapter 4 Intra-Articular Injections for the Treatment of Osteoarthritis:
Focus on the Clinical Use of Several Regimens 67
Dong Rak Kwon and Gi Young Park
Chapter 5 Hyaluronic Acid in the Treatment
of Osteoarthritis: What is New 101
Michele Abate and Vincenzo Salini
Chapter 6 Gene Therapy for Human Osteoarthritis 123
Magali Cucchiarini and Henning Madry
Part 2 Alternative Treatment of OA 141
Chapter 7 Peloidotherapy in
Osteoarthritis-Modulation of Oxidative Stress 143
Viorica Marin, Olga Surdu, Daniela Profir and Sibel Demirgian
Chapter 8 Ginger and Osteoarthritis 157
Tessa Therkleson
VI Contents
Part 3 OA in Upper Extremity
(Hand, Wrist, Shoulder, and Elbow) 169
Chapter 9 Osteoarthritis of the Wrist 171
Nimit Patel, Glenn Russo and
Craig Rodner
Chapter 10 Osteoarthritis of the Trapeziometacarpal
Joint (TMJ): A Review of the Literature 203
Oliver Boughton and Hugh Mackenzie
Chapter 11 Low Level Laser Therapy in
the Treatment of Temporomandibular
Joint Arthritis: Questions and Answers 211
Marini Ida and Gatto Maria Rosaria
Part 4 Diagnosis of OA in
Lower Extremity (Hip, Knee, and Ankle) 225
Chapter 12 Treatment Preferences in Patients with
Knee or Hip Osteoarthritis: An Overview 227
Amado Rivero-Santana, Lilisbeth Perestelo-Perez,
Jeanette Perez-Ramos, Marien Gonzalez-Lorenzo and
Pedro Serrano-Aguilar
Chapter 13 The Plica: Is a New Aetiological
Factor in the Knee Osteoarthritis? 243
Ahmet Guney and Ibrahim Kafadar
Chapter 14 Knee Osteoarthritis and
Associated Periarticular Conditions:
Iliotibial Band Friction and Baker Cyst 253
Violeta Vasilevska, Ulrike Szeimies,
Milan Samardziski and Axel Stäbler
Chapter 15 Evaluation of In Vivo Proteolytic Activity 265
Wataru Yoshida, Akihisa Kamataki,
Miwa Uzuki and Takashi Sawai
Chapter 16 Phonoarthrography:
A New Technique for Recording Joint Sounds 275
Hassan M. Bassiouni
Part 5 Sugery of OA
in Lower Extremity (Hip, Knee, and Ankle) 289
Chapter 17 Surgery for Osteoarthritis of the Knee 291
J.R. Lewis and R.L. Carey Smith
Contents VII
Chapter 18 High Tibial Open-Wedge Osteotomy –
New Techniques and Early Results 319
Werner Kolb, Hanno Guhlmann,
Christoph Windisch and Klaus Kolb
Part 6 Treatment of OA in
Lower Extremity (Hip, Knee, and Ankle) 347
Chapter 19 Ultrasound Guided Hip Injection Techniques 349
Micu Mihaela Cosmina
Chapter 20 Hyaluronate for the Treatment of Ankle Osteoarthritis 367
Shu-Fen Sun, Chien-Wei Hsu,
Yi-Jiun Chou, Yu-Nong Wang and Mei-Chia Chou
Chapter 21 Knee Health Promotion Option for
Osteoarthritic Knee: Cartilage Regeneration is Possible 379
S.R. Lyu, D.S. Liu, C.E. Tseng, H.S. Wang and L.K. Chau
Preface
Osteoarthritis is one of the most debilitating diseases worldwide. Millions of people
suffer from pain and disability associated with this disease. There are two major
types of OA: primary and secondary. The primary OA is associated with aging.
While people live longer and longer, the prevalence of OA becomes more
prominent. It is expected that the percentage of the people who suffer from OA will
continue to rise in the coming decades. The secondary OA is a consequence of injury
to the joints. It is often associated with sports injury and/or other traumatic events.
Thus, it often occurs in young people and adults who enjoy an active life style.
Although the direct damage to the joint such as rapture of the ligaments is often
repairable by surgery, the patients nevertheless would likely suffer from
degeneration of the joint cartilage later in life.
My connection to OA is several fold. Because of the prevalence of OA, many of us
know family members and/or friends who suffer from the disease. I am no
exception. My mother suffered from both rheumatoid arthritis (RA) and OA.
Although she also suffered from other diseases, she complained most about arthritis.
Some of the other diseases might be more life-threatening; however, none of them
brought as much pain and restrained her to bed on a daily basis as arthritis. She
often said that life is not worth living if there is no quality. After her RA was
brought under control by new drug therapy and both her knees were replaced by
surgery, her pain became manageable and her mobility was regained. She was able
to perform daily routine activities by herself that many of us take for granted, such
as going to the bathroom, standing up after sitting, and walking the stairs. Her
outlook on her life in the old age was brightened significantly because of the new
treatment and surgery.
As a biomedical researcher, I was fascinated by the intricate process of cartilage
development and aging since I was a young graduate student. The research was
driven primarily by interest and curiosity. However, my mother’s life experience and
my interactions with other arthritis patients brought urgency as well as practicality
into the basic research we were conducting. The basic knowledge gained from
research must be translated into new methods of diagnosis, treatment, and surgery for
patients. That is the most direct and effective way to improve the life quality of
patients.
X Preface
So far, there is no FDA approved disease modified drugs for OA. Joint replacement
surgery remains the last, and perhaps the most effective way to restore the functions of
the joint. Due to these circumstances, a multifaceted approach is needed to improve
the current treatment as well as to develop new therapy for the future. We need to
emphasize the improvement not only diagnosis and treatment of OA, but also the
surgery to restore the function of the joint. We need to consider not only
mechanistically driven research, but also alternative medicine that has been in practice
in treating OA related symptoms in different parts of the world for long time.
Based on these guiding principles, we have included a variety of articles written by
physicians and OA researchers from different parts of the world. The topics of the
articles include general as well as alternative treatment of OA, diagnosis of OA in
upper extremity (hand, wrist, shoulder, and elbow) as well as in lower extremity (hip,
knee, and ankle), and common strategies for treatment as well as surgery of OA. We
hope that this book serves as a comprehensive resource for professionals as well as
patients who are interested in learning the state-of-the-art of OA diagnosis, treatment,
and surgery. To borrow a Chinese proverb 抛砖引玉 (cast a brick to attract jade), we
hope that this compilation of a variety of articles in this book, some of which are non-
traditional or even provocative, may serve as a precursor to the breakthrough in
developing new therapy and treatment of OA in the future.
Qian Chen, Ph.D.
Alpert Medical School of Brown University, Providence, RI,
USA
. OSTEOARTHRITIS –
DIAGNOSIS, TREATMENT
AND SURGERY
Edited by Qian Chen
Osteoarthritis – Diagnosis, Treatment and Surgery
Edited. be obtained from orders@intechweb.org
Osteoarthritis – Diagnosis, Treatment and Surgery, Edited by Qian Chen
p. cm.
978-953-51-0168-0
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