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Osteoarthritis in Ireland Print E-mail
  • ImageOsteoarthritis is one of the most common chronic diseases and the most frequent cause of pain leading to long term disability in the older population in Ireland.
  • Every year in Ireland, around 400,000 people consult their doctor with symptoms related to arthritis.
  • It occurs most frequently in knees, hands, thumb base, hips, back, neck.
  • The incidence and prevalence is higher in women than in men, especially after the age of 50.
  • Chronic cases lead to joint replacement
  • Sports people who suffer cartilage injuries as well as wear and tear to the joints are more susceptible to developing arthritis in later years.

Treatment of Osteoarthritis

  • Weight loss, physiotherapy and exercise recommended
  • If unsuccessful, analgesics, as well as anti-inflammatory drugs may be used as well steroids to relieve pain - but effects, even of steroids, are short lived -up to six weeks.
  • Since Dec. 2004 some of the well-known anti-inflammatories have been withdrawn from the market and others have new warnings for people with heart (Cardiovascular) problems.
  • Waiting lists for Orthopaedic and Rheumatology services in Ireland can be months, even years long and this causes further difficulty for patients in extreme pain.
  • Need for new treatment - Synovial Fluid Replacement Therapy

What's New about Synovial Fluid Replacement Therapy

  • A real option to anti-inflammatory drugs
  • Can provide up to six months pain relief.
  • Effective in treatment of sport injuries to the knee providing athletes and sports persons with pain relief reducing their dependence on anti-inflammatory drugs.
  • Valuable tool for GPs whose patients find themselves on long waiting lists to see an orthopaedic surgeon.
  • May delay need for joint replacement surgery
  • Available on Medical Card scheme

Synovial Fluid Replacement Therapy - How it works

  • Injection of Hyaluronan into the knee once a week for three consecutive weeks
  • lubricates the joint and restores the elastic properties of the fluid 
  • Ability to act as a shock absorber. 
  • Movement of the joint becomes easier and more comfortable.
  • Decreases pain for up to six months and also improves function in patients with OA of the knee. 
  • Patient's reliance on other pain relieving medications is significantly reduced.
  • Valuable tool for GPs whose patients find themselves on long waiting lists to see an orthopaedic surgeon.
  • May delay necessity for knee replacement surgery
  • Effective in treating patients with early to middle stage arthritis who wish to improve their function and reduce pain.
  • Effective in patients with more advanced arthritis who may experience delays in receiving a total joint replacement. 
  • Effective use in treatment of sports injuries particularly in the knee 
  • Can prevent further loss of cartilage
  • May stimulate the natural production of synovial fluid by the body a process know as visco-induction
  • Is a longer lasting alternative which is safe and could help to reduce dependence on anti-inflammatory medication

Viscosupplementation (Synovial fluid replacement therapy) came into clinical use in Japan and Italy in 1987 and Canada in 1992 and in Europe in 1995. It has been approved in the United States since 1997. Synovial Fluid Replacement Therapy is a prescription only product and is now available on the GMS (General Medical Scheme) in Ireland since February 1, 2005.

Can delay need for knee replacement surgery

ImageRecently in Washington DC - Dr David Waddel and Dr DeWayne Bricker (PAC Orthopedic Specialists of Louisiana, Shreveport) reported on patients with severe osteoarthritis of the knee who were candidates for total-knee-replacement (TKR) surgery, treatment with intra-articular injections of hyaluronan delayed the need for surgery by nearly 4 years, according to data from a prize-winning poster presentation at the American Academy of Orthopaedic Surgeons (AAOS) 2005 meeting. "Given that total knee replacement is costly, can carry serious risk, and may need revision in younger patients, hyaluronan is a viable treatment option before last-resort surgery," the presenters conclude. Several other presentations at the AAOS reported on the successful use of intra-articular injections of hyaluronan in other joints such as the hip, ankle, shoulder, and elbow.

Applications in Sport Medicine

Another development more recently is the use of Hyaluronan in the area of Sport-medicine. Many patients have been treated successfully to date and this therapy and its applications to sport medicine are currently attracting a lot of interest from specialist's world-wide. Rudolf Zioloko, a sports-medicine specialist from Cologne, discussed sports-related injuries at the EULAR (European League against Rheumaticism) symposium in Berlin 10th June 2004 as another area of application for hyaluronan injections. 'In this case it is important to treat the patient while they are still in the chondropathy (cartilage disease) stage', he said, 'otherwise cartilage defects no longer spontaneously heal and the subchondral bone eventually also becomes involved'. However as he explained, hyaluronan injections can prevent further loss of cartilage.

This is good news for team doctors, sports persons, GPs and physiotherapists where early symptoms of wear and tear osteoarthritis are apparent. Considering the results of a survey of over 260 top GAA players conducted by Dr. Doug Veale Consultant Rheumatologist at St.Vincent's Hospital with the help of team doctors last year during the championship season where results showed that 65% of players were suffering pain and stiffness compared to rates of around 10% in the general population.

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