The Current Scenario of Rheumatological Orthopedic Management
Manish Khanna*
Department of Orthopedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, India
Submission: May 08, 2019;Published: June 13, 2019
*Corresponding author: Manish Khanna, Department of Orthopedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
How to cite this article: Manish K. The Current Scenario of Rheumatological Orthopedic Management. Ortho & Rheum Open Access J 2019; 14(2):555882. DOI: 10.19080/OROAJ.2019.14.555882
Editorial
Orthopedic Rheumatology is a rapidly evolving medicosurgical specialty important for Orthopedic Surgeons busy in Surgical practice. Challenges that are more specific in different part of Globe like limited numbers of specialists with rheumatology training (especially in semi-urban areas) make us to further learn and share in order to create awareness among selves. There is always a huge pressure of patients with Joint problems coming to Orthopedic OPD, so a proper management regimen must be followed. Knee arthritis is most common presentation in clinics specially in India. Immunology explains pathogenesis and the characteristics of rheumatological disorders, and most of the new treatment modalities are based on immunology. Rheumatoid arthritis affects 1% of adult population as far as India is concerned. Onset usually occurs between 25 years and 60 years of age. It is now a well-known fact that Free Radicals are an important factor in the development and aggravation of the Polyarthritis/Rheumatoid arthritis in humans. These reactive species are produced within the synoviocytes and chondrocytes.
Reactive arthritis is common presentation which if do not remit spontaneously then can lead to Rheumatoid or another form of inflammatory arthritis. Rate of progression of disease is significantly more rapid in first year than in second & third year of disease so the early detection and treatment is must to prevent deformities. We should constantly educate our patients the importance of regular proper follows up in order to monitor the effects of the Drugs. There has been increased interest with use of Biological Drugs for patients with RA. Research have shown better clinical and radiographic outcome with the combi nation of Biological drugs and Conventional drugs compared if giving them alone. But due to cost factor Biological are reserved to resistant or serious form of cases. New scientific discoveries related to this specialty are largely related to better understanding of immunology, pathogenesis of major rheumatological disorders thus recent treatment advancements made such as arthroscopic synovectomy in rheumatoid arthritis, introduction of chondroprotective drugs, role of Gelatinase (matrix metalloproteinase 2 and 9) in osteoarthritis needs to be emphasized on.
These advances have given us hope to help in increasing quality of life of our patients. Regenerative science holds great promise for orthopedic surgery. As surgeons continue to face challenges regarding the healing of diseased or injured musculoskeletal tissues, regenerative sciences aim to develop novel therapies that will replace, repair or promote tissue regeneration. The potential use of stem cells for orthopedic tissue engineering will be pioneering in upcoming times. The human body has a remarkable capacity to repair itself. We carry our own healing kits in ourselves which is known as stem cells. Regenerative sciences seek to support, stimulate and enhance the body’s natural repair mechanism to help them heal defects that they could not normally heal on their own. It has offered an unprecedented opportunity for treatment of debilitating orthopedic conditions. It has shown its miracles in conditions like bone healing, genetic disorders to some extent, cartilage repair, ligament and tendon healing, spinal cord injuries, osteoarthritis, rheumatoid arthritis, orthopedic oncology, avascular necrosis, cystic lesion of bone etc. This approach of regenerative sciences needs a public awareness as well.