Senior Connect Program - December 2009

22 Nov '09 - Talks on Managing Knee Osteoarthritis and Shoulder Pain

The talk was presented by Dr Tho Kam San, Consultant Orthopaedic Surgeon, Island Orthopaedic Consultants, Gleneagles Medical Centre, Singapore.

We had a very good turn out during this talk with seniors, who have benefitted from previous talks, bringing new friends.

Osteoarthritis, affects mainly the elderly but it is now appearing more commonly in patients under sixty. The main problem is the loss of joint cartilage through overuse, wear and tear as well as injuries.

In the early stages, patients can be managed with physiotherapy (to strengthen the weakened leg muscles), weight loss and activity medication (do activities that don’t involve deep knee bends and high impact, e.g. jumping) like walking, elliptical trainer, cycling and swimming. Medication like panadol, anti-inflammatories and glucosamine often help, along with injections of hyaluronic acid and very occasionally, steroids.

Newer types of therapy include plasma rich-in-platelets (PRP) and stem cell therapy. PRP has been used in several applications in medicine and surgery. These include accelerating tendon and muscle tear healing, plastic surgery, oral and maxillofacial surgery, head and neck surgery and orthopaedic surgery. Essentially, about 50-100 mls of a patient’s blood is centrifuged with reagent or passed through filters to extract a plasma component rich in platelets. It is then injected into the site of interest. PRP has been shown to possess more than 5 types of growth factors and is rich in leukocytes. Stem cell therapy is still under investigation. Stage III clinical trials have just reached their 2nd year in the US. These have the potential to reverse or at least markedly slow down early arthritis. This should be available commercially in the next few years. Patients with limited loss of joint cartilage can have it resurfaced with artificial cartilage grafts, cultured cartilage cells or even cartilage resurfacing implants. Patients younger than sixty should try to avoid a TOTAL knee replacement as further surgeries in their lifetime will be needed to replace the worn components; the results decline with increasing number of surgeries. However, in severe cases, this will be unavoidable.

In the final stages, when pain is severe and function is markedly diminished, some form of knee replacement will be necessary to restore function. There are several types and brands of implants available, from 1/3 knee replacement to 2/3 to a full replacement. Some can be inserted through a minimally invasive approach. Most implants can also be inserted with the aids of computers to ensure a more consistent placement of components. The surgery takes about 1 to 2 hours and is done under a general or spinal anaesthesia. With current pain control techniques, most patients experience soreness rather than severe pain. Most patients can begin walking the next day and can usually go home from the 3rd day onwards. Partial knee replacement patients can begin walking on the same day and can be discharged on the same day. Most implants will last 10-20 years, depending on the amount if use and the weight of the patient. With the newer implants, it is hoped that not only will they last longer or even a lifetime, but allow patients to engage in moderately intense sports.

A well deserved talk won't be completed without a well deserved meal.

After the break, Dr Tho gave a talk on shoulder pain.

Dr Tho taking one of the many questions from the floor.

Senior Connect Program on the 25 Oct 09 - Exercise & Sudden Death

This week's program was on Exercise & Sudden Death and Understanding Dementia. It had certainly drawn a big interest among the seniors for we saw the attendance was one of the best paticipation of over 70 people.

Our chairman and host, William, surveying new participants.

On whether the Senior Connect Program be held at some other place, there were a resounding "no" from the attendees.