9/8/2018 Arthritis patients can now postpone surgery - Times of India

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Arthritis patients can now postpone surgery

TNN | Aug 17, 2010, 06.11 AM IST

NEW DELHI: For those suffering from arthritis and osteoarthritis, especially young people, can now postpone their surgery as
orthopedists recommend visco-supplementation and corticosteroids to get relief from a painful knee. Experts say that one
injection of visco-supplementation can provide relief from knee pain for nearly a year. But doctors have to be careful while
choosing between visco-supplementation and corticosteroids.
According to Dr J Maheshwari, senior consultant, orthopedist, Sita Ram Bhartiya Hospital, "Corticosteroids have been there for
some time now, but people have a lot of misconceptions about it. Steroids, no doubt, have serious side-effects, but when given
locally to a particular area the damage is minimal. The advantage is more than the side-effects.''

Though knee replacement has, of late, become a very common procedure in India, doctors say that a majority of arthritis and
osteoarthritis patients are still reluctant to undergo a surgery. "For those who want to postpone the surgery, corticosteroids are
an effective solution,'' said Dr Maheshwari. With an increasing number of young adults being diagnosed with arthritis and
osteoarthritis, doctors say that these injections can help them get rid of the pain to a greater extent. "We recommend these
injections to young patients who want to delay or avoid surgery. We have seen that patients, who come to us in the early
stages, get 80% relief from joint pain,'' said Dr Rajesh Malhotra, professor, orthopaedics and knee replacement, AIIMS.

Doctors say that one should be careful while choosing between corticosteroids and visco-supplementation. "If the joint is dry
and painful then visco-supplementation should be given. But in case of fluid retention, corticosteroids are ideal. Visco-
supplementation is more effective when there is no other medium available. That is why we don't give visco-supplementation
under local or general anaesthesia,'' said Dr Malhotra. But it is the cost factor that forces a lot of patients to opt for
corticosteroids. "It (corticosteroids) costs around Rs 800-Rs 1200 whereas one injection of visco-supplementation costs nearly
Rs 14,000,'' said Dr Maheshwari.

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9/8/2018 Arthritis patients can now postpone surgery - Times of India

According to Dr P K Dave, head of the department, orthopaedics, Rockland, "Visco-supplementation is more effective and has
less side-effects. There are a lot of patients who want to postpone the surgery or don't qualify for surgery due to underlying
health conditions. For them, visco-supplementation is a good solution.''

The biggest advantage of visco-supplementation is that the drug is washed out of the body within four weeks and in that
duration it stimulates the knee cells to make fluid (Hyaluronic acid) on its own. "The knee cells starts producing its own lubricant
and this helps in keeping the knee flexible and almost pain-free. Corticosteroids just helps in reducing the inflammation of the
joints,'' said Dr Malhotra.

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