The specialty of orthopaedics encompasses the surgical aspects of musculoskeletal and sports medicine. This broad specialty involves the treatment of patients of all ages, although the prevalence of specific disorders changes with age.
Paediatric orthopaedic surgery includes the treatment of congenital disorders; dysplasia of the hip, foot malformations (metatarsus adductus, metatarsus varus and clubfoot) and spinal deformities (kyphosis and scoliosis).1 However, musculoskeletal trauma is the most common reason for children to require orthopaedic treatment. Fractures are more prevalent in children due to weaknesses at the epiphysial growth plates and they perform more physical activity than adults.2
The main cause of orthopaedic treatment in adults is trauma; more specifically patients involved in transport collisions. Among this group, the most frequent orthopaedic trauma injuries occurred in males under the age of 65.3
In elderly patients, diseases such as osteoarthritis and osteoporosis are more common. Osteoarthritis is the degeneration of articular cartilage in synovial joints causing bone hypertrophy. It affects 45% of women over 65 and is a major cause of disability in these people.4 Osteoporosis is a disease that affects post-menopausal women and men over the age of 50, and is more common in smokers than non-smokers.5,6 This bone demineralising disorder causes a higher proportion of fractures, of which hip fractures are the most common.5 The ageing worldwide population has therefore caused an increased need for total joint replacements, of which the most common are total hip and knee arthroplasty.7
1. Nemeth B. The Diagnosis and Management of Common Childhood Orthopedic Disorders. Current Problems in Pediatric and Adolescent Health Care. January 2011 ; 41 (1) : 2-28
2. Mencio G.A. et al. Pediatric Orthopedic Trauma. Ashcrofts Pediatric Surgery. Elsevier Inc. 2010 : 221-234
3. Urquhart D.M. et al. Characteristics of Orthopaedic Trauma Admitted to Adult Level 1 Trauma Centres. Injury. February 2006 ; 37 (2) : 120-127
4. Chasm R.M. et al. Pediatric Orthopedic Emergencies. Emergency Medical Clinics of North America. November 2010 ; 28 (4) : 907-926
5. Symmons D et al. Global Burden of Osteoarthritis in the Year 2000. Global Burden of Disease. 2006 : 1-26
6. Law M.R. et al. A Meta-Analysis of Cigarette Smoking, Bone Mineral Density and Risk of Hip Fracture: Recognition of a Major Effect. BMJ. June 1997 ; 315 (841) :
7. Wilsgaard T. et al. Lifestyle Impact on Lifetime Bone Loss in Woman and Men: The Tromso Study. Bone. May 2009 ; 44 (S1) : S38
8. Levine H.B. et al. Joint Replacement in the Geriatric Orthopaedic Patient. Operative Techniques in Orthopaedics. 2002 ; 12 (2) : 92-102
Arthritis is a complex disorder that comprises more than 100 distinct musculoskeletal conditions and can affect people at any stage of life. Arthritis causes joint pain, loss of movement, and inflammation.
Common forms of arthritis include osteoarthritis (OA) and rheumatoid arthritis. Both OA and RA are chronic and incurable but respond well to intervention.Osteoarthritis is the most common type of arthritis.
The prevalence increases with age, and most people over 60 years will have some radiological evidence of it. Osteoarthritis is the result of active, sometimes inflammatory but potentially reparative processes rather than the inevitable result of trauma and ageing.Rheumatoid arthritis is a chronic symmetrical polyarthritis of unexplained cause.
It is a systematic disorder characterized by chronic inflammatory synovitis of mainly peripheral joints. Its course is extremely variable and it is associated with nonarticular features.
To diagnose arthritis, there are a number of guidelines which outline the classification criteria, as well as tools to assess the patients pain.
There are a variety of treatment options available to help manage the pain and inflammation of osteo and rheumatoid arthritis, both pharmacological and non-pharmacological. It is important to balance the potential benefit against the potential side-effects.
Enter the Arthritis Knowledge Centre
What’s in the Knowledge Centre?
The EULAR (European League Against Rheumatism) 2011 satellite symposium was held in London in May 2011. The symposium entitled Clinical Choices in Osteoarthritis Pain Management – Evidence Versus Practice: An Interactive Case-Based Assessment discussed the treatment regimens available for the treatment of OA.
Discussion of Clinical Approach to Lower Back Pain
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