All::Rheumatology::Diseases::Osteoarthritis

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Intro

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According to NICE, how can osteoarthritis be diagnosed clinically without the need for investigations?

Clinically diagnose if the patient is > 45 years, has exercise-related pain, and no morning stiffness or morning stiffness lasting > 30 minutes.

Osteoarthritis

What are the first-line analgesics recommended by NICE for osteoarthritis, particularly for knee or hand OA?

Topical NSAIDs.

Osteoarthritis

What is the second-line treatment for osteoarthritis, and what should be co-prescribed with it?

Oral NSAIDs; co-prescribe a proton pump inhibitor with NSAIDs. Avoid if the patient takes aspirin.

Osteoarthritis

According to NICE, what pharmacological treatments are not recommended for osteoarthritis?

Paracetamol, weak opioids, glucosamine, and strong opioids.

Osteoarthritis

What non-pharmacological treatment options are mentioned for knee and hip osteoarthritis?

Walking aids and intra-articular steroid injections.

Osteoarthritis

When is joint replacement (arthroplasty) considered for osteoarthritis?

Considered if conservative methods fail. Joint replacement is the most effective treatment for patients with significant pain.

Osteoarthritis

What are the selection criteria for joint replacement in osteoarthritis patients?

Approximately 25% of patients are younger than 60 years. Obesity, although thought to be a barrier, only slightly increases short-term complications with no difference in long-term joint replacement survival.

Osteoarthritis

Describe the most common type of operation for hip replacement, and mention an alternative for younger, more active patients.

The most common is a cemented hip replacement. An alternative is uncemented hip replacements, more popular in younger, more active patients.

Osteoarthritis

What is the advantage of hip resurfacing in joint replacement surgery?

Preserves the femoral neck, potentially useful if conventional arthroplasty is needed later in life.

Osteoarthritis

What post-operative care do patients receive after joint replacement for osteoarthritis?

Patients receive both physiotherapy and a course of home exercises.

Osteoarthritis

What assistive devices are typically used for up to 6 weeks after hip or knee replacement surgery?

Walking sticks or crutches.

Osteoarthritis

What basic advice should patients who have had a hip replacement receive to minimize the risk of dislocation?

Avoiding flexing the hip > 90 degrees, avoiding low chairs, not crossing legs, and sleeping on the back for the first 6 weeks.

Osteoarthritis

What complications are associated with hip or knee replacement surgery?

Wound and joint infection, thromboembolism (NICE recommends low-molecular-weight heparin for 4 weeks following hip replacement), and dislocation.

Osteoarthritis