Adjuvant drugs in management of osteoarthritis: spotlight on type II collagen

Osteoarthritis (OA) is a common musculoskeletal disorder that affects large and small joints and is seen in all ages due to diverse aetiologies. Pain, joint stiffness and limitation of daily activities affects the quality of life of individuals with OA. Conventional analgesics like non-steroidal anti-inflammatory drugs affect pain and inflammatory component but do not target the disease pathogenesis. Damage to the joint cartilage is central to the pathogenesis of OA. Better understanding of the pathogenesis has led to evolution of various adjuvant drugs in management of OA. Among them, undenatured type II collagen induces immune tolerance and thereby provide benefits by reducing the joint damage. Studies assessing efficacy and safety of undenatured type II collagen in OA have shown to reduce clinical symptoms like pain, joint stiffness and improvement in physical activities, and thus improving the quality of life. It is well tolerated and safe for use in OA. This article discusses the pathophysiology of OA with inflammation and beyond, and overviews the various drugs that are used as adjuvants in the management of OA with special focus on the use of type 2 collagen

Evaluation of Ponseti method in correction of congenital talipes equinovarus

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications.Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot

Effect of Homoeopathic treatment on Activity of Daily Living (ADL) in Knee Osteoarthritis: A prospective observational study

Objectives: To investigate the effect of individualized homoeopathic medicines in improving ADL by reducing pain, stiffness and limiting the disease progress. Materials and Methods: 131 consecutive patients with OA of knee were recruited and followed up for minimum period of twelve months. Two orthopaedic surgeons diagnosed the disease based on clinical examination of the patients. Three trained homoeopathic physicians prescribed individualized homoeopathic simillimum and the patients were evaluated for pain on WOMAC Osteoarthritis Index LK3.1 (IK) survey form measuring pain, stiffness and ADL. The pain was also measured on Numerical pain rating scale for confirmation. Result: Individualized homoeopathic medicines prescribed as per law of similia improved the mean ADL from 35.85 to 19.08 (p- 0.0001). Mean pain on WOMAC Osteoarthritis Index survey form improved from 10.50 to 5.48 (p-0.0001). The mean pain score on NRS improved from 6.34 to 3.77 (p-0.0001) and the mean morning stiffness also improved from 4.55 to 2.18 (p-0.0001). Conclusion: Homoeopathic medicines have potential to improve the ADL of OA patients by reducing pain and stiffness and limiting progress of the disease without any adverse systemic effects and can safely be employed as a comprehensive health care therapeutics

Evaluation of Ponseti method in correction of congenital talipes equinovarus

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications.Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot