KNEE

Gravidity, parity and knee breadth at midlife: a population-based cohort study

Study population

This study utilized a subsample of prospective, population-based Northern Finland Birth Cohort 1966 (NFBC1966)¹⁶. Initially, NFBC1966 comprised pregnant women living in Northern Finland (i.e. the provinces of Oulu and Lapland) whose expected delivery dates fell between Jan 1 and Dec 31, 1966. The cohort included 12,068 mothers and 12,231 children, with a coverage of 96% of all births during 1966 in Northern Finland. Prospective data collection began in the 16th gestational week, and the NFBC1966 participants have been followed ever since. Broad questionnaires and clinical examinations have been used to gather information on the participants’ health status and lifestyle habits.

At age of 46, a total of 5861 individuals responded to questionnaires and participated in clinical examinations. Of them, 1946 individuals residing in the Oulu region (100 km radius) underwent radiography of the knee joint. Of these, 1131 individuals were excluded due to (1) male sex, (2) missing reproductive or confounder data, (3) previous knee surgery, (4) bone pathologies in the radiographs (mostly osteoarthritic changes), or (5) technically inadequate radiographs. Thus, the final sample of this study comprised 815 women.

Knee measurements

Knee breadth measurements were taken from digital radiographs of the right knee joint (Fig. 1) by an author of the study (A.K.). A detailed description of the procedure has been given in a previous publication¹⁷. Radiographs were accessed and measured using neaView Radiology software version 2.31 (Neagen Oy, Oulu, Finland). Posteroanterior radiographs were utilized, with individuals positioned in fixed flexion view^18,19.

Figure 1

Knee measurements. FCML mediolateral breadth of femoral condyles, TPML mediolateral breadth of tibial plateau. Diameter of the calibration disc: 30 mm.

The following measurements were taken from each radiograph: (1) mediolateral breadth of the articular surface of the femoral condyles (FCML), and (2) mediolateral breadth of the articular surface of the tibial plateau (TPML). FCML was measured by drawing a line tangential to the inferiormost points of the femoral condyles; this line was transposed to the widest part between the femoral condyles. TPML was measured as close to the border of the tibial plateau as possible. Measurements were recorded to the nearest 0.1 mm. The initial measurements were converted into true sizes with the help of a metal calibration disc of 30 mm in diameter attached on the participant’s right leg. The technical error of measurement (TEM) and relative technical error of measurement (rTEM) were reported by Keisu et al.¹⁷, and the repeatability was high for all the measurements (TEM 0.1–0.5 mm, rTEM 0.1–0.6%).

Reproductive history

In the 46-year follow-up questionnaire, women were asked about the number of deliveries, ectopic pregnancies, miscarriages and abortions they had undergone during their lifetime. As described in a previous publication²⁰, gravidity was calculated as the overall number of pregnancies, and parity as the number of deliveries of each woman. Women with no deliveries were classed as ’nulliparous’, those with one delivery as ’primiparous’, and those with a history of several deliveries were classed as ‘multiparous’. Those with ≥ 5 deliveries were classed as ‘grand multiparous’.

Confounders

In the clinical examination at the age of 46, a study nurse systematically measured the height and weight of each individual. Body mass index (BMI) in kg/m² was calculated as weight divided by height squared.

Education, smoking history and leisure-time physical activity were elicited in the 46-year follow-up questionnaire. Education years, a proxy for socioeconomic status, was determined by asking: ‘What is your basic education? (1) Less than 9 years of elementary school, (2) elementary school, (3) matriculation examination’; and What is your vocational education? (1) None, (2) occupational course, (3) vocational school, (4) vocational college, (5) polytechnic, (6) university, (7) other, (8) unfinished course’. The responses were classed according to the Finnish education system as follows: < 9 years, 9–12 years, or > 12 years.

Smoking history was elicited using two questions: (1) ‘Have you ever smoked cigarettes (yes/no)?’ and (2) ‘Do you currently smoke (yes/no)?’. Individuals were classed as non-smokers, former smokers, or current smokers.

Leisure-time physical activity was elicited by asking: ‘How often do you participate in brisk physical activity/exercise [defined as causing at least some sweating and breathlessness] during your leisure time? (1) Daily, (2) 4–6 times a week, (3) 2–3 times a week, (4) Once a week, (5) 2–3 times a month, (6) Once a month or less often. The responses were regrouped as follows: < 1 times/week, 1–3 times/week, or ≥ 4 times/week.

Statistical analysis

SPSS software (IBM, Armonk, NY, USA) version 27, 64-bit edition was used for the statistical analyses. P values < 0.05 were considered statistically significant. Means with standard deviations (SDs), medians with interquartile ranges (IQRs) and percentages with frequencies were used as descriptive statistics. Characteristics of the sample were presented before and after stratification by parity.

The associations of gravidity and parity with knee breadth (i.e. FCML and TPML in mm) were analyzed using general linear models. Beta coefficients, 95% confidence intervals (CIs) and P values were documented from the output. Models were first constructed without adjustments (unadjusted models), and then confounder variables were added (adjusted models). Gravidity and parity were modelled as continuous variables (where beta coefficients are interpreted relative to one pregnancy/delivery), and by comparing groups with each other (e.g. multiparous vs. others, where beta coefficients represent mean difference between groups).

Ethical considerations

The study adhered to the principles of the Declaration of Helsinki, with voluntary participation and signed informed consent. Sensitive details were replaced by anonymous identification codes. The Ethics Committee of the Northern Ostrobothnia Hospital District approved the study.

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Originally Appeared Here

ROM Technologies: How Far Knee Recovery Technology Has Come

HARTFORD, CT, July 23, 2022 /24-7PressRelease/ — It is often said that a knee is simply not a knee post-surgery. As is the case with so many aspects of our lives and bodies that we take for granted. We scarcely realize how much pressure a joint like the knee must endure to keep us moving smoothly and pain-free. Of course, this is until something goes wrong and we need surgery to correct it.

While knee surgeries are sometimes the best option, they have come a long way. Improvements have been primarily due to the changes in medical knowledge and available technologies.

How ROM Technologies is Changing the Game

As stated prior, technology has done wonders to improve the results we experience from undergoing knee surgery. Much of this is due to changes in post-surgery knee recovery technology. ROMTech is a leading organization in pre-op and post-op knee surgery recovery.

Knee replacement is the most popular surgical option. In the past, this would leave recipients with stiff knees that would not help them move or function as efficiently as they desired. Today, the opposite is true.

Today, athletes can undergo knee replacement surgery and, with strategic rehabilitative work, find that they can work their way back to peak capacity. Thanks to leading medical technology organizations, having a knee rehabilitation resource helps ensure that patients can recover as quickly and efficiently as possible with smooth, pain free movement.

Knee replacement surgery no longer means that a sporting career has to end or that daily life has to be significantly hampered. Thanks to ROMTech’s work in producing high-quality joint replacement material, their work is not only limited to knees.

ROM Technologies PortableConnect actually used in both knee and hip patients rehabilitation as well. This makes sense, as a debilitatingly injured or arthritic hip can impact the knees negatively and vice versa. It makes sense that these key features of the lower extremities are considered in tandem.

How to Get Started Working with ROMTech

Since their PortableConnect device enables knee and hip recovery it is easy to see what their focus is on, improving quality of life. Sometimes people with knee and hip issues may be concerned with having to do a procedure.

However, the advancements in ROM Technologies help ensure that higher-quality replacements help reduce the likelihood of the same. As such, they encourage anyone who may need replacement surgery (irrespective of age or even profession) to have it done sooner rather than later.

—
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Originally Appeared Here

Report: Vikings TE Irv Smith Jr. to undergo knee surgery, miss start of season

Viking tight end Irv Smith Jr. spoke after Friday night’s preseason finale in Kansas City about a potentially “scary” lineup set to be unleashed for the Vikings offense. He’d played 11 of 12 snaps with the first-team offense in two series against the Chiefs — leading the way by catching both of his targets for 39 yards — before taking a seat in the 28-25 loss. There was no indication he wouldn’t be part of that Week 1 lineup on Sept. 12 in Cincinnati.

But Smith reportedly will miss “at least the start of the regular season,” according to NFL Media, as he’s expected to undergo knee surgery to fix a meniscus injury. The Vikings had no media access Sunday; coach Mike Zimmer is scheduled to give a news conference on Monday morning.

Smith, the 2019 second-round pick, was a strong candidate for a breakout season as he stepped into a starting role vacated by Kyle Rudolph this offseason. Further boosting expectations was Smith’s strong training camp in which he was a go-to target for quarterback Kirk Cousins and the play-action passing game.

Smith offered no indication after Friday’s game that anything was wrong with his health, walking away from the podium without issue after projecting optimism about a struggling offense that played without running back Dalvin Cook and receiver Justin Jefferson during a winless preseason.

“I think it’s going to be very scary, honestly,” Smith said of the Vikings offense. “We have a lot of talent on this offense. We’re just excited to get to it. It’s been a long camp. Now, we’re almost to that time.”

The Vikings offense will have to wait a little longer before it can be at full strength. Smith’s injury moves No. 2 tight end Tyler Conklin into a starting role. Conklin hasn’t played this preseason while dealing with a hamstring injury. The Vikings also have Brandon Dillon, rookie fifth-round pick Zach Davidson and undrafted rookie Shane Zylstra at the position.

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Bristol hospital backlog sees hip and knee patients sent home early after surgery

Hip and knee surgery patients are being sent home from Southmead Hospital early in a drive to get through a backlog of elective operations caused by the pandemic.

Patients who have had a hip or knee replacement and are deemed suitable for ‘hospital at home’ support are being discharged after two days, rather than the usual five days.

Councillors expressed concern about post-operative patients getting three fewer days of hospital care, but a hospital chief assured them the initiative was safe at a public meeting last month.

READ MORE:Coronavirus infection rates across 47 areas of Bristol still above UK average

Elective waiting lists grew during the coronavirus pandemic as NHS hospitals did not have the staff or facilities to carry out all booked procedures as well as provide treatment for Covid-19 and other patients.

By the end of April, 6,425 patients had been waiting for elective surgery for more than a year, and 41 had been waiting for more than two years, across Bristol, North Somerset and South Gloucestershire, a report to the meeting said.

The NHS Clinical Commissioning Group (CCG) for the region was subsequently chosen along with 11 other areas to participate in a government ‘accelerator’ pilot to speed up the delivery of elective operations.

It introduced the early discharge scheme at Southmead Hospital as part of a raft of pilot initiatives paid for with £8.5million of capital funding.

Kingswood councillor April Begley, who is a member of South Gloucestershire’s health scrutiny committee, said: “To take three days away from five is actually quite a lot.”

But Evelyn Barker, deputy chief executive at North Bristol NHS Trust, which runs Southmead Hospital, assured her the orthopaedic supported discharge scheme was well managed.

‘People aren’t just pushed out the door’

Ms Barker said hip and knee replacement patients are assessed for their suitability for early discharge, some are transferred to step-down beds in the community instead of being sent home, and those who are sent home are managed by a dedicated ‘hospital at home’ team of doctors, nurses and physiotherapists.

“People aren’t just pushed out the door home without any support,” she said.

Ms Barker, who is responsible for the accelerator pilot at the CCG, said she was hopeful it would reduce elective surgery waiting times over the coming months.

The initiatives are designed as far as possible not to put extra pressure on NHS staff who have been through the “worst year” in NHS history, she said.

They included ordering more hospital equipment and ‘modular theatres’, as well as extending some outpatient clinics by an hour a day.

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Efforts at Southmead suffered a blow last month when the hospital came under intense pressure from a rising number of Covid cases, emergency patients, and people suffering from the winter diarrhoea and vomiting bug norovirus, just as more and more staff were having to self-isolate amid the so-called ‘pingdemic’.

“We’ve absolutely had everything thrown at us that we could possibly think of,” Ms Barker told the health scrutiny committee on July 28.

She said Southmead had only one of three wards left for elective surgery patients, having lost at least one to emergency patients.

Three wards in the hospital were being used for norovirus patients.

Two wards were for Covid patients but this has since dropped to one, a spokesperson for the hospital trust said.

The spokesperson said: “Orthopaedic Supported Discharge is a scheme that is currently only being offered by North Bristol NHS Trust, but with a view to rolling it out elsewhere in the future.

“It is offered to appropriate patients who are screened in advance to check their suitability and ensure they meet key criteria, such as having someone at home with them. It only relates to knee and hip replacement surgery.”

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Originally Appeared Here

How to Prepare Your Home Before Hip or Knee Surgery

If you’re worrying about how to prepare your home before hip or knee surgery, this article should help you enormously.

First important tip: set up your home BEFORE you go to the hospital. This will make it easier for you to recover and to live in comfort when you return. This should be done well in advance.

Ask your doctor or physical therapist to get your home ready.

Advance Home Preparation Makes It Easier

Make sure that everything is easily accessible and on the main floor (or wherever you spend most of your time.) Limit the amount of stairs you use per day to one.

A bed should be low enough that your feet touch the ground when you are seated on the edge.
If possible, place your bed on the main/first floor. Although you don’t necessarily need a hospital bed for your comfort, your mattress should be firm.
You should have a toilet or portable commode located on the same floor as where you spend most of your time.
You can stock up on canned and frozen food, toilet paper and shampoo.
Buy or make single meals that can be frozen then reheated.
You should be able to reach all the things you need without bending or getting on your knees.
Place food and other supplies in a cabinet that is at your waistline and shoulders.
Place glasses, teapots, and any other items that you use often on the kitchen countertop.
You must be able to reach your phone. You can use a portable phone to get around.
In the kitchen, bedroom, bathroom and any other areas you use, place a sturdy chair. You will be able to sit comfortably while you complete your daily tasks.
Attach a bag or small basket if you plan to use a walker. You can keep your phone, notepad, pen and other essential items in the bag. A fanny pack can also be used.

It is possible that you will need assistance with bathing, toilet use, cooking, shopping, going to doctor visits, exercising, and even running errands. Ask your provider to send a caregiver to your home if you don’t have anyone to help you for the first few weeks following surgery. This caregiver can help with daily activities and check on the safety of your home.

You might also be interested in these other items:

Shower sponge with a long handle
A long-handled shoehorn
A cane, crutches, or a walker
You will need a reacher to pick up items from the ground. Put on your pants and take off your socks.
Help you put on your socks with a sock aid
To help you stay steady, use the handles bars in your bathroom.

(Amazon has a Hip – Knee Replacement Kit that may be of interest.)

Bathroom Setup for Easier Use After Knee or Hip Surgery

You can reduce your knee flexion by raising the height of the toilet seat. This can be done by installing a seat cover, an elevated toilet seat, or a safety frame for the toilet. A commode chair can be used in place of a toilet.

Safety bars may be required in your bathroom. Grab bars should be attached vertically or horizontally to a wall, and not diagonally.

Towel racks should not be used as grab bars. They will not support your weight.
Two grab bars are required. The first helps you to get in and out the tub. The other assists you in standing from a sitting position.

There are many ways to make sure you’re safe when you take a shower or bath.

To prevent falls, place non-slip silicone decals or rubber suction mats in the tub.
For firm footing, use a non-skid bathmat outside the tub.
Dry the floors outside of the bathtub or shower.
You can place soap and shampoo anywhere you don’t need to stand, reach, or twist.

Take a shower in a chair or a bathtub.

Rubber tips are recommended for the bottom.
If the seat is to be placed in a tub, you can buy a chair without arms.

Avoiding Falls and Tripping In Your Home After Surgery

Avoid tripping hazards in your home.

To move from one room to the next, remove any wires and cords.
Take out any throw rugs that are not in use.
Doorways with uneven flooring should be repaired. Use good lighting.
Install night lights in darkened rooms and hallways.

You may trip if your pet is small or moves around a lot. Consider letting your pet live with a friend or in a kennel for the first few weeks of your stay.

When you’re walking, don’t carry any items. Your hands may be required to balance. To carry your phone and other items, a small backpack is a good option.

You can practice using a walker, crutches or a wheelchair. It is important to learn how to:

You can get in and out of a seat easily
After using the toilet, sit down and then stand up.
Shower in the morning and get out at night
The shower chair can be used
Stairs can be used to ascend and descend

Is it possible to prevent hip surgery or replacement altogether?

NJ Woman First in Country – Robotic Total Knee Replacement

Eugenia Dziopa has always been an avid walker, enjoying daily walks through her northern New Jersey neighborhood. But two years ago he began to experience left knee pain from degenerative arthritis.

“I realized I couldn’t walk far anymore,” says Eugenia, who was 64 at the time. “If I were even half a block away, or even from the parking lot to work, I would be in pain. That was my breaking point and I knew I needed to see an orthopedic specialist. ”

Eugenia made an appointment with Yair D. Kissin, MD, vice president of orthopedic surgery at Hackensack University Medical Center, the same hospital where Eugenia works as a biorepositive technologist.

“The rule is when a person begins to see a decrease in their function and ability to do things that make them happy on a day-to-day basis, they should seek help,” Dr. Kissin says. “There are non-operational means that we almost always try first. Initially, we did conservative treatments for Eugenia, including physiotherapy followed by injections. In the case of Eugenia, those did not work.

Eugenia adds: “I thought I would get physiotherapy and improvement, but it only helped a little. Steroid injections only gave me temporary relief that lasted one day at a time. ”

In early 2020, Hackensack became the first hospital in the country to offer patients new robotic technology for total knee replacement procedures for patients with degenerative bone or bone arthritis. Thus, in January of that year, Dr. Kissin discussed this new surgical option with Eugenia.

“The moment was impeccable,” Dr. Kissin recalls. “About a week after Hackensack acquired the technology, he was looking for a good candidate. Since Eugenia had been my patient for a while, I had a good relationship with her. I thought he was the right person to talk about this technological advancement. ”

Robot Technology to the Rescue

With the new robotic technology, preoperative planning allows the surgeon to design and prepare, in a virtual environment, the patient’s personalized joint replacement surgical plan. The active robot helps the surgeon execute the preoperative surgical plan with automated cutting and hands-free and removal of diseased bone and cartilage. The technology helps surgeons with optimal joint implant placement based on each patient’s unique anatomy.

In February 2020, Eugenia became the first patient in the country to have a total knee replacement with the new robotic technology after it became commercially available.

“Everything went really well,” Dr. Kissin says. “Eugenia spent two nights in the hospital. Two weeks later, he returned for a postoperative visit, underwent physical therapy, and was already in 90-degree motion. When he saw me at three months, I had 120 degrees of movement, which is normal, without taking pain medication or using a cane.

Dr. Kissin has performed more than 60 joint replacement procedures with the new robotic technology, which is the only active robot system commercially available for total knee replacement that supports an open implant library, giving surgeons the choice of implantation options according to the individual needs of each patient. .

“This is the future of orthopedic surgery and knee replacement,” says Dr. Kissin. “Hackensack is ahead in doing it now.”

Life after knee replacement

In August 2020, just six months after her total knee replacement, Eugenia felt like her old person before she had knee pain.

“I am very happy to have decided to do a total knee replacement and I am grateful to have the option to perform robotic surgery,” she says. “Otherwise, I would just be sitting. I was in so much pain. There really was no alternative. The addition of the robot gave me confidence that the procedure would be precise and precise ”.

In February 2021, Eugenia celebrated the milestone of a year after surgery.

“I can walk more than a mile through my neighborhood with no problems,” he says. “I also take the stairs to work now instead of the elevator to get extra exercise. I can do everything I do before I have knee problems. ”

Eugenia is grateful that she made the decision to have the surgery because it has allowed her to enjoy family time again.

“I have my normal life back. I have grandchildren and I can walk with them. My life is so much better now than it was before a knee replacement surgery, ”he says.

Dr. Kissin could not be more pleased with Eugenia’s result. “Ten years from now, when everyone gets a robotic knee replacement, Eugenia will probably think she was one of the first,” she says.

Next steps and resources:

Material provided through HealthU is intended for use as general information only and should not replace the advice of your physician. Always consult your doctor for individualized care.

For Severe Arthritis Pain, Are Multiple Joint Replacements a Good Idea?

After several joint replacement surgeries, Lorry Graham jokingly calls herself a “bionic woman.” Friendly and optimistic, the 75-year-old Delaware resident always enjoyed an active lifestyle. And she always felt younger than her chronological age. Therefore, when arthritis caused by wear and tear began to cause an unpleasant weight on the knees and hips, she refused to take it sitting. Over the past six years, she has had four joint replacements at New York City’s Special Surgery Hospital (HSS), both her knees and her two hips, so she can enjoy life without pain.

“The pain was very, very limiting. It was affecting my quality of life and I didn’t want to live like that, ” she says. She decided to do something about it and researched a lot. “There were three main factors I considered before surgery,” she explains. “The first was the best hospital I could find, which was HSS. The second was the best surgeon I could find. And the third component was my mental attitude and my willingness to do the work after surgery to get the best result. ”

For each joint replacement surgery, Ms. Graham, a former high school teacher and advisor, made the trip from her home in Delaware to HSS in New York City. “I always knew I had to do it. I love walking, I love shopping, I love playing with my grandchildren, ” she explains. “And arthritis made me limp, it hurt, it affected my sleep. This type of pain is shown on the face. You are not a happy person. I didn’t want to delay the surgery any longer than I had to. ”

Her doctor, Geoffrey Westrich, MD, who specializes in knee and hip replacements in HSS, says it’s not uncommon for patients to have advanced arthritis in two joints. Having four joint substitutions is less common, but it does happen. He recommends that patients considering various joint replacement surgeries do their research to find a high-volume joint replacement center and an experienced orthopedic surgeon who takes the time to answer all their questions and who they are comfortable with. .

“When someone has more than one joint replacement, timing and recovery are important and no two patients are alike,” says Dr. Westrich. “If someone has painful arthritis in both knees, for example, and conservative treatments like physiotherapy and over-the-counter medications offer no relief, we usually wait about three months between surgeries. It’s the time it takes the body to heal. and the time it takes to do physical therapy and make the muscles strong again. Patients will support their weight with the side that underwent the first surgery. ”

Dr. Westrich adds that a critical factor is the surgeon’s experience in knowing when it is safe to proceed with the next joint replacement. That’s why, after the first postoperative visits, Dr. Westrich sees the patients again after six weeks to make sure they are doing well, and sometimes after three months, before proceeding with a second joint replacement.

These days, on the same day, double replacements of the joints are performed less frequently, as Dr. Westrich and other HSS researchers have found that it is best for most patients to have “in-phase” procedures, that is, to have the surgeries performed at least months apart. “In studies, we have found that bilateral knee replacement surgery on the same day can present more challenges for the patient from a medical point of view, more pain medications are needed after surgery and physiotherapy is much more difficult because they don’t have a good standing leg, so to speak, ”he says.

Dr. Westrich points out that sometimes there is a good reason to perform a bilateral joint replacement on the same day. For example, both arthritic knees may have a severe flexion contracture, meaning they are in a bent position and the patient cannot straighten them. “In these cases, it may be appropriate to do a double joint replacement, as physiotherapy can be much more difficult if the unoperated knee is bent.” He adds that if the contracture is not too severe, a shoe lift can equalize the length of the legs and allow the patient to do physical therapy after two different procedures.

Mrs. Graham had four different surgeries and, less than two months after her final hip replacement in May, said she was feeling very well. “I am shaking this, I am totally shaking it. I went to play mahjong with my friends and when I came in, they couldn’t believe how good I looked and how good I was doing.”

She believes her mental attitude and willingness to work hard in rehabilitation after surgery played an important role in optimizing the outcome of each joint replacement. Dr. Westrich agrees that going in with a positive attitude and dedicating yourself to work can improve outcomes.

“Clearly, Lorry Graham was very interested in his recovery and worked very hard after the surgery to get a good result,” he notes. “There is no doubt that patients who work hard and spend a lot of time on physiotherapy tend to progress faster and have a better overall recovery.”

Just two months after her last hip replacement, Mrs. Graham visited a new New York City park with her friend and walked for more than an hour without pain. “I walk everywhere,” she says. “I am doing better than in the last six years. It feels great. ”

No Knee Replacement Necessary? Perhaps, with High-Tech Knee Brace

A California robotics company is about to launch a high-tech knee brace that can alleviate the suffering of millions of Americans facing knee osteoarthritis. It can be especially appealing to patients who want to avoid knee replacement surgery.

San Francisco-based Roam Robotics said its $ 7,000 Ascend orthosis should begin shipping this winter. Certified by the FDA as a Class 1 medical device, Roam provides for reimbursement for both Medicare and private insurance. Medicare could cover 50% or more, and private insurance could cover the entire cost in some cases, Roam says.

Roam Robotics CEO Tim Swift

Roam is located in San Francisco’s Mission district, across the street from Oltrelab, an engineering company that has awarded tens of millions of dollars in government research contracts, primarily for robotics and energy projects. Roam is one of several emerging companies emerging from Altrelab. Its founder and CEO Tim Swift is a veteran of Ekso Bionics, a pioneer in the field of the exoskeleton. After working on heavy, super-expensive exoskeletons, Swift concluded that a radical move away from conventional designs was needed if exoskeleton technology became accessible and affordable.

“Our goal is not to build cyborgs. It’s to make people more human than they ever were.”

“I think we have the ability to change the relationship that people have with robots on a scale that has never been considered before,” Swift says. “I don’t want people to see robots as something beyond human beings. Our goal is not to build cyborgs. It’s about making people more humane than they ever were. ”

Ascend is made of lightweight carbon fiber and high-strength fabric. The pneumatically powered device is connected to a rechargeable battery that is carried in the backpack. Custom knee arm sensors provide real-time data to Ascend microprocessors, where proprietary algorithms detect the user’s intent and then extend and flex the knee. Ideally, this relieves pain and increases patients ’ability to navigate stairs and master simple daily activities.

Rowan Paul, a sports medicine doctor who has consulted with Ascend, says he may like those who are reluctant to use a cane because of the stigma of disability it entails. Knee strengthening makes them look like an athlete with an injury, he says. Ascend can also reduce or eliminate the need for opioid pain medications or cortisone injections, which offer temporary relief from osteoarthritis, but are at risk for side effects.

“I’ve seen several patients, where if we can just give them a little help in a very specific and precise way, they don’t need to do a knee replacement,” Paul says.

Roam market research places the number of patients living with severe pain and limited mobility due to knee osteoarthritis at 10 million or more.

The company has opened a storefront in San Francisco where patients can try Ascend driving. Reid Weaver came down from Tacoma, Washington, in June to try one and it was sold with the product. “It’s so comfortable and so light, that you don’t even feel like it’s there,” says Weaver, who spent 19 years as a SWAT police officer in Washington state and now works as a court officer protecting the judges of Tacoma.

The weaver had surgery on his legs after a hiking accident, but surgery exacerbated his osteoarthritis. Weaver, 60, is an avid outdoor enthusiast who played football in college and manages to ride a motorcycle to work. With the Ascend knee put on, Weaver finds that he can go up and down the stairs with ease and was surprised that it was no longer a struggle to get up from a chair, a challenge for many with osteoarthritis in the knees.

“That was a lot more powerful than I thought it would be,” Weaver says. “It basically got me out of the sitting position without using my hands, without moving forward. I think it will change the game.

Angelique Newman-Malone, 52, of San Jose, California, says she felt trapped in her own body from osteoarthritis. After coming across an Ascend ad on Facebook, Newman-Malone wore his knee on several occasions and declared it a gift from God.

“I felt like someone was supporting me, like a partner walking beside me,” he says. “That feeling is amazing.”

But the best advantage for Newman-Malone is that the knee strap allows him to kneel and then stand up. A devoutly religious Christian, she said the ability to kneel when praying is key.

98-year-old Woman Walking Smoothly One Day After Knee Replacement

A 98-year-old woman with severe osteoarthritis of the knee has recently undergone total knee replacement surgery. She was discharged 24 hours after the surgery which was performed using the minimally invasive surgery (MIS) technique at Manipal Hospital.

Dr. Rohan Desai, a hip and knee replacement surgeon, said the patient had seen them a couple of years ago with left knee problems. The need for surgery was not felt then. “About a couple of weeks ago he visited us and, after the examination, it was found that his knee was very deformed. He could not stop or walk and was confined to a wheelchair,” Desai said.

After doing the necessary tests and medical advice, it was decided to do the knee replacement surgery. He suffered from comorbidities such as hypertension, heart problems: pacemakers for 15 years, nephropathy and anemia. Diseases were controlled long before and after surgery. “Medical management of comorbidities is very important for successful surgery. We did it with the MIS technique and, in a few hours, he was able to stop and walk to everyone’s surprise. This is the first time that a 98-year-old boy with comorbidities has undergone such surgery in Goa,” he said.

Manish Trivedi, director of the hospital, said people do not usually undergo these procedures once they reach a certain age, for example, after 60 or 70 years. “It is never too late to undergo any type of medical procedure, after consulting a doctor. The patient in question was able to stand up and walk smoothly only one day after the surgery, ”said Trivedi.

“Rapid mobilization was possible in a few hours, thanks to multimodal analgesia and advances in anesthesia techniques, which we use,” he said.

Patients Waiting for Hip and Knee Surgery “Disproportionately” Affected by COVID-Related Delays

The question: My knee replacement surgery was postponed due to the COVID-19 pandemic. I’m not sure when it will be rescheduled. Knee pain is exciting. What should I do in the meantime?

The answer: Surely you are not alone. Many elective (or non-emergency) procedures were suspended when hospitals cleaned the decks to make way for COVID-19 patients during the various waves of the pandemic.

And patients waiting for knee and hip surgery were disproportionately affected by these delays, according to Dr. Mohit Bhandari, president of the Canadian Orthopedic Association.

As hospitals faced limited time in the operating room, priority was usually given to patients who needed immediate and potentially life-saving surgical care.

Knee and hip replacement cases tend to differ because “they were perceived as lifestyle surgeries, which is the furthest from the truth,” says Dr. Bhandari. “These are restorative surgeries to weaken conditions.”

“This unfortunate lifestyle brand has given priority to some of these patients who are really in agony.”

Prior to the pandemic, the waiting time for knee and hip surgeries ranged from six to twelve months. This wait will now be substantially longer until the pending cases are cleared, Dr. Bhandari says.

Orthopedic surgeons are concerned that their patients will continue to deteriorate during the delay.

It’s vitally important that patients who need a knee or hip replacement stay physically active, says Dr. Vickas Khanna, an orthopedic surgeon and assistant professor at McMaster University in Hamilton.

A targeted exercise program strengthens the muscles that support the knee or hip and can reduce pain. In addition, exercise helps maintain a healthy weight, so there is less pressure on troubled joints.

Doctors often recommend low-impact activities, such as using elliptical machines, swimming, cycling, walking, and Tai Chi.

However, Dr. Khanna easily acknowledges, “It’s hard to tell patients to exercise when they can barely move a knee or hip.”

In these cases, doctors may suggest various treatments to relieve the discomfort.

“Each option has advantages and disadvantages,” explains Dr. Khanna, adding that they can only provide “minimal benefit in people with severe degenerative changes in the joints.”

Therapies include:

An injection of cortisone into the joint can reduce inflammation and stiffness for four to eight weeks. But cortisone should be used judiciously. Research suggests that repeated shots can accelerate the deterioration of cartilage, the shock-absorbing material between bones.
An injection of hyaluronic acid works for about six months. It is a synthetic material that mimics the natural lubricating fluid found inside healthy joints. Unlike cortisone, hyaluronic acid is not associated with cartilage degradation. But the cost is not covered by most provincial health systems. Some private insurance plans will pick up the tab. Patients without this coverage will pay about $ 500 out of pocket for treatment.
Platelet-rich plasma or PRP is said to potentiate the body’s own healing powers and can relieve pain and inflammation for six to 12 months. The blood is drawn from the patient and placed in a centrifuge. The machine rotates the blood, separating it into different parts. Some of the components, such as platelets and growth factors, are used to produce PRP, which is then injected into the sore joint. Sometimes, several injections are given over several weeks. Each injection costs between $ 500 and $ 700.

Dr. Moin Khan, an orthopedic surgeon and assistant professor at McMaster University, says the effectiveness of injections, especially in the case of PRP, can vary from patient to patient. “There are different commercial PRP formulations on the market,” he says, adding that there is a lack of high-quality comparative studies that show which is the best.

In addition to injections, doctors may recommend a custom device that redistributes weight on a worn joint. But again, price can be an issue for certain patients. “A medical fiber orthopedic appliance can cost $ 1,500,” says Dr. Khanna.

There is no doubt that the expense of some of these specialized therapies will put them out of the reach of many people.

Still, “there are a lot of things people can do on their own to maintain muscle strength,” says Dr. Jihad Abouali, an orthopedic surgeon and assistant professor at the University of Toronto.

He notes that the Canadian Arthritis Society website provides information on home exercises for knees and hips.

And, for pain control, doctors often suggest topical painkillers because prolonged use of nonsteroidal anti-inflammatory pills can cause stomach problems.

Despite their best efforts to stay fit, some patients will “get worse while on a waiting list,” says Dr. Bhandari. He believes every effort should be made to provide them with “restorative” surgery. “Pain patients can’t wait.”