OSTEOARTHRITIS – DIAGNOSIS, TREATMENT AND SURGERY Edited by Qian Chen Osteoarthritis – Diagnosis, Treatment and Surgery Edited by Qian Chen Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. 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Publishing Process Manager Vana Persen Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published February, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Osteoarthritis – Diagnosis, Treatment and Surgery, Edited by Qian Chen p. cm. 978-953-51-0168-0 Contents Preface IX Part 1 General Treatment of OA 1 Chapter 1 Long-Term Treatment of Osteoarthritis Pain: Achieving a Balance Between Efficacy and Tolerability for a Successful Chronic Therapy 3 Mila Etropolski Chapter 2 Characterization of Live and Experimentally Degenerated Hyaline Cartilage with Thermal Analysis 27 Gellért Sohár, Piroska Szabó-Révész, Kálmán Tóth and Zoltán Aigner Chapter 3 Topical and Regional Treatment for Osteoarthritis 47 Leena Patel and Charles Mackworth-Young Chapter 4 Intra-Articular Injections for the Treatment of Osteoarthritis: Focus on the Clinical Use of Several Regimens 67 Dong Rak Kwon and Gi Young Park Chapter 5 Hyaluronic Acid in the Treatment of Osteoarthritis: What is New 101 Michele Abate and Vincenzo Salini Chapter 6 Gene Therapy for Human Osteoarthritis 123 Magali Cucchiarini and Henning Madry Part 2 Alternative Treatment of OA 141 Chapter 7 Peloidotherapy in Osteoarthritis-Modulation of Oxidative Stress 143 Viorica Marin, Olga Surdu, Daniela Profir and Sibel Demirgian Chapter 8 Ginger and Osteoarthritis 157 Tessa Therkleson VI Contents Part 3 OA in Upper Extremity (Hand, Wrist, Shoulder, and Elbow) 169 Chapter 9 Osteoarthritis of the Wrist 171 Nimit Patel, Glenn Russo and Craig Rodner Chapter 10 Osteoarthritis of the Trapeziometacarpal Joint (TMJ): A Review of the Literature 203 Oliver Boughton and Hugh Mackenzie Chapter 11 Low Level Laser Therapy in the Treatment of Temporomandibular Joint Arthritis: Questions and Answers 211 Marini Ida and Gatto Maria Rosaria Part 4 Diagnosis of OA in Lower Extremity (Hip, Knee, and Ankle) 225 Chapter 12 Treatment Preferences in Patients with Knee or Hip Osteoarthritis: An Overview 227 Amado Rivero-Santana, Lilisbeth Perestelo-Perez, Jeanette Perez-Ramos, Marien Gonzalez-Lorenzo and Pedro Serrano-Aguilar Chapter 13 The Plica: Is a New Aetiological Factor in the Knee Osteoarthritis? 243 Ahmet Guney and Ibrahim Kafadar Chapter 14 Knee Osteoarthritis and Associated Periarticular Conditions: Iliotibial Band Friction and Baker Cyst 253 Violeta Vasilevska, Ulrike Szeimies, Milan Samardziski and Axel Stäbler Chapter 15 Evaluation of In Vivo Proteolytic Activity 265 Wataru Yoshida, Akihisa Kamataki, Miwa Uzuki and Takashi Sawai Chapter 16 Phonoarthrography: A New Technique for Recording Joint Sounds 275 Hassan M. Bassiouni Part 5 Sugery of OA in Lower Extremity (Hip, Knee, and Ankle) 289 Chapter 17 Surgery for Osteoarthritis of the Knee 291 J.R. Lewis and R.L. Carey Smith Contents VII Chapter 18 High Tibial Open-Wedge Osteotomy – New Techniques and Early Results 319 Werner Kolb, Hanno Guhlmann, Christoph Windisch and Klaus Kolb Part 6 Treatment of OA in Lower Extremity (Hip, Knee, and Ankle) 347 Chapter 19 Ultrasound Guided Hip Injection Techniques 349 Micu Mihaela Cosmina Chapter 20 Hyaluronate for the Treatment of Ankle Osteoarthritis 367 Shu-Fen Sun, Chien-Wei Hsu, Yi-Jiun Chou, Yu-Nong Wang and Mei-Chia Chou Chapter 21 Knee Health Promotion Option for Osteoarthritic Knee: Cartilage Regeneration is Possible 379 S.R. Lyu, D.S. Liu, C.E. Tseng, H.S. Wang and L.K. Chau Preface Osteoarthritis is one of the most debilitating diseases worldwide. Millions of people suffer from pain and disability associated with this disease. There are two major types of OA: primary and secondary. The primary OA is associated with aging. While people live longer and longer, the prevalence of OA becomes more prominent. It is expected that the percentage of the people who suffer from OA will continue to rise in the coming decades. The secondary OA is a consequence of injury to the joints. It is often associated with sports injury and/or other traumatic events. Thus, it often occurs in young people and adults who enjoy an active life style. Although the direct damage to the joint such as rapture of the ligaments is often repairable by surgery, the patients nevertheless would likely suffer from degeneration of the joint cartilage later in life. My connection to OA is several fold. Because of the prevalence of OA, many of us know family members and/or friends who suffer from the disease. I am no exception. My mother suffered from both rheumatoid arthritis (RA) and OA. Although she also suffered from other diseases, she complained most about arthritis. Some of the other diseases might be more life-threatening; however, none of them brought as much pain and restrained her to bed on a daily basis as arthritis. She often said that life is not worth living if there is no quality. After her RA was brought under control by new drug therapy and both her knees were replaced by surgery, her pain became manageable and her mobility was regained. She was able to perform daily routine activities by herself that many of us take for granted, such as going to the bathroom, standing up after sitting, and walking the stairs. Her outlook on her life in the old age was brightened significantly because of the new treatment and surgery. As a biomedical researcher, I was fascinated by the intricate process of cartilage development and aging since I was a young graduate student. The research was driven primarily by interest and curiosity. However, my mother’s life experience and my interactions with other arthritis patients brought urgency as well as practicality into the basic research we were conducting. The basic knowledge gained from research must be translated into new methods of diagnosis, treatment, and surgery for patients. That is the most direct and effective way to improve the life quality of patients. X Preface So far, there is no FDA approved disease modified drugs for OA. Joint replacement surgery remains the last, and perhaps the most effective way to restore the functions of the joint. Due to these circumstances, a multifaceted approach is needed to improve the current treatment as well as to develop new therapy for the future. We need to emphasize the improvement not only diagnosis and treatment of OA, but also the surgery to restore the function of the joint. We need to consider not only mechanistically driven research, but also alternative medicine that has been in practice in treating OA related symptoms in different parts of the world for long time. Based on these guiding principles, we have included a variety of articles written by physicians and OA researchers from different parts of the world. The topics of the articles include general as well as alternative treatment of OA, diagnosis of OA in upper extremity (hand, wrist, shoulder, and elbow) as well as in lower extremity (hip, knee, and ankle), and common strategies for treatment as well as surgery of OA. We hope that this book serves as a comprehensive resource for professionals as well as patients who are interested in learning the state-of-the-art of OA diagnosis, treatment, and surgery. To borrow a Chinese proverb 抛砖引玉 (cast a brick to attract jade), we hope that this compilation of a variety of articles in this book, some of which are non- traditional or even provocative, may serve as a precursor to the breakthrough in developing new therapy and treatment of OA in the future. Qian Chen, Ph.D. Alpert Medical School of Brown University, Providence, RI, USA . OSTEOARTHRITIS – DIAGNOSIS, TREATMENT AND SURGERY Edited by Qian Chen Osteoarthritis – Diagnosis, Treatment and Surgery Edited by Qian Chen. due to changes in diet and Osteoarthritis – Diagnosis, Treatment and Surgery 6 exercise habits was associated with significant improvements in physical functioning and mobility (Messier. mechanisms involved in osteoarthritis pain (Flood, 2010). Osteoarthritis – Diagnosis, Treatment and Surgery 8 In general, results from the published literature indicate that at standard recommended