Pain free swag to the next athroplasty

Osteoarthritis and intra articular steroids treatment is probably the only way to pain free survival until next athroplasty.

I am not a Texan. Definitely not an American by any means. 

Pathophysiology and disease management based on understanding is my mainstay at every level. 

I have yet to see a more satisfied patient doctor relationship than OA clinic when celestone rémicaine  is the communication of choice. Trigger happy shooting from the hip, all day long. 

No side effects compared to NSAIDS, no squabbles about pharmacy waiting periods. Heck, I have had to inject some difficult customers even before getting their file, just to ease the wrestling in the quieie while waiting, and none leaves without delivering their file for documentation. 

Only justification I use is the intervening periods between the shots. It should preferably be about 6 months for me to face finance department without twitching. I will come down to 3 without a snort though. 

Not enough research done there as the HMO tactics of justifying interventions based on cost tends to be frowned upon in medicine, for good reason, sometimes. 

The complications is when say fibromyalgic patients gate crash to have access to magic results when the word gets out. 

I will allow those provided a reasonably good biokinetist can pre mark the trigger points. And the expectations are accordingly lowered. 

This is as close to anesthesia environment as one can possibly get, no talking to patients, just smiles.

The variables are best kept minimal and under one roof though. 

It's advisable to screen gout and inflammatory athropathies first. Those should be managed differently with  support from departments other than orthopedics, when say the joint is only part of a syndrome.

 

Intra articular steroids will for sure hasten the time to athroplasty if time from a wrist watch is the only criteria used. If you use displacement  from point A to point B, pain free extended interval to athroplasty can be the only conclusion. And the displacement will be significant, whether Newtonian or Einstein in parameter. 

The fact that it's without renal complications in the sample most  at risk is a big bonus.

 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured