Daily Mail - 03.03.2020

(John Hannent) #1

Page 38 Daily Mail, Tuesday, March 3, 2020


By ROGER DOBSON


Nerve-burning blast


to ease creaky knees


The surprising links
between different
diseases.
This week:
Flu and stroke
Yo u r r i s k o f
stroke rises by
4 0 p e r c e n t
within 15 days
of catching flu
— and you’re at
a higher risk for
a whole year
afterwards,
according to a 2019 study of
31,000 people by Columbia
university in the u.S.
‘There are many theories
why the two might be linked,
but the main one is what’s
known as the coagulation
cascade,’ explains epidemi-
ologist Professor Amelia
Boehme, who led the study.
‘Infections and inflammation
can trigger clotting — and
clots cause ischemic stroke
[the most common type of
stroke that is caused by a
clot blocking blood flow
to the brain].’
So, what lesson should you
take from the study? ‘Get
your flu vaccination,’ says
Professor Boehme.

WhaT is your breath trying
to tell you? This week:
a rotten egg smell
A GIVEAWAY that you have
cavities — holes in the teeth —
is the smell of rotting eggs on
your breath, says Guy Barwell,
a dental surgeon at The
Implant Centre, East Sussex.
‘Food or debris can get
trapped in cavities, or bacte-
ria may leak under a crown.
‘In these spaces, the bacteria
develop their own bio-system
and flourish,’ he says. These
bacteria produce
gases that contain
sulphur, which has
the odour of
rotten eggs.
When there
is gum disease,
ba c t e r i a a n d
inflammation
c a n m a ke t h e
bone push away from
the gum, leaving pockets
around the tooth where more
food can get trapped and
bacteria can build up.
If the areas aren’t cleaned
properly, these can also
produce sulphurous gases and
an unpleasant eggy smell.

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recovery, and younger patients
may need a further replacement in
the future.
The new treatment, known as
radiofrequency ablation, may offer
another option. It works by stop-
ping the genicular nerves in the
knee from sending pain signals to
the brain.
To test whether a patient is likely
to benefit, a temporary nerve
block is first injected into the knee
so that doctors can monitor how
successful it is in reducing pain and
improving movement.
The treatment itself involves
having the needle-like radiofre-
quency equipment, which is loaded
into a catheter (tube), inserted into
an artery in the thigh and guided to
the knee area using ultrasound.
Once in place, two one -minute
blasts of 80c radiowaves are fired to
destroy a portion of nerve tissue.
Some small studies have shown
the ablation treatment is effective,

A


TwO-mInuTe nerve-block-
ing procedure could help
improve mobility and pain in
those with osteoarthritis of
the knee.
The procedure involves destroying a portion
of nerve tissue in order to disrupt pain signals,
and researchers say it could also help reduce
or delay the need for a knee replacement.
Osteoarthritis, commonly known as ‘wear


and tear’ arthritis, occurs when the cartilage
that provides cushioning between joints wears
away, leaving the bone ends to rub against
each other. This results in pain, swelling,
stiffness and problems with mobility.
It affects nine million in the uK, with the
knee the most commonly affected joint. In

fact, 20 per cent of the over-45s are thought to
have some degree of knee arthritis.
There is no cure, and the condition is
normally managed in the earlier stages with
painkillers or steroid injections. But as the
damage to the joint increases, a knee replace-
ment is usually required.
There are around 100,000 knee replacements
carried out each year, according to national
Joint Registry figures.
However, the procedure involves a lengthy

particularly on patients for whom
physiotherapy, anti-inflammatory
painkillers and steroid injections
have provided little benefit. The
treatment can cut pain symptoms
by 70 to 80 per cent.
now a trial involving 50 patients
with osteoarthritis of the knee is
being held at mansoura university,
in egypt. Some of the group will
have the actual treatment, while
the others will have a placebo treat-
ment. Doctors will assess the effects
on pain and movement for up to six
months afterwards.
Previous studies have found that
the effects can last up to a year or
m o r e a n d t r e a t m e n t c a n b e
repeated if necessary.
Commenting on the research,
Roger Hackney, a consultant ortho-
paedic surgeon at Spire and nuffield
hospitals in Leeds, said: ‘Any inter-
vention that can extend the time of
relative comfort for a patient is likely
to be welcome. However, the risks
need to be quantified, as introduc-
ing a device into an artery is not
risk-free. If the pain relief proves to
be prolonged, then there is a risk of
the osteoarthritis changes to the
knee progressing to the stage where
surgery becomes more challenging.’

÷ STICKING to a healthy diet can
slow the progression of knee
osteoarthritis, according to a
study by Harvard university.
researchers monitored nearly
3,000 people in their 60s for
three years and compared their
diets with their arthritis. The
results showed that those who
kept to a traditional Western
diet, high in saturated fat and
meat, had more X-ray evidence
of joint damage than those who
had a healthier Mediterranean-
style diet. The researchers said
that their results show that
eating a diet rich in fruit,
vegetables, fish, wholegrains,
and legumes may reduce the
progression of symptoms.
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