Is it common to develop arthritis after a fracture?
Q: I had a fracture in the lateral condyle last year, which has been fixed with 2 screws. I am able to perform all normal activities except sitting on the floor. Recently, the doctor diagnosed that I have developed post-operative osteoarthritis. He advised for removal of screws after about 2 months and has advised the following medicines in the meantime - Gluosamine 500 thrice daily, Vitamin B complex twice daily, Vitamin E once daily and Omiprazole once daily. Kindly advise the suitability and side effects of Gluosamine 500 and whether removal of screws may lead to any complications?
A:Post traumatic, arthritis is common after fractures of the condyles of the femur and tibia. There is no medical treatment for this kind of arthritis. If the joint is very painful then the patient can have pain killers for relief of symptoms. You may also put the patient on static (isometric) exercises for the quadriceps to delay early deterioration. You will need to learn this from a qualified physiotherapist. To answer your specific questions: 1. Glucosamine is a substance which is useful for cartilage formation. This actually is not a drug it comes in a category described as dietary supplement. So if you are having a normal balanced diet, there is no need for any such supplementation. Recent review articles on evidence for benefits of glucosamine have not been very encouraging. some even suggest that the effect could be more of a placebo effect. In other words the evidence is not sufficient to warrant its continued use. 2. All Vitamin B complex again used as a dietary supplement while Vitamin E supposedly works as an anti oxidant. If you think your diet is not adequate you could consider these. Again more as nutritional supplements not with a view to reduce your arthritis. 3. Omiprazol is given to reduce the acidity in the stomach which is quiet common with pain killers. Removal of screw per se may not have problem if the fracture is united well. normally implants are removed almost after 1 to 1½ years after fracture union. There are no major complications after removal, however, removal of screws may not in any way affect your symptom of pain.