Date: 07 Jul 2018
Event: Injection & Bracing Workshop
What Do Braces do for Lower Limb problems & How to Prescribe them – Dr Khong Kok Sun
How to Perform Intra-Articular Injections in the Knee – Dr Chong Keen Wai
Conditions affecting the lower limbs are becoming ever more common today. In the past, such people were young and presented with sporting injuries. Whilst this group continue to seek consultation, we are seeing even more numbers of those who are middle-aged and even elderly, ie. over the age of sixty-five. In this latter group, it was quite easy previously to advise them to “slow down” or “do less exercise”, but today the elderly are encouraged to do just the opposite. Hence there is a need to ensure a rapid return to pre-condition function. Bracing has been an established form of orthopaedic management of joint conditions and deformities since the early days of this specialty. It was for a long time the mainstay of treatment such as scoliosis and poliomyelitis.
Today techniques and technology has advanced with greater application of biomechanics and brace materials. In cases after surgery, post-operative casting has been replaced by functional bracing. Braces are today used for resting a joint or allow functional range but constrained to specific limits. Intra-articular injections today are in the form of anti-inflammatory agents or joint viscosupplement agents. In acute painful joint conditions or synovial swelling steroids like triamcinolone are commonly given. When there is evidence of cartilage degeneration, then high-molecular weight hyaluronic acid may ameliorate frictional forces by lowering the coefficient of friction. While these may not be curative, they are simple part-solutions to tide the patient while other forms of treatment like physiotherapy begin to work.
This workshop is designed to educate and provide hands-on experience to GPs when prescribing or applying braces and intra-articular injections.