Abstract
BACKGROUND: Knee osteoarthritis caused by endemic skeletal fluorosis is a complex and chronic systemic disease,which can cause the damage of surrounding bone and sclerotin of knee joint.
OBJECTIVE: To investigate the effect of total knee arthroplasty (TKA) in the treatment of knee osteoarthritis caused by endemic skeletal fluorosis.
METHODS: Nine patients suffered from knee osteoarthritis caused by skeletal fluorosis that diagnosed by local epidemiology,dental fluorosis,clinical and imaging from March 2010 to October 2011 and all the patients were treated with bilateral TKA. The clinical efficacy was evaluated according to the knee scoring system of United States Hospital for Special Surgery before arthroplasty and final follow-up after arthroplasty.
RESULTS AND CONCLUSION: Score results showed that 5 knees were excellent, 3 knees were good and 1 knee was fair after knee arthroplasty. All patients have been improved in pain, function and range of motion. TKA is an effective method for the treatment of knee osteoarthritis caused by skeletal fluorosis.
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[Clinical and imaging study of fluoride-poisoning arthropathy].
Objective: To probe into the clinical and imaging manifestations and mechanisms of fluorosis-associated arthropathy. Methods: Analyses were conducted on the clinical manifestations, X-rays and magnetic resonance examinations in 18 cases with fluorosis-associated arthropathy. Results: Skeletal fluorosis of different severities was revealed in the 18 cases. Major clinical symptoms were as follows: pain
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The Joints
Of 300 patients with endemic skeletal fluorosis 187 (110 children and 77 adults) showed evidence of arthritis. The spine, especially its cervical portion, appeared to be mainly involved; elbow, hip and knee joints followed next in order.
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Experimental fluorosis in rats: NaF induced changes of bone and bone marrow
The results of our experiments suggest that increased doses of NaF cause more extensive osteosclerosis due to the decrease in number and/or activity of osteoclasts. Therefore oateosclerosis is caused primarily, not by increased bone formation but, by the inhibition of bone resorption. This view is supported by the fact that
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Radiological modifications of the skeletal system among aluminum smelter workers: A 15 year retrospective study
Previously by the time skeletal fluorosis among aluminum smelter workers due to high fluoride exposure was diagnosed numerous cases of bone fluorosis had already reached stages II and III according to Roholm. Today, as a result of improved working conditions and continuous health care, the picture has changed. This paper
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Industrial skeletal fluorosis: preliminary report on 61 cases from aluminum smelter
SchIegel presented data on 61 cases of skeletal f1uorosis among workers of a Swiss aluminum factory. Of 350 cases ofìndustrial fluorosis reported in the world's literature, approximately 20 occcured in the smelting area of the aluminum industry. For processing aluminum from clay, cryolite (NaAlF6) is used as a fluxing agent.
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Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
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Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
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"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
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Skeletal Fluorosis Causes Bones to be Brittle & Prone to Fracture
It has been known since as the early as the 1930s that patients with skeletal fluorosis have bone that is more brittle and prone to fracture. More recently, however, researchers have found that fluoride can reduce bone strength before the onset of skeletal fluorosis. Included below are some of the
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Fluoride & Osteopetrosis
One of the most common radiological findings in skeletal fluorosis is osteosclerosis - a hardening of bones with a blurring of the trabecular structure. In advanced cases, the osteosclerotic form of fluorosis may closely resemble the appearance of osteopetrosis, a "marble bone" disease in which the bones are dense, but fragile and prone to fracture.
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