Osteoarthritis
What About Surgery? Arthroscopy is rarely recommended for treatment of knee arthritis alone since it does not cure the arthritis and other less invasive techniques give similar results. It may be helpful to fix a torn meniscus or other specific injury, however, when arthritis is not the main source of symptoms. Arthroscopy may provide better relief from arthritis pain in non-weight bearing joints, such as the shoulder. The only curative procedure available for degenerative arthritis is Total Joint Replacement. This procedure removes the worn out joint surfaces and “caps” the bone ends with new gliding surfaces of metal (usually cobalt-chrome) and plastic (ultra high molecular weight polyethylene) or alternative bearing surfaces. This usually gives dramatic pain relief and often restores function to patients with severe arthritis. When only a portion of a knee has worn out, Partial Knee Replacement may provide good symptom relief with a smaller operation and more natural”feel.” Joint Replacement is a major surgical procedure and is associated with a low incidence of risks such as infection, nerve vessel injury, and unanticipated breakage of the bone, dislocation or even death. In addition, the replacements may loosen or wear out over a period of 15-30 years (sometimes much less or more). Repeat joint replacements can be done but are less likely to give as good a result. It is therefore desirable to carry this surgery out in hopes of it lasting a lifetime. It may also wear out more rapidly in people who are very active, younger or over-weight. Under the right circumstances, however, this procedure is effective and rewarding.
Find more information on Osteoarthritis at: orthoinfo.aaos.org arthritis.org nih.gov/niams
WASHINGTON ORTHOPAEDIC CENTER waortho.com 1900 Cooks Hill Road Centralia, WA 98531 360-736-2889 • 800-342-0205
WASHINGTON ORTHOPAEDIC CENTER
What Is It?
What Can Be Done?
Arthritis means oint in ammation. Osteoarthritis is the most common form of arthritis. t occurs to some extent in most people as the age. t can egin earlier however as the result of oint in ur or disease and sometimes for reasons that are less clear. ips and nees are most commonl affected ut shoulders hands and other oints can also e involved.
A variety of Medications ma e helpful. cetaminophen can provide su stantial pain relief. e careful however not to ta e more than 4 grams of acetaminophen (two extra strength ta lets four times per da . e aware that other medications ma contain acetaminophen. here are man non steroidal anti inflammator medications aspirins i uprofen or naproxen as well as prescription anti inflammatories which ma help relieve pain and improve function. he most common ris s are stomach irritation though some are less li el to cause this. medications such as lucosamine hondroitin or her al supplements ma also e helpful. arcotic medications are less commonl used ecause of their ris s and side effects.
he ma or pro lem from this condition is simpl wearing out of the smooth gliding cartilage on the surface of the oint. his is seen on x ra s as a decrease in space etween the one surfaces since the cartilage itself is clear on x ra s. his can ultimatel progress to the point where there is one on one. n addition to narrowing of the oint space the od responds to the excessive stress forming roader on surface which we see on x ra s as one spurs. lthough extensive research is ongoing the exact cause and means of preventing osteoarthritis is still un nown. reatment is directed primarily at relieving the symptoms of arthritis which can cause a vicious c cle of wea ness and immo ilit that interfere with dail activities and ualit of life.
here are man inds of Topical Medications capsaicin spercreme c ot and others which ma ease s mptoms to improve function. Braces ma provide support or improve alignment. Cane can often e ver useful in unweighting the oint while still permitting normal activities. esorting to a wheel chair is discouraged as this allows muscles to ecome wea ened the oints to ecome stiff and the ones to ecome rittle and diminish the li elihood of regaining the a ilit to wal .
Exercise to strengthen the muscles around the oint has een proven to improve function and decrease pain and protect the oint. lexi ilit and conditioning exercises are also ver helpful in reducing s mptoms. n general exercise which minimi es the impact loading pounding experienced the oints such as swimming or ic cling is preferred ut an exercise is etter than none. Weight Control is also extremel valua le in decreasing the stress on the oints. ach step results in three times the od weight through the hip and nee. herefore each pound gained or lost has a tremendous influence on the stress experienced the oints. t is advisa le to use good supportive well padded shoes or impact a sor ing shoe inserts for an wal ing or running on hard surfaces. Cortisone Injections decrease inflammation. he have een proven to provide significant relief in a ma orit of people with arthritis pain. Hyaluronate iscosupplementation in ections are designed to provide extra shoc a sor ing fluid and lu rication in the oint. t t picall re uires three wee l in ections and ma give significant relief for man months.