by Michael Gillman, MD
Osteoarthritis is the most common type of arthritis. It is caused by previously damaged and/or worn out cartilage. Cartilage is a normally smooth, Teflon-like coating at the ends of our bones. When the cartilage wears out and a joint becomes arthritic, patients typically experience pain, stiffness and not uncommonly swelling. If you have a parent that has had arthritis, you are more likely to have it as you age, but many patients have no family history nor do they recall a specific injury before it develops.
The knee joint is commonly effected by arthritis. In fact, about 4.7% of the current U.S. population aged 50 and older had gone through knee replacement surgery for arthritis.
Unfortunately, this number is predicted to more then triple over the next two decades due to the number of baby boomers, the number of obese people in the population and because of the active lifestyles that many older patients want to continue to live.
Certainly, prevention of osteoarthritis would be ideal if possible. We know that staying active with regular exercise can help to delay the progression of osteoarthritis and also reduce pain in those who do have it. I encourage patients to try stationary bicycling, swimming or water aerobics as these tend to be less stressful on joints that are already painful. Attempting to lose weight, or even focusing on not gaining weight as you get older can also help to lower the chance that an arthritic will become painful. Despite some companies’ claims oral supplements (pills) such as glucosamine, chondroitin and hyuloronic acid are not scientifically proven to reduce pain or prevent osteoarthritis.
Common treatments for osteoarthritis of the knee include medications such as Tylenol, aleve and other antiinflammatories, physical therapy, cortisone shots, and shots of sodium hyuloronate (eg Synvisc, Orthovisc, Euflexxa, hyalgan, Supartz). When all else fails, knee replacement surgery is an excellent option and more then 90% of patients who have this surgery are satisfied with the improvement after having it. Typically this is recommended for people who have tried all other treatments and who have significant pain or limitation in their ability to be as active as they would like.
It used to be common to have to stay in the hospital for a long time after a knee replacement surgery. Newer techniques make the procedure much less painful. Some patients can go home after 1 day but typically 2-3 days are required in the hospital. Full recovery can take several months but a majority of patients are happy about 2 months after the procedure.
About the author:
Dr. Michael Gillman of Advanced Orthopaedic Specialists of Orange County in Laguna Beach is a Board Certified Orthopaedic Surgeon and a member of both the AAOS and AOFAS. After graduating with honors from Stanford University, he went on to get a Master of Science degree there before studying at Case Western Reserve University Medical School where he was inducted into the Alpha Omega Alpha Honor Society. He served as Chief Resident at the New England Baptist Hospital and received a fellowship in Orthopaedic Foot and Ankle Surgery at Baylor College of Medicine in Houston.
He is an Orange County native, is married and the father of three sons.
Advanced Orthopaedic Specialists of Orange County is located in the professional building behind Mission Hospital in Laguna Beach (31862 Coast Highway, Suite 400) He can be reached at 949.499.8226