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Arthritis and Joint Replacement


Sometimes called "wear-and-tear" arthritis, osteoarthritis is a common condition that many people develop during middle age or older. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip or knee. Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Below, you’ll find common questions and answers about arthritis and the treatment options available:

How do I know if I have arthritis?

If you have osteoarthritis you generally complain of pain related to an activity. As the disease progresses you might feel pain when you are at rest and even while sleeping. Additional symptoms often include joint stiffness and deformity. These often limit your joint function and often results in limitations and challenges in your quality of life. In some individual’s osteoarthritis progresses very slowly and can be managed for years with nonsurgical care. In other individuals’ osteoarthritis can progress rapidly and cause severe pain, sometimes prompting the need for surgery when other measures fail to control these items.

Are there other forms of arthritis?

Although osteoarthritis is the most common form of arthritis there are many other forms. Rheumatologists and orthopedic surgeons treat a spectrum of arthritic problems which include osteoarthritis and rheumatoid arthritis. Osteoarthritis results in loss of cartilage due to mechanical overloading or poor underlying cartilage that is not capable of withstanding normal loads and this cartilage wears out prematurely. Rheumatoid arthritis is different. This is the most common form of inflammatory arthritis. In individuals with rheumatoid arthritis the body's own immune system and the joint lining, which is known of this as the synovium, for unclear reasons destroy the joint cartilage. This is an autoimmune reaction. In general, both rheumatoid arthritis and osteoarthritis are progressive problems that can result in cartilage loss, joint deformity, stiffness and pain.

What causes osteoarthritis?

The cause of osteoarthritis is unclear but there are several factors that often contribute to its development. These include obesity, genetics, trauma, injury, instability and age. Obesity correlates with a significant rise in the frequency of arthritis, particularly in the knee joint. Genetics clearly play a role and these have been correlated with arthritis, especially in the joints of the hand and the wrist. Trauma and injury can result in damage to the cartilage and poor alignment of the bones can contribute to the development of arthritis as well. Instability of the joints related to poor ligaments or weakness can sometimes lead to arthritis as they result in cartilage loss. Age has been associated with arthritis as well although the frequency of arthritis increases with age, it does not occur in all people and should not be considered inevitable.

Is there a cure for osteoarthritis?

There is currently no cure for osteoarthritis and all our non-surgical and non-operative measures are geared toward treating your symptoms. Despite recent claims of injections that can “cure” your arthritis, we currently have no disease-modifying agents for osteoarthritis of the hips and the knees. Even though there is no cure for the disease, we can treat your symptoms if you're experiencing significant pain. And these can provide you with significant pain relief and improvement of your function. It is important to understand the extent of your osteoarthritis and how this relates to your symptoms and your treatment options.

What are the common symptoms of hip osteoarthritis?

The most common symptom of hip osteoarthritis is pain around the hip joint. Usually, the pain develops slowly and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:

  • Pain in your groin or thigh that radiates to your buttocks or your knee
  • Pain that flares up with vigorous activity
  • Stiffness in the hip joint that makes it difficult to walk or bend
  • "Locking" or "sticking" of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
  • Decreased range of motion in the hip that affects the ability to walk and may cause a limp
  • Increased joint pain with rainy weather

What surgical options exist for hip arthritis?

When non-surgical treatments for hip arthritis fail, you and your doctor may consider surgery. Learn about which surgical options are optimal for treating osteoarthritis in your hip.

Arthroscopy

Hip arthroscopy is usually an outpatient procedure to repair torn cartilage and to remove extra bone that occurs in the very earliest stages of osteoarthritis. The surgeon uses small incisions around the hip to allow for insertion of a tiny camera called an arthroscope. For patients over 40 years of age, there are rare circumstances that would require arthroscopy.

Osteotomy

Femoral and acetabular osteotomy surgery involves cutting the bone to reorient your hip joint when your hip has structural abnormalities. It is extensive surgery that requires the insertion of plates and screws to fix the bone while it heals. It requires inpatient hospitalization for several days, and recovery usually takes six to twelve weeks.

Hip resurfacing

Hip resurfacing is a type of hip replacement that is usually reserved for young, active males. It is a metal-on-metal device where the hip ball is capped. It usually requires inpatient hospitalization for several days, and recovery usually takes six to twelve weeks. This procedure has recently fallen out of favor, and there are few circumstances where it would be required.

Total hip replacement

Total hip replacement (THR) is the gold standard for treating your disabling hip pain. Circumstances that indicate the necessity of THR occur in individuals of all ages, sexes, and activity levels. It is best to have THR after you turn the age of 60 because of the risk of having to undergo surgery again due to mechanical failure after 15 to 20 years. It can be performed through various approaches (front, back, side) with various implant designs. Currently the most common designs are made of titanium with metal heads against the newest plastics. It can be extensive surgery that may require inpatient hospitalization for one to three days, and recovery usually takes six to twelve weeks. The latest in pain management and minimally invasive surgery have shortened the hospitalization for total hips to as little as 23 hours after surgery in some patients.

If you have additional questions about arthritis or would like more information about treatment options please contact our office at 972-403-2843.