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Joint Replacement for Arthritis


Osteoarthritis: the primary culprit behind joint pain

As you get older, you’re likely to put up with a few aches and pains now and then. But if you’re one of 27 million Americans living with osteoarthritis, you’ll want to take steps to proactively manage joint pain and stiffness. 

The most common form of arthritis, osteoarthritis typically is sometimes called "wear-and-tear" arthritis because it’s associated with aging as well as injuries or overuse of the affected joint.

“Cartilage is the flexible, rubbery tissue that serves as a ‘shock absorber’ in the joints,” said Dr. Donald Hohman, a joint replacement specialist on the medical staff at Texas Health Center for Diagnostics & Surgery. “With osteoarthritis, that cartilage breaks down between the bones in a joint.”

As cartilage deteriorates, the tendons and ligaments stretch, causing pain. Eventually, it can progress to the point where the patient experiences painful “bone on bone” contact.

Symptoms of Osteoarthritis

Osteoarthritis usually develops in weight-bearing joints, such as the hip or knees, but can affect any joint in the body. The resulting pain and stiffness make simple, everyday movements – such as rising from a chair or bending over to tie a shoe – difficult.

Other symptoms may include swelling of the joint, cracking or grinding noise with joint movement and decreased function of the joint. The pain may worsen after inactivity or after periods of vigorous activity, or even flare up in rainy weather.

While there’s has no single cause, you’re more likely to develop osteoarthritis if you have a family history of the disease or if you’re obese. A previous injury to the joint is another risk factor; young athletes who have sustained a knee injury, for example, are at a 25 percent higher risk for developing osteoarthritis within three to ten years.

Diagnosis and Treatment

Where to begin

Many people with osteoarthritis assume that nothing can be done for the pain, or that surgery is the only option. Not so, says Dr. Hohman. “Treatment can reduce pain and increase function,” he said. “Anyone with pain that lasts more than a week and interferes with daily life should consult with a physician.”

In making a diagnosis, your doctor will consider the location and pattern of pain, a physical exam and x-rays, which show the extent of the damage. Sometimes an MRI may be required to get a better look at the joint. Blood tests can help rule out other forms of arthritis.

Although there is no cure for osteoarthritis, you can manage symptoms through a combination of gentle exercise (such as swimming or walking), weight loss if needed, physical therapy and nonprescription and prescription medications. In some cases, steroids injected directly into the joint may provide relief. Supportive devices, such as splints, braces or canes may also help.

One common misconception is that people with joint pain should not exercise. In fact, low-impact exercises can reduce pain and help maintain range of motion. Motion at the joint is the best thing for the remaining healthy cartilage in the joint. (Of course, always check with your doctor before beginning any program of exercise.)


When to consider surgery

If these interventions don’t work, surgical treatment may be an option, including arthroscopy – for the appropriate indications, for example meniscal tears, (surgery through small incisions and a camera to help visualize the joint) – depending on the wear pattern of the arthritis there are several options including procedures to address stress fractures around the knee, minimally invasive partial knee replacements (unicompartmental knee arthroplasty) or minimally invasive total joint replacement surgery.


Is joint replacement surgery right for you? 

Keep in mind that, while joint replacement is the last resort, patients are often pleasantly surprised at the speed of recovery after surgery. Patients routinely begin basic movements the day of surgery and are walking immediately following the procedure. With the rapid recovery program patients are routinely home within 24 hours following the procedures (minimally invasive muscle sparing anterior total hip arthroplasty/ replacement and minimally invasive partial and total knee arthroplasty). These activities include walking up stairs and simple activities of daily living before leaving the hospital.

The most important takeaway is this: if osteoarthritis is limiting your ability to enjoy life, consult your doctor sooner rather than later. “Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely you are to lessen its impact on your life,” said Dr. Hohman.