Knee and Hip Arthritis
Posted 12/20/2017 by UHBlog
Does taking a short walk or navigating your stairway cause excruciating knee or hip pain? Talk to us about what can you do about it.
An estimated 7 million American men and women live with artificial knees or hips as of 2015, according to a study published in The Journal of Bone and Joint Surgery.
However, says orthopedic surgeon William Petersilge, MD, only about one of every five patients who suffers from arthritis of the knee or hip are treated with surgery, despite the fact that an increasing number of people are getting knee and hip replacements.
Depending on the extent of your pain and the impact on your daily function, you're most likely to be treated with oral pain medications, then with injections, before surgical options are considered, Dr. Petersilge says.
According to Dr. Petersilge, arthritis is a broad term that includes a variety of painful conditions that may be treated with a replacement joint. Osteoarthritis is a condition caused by the breakdown of joint cartilage and underlying bone in a joint. The breakdown can take years with no or little pain, but once the cartilage wears through, the pain can be sudden and severe.
“The cartilage covering doesn’t have nerves, so as the knee starts to wear a person doesn’t feel pain symptoms,” he says. “As the cartilage wears through, the bones, which do have nerves, can rub together and cause intense pain.”
Initially, an orthopedic surgeon may suggest exercises to strengthen the joint, weight loss, when appropriate, to reduce the load on a patient’s joints, and prescribe medication or other pain relief methods.
“Subsequent treatment could include injecting medications – such as corticosteroids – into the joint to reduce pain and swelling or, alternatively, using a series of lubricant or 'gel injections' to increase lubrication and reduce pain,” Dr. Petersilge says. “Patients who are not adequately responding to that second tier of management may be candidates to consider surgical treatment.”
Injections are typically done three to four times a year, and if successful, may be used to control symptoms for several years.
“Unfortunately, it's not a cure, but rather a way to manage pain,” he says. “Eventually as the arthritis gets worse, these treatments become less effective.”
Surgical options for people over the age of 65 usually involve joint replacements, since their condition is more likely to result from osteoarthritis. Younger patients, he says, may suffer from a variety of other conditions that can be managed without replacing a joint.
However, Dr. Petersilge notes, younger patients are opting for artificial joints with increasing frequency.
“One reason is that the life span of the replacement joints has improved so much since we started to use them,” he says. “Thirty years ago, they were expected to last eight to 10 years, so replacing a joint in somebody at age 50 made no sense at all, because they would be back multiple times. They are now lasting 25 to 30 years, so it is more reasonable to consider.”
Dr. Petersilge says maintaining an appropriate weight and doing plenty of exercise during one’s younger years can help to reduce the risks of developing knee or hip arthritis.
“If you keep your muscles strong, you have a better chance to prevent joint injuries,” he says.
William Petersilge, MD is an orthopedic surgeon and division chief of orthopedic surgery at University Hospitals Ahuja Medical Center. You can request an appointment with Dr. Petersilge or any doctor online.