From conservative treatment to surgical interventions
Osteoarthritis is a chronic progressive condition that results from wear and tear on the cartilage between the joint spaces. This is commonly found in the fingers, back, knee and hip joints. Arthritis is an age-related condition that usually becomes most apparent in our fourth or fifth decade of life when symptoms develop. Rheumatoid arthritis (RA) which is not due to wear and tear but an inflammatory reaction that occurs in the body is an autoimmune condition that may present differently than tradition arthritis.
Arthritis can cause an array of symptoms including swelling, pain, stiffness, deformity of the joint, and instability. Most people will not seek care until the condition has worsened to the point where it has started to affect quality of life. This can be unique to an individual but can be the inability to participate in activities such as walking, exercise, or simply having more days with pain than days without. Women are more likely to present with more advanced stages of arthritis, report significantly higher levels of pain and disability, and show arthritis progression in the patellofemoral joint more often than men.
Treatment usually begins at home with activity modification, rest, ice, over the counter pain relievers like ibuprofen, Tylenol, Voltaren gel, weight loss, exercises, and a simple brace or sleeve.
Injections can be used to treat acute and chronic inflammation in a joint.
Knee arthritis can be treated with cortisone injections and with Viscosupplementation injections. Cortisone injections consist of a numbing medication and an injectable steroid to help with inflammation and pain in the joint. Cortisone injections can provide relief for acute and chronic knee pain. Viscosupplementation injections or hyaluronic acid injections are given in a series of injections to help lubricate the joint. These injections can provide relief of early arthritis. Results will vary depending on the severity of your arthritis, the level of pain you are experiencing, and other pre-existing conditions. Cortisone and Viscosupplementation injections may require authorization from your insurance company.
Cortisone injections can be given for hip arthritis, but usually require guidance under ultrasound. Injections for greater trochanter bursitis can also be given if your pain is in the upper outer buttock area.
Arthroscopy or a knee scope can benefit those that have a torn meniscus or ligaments but do not suffer from severe osteoarthritis. Many patients will find that they have some degree of meniscal pathology and osteoarthritis due to the wear and tear of their joints.
Other surgical options include partial or total knee replacement or arthroplasty which is performed to treat end-stage osteoarthritis when all other conservative treatment measures have been exhausted. A joint replacement will restore the functionality of the knee by straightening the leg, minimizing pain caused by the -rubbing of bone on bone arthritis, and provide stability back to the joint. Surgical techniques have improved since your mother’s joint replacement. Gone are the days of lengthily hospital stays, followed by weeks in inpatient rehabilitation centers and years of restrictions.
Today knee arthritis does not have to mean the end of your favorite activities. You can still get back to your previous activities with advances in treatment options.
End stage hip arthritis and severe avascular necrosis of the femoral head is best treated with a total hip replacement. At Orozco Orthopaedics, an anterior approach is performed through the front of the body to minimize trauma to the surrounding tissues, and avoids cutting the major gluteus muscles. A total hip arthroplasty today can be done same day for many patients. With newer techniques there are no restrictions after a hip replacement.