Each year more than 700,000 Americans undergo joint replacement surgery for arthritic knees and hips. For people suffering with the pain and disability of an affected joint, surgery can be life changing. The popularity of these procedures, combined with the practice of direct marketing to consumers by joint implant manufacturers, has led to some misinformation and myths. Understanding the causes, symptoms and available options is crucial for patients to make informed and educated decisions about their individual medical condition.
What is Arthritis?
The word arthritis literally means “inflammation of a joint”. There are over 100 types of arthritis. The two most common forms are osteoarthritis and rheumatoid arthritis. Osteoarthritis is by far the most widespread, affecting 27 million Americans over the age of 25. Rheumatoid arthritis affects 1.3 million Americans most commonly between the ages of 40 and 60. Females are twice as likely as males to be diagnosed with rheumatoid arthritis.
Osteoarthritis occurs when the cartilage (the smooth, shock-absorbing cushion on the end of a bone) begins to breakdown and cannot regenerate itself. When cartilage is damaged or worn, bones can no longer slide over one another without friction. When this happens, the term “bone on bone” is often used. Osteoarthritis can be genetic, age related, caused by joint trauma or repetitive motion.
Rheumatoid arthritis is an autoimmune inflammatory condition. This means the immune system, which normally protects the body, begins destroying healthy cartilage. When a person has rheumatoid arthritis, the lining of the joint becomes inflamed and swollen. The body’s immune system incorrectly responds by destroying the joint surface or cartilage. Pain, swelling and stiffness is the result. Although the primary areas affected by rheumatoid arthritis are the joints, it may also affect other organs and tissues.
Knees are the most common area to be affected by arthritis followed by hips and shoulders. The symptoms are as varied as the sufferers who experience it. Despite the many causes and types of arthritis, the symptoms share common features. Subtle morning stiffness over time may become a disabling loss of motion. Nagging soreness that shortens a walk may progress into pain that eliminates activities. Knees may catch, buckle or give way. Swelling and pain in the shin or calf and limited motion are common. Hip arthritis often gives a telltale pinch in the groin. Difficulty rising from a chair, getting out of the car or turning over in bed are common complaints. Eventually the desire to stay active can be overcome by the severity of symptoms and patients are forced to make unwanted changes in lifestyle.
There are many treatments that can bring patients relief and allow them to participate in the activities they enjoy. Physical therapy, body weight reduction, use of braces or assistive devices, oral medications (Motrin®, Tylenol®), injectable medications (cortisone, hyaluronic acid) and nutritional supplements (glucosamine, chondroitin) have all proven to be successful. When the pain or disability caused by an arthritic joint fail to appropriately respond to these options, joint replacement surgery may need to be investigated. Meeting with an experienced, board-certified orthopedic surgeon to assist with education and treatment options is a crucial step towards making the right decision.
A joint replacement performed by an experienced orthopedic surgeon for a well-informed patient has a success rate exceeding 98 percent. Pain can be nearly eliminated and a level of activity can be restored that many patients had long ago abandoned. Advances in technology have widened the population of patients benefiting from this surgery. The durability of modern materials allows patients of nearly any age with an indication for joint replacement to consider the procedure.
Finding the Right Surgeon
Surgeon experience is the only defined variable that affects the outcome of a joint replacement procedure. An experienced orthopedic surgeon can be found in nearly any location. University hospitals do not enjoy success or avoid complication to any degree differently from your local facility. Patients can feel confident that the recommendation of a friend, their local hospital, a physical therapist, or a referral from their primary doctor can lead to an expert in joint surgery. Becoming familiar with a joint replacement surgeon through questions and education about your condition will build a relationship to guide to relief and function that may feel like a miracle.
Dr. Shawn W. Palmer is a board certified orthopedic surgeon. In addition, he completed a year of highly specialized fellowship training in complex reconstructive joint surgery at the world-renowned University of Chicago Bone and Joint Replacement Center.