Joint Replacement Advised for Some Arthritis Patients

Osteoarthritis is a degenerative joint disease that affects more than 32.5 million U.S. adults. It is the most common form of arthritis.

OA is known as “wear and tear” arthritis. The cartilage within a joint breaks down and the underlying bone changes, according to the Centers for Disease Control (CDC). Without treatment, this disease may cause long-term damage to joints, causing pain and reducing mobility.

Two health organizations recommend patients with moderate-to-severe osteoarthritis should not delay joint replacement surgery. These patients have not responded to nonsurgical therapies.

In March, the American College of Rheumatology and the American Association of Hip and Knee Surgeons released new guidelines for the “optimal timing of elective hip or knee replacement.”

Susan M. Goodman, MD, an attending rheumatologist at the Hospital for Special Surgery, was a co-principal investigator of the guidelines.

“There is no evidence that delaying surgery for any of the additional nonoperative treatments studied, including physical therapy, gait aids, oral anti-inflammatories or injections, leads to improved outcomes, and [such delays] may burden patients without clear benefit,” Dr. Goodman said in the release.

A panel, which included rheumatologists, orthopedic surgeons and patient representatives, developed 13 recommendations. These recommendations included guidelines for surgical candidates with high BMIs, diabetes and nicotine dependence.

The guidelines issued are “conditional” or based on a case-by-case basis. A patient should discuss any treatment with his or her doctor.

“This shared decision-making process should comprehensively discuss the unique risks and benefits of the procedure for the individual patient,” Dr. Goodman said. “Patients with medical or surgical risk factors as described in this guideline should be counseled as to their increased risks, and preoperative attempts to modify these risk factors through efforts such as weight loss, glycemic control or smoking cessation should be encouraged.”

The full manuscript will be published later this year in Arthritis & Rheumatology, Arthritis Care & Research and the Journal of Arthroplasty.

Factors affecting arthritis

May is National Arthritis Awareness Month. During this observance, it is important to highlight factors affecting or leading to an osteoarthritis diagnosis.

Symptoms of osteoarthritis may include pain or aching, stiffness, decreased flexibility or swelling in your knees, hips or hands.

The risk of developing osteoarthritis (OA) increases as we age. According to the CDC, people who have family members with OA are more likely to develop the disease. Women are more likely to develop OA than men, especially after age 50.

The CDC notes that repetitive stress on a joint can damage and increase the risk of OA in that joint. Carrying extra weight puts more stress on joints, particularly the hips and knees.

When to seek a doctor’s care

If chronic pain interrupts daily activities like bending over to tie a shoe, rising from a chair or taking a short walk, you should schedule an appointment with your healthcare provider.

A routine physical exam and some tests will help to determine if you have osteoarthritis. To better evaluate your condition, your doctor will ask questions about your symptoms, general health, family history and daily habits.

Once diagnosed, your doctor can educate you on your medication plan and teach you how to manage your arthritis daily.

The Arthritis Foundation recommends staying active with low-impact activities such as walking, biking, swimming, yoga and water aerobics as part of your treatment plan.

If you are overweight, losing 10 to 20 percent of your body weight improves pain, function and quality of life, according to the Arthritis Foundation.

Don’t delay your care

If you suffer from chronic pain possibly caused by arthritis, do not ignore these symptoms or your condition may worsen.

Depending on your condition, treatment plans may vary. The Arthritis Foundation recommends at-home remedies like hot or cold therapies and massage for pain relief.

• Applying a heating pad and taking a warm bath can improve blood flow and ease joint stiffness. Using cold packs (such as a bag of frozen vegetables placed on the painful joint) reduces pain and swelling.
• Rubbing and kneading of muscles and joints can help reduce OA pain, improve joint function and ease stress.

Other treatments may include physical therapy or even hip or knee replacement. If a doctor recommends joint replacement surgery, the goal is to reduce your pain and increase your range of motion. During surgery, the damaged bone and cartilage will be replaced with prosthetic components, called implants.

If you are experiencing joint pain, don’t delay your care. Request an appointment today for an evaluation.