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June 2010 | 0 Comments | Print

Osteoarthritis of the knee and shoulder

With Daniel Funk, MD, and Marc Schneider, M.D., with The Christ Hospital

Osteoarthritis is a chronic condition characterized by the breakdown of the joint’s cartilage. When cartilage breaks down, bones rub against each other, causing stiffness, pain and loss of movement. Osteoarthritis affects people of all ages and prevalence starts increasing sharply at age 45 and older. Treatment often depends on the joints involved and can include medicines, lifestyle changes, surgery and physical therapy.

In some cases, surgery can be the best treatment option for osteoarthritis. The most common joint surgeries for osteoarthritis relief are arthroscopy and joint replacement. Arthroscopy is a minimally invasive procedure used to diagnose and treat conditions of the joint. A small instrument allows surgeons to see inside a joint and repair problems through a very small incision. Arthroscopic procedures generally are helpful to patients with mild to moderate symptoms.

Surgical treatment options

Joint replacement surgery can be a very effective solution to the pain and disability of advanced osteoarthritis. During joint replacement, the rough, worn surfaces of the joint are relined with smooth surfaced metal and plastic components. Patients often experience reduced pain and improved function.

The knee is one of the most common joints to develop osteoarthritis. One of the greatest factors contributing to the development of osteoarthritis is a person’s weight, which is multiplied three to seven times on the knee’s surface. If a person is 20 pounds overweight, the knee is stressed an additional 60 to 140 pounds. This additional stress causes the articular cartilage to deteriorate more quickly, resulting in osteoarthritis.

Knee and shoulder replacement surgery

Orthopedic surgeons consider total knee replacement to be the most successful of the joint replacements. In a knee replacement, a metal cap is placed on the end of the femur (thigh) and a metal tray on the top of the tibia (shin). A plastic insert is then placed between the two metal pieces. The metal covers the nerve endings in the bone and the plastic provides lubrication so that the joint moves smoothly and without pain. The majority of patients are satisfied and experience reduced pain and improved function.

Patients with shoulder arthritis typically describe a deep ache within the shoulder joint that is worse with movement and activity, but better with rest. As the arthritis progresses, the pain may even occur at night. Over time, the shoulder becomes stiff and patients may experience a catching, grabbing, clunking or locking sensation in the shoulder.

Arthritis is the most common reason for people to have shoulder replacement surgery. Over time, the shoulder joint slowly becomes stiff and painful. However, patients with bone-on-bone arthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement. Total shoulder replacement surgery replaces the damaged bone and cartilage with metal and plastic implants to help alleviate pain and improve shoulder function.

Exercise alleviates osteoarthritis

Exercise and physical therapy can be beneficial in reducing symptoms of osteoarthritis by improving muscle strength and regaining motion in stiff joints. Water exercises, such as swimming, can be especially helpful as they provide exercise in a low-impact environment.

The Christ Hospital Physical and Occupational Therapy Centers offer high quality outpatient rehabilitative care with licensed professionals. We use the latest equipment, a wide range of therapeutic exercise and a variety of options to help patients return to an active and healthy lifestyle. To learn more about these services or to make an appointment at one of our nine convenient locations, call 513-936-5299 or visit www.TheChristHospital.com

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