By Ranbir Singh, MD
Arthritis is defined as inflammation of the joint and refers to more than 100 different diseases that can affect joints. However, today we will focus on the two most common types of arthritis, rheumatoid arthritis and osteoarthritis.
Rheumatoid arthritis is usually diagnosed at much younger ages than osteoarthritis. It is not as common, but it can affect multiple joints at one time. It causes excess synovial fluid to build up in the joint. The excess fluid builds pressure inside the joint leading to cartilage erosion. Rheumatoid arthritis causes painful, swollen joints and limited joint motion.
Osteoarthritis is the most common form of arthritis. It is a “wear and tear” condition that affects joint cartilage. Osteoarthritis develops over a lifetime of overuse, injury, repetitive movement, or developmental disorders of the bone. In osteoarthritis, the healthy cartilage just wears away and the joint space becomes narrowed. When bone-on-bone contact occurs, abnormal bone formations, called spurs, develop and can lead to joint deformities. Fortunately, osteoarthritis is a condition that can usually be managed with either conservative or surgical treatments.
For patients with arthritis, a proper diagnosis is crucial to get the best treatment options. It is important to be seen by an orthopedic surgeon trained in joint replacement surgery. But seeing an orthopedic surgeon does not mean that you are going to have joint replacement surgery. It simply means you are seeing a specialist in the care and treatment of joint, muscle and other skeletal disorders.
A well-balanced diet coupled with regular doctor prescribed low-impact exercise can help reduce excess body weight, decrease pressure on the joints and increase joint space.
Medications such as pain-relievers, anti-inflammatories and steroid injections can help relieve both joint swelling and pain. Glucosamine, a building block of cartilage, and chondroitin sulfate, also found in cartilage, are two common supplements that have been shown to help relive the symptoms of early osteoarthritis. You should speak with your doctor before taking any vitamins or nutritional supplements.
Physical Therapy may be used to help strengthen the joint and promote less painful functions. Weak or tight muscles provide little support and can make it difficult to move the joint. Physical therapy can help loosen and strengthen muscles, possibly providing relief from joint pain.
Is there a cure for Osteoarthritis?
There is no known cure, however, patients have many treatment options available to restore motion and reduce pain. For end-stage osteoarthritis, joint replacement has proven effective in accomplishing these goals.
Does Joint Replacement Work?
After joint replacement surgery, many patients experience reduced pain, increased mobility and improved quality of life. The performance and life span of an implant depends upon many factors, including the patient’s pre-surgical physical condition, anatomy, weight, activity and willingness to follow surgeon instructions before and after surgery.
What is Partial Knee Replacement Surgery?
Unlike total knee replacement involving removal of all the knee joint surfaces, the Oxford Partial Knee Replacement replaces only one side of the knee joint, removing 75 percent less bone and cartilage. Knee osteoarthritis usually occurs first in the medial, inside compartment of the knee, as this side of the knee bears most of the weight. In knees that are otherwise healthy, a partial approach allows the outer compartment and all ligaments to remain intact. By retaining all of the undamaged parts, the joint may function more naturally with faster recovery after surgery. However, in situations when all three compartments of the knee are damaged, then the patient will need a total knee replacement.
The Oxford Partial Knee is the only FDA-approved free-floating meniscal partial knee system available in the United States and has been utilized throughout Europe for more than two decades. Often recognized as the most widely used and clinically proven partial knee system in the world, the Oxford Partial Knee System has demonstrated excellent clinical results. Surgeons in the US who wish to use the Oxford Partial Knee System are required by the FDA to attend an advanced instruction course on the device and there are only a few in the state of North Carolina who have done so including myself and I am the only one performing this procedure at Randolph Hospital.
In a healthy knee, the meniscal cartilage serves as a shock absorber between the ends of bones. In a partial knee replacement the implant has an artificial meniscal designed to glide freely throughout the knee’s range of motion to more closely replicate normal movement. It is designed to balance the soft tissues and to accurately replicate normal knee motion. It may also allow for a more rapid recovery due to the use of minimally invasive instruments – meaning the procedure is performed through a very small incision.
Returning to Daily Activities
Patients should be able to return to low impact activities like golfing, swimming, bicycling between one and two months after surgery. To help evaluate your progress after surgery, you will have several follow-up visits to see your surgeon. During the first year, you will follow up with a surgeon about every three months so your progress and the condition of your implant can be monitored.