Out of Joint

1
Out of Joint?

• What to consider when arthritis and wear and tear
  take their toll.
• J. Christopher Sherrell, M.D.

2
Arthritis

• Arthritis actually refers to more than 100
  diseases that can cause problems with joints and
  connective tissue and is the primary reason
  people have joint replacement

3
The American Academy of Orthopedic Surgeons has
designated this the Bone and Joint Decade to
increase awareness and research in the area of
arthritis
4
Statistics

• Arthritis
• Is the leading cause of disability among American
  adults
• Affects 43 million Americans
• Is one of the most common chronic health problems
• Is the most common cause of long-term pain and
  disability
• Costs the economy over 200 billion per year
• Affects people of all ages

5
Types of Arthritis

• Osteoarthritis
• Rheumatoid Arthritis
• Gout
• Inflammatory Arthritis
• Lupus
• Other types of arthritis

6
Osteoarthritis

• By far the most common form
• Also called degenerative joint disease
• Causes symptoms in 1 out of 3 people over 60
• Caused by a breakdown of
• joint cartilage

7
Symptoms of Osteoarthritis

• Pain
• Swelling
• Decreased motion
• Tenderness to touch
• Noise
• Enlargement
• Deformity / malalignment

8
Possible Causes

• Obesity
• Age
• Excessive stress on joints
• Malformation
• Injury

9
Cartilage
Bone
10
Cysts
Cartilage
Bone
Spurs
11
Knee Joint
Cartilage
Osteoarthritic Knee
Healthy Knee
12
X-Ray
Healthy knee
Osteoarthritic knee
13

• This is what an arthritic joint looks like.
• Notice the surfaces between the bones are worn
  and uneven.
• This creates friction, which causes pain.

14
Osteoarthritis
15
Commonly affected joints
Shoulders
Spine
Hips
Hands
Fingers
Knees
Ankles
16
Arthritis

• Treatment options
• Medication
• Vitamins and nutraceuticals
• Alternative medicine
• Joint protection
• Exercise
• Viscosupplementation
• Surgery

17
Goals of Treatment

• To relieve pain
• Increase motion
• Improve strength

18
Primary Medical Treatment

• Over the counter
• Medication
• Non-steroidal anti-inflammatory meds
• Intra-articular steroid injections

19
Over-the-Counter Medications

• Acetaminophen (Tylenol)
• Anti-inflammatory Drugs (NSAIDS)
• Aspirin
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Topical Medications
• Methylsalicylate
• Capsaicin

20
Prescription Medications

• Traditional NSAIDS
• COX-2 inhibitors
• Celebrex
• Mobic
• Corticosteroids (cortisone, prednisone)

21
Other Forms of Medication

• Injections
• Liquid cortisone
• Hyaluronate

22
Non-Medical Treatment

• Pacing activities
• Joint protection
• Exercise
• Application of heat and cold
• Self-care skills

23
Pacing Activities

• Alternate between periods of activity and periods
  of rest
• Alternate heavy tasks with light tasks
• Change position frequently
• Plan rest breaks between daily activities

24
Heat Ice May Alleviate Pain

• Moist Heat
• Towels, hot packs, bath or shower
• 15-20 minutes
• 3 times each day

• Cold Therapy
• Ice packs
• 10-15 minutes at a time

25
Exercise/Physical Activity

• Range of motion exercise
• Strengthening exercises
• Endurance exercises
• Note always consult your doctor prior to
  beginning any new exercise program

26
Surgical Options

• Arthroscopy
• Surgical abrasion of cartilage
• Synovectomy
• Osteotomy (joint re-alignment)
• Joint replacement

27
Asking Questions About Surgery

• Why?
• Alternatives?
• Benefits and for how long?
• Risks?
• What is procedure called?
• How is it done?
• Results

28
Total Joint Replacement
Joint replacement means the damaged joint is
replaced with an artificial implant
Knee
Hip
29
Total Joint Replacement - Current

• 98 success _at_ 10 years
• 90 success _at_ 15 years
• Current implants goal 20-30 years

30
Future Treatments

• Research
• Medications
• Surgery
• New Materials

31
NEW OPTIONS FOR JOINT REPLACEMENT
Minimally invasive procedures Unicondylar or
partial knee replacements Special instruments
for smaller incisions Hip arthroscopy
32
THANK YOU www.kocortho.com