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Whether you have been living with painful joints for years or just recently noticed pain during daily activities, you undoubtedly have questions.  Dr. Curtis Hanson recently took some time to answer some common questions around arthritis and joint replacement.

WHAT IS ARTHRITIS?

Arthritis is a general term indicating damage to a joint.  Any joint in the body can be affected but some of the most frequently involved are knees, hips, shoulders, hands, and the spine.

 

WHAT ARE THE CAUSES OF ARTHRITIS?

Osteoarthritis is the most common form of arthritis and simply refers to mechanical wear and tear on a joint.  Rheumatoid conditions can also cause arthritis.  This type of arthritis indicates an inflammatory nature where the body's immune system attacks the joint.  Traumatic conditions such as fractures, ligament injuries, or cartilage injuries can also cause or accelerate the wear on a joint.

 

HOW DOES BODYWEIGHT AFFECT MY JOINTS?

Weight-bearing joints like knees experience 3-5 times your body weight.  Heavier people are more likely to develop arthritis and surgical outcomes are not as good at higher body weight.  That said, if patients lose 10 pounds, the knee will experience 30-50 pounds less loading.  This will likely decrease the rate of wear on the joint and help put off surgical treatment.

 

DOES JOINT REPLACEMENT HELP PATIENTS LOSE WEIGHT?

Although many patients believe that they are unable to lose weight because they have arthritic joints that prevent them from exercising, current data does not support that patients lose weight after joint replacement.

 

WHAT IS JOINT REPLACEMENT?

Joint replacement surgery removes the worn areas of a joint and replaces those areas with metal, plastic, or ceramic.  The cartilage in a joint is much like the tread on your tires.  It wears over time at a rate affected by the harshness of use.  A joint replacement replaces the "tread" on the joint.

 

WHEN SHOULD I CONSIDER JOINT REPLACEMENT?

The time to consider a joint replacement is when your pain and quality of life are limited to a level that is below what would be considered a "successful' outcome of a joint replacement.

 

HOW SUCCESSFUL IS JOINT REPLACEMENT?

Joint replacement is considered one of the most "successful" surgeries in all of medicine.  Around 90-95% of people are happy with hip and knee replacement, with hip replacement being at the highest end of the range.

 

WHAT ACTIVITIES CAN I DO WITH A JOINT REPLACEMENT?

Joint replacements are not "normal" joints.  They are internal prosthetics and will not perform exactly like a native human joint.  They are fine for prolonged walking, biking, swimming, and other low impact activities but they are not ideal for higher impact activities such as running or contact sports.  Doubles tennis would be considered at the high end of recommended activities.

 

WILL JOINT REPLACEMENT ELIMINATE MY PAIN?

Joint replacement is quite successful at improving pain.  This is probably the greatest advantage.  However, many people will describe some discomfort (generally minor) with prolonged activity and sometimes with weather changes.

 

WHAT ARE THE RISKS OF JOINT REPLACEMENT?

Joint replacement is considered a relatively low-risk surgery.  Complication rates are around 1-2%.  These include infection, blood clots in the leg/lungs, and mechanical problems such as loosening or failure of the implants.  Hip replacements can dislocate if put in extreme positions.  Dislocation is not generally an issue for knee replacements but they can have more subtle instability.  Hip replacements can change the length of your leg but the difference is usually very small.

 

HOW LONG WILL A JOINT REPLACEMENT LAST?

This is difficult to know because there is variability based on age, weight, sex, etc.  Also, the current materials have only been around for about 15 years.  However, 20 years would be a reasonable expected longevity for knee replacement and likely longer for hip replacement.

 

ARE THERE BIOLOGICAL ALTERNATIVES TO JOINT REPLACEMENT?

While we have cartilage restoration procedures that can be successful for smaller areas of cartilage loss, these options are not usually successful for more generalized wear.  The success rate of cartilage restoration procedures also decreases with age.  There are different types of injections that can be used as temporizing measures but they do not "fix" arthritis.

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