Osteoarthritis Treatment From Sarasota Orthopedic Surgeon Dr. Bennett
Osteoarthritis, also known as “wear and tear” arthritis, can be debilitating. Interestingly, the term arthritis is often only utilized after tell-tale signs show on an x-ray. These changes include joint space narrowing and spurring. However, the precursor of arthritis is often cartilage damage. Cartilage is the cap of tissue on the ends of all our bones which provides for a low friction environment and easy gliding of our joints.
Cause of Osteoarthritis
With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Because the cartilage is no longer dissipating forces normally the underlying bone called subchondral bone experiences changes that may include hardening in some areas and softening in others. Additionally, because the forces are dissipated well, the body reacts by creating increased surface area and additional bone called spurs or osteophytes. This is the body’s attempt to dissipate forces across a bigger surface area. Cartilage damage can occur from acute injuries, or chronic increased forces. Additionally, angular deformities can also damage cartilage, like excessively bowed knees.
Symptoms of Osteoarthritis
Osteoarthritis can affect any joint in the body, with symptoms ranging from mild to disabling. A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other when the joint moves. While this may cause some pain, much arthritic pain is related to the fact that inside the joint the cartilage is breaking down creating small particles which creates an inflammatory effect in the joint. Inflammatory enzymes are direct pain producers.
As arthritis worsens, bending the joint becomes difficult and can become limited.
Dr. Bennett will assimilate your diagnosis by taking a careful history, performing a physical exam, taking an xray. Often arthritic joints are painful for other reasons; inflammations of surrounding tendons, inflammation of the synovium or a torn meniscus cartilage.
Early, nonsurgical treatment can slow progression of osteoarthritis, increase motion, and improve strength. Most treatment programs combine lifestyle modifications, medication, and physical therapy.
Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, the doctor may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide temporary relief of pain and swelling. Dietary supplements called glucosamine and chondroitin sulfate may help relieve pain from osteoarthritis.
A balanced fitness program, physical therapy, and/or occupational therapy may improve joint flexibility, increase range of motion, reduce pain, and strengthen muscle, bone, and cartilage tissues. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.
Often arthroscopy can be utilized to temporize pain from meniscal tears associated with arthritis of the knee or loosen up the capsule of the joint if there restrictions or adhesions are present. Long-term, however, others techniques are more permanent.
The long bones of the arm or leg are realigned to take pressure off of the joint. Thisis falling from favor as a treatment approach.
A surgeon removes parts of the bones and creates an artificial joint with metal or plastic components (total joint replacement or arthroplasty). This surgeon can replace a portion of the joint or the entire joint. Dr. Bennett can provide a custom implant made exactly for you.
Following joint replacement surgery, especially for the knee, often patients are on a walker for a long period of time. At Bennett Orthopedics and Sportsmedicine, Dr. Bennett can perform a minimally invasive total knee replacement which should allow you to walk without a cane in 2 weeks.