One of the truly great advances in the treatment of arthritis has been in Orthopedic surgery. In the past, osteo-arthritis sufferers were doomed to bed, or experience knee pain daily, when climbing stairs or after squatting on the floor. Now with the advent of advances in imaging, medications, appropriate surgery, these previously symptomatic and infirm or fit people, can now lead a life of comfort. The results are not exaggerated but are real. People have a wide variety of choices. However the exact procedure has to be tailored to the activity level, age, pain thresholds and pattern of involvement of the arthritis.
It is important to caution people about prolonged medication at first. Pain killers are prescribed as demanded and as a first line of treatment. Consumption of drugs on a long term can lead to adverse affects. The recent withdrawal of a drug called ‘Rofecoxib’ by MERCK in the US was forced by its possible association with hypertension and heart attacks after prolonged consumption for two years. Nutraceuticals like Glucosamine are also tried but are expensive in the long run.
Orthopedic Surgery in people with arthritis should not be viewed as a last resort, but it actually serves two purposes.
Joint replacement in a joint destroyed by arthritis serves to correct something that is drastically wrong and restore function to the joint. Senior citizens with arthritis need joint replacement. A second major purpose of surgery is to prevent further injury from happening. Middle aged people with bony deformities like bow legs, obese individuals, are bound to get arthritis and will need a major surgical intervention within the next ten years. In these set of people alternatives to joint replacement, are applicable and available locally. These alternatives are less expensive and safer to do. They have a very good success rate.
In deciding whether you need to go through an operation for a particular problem, it is important to consider the basic disease as well as the injury itself to the articular cartilage. Articular cartilage is the rubbery tissue that lines the ends of bones forming a joint. It is a precious tissue capable of only very limited regeneration after injury unlike the other tissues of the body. Loss of cartilage leads to bone grinding on bone and is pointed out on X–rays by your Orthopaedic surgeon as loss of joint space. Lying X-rays taken commonly with patient lying on the X- ray table ‘lie’ about the severity of the problem and special x rays are needed in assessment of younger individuals with knee pain.