Could the pain you are feeling be arthritis? Francisco J. Garcia, Physician Assistant at the Miami Orthopedics & Sports Medicine Institute Arthritis Clinic, answered this frequently asked question when he discussed self-assessment and management of arthritis of the knee and joint. hip during a recent virtual community health discussion.
“Symptoms of knee and hip arthritis can interfere with your ability to exercise, participate in social activities and go on vacation, and this decrease in activity can lead to muscle weakness, obesity, falls and ultimately depression,” Garcia said.
Arthritis can be classified as osteoarthritis, inflammatory arthritis, or post-traumatic arthritis, Garcia explained.
Osteoarthritis involves the degeneration of hyaline cartilage – the tough, slippery tissue that covers the ends of bones where they form a joint. The condition is usually caused by wear and tear over time. The most commonly affected joints are the knees, hips, neck, lumbar spine and hands, says Garcia. Osteoarthritis is linked to genetics and age, with the first signs appearing around the age of 50.
Inflammatory arthritis is triggered by an autoimmune disease that attacks the lining of the joint capsule, most commonly in the wrists, hands, fingers, toes and knees. The inflammatory process can eventually destroy the cartilage and bone in the joint, says Garcia. The most common types are rheumatoid arthritis, gout, lupus, and psoriatic arthritis. These diseases have a genetic component, can occur at any age and affect women more than men.
Post-traumatic arthritis is caused by a physical injury that damages the cartilage and/or bone and changes the mechanics of the joint, causing it to wear out more quickly. The injury can be from a sports or vehicle accident, a fall, or a military injury.
Because the knees and hips bear weight, they are among the joints most commonly affected by arthritis.
Knee arthritis occurs when the cushion between the femur and the tibia has deteriorated. When self-assessing your knee health, consider these symptoms of knee arthritis:
- Pain, which may be constant or intermittent and present during weight-bearing activities such as walking, standing, or kneeling
- Deformity, which occurs when the knee is misaligned, causing knee varus (bow leg) or knee valgus (knock knee)
- Gait instability and imbalance
- Loss or decrease in range of motion
- Muscle atrophy
- Crepitus, which is a grinding sound or sensation produced by friction between bone and cartilage
Hip arthritis occurs when the cartilage in the joint gradually wears away and the protective joint space between the bones decreases. In addition to osteoarthritis, inflammatory arthritis and post-traumatic arthritis, this degeneration can be caused by hip dysplasia – a genetic disease in which the socket of the hip does not entirely cover the spherical part of the upper femur.
When self-assessing your hip health, Garcia recommends you consider these symptoms of hip arthritis:
- Pain with active and passive range of motion
- Pain with hip rotation
- Pain that radiates to the groin and the front of the thigh, buttock, or knee
- Decreased range of motion, including difficulty crossing legs, putting on shoes, and cutting toenails
- Tightness of the hips
- Development of lameness
- Leg length discrepancy
To reduce the effect of arthritis on your quality of life, Garcia recommends seeing a specialist to assess your condition and initiate a non-surgical management plan to reduce your symptoms. Your conservative care plan may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, if tolerated
- Weight Reduction – A one pound weight loss leads to a five pound pressure reduction on the knee
- Topical creams
- Natural products, such as chondroitin, glucosamine, honey, turmeric and ginger
- Assistive devices, such as canes, walkers, or crutches
- Physiotherapy, which can strengthen muscles and improve balance, gait, and proprioception
- Low-impact exercises, such as swimming, walking, yoga, Pilates and Tai Chi – “Patients achieve better results when combining low-impact exercises and/or physical therapy with other modalities treatment,” Garcia said.
- Injections, such as cortisone, hyaluronic acid, platelet-rich plasma, stem cells, and amniotic fluid
“The injections can lubricate the joint and reduce pain and inflammation,” Garcia explained. “For the knee, a cortisone injection can provide relief for two to three months while a hyaluronic acid injection is effective for three to six months. Hip injections provide brief, mild relief, but do not last as long as knee injections.
When conservative treatments fail and pain affects your quality of life, surgical management may be warranted. Partial knee arthroplasties and total knee arthroplasties are performed under spinal anesthesia and sedation. Some patients will stay overnight in the hospital while other qualified patients will go home the same day. Garcia recommends that all patients undergo physical therapy for six to eight weeks for best results.
Patients undergoing hip replacement surgery can also stay overnight in the hospital or be discharged the same day. Orthopedic surgeons at the Miami Orthopedics & Sports Medicine Institute use the anterior approach, which protects soft tissue from damage, rather than the posterior or lateral approach, which has a longer recovery time and increases the risk of dislocation and discrepancy. leg length. Patients will move on the day of surgery and begin physiotherapy immediately.
For most people, joint replacement surgery is a game-changer, providing pain relief, improved mobility and a better quality of life, Garcia says.