Ask the Doctors February 2004 Issue

Ask Dr. Marks: 02/04

I知 going to have hip replacement surgery next month. What can I expect to undergo or experience prior to surgery?

Preparation for a total joint replacement is an important part of your overall care. It includes a complete health evaluation, laboratory studies, a nutritional assessment, a session with a physical therapist, and patient information concerning the surgery. You値l learn about total joint replacement and why postoperative care is important in achieving good results. The physical therapist will familiarize you with post-operative exercises prior to surgery. After surgery, you値l receive pain medications and physical therapy procedures. You値l also learn why following the postoperative plan is important to achieve maximum results. Good nutrition is important様ack of proper nutrition can lead to many complications, such as wound-healing problems. If there is a serious nutritional problem, it will have to be corrected prior to surgery. The goal of your preoperative evaluation is to decrease the risk of complications during the surgery and to allow the postoperative course to proceed smoothly.

----------

Can steroid therapy cause osteoporosis, particularly in the elderly?

It is true that systemic steroid therapy can cause severe osteoporosis, which can lead to fractures of the vertebrae and other bones. Steroids are very effective in decreasing inflammation, and therefore pain. They do, however, produce numerous side effects, one of which is osteoporosis. Steroids should always be monitored by your doctor and given for only significant medical conditions.

Steroid injections into joints four to five times a year will have very little effect on your overall system since the body will have been exposed to very little of the injected medication. Unless abused, joint steroid injections are not associated with generalized osteoporosis either in the elderly or in younger patients.

----------

I致e heard that milk, and apple cider vinegar, can help my osteoarthritis. Is there any truth to this?

The ingestion of apple cider vinegar will not relieve the symptoms of osteoarthritis. It certainly has no effect on the progression of this degenerative disease.

Over the years there has been a great deal of folklore surrounding the treatment of OA. Most home remedies have not withstood scientific scrutiny and have been discarded. On the other hand, some home remedies have been found to help stem the pain of OA. I have discussed in this column, for example, the mild but beneficial effects on arthritis pain of fish oil that contains Omega-3, one example of a small group of beneficial home remedies.

Unfortunately, a multi-million-dollar industry has been developed, and continues to thrive, on supplying the public with unproven arthritis remedies. Most, but not all, of these remedies are expensive, useless, but not harmless耀ome can have unwanted interactions with other medications.

Milk, on the other hand, is an important source of calcium. Maintaining a proper level of calcium during your lifetime can protect you from osteoporosis, but the ingestion of milk does not help to prevent or decrease the symptoms of osteoarthritis.