Exercise & Prevention

With robot-assisted joint replacement surgery, the surgeon can accommodate for each person's unique anatomy. "During knee replacement surgery, we place markers in the thigh bone and the shin bone and then we map out the ends of the bones," says Dr. Molloy. The computer detects the markers and overlays a map of the knee joint over a computed tomography (CT) image that was taken before the surgery. The surgeon can then very accurately position the components of the implant.

For the knee osteoarthritis study, the participants doing HIIT started with a seven-minute warm-up, during which they slowly increased the cycling intensity. This was followed by a high-intensity burst, during which they cycled at a cadence up to 110 revolutions per minute (RPM) for 45 seconds. Then they slowed down to about 70 RPMs for 90 seconds. They switched between high intensity and lower intensity a total of five times before a six- to seven-minute cool-down of light to moderate pedaling.

Evenity is different. The idea for it came from research on a group of people in South Africa with a rare disease that causes them to have extremely high bone density and bones that grow too much. They were found to have a gene mutation that blocks the production of a protein called sclerostin.

The number of osteoporosis drugs and the different ways they are taken can be confusing. There are pills, injections and infusions, taken weekly, monthly or at other intervals. Your doctor chooses the best drug based on a variety of factors. A small percentage of people who take bisphosphonates have gastrointestinal problems, such as nausea, stomach pain, constipation, diarrhea and gas. This may be one reason your doctor prescribed Prolia, which is given as an injection and is easier on the stomach.

Some studies, many of them conducted in Japan, found that supplementation with vitamin K1 or vitamin K2 improved bone mineral density, and a few studies showed a decreased risk of bone fractures. Some subsequent studies found that vitamin K supplementation had no effect on bone mineral density. Many of the studies conducted thus far are limited by flaws in the design or a small number of participants.

"If we're seeing a patient early on, when they have mild-to-moderate changes inside the knee joint, they have a much better chance of the injection lasting a long time," Golnick says. The effects of the injection can last for three months or more in someone with mild-to-moderate arthritis, but those with more severe arthritis could have a return of symptoms within a fewweeks.

Joint replacement seems appealing because it retains, and may even improve, range of motion in the wrist. "The problem is durability of the implant," says Dr. Shapiro. With wrist replacement, bones are removed and an implant composed of metal parts and a plastic spacer is inserted. These implants are not as predictably long-lasting as implants for other joints, such as hips and knees. And complications can be particularly challenging to treat.

"For some people, shoveling snow is the first strenuous physical activity they've done in a while," he says. "Preventive measures should be taken." Everyone should be getting regular physical activity, even when it's cold outside. This will keep your body in shape when it's time to do vigorous activities. It will also help to make sure your heart is up to the task.

When it's cold outside, wearing warm socks, gloves and a hat should keep your feet, hands, and ears sufficiently warm. Some people have a condition called Raynaud's syndrome. This generally benign condition causes blood vessels in the fingers and toes to be overly constricted, making them feel very cold. The nose, lips and ears can also be affected. Raynaud's also causes temporary color changes. An affected finger may turn white or bluish and feel numb. It may turn red as it rewarms and throb or tingle.

There's a common belief that gout is caused by overindulging in foods high in purines, such as red meat, seafood and alcohol. This is because purines break down to uric acid, which is the substance that at high levels in the body can lead to gout. But it's not that simple. In fact, a recent study, published in the journal BMJ (October 2018), found that genetics was far more likely to be responsible for variations in uric acid levels than food. High-purine foods raise uric acid levels only a very small amount.

If you have neck pain, modify your activities for a few weeks to avoid putting additional strain on your neck. To relieve more severe pain, you can take an over-the-counter non-steroidal anti-inflammatory drug (NSAID) or get a prescription from your doctor. The drug gabapentin (Neurontin) may help with nerve-related neck pain. If you don't improve on these medications, your doctor might suggest an epidural steroid injection to decrease inflammation around and inside the nerve.

Telemedicine also includes a standard doctor's office visit, with the notable difference being that the doctor is in his or her office and the patient is at home. Using a computer, smartphone or tablet, the patient signs in on a website at the time of the appointment. Doctor and patient can then see and hear each other on their screens. It's like having a chat on FaceTime or Skype. In the case of virtual office visits, the software used for the video conferencing must comply with strict standards of security and confidentiality.