Surgical Solutions

When you have a joint replaced, your anesthesiologists job is to keep you comfortable and safe during your surgery and as pain-free as possible after the procedure. In the past, that often meant going under general anesthesia and getting strong narcotics to dull the pain. Not anymore. Today, when it comes to anesthesia, less is more.

Do you have pain in the front of your knee and feel a grinding sensation when you bend your knee? If so, you may have chondromalacia patella. This is the breakdown of articular cartilage on the underside of the kneecap (patella). Articular cartilage is a tough, elastic tissue that covers the ends of bones in the most mobile joints in the body, including the knees. It allows for smooth, pain-free movement.

Total knee replacement surgery is always the last resort. It is an option only after all other measures have failed to provide adequate relief. These include physical therapy, pain medications, corticosteroid injections, bracing and others. The goal of knee replacement surgery is to eliminate the chronic disability from pain. Youre not going to get the knee you had when you were 19, says Nageotte. But you can get pain relief and improved function.

If you are having joint replacement surgery, its likely that youll be going home soon after the surgery, possibly even the next day. Fewer and fewer people go to a rehabilitation facility, and thats for the best. Studies are showing that people who undergo joint replacement recover just as well at home.

Theres no doubt that our bodies, including the complex array of structures in and around the spine, change with age. For example, the cylindrical disks tucked between each bone (vertebra) of the spine are subject to some deterioration. This may or may not lead to pain or other symptoms.

Rheumatoid arthritis commonly affects the hands and wrists. Medications and nondrug measures, such as physical therapy and joint protection strategies, are the primary treatments. If pain and dysfunction become severe and seriously limit movement, surgery can be considered. There are many possible causes of the symptoms you describe, and you may have more than one problem. For example, you may have arthritis plus the flu. But there are other reasons for joint pain besides arthritis. The fact that you spend a lot of time outdoors raises suspicion that you may have Lyme disease.

Total hip or knee replacement surgery can be life-changing for many people with severe arthritis, allowing them to return to a high level of function free of pain. But for people with rheumatoid arthritis or another form of inflammatory arthritis (rather than osteoarthritis), there are some added concerns.

Some bone loss occurs in everyone with age. For women at menopause, this process speeds up. A study published in the Journal of Bone and Mineral Research (February 2017) found that women who ate what is considered an anti-inflammatory diet (high in vegetables, fruits, fish and whole grains and low in sugar and processed foods) had less bone loss. The researchers analyzed data from the large Womens Health Initiative study to look for an association between inflammatory elements in the diet and bone density and fractures.

For people with the bone-thinning disease osteoporosis, the greatest concern is a broken bone. Once the bones of the spine (vertebrae) become fragile from osteoporosis they can fracture even without a traumatic injury, like a fall. This is called a vertebral compression fracture.

For being relatively small joints, your ankles do a big job. They support your weight and absorb more force per square centimeter than any other joint. You might think this would make them especially susceptible to osteoarthritis, in which cartilage (the cushioning material between bones at joints) deteriorates over time. Yet osteoarthritis from normal activity is far less common in ankles than it is in hips and knees.

Ever since the nonsteroidal anti-inflammatory drug rofecoxib was taken off the market in 2004 because of its link to heart disease, questions have been raised about other NSAIDs. The ancient Chinese practice of tai chi has become a popular form of exercise around the world. Medications for rheumatoid arthritis (RA) can be very effective, especially when treatment is started early. In addition to helping people lose weight, weight-loss surgery (called bariatric surgery) has been shown to have positive health effects, such as reversing or preventing diabetes.

Pain in your knee may be a sign of osteoarthritis. It could also be a torn meniscus (a C-shaped piece of cartilage in the knee joint). Or, it could be both. There is a high prevalence of both meniscus tears and osteoarthritis in the knee in middle-aged and older adults, says orthopaedic surgeon Kurt P. Spindler, MD. Surgery to repair a torn meniscus is an option, but should you go this route? A study comparing surgery to physical therapy for meniscal tears found that both are equally effective, which caused some people to conclude that surgery is practically useless.