Ask the Doctors August 2018 Issue

Ask The Doctors: August 2018

Arthritis gloves……Timing for knee replacement

Q: I have arthritis in my hands. I’ve heard about arthritis gloves. Will these help?

Dr. Steven Maschke

Arthritis Advisor Editor-in-Chief Steven Maschke, MD, Department of Orthopaedic Surgery, Cleveland Clinic Orthopaedic & Rheumatologic Institute.

A: Arthritis in the hands, whether from osteoarthritis (the wearing down of the cushioning cartilage in joints) or rheumatoid arthritis (an autoimmune disease), can make even simple daily tasks challenging. If you have arthritis in any of the hand joints, it’s best to avoid excessive stress to protect them. There are many products that can help, including arthritis gloves. Most provide gentle compression, which increases circulation and helps decrease swelling and pain. They are made from a material that helps maintain warmth in joints, which helps decrease discomfort during motion. Arthritis gloves can make your hands feel better, but they do not stop the destruction of arthritis.

When choosing a pair of these gloves, look for ones with open fingertips. These allow you to feel, touch and grip items. There are several arthritis gloves on the market. The Arthritis Foundation recommends the IMAK® brand.

Other products that help people with arthritic hands to carry out daily tasks eliminate the need to use the affected joint or reduce stress. For example, electric jar and can openers do the work for you. A product called Dycem® is a non-slip material that comes in rolls. It can be wrapped around items such as utensils, improving the grip, which allows you to use less force to hold the item. When buying kitchen or gardening tools look for ones that have a large handle. The larger the diameter of the handle, the less stress there will be on joints.

If arthritis is in the joint at the base of the thumb, using a splint that immobilizes the thumb can help with pain. To learn more and get recommendations tailored to your needs, consult an occupational therapist.

Q: I have pretty bad knee pain from osteoarthritis, but I’m not eager to have knee replacement. How long can I postpone surgery?

A: There’s no straightforward answer to the question of when is the right time to have knee replacement surgery for osteoarthritis. It is an elective procedure, meaning the timing is a decision to be made between you and your doctor. Before getting to the point of even considering surgery, more conservative measures are used to treat knee osteoarthritis. These include weight loss if overweight, physical therapy, regular exercise, a knee brace, pain medications, and possibly injections of corticosteroids or hyaluronic acid.

You can put off surgery for as long as you want and continue with these other treatment modalities. This may be enough. Pain that can’t be adequately treated and declining function usually mean it’s time to consider surgery.

Your reluctance is understandable. But you should know that joint replacement surgery has improved over the years. Advancements have allowed for shorter hospital stays, less pain and fewer complications. The success rate is over 90percent.

You should also be aware that there may be negative consequences of waiting too long before having joint replacement surgery. If pain prevents you from getting enough exercise, muscles can weaken. This can make recovery more difficult. If arthritis causes your leg to become bent, especially if you develop knock knees, or your knee no longer straightens all the way, surgery may be more difficult to perform. And you may not be able to straighten the knee completely after surgery because the muscles, tendons and ligaments have adapted to thebend.

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