October 2019

Download The Full October 2019 Issue PDF

Subscribers Only — NSAIDs are effective because they block an enzyme called cyclooxygenase (COX), which exists in two forms—COX-1 and COX-2. These enzymes make chemicals called prostaglandins, which contribute to inflammation in the body.   More...

Ask The Doctors: October 2019

Corticosteroids are powerful anti-inflammatory medications. They suppress inflammation and pain, and they also suppress the immune system. If the immune system is weakened in any way, it can put you at increased risk for infections. A possible complication of any joint replacement surgery is infection. While this occurs only rarely, the risk is increased if the immune system is impaired. For this reason, people should wait to have joint replacement surgery after having a steroid injection until the immune system has had time to recover.   More...

Children Get Arthritis Too

Subscribers Only — Juvenile arthritis can present in much the same way as adult-onset arthritis, with joint swelling, stiffness and soreness that's more pronounced in the morning or when children are active. In an active child, these symptoms can be hard to tease apart from the normal aches and pains of playing sports, which is why a thorough diagnosis with a complete health history is important. That's often followed by imaging scans, such as ultrasound or MRI, to give the doctor a closer look at the child's joints.   More...

Get Nutrients from Food

For optimal bone health, we need a combination of multiple nutrients, including calcium, vitamin D, vitamin K and magnesium. Recommended calcium intake is 1,000 mg a day for men up to age 70 and women up to age 50, and 1,200 mg a day for women over age 50 and men over age 70. "If you can't get that much from food, try to get at least half," says Ilic.   More...

Should You Get a Partial Knee Replacement?

Subscribers Only — Osteoarthritis results from the deterioration of cartilage in joints. Cartilage is the tough material that covers the ends of bones, providing a smooth gliding surface. In the knee joint, where the thigh bone (femur) meets the shinbone (tibia), there are three places where bones make contact. One of them is on the inside (nearest the opposite knee, referred to as medial) and one is on the outside (farthest from the opposite knee, referred to as lateral). The kneecap (patella) is the third point of contact.   More...

Don't Ignore Ball-of-Foot Pain

Subscribers Only — The plantar plate is a fibrous structure underneath the foot that supports and stabilizes the joints between the toe bones and the bones of the foot. (These are the metatarsophalangeal joints [MPJ].) The plantar plate, which is made of collagen, consists of bands that provide attachments for ligaments that go to each toe and that go between toes. These keep toes straight (preventing them from drifting up) and also in alignment (preventing the toes from separating).   More...

In The News: October 2019

People with osteoarthritis in the knee or hip may be at increased risk for heart disease, according to a study published in the journal Osteoarthritis and Cartilage (June 2019). The researchers studied 469,177 residents of southern Sweden who were 45 to 84 years old in 2003. They analyzed health data from 2004 to 2014. Overall, 15,901 of the residents had osteoarthritis in the knee, hip, hand or other joints. For most causes of death, the researchers found no difference in risk between people with osteoarthritis and those without it. However, people with osteoarthritis in the hip or knee were almost 20% more likely than the general population to die of heart disease. Most deaths were from ischemic heart disease (from clogged arteries) and heart failure. The risk increased with duration of osteoarthritis. The increase is thought to be due to mobility problems and lack of physical activity among people suffering with painful joints. The study highlights the need to find pain-free ways to stay active.   More...

Use NSAIDs Cautiously

COX-2 inhibitors were developed to avoid the stomach problems that can occur with traditional NSAIDs. The COX-1 enzyme protects the stomach lining from corrosive effects of stomach acid, so it was thought that inhibiting just COX-2 would be easier on the stomach. But COX-2 also has a protective effect. The risk for stomach issues is about 50% lower with COX-2 inhibitors than with nonselectiveNSAIDs.   More...