Living with osteoarthritis
Osteoarthritis is the most common form of arthritis, affecting over 32.5 million adults in the United States. Also known as “wear and tear arthritis,” osteoarthritis (OA) is a common condition that develops with age and worsens over time.
Dr. Raul Cabos, a rheumatologist at the Internal Medicine Group, said that this slowly progressive degenerative disease is the leading cause of disability in the elderly.
“OA preferentially affects the hand joints, spine and weight-bearing joints of the lower extremities,” he said. “Areas that are more susceptible to this condition are your hands – especially the thumbs and tip of the fingers, hips, knees, lower back and the big toes.”
Dr. Cabos, who is board-certified in both rheumatology and internal medicine, said osteoarthritis is seen in an estimated 20 to 30% of the population, mainly in people ages 45 and older. Joint pain is the most common sign that a person may have the condition.
Raul Cabos, MD
“Your joints may feel stiff and painful after a lot of activity, such as at the end of the day. OA may cause morning joint stiffness, but it usually lasts no more than 20 minutes,” he said. “Other signs and symptoms may include joints that crack or grind; swollen knobs at the affected joints; difficulty moving joints; and loss of function or disability over time.”
Am I likely to get osteoarthritis?
Dr. Adam Goodyear, an orthopedic surgeon at OrthoKansas, said that while genetics play a part in determining whether a person will develop osteoarthritis, other factors are also at work.
“Osteoarthritis is the process of the breaking down of cartilage in the joints and the inflammatory response to that. Subsequently, patients aren’t able to function as well or perform daily tasks without pain, which can lead to a decrease in a patient’s quality of life,” he said.
Adam Goodyear, MD
“We know a great deal about osteoarthritis, including that there are genetic components to it, and there is active research into the causes and what predisposes someone to develop it. We know that OA can occur in people who’ve experienced trauma to their joints or have repetitive high-impact loading to their joints. We also know that obesity is a risk factor. But there are people who don’t seem to have any risk factors and still develop end-stage OA. We continue to learn more and more about it, which will hopefully help us predict and prevent the disease.”
While you can’t control some of the factors that contribute to the development of osteoarthritis, there are some steps patients can take to lower their risk or to manage their condition.
“Lose weight if you are overweight or obese. This can reduce pain by easing the stress on joints like the back, hips and knees,” Dr. Cabos said. “Exercise daily. Regular exercise can build muscle strength, ease joint pain and stiffness and lower your disability risk. Stretching, walking and water aerobics are good activities for people with OA.”
I’ve got OA. How can I fix it?
If you’re experiencing symptoms that aren’t alleviated with over-the-counter medication or through rest, ice, compression and elevation (RICE), it’s important to seek medical treatment. Contact your primary care provider for diagnosis and treatment or seek out a specialist. Rheumatologists, like Dr. Cabos, and orthopedic surgeons also care for patients living with osteoarthritis.
While there isn’t a proven treatment at this time to reverse joint damage caused by osteoarthritis, there are options to help manage the condition like:
- Over-the-counter pain relievers, such as acetaminophen (Tylenol), and non-steroidal anti-inflammatory medications like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) are helpful for a number of patients.
- Topical medications that can be rubbed on the skin over the sore joint
- Injections to help alleviate pain and symptoms
- Prescription medications such as duloxetine (Cymbalta)
“Patients can also work with a physical therapist or occupational therapist to learn safe exercises or movements, and how to properly use assistive devices that can help you in your daily life,” Dr. Cabos said.
Tyrel Reed, DPT, PT
Tyrel Reed, physical therapist at LMH Health, helps treat patients living with osteoarthritis. In Kansas, you can make an appointment with a physical therapist without a referral from a physician.
“During your first visit with the therapist, we gather a full medical history and perform objective tests to establish your baseline function,” said Reed, a former KU athlete who joined OrthoKansas in 2015. “We’ll assess your range of motion, strength, visualize gait mechanics and posture and look at the surrounding joints to see if they’re contributing to the osteoarthritis.”
Reed agrees that exercise is one of the best tools people can use to combat the pain or dysfunction caused by osteoarthritis. Walking, biking, elliptical, swimming and other aerobic exercises are some low-impact activities that can be beneficial.
“At the LMH Health West Campus, we can use an aquatic treadmill for patients that are unable to tolerate the stress from regular walking. This can be beneficial for restoring strength and range of motion to progress back to land-based exercise,” he said.
Patients benefit from access to state-of-the-art therapy equipment, sports medicine expertise and world-class imaging technology, all in a one-stop shop at the LMH Health West Campus.
Time for surgery
If medications and therapy don’t relieve pain and improve function, people with severe osteoarthritis may need surgery to repair or replace damaged joints. Patients can turn to an orthopedic specialist for evaluation and options. Patients throughout the region come to Lawrence to benefit from the depth and breadth of expertise and knowledge of the hip and knee replacement specialists at OrthoKansas - Dr. Goodyear, Dr. James Huston and Dr. Richard Wendt.
At their first appointment, patients who turn to OrthoKansas for evaluation and treatment can expect to undergo a thorough examination and x-rays, even if they’ve been done before.
“A lot of the time, we’ll have patients get x-rays from the very beginning,” Dr. Goodyear said. “There are specific x-rays that help us determine if there are arthritic changes in the joint. Because we’ll be taking those images, we tell patients to make sure to wear shorts or loose fitting clothing that they can easily change out of.”
Once x-rays and the exam are complete, the orthopedic team sits down with the patient to discuss treatment recommendations and options.
“Treatment plans are patient-driven, meaning that we provide you with information, but it’s a shared decision-making process between the patient and the surgeon. We won’t dictate what your process is going to be,” said Dr. Goodyear.
Surgical management for osteoarthritis can encompass a number of things – partial knee replacement or full hip or knee replacement if osteoarthritis is a factor. Arthroscopic surgery can also sometimes be an option. Your surgeon will discuss which options are appropriate for your situation.
Robotic joint replacement technology and new national certification
Patients can be confident that at OrthoKansas they’re treated with the most up-to-date, evidence-based practices that result in superior outcomes. In March 2021, The Joint Commission awarded OrthoKansas its Gold Seal of Approval® for Advanced Total Hip and Knee Replacement Certification. LMH is one of only two hospitals in Kansas to earn this designation, both west of the Kansas City metro area.
In addition, patients have access to the newest technology, including the MAKO robotic arm, an instrument used to perform partial and total knee replacements, as well as total hip replacements. Donor support through gifts to the LMH Health Foundation helped provide funding for this patient-centered technology.
“The MAKO system can be more precise than traditional surgical techniques because it can create a 3-D model of each patient’s joint,” Dr. Goodyear said. “Using the system, physicians create a personalized surgical plan. The robotic arm allows us to work within the parameters created and use it to assist in placing the new joints.”
Overall recovery times for traditional knee and hip replacements are similar, with complete recovery being a 3 to 6 month process. With the use of minimally-invasive surgical techniques, robotic surgery and improved pain management, the team is moving the needle toward quicker recovery times.
“Patients benefit from MAKO robotic arm assisted surgery through shorter hospital stays, faster recovery, improved joint function and less discomfort, resulting in a decreased need for pain medication,” Dr. Goodyear said. “We see that patients have better outcomes when they get care close to home, and we’re able to perform hip and knee replacements on an outpatient basis at the LMH Health West Campus. Our team at OrthoKansas has the experience and the expertise to deliver world-class care, close to where you live and play.”
Surgery isn’t the final hurdle
As they recover from surgery, patients will benefit from the expertise of a physical or occupational therapist. It’s vital for patients who undergo a joint replacement to follow the recommendations of their surgeon and be active participants in their recovery. The therapy team at LMH Health can help you get back on your feet.
“Our physical therapists will typically see a patient within a few days of their hip or knee joint replacement surgery, and we’ll see them two to three times per week,” Reed said. “As they show functional improvements and decreased pain, we’ll back the frequency of therapy down to once or twice per week.”
Reed said that hip and knee joint replacement patients typically undergo physical therapy for six to twelve weeks, based on their prior level of function and their goals moving forward.
“Even after therapy, our patients will continue gaining strength following a hip or knee replacement up to a year after surgery,” he said. “LMH Health and OrthoKansas have the clinicians, technology and facilities to provide care that’s exceptional and among the best anywhere. Give us a call and let us help you get moving again.”