Osteoarthritis of the Knee and Hip

Arthritis is not just a single disease.  It is a term used to describe more than 100 different conditions that affect the joints in the body.  The word arthritis actually means inflammation of a joint.  Almost every animal that can walk is susceptible to this inflammation. Although many types of arthritis have some common aspects, each type has its own pattern of symptoms and affects different people in different ways. Two major forms of arthritis are rheumatoid arthritis and osteoarthritis.  In cases of rheumatoid arthritis, the body's immune system appears to go awry and attacks healthy parts of the body, particularly the joints.  In severe cases, the joints become deformed and internal organs are adversely affected.
 

What is osteoarthritis?

Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear and tear" arthritis.  Almost everyone is affected by it to some extent as they grow older.   It most frequently occurs in weight-bearing joints, mainly knees, hips and ankles.

This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones; but, with osteoarthritis, the smooth surface becomes rough and pitted.  In advanced stages, it may wear away completely.  Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement.  Bone spurs may form. In osteoarthritis of the knee, the shape of the bone and appearance of the leg may change over the years.  Many people become bowlegged or knock-kneed. In osteoarthritis of the hip, the affected leg may appear shorter.

What are the symptoms?

The number one symptom is pain.  The pain is caused by irritation and pressure on nerve endings as well as muscle tension and fatigue.  The pain can progress from mild soreness and aching with movement to severe pain, even when resting.The second symptom is loss of easy movement, such as bending or rising normally.  Morning stiffness is a problem for many people.  This lack of mobility, in turn, often causes the muscles serving the knee or hip to weaken, and overall body coordination suffers.

How is it diagnosed?

A simple weight-bearing s-ray and examination by a skilled orthopedic doctor will determine if you have osteoarthritis.  Time consuming and costly diagnostic procedures are not required.

 What is the treatment?

There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility and fatigue that are among its most disabling symptoms.  During the early and middle stages, a treatment program of medicines, cortisone shots, ice treatments, exercise and physical therapy can be very effective in deducing symptoms and improving mobility.

• Medicines  Acetaminophen or coated aspirin help relieve pain and have few side effects.  Nonsteroidal anti-inflammatory drugs (NSAIDS) are prescription drugs for pain and inflammation.  Do not take aspirin if you are taking NSAIDS.
• Cortisone Shots  Cortisone shots are given for inflammation.  for many people, joint arthritis is often made symptom-free of months or even years after cortisone shots.
• Ice Treatments  Ice packs on the knee (three times daily, 10 - 20 minutes at a time) are helpful for inflammation and temporary relief of pain and soreness.  Heat applications may be beneficial to warm up the joint prior to exercise or activity.
• Diet  There is no evidence that any specific foods will prevent or relieve arthritis symptoms.  It's important to keep thin, however, because excess weight aggravates arthritis by putting added pressure on the joints.
• Exercise and Rest  Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. 
• Motion is lotion for arthritis.  At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage.  A balanced routine of rest and exercise is best.

What about surgery?

• Arthroscopy  An arthroscope is a small instrument that allows a surgeon to see inside a joint and repair some problems through a very small incision.  Unfortunately, arthroscopic procedures generally are not helpful for arthritis.  In some cases, a flap of torn knee cartilage can aggravate arthritis and cause additional pain.  The cartilage flap can be removed by arthroscopy.
• Knee or hip replacement  Knee or hip replacement is a very positive solution to the pain and disability of advanced osteoarthritis.  The rough, worn surfaces of the joint are relined with smooth-surfaced metal and plastic components.

How can I schedule an evaluation?

To find a joint specialist, call 1-888-749-DrDr (3737).  One you have the physician's name and office number, just let them know you heard of the Alliance Joint Replacement Centers and would like to schedule an evaluation.

The Health Alliance and its Joint Replacement Centers have partnered with the Arthritis Foundation to offer free courses to help you learn how to cope with arthritis. This six-week class meets one day a week for two hours each class.  It is offered several times each year at the Health Alliance hospitals, including The Christ Hospital, The University Hospital, The St. Luke Hospitals, The Jewish Hospital and The Fort Hamilton Hospital.  To register for the next Arthritis Self-Help Course, call 1-888-640-CARE (2273).

The Health Alliance hospitals accept Medicare assignment. This information is not intended to render medical advice but to provide general information on osteoarthritis. Your doctor will review your particular diagnosis and recommend the best course of treatment for you.