Know the risk factors, treatment options for osteoarthritis

Osteoarthritis is the most common form of arthritis, affecting more than 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.”

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 and stiffness after a lot of activity, such as at the end of the day, is the most common sign that a person may have the condition.

Risk factors

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.

“We know that OA can occur in people who’ve experienced trauma to their joints or have repetitive high-impact loading to their joints,” he said. “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 you can take to lower your risk or to manage the condition, like losing weight if you are overweight and exercising daily to build muscle strength.

Treating osteoarthritis

If you’re experiencing symptoms that aren’t alleviated with over-the-counter medication or through rest, ice, compression and elevation, it’s important to seek medical treatment. Contact your primary care provider for diagnosis and treatment or seek out a specialist or an orthopedic surgeon.

“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,” Cabos said.

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 University of Kansas 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.

Surgical treatments

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.

At their first appointment, patients can expect to undergo a thorough examination and X-rays. Once those are complete, the orthopedic team sits down with the patient to discuss recommendations and create a personalized treatment plan.

“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,” Goodyear said. “We won’t dictate what your process is going to be.”

Surgical management for osteoarthritis can encompass a number of things, but your surgeon will discuss which options are appropriate for your situation.

Robotic joint replacement and new national certification

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.

Patients also have access to technology such as the MAKO robotic arm, an instrument used to perform partial and total knee replacements, as well as total hip replacements.

“The MAKO system can be more precise than traditional surgical techniques because it can create a 3-D model of each patient’s joint,” 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 taking three to six months. 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,” Goodyear said. “We see that patients have better outcomes when they get care close to home, 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.

“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 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.

— Autumn Bishop is the marketing communications manager at LMH Health, which is a major sponsor of the Journal-World’s Health section.

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