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Joint Replacements

  • Category: News
  • Posted On:
  • Written By: Chandra S. Reddy, MD., Orthopedic Surgeon
Joint Replacements

Joint Replacements

As Americans continue to live longer, we all expect to lead the same quality of life as we age. While life expectancy has increased significantly in the past hundred years, our bones and joints unfortunately don’t always comply with our wishes for a quality lifestyle.

As we age, the cartilage in our joints starts to wear out. Our joints, especially synovial joints like the hip, knee, and shoulder, are like world class ball bearings. When cartilage begins to wear out due to age, trauma or fractures in a joint, the ball loses its smoothness. And as the cartilage wears off, we ultimately start getting signs and symptoms of arthritis.

Initially, individuals experience mild pain, which gradually progresses and can cause difficulty with everyday tasks like shopping, walking up the stairs, playing with the grandkids, or even sports, like golf or tennis.

Luckily, science has advanced and stepped in to provide relief.

We can now grow cartilage cells, which we culture and use, but only for select younger patients and isolated cartilage defects. For the vast majority of patients, we start off with non-surgical measures.

Maintaining a healthy weight is critical to joint and cartilage health. Weight loss helps protect cartilage because every time we walk, we put six times our body weight on our knees and hips. That means taking 50 pounds off will unload your weight-bearing joints by 300 pounds.

Getting active is an equally important part of losing weight and exercising joints. Walking, swimming, yoga and other activities can be good ways to keep moving, and physical and occupational therapies will help as well.

Over-the-counter pain medication, along with stretching and a home exercise program, are also recommended. If exercise, weight loss, therapy or medications fail to alleviate the problem, it is time to visit an orthopedic specialist, where he or she will perform an exam and often get an X-ray of the affected joint to classify the amount of arthritis present.

For many patients, the next stage will be injection therapy. For knee, shoulder, thumb, or ankle arthritis, we can inject a local anesthetic with a corticosteroid. The injections are safe for the majority of patients, and relief can be significant and can last from a few months to years. Side effects are rare and include skin depigmentation, elevated blood glucose levels (especially in diabetics) and very rarely, infections.

If corticosteroids cannot be tolerated, or the effects are not long-lasting, there are FDA and insurance-approved hyaluronic acid injections for arthritic knee patients (brand names Synvisc, Durolane, Supartz, Eufflexa). Approval depends upon each insurance company and since the injections can be expensive, they must go through an approval process to be authorized once every six months, and only for knee arthritis.

Because the hip joint is deeper, it will need to be injected under fluoroscopy ( X-ray control with a longer needle). This is performed by an interventional radiologist or pain management specialist and done as an outpatient procedure. If or when all these non-operative measures fail, the next step is likely joint replacement.

We now have good long-term results and success with replacing hips, knees, and shoulder joints, and there are new ankle and elbow replacements available as well.

Most joint replacements are done in a hospital or surgery center as a same-day surgery or next-day discharge to home or rehab, if indicated by the physical therapist.



 

Chandra S. Reddy, MD., Orthopedic Surgeon

Board-certified orthopedic surgeon who’s been practicing for over 20 years. He received his medical degree from Bellary Medical College, in India, completed a general surgery internship at Mercy Fitzgerald Hospital and a residency at St. Johns Medical College, in Bengaluru, India, and Temple University Hospital, in Philadelphia. He went on to complete his Fellowship at Nirschl-Georgetown University in Sports Medicine, Arlington, VA. He specializes in orthopedic medicine and is experienced in acute injuries, adult reconstruction joint replacement surgery, sports medicine, and arthroscopic surgery as well as injuries and illness which may have a medical or metabolic basis.

To schedule an appointment with Dr. Reddy, call (610) 278-2802.

Suburban Medical Group | Suburban Orthopedics | 2705 Dekalb Pike |Suite 309 | Norristown, PA 19401 | (610) 278-2802 | www.suburbanhosp.org