Osteoarthritis

What is Osteoarthritis?

Arthritis or osteoarthritis is a disease that involves a breakdown in the structure of joint cartilage. Deformations in the cartilage or in the bony tissue under cartilage cause an abnormal growth in the bone and swelling in the sides of joints.

How is the course of disease?

Arthritis is a disease with a slow course. It causes pain and limited range of motion in the joints.

Who may have arthritis?

Arthritis is an aging-associated disease. It rarely occurs before 40. Half of the people over 60 have symptoms of arthritis. It is 3 times more common in women.

Does weight affect arthritis?

Overweight increases the risk of arthritis (especially in the knees) due to a heavier load on the joints. Weight gain can cause a rise in a patient’s complaints. Even the loss of some pounds may decrease the risk of arthritis.

Is arthritis hereditary?

It is known that it occurs in some families earlier and more often. This is due to the hereditary aspect of this disease. The type that causes swelling in the finger joints is particularly affected by heritage.

Can arthritis occur based on other causes?

Structural defects in the joints (like hip dislocation, or some other irregularity on hip joints) or accidents and impacts increase the risk of arthritis due to the disruptive effects on joints.

Which joints are most commonly affected by arthritis?

Arthritis occurs mostly in knees, hips, fingers, toes and spine. Knee arthritis is particularly common in women and more likely in overweight. Hip arthritis occurs in men as much as women. Finger arthritis occurs especially in the anterior joints. Arthritis on thumbs causes swelling and decreased movement. Arthritis on big toes (hallux rigidus) causes an outward grow and/or a complete loss of movement in the toe. Arthritis may also occur on the most active regions of the body like neck and waist. It causes pain and soreness by disrupting the movement of facet joints. Symptoms of bone spurs pressuring the neural canals or spinal cavity may be found.

What type of complaints does arthritis cause in patients?

Patients mostly complain about pain and decreased movement in their joints. Pain is usually felt during movement or later in the day. Patients often feel relieved after rest. As the corrosion and disorder in the joint cartilage progresses, the patient may start to feel pain even during rest and joint movements may become so limited to create impairment in daily activities. Cracking sounds may be heard during movement. Movements may be blocked for a short time after a long rest or during mornings or after standing up from being seated. It often happens in the mornings and lasts for no longer than 30 minutes. Neighboring muscles around the arthritis may become thinner and weaker.

How is arthritis diagnosed?

An experienced orthopedist can diagnose arthritis by examination. Swellings, angular deformations (like bandy knees) and decreased movement in the joints make it easier to diagnose. X-ray is necessary to diagnose and to determine the stage of the disease as well as to plan the treatment.

How is arthritis treated?

The main purpose of treatment is to remove the pain, the swelling and decreased movement in order to enable the performance of daily activities without a problem. There is no treatment that corrects arthritis fully. It is impossible to renew the impaired joint. Weight-loss can decrease the pain on the joint by decreasing its load. It is very important to spread the daily activities and suggested exercises evenly throughout the day. The environment of home and workplace should be adjusted to the patient’s conditions (like raising the chairs in order to facilitate sitting and standing).

What are the effects of joint supplements?

Methylsulfonylmethane (MSM), chondroitin sulfate, collagen hydrolysate and glucosamine are the most known joint supplements. There are many studies showing that these supplements have a regenerative effect on joints in knees, hips, wrists and ankles especially when the disease is age-related. It is thought that medicines with a mixture of glucosamine, chondroitin sulfate and MSM are useful in decreasing the pain and supporting the joint movements.

Do thermal springs help in treatment?

Thermal springs or physical treatment can help according to the phase of disease. It might decrease the pain and increase the joint functionality.

What can be done about pain treatment?

If simple painkillers become insufficient, the pain can be relieved via anti-inflammatory drugs without cortisone. When arthritis causes extreme destruction in the joints, the patient may become unable to perform even the simplest of daily activities. In this phase, the patients complain about serious pains while walking and climbing up the stairs as well as waking up at nights due to intense pain. Arthritis at such an advanced stage can only be treated with a surgery of articular surface replacement of the joint.

What is a joint replacement (prosthesis) surgery?

Prosthesis surgeries are the replacement of broken down articular surfaces with metal, porcelain or polyethylene new surfaces. Many of the joints can be subject to replacement. Patients attain a normal, functional, pain-free joint after this surgery.

Which joints are most commonly replaced by surgery?

The most commonly operated joints are the hips and knees. But other joints in shoulders, hands, feet and even the broken down intervertebral discs can be replaced by prostheses.

How long are patients relieved after replacement surgeries? Do prostheses wear off? Do they need to be replaced after some time?

Patients are relieved for 10-20 years after replacement surgery. Prostheses do wear off or become loose after some time due to weakening of bones. They should be replaced with anew in these cases.

Is age important in a replacement surgery?

Patients from all ages can have replacement surgery.

Is weight important in a replacement surgery?

Most of the patients that suffer from knee or hip joint arthritis are overweight. Patients are weighed before surgery to calculate body mass index. Overweight patients are informed about the difficulties of post-operative period. But the results are not different for overweight patients than for those with normal weight. So it is good for overweight patients to undergo surgery if they have no other medical problems that preclude them.

There seems to be several types of prostheses. Which is the better one? How should prostheses be?

Yes, prostheses vary based on:

• the type of fixing
  • fixed by bone cement
  • fixed by growing into bones
• its material
  • metal, ceramic or polyethylene
• its size and shape

The important thing is for the surgeon to know which prosthesis is most suitable for the patient.

Can patients walk right after surgery?

It is generally possible for patients to walk 2 days after the surgery. However, in the cases of knee and shoulder surgeries, there has to be a rehabilitation period until joint movements become normal.

Is it possible to choose a wrong prosthesis?

It is not probable to choose a wrong prosthesis. However, we sometimes encounter patients that have less preferred (low quality) prostheses in their bodies because of its cheapness or lack of other options.

How is the procedure in hip joint replacement?

Hip joint is a synovial ball and socket joint. The femur moves forward, backward, inward and outward by the ball’s sliding in the socket. In a replacement surgery, the side of hip joint receives a 6-inch incision. The bones of hip joint that are affected by arthritis are reached through muscles and removed. The procedure ends after replacing them with prosthesis.

How is the procedure in knee joint replacement?

The knee joint is approached by an incision at the front. The damaged cartilage tissue in the surfaces of three bones that compose the joint is removed with a small amount of underlying bone. Then the proper-sized components of prosthesis are fixed to bone surfaces by the filling material called bone cement.