Arthritic joints are swollen, or inflamed, usually because the smooth cartilage around them has been damaged in some way. Patients with arthritis suffer from pain, stiffness and swelling in the affected area(s).
Nearly one in three adults suffers from arthritis or other chronic joint symptoms. Arthritis is the most common chronic ailment among the elderly, although it can affect people of any age, including children.
There are over 100 different types of arthritic diseases. The most common is osteoarthritis, a degenerative joint disease in which the cartilage protecting the bone ends wears away. At first, discomfort results from inflammation in the joint. Then, as the condition progresses, the worn bones rub together with painful friction whenever the joint moves. Osteoarthritis frequently affects weight-bearing joints such as the spine, hips and knees.
Rheumatoid arthritis is a chronic condition in which the body's own immune system attacks the joint lining. This autoimmune disorder usually affects the hands and feet and can cause pain even when the joint is not being moved.
A diagnosis of arthritis is made after an evaluation of symptoms, a physical examination and one or more diagnostic imaging tests.
Unfortunately, most types of arthritis are currently incurable – but today's treatment options can be very effective. Treatment typically involves a combination of anti-inflammatory medication and devices to relieve stress on the joint (canes, crutches or splints). Regular exercise, weight loss for overweight patients, and cortisone injections may also be helpful. In severe cases, orthopedic surgery such as joint replacement may be the only way to improve or restore function and relieve pain.
Sometimes the best way to relieve pain and restore function to a joint is to replace all or part of it with a prosthesis (an artificial joint). Prostheses are intended to restore function to the joint and relieve pain associated with arthritis, other chronic conditions, or traumatic injury.
Prostheses are designed to move like a regular joint. They are made of durable plastic and metal parts that fit together snugly but glide smoothly (as opposed to the painful friction associated with the worn cartilage of arthritic joints). The pieces are shaped like the structures they replace – for example, the damaged bones in a ball-and-socket joint of a hip or shoulder are replaced with a metal ball and plastic socket. They are held to the surrounding bone either with a locking mechanism or with a special bone cement.
The length and difficulty of recovery depend on the location of the joint replaced as well as the patient's age and overall health. Hip or knee surgery typically requires temporary use of a cane or walker. Some pain and stiffness following surgery is normal. Gradually the weakened muscles regain strength and flexibility as the patient becomes accustomed to using the joint. The physician will discuss when it is safe to return to any athletic activities. Once in place, prostheses usually perform well for up to a decade or longer.
Which joints can be replaced?
The hip and knee are the most frequently replaced joints, although it is possible to treat many others. Procedures include:
A fracture is a break or crack in a bone that occur when the bone cannot withstand outside forces, often as a result of trauma or disease. Fracture, break and crack all refer to the same thing. Fractures can range from a small crack in the bone to complete separation. They are often caused by a fall, motor vehicle accident or sports injury. Normal activities can also cause fractures for people at a higher risk, including those with low bone density (osteoporosis), bone tumors, cancer or brittle bone disease (osteogenesis imperfecta).
Some of the different types of fractures include:
A bone fracture causes pain, swelling and sometimes bruising of the affected area. Applied weight or pressure causes even more severe pain. They are usually easy to diagnose, but treatment requires precision and care by experienced professionals.
We offer specialized knowledge and care for the treatment of fractures. Our doctors will treat your injury every step of the way until it is completely healed. Bone fractures can be diagnosed by physical examination and an X-ray or CT scan. Immobilizing the area is often helpful in relieving pain before proper treatment begins. Treatment for bone fractures depends on the location and type of fracture, as well as the patient's medical history. We take all of these factors into account when developing a treatment plan.
Mild fractures, including stress and greenstick fractures, usually only require the conservative treatment methods of ice, rest and anti-inflammatory medication. Moderate fractures may require splints or braces along with pain medication. The immobilization helps relieve pain and speed up recovery. More severe fractures may require surgical treatment, especially open fractures with wounds that need to be closed.
After the proper treatment is performed, the rehabilitation process begins. It is important to care for your fracture while it heals. Full healing can take several weeks to several months. Your doctor will advise you on how to care for your fracture and helpful measures you can take to ensure a speedy and healthy recovery.
The Osteoarticular Transfer System, commonly known as OATS replaces damaged cartilage in the knee with healthy cartilage from another area of the joint, relieving pain and restoring movement and function to the joint. A mosaicplasty is the name for a general procedure that treats severe cartilage damage, and the OATS procedure is one type of mosaicplasty.
Although cartilage is essential to smooth, painless movement of the joints, some areas have a more critical need for the support and cushioning provided by the cartilage. During the OATS procedure, small plugs of healthy cartilage are removed from areas of the joint that are not in critical need, and transferred to the area of damaged cartilage.
The OATS procedure is ideal for patients with small areas of cartilage damage that can be easily repaired with a graft. Widespread cartilage damage cannot usually be treated with this procedure, since there may be insufficient amounts of healthy cartilage available.
After the OATS procedure, patients will need to undergo a lengthy physical therapy program in order to restore range of motion and relieve pain and swelling on the joint. Most patients will be on crutches for 6 to 12 weeks after surgery before they can successfully bear weight on the joint again. Long-term follow-up care will be required in order to maintain the results of this procedure.
Autologous Chondrocyte Implantation, commonly known as ACI, is a surgical procedure that treats cartilage damage caused by injury or degeneration. This procedure is most often performed to treat the knee, although it can be used on other joints as well. It is used after non-surgical treatments have failed and cartilage damage is severe.
During the ACI procedure, Dr. Sumida will use arthroscopy to identify the area of cartilage damage and remove a small sample of healthy cartilage cells. These cells are sent to a lab, where they are duplicated over the next four to six weeks. Once enough cells have been grown, a second procedure is schedule, during which the new cartilage is implanted into the joint with the aid of a periosteal patch.
After this procedure, patients will need to undergo a physical therapy program in order to restore full function to the treated area. The ACI procedure is ideal for patients with only small areas of cartilage damage, who have significant pain and swelling, and who are not obese. This procedure is considered safe for most patients, although there is a risk of scar tissue formation, infection and knee stiffness developing after surgery.
A fracture is a break in a bone. It may be a crack in the bone (a stress fracture) or a complete break; the bones may shift out of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break as well as the patient's overall health.