Joint Fluid Therapy: A Solution for Keeping Knee Surgery at Arm’s Length

While the risk of arthritis increases with age, more than one-half of the 70 million Americans with arthritis are currently under the age of 65.

Bone and joint disorders are the number one reason patients see their doctors. One in eight Americans has a musculoskeletal impairment and one in three of these is secondary to osteoarthritis. It is estimated that about 30 million cases are reported each year.

It is hoped that the following information will increase your knowledge and awareness of osteoarthritis and help improve your ability to understand the treatment options and improve your lifestyle.

Osteoarthritis affects more than 70 million Americans. Everyone who lives will get osteoarthritis. It is not a matter of IF, but WHEN, will it become present and how much it will affect your life.

Everyone has different symptoms with osteoarthritis. Some people have a lot of pain and others have very little pain. Pain varies from patient to patient. Some people develop a lot of deformity and others develop very little deformity. It is the most common form of arthritis, affecting every lifestyle to some degree, and it will affect one out of three adults. It is the number one cause of disability in women and the number two cause of disability in men, and it is the leading cause of disability worldwide.

People with osteoarthritis complain of pain when walking, especially on unleveled ground, inclines, and stairs. They find it difficult to get out of a chair, off of a toilet, or into their car.

By the year 2010, 50-year-olds will make up one-third of our population. Approximately 25 million people with osteoarthritis are under the age of 50. Unfortunately, there is not a cure for osteoarthritis. Your comfort and mobility may depend on the quality of information you receive and how you apply it to your life.

Osteoarthritis affects your life when you get out of bed in the morning. It affects the lifestyle you live whether you are at the computer, putting on your clothes, walking, riding in your car, or sitting at church.

Osteoarthritis is most commonly found in the knee joints. The knee joint is the largest joint in the human body, and it is the most complex joint.

The knee is controlled by multiple muscles, tendons, and ligaments and is made up of four bones. These include the femur (the thigh bones) which articulate with the tibia (the shin bone) that goes from the knee to the ankle. There is a smaller shin bone that goes from the knee to the ankle along the outside portion of the leg. The patella, or knee cap, is the small bone in front of the knee that moves with motion.

There are four main ligaments in the knee joint that stabilize the bones as you move the knee joint. There are “cushions” in the knee called the meniscus. They help protect the knee through motion, and they give motion stability and they cushion the joint surface.

The articular cartilage is the smooth cushioning material that covers the surface of the bones that move on each other. Anywhere that two bones move together, there is also fluid to help the slip and slide of the bones. When you develop osteoarthritis, the fluid in your knee begins to dilute and you start to lose your “slip and slide.” You are losing your WD-40 effect. Your bones lose their mechanical slip and slide and a cushioning effect. So, like an old engine valve with bad motor oil, it begins to wear out normally and causes increased damage.

The first line of treatment for osteoarthritis is aimed at relieving pain. Pain medication, anti-inflammatory drugs (NSAIDs), physical therapy, topical analgesics, steroid injections, and viscosupplementation can bring relief.

If continued damage and deformity occurs to the joint as the conservative care fails, then surgery may be required, including total joint replacement surgery. You must remember, however, that a chance to cut is not a chance to cure.

Viscosupplementation has proven to be a very productive and successful conservative treatment plan. It is an injection procedure that helps reestablish the viscosity of the knee joint to reestablish lubrication. This will increase the cushioning effect, help lubricate through range of motion, and diminish pain. Hyaluronate is normally found in our knee joints. It is the fluid we have that lubricates and cushions our knee joints. It enables bones to move smoothly over each other and acts as a shock absorber for joint loads.

Viscosupplementation has been used for over 10 years with a very high success rate. It offers a very good therapeutic option for individuals with osteoarthritis of the knee.

One of the added procedure techniques used at Oaktree Orthopaedics is the use of fluoroscopy (motion picture x-ray) during the injection of Hyaluronate so that there is no “poke and hope” during the placement of the needle. It perfects the injection technique.

It is my desire to help patients learn more about prevention and treatment options related to osteoarthritis. This includes all type of treatment from conservative care to the point of surgical intervention.

If you believe that you are having symptoms associated with osteoarthritis of your knee, myself and Oaktree Orthopaedics would be happy to evaluate you. After evaluation, we can discuss treatment plan options that hopefully would allow you a more functional lifestyle, offer some pain relief, and allow you to stay mobile and independent.

Just call us at (864) 855-1633, and we will make arrangements to evaluate you.

(Dr. Dwight A. Jacobus, D.O., is a Board Certified Orthopaedic Surgeon with offices in Anderson, Greer, Easley and Seneca.)