...less medical jargon in a 'Quick Glance' format!
Degenerative Joint Disease Treatment:
Treatment of OA depends upon multiple factors including patient age, activities, medical condition, and x-ray findings. Patients with mild to moderate osteoarthritis of the hips and knees may benefit from a supervised exercise program such as walking. Non-impact activities such as swimming, cycling, and walking tend to be more comfortable for patients with OA. In a younger patient with signs or symptoms of OA, other causes of arthritis such as deformity, medical conditions, or bone disorders should be carefully sought for in order to rule out other conditions.
A program of regular physical activity can strengthen the muscles, tendons, and ligaments surrounding the affected joints and preserve mobility in joints that are developing bone spurs. Many physicians believe that osteoarthritis may be prevented by good health habits. Remaining active, maintaining an ideal body weight, and exercising the muscles and joints regularly so as to nourish cartilage.
The first thing to try in degenerative joint disease treatment should be acetaminophen (Tylenol). It is effective and has less side effects than other non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, or aspirin.
Glucosamine-chondroitin sulfate may be prescribed by your doctor. This medication, when taken over a period of months, may reduce pain and symptoms by restoring or replenishing nutrition to diseased cartilage cells. It tends to be more effective in earlier stages of OA. The dosage and combination of each ingredient is an important aspect of the therapy, as not all preparations and brands are the same. Patients who fail to improve on acetaminophen or glucosamine may be treated with salicylates and other oral anti-inflammatories. Previously, medications such as Vioxx, Celebrex, and Bextra were preferred due to fewer ulcers and improved pain relief for arthritis. However, currently the use of these medications should be reviewed with your doctor, as concerns about their use in certain patients has been recently reported. More traditional NSAIDS (ibuprofen, naproxen, etc.) are available over the counter, and they also provide excellent relief of symptoms. Capsaicin cream 0.25% applied twice daily may reduce knee pain. Injections of steroids within the joint may also be helpful, although the duration and amount of pain relief is often unpredictable, especially in more advanced stages of OA. Hyaluronic acid (HA)* peparations are also available and may be very useful in the treatment of OA. These injections are indicated for OA of the knee, and typically require an injection once a week, over a period of three to five weeks. The hyaluronic acid is injected into the knee joint, and similar to oral glucosamine, may provide nutrition to the diseased cartilage cells and collagen within the cartilage. The fluid is a gel-like material that appears to act initially like a lubricant for the joint. However, studies have shown that the lubricant aspect plays little role and, in fact, the fluid is absorbed quickly by the cartilage cells.
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Bracing, splinting, and other orthotic treatments may be useful in managing or “unloading” an arthritic joint surface. These nonoperative treatments are simple, often effective, however cost and ease of use are factors in their selection in treatment.
As a degenerative joint disease treatment, surgery may be dramatically effective for patients with severe osteoarthritis of the weight-bearing joints. Total hip replacement and newer hip resurfacing replacements and total knee replacement or partial knee replacement can be extremely effective. Joint replacement is now being performed in younger patients also. The concerns about wear of the prosthetic joint surface in younger patients make this the most challenging aspect of future research in this area. Newer joint surfaces for joint replacement including highly cross-linked polyethylene, metal on metal bearing, ceramic bearings, and others have emerged and currently are available in the U.S.
Although arthroscopic surgery for knee osteoarthritis is a common procedure, its long-term effectiveness is unclear, and may be best for symptoms such as catching, locking, or those that have been present for only a short duration. In addition, not all patients that have arthritis should have an arthroscopy, as this may not improve their symptoms.
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In younger patients, hip and knee preserving procedures should be considered, in order to avoid a hip or knee replacement. Although performed less frequently, hip and knee preserving procedures, such as cutting the bone and realigning the bone or joint surface, may restore a joint to a normal alignment and be an excellent alternative to joint replacement.
. . . Alternative Degenerative Joint Disease Treatment
Experimental techniques to repair cartilage loss in the knee by transplantation of cartilage cells is promising. This is most effective in small, localized areas of cartilage loss and not in advanced arthritis. These procedures also may be combined with joint osteotomy to alter joint alignment in order to allow this new cartilage to heal.
. . . Prevention of Degenerative Joint Disease
Weight reduction may reduce the risk of symptomatic knee osteoarthritis and, more importantly, reduce the symptoms of OA in the knee in overweigh patients.
If you have an injury to your joint, activity modification while maintaining an active lifestyle and joint range of motion provide for a healthy joint recovery.
