OSTEOARTHRITIS AND YOU

1. I.M. Doctor, M.D. My Office My City, State OSTEOARTHRITIS AND YOU

2. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred.

3. Osteoarthritis and You • Orthopaedics and the Bone and Joint Decade • Osteoarthritis

4. What is an orthopaedic surgeon? • MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

5. What is an orthopaedic surgeon? • The expert in treating the musculoskeletal system • The expert in maintaining musculoskeletal health

6. Educating an Orthopaedic Surgeon • College • Medical School • Internship • Orthopaedic Residency • Fellowship (optional) • 2 Years Practice TOTAL 4 4 1 4 (1) 2 16 years!

7. What do orthopaedic surgeons do? • Diagnose • Treat • Medication • Physical Therapy • Exercise • Brace • Surgery • Prevent

8. Osteoarthritis Your Orthopaedic Surgeon Getting You Back In The Game

9. Nearly 27 million Americans age 25 and older have osteoarthritis 46 million U.S. adults report doctor-diagnosed arthritis As the U.S. population ages, these numbers are likely to increase dramatically. People who have doctor-diagnosed arthritis is projected to increase to 67 million in 2030. Osteoarthritis

10. Synovial Joints Fibrous capsule Bone Synovial membrane Joint space filled with synovial fluid Articular cartilage

11. Osteoarthritis Spine Hips Hands Fingers Knees Feet

12. Osteoarthritis (Inflammation of Joints) Pain Loss of Motion Avoidance of Motion Increased Muscle Tightness

13. Osteoarthritis Cartilage Osteoarthritic Knee Healthy Knee

14. Who is affected by osteoarthritis? • Before age 45, osteoarthritis occurs more frequently in males. • After age 45, it occurs more frequently in females Gender:

15. 11 million visits to physicians offices 815,000 hospitalizations Burden of Disease

16. Pain in affected joints Pain worse with prolonged overuse Pain better with rest and exercise Stiffness relieved by flexing Symptoms

17. Physical exam X-rays Blood test to rule out other diseases Diagnosis

18. Diagnosis Healthy knee Osteoarthritic knee

19. Diagnosis Before your appointment: • Prepare to describe your symptoms • Gather medical history • Make list of medications • Write down questions and concerns

20. During Your Appointment What should I expect from my treatment? What effect will my treatment have on my daily activities? What can I do to prevent further disability? Diagnosis

21. Location, duration, & character of symptoms Appearance of joints Results of clinical diagnosis tools Diagnosis

22. Primary Osteoarthritis: Most Common Thought to be result of aging Decreased ability of cartilage to repair itself Ligaments and muscles supporting joints weaken Causes

23. Secondary Osteoarthritis Obesity Trauma Surgery Abnormal joints Gout Diabetes Hormone disorders Causes

24. Treatment

25. Treatment • Health and behavior modifications • Drug therapy • Intra-articular treatment • Surgery • Experimental/alternative treatments

26. NSAIDs are nonsteroidal anti-inflammatory drugs Aspirin Ibuprofen Naproxen Medication: NSAIDs

27. Vitamins & Nutritional Supplements

28. Glucosamine Chondroitin Sulfate Some positive results Mild to moderate pain relief If benefits not seen within 8 weeks, not likely Proceed with caution Vitamins & Nutritional Supplements

29. Complementary Approaches May: Ease symptoms Improve outlook and attitude Alternative Medicine

30. Complementary Approaches Will Not: Cure acute illness Replace proven medical treatments for osteoarthritis Alternative Medicine

31. Exercise

32. Strengthening exercises can help Correct positioning is critical Exercise 32

33. Include flexibility, strengthening, and aerobic exercises Exercise when pain and stiffness lowest Exercise when you are not tired Exercise when medication having greatest effect Exercise Dos

34. Always warm-up and cool down Start slowly, progress gradually Avoid becoming chilled or overheated when exercising Use heat, cold, & other pain reducers Exercise Dos

35. Use aids like walking sticks or canes if needed Expect minor discomfort Use two-hour rule: No more pain two hours after exercising than before you started Exercise Dos

36. Talk to your doctor first Consider athletic trainer or physical therapist Exercise Dos

37. Do too much too soon Hold your breath while exercising Take extra medication before unless your orthopaedic surgeon suggests it Exercise Don’ts

38. Moist Heat Towels, hot packs, bath, or shower 15-20 minutes 3 times each day Heat & Ice

39. Cold Therapy Ice packs 10-15 minutes at a time Heat & Ice

40. Consult your doctor if these symptoms are present: Unusual or persistent fatigue Increased weakness Decreased range of motion Increased joint swelling Continued pain 1 hour after exercising Too Much Exercise

41. Why? Alternatives Benefits and for how long? Asking Questions About Surgery

42. Asking Questions About Surgery • Duration of recovery? • Assistance at home? How long? • Disability after surgery? • Physical therapy? • Return to normal activity?

43. Arthroscopy Surgical abrasion of cartilage Surgery

44. Surgery Pre-Osteotomy Post-Osteotomy

45. Surgery: Total Joint Replacement Knee Hip

46. Getting You Back in The Game Name: Karen Skinner Age: 51 Condition: Torn Meniscus and Osteoarthritis of Knee

48. Emerging Knowledge and Future Research

49. AAOS Research Agenda • Developed a summary of common OA research questions • Moving beyond drug testing and surgical outcomes

50. AAOS Research Agenda • Inflammatory response & OA disease • Important risk factors • Genes that trigger OA • Impact of improved implant design • Biological & mechanical factors that influence OA