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

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 (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 Osteoarthritis 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.

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

11 Spine Hands Hips Knees Fingers Osteoarthritis Feet

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

13 Healthy Knee Osteoarthritic Knee Cartilage Osteoarthritis

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

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

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

18 Diagnosis Osteoarthritic kneeHealthy knee

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

20 Diagnosis During Your Appointment 1. What should I expect from my treatment? 2. What effect will my treatment have on my daily activities? 3. What can I do to prevent further disability?

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

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

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

24 Treatment

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

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

27 Vitamins & Nutritional Supplements

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

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

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

31 Exercise

32 Exercise Strengthening exercises can help Correct positioning is critical 32

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

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

35 Exercise Dos 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

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

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

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

39 Heat & Ice Cold Therapy Ice packs minutes at a time

40 Too Much Exercise 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

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

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

43 Surgery Arthroscopy Surgical abrasion of cartilage

44 Surgery Pre-OsteotomyPost-Osteotomy

45 KneeHip Surgery: Total Joint Replacement

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

47

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 1) Inflammatory response & OA disease 2) Important risk factors 3) Genes that trigger OA 4) Impact of improved implant design 5) Biological & mechanical factors that influence OA

51 OA Knee Research Agenda 6) Cartilage cell transplantation & other soft tissue grafts 7) Impact of standardized criteria for diagnosis 8) Exploration of factors that account for high incidence rates 9) Societal impact of OA 10) Activity and exercise levels and OA

52 Osteoarthritis If you are experiencing chronic or recurring pain, stiffness, or swelling around a joint, consult your physician Your orthopaedic surgeon can determine what type of arthritis you have and make treatment recommendations

Resources

54 What are your questions and concerns? Osteoarthritis and You

55 Thank you for participating today Remember, your orthopaedic surgeon can help get you back in the game Osteoarthritis and You