“Helping Osteoarthritis Patients Regain Mobility”

Arthritis affects over 70 million Americans 2 nd only to heart disease in causing disability 1 million new patients diagnosed each year Affects 50% of people 65 yrs or older 2 nd only to heart disease in causing disability 1 million new patients diagnosed each year Affects 50% of people 65 yrs or older

Osteoarthritis is most common form of Arthritis  Rheumatoid arthritis  Post-traumatic arthritis  Inflammatory arthritis  Septic arthritis All result in loss of joint cartilage  Rheumatoid arthritis  Post-traumatic arthritis  Inflammatory arthritis  Septic arthritis All result in loss of joint cartilage Healthy Diseased

Factors that influence the onset of arthritis  Heredity / Family history  Age  Weight  Gender  Trauma / Repetitive stress  High impact sports  Other illnesses  Heredity / Family history  Age  Weight  Gender  Trauma / Repetitive stress  High impact sports  Other illnesses Diseased compartment

The Knee is the #1 Joint Affected by Arthritis  Stiffness  Swelling  Deformity  (“knocked-knee”/ “bow-legged”)  Crepitus (clicking, crunching, grinding)  PAIN  Start-up  Activity limiting  Nighttime  Stiffness  Swelling  Deformity  (“knocked-knee”/ “bow-legged”)  Crepitus (clicking, crunching, grinding)  PAIN  Start-up  Activity limiting  Nighttime Symptoms of Knee Arthritis

Initial Conservative Treatments  Aspirin  NSAID’s (non-steroidal anti- inflammatory drugs)  Physical Therapy  Aspirin  NSAID’s (non-steroidal anti- inflammatory drugs)  Physical Therapy  Activity Modification  Weight Loss  Nutritional Supplements  Corticosteroid injections

Surgical Options for Knee Arthritis  Arthroscopy  Debridement  Meniscectomy  Chondroplasty  Osteotomy  Bone cut and re-aligned onto remaining good cartilage  Joint Replacement  Uni-compartmental knee replacement (partial knee replacement)  Tri-compartmental knee replacement (total knee replacement)  Arthroscopy  Debridement  Meniscectomy  Chondroplasty  Osteotomy  Bone cut and re-aligned onto remaining good cartilage  Joint Replacement  Uni-compartmental knee replacement (partial knee replacement)  Tri-compartmental knee replacement (total knee replacement)

Total Knee Replacement  Most common joint replaced  First performed in 1968  Nearly 470,000 TKR’s performed per year in US  Most common joint replaced  First performed in 1968  Nearly 470,000 TKR’s performed per year in US

Total Knee Replacement  Patient satisfaction typically %  Relieves pain  Restores mobility  Durability well documented at ~90%  Improvements in materials and techniques continue  Patient satisfaction typically %  Relieves pain  Restores mobility  Durability well documented at ~90%  Improvements in materials and techniques continue

Total Knee Replacement: Who’s a candidate?  Many patients that could be helped by knee replacement don’t know about it or do not seek care  Lack of knowledge  Misconceptions  Fear  Many patients that could be helped by knee replacement don’t know about it or do not seek care  Lack of knowledge  Misconceptions  Fear How long do patients wait before they see their surgeon?

Common Misconceptions Delaying Knee Replacement Surgery  Myth #1- Arthritis pain is just part of the aging process…live with it.  Myth #2- It won’t feel natural.  Myth #3- Too young for a knee replacement.  Myth #4- Should wait as long as possible to undergo knee replacement surgery  Myth #5- It doesn’t matter how long I wait to have knee replacement surgery.  Myth #1- Arthritis pain is just part of the aging process…live with it.  Myth #2- It won’t feel natural.  Myth #3- Too young for a knee replacement.  Myth #4- Should wait as long as possible to undergo knee replacement surgery  Myth #5- It doesn’t matter how long I wait to have knee replacement surgery.

Important Patient Demographic Trends  Over 65 yr group is the most rapidly expanding segment of our population  Increasing individual longevity will result in a greater number of individuals living long enough to be diagnosed with arthritis  Average age of today’s total knee replacement patient is 67 yrs.  Over 65 yr group is the most rapidly expanding segment of our population  Increasing individual longevity will result in a greater number of individuals living long enough to be diagnosed with arthritis  Average age of today’s total knee replacement patient is 67 yrs.

Important Patient Demographic Trends  36% of knee replacement patients are between ages  This group of younger patients requiring knee replacement is increasing  Those individuals requiring treatment for their arthritis will need solutions with even greater durability  36% of knee replacement patients are between ages  This group of younger patients requiring knee replacement is increasing  Those individuals requiring treatment for their arthritis will need solutions with even greater durability

When to Refer to an Orthopaedic Specialist  Pain and limitations alter quality of life  Night time pain and sleep disturbance  When conservative treatments no longer resolve activity limiting pain caused by osteoarthritis  Pain and limitations alter quality of life  Night time pain and sleep disturbance  When conservative treatments no longer resolve activity limiting pain caused by osteoarthritis

Postponing Knee Replacement Surgery Can Have Detrimental Effects  Bones serving as the foundation for the implant will continue to deteriorate.  Reduce chance of regaining full functionality  Bones serving as the foundation for the implant will continue to deteriorate.  Reduce chance of regaining full functionality

Life After Knee Replacement Surgery  Patients encouraged to resume a healthy, active lifestyle, including participating in low- impact sports such as:  Walking  Swimming  Cycling  Golfing  More aggressive sports or activities should not be attempted without a doctor’s approval  Patients encouraged to resume a healthy, active lifestyle, including participating in low- impact sports such as:  Walking  Swimming  Cycling  Golfing  More aggressive sports or activities should not be attempted without a doctor’s approval

Unique Joint Replacement Option: Rotating Platform Knee System  Articulates like the natural knee  Allows the knee to slightly twist and turn, as well as flex and extend  Outstanding clinical results for over 25 years  Demonstrated 97 percent survivorship at up to 20 years.  Articulates like the natural knee  Allows the knee to slightly twist and turn, as well as flex and extend  Outstanding clinical results for over 25 years  Demonstrated 97 percent survivorship at up to 20 years.

Rotating Platform Knee System  This procedure is not for everyone. As with any surgery, there are risks. Recovery takes time and hard work. The life of a joint replacement depends on weight, activity level, age and other factors. Each patient responds differently.

Solutions for Arthritis of the Knee Summary  The number of patients suffering from arthritis of the knee is steadily growing  Of the patients suffering from knee arthritis nearly half may not seek treatment due to poor information or fear  Total knee replacement is an effective treatment for end- stage knee arthritis  The number of patients suffering from arthritis of the knee is steadily growing  Of the patients suffering from knee arthritis nearly half may not seek treatment due to poor information or fear  Total knee replacement is an effective treatment for end- stage knee arthritis

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