1. 1 Living With Arthritis I.M. Doctor, M.D. My Office My City, State

2. 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. 3 Living With Arthritis Orthopaedics and the Bone and Joint Decade Arthritis Different Forms Causes and Risks Treatment Options Managing Arthritis

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

5. 5 The expert in treating the musculoskeletal system The expert in maintaining musculoskeletal health

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

7. 7 What do orthopaedic surgeons do? Diagnose Treat Non-surgical Medication Physical Therapy Exercise Bracing Surgical Prevention

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9. 9 Why Musculoskeletal Problems? Musculoskeletal conditions affect hundreds of millions of people Account for half of all chronic conditions in people over 50

10. 10 Why Musculoskeletal Problems? Goals: To improve quality of life for sufferers To enhance education and advance treatment through research

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12. 12 Part of AAOS commitment to Bone and Joint Decade Resource for physicians and clinicians Focus on conditions with greatest burden/cost to society Improving Musculoskeletal Care in America (IMCA)

13. 13 Living With Arthritis Your Orthopaedic Surgeon Getting You Back In The Game

14. 14 Bone Fibrous capsule Joint space filled with synovial fluid Articular cartilage Synovial membrane Joints Ligament

15. 15 Pain Avoidance of Motion Increased Muscle Tightness Loss of Motion Joint Inflammation

16. 16 Arthritis 21% of the U.S. population aged 18 or older have arthritis The percentage grows higher with age 67 million, or 25 percent of the adult population, will have arthritis in 2030.

17. 17 Symptoms Weakness in the muscles Tenderness to touch the joint Limited ability to move the joint Pain or swelling in single or multiple joints A grating feeling or sound with movement Pain when pressure is placed on the joint or the joint is moved

18. 18 Diagnosis Arthritic kneeHealthy knee

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

20. 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? AAOS site: orthoinfo.org

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

22. 22 Types of Arthritis Osteoarthritis Rheumatoid arthritis Juvenile arthritis Joint infections

23. 23 Spine Hands Hips Knees Fingers Osteoarthritis Feet Shoulders

24. 24 Osteoarthritis 27 million Americans live with osteoarthritis Before age 45, osteoarthritis more prevalent in males. After age 55, it is more prevalent in females

25. 25 Osteoarthritis: Causes Primary Osteoarthritis Thought to be result of aging Decreased ability of cartilage to repair itself Ligaments supporting joints become more lax

26. 26 Osteoarthritis: Causes Secondary Osteoarthritis Obesity Trauma Surgery Abnormal joints Gout Diabetes Hormone disorders

27. 27 Osteoarthritis: Symptoms Pain in affected joints Pain worse with prolonged overuse Pain better with rest and exercise Stiffness relieved by gentle motion

28. 28 Rheumatoid Arthritis 1.3 million Americans affected 1% of world population affected Women are up to three times more likely to have rheumatoid arthritis High risk of death and disability

29. 29 Rheumatoid Arthritis: Causes Autoimmune condition Cause unknown Genetics a factor Onset usually in middle age Can affect other organs and systems

30. 30 Rheumatoid Arthritis: Symptoms Pain, swelling, and stiffness in fingers, wrists, and feet Multiple joints Fatigue, appetite loss, fever

31. 31 Rheumatoid Arthritis: Symptoms

32. 32 Juvenile Arthritis One of the most common childhood diseases Nearly 300,000 affected Chronic autoimmune disease

33. 33 Juvenile Arthritis: Causes Cause is unknown Foods, toxins, allergies, vitamin deficiencies do not play a role Genes may be a factor

34. 34 Juvenile Arthritis: Symptoms Pain, swelling, tenderness Stiffness and limited range of motion

35. 35 Juvenile Arthritis: Progression Damage to bones and cartilage, leading to deformity and impairment Can affect growth Symptoms can disappear and recur Some children may outgrow disease

36. 36 Arthritis: Treatment

37. 37 Treatment Health and behavior modifications Medications Surgery Experimental/alternative treatments

38. 38 Treatment: Health Modifications Lose weight Quit smoking Eat healthier Exercise

39. 39 Exercise

40. 40 Exercise Strengthening exercises can help Correct positioning is critical 40

41. 41 Exercise Include flexibility, strengthening, and aerobic exercises Exercise when pain and stiffness lowest Exercise when you are not tired Exercise when medication having greatest effect DO:

42. 42 Exercise Always warm up and cool down Start slowly, progress gradually Avoid becoming chilled or overheated Use heat, cold, and other pain reducers DO:

43. 43 Exercise Use aids like walking sticks or canes if needed Always use any braces or supports recommended by your physician or trainer Expect minor discomfort Use two-hour rule: No more pain two hours after exercising than before you started DO:

44. 44 Exercise Talk to your physician first Consider athletic trainer or physical therapist DO:

45. 45 Exercise Do too much too soon Hold your breath while exercising Take extra medication before unless your physician directs you otherwise DONT:

46. 46 Exercise Unusual or persistent fatigue Increased weakness Decreased range of motion Increased joint swelling Pain that lasts an hour after exercising Consult your doctor if these symptoms are present:

47. 47 Treatment: Medication NSAIDs are nonsteroidal anti- inflammatory drugs Aspirin Ibuprofen Naproxen

48. 48 Treatment: Medication Prescription medications Cortisone injections Lubrication injections in the knee

49. 49 Treatment: Vitamins and Supplements

50. 50 Treatment: Surgery Why? Alternatives? Benefits and for how long?

51. 51 Treatment: Surgery Duration of recovery? Assistance at home? How long? Disability after surgery? Physical or occupational therapy? Return to normal activity?

52. 52 Surgery Arthroscopy Osteotomy Total joint replacement

53. 53 Surgery: Arthroscopy Less invasive Often done on outpatient basis Repair or removal of damage Abrasion can stimulate repair

54. 54 Surgery: Osteotomy Pre-OsteotomyPost-Osteotomy

55. 55 KneeHip Surgery: Total Joint Replacement

56. 56 Treatment: Alternative Medicine Ease symptoms Improve outlook and attitude Complementary Approaches May

57. 57 Treatment: Alternative Medicine Cure acute illness Replace proven medical treatments for osteoarthritis Complementary Approaches Will Not

58. 58 Arthritis: The Future

59. 59 American Academy of Orthopaedic Surgeons 6300 North River Road Rosemont, IL 60018 www.orthoinfo.org Arthritis Foundation 800-283-7800 www.arthritis.org Arthritis Resources

60. 60 What are your questions and concerns? Living With Arthritis

61. 61 Thank you for participating today Remember, your orthopaedic surgeon can help get you back in the game Living With Arthritis