Welcome… Aging, Agility and Arthritis

Abbas Zand, M.D.Orthopedic SurgeonEast Lansing Orthopedic Association

(517) 394-3200

Aging is not what it used to beArthritis — what exactly is it?Possible causes How you can best address the pain and soreness

Structure and Function of Joints

Skeleton are connected by the joints which allow motion between the partsJoints Classification:– Synovial– Fibrocartilaginous

Synovial Joints

Allow more or less free movementBones are covered with Hyaline cartilageBone connected by capsule, ligaments, synovial membrane

Types of Joints

Ball and SocketHingeSaddle

Examination of Joints

Color, consistency, temperatureSwellingTendernessCrepitationDeformityLimitation of motionMuscle AtrophyNodulesGait Analysis

Damaged Joint

Bones grind causing pain, stiffness and inflammationCaused by– Fractures– Arthritis– Natural wear and tear– Excessive exercise

Determining Severity of Your Condition

Physical examinationX-rays, MRI or CAT scanMedical historyAll other treatment methods have failed

What Is Arthritis?

Inflammation of the joint and soft tissue around it.

Classification of Arthritis

Infectious caused by microorganismUnproved etiologyDegenerativeTraumaticMetabolic

Hip Osteoarthritis – What does it look like?

In a healthy hip, cartilage provides a cushion between the

hip ball and socket.

In an arthritic hip, the cartilage has thinned and deteriorated, allowing bone to rub against

bone, causing pain.

.

Knee Osteoarthritis – What does it look like?

Healthy Knee Knee with Osteoarthritis

Femur(thigh bone)

Cartilage

Tibia(shin bone

Knee Osteoarthritis – What does it look like?

Healthy Knee Knee with Osteoarthritis

Diseases Associated with Arthritis

SarcoidosisRelapsing PolychondritisUlcerative ColitisRegional IleitisWhipple DiseaseSystem LupusPsoriatic

Demographics of Arthritis

Affects nearly 70 million AmericansThree in seven people suffer from diseaseOccurrence increases after age 45Usually lasts a lifetimeMore women than men have arthritisAffects people of all ages

Economic Implications

Costs the U.S. economy $64.8 billion per year in medical care and lost wagesAccounts for 427 million days of restricted activity

Causes

Unknown and likely to be different for the various types of diseaseFactors within your control– Weight– Injuries

Factors you can’t control– Genetics– Unknown and likely to be different for the

various types of disease

Symptoms

The first symptom is painJoints may feel stiff and difficult to moveSwelling or inflammationFatigue

Diagnosis

Only a physician can determine if you have arthritis– Physical exam– X-rays– Lab tests

Treatments

MedicationExerciseHeat or coldCarefully pacing activitiesJoint protectionSelf-help skillsSurgery

Alternative Of Treatment

Hip joint resectionArthrodesisArthroplastyOsteotomy

New Developments

Research:Genetic materialsLeumedinsRegular exerciseLosing weight

So What’s On the Horizon?

Advances in molecular biologyRole of the immune systemUse of biologic response modifiers

Joint Replacement Surgery

IntroductionHealthy and damaged jointCommon causes of joint painJoint replacement surgery

Joint Replacement Surgery

Relieves joint pain and restores movement and functionBone is resurfaced with an artificial joint —prosthesisMost commonly performed on knee and hip joints– Also shoulders, fingers, elbows

Indication of Total Hip Arthroplasy

Degenerative arthritisRheumatoid arthritisAnkylosing spondylitisAvascular necrosisTumorsFracture of the hip

The Decision Is Yours

Risks involvedSurgical team takes precautionsObtain second opinionMake an appointment with your physicianComplete dental workConsider donating your own blood, orautotransfusion

Day of Surgery

Admitted to the hospital – Insert intravenous tube (IV) – Administer anesthesia

Surgery lasts two to four or five hoursDamaged bone and cartilage removedEnds of the bones resurfaced and reshapedProsthesis implant secured to the bones for stabilityDrainage tubes inserted into the wound to drain fluids

Hip Prosthesis Secured To Bone

Knee Prosthesis Secured To Bone

Knee Prosthesis Secured To Bone

After Surgery

Taken to the recovery room, then to orthopedic unitBegin rehabilitation program with physical therapistTake medication as neededLearn new methods from an occupational therapist to help you perform certain daily tasksDischarged two to three days after surgeryDoctor may prescribe pain or other medicationsFollow the recovery instructions

Post-Operative Follow-Up Examinations

At six weeks, three months, six months and one year after operationFull recovery period normally lasts three to six months

Benefits of Joint Replacement Surgery

Relieve pain and stiffnessRegain your range of motion and active lifestyleImprovement in the appearance of deformed joints

Durability of Hip or Knee

Varies from patient to patientDepends on patient’s – Physical condition– Activity level– Weight– Doctor’s skill in surgery – Alignment, placement and balancing of the

joint

Any Questions?

Thank you.