Osteoarthritis

Osteoarthritis Operation in Türkiye: Causes and Treatment

Understanding Osteoarthritis and Joint Replacement Surgery

Osteoarthritis, also known as arthritis, is a condition characterized by the breakdown of joint cartilage, leading to deformations in the bone and swelling around the affected joints. The disease progresses slowly and causes pain and limited range of motion in the joints.

Arthritis is most commonly associated with aging, rarely occurring before the age of 40, and is more prevalent in women. Overweight individuals have an increased risk of arthritis, especially in weight-bearing joints like the knees. However, weight loss can alleviate joint pain and reduce the risk of developing arthritis.

The disease may have a hereditary component, with some types affecting finger joints particularly influenced by genetics. Structural joint defects, accidents, or impacts can also contribute to the risk of arthritis.

The most commonly affected joints include the knees, hips, fingers, toes, and spine. Symptoms include joint pain during movement, decreased range of motion, and stiffness, often improving with rest. As the disease progresses, pain can occur even at rest, and joint movements become more limited.

Diagnosis involves a physical examination by an experienced orthopedist, and X-rays are necessary to determine the stage of the disease and plan the appropriate treatment.

Treatment aims to reduce pain, swelling, and limited movement to enable patients to perform daily activities comfortably. While there is no complete cure for arthritis, weight management and daily exercise help to alleviate symptoms. Joint supplements like MSM, chondroitin sulfate, collagen hydrolysate, and glucosamine may provide regenerative effects in age-related arthritis. Thermal springs and physical therapy can also aid in pain relief and improve joint functionality.

For severe cases, anti-inflammatory medications and joint replacement surgery may be considered. Prosthetic surgeries replace damaged joint surfaces with metal, porcelain, or polyethylene components. The hips and knees are the most commonly replaced joints, but other joints like shoulders, hands, feet, and intervertebral discs can also undergo replacement.

Patients typically experience relief for 10-20 years after surgery, but prostheses may wear off or become loose over time and may require replacement. Both age and weight are not significant factors for eligibility in replacement surgeries.

The procedure for hip joint replacement involves a 6-inch incision to access and replace the affected bones. Knee joint replacement surgery involves an incision at the front, with damaged cartilage removed and replaced with prosthetic components secured with bone cement. Patients can usually walk within two days of surgery, but rehabilitation is necessary for complete joint functionality in some cases. The choice of prostheses depends on various factors, and it is essential for the surgeon to determine the most suitable option for each patient.

Diagnosing Hip Osteoarthritis

The diagnosis of hip osteoarthritis is based on a physical examination and the patient's medical history. During the examination, the doctor assesses tenderness, the range of motion, joint sounds, pain levels during movement, walking patterns, and the condition of the muscles and ligaments surrounding the hip joint. A definitive diagnosis is often confirmed through X-rays, which reveal intra-articular narrowing and bone spurs around the joint. In some cases, Magnetic Resonance Imaging (MRI) may be required for further evaluation.

Treating Hip Osteoarthritis

While there is no cure for hip osteoarthritis, various adjunctive therapies can help reduce pain and enhance the range of motion:

  • Rest: Allowing the affected hip joint to rest can alleviate pain and improve functionality.
  • Weight management: Losing weight can significantly relieve pressure on the hip joint and reduce discomfort.
  • Lifestyle changes: Avoiding activities that contribute to osteoarthritis development, such as excessive stair climbing, and opting for low-impact activities like swimming and cycling can be beneficial.
  • Physical therapy: Specialized exercises can enhance hip muscle flexibility, strengthen the surrounding muscles, and increase the joint's range of motion. A tailored rehabilitation program is created by the physician to suit each patient's needs.
  • Assistive devices: Walking sticks, crutches, and walkers can support unassisted walking, and tools for picking up objects from the floor can help alleviate pain during daily activities.
  • Medication: Painkillers may be used when the pain is severe enough to interfere with daily tasks. However, it's important to be cautious about potential interactions with other medications and potential side effects, especially for individuals with conditions like hypertension.

What causes Knee Arthritis?

Knee arthritis occurs when the knee joint cartilage breaks down, leading to decreased functionality and limited joint movements over time.

Who Can Be Affected by Knee Arthritis?

Knee arthritis is more common in individuals over the age of 45, but it can also affect young people. Women are more prone to knee arthritis than men.

Causes of Knee Arthritis

Various factors contribute to knee arthritis, including age-related cartilage deterioration, excessive weight, hereditary factors, and certain physical activities like repetitive movements or heavy lifting.

Symptoms of Knee Arthritis

Symptoms of knee arthritis include difficulty in bending and straightening the knee joint, increased soreness with activity, stiffness in the morning or after prolonged sitting, swelling, reduced walking distance, discomfort while climbing stairs, and crackling sounds in the knee joint.

Diagnosing Knee Arthritis

To diagnose knee arthritis, your doctor will conduct a physical examination and may request X-rays and MRI scans to assess bone and cartilage deformations and the state of ligaments and meniscuses.

Treatment for Knee Arthritis

The primary goals of knee arthritis treatment are pain relief and improved functionality.

  • Weight Management: Losing weight can reduce the load on knee joints and alleviate pain.
  • Physical Exercise: Strengthening the muscles around the knee can enhance joint durability and alleviate discomfort.
  • Medical Treatment: Medications may help control pain, but long-term use is not recommended due to potential side effects.
  • Intra-Articular Injections: Cortisone injections can alleviate pain and swelling, while hyaluronic acid injections improve joint mobility and cartilage formation. Stem cell therapies like PRP and Ortokine may also provide relief and reduce the need for replacement surgery.

Arthroplasty: Restoring Functionality and Relieving Joint Pain

Arthroplasty is a surgical procedure aimed at restructuring and rejuvenating painful and dysfunctional joints, alleviating pain, and restoring their range of motion. This process involves the renewal of a joint using artificial components, effectively enhancing the patient's quality of life by facilitating daily activities and improving overall well-being. Joints affected by arthritis can be replaced with artificial parts made from durable alloys like steel, titanium, vanadium, aluminum, cobalt, and chromium to ensure a pain-free range of motion.

Hip Arthroplasty (Hip Prosthesis)

Hip arthroplasty is a common and highly effective surgical procedure for individuals experiencing hip pain and restricted motion due to arthritis. When other treatment methods fail to provide satisfactory results, arthroplasty is considered as a last resort. The procedure involves the removal of arthritis-affected bones and cartilage, replacing them with durable polyethylene and metal joint surfaces. Hip arthroplasty significantly improves the patient's quality of life.

Total Hip Replacement

Total hip replacement may be required for patients with hip arthritis, traumatic fractures around the hips, or avascular necrosis, a condition where bone tissue dies due to inadequate blood supply. The procedure involves replacing the fractured or necrotic bones with prosthetic components to restore hip functionality. Two methods are used to stabilize the prostheses to the hip joint: cemented and cementless. Cemented knee prostheses are stabilized using a medical cement called polymethyl methacrylate, while cementless prostheses integrate with the bones during bone development.

Types of Prostheses

There are three types of prostheses based on the materials used:

  • Metal-on-polyethylene connection: This traditional prosthesis has been significantly improved with the development of plastic (polyethylene) inserts and special coated heads, increasing its durability to near that of ceramic prostheses.
  • Ceramic-on-ceramic connection: A newer system with superior wear resistance, often preferred for young, active, and lightweight female patients.
  • Metal-on-metal connection: The most resistant prosthesis against impacts and corrosions, commonly chosen for young, overactive, and overweight male patients.

Surface Arthroplasty

Surface arthroplasty, also known as hip resurfacing, is an alternative form of hip arthroplasty that preserves proximal femoral bone. This procedure, affixed with cement, is more suitable for younger patients, particularly males under 50 and females before menopause. Compared to total hip replacement, surface arthroplasty offers higher functional capacity, faster recovery, and less need for rehabilitation while preserving joint range of motion.

Platelet-Rich Plasma (PRP) for the Hip Joint

Platelet-Rich Plasma (PRP) treatment involves using plasma rich in thrombocytes, which release healing proteins when activated. Thrombocytes are obtained from the patient's blood samples and injected into the damaged regions of the hip joint affected by arthritis. PRP accelerates the healing process by activating stem cells through concentrated thrombocytes, contributing to more rapid recovery and relief from joint pain.

> What is Osteoarthritis?
Osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown and eventual loss of joint cartilage, leading to pain, swelling, and reduced mobility.
> What causes Osteoarthritis?
OA is typically caused by wear and tear over time, but it can also result from joint injuries, genetic factors, and certain metabolic conditions.
> How is Osteoarthritis different from Rheumatoid Arthritis?
While both are forms of arthritis, OA is caused by mechanical wear and tear, whereas Rheumatoid Arthritis is an autoimmune disorder where the body's immune system attacks healthy joint tissues.
> What are the primary symptoms of Osteoarthritis?
Common symptoms include joint pain, tenderness, stiffness, loss of flexibility, grating sensation, and bone spurs.
> Which joints are most affected by Osteoarthritis?
While any joint can be affected, OA most commonly impacts the knees, hips, hands, spine, and small joints of the fingers and toes.
> How is Osteoarthritis diagnosed?
OA is diagnosed based on a combination of physical examination, medical history, and imaging tests like X-rays or MRI.
> Are there treatments available for Osteoarthritis?
Yes, treatments can range from lifestyle changes, physical therapy, medications, and in severe cases, surgery. The aim is to reduce pain, improve mobility, and slow progression.
> Can Osteoarthritis be prevented?
While genetic predisposition cannot be changed, maintaining a healthy weight, staying active, and avoiding joint injuries can reduce the risk or delay the onset of OA.
> Does cold weather worsen Osteoarthritis symptoms?
Many people with OA notice their symptoms are more pronounced in cold or damp weather, but the reasons for this correlation are still under study.
> Are supplements like glucosamine and chondroitin effective for Osteoarthritis?
Studies on these supplements have produced mixed results. Some people find relief from OA symptoms with their use, but they're not universally effective. It's essential to consult with a doctor before starting any supplementation.

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