Osteoarthritis is a degenerative condition that can affect any of the joints in your body. It is the most common form of arthritis and is sometimes referred to as “wear and tear” arthritis because it is associated with ageing. There is no cure for the condition once it develops although there are many effective treatments to slow its progression and relieve symptoms. In this article we will look at surgical and other options for people affected by osteoarthritis.
What causes osteoarthritis?
The disease affects the cartilage which lines the joint, allowing the bones to slide smoothly over each other as you move. Osteoarthritis causes pain, inflammation and stiffness in the joint and can result in bone deformity, bony spurs and loss of function. While osteoarthritis can affect any joint, it occurs most commonly in the hips, knees, hands, neck and lower back.
People over the age of 50 are most at risk of developing the disease, but it can also occur in younger people, particularly following an injury. While age-related osteoarthritis may develop quite slowly, post-traumatic arthritis can develop within a few years of the original injury. Other common reasons for osteoarthritis include: obesity which puts increased pressure on the joints and increases inflammation in the body; overusing the joints (this can occur with certain sports or occupations); and muscle weakness which causes poor alignment of the bones. Women are more prone to the disease than men and having a family member with the condition also increases your risk.
How is osteoarthritis diagnosed?
Your doctor will carry out a physical examination of the affected joint. You may also be sent for an X-ray which can reveal the extent of any bone damage or changes to the joint. In some cases you may be offered an MRI scan which can provide a clearer view of the cartilage and joint structure. If other medical conditions are suspected, you may need a joint aspiration, which involves inserting a needle into the joint to extract joint fluid. This can then be tested for signs of any infection, which is rare.
What treatments are available?
Non-surgical
In the early stages, the symptoms of osteoarthritis can normally be managed with a combination of painkillers and anti-inflammatories. If you are overweight, losing excess weight can reduce the strain on weight-bearing joints and reduce pain. For every pound of weight you lose, there is a reduction of about four pounds of pressure on lower body joints. A physiotherapist may be able to recommend exercises to relieve pain and increase flexibility in the stiffened affected joints. Injections of corticosteroids and hyaluronic acid directly into the damaged joint may help to relieve inflammation and reduce pain. You may also be offered platelet-rich plasma (PRP) injections which are designed to stimulate the body’s natural healing responses and reduce inflammation.
Surgical
As the disease progresses, it is likely that non-surgical treatments will no longer be sufficient. At this point, your orthopaedic surgeon will discuss your treatment options with you. In some cases – if the condition has damaged one side of the knee more than the other, for example – you may be offered key-hole surgery or surgery to realign the bones. In the most advanced stages of osteoarthritis, however, joint replacement surgery may become necessary. This involves removing the damaged joint and replacing it with an artificial joint made of medical plastic, metal or ceramic.
Joint replacement is now a routine surgical procedure and the outcomes are good, with most people able to enjoy a full and active life after surgery.
At Carrothers Orthopaedics we use a state-of-the-art approach called Mako robotic arm-assisted surgery which helps to increase accuracy and improve surgical outcomes.
Mr Carrothers performed a full robotic replacement on my right hip. from start to finish he informed me about my options and was very respectful. Mr Carrothers and his secretary have been brilliant all the way through the process and would like to say a massive thank you as I am now pain free.
Written by a private patient at Nuffield Hospital Cambridge24th April 2023
When is surgery recommended?
We recommend treating osteoarthritis non-surgically in the early stages. This is partly because all surgery comes with potential risks and so it is advisable to avoid invasive procedures for as long as possible. It is also because delaying the need for joint replacement surgery means you are less likely to need to undergo repeat surgery in the future.
While there have been major advances in the development of prosthetic implants in recent years, nevertheless the artificial joints do eventually wear out. Precisely how long an implant lasts will be determined by a range of factors but most last in the region of 18 to 25 years. Once the joint becomes worn, it may start to loosen or function less efficiently and you may then need a further surgical procedure called a revision joint replacement. The outcomes of revision joint surgery are generally poorer than primary joint replacements, so we prefer to avoid this type of surgery wherever possible.
By delaying your joint replacement surgery for as long as possible, it is more likely that your artificial joint will continue to perform well for the remainder of your life.
Of course, it is important to strike the right balance as we don’t want people to experience severe pain and functional restrictions due to advanced osteoarthritis.
If in doubt, talk to us about the best time to undergo joint replacement surgery. We can also advise on diagnosis and creating a treatment plan that is suitable for your individual circumstances.
Talk to an orthopaedic consultant | Cambridge
We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako robotic arm assisted surgery and conventional surgery.
For more information, please contact us.
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For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.
