By 2030, the demand for total hip arthroplasties is estimated to increase 174% to 572,000 procedures; and the demand for total knee arthroplasties is projected to increase 673% to 3.48 million procedures. (1) With the number for joint replacement surgeries on the rise, we need to remind patients to remain active to keep their joints healthy. Pain is the primary reason for joint replacement surgery, if we can eliminate pain, we may eliminate the need for some patients to have joint replacement surgery.

These 5 tips will help your patients keep their joints strong:

1. Maintaining Proper Weight. Additional body weight leads to excess stress on joints and can cause cartilage to break down more quickly. Therefore, emphasizing the importance of maintaining a healthy weight can help patients avoid surgery. Encouraging patients to lose just 5 percent of their body weight can relieve excess joint pressure. While losing weight won’t replace cartilage; it will help them to reduce the stress on their joints.
2. Exercise Regularly. Remind patients that limiting physical activity can make joint damage worse. Inactivity leads to cartilage loss between bones and can lead to bone-on-bone contact, which is extremely painful. Exercise helps to stimulate the release of synovial fluid, and provides the cartilage with nutrients to lubricate and loosen the joint. Suggesting aerobic exercises and low-impact activities such as the elliptical, recumbent bike, walking and swimming at least 3 times week will help patients achieve optimal joint health.
3. Joint injections. Injections with cortisone, or hyaluronic acid, are non-operative treatment options that can help to reduce knee pain. Knee pain may also be treated with regenerative medicine treatments such as platelet rich plasma therapy may help patients to produce more cartilage. Cortisone injections are also effective treatment plans for hip pain. These injections are best done under fluoroscopy.
4. A knee unloader brace. An unloader brace unloads the painful side of the knee, and shifts the stresses to the side with minimal arthritis. These braces can be used very effectively in treating patients with osteoarthritis of the knee. Unloader braces help to reduce pain and therefore increase mobility. I prescribe these braces often to patients who want to consider an effective non-surgical solution to treat osteoarthritis of their knee.
5. Medications and supplements. The use of supplements like glucosamine and chondroitin can have beneficial effects on osteoarthritis. Opioid analgesics can be given for severe pain if there is no response to other treatments. These non-surgical options depend on the patient’s level of commitment to make behavioral modifications through weight loss and exercise.

REFERENCE

1. Kurtz S, Ong K, Lau E, Mowat F, Halpern; J Bone Joint Surg Am. 2007; Apr;89(4):780-5.

Winifred D. Bragg, MD, FAAPMR
Diplomate, Pain Medicine
Medical Director, Spine and Orthopedic Pain Center, Norfolk, Virginia
www.knockoutpain.com
Dr. Bragg is the author of Knockoutpain®: Secrets to Maintain a Healthy Back