As we age, our joints can start to wear out, often becoming sore, stiff and arthritic. Each year almost 100,000 Australians undergo a hip or knee replacement, and current research indicates as many as one in four procedures might be unnecessary.1
We spoke to Dr Rob Wallace, an Orthopaedic Surgeon at sportsmed, to find out why joints are replaced, and discuss effective treatments for Osteoarthritis that could see you delay or even avoid the need for replacement surgery.
Joint replacement surgery is a procedure that removes the worn-out surface of a joint and replaces it with an artificial one. The most common joints that are replaced are hips and knees, followed by shoulders and, occasionally, some smaller joints.
When either a hip or knee is replaced, a device called a ‘prosthesis’ will be inserted in its place, which helps replicate the movement of a normal, healthy joint. Usually, it has a metal component that is fitted into the bones either side of the joint, and the joint surface is replicated by either a ceramic or polished metal surface that articulates on a specialised form of hard plastic.
Usually, it’s due to a condition called Osteoarthritis, which occurs when the cartilage between bones breaks down, resulting in pain and inflammation. Osteoarthritis is a common, chronic condition that can be brought on by family history, previous injuries, obesity, or just ‘wear and tear’ over time. Symptoms usually include stiffness, pain and a loss of flexibility in the affected joint.
While there is no cure for Osteoarthritis, Dr Wallace shares some effective treatments to help alleviate the pain associated with an arthritic joint and get you back to leading an active lifestyle. He gave us six treatment options that can delay the need for invasive surgery, and in some cases avoid it entirely.
1. Keep up regular exercise
“Maintaining some degree of low-impact, regular exercise has been shown to be helpful in managing Osteoarthritis, so we recommend trying to do what is possible within the limits of your arthritic pain,” says Dr Wallace.Not only does exercise help maintain mobility and manage pain levels, it also helps prevent muscle wastage, which means, if you ultimately require joint replacement surgery, you’ll be in a better position to recover quicker.
2. Maintain a healthy body weight
The more weight you’re carrying, the more stress is being placed on your joints day-to-day, which causes and exacerbates the symptoms associated with Osteoarthritis.It’s important not to get caught in what’s called an ‘obesity cycle’, where you avoid exercise because of joint pain, which leads to you putting on even more weight and, in turn, additional pressure on your already achy joints. To break that cycle focus on your diet and reducing your calorie intake while continuing to burn calories through exercise.
3. Get in the pool
“One of the things that can help, even when obesity is a problem, is to take some weight off your joints through buoyancy in water,” suggests Dr Wallace. Swimming is a great way to build strength, relax sore muscles or joints, and lose weight, without any of the impact and weight-bearing associated with running.
4. Use pain medication where necessary
“Regular paracetamol has been shown to be an effective arthritis management method in reducing overall pain levels,” says Dr Wallace.“Other medication like anti-inflammatories and stronger painkillers can also be effective in the short-term, but problems can develop if you use those for a longer period, so we tend to try and minimise their use.”
5. See a specialist
If exercise and ‘pre-habilitation’ – the act of getting your body in the best possible condition prior to surgery – doesn’t come naturally to you, there are always professionals who can give you great advice. Exercise Physiologists and Physiotherapists are the best placed to prescribe you an individualised exercise program that has proven benefits, saving you time and taking the guesswork out of it.
6. Consider supplements
“There are other treatments that are less pharmaceutical and more in the realm of supplements, which have been advocated for as arthritic treatments” advises Dr Wallace. “They include things like fish oil, glucosamine, chondroitin and turmeric. But the evidence for those is mixed – some studies show some benefit and some show none, so the jury is out on those treatments.”
If surgery is unavoidable, it’s important to know what to expect from the procedure and how you can give yourself the best chance of a smooth recovery. We continue speaking with Dr Rob Wallace about joint replacement surgery and how you can prepare for the best outcome.
1 Hospital and Healthcare, 1 in 4 joint replacement surgeries unnecessary, https://www.hospitalhealth.com.au/content/clinical-services/news/1-in-4-joint-replacement-surgeries-unnecessary-784030259#axzz63iiUonfh (accessed October 2020)