What is osteoarthritis?

Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear-and-tear" arthritis. Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight-bearing joints, mainly knees, hips, and ankles. This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may form.

What are the symptoms?
The number one symptom is pain. The pain is caused by irritation and pressure on nerve endings as well as muscle tension and fatigue. The pain can progress from mild soreness and aching with movement to severe pain, even when resting. The second symptom is loss of easy movement, such as bending or rising normally. Morning stiffness is a problem for many people. This lack of mobility, in turn, often causes the muscles serving the knee or hip to weaken, and overall body coordination suffers.

How is it diagnosed?
A simple, weight-bearing x-ray and examination by a skilled orthopedic doctor will determine if you have osteoarthritis. Time-consuming and costly diagnostic procedures are not required.

There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility, and fatigue that are among its most disabling symptoms.

• Hyaluronate - The new treatment lubricates the knees and can reduce pain for 9-12 months. It’s the first major breakthrough in 20 years for arthritis knee pain. Hyalgan is the brand name, and five injections are given one week apar into the kneet.
• Medicines - Coated aspirin helps relieve pain and has few side effects. Non-steroidal anti-inflammatory drugs (NSAIDS), such as Voltaren, Feldene, Naprosyn, and Clinoril, are prescription drugs for pain and inflammations. The Cox-2s are helpful as well, such as Vioxx, Celebrex and Bextra. Do not take aspirin if you are taking NSAIDS.
• Cortisone Shots - Cortisone shots are given for inflammation. For many people, joint arthritis is often made symptom-free for months or even years after cortisone shots. Four to six shots a year can be given without any dangerous side effects.
• Diet - There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It’s important to keep thin, however, because excess weight aggravates arthritis by putting added pressure on the knee and hip.
• Exercise and Rest - Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. Motion is lotion for arthritis! At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best.

Arthroscopy - Arthroscopic procedures are not generally helpful for arthritis. In some cases, a "flap" of torn knee cartilage can aggravate arthritis and cause additional pain. The cartilage flap can be removed by arthroscopy arthroscopy and the knee can be washed out and cleaned of arthritic debris.

Knee or Hip Replacement - Knee replacement or hip replacement is a very positive solution to the pain and disability of advanced osteoarthritis. The rough, worn surfaces of the joint are relined with smooth-surfaced metal and plastic components.

How can I schedule an evaluation?
Request an appointment by calling (415) 353-6380. Joint Center physicians are available on Tuesday and Wednesday mornings from 9 am to 12 noon and alternating Monday afternoons. The Center accepts Medicare assignment and bills Medicare and secondary insurance. The Center also participates in most managed care plans as well as other insurances. Appointments for Workers' Compensation patients are authorized and scheduled through adjusters for the compensation insurance companies.