Maybe it's today, maybe it's tomorrow. If you have been getting little or no relief from your medications for osteoarthritis, it's likely to happen one day. You'll ask yourself that perhaps long-avoided question: is it time to consider joint surgery?
How do you answer yourself? If you have explored any other recommended treatment for the pain of osteoarthritis, the answer may well be "yes". If you're in severe pain, if you've lost cartilage, if other meds haven't worked, and if you're in overall good health, the answer also may well be "yes".
The next step may be a talk with an orthopedic surgeon about the best surgery for you and your particular condition. Here are some possibilities:
- Arthroscopy. A light-bearing arthroscope is inserted through a small incision near the damaged joint to allow the surgeon to clean out bone and cartilage fragments. Relief may last in some for a long time, but it is usually most beneficial for those with mild to moderate osteoarthritis.
- Arthrodesis. Two bones in the damaged joint are joined (fused), making the joint immovable.
- Osteotomy. Bones near the joint in the hip or knee are cut and moved from joint-bearing areas. This works best with those 60 or younger with mild arthritis and may be used to delay replacement surgery.
- Resection Arthroplasty. All or part of a joint is removed so that damaged surfaces no longer rub against each other.
- Total Joint Arthroplasty or Total Joint Replacement. This follows when other procedures haven't worked. Surgery replaces the ends of bones in the damaged joint. Total replacement often follows when less invasive techniques have not worked and the patient is severely limited in movement, including walking.
You and your orthopedic surgeon can decide which surgery promises the best outcome for your physical condition and lifestyle.
Whichever technique is used, arthritis of almost any joint can benefit from arthroscopic surgery. There is a lower risk of complications in this type of operation with reduced surgery time and less pain following. Any surgery, however, does carry some risks. In this case, there may be danger of blood vessel or nerve damage, blood clots, cartilage or muscle damage, or a reaction to anesthesia.
What about the rehabilitation period? This all depends upon the type of surgery and the condition of the patient. However, in general, about six weeks of physical therapy will be necessary to rebuild adjoining muscles and strengthen nearby ligaments. During this time, patients can expect to experience considerable pain. Hip surgery patients are usually able to walk and climb stairs after surgery, but they cannot run. Most knee surgery patients experience improved walking distance, but they cannot run.
If you are answering "Is it time?" with "Yes, it is," then it is also time for a talk with your orthopedic surgeon. One of these methods may free you from the limitations of severe osteoarthritis.