What are your options?
Management of Osteoarthritis
The objectives of the treatment are to reduce pain, improve joint movement, and prevent further damage to the joint.
The non-surgical treatment of osteoarthritis involves:
- Medications: Simple analgesics such as Panadol are a good start. Other stronger pain-relieving medications such as NSAIDs, COX-2 inhibitors and opioids may be prescribed. Topical medications such as ointments can be applied over the skin where there is pain.
- Steroid Injections: These injections of steroids are given directly into the affected joint for severe pain when simple measures do not bring relief.
- Lifestyle modifications: Some of the lifestyle modifications include:
- A moderate exercise program – avoiding activities that aggravate the pain
- Use of Heat or cold treatments
- Eating a healthy and well-balanced diet
- Get adequate rest
- Protect your joints with the use of assistive devices such as splints or braces to support the painful joints
- Physiotherapy: Your physiotherapist will teach you exercises to keep joints flexible and improve muscle strength.
Surgery is usually considered if nonsurgical treatment fails to provide relief. There are different surgical procedures that can be used and may include:
- Arthroscopy: Arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is performed through very small incisions to evaluate and treat a variety of joint conditions. Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscope is a pencil-sized instrument that has a small lens and lighting system at its one end. Arthroscope magnifies and illuminates the structures inside the joint with the light that is transmitted through fibre optics. It is attached to a television camera and the internal structures are seen on the television monitor.
- Debridement: Arthroscopic debridement, or a clean-up, is a surgical procedure performed using an arthroscope. In this procedure, the inflamed synovium, loose bits of cartilage or bone is removed using surgical instruments and the edges of the articular cartilage that are rough are smoothened. A wash out or joint lavage is done using a special tool to spray jets of fluid to wash and suck out to remove the remaining debris around the joint. After lavage any remaining loose bodies or fragments are removed. Debridement help to reduce pain, mechanical symptoms and slows down the progression of arthritis.
- Joint Replacement: If the arthritis is severe the joint surfaces can be excised and replaced with metal and plastic components. These are generally good at improving the pain and motion but complications can occur.
- Custom made prosthesis: A custom or tailor made prosthesis or tailor made prosthesis is the latest technology designed specifically for the size and shape of an individual’s anatomy. It uses CT-scanning for extremely accurate 3-dimensional mapping and measurement of the joint. Computer software transforms the data from the scan into a 3-D model of your arthritic joint and then virtually creates the new 3D printed joint replacement. This allows the surgeon to reconstruct the deficient bone to create the joint replacement implant.
Professor Bain will discuss the options and help you decide which type of surgery is the most appropriate for you.