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Knee Replacement Surgery May Be A Thing Of The Past For Many Baby Boomers

Sep 13, 2008
Today, Baby Boomers (defined as those people born between the years 1946 to 1964) are living longer, staying more active, and very interested in continuing to maintain a vigorous lifestyle.

Multiple research studies have demonstrated the benefit of regular exercise in forestalling the complications related to such degenerative conditions as diabetes and Alzheimer's disease.

Exercise is also important in maintaining the health of joints by strengthening muscles, improving blood flow, and promoting joint flexibility.

Nonetheless, many people find, even as early as their 40's that they have significant problems with arthritis. They then go to see orthopedic surgeons who- as surgeons are trained to do- want to operate.

According to statistics provided by the American Academy of Orthopedic Surgeons, hip replacements in the United States are expected to double from 285,000 in 2005 to 572,000 in 2030, with knee replacements also shooting through the roof from 523,000 to 3.4 million over the same period of time.

Most joint replacement operations are performed for osteoarthritis, the most common form of arthritis. Osteoarthritis (OA) is a disease where the cartilage, the gristle that caps the end of long bones, begins to degenerate and deteriorate. As the disease progresses, the cartilage softens and further wears away. Eventually the underlying bone is exposed. In addition, inflammation affects the joint capsule. In joints like the hip and knee, once the cartilage has worn away, mechanical factors come into play and aggravate the situation.

While newer techniques for joint replacement are making this operation more attractive, what can a Baby Boomer who has OA but who doesn't want joint replacement surgery to do?

Standard conservative therapies consist of weight control, regular exercise, and avoidance of activities that aggravate symptoms.

For pain control, analgesics such as acetaminophen (Tylenol) and various non-steroidal-anti-inflammatory drugs (NSAIDS) are sometimes helpful. Unfortunately, they also have the potential for harmful side effects.

For patients with more severe symptoms, injections of glucocorticoids ("cortisone") and viscosupplements, which are special lubricants, can alleviate pain.

Devices such as lateral wedge insoles worn in shoes to realign the knee or braces can also be useful for some.

In patients with significant discomfort who still have cartilage left, there is another option. Born of the regenerative medicine movement, resurgent interest in the use of autologous stem cells, stem cells obtained from the patient, has prompted the development of new treatment approaches.

One such approach is the use of autologous stem cells along with platelet rich plasma (platelets are blood cells rich in healing and growth factors) to help grow new cartilage.

While the data is still in its infancy, there is solid evidence that the combination of stem cells and platelet rich plasma introduced into an osteoarthritis joint that has been primed with injury (using a small gauge needle with ultrasound guidance) may lead to cartilage regeneration.

Certainly, symptoms improve in the vast majority of patients. Studies are currently underway to assess the degree to which and the rapidity at which new cartilage grows using this technique. The attraction is that this procedure is done using local anesthetic and is minimally invasive.

For more information, contact the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800.
About the Author
Nathan Wei, MD FACP FACR is a nationally known board-certified rheumatologist. For more info: Arthritis Treatment
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