People with osteoarthritis in their knees, hips, shoulders or wherever else are often bewildered when faced with the prospect of having surgery, says ProMedica Physicians orthopaedic surgeon Craig Assenmacher, MD. Simply put: They don’t know what to do.
“The decision is not straightforward; there’s a lot that goes into it. There’s no one-answer-fits-all,” Dr. Assenmacher says. “I suggest to patients with arthritis that they initially try non-operative treatments such as using oral anti-inflammatory medications or having a steroid injection before considering any surgical options.”
It’s also helpful, Dr. Assenmacher, says, that people quit smoking, lose weight (if they’re obese), exercise and consult with their physician to find out if they should be taking supplements. “There’s good research that Vitamin D and calcium supplementation not only can improve bone density but may also be effective in slowing the progression of arthritis.” (Click here to learn more about the benefits and best sources of vitamin D.)
There’s been a lot of talk about stem cell therapy for the treatment of osteoarthritis, and when asked about its efficacy, Dr. Assenmacher says some studies suggest they may have the potential to decrease joint pain and inflammation. Through regenerative medicine, an individual’s own stem cells may be used to treat osteoarthritis of the knee, hip or shoulders in a nonsurgical process.
Before recommending surgery, Dr. Assenmacher says, “I have a discussion with the patient regarding whether they have exhausted nonsurgical options and continue to have significant symptoms that affect their ability to perform daily activities. I try to answer all of their questions and concerns regarding joint replacement and give them realistic surgical expectations.”
He continues, “those who elect to have surgery should know that there have been improvements in the last 10 to 15 years in the management of pain around the surgery. There’s a multi modal pain regimen to improve pain control, for one thing. Also, there’s a trend in trying to get patients home either on the same day or within three days.”
There have also been improvements in the surgery itself. Dr. Assenmacher explains, “There are minimally invasive surgical techniques we use in properly selected patients. We make smaller incisions that cause less soft tissue damage and bleeding, which translates to less pain after surgery and a more rapid recovery.”
Speaking of rehab, there’s now a team approach, which Dr. Assenmacher says facilitates healing. “This includes nursing, physical therapy, anesthesiology and social workers. Everyone works to get the patient walking right after surgery. By about three months, they’re at about 90 percent.”