For A.M. Release Wed., March 15, 2000
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New nonoperative treatments help patients with knee osteoarthritis
ORLANDO, Fla.--As many as 36 million people in the United States have some form of arthritis or joint inflammation. There are more than 100 different types of arthritis, the most common being osteoarthritis. Treatments for osteoarthritis range from medications to joint replacement surgery.
At a media briefing here today at the 67th annual meeting of the American Academy of Orthopaedic Surgeons, a panel of orthopaedic surgeons discussed the newest nonoperative treatments for knee osteoarthritis. Moderated by Joseph Buckwalter, MD, the panel included Robert Schenck, MD; William Stanish, MD; Douglas A. Dennis, MD; and Randy Rosier, MD.
In osteoarthritis, the cartilage covering the ends of the bone gradually wears away. Osteoarthritis in the weight bearing joints of the knee, hip and spine is typically more painful than the wrist, elbow and shoulder. In many arthritis cases, bone growths called "spurs" develop. The joint inflammation causes pain and swelling even in everyday activities such as walking or standing.
"The number of cases of knee osteoarthritis is increasing rapidly as the population ages. It is now a significant health problem," said Dr. Buckwalter. "There are a wide variety of new nonoperative treatments offering relief from pain and increased mobility for tens of millions of patients."
Some of the new treatments available are injections within the joint, nutritional supplements, braces to shift pressure from the painful part of the joint, exercise programs, prescription medications and heal wedges that fit in shoes.
One of the new treatments showing great promise involves injecting a lubricating substance directly into the knee joint. Ongoing testing shows improved function and decreased pain in patients with mild to moderate osteoarthritis. Patients receive three to five injections during a one week period with relief lasting up to six months.
"Injections work well for patients who do not tolerate antiflammatory medications or who do not find those medications to provide relief," said Dr. Rosier. "It is an alternative to conventional arthritis treatments that is becoming more and more a mainstream therapy."
Another growing area of treatment involves nutritional supplements. Researchers are finding that many new supplements provide nutrition for cartilage that may help increase mobility and reduce inflammation.
"Supplements can be a good adjunct in a comprehensive knee osteoarthritis treatment program, but it is important for patients to work with their orthopaedic surgeon rather than self-medicating with any over-the-counter treatments," said Dr. Schenck. "Each patient requires an individualized treatment program that takes into account all of the medications, both prescription and over-the-counter, he or she is taking for other medical conditions or to reduce the pain and swelling in the knee."
Arthritis, including osteoarthritis, is diagnosed using an evaluation of symptoms, a physical examination and X-rays to show the extent of damage to the joint. Blood tests and other laboratory testing helps to determine the type of arthritis. There is no cure for arthritis.
"The more patients understand about the increasing number of nonoperative treatments available for knee osteoarthritis, the better participants they can be in their treatment programs," said Dr. Buckwalter. "With the new treatments, the vast majority of patients can find relief without surgery."
In the first year of the United Nations-declared Bone and Joint Decade (2000-2010) (http://www.boneandjointdecade.org), the Academy is holding its annual meeting at the Orange County Convention Center, Orlando, March 15-19.
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