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Issue Date: March 2009


Best Docs 2009 - Flex Plan


Jennifer Keirn
How To Avoid Seeing This Doctor
Arthritis

1 Keep joints happy.
The best defense against the joint cartilage deterioration is to follow a low-impact exercise regimen that builds flexibility and range of motion and keeps muscles strong. “Intermittent compression and gliding [of the joint during low-impact activity] is important to cartilage cell health,”says Dr. Scott Weiner, chairman of the department of orthopaedic surgery at Summa Health System.

2 Avoid jolts. Participation in grueling sports such as marathon running, football and motocross can increase your chances of developing arthritis, says Weiner. ”When there’s excessive compression or a fracture involving the articular cartilage, it can lead to cartilage cell death,” he says. “Eventually, the joint can become bone-on-bone when no articular cartilage remains.”

3 Don’t listen to the ads. The rise in advertising for joint replacement surgery has patients with a little knee pain asking Weiner for a knee replacement. “When you look at the ads, it sounds like joint replacement is the cure-all,” he says. “It’s a very good procedure, but you don’t want to jump into it too quickly.”Dr. Scott Weiner
Exercise, exercise, exercise. It’s doctor-recommended, trainer-tested and reality TV-endorsed.

But some of us have listened too well, and we’re paying the price.

Arthritis is one of the most prevalent chronic health problems in the U.S., and yet one that doctors still know little about. And if you think it’s something only old people get, think again.

“We’re seeing it a lot more in younger patients,” says Dr. Scott Weiner, chairman of orthopaedic surgery at Summa Health System. “It’s due to our active population, which is good, but if you’re hard on your joints it can lead to premature arthritis.”

Arthritis can refer to any number of conditions affecting the joints and other parts of the body. The most common is what Weiner refers to as “wear-and-tear arthritis,” or osteoarthritis, caused by the breakdown of cartilage and characterized by aching joints that get worse as the day wears on.

There are no clear indicators of who will develop osteoarthritis, Weiner says, although your chances increase if you’ve damaged a joint in a car or motorcycle accident, or if you’ve participated in sports such as football or marathon running.

A joint X-ray may indicate whether a patient is a good candidate for joint replacement surgery, but the person may experience little pain, he says. “That’s why we don’t treat the X-rays, we treat the pain the person’s having.”

Treatment for osteoarthritis may include cortisone injections into the joint, physical therapy and reducing high-impact activity such as running. But “after three to six months of nonoperative care, that’s when we start talking about joint replacement,” says Weiner.

Although joint replacement technologies have made strides, Weiner says, today’s artificial joints only last 15 to 20 years. That makes subsequent replacements likely for younger sufferers.

“Joint replacement is a great operation, but about one in 100 will have a serious complication,” says Weiner. “You want to do everything you can without surgery first.”

Current research — including an ongoing study at the Northeast Ohio Universities Colleges of Medicine and Pharmacy — is seeking to uncover the factors that influence cartilage degradation. “But it’s such basic science that it will be several years, maybe even a decade, before you have something that could lead to a treatment,” says Weiner.

In the meantime, Weiner looks forward to new technologies in the works to make replacement joints last longer, possibly even forever, until other treatment options are found.

“Unfortunately, we haven’t had many good solutions. Once you get osteoarthritis, you have it,” Weiner says. “We need to have more advances at a younger age to modify the disease.”
 

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