OA of the Knee

Dr. Dean Edell: Welcome to Medical Breakthroughs, I'm Dr. Dean Edell. Every time you take a step, your knees bear more than their fair share of the burden. Think about this; every pound you weigh translates into 4-7 pounds of pressure on the knee. For a 150 pound person, that can be as much of 1050 pounds of pressure per step. So when osteoarthritis attacks the knee, we look for ways to hit back. Kelly Kirkbride: I'd go home and crawl up the stairs literally using my feet. Cheryl: My bones tend to grind together. Dr. Dean Edell: More than 20,000,000 Americans suffer with osteoarthritis and as baby boomers get older -- Dr. Jeffrey Rosen: In 2030, that number is predicted to be 67,000,000 people in the United States. Dr. Dean Edell: Age causes it, so can traumatic injury and genetic factors, but the bottom line is the same. Dr. Jeffrey Rosen: Through progressive wear-and-tear and breakdown of the cartilage, you lose the cushioning effect of the cartilage inside the joints. Dr. Dean Edell: And some joint like the knees take it harder than others. Dr. Jeffrey Rosen: We don't give our knees a rest. We are on our knees all day, everyday, we walk up and downstairs, walk up and down-hills, get in and out of chairs and it's a major weight-bearing joint in the body. Dr. Dean Edell: There is no cure. So when pain starts people reach first for common remedies like aspirin, acetaminophen, Ibuprofen, and Naproxen. Dr. Stanley Dysart: They have side-effects. They can cause stomach ulcers, they can cause problems with kidney function, they can also cause problems with the liver. Dr. Jeffrey Rosen: People are much more interested in taking something that is directed at where their problem is. Dr. Dean Edell: Like a shot of relief delivered right where it hurts. Our bodies naturally produces substance called hyaluronic acid or hyaluronate. Dr. Stanley Dysart: It acts as shock absorber per se, it also has important effects we are finding on the cartilage, and on the lining of the knee. Dr. Dean Edell: When osteoarthritis attacks, hyaluronic acid thins out, injecting it back into the knee re-lubricates the joint. Dr. Jeffrey Rosen: They have the ability to help with pain control inside the joint, they have been shown to help with stiffness, and alleviating stiffness within the surrounding tissues. Dr. Dean Edell: A series of shots over the course of several weeks can provide relief for six months or more. Cheryl: Your bones don't grind together, you are more flexible, you just are much more comfortable. You are willing to go out and do more things. Dr. Dean Edell: Hyaluronate shots can be derived from animal proteins. So in some patients, it causes swelling or allergic reactions. A newer process allows bioengineers to create it from harmless bacteria using a process called bio-fermentation. Studies have found it to provide better symptom relief with fewer adverse reactions. Dr. Stanley Dysart: It's not produced by using chickens or roosters or any animal product and that's the advantage. Dr. Jeffrey Rosen: The claims are that they are 99.9% free of any detectable impurities. Dr. Dean Edell: For one in four patients though, surgery is inevitable. Dr. Paul Lux: There has been a lot of advances obviously in almost 20 years that I have been doing knee replacement. Dr. Dean Edell: Until recently surgeons had only a few knee sizes to choose from. Dr. Paul Lux: We don't cut the muscle like we did in the old days. Dr. Dean Edell: The advanced stature knee offers a more custom fit. Dr. Paul Lux: This is a knee that's shaped a little bit different depending not only on your gender, but on your stature, and you can see the difference in the width of the implants. Before we had to compromise on, sort of this fits okay but it's not, it's not perfect. Now we can say that things are getting pretty close to fitting perfect. Dr. Dean Edell: For Kelly Kirkbride, it means being able to do simple things, most of us take for granted. Kelly Kirkbride: I can go upstairs, I can walk a few blocks, I can get up and down out of a chair. Dr. Dean Edell: Despite these advances, lifestyle goes a long way in helping protect joints. Dr. Jeffrey Rosen: Diet and exercise should be at the top of the list of things to do for patients with osteoarthritis. Dr. Dean Edell: Remember what we said at the beginning; every pound of body weight is multiplied in terms of pressure on the knees, so extra weight is an obvious enemy. Dr. Jeffrey Rosen: We get them to lose weight, we get them on exercise protocol and many have less pain. Dr. Dean Edell: The Osteoarthritis Foundation recommends regular walking. Swimming or aquatic exercise, even golf, because it's easily adapted to individual capabilities. Dr. Stanley Dysart: These all contribute to their own treatment. The result of their treatment will be much, much better. Dr. Dean Edell: Early diagnosis will help control the painful symptoms of osteoarthritis. If you have joint tenderness and swelling don't try to self diagnose, see your doctor for help.