What is Osteoarthritis

Dr. Dean Edell: Americans are living longer but their knees aren't, the Arthritis Foundation says about 10,000,000 Americans suffer from osteoarthritis of the knee, a disease of the body's own shock absorbers. Although there is no cure, osteoarthritis is treatable, and here are a few of the latest treatments that provide relief and help to avoid invasive surgery. John Grampa: Any repetitive motion is, you simply can't do. Ed Schultz: When I'd walk, it was a mortar and pestle grinding away at each other and that's what it was. Joann Wilkerson: It feels as though there's something pushing in there really hard and it's trying to explode the bones. Dr. Dean Edell: Pain, stiffness, swollen joints, loss of function, all are classic symptoms of osteoarthritis. Dr. Michele Hopper: Osteoarthritis accounts for more lost days from work, more healthcare dollars used in low back pain. That's how big it is. Dr. Dean Edell: Osteoarthritis occurs when the cartilage between your joints wears away. Without this smooth, springy substance, the bones scrape together against each other. Dr. David Dore: If you've lost a shock absorber, it's all going across the bone now and that's going to cause a slow wearing out. Dr. Dean Edell: Well, age plays a big part in developing osteoarthritis, but it's not the only risk. Women are three times more likely to develop it than men, and in overweight person, their risk is nine times greater than someone who is slim. Dr. David Dore: Every step you take, you put two, three times your body weight across your knee and hip joint. Dr. Dean Edell: Once the cartilage wears away, it won't grow back. But there are new ways to treat it. Medications like acetaminophen and aspirin help ease symptoms but they can be hard on the stomach. That's where newer prescription medications, called Cox-2 Inhibitors come in. They're designed to reduce both pain and swelling with less stomach irritation. Dr. Michael Bronson: Unfortunately, none of those things change the natural history of the arthritis, that make it feel better but they don't change the progression. Dr. Dean Edell: That's why researchers are studying Glucosamine and Chondrotin. Some experts believe these popular supplements actually have preventative benefits. Dr. Sam Blick: And the thought was if you take calcium for your bones and it builds your bones, if you take this proteins, then they should build the cartilage back up but there's really not of evidence of that actually happens. Dr. Dean Edell: Businessman, John Grampa, uses a different non-drug approach to treat pain and avoid surgery. John Grampa: What I'd like to do and what the doctors would like to do is delay it for as long as possible. Dr. Dean Edell: Rheumatologist Michelle Hooper gives him lubricant injections using a substance called hyaluronic acid. Dr. Michele Hooper: Hyaluronic acid is a molecule that the body produces, and particularly in the knee joints. Dr. Dean Edell: When osteoarthritis sets in, hysaluronic acid around the joint becomes thinner. Dr. Elton Strauss: We think that you lose at least a third, two-thirds of your hyaluronic acid with osteoarthritis. Dr. Dean Edell: By injecting it into the knee, hyaluronic acid acts like a lubricant, coating the joint and making the bones glide more smoothly. Dr. Elton Strauss: So by giving you back this lubricant, it kind of greases the joints just like we grease the joint on a car. Dr. Dean Edell: Patients get three shots over a two-week period. Pain relief can last from six months to 12 months year. The treatment gives John mobility and delay surgery for now. But some osteoarthritis patients aren't so lucky. Take Joann Wilkerson, an injury contributed to her condition. Joann Wilkerson: I'm a amateur photographer and I had stepped in a hall taking pictures one time. Dr. Dean Edell: Traditionally, she'd had been a candidate for total knee replacement. Instead, Dr. Steve Lyons used a new implant called a unispacer to repair her knee. Dr. Steve Lyons: There are no screws, sauce, glue, there is nothing to hold this thing in. It centers itself within the knee, geometrically with the anatomy of the knee, and it's held in place with the ligament tension. Dr. Dean Edell: A small incision is made but the bones are not cut. The device fills up space where the cartilage has worn away, and props up the collapse area on the inside of the knee. Here is your Joann's knee before and after. The catch is long-term results for the unispacer are unknown. But patients like Joann are willing to take a chance to avoid painful knee replacement. Joann Wilkerson: And I'm able to do the sowing and the walking, and the gardening, the things I like to do. Dr. Dean Edell: While technology can repair the damage, Dr. David Dora says joint protection is a lifelong practice. Dr. David Dora: What I always tell people is it's like a tent. You know the joints are like tents. The bones are the poles and maybe the poles are getting little rickety but if you have got good strong ropes, the tents are going to stay up. Dr. Dean Edell: A change in diet is a start. It helped Ron Clifton shade 30 pounds for which his knees are thankful. Ron Clifton: Getting off of the carbohydrates and controlling what you eat, very quickly you can stabilize your weight. Dr. Dean Edell: And although it's easier to take a pill for pain, it's better to get up and move. Marilyn Bagnell stumbled on to an exercise class by accident, now it's her daily routine. Marilyn Bagnell: So I find if I miss the class, I have problems with stiffness, so isn't that an incentive to keep going? Male Speaker: Everybody can exercise, not that everybody can play for the Yankees but you can find something to do. Dr. Dean Edell: The more you do to take care of your own set of shock absorbers, the longer you can keep the originals. Stretching is another way to keep joints and muscles flexible and offset pain. Before starting any new exercise program, talk to your doctor first.