When Pain Is Severe, Joint Replacement Can Be a Boon
Imagine having so much arthritic pain in your knees that you can't walk up or down a flight of stairs or even drive a car. Or so much pain in your hip that you rarely leave your home, even to walk in the yard. Now imagine the effect a new knee or a new hip would have on your life.
Such pain is the result of cartilage damage in the joints, and though seen more frequently in older people, it's a problem faced by individuals of all ages. The most common cause of this type of joint damage is simple "wear and tear" (often referred to as osteoarthritis).
Normally, cartilage is very smooth, permitting the bones to slide against each other with minimal friction (and without pain). In an arthritic joint, the cartilage deteriorates and becomes rough, causing pain, stiffness and swelling when the joint is moved and the bones rub against each other.
While everyone's cartilage gradually deteriorates with age, the process is accelerated in some people. Individuals who are overweight, for example, are at increased risk of osteoarthritis of the knee because of the additional load on their joints. A traumatic injury to a joint (such as a fracture or a ligament tear) and rheumatoid arthritis (in which the lining around the joint becomes inflamed) can also result in permanent cartilage damage.
For many people with extensive joint damage, there is a solution: surgical joint replacement. Every year, more than 250,000 Americans replace painfully crippling knee joints; 150,000 more replace hip joints. (Shoulders, elbows and ankles are replaced as well, but much less frequently.)
The majority of these procedures are done to relieve joint pain, improve mobility and permit a return to relatively normal function. The operation removes not only the damaged cartilage but also adjacent bone, replacing them with smooth plastic and metal substitutes.
Typically, joint replacement is recommended only after more conservative measures are no longer effective at relieving pain. Arthritic joint discomfort can often be adequately controlled with nonsteroidal anti-inflammatory medications (such as ibuprofen), particularly before the joint becomes too badly damaged. Physical therapy can be helpful at this stage as well. Nutritional supplements chondroitin and glucosamine are effective in about 30% of users, although it can take about 60 days before relief is noted. One recent study demonstrated that this combination may help to rebuild and restore cartilage.
