Sooner or later, hips, knees, etc. just seem to give out on us

Even if you have the luck of the Irish, if you are older than 65, you stand a very good chance that you will need one or more joints replaced. Seventy-million Americans suffer from some sort of joint disability. Since I celebrated my 65th birthday some time ago and I’m not Irish either, I hurried to hear a lecture recently by the well-known orthopedic surgeon, Dr. Christopher Lynch, at the Village at Mariner’s Point, the waterfront senior living community in East Haven.

Osteoarthritis and the loss of joint cartilage, which then results in pain, is the most common reason people consider knee or hip replacement surgery. Women need knee surgery more often than men, but there are varied causes for any joint surgery: age, weight, repetitive stress to a joint by high-impact sports, and other illness — all can be causative factors.

Signs of a problem are stiffness and swelling and sometimes a grinding pain. While there is no way to reverse the process, Lynch said weight loss and medications such as NSAIDS or anti-inflammatory drugs can lessen the pain. The verdict is not in yet on supplements. He said they seemed to help some people, so you should do whatever seems to help.

Cortisone injections give dramatic, but short-term relief, working at first when they are given at four-month intervals, but then becoming less and less effective. Hyaluronic acid has a delayed effect, but does give more long lasting relief; six months to a year, when successful.

Lynch feels that arthritis is not an emergency and since recovery can be long and sometimes difficult, most patients should try injections and medications, first. Surgery might want to be considered if the joint is painful and prevents you from performing even the simplest of activities.

The different types of knee-replacement surgery should be discussed beforehand with your surgeon. Arthroscopy or “camera” surgery is unpredictable and therefore, controversial. Knee osteotomy in which bone is cut and re-aligned was previously used for young or heavier patients.

Now, uni or partial, requiring a smaller incision and resulting in a more normal feeling knee, is used along with tri-compartment or total when the patient has arthritis in two or more compartments. This type of surgery was first performed in 1968, but now there are 600,000 total knee surgeries performed each year in America.

The patient is usually out of the hospital in three days, but therapy will take 6-8 weeks and recovery, about 6 months.

An article in a leading health magazine pointed out the importance of post-operative narcotics to relieve pain. Epidural implants or patient-controlled infusion pumps can be used to control pain and speed recovery.

Lynch answered questions from the audience about hip surgery which he said, seemed to achieve the highest satisfaction rate among patients. Hip surgery usually lasts 10-20 years, depending on the patient’s weight, how much stress is put on the hip and how the joint and bones mend. The upper end of the thighbone or femur is replaced with a metal ball, and the hip socket in the pelvic bone is re-surfaced with a metal shell or plastic liner. New, minimally invasive surgery has reduced the incision from 8-12 inches to 3-5 inches.

What can you do (other than not growing older) to avoid knee or hip surgery?

-Keep moving to keep joints healthy

-Change positions often; take breaks from desk, chair or car.

-Low-impact exercise such as walking, biking, swimming.

-Strengthen your core which improves balance, preventing falls.

-Every pound you lose takes 4 pounds of pressure off your knees.

Even if you have the luck of the Irish, if you are older than 65, you stand a very good chance that you will need one or more joints replaced. Seventy-million Americans suffer from some sort of joint disability. Since I celebrated my 65th birthday some time ago and I’m not Irish either, I hurried to hear a lecture recently by the well-known orthopedic surgeon, Dr. Christopher Lynch, at the Village at Mariner’s Point, the waterfront senior living community in East Haven.

Osteoarthritis and the loss of joint cartilage, which then results in pain, is the most common reason people consider knee or hip replacement surgery. Women need knee surgery more often than men, but there are varied causes for any joint surgery: age, weight, repetitive stress to a joint by high-impact sports, and other illness — all can be causative factors.

Signs of a problem are stiffness and swelling and sometimes a grinding pain. While there is no way to reverse the process, Lynch said weight loss and medications such as NSAIDS or anti-inflammatory drugs can lessen the pain. The verdict is not in yet on supplements. He said they seemed to help some people, so you should do whatever seems to help.

Cortisone injections give dramatic, but short-term relief, working at first when they are given at four-month intervals, but then becoming less and less effective. Hyaluronic acid has a delayed effect, but does give more long lasting relief; six months to a year, when successful.

Lynch feels that arthritis is not an emergency and since recovery can be long and sometimes difficult, most patients should try injections and medications, first. Surgery might want to be considered if the joint is painful and prevents you from performing even the simplest of activities.

The different types of knee-replacement surgery should be discussed beforehand with your surgeon. Arthroscopy or “camera” surgery is unpredictable and therefore, controversial. Knee osteotomy in which bone is cut and re-aligned was previously used for young or heavier patients.

Now, uni or partial, requiring a smaller incision and resulting in a more normal feeling knee, is used along with tri-compartment or total when the patient has arthritis in two or more compartments. This type of surgery was first performed in 1968, but now there are 600,000 total knee surgeries performed each year in America.

The patient is usually out of the hospital in three days, but therapy will take 6-8 weeks and recovery, about 6 months.

An article in a leading health magazine pointed out the importance of post-operative narcotics to relieve pain. Epidural implants or patient-controlled infusion pumps can be used to control pain and speed recovery.

Lynch answered questions from the audience about hip surgery which he said, seemed to achieve the highest satisfaction rate among patients. Hip surgery usually lasts 10-20 years, depending on the patient’s weight, how much stress is put on the hip and how the joint and bones mend. The upper end of the thighbone or femur is replaced with a metal ball, and the hip socket in the pelvic bone is re-surfaced with a metal shell or plastic liner. New, minimally invasive surgery has reduced the incision from 8-12 inches to 3-5 inches.

What can you do (other than not growing older) to avoid knee or hip surgery?

-Keep moving to keep joints healthy

-Change positions often; take breaks from desk, chair or car.

-Low-impact exercise such as walking, biking, swimming. Continued...

-Strengthen your core which improves balance, preventing falls.

-Every pound you lose takes 4 pounds of pressure off your knees.

- Article by Jean Cherni, founder of the retirement advisory service, Senior Living Solutions. Contact her at jeancherni@sbcglobal.net or 15 The Ponds at Hotchkiss Grove, Branford 06405.

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