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The Lunch and Learn Seminar on arthritis was held on Thursday at Rolling Plains Memorial Hospital (RPMH), as a packed house learned more about a condition that affects many people.
The free program was presented by Dr. Mark Seibel, an orthopedic surgeon at RPMH.
Arthritis is a generic, non-specific term which can be translated to be defined as "joint inflammation". The first part of the word, "arthr-," means joint, while "-itis" means inflammation.
The disorder can affect any type of joint in the body, but the most common areas affected are the hip, knee and back. While a degeneration is the most common cause of arthritis, other examples include infection, trauma, or a rotator cuff tear in the shoulder.
Due to the progressive destruction of cartilage and bone, arthritis is usually a slow change. Symptoms include pain, stiffness, loss of motion and function, and deformity.
Dr. Seibel showed participants some x-rays of a hip and knee affected by arthritis. He noted that 75% of the time, arthritis sufferers are affected in the inner half of the joint, while the other 25% see damage to the outer half of the joint.
When evaluating if a patient has arthritis, history will be considered while some other procedures take place. Among them are a physical exam and plain x-rays.
However, a full-length x-ray would be performed as needed, but is not conducted very often. And if no other factors are at play, no lab work will typically be done.
There are two ways to treat arthritis: through non-surgical and surgical means.
The former tends to be less costly with readily available options. But with arthritis, there is no middle ground with pain and treatment, as Dr. Seibel called it an "all or none" approach.
With non-surgical treatment, activities can be modified, heat or cold can be applied to the area, or different medicines can be taken. Tylenol is usually the first method, while anti-inflammatories (like Motrin or its generic form) can be given.
However, an anti-inflammatory like Celebrex would need to be prescribed by a doctor. Narcotics can be useful for some period of time, while glucosamine/chondroitin sulfate--like Osteo Bi-Flex--can be administered.
Non-traditional methods like tai chi or acupuncture can be used, but patients must educate themselves before selecting the treatment. Additionally, physical therapy, cautious bracing, assistive devices, weight loss, and smoking cessation can be beneficial.
Injections, like a cortisone steroid or a viscosupplementation (hyaluronic acid/rooster comb) can be used as well, but the method is not very simple. Patient history and an exam must be done prior to the injection--typically done in the knee--and can be very costly depending on insurance.
Furthermore, injections have shown to be unreliable in their effectiveness, only offering a temporary solution. As the deterioration of the joint continues, there are also problems on how and how long the treatment works.
The same can be said for any non-surgical methods, as a temporary effect is evident with an unreliable effectiveness. But while medication risks are also present with non-surgical treatment, some people are not candidates for surgery, leaving them with the only option of non-surgical methods.
On the other hand, the surgical solutions for arthritis range from arthroscopy, realignment, or a partial or total joint replacement. Dr. Seibel also showed x-rays with joint replacement components in the knee, shoulder and hip.
For knees, some patients are opting for gender specific knees offered, although it is not yet conclusive on how they works and tend to be more costly.
Hip replacement options include metal-on-metal and ceramic--although both have been recalled as of late--and metal-on-plastic. Patients should always ask their doctor which option is being used and why the selection was made.
As with any surgery, problems with pain, function, infection and wound healing may arise. Some loosening or dislocation may also occur, leading to the possible need for revision.
Since joint replacement is a big surgery, Dr. Seibel made some recommendations. Patients should do their homework, get a second or even third opinion (if necessary) and have a lengthy discussion with their surgeon by asking lots of questions.
Since arthritis is slowly progressive in most cases, sufferers should not be in a hurry to have surgery. Make sure that surgery is the best option--as it cannot be undone, and that the final decision is made by you, the patient.
Attendees were also able to take home various handouts which discussed an arthritis treatment guideline for the knee, guidelines on antibiotics for dental work and DVT (deep vein thrombosis) prophylaxis, risks on injections and a list of websites.
Dr. Seibel stressed that with websites, patients should be cautious if a site promotes a product or service, as the information may be skewed. Because a professional site's purpose is to inform and educate others, they typically have no advertising.
To learn more about arthritis, visit the following websites: arthritis.org (Arthritis Foundation), orthoinfo.aaos.org (American Academy of Orthopaedic Surgeons) or acr.org (American College of Rheumatology).