Is arthritis preventable?
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Arthritis is not inevitable but factors like excess body weight and prior injuries increase your risk of developing arthritis. So you can help to reduce the risk and delay the onset of your knee and hip arthritis by having your bone and joint pain evaluated as early as possible to first determine the cause of your pain, and then to develop a treatment plan to help you feel better and be more active and also potentially to slow down the development of worsening arthritis.

With hip arthritis, why is there pain in the groin?
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The hallmark of hip arthritis inflammation is pain in the groin area in front and occasionally in the upper thigh to the knee. But never below the knee and the cause of that kind of pain is usually the sign of a pinched or irritated nerve in your back.

What diagnostic test(s) are the final determination for hip or knee replacement surgery?
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First, we look at whether there is little or no cartilage in the joint as determined by simple x-rays done in the office. Then pain, pain, pain and how much the pain from the arthritis is affecting your activities and what you would like to be able to do pain free.

You and your doctor, nurse practitioner or physician assistant will review all this information with you and discuss your individualized treatment plan. Remember, when it comes to deciding on how to begin treatment and whether it is non-operative or operative, the most important factor is your pain and disability.

How do you use pain to determine when your indicator is a subjective measure?
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We understand pain is very much subjective, so our treatment plans are customized to your needs and goals in life. For example, your x-rays might indicate you have little or no cartilage left but if your pain levels aren’t extreme and you are still doing the activities that you would like to do, then there are initial non-operative treatments such as exercises and injections that will be recommended.

With hip arthritis, why is there pain in the groin?
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The hallmark of hip arthritis inflammation is pain in the groin area in front and occasionally in the upper thigh to the knee. But never below the knee and the cause of that kind of pain is usually the sign of a pinched or irritated nerve in your back.

If you have a hip or knee replacement, can you still have arthritis in that joint?
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Joint replacement surgery removes all of the arthritis, and it cannot return.

Please explain the difference between osteoarthritis and rheumatoid arthritis.
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Osteoarthritis is caused by the wear and tear of the cartilage inside the joint that occurs over time. Cartilage acts as a shock absorber and allows the joint to move smoothly and without pain. Rheumatoid arthritis is an autoimmune and whole-body disease where the body’s immune system mistakenly recognizes healthy cartilage as a threat and attacks it causing the loss of cartilage and severe inflammation.

Is osteoporosis and osteopenia a form of arthritis and are they reversible?
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Osteoporosis is not a form of arthritis. Osteopenia is a precursor to osteoporosis which are the conditions where there’s a loss in bone density and mass and although it isn’t reversible, you can slow down the loss of bone. Osteoarthritis is the deterioration of the cartilage between joints.

What food/diet is good for arthritis?
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Implement an anti-inflammatory diet into your daily food intake since arthritis pain is from inflammation. Prioritize eating whole foods above processed foods. Limit saturated and trans fats; reduce sugar intake; limit full-fat dairy, red meat, fried foods, alcohol intake and eat more fruits and vegetables.

Does your diet have an impact on arthritis?
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Yes, a diet can reduce the inflammation of the joint as well as reduce your body weight which will ultimately decrease the stress and weight load on your arthritic joint. Remember that for every one pound of body weight, it’s actually 5-6 pounds of pressure on your hips and knees.

What is the best way to use heat and cold for arthritis treatment? In what order and how often?
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Cold therapies reduce inflammation and swelling. Heat relaxes your muscles and stimulates blood circulation. Applied directly to the painful joint. We always say, “heat before, ice afterwards” when it comes to activities. Heat may also be more useful for chronic pain or for“warming up” before exercising. Cold packs may provide relief from acute pain or for after exercising.

How effective is stem cell or plasma therapy to “cure” arthritis and potentially prevent joint replacement surgery?
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There are NO treatments currently available that can replace cartilage that has worn away. However, these kinds of injections can be thought of as “natural” anti-inflammatory treatments which can reduce the pain caused by inflammation and may buy you time before surgery is needed. But the only “cure” for the arthritis is joint replacement surgery.

Learn More about Iovera Treatment Learn More about PRP Injections

What are the injection options offered?
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We offer anti-inflammatory injections such as cortisone/corticoid injections and hyaluronic acid injections, that stay inside your knee or hip joints which can be very effective in relieving pain, and many times for several weeks and months. We also offer Platelet RichPlasma Injections and Cryotherapy injections (Iovera).

Learn More about Injections

What is “cryotherapy” (Iovera) and is it offered at the Bone and Joint Center?
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This treatment is currently used for knee arthritis only and it uses “cryoanalgesia” technology that implements freezing cold to disrupt the pain transmitting portion of nerves to produce immediate, longer lasting “block” of those pain sensors. This is only for the sensory nerves and leaves muscle function intact.

Learn More about Iovera Treatment

Are there any oral drug treatment options (non-surgical) for osteoarthritis before choosing joint replacement surgery asa treatment option?
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Yes, we recommend pain relievers such as acetaminophen, NSAIDs and Celebrex that all have anti-inflammatory effects on your joints.

Learn More about Oral Medications

What is your recommendation for the amount of calcium and vitamin D that one should take (not including what is dietary)?
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Calcium - Men over 50 should take 1,000mg daily. Women over 50 should take 1,200mg daily.

Vitamin D - Adults 19 - 70 years old should take 600 IU daily. Adults over 71 years old should take 800 IU daily.

How helpful are supplements like fish oil and glucosamine?
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Glucosamine - Has an anti-inflammatory effect. It is sugar based so those with diabetes should use it with caution. It has NEVER been proved to replace cartilage that’s gone, but it is falsely advertised that way.

Fish oil - Are potent and safe-to-use anti-inflammatories. However, the downside is that many of these vitamins can be quite costly and should be discontinued before any surgery since they can affect your bleeding.

How long will my recovery be?
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We encourage full activity as soon as possible. On the night of surgery, you will complete a bedside therapy session. The following day you will begin your regular, twice-a-day exercise program. We have no limits on your activities or on how fast you resume your activities. The speed of your recovery depends very much on you.

Will I need a walker, crutches, or a cane?
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Patients are able to walk with the assistance of a walker, and some are able to use just a cane. You are permitted to put as much weight as possible on your operative leg and proceed as quickly as you feel comfortable.

How long until I can drive?
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The general requirements are that you should require only the support of a cane and should be off your pain medications.

When will I be able to go back to work?
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You can begin working when you feel that you are able to do so.

What physical activities will I be able to participate in after surgery?
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Low-impact physical activities such as walking, golf, swimming, dancing, hiking, bowling, and gardening are recommended and encouraged. Skiing or snowboarding is permitted with experience and do so with caution. High-impact activities and those associated with injury risk, such as running, basketball, singles tennis are not recommended.

When will I need to see my doctor following the surgery?
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Your doctor will see you4 weeks after the surgery. You will then be seen at your one-year anniversary.After this visit, the general recommendation is to get x-rays every 3 years. If the doctor feels that you require more frequent visits, this will be scheduled.

What rehab services are required post-operative after total joint replacement surgery? Inpatient? Outpatient? Or done at home?
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Following your in-patient stay, you will receive home physical therapy (PT) for 3 – 7 days, and there after you will start a 4 week course of outpatient PT. Some patients will be able to exercise on their own or go directly to outpatient PT. Outpatient PT can last anywhere from 4 weeks to 8 based on your progress.

How significant is the risk of hip dislocation after total hip replacement surgery? How much does this risk decrease over time?
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Dislocations (when the femoral head is dislodged from the cup component) is usually caused by muscle weakness, slow soft tissue healing or positioning your leg into an awkward position. You will be given instructions on how you can prevent dislocations from happening. Dislocations typically happen in the first 2 to 3 months post op because the soft tissues are still healing.

What can cause a feeling of your legs being different lengths after hip replacement surgery?
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During hip replacement surgery, many times the leg must be lengthened to tighten up the muscles that hold the joint in place, restore normal mechanics and reduce the chance of a dislocation. It can take a few months to re-adjust and feel"balanced" and many times you may not even notice the differences in the leg lengths.

Learn more About Leg Length Discrepancy

What is the recovery after a hip or knee replacement surgery?
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As part of our Rapid Recovery Program you do not have limits on your activities or on how fast you resume your activities.The speed of your recovery depends very much on you and your confidence level.

What are the long term follow up guidelines after surgery?
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You will have a one year after surgery follow up and a visit every 3 years after that. When you come in for your one year office visit, you will have x-rays of your joint replacement(s). You will then be evaluated by your surgeon, physician assistant or nurse practitioner. Your surgeon will review all your x-rays as well.

Learn more About Long-term Recovery

Do you use a Continuous Passive Motion (CPM) machines after knee surgery?
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A CPM machine will be used post-operatively to improve your range of motion more quickly and to make you feel more comfortable following knee replacement surgery. The use of the CPM machine after your total knee replacement guides tissue healing, increases motion, and helps reduce stiffness. Most importantly, using CPM will reduce your discomfort and allow you to be much more active more quickly, and remember, “new joints love to be moved!”

Learn more About CPM and Ice Therapy

Frequently Asked Questions (FAQs)