Osteoarthritis is primarily a disease of degeneration of cartilage (wearing away of cartilage the protective surface covering the bone). As the cartilage wears away pain occurs as the major symptom. This pain is a result of many contributing factors. For example, bone rubbing on bone can produce pain as well as increased friction forces which lead to more cartilage loss. The uneven cartilage surface leads to instability of the joint putting stress on the surrounding ligaments, tendons and muscles that can also cause pain.  Inflammation in the joint and surrounding structures produces pain accompanied by swelling, redness, warmth, stiffness and inhibition of normal movement. Patients with osteoarthritis and inflammation often describe stiffness greatness in the morning or after long periods of inactivity improving with movement. Pain is often the greatest towards the afternoon or evening after a full days use.  Therefore a comprehensive treatment program must recognize and address the variety of pain sources to ensure maximal success.

Total Joint Replacement
Osteoarthritis (OA) is a common cause of pain and disability affecting adults of all ages. In the next twenty years the number of people afflicted by OA is predicted to rise dramatically. As evidence of this, by the year 2030 orthopedic surgeons predict that over 3 million total knee replacements (TKR) will be performed annually compared to the 500,000 procedures performed in 2008. In addition, TKR is being performed for younger patients including those in their thirties and forties. When appropriate, total knee replacement should NOT be avoided. This is particularly true for people over the age of 65. Studies have shown that delaying total knee replacement too long can increase risk for complications such as heart attacks and strokes and result in poor outcomes. While TKR usually achieves excellent pain relief there are other considerations important in younger people. For instance, total knee replacements have a defined lifespan that is unpredictable in younger, more active people. Furthermore, TKR does not always give 100% pain relief. Therefore, you should be certain that you have explored all worthwhile treatment options before undergoing TKR. Similarly, people of any age who have been told by their surgeon “Come back and see me when you are ready for a total knee replacement” need to explore the same treatment options to reduce their pain and maintain mobility in the meantime. Click for more information on how to avoid a knee replacement.