Pink Prescriptions - December 2024
Joint Health—Takes a Joint Effort
December 2024 Issue — Pink Prescriptions
Joint Health—Takes a Joint Effort
Is a new knee or hip on your Christmas list this year? Knowing the pain a worn-out joint can cause, it’s easy to put replacement surgery at the top of your list. Not only does joint replacement surgery give the gift of a new joint, it also gives hope for a pain-free life and freedom of moving with ease. These joint surgeries are giving millions of people a new lease on life. Those who could no longer play golf or tennis, and those who had become so debilitated they could hardly walk without experiencing excruciating pain are enjoying the benefits of joint replacement.
However, surgery is not the answer for everyone. Joint health relief helps thousands of patients to feel better and stronger for their day-to-day routines. And it’s well worth the effort, as regaining physical function and well-being is one of the biggest driving factors in overall wellness and quality of life.
In a joint effort to learn more about our knees, hips, shoulders and general joint health, we turned to local experts in the field of Orthopedics, asking them for the latest details and treatments. Their advice is priceless and relevant for so many—could you be next?
By Dr. Vandit Sardana
Beaufort Memorial Orthopaedic Specialists
What are the top three ways I can keep my joints healthy?
The three best ways to keep your joints healthy are centered around making good lifestyle choices and maintaining a healthy weight.
Watch your diet: Limit foods high in carbohydrates and incorporate more healthy fats into your diet, like olive oil and avocado. Eating an anti-inflammatory diet full of fruits and vegetables, along with taking supplements like glucosamine and chondroitin, may also help.
Exercise mindfully: Regular exercise is important for maintaining joint health. Avoid high-impact activities such as running, and switch to lower-impact workouts such as swimming, walking, or riding a bike to both strengthen your muscles and lessen stress on your joints. Incorporating strength training and balance movements into your exercise routine can also help you stay steadier on your feet. And don’t forget to stretch!
Quit smoking: Smoking increases the risk of fractures, osteoporosis, and osteoarthritis, which are all common causes of joint pain.
Vandit Sardana, M.D., FRCS, is a board-certified, fellowship-trained orthopedic surgeon with Beaufort Memorial Orthopaedic Specialists in Okatie and Port Royal. He specializes in joint replacement and preservation.
By Dr. Kevin Jones
Beaufort Memorial Orthopaedic Specialists
Are there any new, innovative technologies in joint replacement?
Newer surgical systems, like the Mako SmartRobotics and VELYS robotic-assisted system, are improving patient outcomes by allowing surgeons to customize the placement and alignment of the implant components to the patients’ unique anatomy, providing more natural movement of the joint and increasing its longevity.
Modern implants are also made of lightweight, long-lasting materials, including ceramic or ceramic-metal mixtures, medical-grade polyethylene and titanium-chromium or cobalt chromium alloys, which contribute to better longevity of the new joint.
Historically, hip and knee replacements lasted around 10 to 15 years. With the progress in surgical techniques and implant technology, today’s joint replacements, using the longer-lasting materials listed above, are expected to last for 15 to 25 years.
Kevin Jones, M.D., FAAOS, is a board-certified orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists (in both the Port Royal and Okatie locations), as well as the medical director of the Hip and Knee Replacement Program at the Beaufort Memorial Joint Replacement Center.
By Jason Norcross, MD
Hilton Head Orthopedics, now part of Novant Health
My knees snap, crackle and pop, and going up and down the stairs causes me pain. What causes this and is it fixable without knee replacement?
The proper term for this is “crepitus.” It is the result of softening of the padding (cartilage) beneath the kneecap that leads to irregularities in the joint surface. Healthy cartilage is perfectly smooth, and as a result, the motion that occurs beneath the kneecap glides like ice on a countertop. This irregular padding that occurs as the result of the body’s natural degenerative process no longer glides smoothly. Instead, the roughened surface creates a grating sensation. Sometimes, there is audible popping or clicking. More commonly, it is a sensation that the individual feels, especially when you place your hand over the kneecap during movement. Kneecap crepitus is exacerbated by certain common activities, such as stair climbing, squatting, lunging, and arising from a chair. This phenomenon does not require treatment, as long as it isn’t painful. Unfortunately, however, when the padding beneath the kneecap gets too thin, there can be pain associated with those same activities. In that situation, there are very effective non-surgical treatments. Weight loss can be highly effective in reducing pain over the kneecap, as every pound of weight loss reduces kneecap forces by three pounds. Quadriceps strength can be improved which also can help diminish pain. Medications for inflammation (ibuprofen, naproxen) can reduce pain from the kneecap, as well as injections into the joint. Common injection types include corticosteroids or hyaluronic gel injections. Surgery is usually a last resort, as arthroscopic smoothing procedures do not help. Joint replacement is usually the last option.
What are the prerequisites for knee replacement?
How do I know when I’m ready?
Pain that significantly limits functional activities is usually the biggest driver towards knee replacement surgery. If you get some knee pain after playing your fifth pickle ball match in a week, joint replacement surgery is probably not for you. However, if you are having daily pain, difficulty walking without pain, avoiding simple gym workouts due to fear of pain, having pain when getting up out of a chair or the pain is disturbing your sleep, you may be a candidate for joint replacement surgery.
If you have been experiencing a clear deterioration in your mobility, activity level, and quality of life, you should be evaluated by your doctor to see if you are a candidate for surgery. This process consists of weight bearing X-rays, a physical examination, and health screening. If your X-rays show bone on bone arthritis, or near bone-on-bone arthritis, knee replacement surgery may be indicated. Keep in mind that many pain-relieving treatments exist to manage the pain if surgery isn’t the best option for you. However, despite the rising popularity of alternative treatments like stem cell therapy and platelet rich plasma injections, there isn’t a magic potion that will regrow the padding (cartilage) in your knee, especially if you are close to bone-on-bone.
What are the symptoms that usually lead to hip replacement?
Much like knee arthritis, hip arthritis is a padding problem, as well. In this case, it is the padding (cartilage) between the ball and socket of your hip joint that is the culprit. It starts just like the knee, with softening and irregularity of the cartilage, and eventual thinning of the cartilage. This usually leads to bone-on-bone disease. The symptoms often start with stiffness before the sensation of any pain. The rotational motion of the hip becomes limited early in the disease, resulting in difficulty putting shoes and socks on, difficulty crossing the legs or sitting in the butterfly position, or tightness in the hip area trying to get up from a chair or climbing stairs. When pain occurs from a lack of padding in the hip joint, it will often occur in the groin or front pocket area of your upper thigh, sometimes radiating towards the knee. Buttock pain, or pain emanating from the back pocket area, is usually NOT coming from the hip joint. Many things can cause this back pocket pain, including sciatica, sacroiliac joint dysfunction, spinal stenosis, or degenerative discs in the lower spine.
Pain on the side of your hip area, which often hurts when laying on your side, is usually not coming from the hip joint either. This is called bursitis and is treated with physical therapy techniques. When the groin pain and joint stiffness become a real obstacle to functional activities like walking, biking, working out, or begin disrupting sleep, hip replacement surgery may be indicated.
Dr. Jason Norcross is a fellowship-trained orthopedic surgeon specializing in hip and knee replacement surgery. After practicing in Hickory, N.C., for 14 years, Dr. Norcross joined Hilton Head Orthopedics in 2020. He is highly trained in robotic-assisted surgery and has developed a reputation for being compassionate, personable, and completely dedicated to serving his patients. Hilton Head Orthopedics can accommodate urgent and same day appointment requests. Call (843) 682-7480 to schedule an appointment.