Did you know that pain is one of the most common reasons that people go to see the doctor? In fact, Americans spend between 1 and 2 billion dollars annually on over-the-counter pain medications alone. While a lot of pain killers are used for problems such as headaches, fevers, or injury, a big reason that people go to the drug store for pain medicine is to treat pain in their joints caused by arthritis. If you suffer from arthritis of your knees, hips, or other joints, you understand how pain can affect your life. But by seeking medical advice to identify the type of arthritis that you have, treatments can be tailored to meet your individual needs. For example, many Americans suffer from osteoarthritis, especially as they get older. Simply stated, this kind of arthritis is caused by the wear and tear of your joints throughout your life. In contrast, rheumatoid arthritis is a disease caused by the body’s immune system, resulting in inflammation of the joints, pain and if left untreated, deformities. Now, you may have some idea of the type of arthritis you have by looking at family history, but the only way to get an accurate diagnosis and the right treatment is by seeing your doctor. If diagnosed with rheumatoid arthritis, treatments could include physical therapy, exercise, medications, or possibly referral to an orthopedic surgeon to discuss joint replacement surgery.
What is Rheumatoid Arthritis?
Rheumatoid Arthritis is a condition caused by chronic inflammation. The body’s immune system usually protects us from infection and injury. In the case of rheumatoid arthritis, this same immune response causes inflammation in the joints of the body. It is different from osteoarthritis in a number of ways. While you might experience pain and swelling in one joint at a time, usually what happens on one side of the body also happens on the other. In addition, symptoms of rheumatoid arthritis often first appear at a much younger age than those of osteoarthritis. The most common joints affected by rheumatoid arthritis are those in the fingers, wrists, and feet. However, as the disease progresses, other joints can be affected, beginning with those farthest from the middle of the body and moving inward. The medical treatment for rheumatoid arthritis is also different than that of osteoarthritis. Disease-modifying antirheumatic drugs (DMARDs) are prescribed to suppress the immune system’s effect on the body. As rheumatoid arthritis advances either because of not being treated or because treatment is not slowing the disease, chronic inflammation (swelling) in the joints leads to damage within the joint that causes even more pain.
How is the Knee Affected?
One joint that if affected can not only lead to pain but can also make it very difficult to get around and do the things you need or want to do, is the knee. Anyone who has ever had knee pain understands how much it can slow you down. Rheumatoid arthritis can cause pain and swelling in one or both knees, resulting in making it difficult to bend the leg. As it gets worse, deformities can develop in the joint and the surrounding muscles will weaken, causing knock-knees or bow-leggedness. When medications fail to prevent this advanced type of arthritis, knee replacement surgery may be the best option to improve mobility, reduce pain, and improve your quality of life.
How Can Knee Replacement Surgery Help?
Knee replacement surgery (also called total knee arthroplasty) is a procedure performed by an orthopedic surgeon where a damaged knee joint is replaced with new metal and plastic parts. The knee joint is made up of the ends of the long bone of the thigh (femur), the two bones of the lower leg (fibula and tibia) and the kneecap (patella). The joint is held together and protected with tendons, ligaments, cartilage, and lubricating fluid (synovial fluid). During knee replacement surgery, the whole joint (total knee replacement) or only the damaged parts of the joint (partial knee replacement) can be replaced. With rheumatoid arthritis, which impacts all parts of your knee, a full (total) knee replacement is the required solution. While the arthritic knee will cause pain, limited movement, and inflammation as damaged bones rub together, after surgery and rehabilitation, the new artificial knee will have freedom of movement and greatly reduced or even no pain.
What You Can Expect with Knee Replacement Surgery
If you are currently taking DMARDs or certain other medications for rheumatoid arthritis, you might expect to stop them briefly before surgery to decrease the risk of infection that can be associated with these drugs. Don’t stop any medications on your own, but make sure your orthopedic surgeon is aware of all of your medications so that he can coordinate with your primary doctor or rheumatologist on what might need to be stopped. Your surgery will be done under anesthesia and typically only takes about an hour. You can expect to stay 1 night in the hospital, although outpatient knee replacement surgery is also a growing trend. Your doctor will let you know when you can start your rheumatoid arthritis medications again. You will also be prescribed pain medication immediately after surgery and will start physical therapy right away. Following your rehabilitation guidelines faithfully will be a key to a quick and complete recovery. Serious complications are not common after knee replacement surgery, but you will be instructed to watch for signs of infection (fever, chills, increasing pain, redness, and swelling) and blood clots (leg pain or swelling). You should call your orthopedic surgeon if you notice any of these symptoms.
Knee replacement surgery is one of the most commonly performed orthopedic procedures and most people who have it experience a significant reduction or complete elimination of pain after rehabilitation.
If you are experiencing knee pain from rheumatoid arthritis, or for any other reason, your next step should be to seek the expert advice of a board-certified orthopedic surgeon. Our friendly team is here to answer your questions about knee replacement or any other problems with your bones or joints. Call the offices of Dr. Brett Gilbert in Raleigh, Durham, Apex or Cary at (919) 788-8797 or you can request an appointment with Dr. Gilbert using our appointment request form, or you can self-schedule your appointment here.