Robert J. Snyder, MD
Q: What is an outpatient surgery for the treatment of milder arthritis?
A: Arthroscopic joint repair- is typically performed on an outpatient basis, is the first choice for some forms of arthritis that have not progressed to the bone-on-bone stage. This surgical procedure is performed by an orthopaedic surgeon using several small incisions over the joint, into which a camera and surgical instruments will be inserted. The camera allows the surgeon to see what is happening inside the joint and what needs to be repaired, for example, a torn meniscus in the knee or a torn rotator cuff in the shoulder.
Q: Will arthroscopic surgery be effective enough to keep me from having joint replacement surgery?
A: It depends on the individual and the progression of their arthritis. The surgeon will smooth out areas of roughened, eroded bone and repair torn cartilage in the joint during arthroscopic surgery. For some folks, these procedures may be all they need insofar as surgical treatment of their arthritis. For others, it may simply be a steppingstone, buying a little time until their arthritis progresses to the stage where they have to have a joint replacement.
Q: What are considered to be the surgical treatments for severe arthritis?
Joint Fusion (Arthrodesis) – Joint Fusion currently is almost always used to treat spinal, ankle and foot arthritis, but that was not always the case. Until a few years ago, when technological advancements in surgical implants and the components in them were vastly improved, joint fusion was commonly used to treat severely painful arthritis in the ankles, elbows, some shoulders, fingers and toes. Fusion denies joint movement, and many patients were willing to trade that for pain relief. In some instances, arthrodesis will still be the best option for treating the painful arthritis of a joint, depending on the body part.
Spinal Fusion is a very common and effective way to treat arthritis in the spine and the concurrent issues that it may cause, such as spinal stenosis, nerve impingement, instability due to boney changes, and facet and sacroiliac joint dysfunction.
Joint replacement (Arthroplasty) – Replacement of arthritic joints has become commonplace in today’s world, with millions undergoing these procedures every year. As the American population ages, the demand for living well without pain has increased, and so has the need for medical innovation in the area of joint arthroplasty.
The most commonly replaced joint is the knee and technology has evolved so that we can replace only the compartment of the knee that is severely compromised, like the patella (kneecap) or the lateral (outside) component of the knee joint. We can also replace two damaged compartments or all three, which is a total knee replacement. (Dr. Snyder is shown above in the OR with the ConforMIS Knee Replacement System, which is a patient-specific, custom system for surgery, designed to the patient’s own anatomy)
Hip replacement is the second most common arthroplasty procedure and based on physician and patient feedback, is the easiest from which to rehabilitate and recover, again, due to surgical technique improvements that allow for minimal soft tissue trauma during this major procedure.
Shoulder replacement comes in third, with two types of surgical procedures. 1) Traditional arthroplasty, which replicates the natural anatomy of the shoulder, is used when the patient has a viable rotator cuff. 2) Reverse shoulder arthroplasty is used when the patient does not have an intact rotator cuff. The natural anatomy of the shoulder is reversed surgically, meaning the ball and socket of the shoulder joint switch places and the deltoid muscle is used in place of the rotator cuff to allow the patient to lift their arm.
Ankle and elbow joints can now be replaced by prosthetic joints, as they have improved enough to make them real alternatives to fusion (arthrodesis).
Q: Can arthritis be prevented?
A: While not all forms of arthritis can be prevented, you can reduce your risk by:
- Losing weight, if needed & maintaining a healthy weight
- Staying physically active and fit
- Avoiding joint injuries
- Eating anti-inflammatory foods (avoid sugar, simple carbohydrates and processed foods) and following a balanced diet plan