Arthritis

Dr. Donald Johnston, an orthopedic surgeon with Memorial's Orthopedic and Neurosciences Center, explains what arthritis is and details treatment options including joint lubrication injections and surgery.


What is arthritis?

Arthritis...arthro- means joint and -itis means inflammation...so it's inflammation. There are different types of arthritis. People are most common with osteoarthritis, the wear and tear as we age. But rheumatoid arthritis is also very common. The most common sites are the knee, the hip, and the shoulder. Memorial has two hand surgeons in the group that do a wonderful job. But as far as the knee and the hip when arthritis starts to interfere with people's activity, pain that wakes them up at night time, can't do what you want to do, can't walk, can't remain active, can't exercise, then it's really a lifestyle issue that people come in to see what the different options are for treatment.

What are some of the treatment options for arthritis?

For somebody that's never had any treatment, we like to start off with anti-inflammatory medications as long as they don't have any contraindications like stomach issues or bleeding disorders. A lot of times we start off with comfort measures like stretching exercises, flexibility, core strengthening, and as we go on we could include physical therapy. Physical therapists are right here in the office. We also have additional options like injections like cortisone injections. There are also lubrication injections, a viscose supplementation, which is like trying to replace the normal lubrication of the joint that is not working as well when you have arthritis. Many people respond with lubrication injections, and if they do that's all we need to do, but over time, getting further down the road if those things are no longer working, surgery is an option.

Explain joint lubrication and how injections can help.

Normally a joint makes a synovial fluid, and it almost feels like the normal oil that you put in your car. And I tell people that just like you have the oil lubricating the moving parts of the engine, the lubrication of your joint works same way to help lubricate and maintain. When you get arthritis, it loses its function. It becomes more watery thin. It doesn't function as well, and so even though you have more fluid in your joint, it doesn't function as well. And then for lack of a better analogy, I tell people instead of putting six or eight quarts of oil in your car for lubrication, it's like putting buckets of water in there. There's more of it, but it doesn't function like it should. So that type of lubrication shot is something that has been shown to be many times beneficial. I tell people it's not a cure all because we still do joint replacement surgery.