June 17, 2021 by John Fernandez
Arthritis Awareness: You’re ‘Never Too Young or Too Old’ to Seek Treatment, Surgery – But Don’t Delay Consultations
To say that arthritis is a widespread health condition in the U.S. may be an understatement. It is a leading cause of disability, and contributes to pain, aching, stiffness, and swelling of the joints. Yet, it doesn’t have to be a normal part of aging.
It affects about one in four adults overall, and while arthritis affects more people as they get older, it can affect just about anyone at any point in life.
“You’re never too young and you’re never too old to see an orthopedic surgeon because we see patients of all ages,” says orthopedic surgeon Alexander D. Gaukhman, M.D., with Baptist Health Orthopedics and Sports Medicine, a part of Baptist Health South Florida. “Early intervention is always best. For the majority of patients that have undergone a total joint replacement, their biggest complaint is that they didn’t do it sooner.”
To highlight the toll this condition takes on the health of an estimated 55 million men and women, the U.S. Centers for Disease Control and Prevention (CDC), the Arthritis Foundation and other partners observe Arthritis Awareness Month in May.
Dr. Gaukhman, who specializes in total joint replacement surgery, particularly of the hip and knee, says many patients “think they’re too old for surgery.” That’s just one major misconception about arthritis.
Total Hip Replacement on a 93-Year-Old
“Patients are living longer healthier lives and want to enjoy a high quality of life,” he adds. “The goal of total joint replacement is to decrease pain, increase function and improve patient’s quality of life. When it comes to risks factors, patients have to be evaluated by their surgeon to see if they’re an appropriate candidate for surgery.
“There’s age and then there’s age with a lot of comorbidities. The majority of patients that have undergone a joint replacement or are waiting for surgery are usually been 70-90 years of age. They are typically active, may have a few comorbidities but are overall great candidates for surgery.”
However, age is only a number since arthritis can span the spectrum from teenagers to octogenarians, he says. In the same week, Dr. Gaukhman performed surgery on a patient in their early 40s and another in their early 90s. “So, getting in early for a consultation and getting educated about your condition is the best possible thing you can do.”
Dr. Gaukhman is fellowship-trained in adult hip and knee reconstruction. His practice focuses specifically on conditions of the hip and knee in the adult population with a particular interest in complex primary and revision surgeries.
Revision hip and knee replacement surgeries are on the rise across the nation. They involve replacing part or all of a previous knee prosthesis with a new prosthesis. Unfortunately, failure can occur after a total joint replacement surgery necessitating a second surgery known as “revision surgery.”
“Revision surgeries are quite common nowadays because there are so many primary surgeries being done,” explains Dr. Gaukhman.
“Patients that have pain after a total joint are usually very disappointed, frustrated and are looking for an answer to their problem,” he adds. “Often times, making a diagnosis is challenging in these patients and requires advanced testing and imaging. It may take weeks to months to correctly identify the issue. However, when the correct treatment is implemented, patients are eternally grateful.”
Prevalence of Osteoarthritis
Osteoarthritis is the most common type of arthritis It has been called “wear and tear arthritis.” It develops when the smooth cushion between bones (cartilage) breaks down and joints get painful, swollen and hard to move.
“There are obviously other types that are inflammatory and traumatic types, but osteoarthritis, affects all the joints,” says Dr. Gaukhman. “It is more prevalent in the hip, knee, and hands. I would say another big misconception is that someone with arthritis immediately needs surgery. A lot of patients are very hesitant to see a surgeon because a surgeon to them means surgery. But there are non-surgical ways to treat osteoarthritis – but that’s usually best instituted in the hands of a surgeon.”
Weight, Other Risk Factors, and Exercise
People who are overweight or obese are more likely to get knee osteoarthritis than people who are not overweight. Moreover, physical activity can decrease pain and improve physical function by about 40 percent, says the CDC. Still, 1 in 3 adults with arthritis are inactive.
“Exercise is a great way to improve your general health, whether it’s cardio, weightlifting or playing sports,” says Dr. Gaukhman. However, there’s some exercises that are higher impact, such as a running, that may affect the joints more.”
He adds that there’s an ongoing debate in the orthopedic community as to whether long-time running can lead to arthritis. There is a large genetic component associated with arthritis. Furthermore, radiographic evidence of arthritis may not necessarily manifest as painful symptoms.
“Some patients have very bad arthritis on X-rays,” he says. “However, they have very little pain, and vice versa. We always treat the patient and not the X-ray. Therefore, depending on the level of activity, arthritis can present in various forms. Patients who are highly active may notice symptoms sooner than those are generally more sedentary.”
Having osteoarthritis can decrease function, weaken muscles and increases the likelihood of falling. Side effects from pain medications, such as dizziness, can also contribute to falls. However, a key message during Arthritis Awareness Month is that everyone, no matter the age, should seek medical advice, says Dr. Gaukhman.