Questions your doctor might ask you:

Ready to see an orthopaedic specialist about joint replacement to relieve your pain? Before you go, consider how you’d answer certain questions he or she may ask. Your specialist should also ask questions about your medical and health history. Of course, you should be as thorough as possible when answering.

  • Where is your pain located? Does more than one joint hurt?
  • When did the pain first begin? What caused it (if known)?
  • Rank your pain on a scale of 1 to 5
  • Has the pain gotten worse recently? If so, is it more severe, does it occur more often, or both?
  • Does your pain get worse, or occur more often, when you do weight-bearing activities (Example: walking), at rest, or at night?
  • Are you taking any medication for the pain? (Make a list of both prescription and non-prescription medications.)
  • Are you taking any dietary supplements? (Make a list of vitamins or other “pills” for arthritis, such as chondroitin or glucosamine.)
  • How far can you walk without support? With support?
  • Can you climb stairs comfortably without help? Do you need to go very slowly and carefully?
  • How physically active are you?
  • What tests have previously been done to evaluate your joint pain?

Questions to Ask Your Doctor

The questions below provide a way to discuss your joint pain with your doctor or specialist, and whether you’re a joint replacement candidate. Take them with you to your doctor, and be sure to ask any additional questions you may have to address your concerns:

  • Are there any pain relief options for me that could work as well as joint replacement?
  • If I have joint replacement, how much will it relieve my pain?
  • How is the procedure done?
  • What do you do to manage the pain after the surgery?
  • What are the risks or complications of joint replacement?
  • How long will I be in the hospital, and how soon after having the procedure can I get back to normal daily activities?
  • Is joint replacement covered by my insurance?
  • After the procedure, will I see you or my regular doctor for follow-up care?
  • If I decide to have joint replacement, which company’s product do you think will be best for me? Why?
  • If I have joint replacement, will you perform my surgery? How many of these procedures have you performed?
  • What kind of activities will I be able to participate in after joint replacement?

The Orthopaedic Evaluation

While every orthopaedic evaluation is different, there are many commonly used tests that an orthopaedic surgeon may consider in evaluating a patient's condition.

In general, the orthopaedic evaluation usually consists of:

  • A thorough medical history
  • A physical examination
  • X-rays
  • Additional tests, as needed

Your medical history is taken to assist the orthopaedic surgeon in evaluating your overall health and the possible causes of your joint pain. In addition, it will help your orthopaedic surgeon determine to what degree your joint pain is interfering with your ability to perform everyday activities.

What the physician sees during the physical examination — which includes examination of standing posture, gait analysis (watching how you walk), sitting down, and lying down — helps to confirm (or to rule out) the possible diagnosis. The physical exam will also enable the orthopaedic surgeon to evaluate other important aspects of your hips and knees, including:

  • Size and length
  • Strength
  • Range of motion
  • Swelling
  • Reflexes
  • Skin condition

If you are experiencing pain in your hip joint, your back may be examined because hip pain may actually be the result of problems in the lower spine.

After the physical examination, X-ray evaluation is usually the next step in making the diagnosis. The X-rays help show how much joint damage or deformity exists. An abnormal X-ray may reveal:

  • Narrowing of the joint space
  • Cysts in the bone
  • Spurs on the edge of the bone
  • Areas of bony thickening called sclerosis
  • Deformity or incorrect alignment

Occasionally, additional tests may be needed to confirm the diagnosis. Laboratory testing of your blood, urine, or joint fluid can be helpful in identifying specific types of arthritis and in ruling out certain diseases. Specialized X-rays of the back can help confirm that hip pain isn't being caused by a back problem. Magnetic Resonance Imaging (MRI) or a bone scan may be needed to determine the condition of the bone and soft tissues of the affected joint.

In order to assist the orthopaedic surgeon in making a diagnosis, it may be helpful to write down your answers to the following questions before the appointment:

  • Where and when do I have pain?
  • How long have I had this pain?
  • Do I have any redness or swelling around my joints?
  • What daily tasks are hard to do now?
  • Did I ever hurt the joint or overuse it?
  • Does anyone in my family have similar problems, such as spurs on the edge of the bone?

General Orthopedic Links

Below are links to the American Academy for Orthopedic Surgeons information:

Staying Active As You Age
Flexibility Exercises for Young Athletes
Healthy Bones at Any Age
Understanding Complimentary and Alternative Medicine
Use of Pain Medication (NSAIDs)
X-Rays, CT Scans and MRIs

 

Understanding Osteoarthritis

What is osteoarthritis (OA)?

Osteoarthritis (OA) is the most common form of arthritis in the world.1 You may have heard OA referred to as "wear and tear" arthritis. When OA begins to affect one of your joints, a series of reactions take place that actually begin to degrade your once-healthy bone and the "soft tissue" around the joint – tendons and cartilage. Once the cartilage that normally cushions and protects the bones of the joint breaks down, the bones of your joint eventually rub directly against each other. Your body reacts to this by creating bone spurs and the joint capsule itself may thicken and weaken. Inflammation eventually sets in.

Doctors talk about two kinds of OA. Primary OA often refers to "everyday wear"; Secondary OA is considered the result of a malaligned joint, being overweight, injury or overuse.1, 2

Who does OA affect?

Twenty-one million people are affected by OA in the United States alone.3 Although OA can affect anyone at any age, it has been linked to the aging process. More than 50% of everyone over 65 has OA symptoms in one or both knees. By 75, virtually everyone suffers with OA in one or more joints. In fact, OA of the knee and hips continues to be the most common cause of arthritis-related disability for Americans. The Arthritis Foundation cites that men and women may develop OA at different times in life. Most people develop symptoms after 45, but, as a group, men under 55 and women over 55 develop OA more frequently.

What are the symptoms of OA?

Although some people who have osteoarthritis say they feel no pain, most people who have OA experience pain, feel joint stiffness (especially in the morning), show signs of swelling and tenderness in one or more joints and may even hear a crunching sound in their joints. For some people, OA can become completely debilitating.3

In order to diagnose you properly, your doctor will consider your symptoms and your medical history, examine your joint(s) and order one or more diagnostic tests. Your doctor may order blood work, X-rays, a CT scan or an MRI to get a clear view of the alignment of your painful joint and its condition.

How is OA treated?

Your doctor may recommend different treatment options depending on the severity of your osteoarthritis and its impact on your joint(s).

Manage the pain.

Your doctor may prescribe or recommend the use of anti-inflammatory medications (like aspirin or ibuprofen) and cold packs that may help to reduce inflammation as well as the pain associated with arthritis. Sometimes a local injection of cortisone helps to further reduce inflammation.

Look at the big picture.

Your doctor may recommend that you lose weight, take certain nutritional supplements and exercise. In some cases, a physical therapist may help provide pain relief and the return of some lost mobility through guided exercise and other techniques.

Get the right support.

Orthotic devices sometimes help. Custom-made shoes and shoe inserts provide support for those with OA in the foot or ankle. Your doctor may recommend a brace or a cane to help take some of the pressure off your affected joint while you walk if OA is affecting your knee or hip.

Understand your surgical options.

If you are still experiencing arthritis pain and joint damage that's affecting your quality of life even after all other conservative measures have been taken, your doctor may suggest surgery to help relieve your pain and restore your mobility. Your doctor will determine the proper surgical treatment based on the severity of your arthritis and its location. Today, a full range of surgical solutions exist that enable your doctor to customize surgical procedures to your particular needs and anatomy, whether you need arthroscopic debridement (removing inflamed and/or irritating debris from the joint), arthrodesis (fusing the joint for greater support) or arthroplasty (replacing the arthritic joint).

Be sure to talk with your doctor about the best treatment option for you.

References:

1. Mayo Foundation for Medical Education and Research. Osteoarthritis: Introduction. Available at: https://www.mayoclinic.com/health/osteoarthritis/DS00019. Accessed February 4, 2008.
2. MedicineNet, Inc. Osteoarthritis. WebMD. Available at: http://www.medicinenet.com/osteoarthritis/page5.htm#minimal. Accessed February 4, 2008.
2. MedicineNet, Inc. Osteoarthritis. WebMD. Available at: http://www.medicinenet.com/osteoarthritis/page5.htm#minimal. Accessed February 4, 2008.
3. Arthritis Foundation. Osteoarthritis: Who Gets It? Available at: http://www.arthritis.org/disease-center.php?disease_id=32&df=whos_at_risk. Accessed November 5, 2008.

© Stryker Orthopaedics 2008