MEDICAL MATTERS: Preserving your hips and knees

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/article_7d318b3e-0111-11e7-9e4a-a381343842e9.html

by Dr. James Ingram

Time takes a toll on our bodies and our weight bearing joints and cartilage are no exception. Watching a youngster spring up from a sitting position at the speed of a slingshot reminds us all of the creaks and squeaks of our aging joints. However, you can take control and slow Father Time with a few key non-operative interventions.

Decreasing weight through exercise has a dramatic effect reducing wear and tear on hips and knees. Just to name a few, it improves circulation and cardiovascular health; helps the management of blood sugar; preserves and maintains joint cartilage. Low impact exercises are key. Stick with cycling, swimming or elliptical and stair stepping machines. The benefit of low impact exercise in addition to weight loss, is a reduction of shear force on weight bearing joints, minimizing cartilage loss and improving flexibility.

Supplements have a huge following but no supplement has FDA approval. Of all the supplements, the only one shown to minimize cartilage loss was Glucosamine. When trying supplements, I suggest avoiding ones with multiple ingredient, ie. Glucosamine, Chondroitin, MSM. If you have an untoward reaction with a multiple ingredient supplement, it’s virtually impossible to determine which ingredient did not agree with you. I recommend starting with Glucosamine because it’s the only one proven to be effective.

Support braces that unload the joint showing signs of wear is another intervention worth consideration. Two options are available; off-loader braces, or lateral wedge orthotics. Off-loader braces are bulky where lateral wedge orthopedics are more discretely worn. Although purely mechanical, both unload the burden to tired joints.

Anti-inflammatory, biologicals and injectable are pharmaceutical approaches to joint health. Non-steroidal anti-inflammatory drugs (NSAIDs) were the corner stone for osteoarthritis and rheumatoid arthritis until biologicals (Embrel, Humira, etc.) were developed. Over-the-counter or prescribed NSAIDs are still extremely effective but create cardiovascular risks, elevate blood pressure, can cause stomach ulcers, and even kidney failure. Injectable intervention falls into two categories; cortisone and injectable viscosupplementation. Cortisone injections have been around for decades and provide rapid but short term relief. They also exhibit side effects therefore should be used in moderation. In my practice, no more than once a quarter. Injectable viscosupplementation (“rooster shots”) are injections of a protein normally found in our joints and make a cushion to replace cartilage while improving the viscosity of joint fluid. These injections are performed in an office environment on a weekly basis for a period of 3-5 weeks.

Utilizing these recommendations will hopefully make your interaction with your orthopedic surgeon a social visit rather than professional.