Osteoarthritis

Osteoarthritis is a common joint disorder also known as degenerative joint disease. It is often referred to as the “wear and tear” on a joint. It affects the cartilage, joint fluid and the surrounding supportive structures. The resulting symptoms may include pain, swelling and stiffness.

Treatments for Osteoarthritis

Conservative

The conservative treatment option consists of low impact cardiovascular activities, such as walking, biking, swimming, and use of an elliptical exercise machine. It is also important to participate in exercises that strengthen the body’s core (e.g. Pilates), the surrounding joints and help with balance. These activities should be done regularly, regardless of other options chosen. These are often done initially in physical therapy and then later on at home. Losing excess weight is important. Many traditional medications may provide short-term relief, such as acetaminophen and NSAIDs (ibuprofen, naproxen, etc.), but can have side effects. Some over-the-counter medications have minimal side effects and may provide some relief: Glucosamine Sulfate (not hydrochloride) 1,500mg, and chondroitin 1,200mg per day; avocado/ soybean unsaponifiable extract 300-600mg per day. Ice massage and acupuncture have been shown to provide short-term pain relief. An unloading knee brace can diminish pain and may be recommended.

Steroid Injections

Short-term relief is possible through steroid injections. However, additional articular cartilage damage will occur with each injection.

Viscosupplement Injections
    Viscosupplement Injections, also referred to as “Rooster Comb” shots, are another option for osteoarthritis treatment. Supartz, Orthovisc, Hyalgan, Euflexxa and Synvisc are examples of these medications. These hyaluronic acids are a viscous substance that mimics the normal synovial, or joint fluid. They feel like motor oil.

    Pros

  • Most patients will experience short-term relief for up to 6-12 months, with more prolonged relief compared to steroids
  • No articular cartilage damage occurs
  • The knee joint is generally covered by insurance
  • If this treatment is unsuccessful, other options are still available
  • Cons

  • Articular cartilage regeneration is not possible
  • Insurance generally does not cover joints other than the knee
  • A series of up to 3-5 injections is required
Biologic Injections

Pros

  • Articular cartilage may regenerate
  • Platelet Rich Plasma is completely natural
  • Shorter recovery time than surgery
  • Typically combined with fat and/or bone marrow to further enhance the regenerative effects
  • If unsuccessful, other options are still available
  • Cons

  • Typically not covered by insurance
  • Usually requires a series of three injections
Structural Autologous Fat Graft

This procedure is done using your own fat. The fat is mixed with PRP and/or Bone Marrow and acts as a matrix (scaffold or “spackling”) to which other injected cells attach. A multitude of
progenitor cells are in the fat. These cells have a tremendous potential to regenerate the body’s articular cartilage.

Pros

  • Long-term relief may be possible
  • Articular cartilage may regenerate
  • Autologous fat is completely natural
  • Shorter recovery time than surgery
  • Many progenitor cells are in the fat. These cells have a tremendous regenerative potential and may be able to regenerate the articular cartilage
  • If unsuccessful, other options are still available
  • Cons

  • Typically not covered by insurance
  • Usually requires a series of three injections
Autologous Bone Marrow

This procedure uses your own bone marrow and has similar pros and cons as to that of the Structural Autologous Fat Graft, although it is more invasive. Your bone marrow and/or PRP may be combined with fat to further enhance the regenerative effects.

Surgery

Surgical options may include joint resurfacing, total or partial joint replacement. When undergoing surgery, pain is often relieved. However, recovery time is prolonged, usually lasting a few months. In addition, younger patients may need further replacements as the prosthetics wear out. If, for whatever reason, the surgery is unsuccessful, other options are no longer possible.

  • Foot and Ankle
  • Hip
  • Knee and Shoulder
  • Wrist