Category Archives: Surgery

question answer rheumatologist

Q&A: Don’t Want Knee Surgery?

Question to the Doctor: I have bone-on-bone arthritis in both knees. I don’t want surgery. I am 70 years old and overweight, and I can’t exercise because of my knees. All I want is my life back. Can you give me some advice?

Answer: Weight loss isn’t easy, but it will reduce pressure on your joints, give you more energy and make you feel better overall. Consider exercise options like gentle swimming, water aerobics and upper body exercises that won’t put pressure on your aching knees.

Ask your doctor about nonsurgical treatments to reduce pain like cognitive behavioral therapy, joint injections and acupuncture. A referral to a physical therapist could introduce lifestyle modifications and assistive devices to reduce pain and increase function.

Also, talk with your doctor about why you don’t want surgery. Learning more about the process, risks and benefits may ease your concerns and make it a more attractive option for you.

David Pisetsky, MD, rheumatologist, Duke University Medical Center, Durham, N.C.

Related Resources:

joint replacement cardiovascular side effects

Joint Replacement May Help Your Heart

Replacing damaged joints gives people with arthritis a dramatically improved quality of life – with reduction or even elimination of pain and improved mobility. A new joint can give you a new lease on life, allowing you to resume activities you love and improve your mood and relationships. But like anything in life, there are risks and benefits. A group of studies about the effects of joint replacement on your heart demonstrate those risks and benefits.

Studies published in recent years,  suggested that certain people are at increased risk of heart trouble following joint surgery. For example, a study in Annals of the Rheumatic Diseases in 2011 found an increased risk for cardiac complications following joint replacement surgery in older patients and in those who had pre-existing heart disease, deep vein thrombosis or pulmonary embolism. And a 2012 study published in Archives of Internal Medicine found that hip and knee replacement surgery boosts the risk of heart attack  during the first two weeks after surgery, particularly in patients older than 60.

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Home Physical Therapy for Arthritis

At-Home Exercises vs. Physical Therapy After Joint Surgery

Do people fare better after knee surgery with at-home exercise or clinic-based physical therapy (PT)? That is the question posed in a 2014 Australian study in the journal Arthritis Care & Research. Researchers found that those patients who had total knee replacement and followed a structured, at-home exercise program did no worse – in terms of pain and range of motion – than those who participated in a standard clinic-based physical therapy program.

According to the Centers for Disease Control and Prevention, more than 700,000 knee replacement surgeries, also called total knee arthroplasty, are done every year. That number is expected to rise as the population ages and grows heavier.

Continue reading At-Home Exercises vs. Physical Therapy After Joint Surgery