Will I need surgery if I have arthritis?
It depends on the severity of your arthritis. Some types of arthritis do not need surgery. But if your condition is severe already, then yes, you will need surgery. There is a specific surgery for your specific arthritis. Here are a few samples of the types of surgery available to people with arthritis.
TJA (Total Joint Arthroplasty) is the most common surgical procedure. It is the surgical creation of a joint. It is otherwise known as TJR (total joint replacement). This procedure is the last resort for pain management. It is used when all other methods of pain relief have been unsuccessful. The hips and knees are the joints commonly replaced, but replacements of finger and wrist joints, elbows, shoulders, toe joints, and ankles have become more popular in the past twenty years.
Although TJAs are performed most often for clients with osteoarthritis, other conditions causing joint damage may also require surgery. These disorders include rheumatoid arthritis, congenital anomalies, trauma, and osteonecrosis.
THA (Total Hip Arthroplasty) is a procedure performed most often in clients older than 60 years of age.
Arthrodesis is a surgically induced fixation of a joint to relieve pain or provide support. It is usually done in the fingers, thumb and the wrists.
Arthroplasty is the surgical reconstruction or replacement of a painful, degenerated joint, to restore mobility to a joint in osteoarthritis or rheumatoid arthritis or to correct a congenital deformity. Under general anesthesia one of two procedures is used: Either the bones of the joint are reshaped and soft tissue or a metal disk is placed between the reshaped ends, or all or part of the joint is replaced with a metal or plastic prosthesis.
Arthroscopy is the examination of the interior part of a joint, performed by inserting a specially designed endoscope through a small incision. The procedure, used chiefly in knee problems, permits biopsy of cartilage or synovium, the diagnosis of a torn meniscus, and in some instances, the removal of loose bodies in the joint space.
Oesteotomy for arthritis
Osteotomy is the sawing or cutting of a bone. Kinds of osteotomy include block osteotomy, in which a section of bone is excised, cuneiform osteotomy to remove a bone wedge, and displacement osteotomy, in which a bone is redesigned surgically to alter the alignment or weightbearing stress areas.
Synovectomy is the excision of a synovial membrane of a joint. This helps lessen the pain and swelling in rheumatoid arthritis.
How is arthritis diagnosed?
Arthritis can be diagnosed by your doctor through subjective and objective findings. For the subjective part, he may ask you questions about your symptoms if you have arthritis, how you feel, where do you feel pain / discomfort and of course ask about your medical and family history about arthritis. He will also ask about your lifestyle practices, and may include your work. Hence, this could figure out arthritis occurence.
Diagnostic Test varies with the type of arthritis.
For the objective part, a series of diagnostic tests will be conducted but it varies with every type of arthritis. The following are the common diagnostic tests:
- Routine x-rays are very useful in determining structural joint changes. Specialized views are obtained when the disease cannot be visualized on standard x-ray film but is suspected.
- A CT scan (computed tomography scan) may be used to determine vertebral involvemen
- MRI (magnetic resonance imaging) may be ordered by the health care provider to detect degenerative bony changes, especially in the spine.
Hence, these tests provide us reasons to be more careful with arthritis.
Different kinds of arthritis tests
Rheumatoid arthritis factor test measures the presence of unusual antibodies of the immunoglobulin G(IgG) and IgM type that develop in a number of connective tissue diseases. Two methods may be used to ascertain the degree to which these antibodies are present in the body: Rose-Waaler and latex agglutination. In both procedures, values are reported as titers.
The Rose-Waaler test is more specific for diagnosing rheumatoid arthritis than latex agglutination test, but it is not as sensitive.
The Antinuclear antibody (ANA) test measures the titer of unusual antibodies that destroy the nuclei of cells and cause tissue death. The fluorescent method is sometimes referred to as FANA. If this test result is positive ( a value higher than 1:8), various subtypes of this antibody are identified and measured.
When the Erythrocyte sedimentation rate is elevated, it suggests inflammation or infection is present in any part of the body. An elevation in the ESR helps point to a diagnosis of an inflammatory connective tissue disease; however, a high ESR does not always relate to severity inflammatory disease.
The hsCRP (high-sensitivity C-reactive protein) test is another useful tool to measure inflammation. It may be done along with or instead of the ESR.
An arthrocentesis is another diagnostic procedure which is used for clients with joint involvement. It is performed at bedside or at a doctor’s clinic. A local anesthetic like xylocaine is administered first, and then followed by a large-gauge needle into the joint to aspirate a sample of synovial fluid. The fluid is then analyzed for inflammatory cells and immune complexes, including RF (rheumatoid factor).
Skin biopsy is the only significant test for arthritis to be conducted for DLE (discoid lupus erythematosus) for this condition is not systemic. Skin cells from the rash are gently scraped to be evaluated through microscopic evaluation. Hence, test varies depending on the type of arthritis.
What drug option do I have for arthritis?
There are specific drug option for every type of arthritis but there are drug option also which are very common and are used with the other types of arthritis. Here are some of the drug option commonly used for arthritis:
Drug Option for Arthritis
- Analgesics are the primary drug option of choice for pain relief. They’re not anti-inflammatory medications.
- NSAIDs (nonsteroidal anti-inflammatory drugs) are often an initial drug option category of choice for inflammatory arthritis to relieve pain and inflammation. The choice of which one to administer depends on the client’s needs and the physician’s preference. Salicylates are an older type of NSAID and were previously the drug option choice of choice for pain and inflammation. Within the United States, they are no longer the drug option of choice to treat rheumatoid arthritis because of toxicities, mainly gastrointestinal bleeding. Salicylates are excellent anti-inflammatory drug option and relatively inexpensive, and therefore they are still used within some countries or when a client has specific needs or restrictions.
- Disease-Modifying Anti-Rheumatic Drugs (DMARDs), such as hydroxychloroquine (Plaquenil), sulfasalazine, or minocycline, may be prescribed to slow the progression of mild rheumatoid disease before it worsens. Plaquenil is an antimalarial drug option that helps decrease joint and muscle pain and often helps clients with early RA or other inflammatory autoimmune diseases such as systemic lupus Erythematosus.
- Sulfasalazine is a medication that may be prescribed for mild to moderate inflammatory arthritis conditions such as rheumatoid arthritis or psoriatic arthritis.
- Minocycline is sometimes used to treat mild rheumatoid arthritis symptoms. Although its mechanism of action is not known, it has both antimicrobial and anti-inflammatory effects. It is also an immune modifier, inhibiting certain chemicals that cause bone and cartilage damage.
- Methotrexate (Rheumatrex) an immunosuppressive medication, in a low, once-a-week dosage, has become the mainstay of therapy for advancing and sustaining rheumatoid arthritis because it is effective and relatively inexpensive.
- Leflunomide helps diminish inflammatory arthritis symptoms of joint swelling, stiffness and improves mobility.
- Glucocorticoids (steroids), usually Prednisone is given for their fast-acting anti-inflammatory and immunosuppressive effects. It may be given in high dose short duration or as a low chronic dose.
- Gold therapy is less frequently used to treat arthritis now that methotrexate and the newer biologic meducations are available; however, gold may still sometimes be used to modify RA disease and reduce pain as well as inflammation. The most commonly used parenteral preparation is gold sodium thiomalate. For intramuscularly administered gold, there is a test dose of 10mg given first to detect an allergy to the drug option. If there is none drug option then weekly gold injections are given.