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Hip, knee replacement: When is surgery needed?

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Related Document: Petrow_GV-News-article_020911.pdf

By Ellen Sussman
Green Valley News
Published Wednesday, February 9, 2011

Osteoarthritis, the most common joint disorder, is a process where the articular cartilage in the joints breaks down, resulting in bone touching bone.

The process usually begins around age 25.

Unlike rheumatoid arthritis, osteoarthritis isn't systemic and doesn't affect other organs in the body.

Dr. Edward Petrow, an orthopaedic surgeon at Tucson Orthopaedic Institute, spoke Jan. 20 at the East Social Center about hip and knee replacement, a procedure he'll discuss with a patient when all non-surgical techniques fail to lessen pain.

Between 20 and 30 million Americans have osteoarthritis; it's the leading cause of chronic disability in the U.S. and most often affects the hips and knees.

Petrow said symptoms include soreness, stiffness, trouble maintaining normal posture and difficulty walking. Age, obesity, injury and genetics play a role in the severity of osteoarthritis.

Non-surgical treatments are the first line of defense and may begin with non-steroidal anti-inflammatory drugs (NSAIDs) and topical NSAIDs.

Acetaminophen doesn't decrease or reduce inflammation from osteoarthritis, he said.

Nutritional supplements glucosamine and chondroitin may help; however, these are not regulated by the Federal Drug Administration. Cortisone injections every three months are another non-surgical aid for some but are not suggested for long-term use.

A surgical technique called arthroscopic debridement may be used for those with mild to moderate symptoms, but is not a technique for anyone where bone has deteriorated from wear and tear or where bone-on-bone results from a breakdown of articular cartilage.

Petrow said he focuses on surgical and non-surgical techniques to improve joint function.

"Techniques I offer include minimally invasive hip and knee replacement, partial knee replacement and computer-assisted surgery.

"I like to exhaust all non-operative alternatives... the minimally-invasive technique decreases complications and speeds recovery."

Though partial replacement is available for knees it is not available for hip-replacement surgery, which is all ball and socket.

To demonstrate one recent successful knee surgery, Petrow had a patient who had bone-on-bone knee surgery Jan. 4 walk without aid in front of the audience.

"I had a lot of pain, but I've had a lot gain," the man said. He was home from the hospital on Jan. 7.

Petrow sees patients in Green Valley at 400 W. Camino Casa Verde. He may be reached at 520-882-0696 or epetrow@tucsonortho.com. 

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