Osteoarthritis

Degenerative disorder resulting from the biochemical breakdown of articular cartilage in the synovial joints. Very common in hands, hips, and knees. VERY debilitating! Exercise can help to maintain ROM and decrease symptoms. 80-90% of individuals older than 65 years have evidence of primary osteoarthritis

Osteoarthritis
Often leads to complete degeneration of articular cartilage

Osteoarthritis and Joint Replacement

Once bone bone articulation develops, joint replacement (Arthroplasty) is only viable option. Most common in Knees and Hips. Very serious surgeries. Often takes months / years to get back to full strength (if ever)

Knee Arthroplasty aka Total Knee Replacement (TKR)

Possible Side Effects of Knee Arthroplasty

blood clots in the leg blood clots in the lung urinary infections or difficulty urinating difference in leg length stiffness loosening of prosthesis infection in knee

Knee Arthroplasty
90% + report increased ROM following surgery 25% report loosening of prosthesis @ 10 years
Caused by osteolysis; inflammatory response: reabsorption of bone

Lots of isometric exercises and walking

Possible Side Effects Of Hip Arthroplasty

blood clots in the leg blood clots in the lung (1-2% Occurrence) urinary infections or difficulty urinating difference in leg length stiffness dislocation of hip infection in hip

Hip Arthroplasty
Dislocation Prevention (2-3% Occurrence)
using 2-3 pillows between your legs while sleeping and not crossing your legs not bending forward 90 degrees

Exercise
Lots of isometric exercises will be prescribed to strengthen muscles surrounding joint Lots of walking, cycling, swimming, etc.
Avoid high impact exercises and follow guidelines listed above regarding prevention of dislocation.

Hip Arthroplasty
90 95% success rate @ 10 years post op. Average lifespan 12 15 years
Less if active (IE Younger person)

Very effective at providing complete pain relief

Often have to keep person from over doing it

Hip Fractures
*

Usually Occurs @ the Surgical Neck of Femur

Often results in disruption of blood flow.Avascular Necrosis *

Treatment of Hip Fracture

Usually requires surgery
THR ORIF (Open Reduction, Internal Fixation)
Uses plates, rods, & screws to fixate femoral fracture

Post operative Exercise

Isometrics, ROM exercises SLOWLY progress to weight bearing exercises as directed by Physician

Hip Fractures
One year post mortality is as high as 40% (leading cause of traumatic death in elderly) Very small percentage regain previous mobility 20% require nursing home care following fracture Often results in accumulation / increase in incidence of other health problem
CAD, diabetes, stroke, pneumonia,etc

Facts about hip fractures and Osteoporosis

44 million Americans suffer from osteoporosis and/or low BMD 80% are Women / 20% Men Women can lose up to 20 percent of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis.

Risk of Hip Fracture and BMD

Facts about hip fractures and Osteoporosis

Annual cost associated with osteoporotic fractures is $17 billion in 2001 ($47 million each day). One in two women and one in four men over age 50 will have an osteoporosisrelated fracture in their lifetime.
300,000 hip fractures; and approximately 700,000 vertebral fractures, 250,000 wrist fractures; and 300,000 fractures at other sites.

MOST ARE PREVENTABLE!!!