Orthopedic conditions
Our physicians offer a multitude of options to treat your arthritis pain, and, most importantly, get you back to the activities you enjoy. Conservative measures range from new pain medication regimens to various intra-articular injections, bracing and rehabilitation alternatives. Surgical options range from minimally invasive hip and knee procedures to conventional total joint replacement. When conservatives methods of treatment fail to provide relief, total joint replacement is considered.
Osteoarthritis
WHAT IS OSTEOARTHRITIS? Osteoarthritis is a progressive loss of articular cartilage from years of wear and tear on the joint that creates joint pain, stiffness and loss of joint function. The loss of the smooth lubricating cartilage eventually uncaps the blood vessels and the nerves in bone. This ultimately leads to swelling, inflammation and pain. The pain ultimately leads to loss of motion, weakness, and eventually loss of independence. The occurrence of osteoarthritis increases with age but it can be related to other disease processes and trauma.
Osteonecrosis of the Hip
Osteonecrosis of the hip occurs when the blood vessel to the top of the femur
becomes obstructed. The result? The bone starts to die causing severe pain.
The problem often strikes younger adults. The most common causes includes
steroids (oral prednisone), trauma and alcohol. Sometimes doctors can't find any
cause at all. Many patients require hip replacement for this disease if it
progresses. Hip replacements have not done as well in this patient population in
the past, so joint preserving procedures are preferred if possible.
Dr. Kuesis is one of the few surgeons who offers alternatives. Options
include a
1) Core Decompression- Simple outpatient surgery with good results but only in
the short to midterm
2) Core Decompression- with a trabecular metal implant to decrease the risk of
collapse and disease progression
3) Free vascularized fibula transfer. This new treatment involves transplanting
the blood supply of the fibula (the small bone of the lower leg) to create a new
source of blood flow to the top of the femur. Often times this prevents collapse
and controls pain so patients can postpone or prevent hip replacement.
In the past patients used to have to go across the country for this
procedure. Now Dr. Kuesis in combination with a microvascular surgeon now offer
this procedure to qualified candidates.
Osteoporosis
WHAT IS OSTEOPOROSIS? Osteoporosis often times is preventable and a treatable bone disease that affects millions of Americans. It involves a decrease in bone mass that leads to an increased risk of fracture. All of us usually start to see a decline in our bone mass after are mid-twenties. The risk of a woman experiencing a hip fracture is greater than her risk of breast, uterine, and ovarian cancer combined. It is a leading cause of disability in older women.
ARE YOU AT RISK FOR OSTEOPOROSIS? The National Osteoporosis Foundation recommends that all women over 65 years old should have osteoporosis testing. Risk factors have been identified that can lead to a simple calculated osteoporosis risk estimation. Included in these risks are white or Asian women, light skin, family history, small frame, recent fracture, estrogen deficiency (post menopause), inactivity, cigarette smoking, steroid use, and poor health. Osteoporosis is not just a disease of older women. Awareness and treatment needs to be started as early as the teenage years.
HOW DO I FIND OUT IF I HAVE OSTEOPOROSIS? Bone density testing is readily available to determine your osteoporosis risk. Your primary care physican or orthopedic surgeon can determine if you should be tested. Medicare and most insurance carriers often reimburse osteoporosis testing or DEXA scanning.
WHAT ARE MY TREATMENT OPTIONS? Many pharmaceutical agents are now available to help decrease bone resorption. Hormone replacement therapy (estrogen) is the most effective in preventing bone loss but it is often poorly accepted due to side effects and other risks such as breast cancer which may preclude one from being treated with this therapy. Other medications now being used are calcium and vitamin D supplements, biphosphonates (alendronate), calcitonin nasal spray (which also provides some pain relief from osteoporotic fractures), and selective estrogen receptor modulators (raloxifene).