Transcript Knee Treatment Options - It`s More Than Joint Pain

Treatment Options for
Severe Knee Pain
What’s the Leading Cause
of Knee Pain?
Osteoarthritis (OA) is what
happens when your knee
cartilage deteriorates, and
friction is created between
the bone surfaces.
What Are the Signs of OA?
Stages of OA
Symptoms
• Joints ache after walking, driving, climbing stairs
Mild
• Chronic knee pain and knee stiffness
• You may limp to accommodate the pain
Moderate
Severe
• Begin to see a reduced range of motion of the joint
• Bones begin to rub together, causing more pain,
swelling, loss of motion
• The joint may begin to change shape
• Small growths, called bone spurs, may grow on the
edges of the joint
Knee Pain Treatment Options:
Early Intervention
• Physical therapy
• Ice down achy joints
• Over-the-counter anti-inflammatory medications
• Acetaminophen
• Nutritional supplements
– Those treatments may become less effective over time
because OA is a progressive disease
• 75% of OA patients are interested in more aggressive
treatments for their osteoarthritis1
1. Harris Interactive, Inc., 2005
Knee Pain Treatment Options:
Non-surgical
• Prescription medications
• Physical therapy
• Injection therapy such as
Orthovisc®
Check Your Mobility
If you have difficulty performing any of the movements
below, it may be time to talk to your doctor about
next steps
Walk
Bend at the
hips and knees
Pretend to drive –
push the gas/brake
Golf
Questions to Consider
 Does your knee hurt one or more
days per week?
 Does the pain interfere with your sleep?
 Is it painful for you to walk more than
a block?
If you answered yes to
these questions it might
be time to speak with
your doctor about knee
replacement surgery
 Are pain medications no longer working?
 Is knee pain limiting your participation in activities such as
family vacations or other functions?
 Has inactivity from knee pain caused you to gain weight?
Knee Replacement Facts
• More than 500,000 knee
replacements are performed
each year in the U.S.1
• A National Institute of Health
(NIH) study shows that 85%
of patients are satisfied with
the results of their knee
replacement surgery.2
1: 2005 (http://www.aaos.org/Research/stats/Knee%20Facts.pdf).
2: NIH Consensus Development Conference on Total Knee Replacement, NIH
Consensus Development Program
(http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=5299)
But You Should Also Know…
• The outcome of joint replacements depends on your
age, weight, activity level and other factors.
• There are potential risks, and recovery takes time.
• People with current infections or conditions limiting
rehabilitation should not have this surgery.
• Potential complications which could result in pain,
stiffness or dislocation of the joint include:
– Loosening
– Fracturing
– Wearing of the components
• Only an orthopaedic surgeon can tell if knee
replacement is right for you.
Sigma® Knees
•
Sigma Knees come in a wide range of shapes, sizes
and materials
•
Your surgeon may be able to fit you with a Sigma
Knee designed to provide a more natural feel and
movement
•
Sigma Knees can be implanted using minimally
invasive surgery
Sigma® Fixed Bearing Knee
• Most widely used type of
knee replacement in the
U.S.1
• Designed to provide
stability of the knee
• New designs and
materials
- Helps reduce wear
1: IMS Health
Sigma® Rotating Platform Knees
• Rotating Platform Knee
- Designed to rotate as it bends, imitating
your natural knee movement
• The surfaces roll and glide against
each other as the knee bends, just
as your natural knee does
• Designed for patients who want to
remain active since it minimizes
implant wear, compared to fixedbearing knees1
• A multi-center DePuy study shows 97%
patient satisfaction at 5 years2
1: McNulty, D. et al. “In Vitro Wear Rates of
Fixed-bearing and Rotating Platform Knees
(Rev. 2)” (2003)
2: DePuy Multi-Center Study (2006)
Should You Delay Surgery?
• Early diagnosis and treatment for total knee replacement
are important1
– Delaying surgery may lower your quality of life before
the operation and for up to two years after surgery2
• Pre-existing medical conditions may become more
serious, delaying elective surgery3
• Osteoarthritis is degenerative – it won’t get better and may
get worse!
1: Fortin, Paul R., et al. “Outcomes of Total Hip and Knee Replacement.” Arthritis & Rheumatism 42
(1999): 1722-1728
2: Fortin, Paul R., et al. “Timing of Total Joint Replacement Affects Clinical Outcomes Among
Patients with Osteoarthritis of the Hip or Knee.” Arthritis & Rheumatism 46 (12) (2002): 3327-3330
3: www.jointreplacement.com
What to Expect With or
Without Knee Replacement
So to Summarize What
You Learned Today….
• The leading cause of knee pain is osteoarthritis
• Osteoarthritis is degenerative – it won’t get better and may get
worse!
• Early diagnosis and treatment for total knee replacement are
important1
• A National Institute of Health (NIH) study shows that 85% of
patients are satisfied with the results of their knee replacement
surgery
• Sigma Knees come in a wide range of shapes, sizes and
materials, so your surgeon may be able to fit you with a knee
designed to provide a more natural feel and movement
1: Fortin, Paul R., et al. “Outcomes of Total Hip and Knee Replacement.” Arthritis & Rheumatism 42
(1999): 1722-1728
Questions
& Answers
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TruMatchTM Personalized Solutions
What is TruMatch
Personalized Solutions?
• A customized knee replacement solution
• Designed specifically for your anatomy
• Helps your surgeon achieve consistency in the placement and
positioning of your knee replacement
How does TruMatchTM Personalized
Solutions work?
• A CT scan of your leg is
taken
• A 3-D model of your knee is
developed
• Personalized guides are
created
• Guides are removed by
your surgeon prior to your
new knee being implanted
Computer Assisted Surgery
• What is computer assisted
surgery (CAS)?
– A new approach to knee
replacement
– The patient’s anatomy is
simulated and displayed
on a computer
– Computer provides
information about where to
place the components
Potential Benefits of CAS
• CAS guides surgeon in areas that are difficult to
visualize
• Relays specific measurements not previously
available to surgeons
• Gives precise, accurate data on your specific
anatomy
• Allows surgeons to make informed decisions
about precise implant placement based on
detailed data from the computer
Important Considerations
for Women
• Osteoarthritis affects three times more women than
men1
– Women are more likely than men to be disabled
– The pain is more severe for women2
• Women’s knees rotate more than men’s, especially
during deep bending (kneeling)3
• Current knee replacements are designed to fit the
anatomies of both women and men
1: Hawker, Gillian A., et al. "Differences Between Men and Women in the Rate of Use of Hip and Knee
Arthroplasty.“
The New England Journal of Medicine 342 (2000): 1016-1022
2: Harris Interactive research survey, April 2005
3: Hsu, Wei-Hsiu, et al. “Difference in Torsional Joint Stiffness of the Knee Between Genders.” The American
Journal of
Sports Medicine Vol. 34, No. 5 (2006): 765-770.
Gender-Specific Implants
• All orthopaedic manufacturers have knee
implant systems with sizes appropriate for
both female and male patients
– Surgeons know which knee will fit each
patient best, based on gender, age,
size, activity levels and aspirations
• There is no clinical support of the need for
gender-specific implants
• It is too early for any clinical data; won’t
know results of gender-specific implant
clinical studies for 10-15 years
Gender-Specific Implants
• More than 60% of knee
replacements have been
implanted in women1
• Current knee replacement
patients have a 90 to 95%
satisfaction rate with the
results of their surgery2
1: American Academy of Orthopaedic Surgeons (http://www.aaos.org/wordhtml/research/stats/Hipkneefacts.htm) (2006)
2: The Arthritis Foundation (http://www.arthritis.org/research/Bulletin/vol51no11/Printable.htm) (2006)
Minimally Invasive
Knee Replacement Surgery
• Minimally invasive surgery (MIS) is still very new
• Sigma Knees can be implanted using minimally
invasive surgery
• Alignment affects:
– How long your knee replacement lasts
– Long-term success
Benefits of MIS
• Some early studies of MIS have shown some
potential benefits of the surgery (when
compared to traditional, “open” surgery), such
as:
– Less blood loss
– Potential for shorter hospital stays
– Potential for faster recovery
Complications of MIS
• Other studies, however, have shown several
complications with the surgery, (when compared
to traditional, “open” surgery), including:
– Increased number of surgical complications
– Poor implant positioning
– No difference in the length of recovery
What Really Matters When It
Comes to MIS
• MIS is still relatively new
• It won’t be known for 10 to 15 years if the new
techniques affect the long-term function and
durability of the implant
• You should discuss with your surgeon whether
MIS is an appropriate surgical course of
treatment for you