Obesity ups risk of knee arthritis
For those of us entering our late middle age, the ravages of time are beginning to be felt. Many of us are now feeling the stiffness and joint pain of osteoarthritis. While time is the great culprit in the wearing down of our joints, other factors enter the equation. Obesity, even being moderately overweight, is a risk factor for developing arthritis, especially in the knees.”Arthritis is a wear-and-tear phenomenon,” said Dr. Tom St. John, a surgeon with Orthopaedic Associates in Glenwood Springs and Basalt, who specializes in joint replacement and spinal surgery. “Knees feel the brunt of stress from body weight,” he said.In fact, according to the John Hopkins Hospital Web site, obese women have four times the likelihood of developing arthritis in the knee, and men five times the risk, of people who are in a healthy weight range.Obesity is evaluated in several ways. One of the most indicative is the body mass index, which is a function of weight and height. People with a BMI of over 29 are considered obese, according to the John Hopkins Web site.Weight loss can decrease the symptoms of arthritis. Medical research has shown that for a woman of normal height, for every 11 pounds of weight loss, or two body mass index units, the risk of knee arthritis drops by 50 percent.But weight loss, especially for those who are obese or severely over weight, is a catch-22, St. John said. People who are obese have a hard time losing weight. “It takes a lot of discipline.”However, it’s especially important for people in the early stages of knee arthritis to get on a weight loss plan.St. John said there are effective programs in the Glenwood Springs area for weight loss, such as Curves and plans offered by Valley View Hospital.Treatment for arthritic knees depends on the severity of the disease.When over-the-counter pain relievers are no longer effective, St. John prescribes injections of synthetic joint fluid that relieves pain and, for a time, restores smooth function to the joint. He also recommends physical therapy and sometimes, cortisone.But if those measures fail, patients are faced with either partial or complete knee replacement.St. John, who held a fellowship at the prestigious Rothman Institute in Philadelphia, has performed over 1,000 knee replacements.Replacement, whether partial or complete, involves resurfacing the joint with metal and plastic. “Plastics have improved significantly,” he said. Doctors have been performing knee joint replacement since the 1960s.But even those man-made materials can wear out over time.”We’d like them to last for 20 years,” he said, but depending on a person’s level of activity after replacement, the new joints may wear out a lot sooner.Surgical techniques are also improving. The good news is, if you need a knee replacement, the procedure is “minimally invasive. We don’t cut up into the tendon as far. There’s a smaller incision … and quicker healing,” he said.
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