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Danbury, CT - Osteoarthritis of the hip or knee currently affects 20 million Americans. It is estimated that by 2030, more than 60 million people will suffer with arthritis in one form or another. Current treatment involves a multimodal approach. Weight reduction activity modification nonimpact exercises such as bicycling and swimming and the use of aspirin, Tylenol, or nonsteroidal anti-inflammatory medications have widespread efficacy in the treatment of the early stages of osteoarthritis.

As the arthritic process progresses, however, these methods become less effective and the intermittent use of intra-articular cortisone injections may be of benefit in the treatment of the intermediate stages of arthritis. Viscosupplementation, a series of three intra-articular injections given at six-month intervals can also be utilized for the treatment of osteoarthritis in the knee. Physical therapy also has an important role in all stages of arthritis in maintaining strength, range of motion, and flexibility.

But the arthritis may still progress and individuals may become increasingly symptomatic. In hip arthritis decreased ambulatory tolerance, limp, groin, hip, or buttock pain develops and it becomes increasingly difficult for individuals to put on shoes or socks. Night pain also occurs. In knee arthritis, there also is a decrease in walking tolerance, a limp develops, knee pain worsens, getting up from a chair or a sofa often requires hand support, stairs often are taken one by one, and night pain worsens. In both, the quality of life is greatly affected and together with worsening pain, eventually leads to replacement surgery.
Total hip replacement and total knee replacement was first introduced in the United States in the late 1960s and early 1970s. It is currently one of the most successful surgical procedures performed by orthopedic surgeons today. There are more than 450,000 total hip replacements and more than 450,000 total knee replacements performed annually. Between 2010 and 2030, it is estimated there will be more than a 200% growth in hip replacement and a 600% growth in knee replacement surgery.

Surgical advances in the past few years have greatly improved recovery. Minimally invasive surgical techniques for both the hip and knee with less surgical trauma facilitate a rapid recovery with significantly less postoperative pain. In total knee replacement, intraoperative computer-aided surgery and more recently MRI evaluation of the knee prior to surgery improves surgical accuracy. Size- and gender- specific prostheses for men and women are also available.

Hip resurfacing arthroplasty, a modification of traditional total hip replacement recently approved for use in the United States by the FDA (2006), has seen tremendous growth in our younger more active patients. Traditional total hip replacement permits a very active lifestyle with activities including tennis, swimming, bicycling, golf, skiing and walking all being permitted after surgery. Hip resurfacing allows for unlimited running and high-impact activities such as karate, judo, and full contact sports.
Advanced prosthetic design with extremely low-wear surfaces combined with advanced manufacturing processes; enable joint replacement surgery to be done in very young individuals. As a result, the phrase, “Wait until you’re older” is no longer applicable as issues of prosthetic longevity have been addressed. As such, the loss of function and its impact on activities of daily living typically seen in osteoarthritis now can be safely and very successfully addressed with total hip and total knee replacement surgeries.

Based on our experience from the past, the new surgical techniques utilized today, and improved prosthetic designs we anticipate even greater success in the future. We look forward to helping you with your arthritic hip and knee problems. (The Total Joint Replacement Program currently performs more than 750 total hip and total knee replacements per year placing us among the top Connecticut Hospitals.)

For more information please refer to: www.myorthoct.com
Robert T. Deveney, M.D. Co-director Total Joint Replacement Program