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Pain Free Knees
"If you have it (arthritis), take the steps to minimize your pain levels, starting with seeing your doctor."
Date: 2/1/2010

It seems from the moment we take our first step we're on the move, and it is easy to take our knees for granted. When the pain of arthritis sets in, however, those knees you've counted on all these years may now need some help to keep you on your feet pain-free.

In the Genes
Osteoarthritis affects more than 21 million Americans and is the most common reason for knee replacement surgery. Researchers worldwide agree all signs point to osteoarthritis being a hereditary condition. As the search continues for the osteoarthritis genetic link, it is important to learn your own family history.

"If one or both parents had arthritis, you may be predisposed to the condition. I recommend anyone with this family history maintain an ideal body weight, a regular exercise routine and take supplements to help keep their joints stron gand to keep the effects of osteoarthritis at bay," says John Schnell, MD, board certified in orthopedic surgery and fellowship trained in total joint replacement.

"Unfortunately, there is currently not much one can do to prevent arthritis completely, so if you have it, take the steps to minimize your pain levels, starting with seeing your doctor," he says.

Learn Your Options
If you're already suffering from arthritis, you know that pain can keep you from doing the things you always do — and the things you love to do. "Arthritis pain is caused by inflammation in the join or bone pain due to loss of cartilage."

There are pain receptors in the bone and as the cartliage breaks down, those pain receptors are stimulated more often, and an individual feels a greater amount of pain," explains Schnell.

"When a patient complains of pain, we typically start with conservative treatments such as supplements and injections. However, if the pain persists, surgery may be the best option," he says.

Advances in Knee Replacement
"Knee resurfacing is probably a better description of the procedure," says Schnell. "The knee joint connects the tibia bone in the lower leg and the femur in the upper leg.  In the custom knee replacement surgery that we offer at RWJ Hamilton, we resurface the knee using special instrumentation and implant the knee with a custom fit using bone cement," he explains.

In the past, knee replacement surgery required longer recovery times. The traditional replacement would also leave every patient with the same alignment, regardless of their alignment prior to surgery.

"With our newer custom knee replacement, patients have less instability or pain after surgery. This allows the patient to return to their natural pre-arthritic alignment."

A Weighty Matter
Before having knee replacement surgery, an important thing to consider is your weight going into the surgery. When arthritis has set in, it is difficult, even impossible, to keep up with a high-level workout routine. Many people with arthritis gain weight as a result.

The excess weight, however, can impact the success of knew replacement surgery.

"When a patient is carrying too much extra weight, he or she is at risk of early failure of the implant, complications with rehabilitation and blood clots," says Schnell.

"I encourage my overweight patients to do whatever they can to bring their weight down a bit prior to surgery to hellp them reach their highest level of success," says Schnell.

  Meet Kathi Harrison of Trenton 

For Kathi Harrison of Trenton, walking was nearly impossible five years ago. With a severe case of osteoarthritis diagnosed at an early age, Harrison was often crippled with pain.

Harrison is a unit secretary at RWJ Hamilton.  Working in a hospital nursing unit, she has to be prepared for anything. "My legs were very weak and I often felt like I would fall. I knew I had to do something."

In 2006, Harrison had knee replacement surgery for her right knee where she was experiencing a lot of pain. Two years later, she needed to have the left knee replaced.  Fortunately for Harrison, in the years since her first surgery, medical technology opened the doors to a new approach: the custom knee replacement.

John Schnell, MD, performed Harrison's surgery and fitted her with a custom second knee replacement. "The custom knee feels so natural. Although my first knee replacement was comfortable, there is defintely a difference," she says.

Harrison admits rehabilitation is the second most difficult par of recovery, but was pleased to find the second knee replacement was a shorter recovery. She says although rehabilitation can be tough, it is worth it in the end. "You have to always remember the therapist is there to help you walk. You have to take it one day at a time," she says. "Dr. Schnell was also so supportive the whole time, and he pushed me to work hard in my rehabilitation. He reminded me how important rehab can be to recovery."

"I walk so well and fast now, people who knew me before are amazed. And I used to have to take stairs one at a time before.  It was difficult and it took so long. Now I go up and down the steps just tine. I just can't believe how different it is," she says.

Her rediscovered agility is not only convenient for Harrison, but an inspiration. "I walk a mile or so every day and I've started eating better. I've even lost 15 pounds. Now that I am pain-fee, I feel like I can lose the weight where it was a challenge before," she says.

Harrison is no stranger to challenge. Between her first and second knee replacement surgeries, she was treated for breast cancer. "My friends call me a tower of strength because of the things I've been through. Some days I don't feel like one, but I do feel I'm very lucky," says Harrison.

Harrison decided to put her new knees to the test by renting a paddle boat at a lake on a recent vacation. "It was the kind you have to peddle to turn the rudders. I went across half the lake and my knees moved so well -- without pain," she says.

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