Articles on arthritis rheumatology

FREQUENTLY ASKED QUESTIONS IN ARTHRITIS & RHEUMATISM

Dr. A N Roy, Rheumatologist
Q) What is Rheumatism?  A) Rheumatism is a popular term for Chronic Pain that applies to a variety of diseases that cause pain, stiffness and limitation of motion of joints, bones, tendons, ligaments and muscles. Q) Who is a Rheumatologist? A) A Rheumatologist is a specialist in treating the musculoskeletal disease (muscle, bone, joint specialist) .The role of the rheumatologist is to diagnose, treat and medically manage patients with Arthritis and other rheumatic diseases. Q) What is the difference between a Rheumatologist and an Orthopaedic Surgeon? A) A Rheumatologist is a specialist trained to diagnose, treat and manage various types of musculoskeletal problems. Surgeons who specialise in surgery of bones/joints are called orthopaedic surgeons.Q) What do Rheumatologist treat? A) Rheumatologists treat all forms of Arthritis, autoimmune disease, musculoskeletal pain disorders and osteoporosis. There are 100 types of those diseases, including Rheumatoid arthritis, Osteoarthritis, Gout, Lupus, Back Pain, Osteoporosis, Fibromyalgia and Tendonitis. Some of those are very serious diseases that can be difficult to diagnose and treat.Q) When should a patient consult a Rheumatologist?A) If the person is suffering from any of the below symptoms, he/she might behaving Rheumatic Diseases.Joint Pains and SwellingsSevere Point Pains and Stiffness in the morning.Severe back pain and Stiffness in the morning.Unexplained generalised body pains.Recurrent mouth ulcers/hair loss.Dryness of mouth/eyes, red rashes on cheeks.Recurrent heel pains.Prolonged unexplained fever after detailed work up by physicians.Wounds on skin not healing over a period of time, suspected to be due tovasculitis refereed by a surgeon/physician.Persistent problems regarding abortions referred after primary workup by aGynaecologist.Recurrent uveitis after primary work up by an Ophthalmologist.Unexplained pulmonary renal syndromes at primary care level. Q) Cause of Arthritis? A) Determining the cause of Arthritis can be difficult, because often several factors such as age, illness or infection, body weight, previous injury etc. contribute to an individual developing this problem. Q) Why me? Nobody in my family has it? A) There is a common misconception amongst people that arthritis runs in the family. This is always not true. It often arises sporadically without any family history. Q) Any Diet medication/restrictions? A) There is no scientific basis regarding food causing Arthritis, except gout, where patients are advised to have low purine diet and avoid alcohol, red meat , beans, mushroom etc. So No diet changes are required for most of these patients. Q) Does the climate influence Arthritis? A) Some patients find their Arthritis worsening in cold weather, while others during the rainy season. However, temperature/climate does not influence the course of Arthritis. Q) Can I walk, exercise, jog, or practice Yoga? A) Most Arthritis patients can walk, exercise or jog within reasonable limits. Yoga, in general, doesn’t ham Arthritis patients and can be carried along with other medicines. However, certain Yogic postures can be avoided as they may put excessive strain on the joints. It is best to consult a physiotherapist for this purpose. Q) Is Arthritis treatable? A) Yes, at present, there is treatment for the symptoms of Arthritis that help in managing pain and joint damage. These involve dietary changes, drugs, and in some cases exercise.

Rheumatology

Dr Aaina
A rheumatologist is an internist or pediatrician, who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles and bones causing pain, swelling, stiffness and deformity.Autoimmune conditions occur when the immune system sends inflammation to areas of the body when it is not needed causing damage/symptoms. These diseases can also affect the eyes, skin, nervous system and internal organs. Rheumatologists treat joint disease similar to orthopedists but do not perform surgeries. Common diseases treated by rheumatologists include osteoarthritis, gout, rheumatoid arthritis, chronic back pain, tendinitis, and lupus.Many rheumatologists also conduct research to find a cause of and better treatment of a rheumatic disease.How is a rheumatologist trained?A rheumatologist must complete four years of medical or osteopathic education followed by three years of residency training in either internal medicine or pediatrics. Some rheumatologists are trained in both. After residency, they must enroll in a rheumatology fellowship for two to three years to learn about chronic musculoskeletal and autoimmune conditions and their treatment.Rheumatologists then take a board examination to become board certified in rheumatology. This certification/exam has to be retaken every 10 years. Physicians are also required to participate in a certain amount of continuing medical education on a yearly basis.

Arthritis of Hands: It Must Be Rheumatoid Arthritis

Dr. Tanoy Bose, Internal Medicine
Vital notes:RA is a chronic debilitating joint disease that affects small joints of hands and foot.More common in females aged 20 to 50 years.It is not synonymous with Rheumatic Fever which occurs in children aged less than 15 years.It has got nothing to do with monthly Penicillin injections and checking ASO titre. Somebody on Penicillin injections or being checked for ASO titre should change the doctor immediately.Untreated disease may cause deformity of hands and foot causing deterioration of quality of life.Erosion of small joints along with loss of entire joint architecture is the basic disease process.Early morning stiffness of joints along with swelling of one or more small joints of hands is very characteristic.Treatment is done with Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide and short courses of steroids.Difficult diseases are treated with costly injections called biologics.The motto of treatment is “ catch early, hit hard and achieve and maintain treatment goal “Lung and cardiac complications are common in long term disease.Rheumatologists but not the Orthopedicians nor neurologist are the best person to treat the disease.Introduction:Rheumatoid Arthritis is an autoimmune disease of mankind where the cells and molecules who are responsible for security of our body, misidentify the joint tissue as foreign substance and start destroying them similar to the way they usually do when a bacteria or virus enters the body. This misdirected attack towards our own body is called autoimmune phenomenon.The worst affected parts of the body are the joints of hands and foot. These small joints that are responsible for performance of day to day activities like eating, holding, writing, typing, washing etc become painful and swollen causing stiffness and deformity. This results in poor quality of life and subsequent depression. Early diagnosis and continuous treatment with specific medicines is cornerstone of treatment.What are the symptoms?Symptoms vary from person to person and also from early stage to late stage of the disease. In early stage there may be mild pain and stiffness involving 1 to 4 small joints of the hands and feet with a typical pattern of stiffness of those joints after rising from bed. During this phase it is very difficult to diagnose the disease. But it is very important to catch the disease in this stage. Researchers have proved that joint damage and bony erosion start even before the symptoms have manifested and hence earlier the treatments better the results.In a full blown case of Rheumatoid arthritis the picture is very classical of a middle aged female presenting with pain and swelling of hand and foot joints along with early morning stiffness that responds to steroids brilliantly. Wrists and the knuckles are predominantly involved. Patients are unable to hold a pen or open the door or do cooking etc. Gripping the wrist firmly causes pain and the hand joints are warm.In a advanced case of the disease we often find elderly people presenting with crooked hands with areas of permanent swelling and skin changes due to chronic friction. The skin fold may contract chronic fungal infections and the joints are swollen and painful.A few other organs are damaged in silence and they create serious problem at the advanced stage of the disease. Lungs, Heart and Blood Vessels are frequently affected. There is accelerated cholesterol deposition in arteries of heart causing increased risk of heart attack and brain stroke. These patients frequently contract infections which are difficult to treat.Involvement of spine or low back is uncommon. However, cervical spine or the neck region is the only part of the spine that may be affected in this disease. What is the difference between Rheumatic Fever & Rheumatoid Arthritis?There is a heaven & hell difference between these two entities. Rheumatic Fever is a disease of childhood. It usually occurs in children aged less than 15 years and is characterised by excruciating pain, swelling and redness of one or more big joints of arms and legs that responds excellently to Aspirin. This disorder may cause cardiac problems and is the leading cause of Valvular Herat disease in India. It is often characterised by some skin rashes and rarely neurologic problems. The disease process, the causative agent and the clinical symptoms are completely different from that of Rheumatoid arthritis.Why Penicillin injections are given on a monthly basis?Patients of Rheumatic fever often suffer a damage to the valves of the heart during the attack of Rheumatic fever. This damaged valves are potential sites of infections that may develop in the later part of the life. This infection is called Infective Endocarditis and may cause serious complications if not addressed properly. Penicillin injections are given as a form of prevention of development of this infection and have got no relationship with the wellness or cure of the disease. People who are aged above 15 years and are being treated with penicillin for the first time for joint pain occurring in small joints of hands should immediately change their doctor and consult a rheumatologist.How is Rheumatoid Arthritis diagnosed?Rheumatoid Arthritis is diagnosed by its classical symptoms and some laboratory investigations. To identify early rheumatoid cases we usually follow a scoring system which includes counting of number of joints involved, the duration of the symptoms, checking ESR and CRP in blood and looking for the positivity of Rheumatoid Factor and Anti CCP Antibody. Patients with high values of Anti CCP Antibody are very much likely to suffering from rheumatoid arthritis and also they are very much likely to suffer a aggressive disease courseDoes each and every patient of rheumatoid arthritis develop crooked hands and foot?No. Not all patients suffer from such a devastating complications. There are important characteristics which if present predict severe destructive disease. Females, Smokers, High values of Anti CCP or Rheumatoid Arthritis, Family History of Rheumatoid Arthritis, Early evidence of Joint destruction on X Ray are a few important features who will go forward to develop destructive disease. How Rheumatoid Arthritis is treated?Continuous Physical activity of the involved joints is the corner stone of treatment. More the joints are active, less the damage.Cessation of smoking is mandatory. Smokers tend to develop early joint destruction. Medicines that used in treating rheumatoid arthritis are together called Disease Modifying Anti Rheumatoid Drugs or DMARDs.Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide are the principal DMARDs. Of these, methotrexate is the backbone of therapy. Methotrexate is used on a once a weekly basis starting from a dose of 5 mg to 50mg/week and a weekly 5mg of Folic Acid supplement is given to neutralise the adverse effects of Methotrexate. The detail of the drugs is mentioned below.Why I am being given Steroids?Steroids are given for a short period of increased disease activity. In rheumatoid arthritis we do not prescribe steroids in a regular basis. It is often prescribed when the patient is put on the DMARDs for the first time and when there is break through pain or active disease during the treatment. Steroids are used in low dose in a decreasing dosage pattern over weeks and usually are not continued more than a month.What are Biologic agents? Why they are so costly?Biologic agents are highly specific molecules who directly block the action of the culprit chemicals in our body that cause the joint destruction. They are highly researched molecule an d is manufactured abroad. They are usually available in injection formats and have their own side effect profile which includes reactivation of Tuberculosis and other opportunistic infections. Usually patients are checked for latent Tuberculosis Infections, HIV, Hepatitis B and C before the treatment is started. Biologics cause excellent response to the disease causing alleviation of pain and swelling and sense of well being but unfortunately they do not provide any cure. Hence, if biologics are stopped then there are chances that the disease activity may worsen requiring more biologics or aggressive treatment with DMARDs.Conclusion:There are Rheumatologists in every city or town of the country. In case of any kind of aches and pains of joints with or without swelling that is not caused due to any trauma, one must consult a Rheumatologist. We keep on posting and distributing such articles to each and every patient so that a perfect transparency is maintained between the treatment and the patient.

Broccoli Helps to Prevent Arthritis

Ms. Swati Kapoor, Dietitian/Nutritionist
Do you have joint pains or suffer from Arthritis? According to a recent study, eating broccoli can help you manage your pain better. The study was published in the journal Arthritis & Rheumatism. It stated that broccoli can help in getting relief from inflammation in osteoarthritis, which is a degenerative joint disease in which cartilages that normally protect joints start to wear away under the influence of inflammatory factors.Broccoli is rich in vitamins A, B, K, C and nutrients such as potassium, zinc and fiber. It is found that consumption of sulforaphane, a compound found in broccoli can lead to less cartilage damage. This sulfur-based compound is found effective in blocking enzymes that contribute to inflammation in cartilages.Other factors that can help you in osteoarthritis are eating healthy and including some activity in your daily routine. It’s a common myth that exercises can harm your joints, if you suffering from arthritis. In fact, doing joint friendly exercises and water based activities can increase muscle strength and bone structure. Strengthening exercises with low impact cardio like walking are swimming are preferable options.You need to watch your diet and stick to healthy and balanced meals. Minimize sugar and fat intake in your diet. You can opt for seasonal vegetables, fruits, whole grains, lentils, low fat dairy products and avoid packaged and processed foods.Eating broccoli can protect your joints from damage. However, consuming broccoli cannot reverse or cure osteoarthritis, but is a way to prevent it.

5 Ways to Prevent Rheumatory Arthritis

Dr. Vishwas Virmani, Physiotherapist
Get Examined EarlyIf you are genetically susceptible to Rheumatory arthritis, which means if even one of your parents has Rheumatory arthritis, then you may be at a high risk of developing this form of arthritis. So, if you experience pain and discomfort in your joints, do not ignore it and consult your doctor because it may be early signs of Rheumatory arthritis, which can be treated or even reversed when caught in early stages. There are several medications that can halt the development of Rheumatory arthritis if it is diagnosed in an early stage.Boost Vitamin D in Your BodyVitamin D is the most essential ingredient for a healthy bone and its deficiency can lead to rheumatory arthritis. It is a great antioxidant that can prevent you from the painful condition of rheumatory arthritis.Try to get into the sun as much as possible, as it is richest source of Vitamin D. In addition, you can eat vitamin D rich food like egg yolk, mushrooms, milk and vitamin D fortified food. If both the things like getting enough sunlight or eating vitamin D rich food are not manageable, then you can resort to taking Vitamin D supplements.Exercise SmartIt is essential to exercise to keep our body fit but the key to preventing rheumatory arthritis is to exercise smartly. You need to exercise in such a way that you do not spoil your joints by overdoing it. To prevent this form of arthritis, you need to be careful about choosing the type of exercises that you may perform every day.You can begin with warming up yourself and stretching your body before venturing out to perform any high-impact exercises. It is best to consult an expert physiotherapist about selecting the suitable exercises.Reduce StressStress can cause extreme damage to the body in several ways. It is one of the most dangerous external triggers that can lead to rheumatory arthritis. It can be a potent cause for flaring up joint pain and stiffness. You should try to make all possible efforts to stay stress free. Develop a hobby and do things that you enjoy doing the most like singing, dancing, listening to music or painting. It will help you keep safe from rheumatory arthritis.Maintain A Healthy LifestyleNutrition plays a significant role in maintaining healthy joints and preventing you from arthritis. If you are overweight, try to lose some pounds to achieve the healthy weight because with the increase of the body weight, increases the strain on the joints that can lead to rheumatory arthritis. So, it is essential to eat a balanced diet and maintain a healthy weight to prevent you from rheumatory arthritis.Rheumatory arthritis is one of the most common autoimmune ailments that are known to affect more women than men. The exact cause to this condition is still a topic of research for many experts, but it is observed that it can get triggered from anything like caffeine or car exhaust smoke.It is important to be vigilant about one’s health, especially the bone health because it may worsen over the years silently and could pose severe consequences all of a sudden, when the symptoms are left treated. There are many things that can prevent you from rheumatory arthritis such as exercise, lots of rest, regular check up and a healthy diet.

Few Points About Arthritis

Dr. Yogesh Kumar, Ayurveda
What is arthritis? Commonly arthritis is referred to as pain in joints in layman’s language. Arthritis is the swelling and painful condition of the joints along with degenerative changes in the joints. The common sites involved are knee joint, joints of fingers, wrist and feet. There are a few clinical conditions related with arthritis are osteoarthritis, gout, rheumatoid arthritis, psoriatic arthritis and septic arthritis.OsteoarthritisOsteoarthritis is caused by wear and tear of cartilages, degenerative process of joints and normal repair work .Usually patient of osteoarthritis complains of pain in the affected joint associated with stiffness and some amount of limitation of movement.Signs and symptoms of osteoarthritis:Osteoarthritis presents with complaints like pain in the joints along with stiffness especially in the mornings and goes by itself after some time. Difficulty in the movements of affected joints.Abnormal changes in the shape and size of the affected joint and surrounding tissues.Presence of click like sound on movement.Gout: Gout is a disorder involving pain, swelling and stiffness in the joints due to deposition of uric acid crystals in the joints. The serum uric acid level increases in gout. Classically the pain involves area around toes and feet.Diagnosis is confirmed by aspiration of synovial fluid and examination of urate crystals and serum uric acid levels.Rheumatoid arthritis:Rheumatoid arthritis is a disorder involving a long standing swelling, pain, tenderness in the joints. It is an autoimmune disorder (when our body turns against itself).How can I know I have arthritis?Signs of degenerative changes in the X-ray of affected joint, rheumatoid factor, synovial fluid examination and erythrocyte sedimentation rate (E.S.R) are some laboratory procedures done to make a diagnosis of arthritis.What causes arthritis?Arthritis is caused by degenerative process in the joints with decrease in the production of synovial fluids.How can I live a better life after arthritis?Tips to live a better life for arthritis:Weight management is the mainstay of the therapy for arthritis for overweight patient. Weight reduction can work wonders.Walking for an appropriate time according to the strength of your body.Healthy diet free of fat and rich in nutrients. Use of milk, other dairy products and fish is good in arthritis.Use of walking stick for elder patients with knee pain due to arthritis.Avoid climbing stairs, sitting on floor as far as possible.Use of commode instead of Indian style latrine.Use of various supports for joints like knee brace for knee.Exercises to strengthen the muscles around the affecting joint. Exercise for arthritis should always be done under the supervision of an expert.Use of good quality calcium and other mineral supplements.Control of other diseases, if present along with arthritis.Stop alcohol and smoking completely.Is there any effective Treatment for arthritis?There is not any specific treatment of arthritis in modern medicine. There is only symptomatic treatment available in modern medicine. The chief principle of treatment includes pain killers, weight management, calcium based supplements and other expensive drugs whose effectiveness is yet to be proven.Alternative therapies: Although some other alternative therapies claim to have a proper treatment for arthritis. Treatments from Ancient Ayurveda and chiropractic therapy have shown great and bright results over the years. Patients who are not satisfied with modern allopathic treatment and looking for alternative treatment for arthritis can find better relief from therapies like chiropractics which is famous for treatment of musculoskeletal diseases. A lot of people are turning to therapies like chiropractics these days as they offer a vast knowledge and treatment options on musculoskeletal disorders.

Back Pain – Could It Be Arthritis of Spine?

Dr. Pravin Patil, Rheumatologist
Ankylosing spondylitisis (AS) often referred as ‘arthritis of spine’ is an overlooked cause of back pain. It is a disease of young adults. Unfortunately, ankylosing spondylitis often remains misdiagnosed as ‘simple’ back pain for years. The symptoms, especially in the early stages, can be very similar to more common back problems. Because of this, many people put up with the pain for some time before seeking help. Also, widely available pain killers like Brufen, Combiflam, voveran mask symptoms of Ankylosing spondylitis.What is ankylosing spondylitis (AS)?The word spondylitis means inflammation of the spine. The word ankylosing means bones that tend to join together (fuse). The spine's bones (vertebrae) fuse together, resulting in a rigid spine like bamboo. It mainly causes pain and stiffness in lower back. Other joints and other parts of the body are sometimes affected.What are the symptoms of ankylosing spondylitis (AS)?Lower back pain usually starts before the age of 40 years (commonly 15 and 25 years of age)Comes on slowly over timeBack pain and stiffness in the mornings or after period of inactivityImproves with exerciseCan often cause pain in the buttocksThe buttock pain may be felt sometimes on one side and sometimes on the other side. Pain can get worse with rest/inactivity. Instead, exercise and movement usually ease the pain. The pain tends to be worse first thing in the morning.Ankylosing spondylitis is a systemic disease, which means symptoms may not be limited to the joints. People with the condition also may have fever, fatigue, and weight loss. Eye inflammation (redness and pain) occurs in some people with spondylitis. Some people also have pain, stiffness and swelling in their knees, ankles, or the smaller joints of their hands and feet. Who should I consult for ankylosing spondylitis?Rheumatologists specialize in medical aspects of arthritis and orthopedic/spinal surgeons specialize in surgical aspects of arthritis. Ideally patients must first visit the rheumatologist as most rheumatic diseases do not require surgery. It is preferable to try medical interventions long before there is a need for surgery.The diagnosis of ankylosing spondylitis is made by a rheumatologist after looking at several factors, including: Symptoms, findings of an physical exam by an expert, MRI scan or X-rays of the back and pelvis, results of lab tests.What treatments are there for ankylosing spondylitis (AS)?With recent advances in management of AS there are a variety of treatments options available. Modern treatment aims at easing your pain and stiffness, keeping the spine mobile and thus helping you to live a normal life. A rheumatologist is an expert in this disease and should be consulted early in the course of the illness. Disease-modifying medications and newer therapies (Biologics) used by the rheumatologist can slow and in many cases stop the disease progression. Simple painkillers will not prevent joint damage. Exercise or diet alone cannot stop disease progression.

3 Amazing Drinks to Keep Arthritis at Bay

Dr. Priyam Sharma, Dietitian/Nutritionist
Arthritis is derived from two words, "Arth" means Joint and "itis" means inflammation.  It is a condition that involves stiffness in the body, accompanied by excruciating pain and inflammation in the joints.Difficulties you could faceIn addition to the awful pain, arthritis can bring with it more trouble than you can possibly imagine. The difficulties vary from the type and severity of arthritis you have. For example, Rheumatoid Arthritis is a chronic arthritic condition where the body's immune system attacks healthy tissues. The cause of this is still unknown to medical science. Arthritis affects people across all ages. Even though there are some types such as Osteoarthritis that usually comes with age and mainly affect the knees, fingers, ankle, and hips.RecipesHere are some simple and delicious concoctions that can ease the pain of inflamed joints, and stiff muscles, even as they help you beat the summer heat.Celery & Spinach Green ShakeApples - 3Celery - 4 stalksGinger - ¼ inch knob, peeledLemon (with rind)Orange - 1 peeledSpinach - 5 handfulsEasy to prepare:Cut then add all ingredients into a blender without peeling, then pour them into a glass and enjoy your drink.Holy Basil CoolerBasil - 3 sprigsLime - ½Cayenne Pepper - 1 dashWatermelon - 5 cupsMuskmelon seeds-2 teaspoonEasy to prepare:Add all ingredients into a blender then pour them into a glass and enjoy your drink.Green Iced Tea Green teaHoneyMint leavesLemonEasy to prepare:Boil water, add the green tea leaves to the boiling water and let it cool down. Refrigerate till its chill and serve with lemon, honey and mint leave. Apples, green tea, watermelon, ginger and dark green leafy vegetables are natural anti-inflammatory agents. They contain phyto-chemicals, gingerols, and tripterpenoid which are beneficial for people suffering from arthritis. Celery contains antioxidants specially flavonoids and polyphenols. Moreover, it helps in removing uric acid crystals . Cayenne pepper consists of a chemical capsaicin which boosts the metabolism and regulates high blood pressure. Beat the summer heat and the pain of arthritis with these drinks and stay cool.

Treatment Options For Joint Pains From Arthritis

Dr. G K Sudhakar Reddy, Orthopedist
Life style changesIf one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. Pain Killers Painkillers help with pain and stiffness but they don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints . They are well tolerated because very little is absorbed into your bloodstream. Nutritional Supplements Glucosamine and chondroitin are nutritional supplements. Studies in animals have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in painJoint injectionsIf pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. Hyaluronic acid injections, which help to lubricate your knee joint, are sometimes given but recent evidence that it works isn’t convincing.Surgery May be recommended if you have severe pain and/or mobility problems.ArthroscopyIf one has frequent painful locking/stiffening episodes especially in the knee joint,an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy. Joint replacement surgeryJoint replacement therapy is most commonly carried out to replace hip and knee joints. It involves involves replacing a damaged, worn or diseased joint withan artificial joint made of special plastics and metal.For most people, a replacement knee will last for at least 15 to 20 years, especially if the new knee is cared for properly and not put under too much strain.There are two main types of surgery, depending on the severity of arthritis:• total knee / hip replacement – both sides of your knee / hip joint are replaced• partial (half) knee replacement (PKR) – only one side of your knee joints replaced in a smaller operation where more of the undamaged knee is preserved with a shorter hospital stay and recovery period.Other surgical options for arthritisArthrodesis or Joint fusionIf hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.OsteotomyIn young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old.