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A Second Look At Osteoarthritis

Reed S Oxman Md
 


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The expanding Orthopedic Surgery population continues to grow. Even with new and more inventive ways of surgically treating Osteoarthritis, the population that needs such treatment still continues to grow at an alarming rate.

The United States national life expectancy is lengthening. Medical care trends are to prevent disease rather than to just treat it. We need to consistently approach Osteoarthritis in this same manner.

Joanne M. Jordan, MD is a Professor at the University of North Carolina and is director of the University’s Thurston Arthritis Research Center. Earlier this month, November 2013, Dr. Jordan spoke publicly about the discrepancies in the availability of surgical treatment for knee osteoarthritis and the population in need. She spoke of that population and how, in the next decade, it could easily grow six fold.

Just as the overall trend in medicine is to prevent disease rather than just treating it, so should be our approach to Osteoarthritis.

In a previous article, I wrote about the need for better and more testing of patients whose population is prone to developing Osteoarthritis. Finding and better defining this population must run concurrently with the need to prevent rather than to just treat this population.

The “Affordable Healthcare Act” is currently the ultimate example of how the approach to disease in the United States of America needs to drastically change. Healthcare dollars are much better spent on the quest of finding and better defining the population that is prone or on its way to developing a disease, rather than spending these costly dollars on its treatment alone.

Traumatic Arthritis is a special subset of Osteoarthritis. Unlike Osteoarthritis as a whole, a history of significant trauma is nearly always a prelude to Osteoarthritis in some degree. This is especially true for the weight-bearing joints.

In general, the acute painful phase of significant joint trauma is followed next by an asymptomatic relief phase. Studies have shown time and again that it is during this asymptomatic phase or period that the expected Traumatic Arthritis, an example Osteoarthritis, develops. Knowing this, it needs to become routine that preventative measures, those that help standoff the development of this arthritis, be instituted. From a purely economic standpoint, it is much better to spend our healthcare dollars on early diagnosis and prevention, than to just wait for those symptoms to develop that then warrant an expensive joint replacement.

In 2010 dollars, a weight-bearing joint replacement, including surgical, hospital and rehabilitative services, can easily reach, if not surpass, a quarter of a million dollars. In conclusion, I hope that I have given you some food for thought. Approaching a disease before it’s inevitable development, can and should be our new standard of care.

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