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What's New on the Osteoarthritis Front?

According to a recent survey by the federal government, 21 million Americans suffer from osteoarthritis, the degenerative disease that wears down cartilage. The survey also found that people are getting osteoarthritis earlier in life. But there is a man who didn't take his diagnosis sitting down, and he thanks visco-supplementation, an experimental treatment for osteoarthritis, for giving him his life back.

At 55, Michael Small was forced to trade in his jogging sneakers for golf spikes. The reason: years of running, long walks, and tennis took a toll on his right hip and now he has osteoarthritis.

"I was taking medication to lessen the pain, but I was sitting back, knowing that over time the hip was deteriorating and I would be a candidate at one point in time for a replacement," says Michael.

More and more people in their 50s are suffering the same fate--getting osteoarthritis, partly because they participate in strenuous sports. But many, like Small, aren't willing to settle for a traditional treatment that leaves them on the sidelines. Small turned to Dr. Vijay Vad and "visco-supplementation"--an experimental therapy Dr. Vad has been using for the last 3 years.

"The joint fluid is degraded, almost like an old car," says Vad, a sports medicine specialist at the Hospital for Joint Diseases. "What we do is remove that oil and then we put in a new oil. Visco-supplementation is not something that will work passively. There has to be a good patient role and good rehab to bring back the muscle strength."

Here to explain more about osteoarthritis is Dr. Jordan Metzl, also a sports medicine specialist, at the Hospital for Special Surgery:

How do you get osteoarthritis?

Osteoarthritis is often referred to as "arthritis." But in reality there are many different types of arthritis including rheumatoid arthritis, which is a genetic form of the disease. Osteoarthritis is also known as "wear-and-tear arthritis." But just because you do a lot of exercise doesn't mean you'll get osteoarthritis.

There is a list of osteoarthritis treatment options. First, exercise

Exercise is the easiest thing to do. The key is muscle strengthening. Often we use physical therapy to strengthen the muscles around an arthritic joint and this can help tremendously. Osteoarthritis doesn't have to mean an end to exercise; however, you may have to modify your routine.

What role do anti-inflammatories like Celebrex and Vioxx play in treating osteoarthritis?

An advantage of Celebrex and Vioxx is that they inhibit an enzyme, called Cox-2, which causes pain and inflammation. But unlike more traditional anti-inflammatory drugs, such as aspirin, Celebrex and Vioxx don't reduce the blood clots that can cause heart attacks and strokes. So, people who rely on aspirin for its anticlotting effect cannot depend on Celebrex or Vioxx to provide the same benefits.

What about vitamin D, which has been shown to help buil strong bones? Can it play a role in treating arthritis?

In fact, new evidence suggests that osteoarthritis is likely to worsen for those who are deficient in vitamin D. It's not going to rebuild cartilage, but studies show that the amount of vitamin D in a daily multivitamin should keep cartilage healthy. A glass of milk fortified with vitamin D and occasional exposure to the sun can help too.

What about the surgery option?

Joint replacement is often the best option for the most severe cases of osteoarthritis. Until recently, however, the drawback for younger patients was that these artificial joints often wore out after about 20 years, so many orthopedists prefers to delay surgery until the patient was 65. But now, laboratories are starting to use a new, highly durable material that often prolongs the life an artificial joint to about 35 years.
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