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I am all for conservative treatment of all conditions, including arthritis. Usually that is the approach I take the first time I see a patient. Conservative therapy for arthritis includes advice concerning lifestyle changes which will help the pain, sometimes injections, or medication. If these do not work, or if the patient's arthritis is already severe, I may do surgery. For the knee sometimes a simple small procedure of arthroscopic "house cleaning" gives benefit. In severe arthritis a joint relining, called a total joint can be done. Although a big operation, I have found patients of all ages, even in the eighties, have a hugely improved quality of life following total replacement. Total refers to replacement of both sides of the joint, not to replacement of large areas of bone. Usually, in the knee, I only resect 0.5 to 1 cm. of bone. The leg will not change in length. The hip is a ball and socket joint, so the operation is different: remove the ball, replace with a metal ball, then reline the socket.
Email: m.wasylenko@lph.org
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