Osteoarthritis is the most common type of arthritis and is also referred to as a degenerative disease affecting the synovial joints. It is a non-inflammatory disease that often affects the elderly. But in Qatar, many cases are diagnosed in younger adults, resulting from a prior injury due to sports and or automobile accidents. Osteoarthritis is caused by ‘wear and tear’ on the joint.
In a recent, in-depth interview with The Peninsula, Dr. Heino Kienapfel, Visiting Orthopedic Surgery Consultant at Doha Clinic discussed osteoarthritis, prevalence in Qatar and treatment options available.
Osteoarthritis is mainly related to aging. But due to lifestyle factors in Qatar, such as obesity, long-term use/overuse related to sports and or prior fractures, many younger adults are seeking treatment for the symptoms of osteoarthritis in Qatar. Kienapfel sees on average 20-30 patients per day when he is working in Qatar. According to Kienapfel, “pain is a major factor in why people seek treatment. But treatment plans must be specific to the patient’s needs and goals.” When asked why younger men in Qatar would have osteoarthritis, Kienapfel replied: “The high rate of automobile accidents and sports injuries in Qatar could be reasons for the increase.”
Kienapfel further explained that osteoarthritis can be categorized into stages: “In stage one, the cartilage is normal; in stage two, the cartilage is on the outside of the bones but is thinning out. In stage three, there are large areas of irregular surface and a decrease in cartilage is noted. Finally, in stagefour, no cartilage remains and swelling is often present. The fourth stage is extremely painful, like metal on metal without any padding. It is in the later stages that a patient may require a hip or knee replacement.”
Severe cases of osteoarthritis of a joint may require surgical intervention. There are several types such as, arthroscopic surgery to repair damaged cartilage or bone alignment to reduce stress on the bone or joint, surgical fusion of bones (arthrodesis, usually in the spine), and then there is the most invasive, which is total or partial replacement of the damaged joint.
According to Kienapfel: “The decision to go forward with surgery requires a full assessment of what the individual patient hopes to achieve after having the surgery. I found that out while working in Berlin. We had a large number of Muslim patients, and they wanted to be able to bend for prayer. This requires different flexing of certain muscles and must be taken into consideration. Also, there are different types of implants for males and females based on anatomical factors. For some, walking is the most important issue and, therefore, we must understand the patient’s needs prior to choosing the type of artificial joint we will use.”
“The patient must be aware that there are a range of implants available, but the quality varies greatly. When considering the cost of surgery it is important to look at what type of implant your physician plans to use. I suggest that you discuss the following items prior to agreeing on a hip or knee replacement: find out how many surgeries (like the one he plans for you) has the doctor done in the past, ask what type of procedure/technique he plans to use and discuss what type of implant he plans to use and why he chose that particular type”, said Kienapfel. For example, longevity of the implant is an important factor in younger patients, but may not be a factor if the patient is in his late 70s or 80s, according to Kienapfel.
So, if you have a joint that is rubbing, grating or cracking, it just may be osteoarthritis. Your joints may be stiffer in the morning and “warming up” time may be required, this may be a first sign. But before you agree to any invasive procedures, discuss your individual case at length with your doctor. Know the facts; be comfortable with your choice of not only the physician, but also the materials he plans to use in the surgery. Be your own patient advocate; joint replacement is a very individual procedure, one size does not fit all.