Mayo Clinic experts offer advice on preventing and coping with osteoarthritis, especially in the knees

Experts from the Mayo Clinic offer tips for both those trying to prevent and those suffering from a painful condition that affects at least 27 million Americans: osteoarthritis.

It is the most common form of arthritis, which most almost everyone is bound to get if they live long enough. One particular form, knee osteoarthritis, may afflict as many as half of Americans at some point in their lives, says a Mayo Clinic release.

Obesity, joint injuries, joint overuse, a family history and aging are among risk factors for knee osteoarthritis. Dr. Aaron Krych, a Mayo Clinic orthopedic surgeon, says maintaining a healthy weight is one key to preventing knee osteoarthritis. “Every pound lost can result in up to a 4-pound reduction in the load on the knee,” Dr. Amin says.

Amin says other tips for prevention including doing exercises to strengthen muscles around joints and preserve your range of motion and using assistive devices, such as special grips to open jars and protect finger joints or a cane, to ease the burden on your knees.

It is also important to maintain overall fitness through low-impact aerobic exercises, such as bicycling and water exercises, said Amin.  If you're an athlete, learn techniques to protect your muscles and joints, he said.

For people already suffering form osteoarthritis, water-based exercises like swimming and water aerobics are good ways to get a workout while taking it easy on joints, said Amin. Tai chi and yoga are also good forms of exercise that can strengthen muscles and help maintain balance.

You can work with a physical therapist to develop a specific exercise program.  And, if osteoarthritis is making life difficult at home or work, making a list of those challenges and working with an occupational therapist can help, says Amin. It may also help to get proper cushioning and insoles for your shoes for both exercise and daily living.  Click here for more tips from the Mayo Clinic.

New type of artificial knee, designed for individual patients, is being implanted at St. Joseph East in Lexington

Saint Joseph East hospital in Lexington is Kentucky's first hospital to offer a customized total knee replacement system in which each the knee implant is made to match the individual patient’s anatomy, says a news release from ConforMIS, manufacturer of the implants. So far, about 20 patients in Lexington have received the ConforMIS total-knee replacement surgery, says the release.

“With this new technology, we’re able to offer an implant that is molded to each individual patient precisely,” said Wallace Huff of Bluegrass Orthopaedics, part of KentuckyOne Health, which includes Saint Joseph. “We’re seeing patients healing faster and more easily acclimating to the new knee.”

Typically, knees are replaced due to osteoarthritis and its breakdown and eventual loss of cartilage of one or more joints. Unlike traditional knee replacements, the ConforMIS system uses technology to design and manufacture knee implants for each individual patient, so less bone is removed during the surgical procedure. This provides the potential for faster recovery from the surgery.

Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Health care decisions by and for Medicare patients differ widely by place; Lexington big in back surgery, low in mastectomy

All medicine involves decisions and, according to a new series of nine reports published by the Dartmouth Atlas Project, those decisions differ drastically by location for Medicare patients. In the East South Central region -- Kentucky, Tennessee, Alabama and Mississippi), the variation between how things are diagnosed and treated can change when one crosses county lines.

An example, with numbers but without explanation: The total knee replacement rate in Harlan is 3.3 per 1,000 Medicare beneficaries; in Bardstown, it's 13.8. As the report goes on to note: "If you have heart disease and live in Huntsville, Ala., you are half as likely to undergo balloon angioplasty than if you live in Hattiesburg, Miss., and twice as likely to undergo back surgery if you live in Lexington, Ky." The greatest variation in the region was seen in mastectomy, ranging from a low of 0.3 percent per 1,000 female Medicare beneficiaries in Lexington to 2.1 per 1,000 in Tupelo, Miss.

The point, researchers say, is that providers and patients need to work together to determine care. The report looked at rates for early-stage breast cancer, stable angina, low back pain, arthritis of the knee or hip, carotid artery disease, gallstones, enlarged prostate, and early-stage prostate cancer. Read the report here.

Report: Two-thirds of Kentuckians obese by 2030 if trends continue; cost to nation's future unquestionably high

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here.