Arthrose (arthrosis) is the wearing of a joint surface, this wearing is usually accompanied with an bone overgrowth (osteophytes) as well as hardening of the bone (sclerosis), joint narrowing and joint deformity. There is also a type of arthritis which is related to joint disease, this is osteoarthritis (OA) or degenerative joint disease. Cartilage and subchondral bone are the tissues which are most involved in osteoarthritis. Both arthrosis and osteoarthritis usually occur after many years of wear and tear on a particular joint. With overuse the cartilage tends to become torn, injured and frayed and sometimes can entirely wear away.
The treatment of osteoarthritis can differ as many factors are taken into consideration, these include x-ray findings, if the patient has a medical condition, activities or hobbies which the patient is involved in and the patients age. Patients who only suffer mild or moderate symptoms are often given an exercise programme to strengthen a particular joint, this would usually consist of non-impact exercise like walking, swimming or cycling. This would be done under supervision. There is also medication for various types of osteoarthritis that can be given to ease symptoms.
There are however times when a weight bearing joint needs to be replace. Knee and hip replacements are very common in the elderly when the joint has worn away entirely. Younger people also benefit from surgery of this kind too.
When the decision has been made to perform a hip or knee replacement, then the patient is usually asked to attend hospital a week before to have a pre-op assessment, an x-ray should have been performed prior to this date on the hip or knee which is to be replaced. Once the pre-assessment is done and the patient has the all clear for surgery, then a date will be given to the patient with regards to surgery.
An orthopaedics (Orthopäde) consultant who specialises in either hips or knees will perform the operation. After surgery the patient is in the care of nurses who are on hand to give pain relief when necessary. A post operative x-ray will also be taken to determine that the prosthesis (hip/knee replacement) is in situ and that no complication has taken place.
The physiotherapists will encourage the patient to walk as soon as they feel fit, but usually within a day of surgery. The patients stay in hospital for this type of operation is usually around 4 days (this all depends on the patients recovery time). Before leaving the hospital the physiotherapists will have made sure that the patient can handle the stairs and walk up them unaided. Physiotherapists and nurses play a big part in the recovery and rehabilitation of a patient, after their initial help then patients have to allow time to recover in the comfort of their own home.
As joint disease is so common thousands of joint replacement operations take place each year, and there is a high success rate. To cut down on NHS waiting lists in England the NHS often have contracts with private hospitals to enable people to be seen quickly. The Consultants in the private sector work in the NHS also, so patients often go for a consultation privately then are referred via the NHS for their operation.