Newport Orthopedic Institute

Approximately one in five Americans suffer from some form of arthritis, the most common form of which is osteoarthritis, or “wear and tear” arthritis.

Arthritis is the leading cause of disability in the United States, and the most frequent cause of discomfort and chronic hip and knee pain.  Generally, the pain associated with arthritis develops gradually, although sudden onset is also possible. The joint may become stiff and swollen, making it difficult to bend or straighten. Pain and swelling are worse in the morning or after a period of inactivity. Pain may also increase after activities such as walking, stair climbing or kneeling. The pain may often cause a feeling of weakness in the joint, resulting in a “locking” or “buckling.” Many people report that changes in the weather also affect the degree of pain from arthritis.

Osteoarthritis

Osteoarthritis is the most common form of arthritis and affects over 50 million Americans. Most people are affected as they age, although some patients experience osteoarthritis at a younger age as a result of injury or overuse. Most patients experience osteoarthritis in weight-bearing joints such as the hip, knee and spine. Any joint that has been extensively used in sports or work, or a previously fractured or injured joint may also be affected.

Osteoarthritis usually occurs after age 50 and often in an individual with a family history of arthritis. In this form of the disease, the articular cartilage conditioning the ends of the bone wears away. The bones then rub against each other, causing hip pain and stiffness. Often, bone growths called “spurs” may develop, causing pain and swelling in the affected joint. Periods of rest may offer some relief from this pain.

Causes of Osteoarthritis:

Although you can get osteoarthritis without having any risk factors, you may be more likely to be affected if you have a family history of the disease. If you are elderly, obese, or have previously injured joints, the stress on your joints may make you more susceptible to the disease.

Symptoms of Osteoarthritis:

- Pain flares when you’re active and gets better when you rest.
- Stiff and inflamed joints, particularly in the morning.
- Pain with weight bearing

Rheumatoid Arthritis

Most patients experience rheumatoid arthritis at middle age, although people of all ages may be affected. Rheumatoid arthritis is a disease in which the synovial membrane becomes inflamed, produces too much synovial fluid and damages the articular cartilage, leading to pain and stiffness. RA usually affects both sides of the body, including the hands, feet, hips, knees, and elbows.

Causes of rheumatoid arthritis:
There is usually a “trigger,” such as an infection or environmental factor, which activates the genes and leads to the development of rheumatoid arthritis. When exposed to this trigger, the immune system responds by beginning to produce substances that attack the joint.

Symptoms of rheumatoid arthritis:
 - Swelling, pain, and stiffness in the joint, even when it is not being used.
 - A feeling of warmth around the joint.
 - Joint deformities and contractures.
 - Developing nodules, or lumps, particularly around the elbow.
 - Systemic symptoms, including fever, anemia and loss of appetite and energy.

Avascular Necrosis Of The Hip

Avascular Necrosis of the Hip:
Avascular necrosis occurs when the blood supply to the ball of the hip joint is damaged. The ball portion of the femur bone may die and eventually weaken or even collapse. Avascular necrosis of the hip occurs because most of the weight is concentrated in this area. As a result of the flattening, the ball no longer fits perfectly inside the socket causing the joint to wear itself out. This leads to osteoarthritis of the hip joint. The same process can occur in the knee and shoulder.

Causes of avascular necrosis:
An injury to the hip can damage the blood vessels. A fracture of the femoral neck (the area just under the ball of the hip joint) can damage the blood vessels. A dislocation of the hip can tear the blood vessels. It usually takes several months for AVN to show up, but it can be a problem for up to two years following injuries like these. Avascular necrosis has been linked to alcoholism, fractures and dislocations of the hip, and long term cortisone treatment for other diseases.

Symptoms of avascular necrosis
 - Pain with weight bearing.
 - A limp and/or stiffness in the hip joint
 - Severe pain, even at rest

Treatment Options

Treatment for arthritis is as unique as every patient is. You will work together with Dr. Caillouette to develop a strategy that works best for you. Some patients may find the relief they need with drug treatments or less-invasive procedures such as joint injections or cartilage transplants, while others may require surgery to relieve their pain.

When conservative treatments no longer provide relief, one of the most effective ways to reduce you pain and restore mobility is hip replacement.  Over the years joint replacement surgery has evolved, and today there are advanced techniques and technology to better meet the needs of patients.  Total hip replacements have been used to treat and repair joint disease since the 1960s, and more that 300,000 people in the United States have a hip replacement each year. The development of total knee replacement technology began more than 30 years ago. Each year, more than 500,000 people in the United States undergo knee replacement surgery.

Dr. Caillouette performs approximately 500 hip and knee replacements and 200 knee arthroscopies annually.