Primary Care Practice; Advances in Chronic OA: Volume 2, Number 3

Issue: Premier Issue 2015

Prior issues of Primary Care Practice: Advances in Chronic OA Management have outlined in detail the comprehensive approach to management of osteoarthritis according to accepted published guidelines. Although many of our patients with osteoarthritis (OA) are aware that knee or hip replacement may loom in their future, they do not consider surgery as long as they respond to conservative treatment and remain functional with reasonable pain relief. What if nonsurgical options begin to fail to meet our patients’ expectations for pain relief and maintaining function? As Dr. Victoria Brander points out in this issue, the resultant limitations lead them to take the next step and consider surgery.

The decision to pursue surgery is complicated, and as a result, our patients will turn to us with their questions and seek our guidance. Dr. Brander in her article and Dr. Susan Joy in the Expert Interview share their experience in answering questions frequently raised by their patients, as well as provide suggestions to identify ideal candidates for surgery and to optimally prepare those patients with “prehabilitation” and weight loss. Joint replacement surgery is not without risk, especially in our patients with OA who have comorbidities, which has been a topic of previous articles. Effective preoperative screening and postoperative medical management are essential to a favorable outcome, as both Drs. Brander and Joy emphasize.

In a separate article, Dr. S. David Stulberg discusses surgical options available to our patients with hip and knee arthritis. He states that available surgical procedures are designed to either slow the progression or definitively treat the disease. Which option is appropriate for a patient will depend on specific patient characteristics, extent of the arthritis and experience of the surgeon.

The goal of this issue is to provide us with the information we need to guide our patients in their decision to have surgery for their arthritis, assess their candidacy, and optimize their outcome from both musculoskeletal and medical standpoints. In the next issue, the role of supplements and nutraceuticals, another source of frequent patient questions, will be discussed. Also, highlights from the Osteoarthritis Research Society International Annual Meeting will be presented, including information that will help us to functionally assess and counsel our patients.

Although many patients with OA are aware that knee or hip replacement may loom in their future, they do not consider surgery until conventional treatments fail to meet expectations for pain relief and functionality. Joint replacement surgery is not without risk, especially in patients with OA who have comorbidities. Effective preoperative screening and postoperative medical management are essential to a favorable outcome. Available surgical procedures are designed to either slow the progression or definitively treat the disease. Which option is appropriate for a patient will depend on specific patient characteristics, extent of the arthritis and experience of the surgeon. The goal of this activity is to provide the information needed to guide patients in the decision to have surgery, assess their candidacy, and optimize their outcome from both musculoskeletal and medical standpoints.

Click here to see this Education Lab Activity.

Learning Objectives:

At the conclusion of this series, participants should be able to:

Apply diagnostic criteria to be better able to diagnose and treat OA early in the course of the condition.
Evaluate patient-centered, multimodal approaches in the chronic management of osteoarthritis.
Assess patient-specific parameters and comorbid conditions when evaluating treatment options for patients with osteoarthritis
Examine preventative, multidisciplinary, multimodal, and self-management strategies that assist in the overall management of osteoarthritis.

Overview

Author(s)/Faculty: A.J. Cianflocco, MD, FAAFP; Susan M. Joy, MD; Aaron Lear, MD, LAQSM; Neil A. Segal, MD, MS; S. David Stulberg, MD
Source: Healio Rheumatology Education Lab
Type: Monograph
Articles/Items: 7
Release Date: 9/1/2013
Expiration Date: 11/30/2015
Credit Type: CME
Number of Credits: 1
Cost: Free
Provider: Vindico Medical Education

CME Information

Provider Statement: This continuing medical education activity is provided by Vindico Medical Education.
Support Statement: This activity is supported by and educational grant from Sanofi-Aventis U.S.
Target Audience: The intended audience for this activity is primary care physicians and other healthcare professionals involved in the treatment of patients with osteoarthritis.