When you live with daily knee or hip pain, you just want the pain to stop. Here, we not only help stop the pain, we work to reserve the function of your joint.

Find relief from pain and stiffness in a major joint like a knee or hip here at The Ohio State University Wexner Medical Center. Because our Orthopaedics program is ranked among the best in the country, people come to us from throughout central Ohio and nearby states for their joint replacement surgery.

We specialize in caring for adults in need of joint replacement due to osteoarthritis, post-traumatic arthritis, avascular necrosis and the late consequences of childhood hip diseases such as dysplasia/dislocation, Perthes disease (osteonecrosis) and slipped capital femoral epiphysis. 

In addition to patient care, our adult reconstruction specialists lead clinical and scientific research, looking for new and better ways to treat osteoarthritis and other degenerative conditions.


Conditions We Treat

Arthritis of the Hip or Knee

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin.

  • Osteoarthritis is the most common type of arthritis. It’s often related to aging or to an injury.
  • Autoimmune arthritis happens when your body’s immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is the most common form of this kind of arthritis. Juvenile rheumatoid arthritis is a form of the disease that happens in children.
  • Infectious arthritis is an infection that has spread from another part of the body to the joint.
  • Psoriatic arthritis affects people with psoriasis.
  • Gout is a painful type of arthritis that happens when too much uric acid builds up in the body. It often starts in the big toe.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


Osteoarthritis

Osteoarthritis is the most common form of arthritis. It causes pain, swelling and reduced motion in your joints. It can occur in any joint, but usually it affects your hands, knees, hips or spine.

Osteoarthritis breaks down the cartilage in your joints. When you lose cartilage, your bones rub together. Over time, this rubbing can permanently damage the joint.

Risk factors for osteoarthritis include:

  • Being overweight
  • Getting older
  • Injuring a joint

No single test can diagnose osteoarthritis. Most doctors use several methods, including medical history, a physical exam, X-rays or lab tests.

Treatments include exercise, medicines and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


Osteonecrosis

Osteonecrosis is a disease caused by reduced blood flow to bones in the joints. The lack of blood causes the bone to break down faster than the body can make enough new bone. The bone starts to die and may break down.

You can have osteonecrosis in one or several bones. It is most common in the upper leg. Other common sites are your upper arm and your knees, shoulders and ankles. The disease can affect men and women of any age, but it usually strikes in your thirties, forties or fifties.

At first, you might not have any symptoms. As the disease gets worse, you will probably have joint pain that becomes more severe. You may not be able to bend or move the affected joint very well.

No one is sure what causes the disease. Risk factors include:

  • Long-term steroid treatment
  • Alcohol abuse
  • Joint injuries
  • Having certain diseases, including arthritis and cancer

Doctors use imaging tests and other tests to diagnose osteonecrosis. Treatments include medicines, using crutches, limiting activities that put weight on the affected joints, electrical stimulation and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


Diagnosis

When you come to our clinic, you’ll meet with an adult reconstruction specialist for a comprehensive review of your medical history. You’ll also undergo a thorough physical exam. Your doctor also may order a series of diagnostic imaging studies, including X-rays or magnetic resonance imaging (MRI). An MRI provides a detailed, high-resolution image so your doctor can see the extent of your joint’s damage or deterioration.

Together, the exam, history and imaging studies help your doctor evaluate your condition and develop a personalized treatment plan. Your treatment may include nonsurgical medical management, partial joint replacement or total joint replacement. Joint replacement is recommended for people with severe and activity-limiting pain that does not respond to nonsurgical medical management and who have some area of bone-to-bone contact in the weight-bearing joint.

Treatments

Surgical knee replacement

Knee replacement surgery can relieve pain and allow you to be more active. Your knee has three compartments¾inside, outside and underneath the kneecap. With total knee replacement, your doctor is replacing the joint surfaces of your knees, not the bone. Total knee replacement surgery involves replacing one or more of the knee’s three compartments with a man-made surface of metal and plastic.

With partial knee replacement, your surgeon replaces only one part of your knee joint, most commonly the inside or medial compartment.

You can expect to spend about two days in the hospital after knee replacement. You will be on your feet bearing weight the day of surgery. Most patients have a home health care nurse and physical therapist come to their house three times a week. You’ll engage in some form of therapy for about six to 12 weeks after surgery and will be off work for at least six weeks.

Our leading-edge surgical knee reconstruction treatment options include:

  • Knee arthroplasty, surgical replacement of the surface of the knee joint to decrease pain and increase mobility
  • MAKOplasty, an innovative robotic partial knee replacement surgery that targets the specific disease area and preserves bone, soft tissue and ligaments for more natural knee function post-surgery
  • Tibial osteotomy to realign the limb and preserve knee function prior to knee replacement

Hip replacement

If other treatments, including physical therapy, pain medication and prescribed exercise have not alleviated your pain and/or restored function to your desired outcome, you may wish to consider hip replacement surgery.

With hip arthroplasty (hip replacement surgery), your surgeon will remove damaged cartilage and bone from your hip joint and replace them with new, man-made parts.

You can expect to spend two to three days in the hospital, and will be bearing weight and walking the day of surgery. With hip replacement surgery, you should feel no hip pain other than normal post-surgical pain.

Because the complication rate is lower, our surgeons prefer the posterior approach to hip replacement. This just means that the surgeon makes an incision on the backside of your hip near the buttocks to avoid the leg muscles used for walking.

Expect six weeks of prescribed limited range of motion, along with six to 12 weeks of home health care and/or physical therapy.


Why Choose Ohio State?

Why choose Ohio State for reconstructive care?

Why choose Ohio State for reconstructive care?

Comprehensive Care: At Ohio State, we take a multidisciplinary approach to your care. That means you have the care, training and expertise of an entire team, including physicians, clinicians and researchers from Orthopaedics, physical therapy, radiology and sports medicine. Working together with the clinical and research arm of a wide range of departments, we provide patients the best, most personalized treatment options available for hip and knee pain.

Diagnostic Expertise: Our Orthopaedics program is ranked by U.S.News & World Report one of the premiere sites in the country for orthopedic surgery.

Research: Through collaborations with Ohio State researchers and medical device manufacturers, our physicians participate in the design and development of hip and knee replacement components, including a composite femoral stem for total hip arthroplasty.

Clinical Trials

Our Adult Reconstruction physicians have special research interest in total hip and knee joint replacements and involve themselves in ongoing research studies to improve future patient care.

Current studies include:

  • Using intraoperative measurements to predict postoperative outcomes of TKA: While TKA (total knee arthroplasty) is generally successful at restoring function and improving quality of life, a wide gap separates those who cannot perform daily living activities (comfortably climbing stairs) from those who return to a more active lifestyle (hiking, golfing, playing tennis). The purpose of this study is to obtain data about patients’ knees during surgery (measurement of custom distances) in order to predict how well patients regain function after surgery, and improve surgeons’ ability to provide individualized interoperative care.

  • Patient-specific modeling of total knee arthroplasty: Similar to the intraoperative measurements study, the purpose of this work is to develop new patient-specific computer simulations of total knee replacement for determining how surgical technique, specifically initial soft tissue balance and component alignment, relate to patients’ activities following total knee replacement. With a focus on the implant, this study looks at restoring the natural, pre-arthritic alignment of the limb and normal kinematics through the use of custom-made tibial and femoral cutting guides constructed from a 3D model of the arthritic knee.

Enroll in a clinical trial at The Ohio State University Wexner Medical Center.

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