DJD affects many adults at a variety of ages but is more common after middle age. Several factors may predispose one to developing DJD including genetics, occupation and previous injury.

Although DJD is a chronic condition, acute injuries may superimpose themselves on the long term problem. For example, people with DJD of the knee may also have a torn meniscus cartilage. The latter condition is very correctable with a minor procedure.

Recent advances in understanding, research and technology are allowing orthopaedic surgeons many more options in the treatment of arthritis than ever before.

Synthetic joint fluid injections, the subject of a previous column, are a highly effective treatment in some people. The injections are minimally invasive, relatively inexpensive and may provide moderate and long term relief of symptoms.

Advances are also being made in the area of pharmacuticals. New anti-inflammatory medicines are available that decrease the pain and inflammation associated with arthritis without the gastrointestinal side- effects that can be associated with their predecessors. These medicines are known as COX-2 inhibitors, the most common of which is Celebrex.

If you’ve been unable to take arthritis medicine previously due to the GI side-effects, ask your orthopaedist is Celebrex is right for you.

From a surgical standpoint, orthopaedist have adapted the minimally invasive arthroscopic (scope) techniques to treat mild to moderate DJD. It has long been known that arthroscopy is an invaluable tool in the surgical treatment of sports injuries. Anyone who has had a torn cartilage, ACL reconstruction, or knee-cap surgery in recent years is likely to be familiar with the knee scope.

More recently however, it has been proven that the knee scope is a very effective treatment for DJD. Using the fiberoptic camera, the orthopaedist can trim away the freyed cartilage, smooth joint surfaces using a shaver or laser, and correct many overlying acute problems such as a small torn cartilage that are common in patients with DJD. Also, the water that is introduced into the joint during the surgery serves as a lavage or wash-out which, in theory and practice, washes away many of the inflammatory molecules that are responsible for pain, stiffness and soreness.

It should be noted that arthroscopy is not a cure for arthirits. Rather, it is yet another way that orthopaedic surgeons can manage and slow the progression of the disease. Although the procedure is largely paliative, many patients have significantly reduced symptoms for months and years following the surgery.

The gold standard for the treatment of advanced DJD is still knee replacement. The vast majority of patients receiving knee replacement surgery have little or considerably diminished pain, stiffness and soreness after recovering from surgery.

Advances in understanding the mechanics of the knee and hip have led to safer, more effective and longer lasting prostetic joints. Today, artificial knee joints more closely approximate the mechanics of the patients knee than ever before. Also, the surgery has been streamlined so that the new knee can be implanted with minimal time under anesthesia.

The average patient who receives a new knee joint in 1999 can expect for the joint to last well in excess of 20 years with normal usage.