Arthritis Can Affect Anyone

By Cat DeBinder, National Naval Medical Center Public Affairs

June 8, 2010 - BETHESDA, Md. (NNS) -- Arthritis, the inflammation of joints, can affect one or several joints throughout the body and its symptoms range from mild to debilitating, which can severely affect Sailors during their daily operations.

"Most arthritis is simply damage to the cartilage on the end of our bones in our joints," said Cmdr. David Schroder, staff orthopedic surgeon in the National Naval Medical Center's (NNMC) Orthopedic Department. "One could argue that every adult has some degree of arthritis."

Schroder wants people to know that it's not an awful thing to be diagnosed with arthritis and not something to be worried and scared about.

"Arthritis is generally broken down into osteoarthritis and inflammatory arthritis," said Schroder. "Inflammation is the body's reaction to stress, be it injury, surgery or illness."

Inflammation can affect any of the components inside the joint such as supporting tissue, cartilage, bones or the joint lining. Pain, stiffness and swelling of the joints are all common symptoms, said Schroder. "Inflammatory arthritis is when the body's immune response is overactive in some way; rheumatoid and psoriatic are examples of inflammatory arthritis."

"Osteoarthritis is by far the most common arthritis we see as joint replacement surgeons, and its causes are multifactorial," said Schroder. "Patient activity, family history, prior injury and anatomy all influence the development of osteoarthritis."

Connie Wilkie, a patient at NNMC, has had osteoarthritis since 1975.

"It came on gradually; the first thing I noticed was that my fingers seemed welded together and I couldn't bend them," said Wilkie. "To some degree it has crippled my lifestyle and reduced my ability to do certain things. I can't grasp well, I'm unable to pick up small items and I can't do things such as peel potatoes."

Wilkie said she takes one prescription and some over the counter dietary supplements for her arthritis.

Schroder said arthritis has many side effects.

"Most commonly the patient experiences pain, stiffness and even instability of a joint with bad osteoarthritis," said Schroder. "These symptoms can become quite severe, even relegating a patient to a wheelchair if the pain is that high."

Schroder said there are also psychological and emotional effects of arthritis. The psychological effects can be great because of the potential for great limitation in mobility. Some patients can become depressed if they cannot do simple tasks for the first time in their lives.

"Orthopedics is an exciting field to be in because I get enjoyment out of helping these people out — like the patient that can't walk and you help them walk," said Schroder. "The best part of joint replacement is patients tend to do well; these are very successful surgeries."

Osteoarthritis tends to get worse with time, said Schroder.

"We surgeons will often make the analogy of tire wear with cartilage wear," said Schroder. "If the patient goes fast and drives hard on tires, they wear more quickly. Nothing cures arthritis today, we encourage our patients to walk and do as much as they can. We help with injections and ask them to modify their activities — avoiding running and losing weight, for example. We can offer anti-inflammatory oral medications."

The ideal goal in the future is to heal injured cartilage, but without a good blood supply, this currently is not possible. This means some sort of man made device to replace the cartilage.

"Because our patient population is so young here, we have to think of other treatments prior to replacements," said Schroder.

Schroder said there are other less invasive treatments for arthritis than replacement surgery. For example, micro fracture induces scar cartilage called fibrocartilage to fill the injury site. Cadaver cartilage and the reinsertion of cartilage cells from the patient are other possibilities.

"We treat each patient based on history, symptoms, examination and X-ray," said Schroder. "I tell every patient that this is a personal process, meaning I don't compare their pain to somebody else's, and I don't operate on the X-rays, I operate on patients."