Geoffrey Westrich, MD

Orthopedic surgeons perform almost 700,000 knee replacements in the United States each year. The procedure has a high success rate, alleviating pain and restoring an active lifestyle. It’s fairly common for patients to have arthritis in both knees, and they often decide to have both of them replaced. The dilemma many people face is whether to have surgery on both sides at the same time, a procedure referred to as “bilateral knee replacement,” or two separate operations. I always advise people to carefully weigh the pros and cons of each option. Many people want to have a double knee replacement because they feel they can get it over with faster since there’s one surgery, one hospital stay and one course of rehabilitation. For the right patient, it’s a good option. However, double knee replacement is not for everyone, and people should be well-informed before making a decision.                   Studies show that bilateral knee...

Advertisements for treatments claiming to cure or slow down arthritis can be found on the Internet, on television and in print ads. They include drinks, certain supplements and rubs. Most are a a waste of money.  The ads target people in pain who want to avoid surgery. The problem is, the longer people wait, the worse their arthritis can get. In the beginning, even if these bogus remedies provide a false sense of security, people are actually worse off because they are not receiving the proper care. The bottom line is that patients should be wary of any advertisement for a product claiming to cure arthritis. Supplements such as glucasomine and chondroitin, more in the mainstream, are also purported to slow the progression of arthritis. However, in 2013, the American Academy of Orthopaedic Surgeons added these supplements to the list of treatments that provide little benefit. Knee lavage or “washing out the knee” has also received a thumbs down from the American ...

Arthritis is a painful condition that can make activities of daily living difficult, if not impossible.   Osteoarthritis, the most common form of the disease, affects millions of Americans and is caused by wear and tear on a joint.  It often affects the knee or the hip.  Misconceptions about arthritis are prevalent, but knowing the facts can help people to better manage the disease. Here are the top myths and facts about arthritis:  1- MYTH: If you have arthritis, you shouldn’t exercise. FACT: It may seem counterintuitive, but the appropriate exercise can help many people feel better. Certain exercises, such as swimming or the stationary bicycle, can help relieve stiffness and alleviate pain. Physical therapy or an exercise program to strengthen muscles around the joint can also be very helpful.   2 - MYTH : Arthritis is a disease of the elderly. FACT : About two-thirds of patients are under 65. In fact, increasing numbers...

When it comes to joint replacement, each patient has his or her own set of circumstances and goals for surgery. David, who is from Alexandria, Virginia, not only wanted pain relief from knee arthritis. He was eager to get back to his active lifestyle. He has a fascinating job that takes him all over the world. So when unrelenting knee pain started slowing him down, he thought it was time to consider joint replacement. As a forensic psychologist with a PhD, he was accustomed to doing extensive research for his work. He explained that before scheduling surgery, he put his skills to use, setting out to find the best hospital and physician for the surgery. After consulting with a number of doctors, he decided to travel to New York City and made an appointment to see me at the Hospital for Special Surgery.     David in Iraq "I saw several different doctors in several different states before I made a decision, as I am very wary of surgeries, especially when it can hin...

As the upcoming Olympic Games shine the spotlight on sports and elite athletes, the excitement is enough to make many us get off our couches and jump into a sport or exercise program.   B ut anybody who's been inactive for an extended period of time should exercise caution.  People who’ve been sedentary are at risk of injury if they don't take a few simple steps before starting a sport or an exercise program.   You cannot ove restimate the benefits of regular exercise for people of any age.  Exercise is good for the heart and lungs, it helps keep bones and muscles strong, plus, it can provide a psychological lift.   Strengthening muscles can also protect a previously injured joint from further injury.   And regular exercise can improve balance and mobility and even reduce the pain of arthritis. But anyone who leaps into a sport or exercise program too quickly can suffer painful consequences, especially if over 40. As we get older, our bodies change, an...

Blood loss and the need for a blood transfusion are concerns in joint replacement surgery, but a new use for an old drug is proving effective in reducing blood loss and transfusion rates, according to a study we conducted at Hospital for Special Surgery. The drug, tranexamic acid, or TXA, has been used for decades in heart surgery, to treat hemophilia and to stop excessive uterine bleeding. After reviewing thousands of patient records, we found that TXA was safe and effective, reducing the need for a blood transfusion by more than 50 percent. The research was just presented at the annual meeting of the American Academy of Orthopaedic Surgeons. TXA is classified as an “anti-fibrinolytic,” or blood clot stabilizer, whose mechanism of action reduces bleeding. TXA should not be used in patients who have a cardiac stent or in those who have had a previous blood clot. We reviewed the records of 4,449 patients who had hip or knee replacement over a six-month period. ...

Knee pain is a very common problem. If your knee has been bothering you for a while or keeping you from activities you enjoy, the new year is a good time to take action. I encourage you to resolve to get the right diagnosis; resolve to take action to relieve the pain ; resolve to live life to the fullest, life pain-free. For some people, strategies such as physical therapy and weight loss may bring so much improvement, they will feel like they have a "new" knee. For others with severe arthritis and constant pain, a "new knee" in the form of a joint replacement may be the best option to eliminate the pain once and for all. Basically, there are two types of knee pain. "Acute" pain is what we experience after a sudden knee injury. When this happens, people are advised to follow the regimen known as RICE:   Rest, Ice, Compression and Elevation. They should rest their knee, apply ice on and off, and keep the joint elevated over the level of their hear...