Dr. James E. Wood, chairman of the department of Orthopedic Surgery at MedStar Harbor Hospital, answers questions on joint replacement and other orthopedic concerns. With over 30 years of practice in total joint replacement and arthroscopic diagnosis and repair of peripheral joints, Wood is excited about helping patients regain their previous lifestyles.
AFRO: How has joint replacement changed in recent years?
Dr. Wood: The major focus is on prevention of complications. With the new prosthesis, as many structures aren’t damaged in order to replace the prosthesis. There are less evasive procedures. We focus on preparing the patient to avoid complications afterwards. The focus is really on pre-surgical strengthening and just getting the patients ready when they come in for their procedure so they are in the best shape possible to have it done.
AFRO: What do you wish people knew about joint replacement?
Dr. Wood: In general, patients have a lot they can do about this. The obesity epidemic is really putting a lot of pressure and force on joints. This is due to inactivity and a lack of taking care of themselves as they should. People are getting much less mobile, morbid obesity is just a vicious cycle that they can do a lot about.
AFRO: If someone loses weight, will that eliminate some of the joint pains?
Dr. Wood: Arthritis is the loss of the cushioning effect of the articulate cartilage of the joint. Consequently, once that is gone it does not come back; it’s an irreversible loss. Even though the joint is damaged, the functional loss can be improved by being in better shape, carrying less weight and being more active.
AFRO: Is it more or less successful depending on gender?
Dr. Wood: Gender, specifically, doesn’t speak to that. Women get joint replacement more, about 60 percent, as opposed to men, which is about 40 percent. Women tend to make their medical decisions over a longer period of time, compared to men who wait to seek medical treatment at the last moment. We haven’t seen a major gender difference between the two. Women will go to the doctors, and are the health leaders of most families.
AFRO: Are over the counter medicines and or creams useful?
Dr. Wood: Over the counter crèmes do work, Aleve and Tylenol help with the pain. If someone is obese they need to lose more weight. If they are inactive, they need to become more active. Flexibility and balance works.
AFRO: Is there a better age to have joint replacement?
Dr. Wood: I think there is an age in which the prosthetic will last you longer in life. I think it should be done when a patient has exhausted their conservative measures such as weight reduction, medications, exercise, injections, braces and physical therapy. When a patient has done all those things, and pain is still occurring that limits their quality of life then joint replacement should be done. Putting it off puts patients at the risk of having more problems down the road.
AFRO: What excites you about your specialty?
Dr. Wood: As an orthopedic physician, I can return patients to their normal lifestyle. I have the ability to get patients back to a functional lifestyle. Patients come in my office and thank us for giving them back their lifestyle. Chronic pain makes you depressed so helping people out of chronic pain is very gratifying.
This is a gratifying career for me. As a kid I’ve broken a lot of bones. I am doing what I love to do.
AFRO: What are some misconceptions?
Dr. Wood: There are a lot of studies out there that compare the African American’s to the Caucasians and ask questions like, do you think you will have more pain after your surgery, or do you know someone who has had joint replacement. On average, African American tend to have higher misconceptions than their Caucasian counterparts. This is still life altering surgery. Again, if you see 50 patients, but the one person you pay attention to is the one who has the problem. Then the trusting nature with the patients with their physicians, because people feel like doctors may only see them as someone they want to cut on, that lack of trust and confidence.
AFRO: What is the size of the incisions
Dr. Wood: If you get a knee replacement it’s about a 4 inch. If a patient is obese, doctors have to go through larger layers of fat in order to get through the joint, patients may find that incision to be larger. These are all concerns that should be discussed prior to having the joint replacement surgery. Incisions are so much less than what they used to be; we are now able to perform less invasive procedures with minimal incisions. If patients are in great condition, they can go home in a day. On average some patients may go home in two to three days after joint replacements. Some people are being done as outpatients