In this medical health video learn about the different treatment options available for you to treat Osteoarthritis (OA).
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Are there oral and surgical treatment options for OA? Stanley Dysart: There are many non operative treatments for Osteoarthritis and as a practicing orthopedic surgeon I use many of these methods. Our academy has recently looked at arthritis and has looked at the various treatments involved. Acetaminophen is a very common treatment for arthritis. It's readily available, it's over-the-counter, but downside seems to be that it does have a problem with the liver in some individuals. So if you have liver disease, or if you heavily involved with alcohol, you really shouldn't take high doses of Acetaminophen and you should monitor your liver functions but it does work. It's a pain reliever. Jeffrey Rosen: The average person may take two Extra-Strength Tylenol, which is 1000 milligrams. You really shouldn't take more than four doses of two Extra-Strength Tylenol a day or eight tablets. The maximal dose of Tylenol that people should take is eight grams a day. Stanley Dysart: A second course of over-the-counter therapy is nonsteroidals and as you know both ibuprofen and naproxen are over-the-counter medication, they are anti-inflammatories and they can be used successfully between Osteoarthritis. The problem here though is their side effects, there are G.I. side effects, they can cause stomach ulcers, they can cause problems with kidney function, they can also cause problems with the liver. So you have to carefully monitor these medications if they are given at the physician prescribed level. Jeffrey Rosen: The long-term use greater than six weeks has been associated with an increased risk of ulcerative disease in the small bowel. The effects on the cardiovascular system have been called into question and it is thought that anyone who has a history of cardiac history of high blood pressure, cardiovascular disease, history of a coronary artery bypass surgery or a history of a stroke may not be appropriate patient to be taking anti-inflammatory medications. Stanley Dysart: I mean patients on these, patients as you know will purchase many of the over-the-counter medications. They say they're effective, in some studies they seem to be helpful, but what they're doing though I am not so sure. Jeffrey Rosen: Because there are so many side effects associated with taking oral medications, people are much more interested in taking something that is directed at where their problem is. So if you could have a topical medication that delivered an anti-inflammatory effect to the knee-joint because you have a knee problem and avoid the systemic effects of taking the medicine that gets dissolved in your digestive system and then distributed throughout your body, that's a very attractive therapy. So there are increasing interests in localized therapies that would deliver topical anti-inflammatory agents to the joint of interest. Stanley Dysart: I don't think it's modifying the disease. I don't really think it's doing anything with making the knee feel temporarily better. Jeffrey Rosen: Many studies in Europe have demonstrated some beneficial effect of the use of Glucosamine and Chondroitin. In the United States the studies that have recently been completed have not supported their use because it was felt that the effects were not any better than the use of a placebo medication. Stanley Dysart: The NIH, the National Institutes of Health did a large study called the GAIT study and in that study they looked at the effectiveness of Glucosamine and Chondroitin as a treatment for Osteoarthritis and their findings were interesting. They found that it was effective in only a small subset of patients, those who had moderate or severe pain, but in that subset, which encompasses many patients with Osteoarthritis, Glucosamine and Chondroitin sulfate were effective. Jeffrey Rosen: It hasn't been shown that there is any real danger in trying these medications other than the fact that we don't know that there are controlled amounts of the substances of interest in th