Newsroom Hospital for Special Surgery

Can Menopause Cause Joint Pain? HSS Expert Explains the Connection

Mon, 31 Aug 2026 16:24:08 -0400

As women enter perimenopause and menopause, a majority will experience musculoskeletal symptoms associated with estrogen loss that has been collectively described as the “musculoskeletal syndrome of menopause,” referring to arthralgia, loss of bone density and muscle mass, and progression of osteoarthritis (OA).

In an article with Medscape, Heidi Prather, DO, Founder and Medical Director of the HSS Lifestyle Medicine Program said, “When middle-aged women present with new joint pain, it is important to determine where they are in the menopausal transition” to guide appropriate education and management strategies. “Women may not offer the information without being asked, as they may be unaware of the links between hormone changes and soft tissue and joint pain.”

For some women, the chronic systemic inflammation associated with estrogen loss can be well managed with lifestyle and conventional medical interventions including hormone replacement therapy (HRT), Dr. Prather explained. “For others, things can seem out of control, and usual care is not as effective.”

Dr. Prather pointed to the need for studies assessing “modifiable and nonmodifiable factors to best arm women with the information they need to manage and improve their health” across the menopause transition and beyond.

Read the full article at medscape.com.

Living Life to the Fullest: Multiple Joint Replacements Enable 73-year-old “Bionic Man” to Maintain Athletic Lifestyle

Mon, 15 Jun 2026 13:54:00 -0400

HSS patient, Mark Hanlon, who turns 74 next month, is more active than many people half his age. After two knee replacements, two hip replacements, a shoulder surgery and several ankle surgeries, he says, “everything works and I have a full, productive life.”

The Long Island resident says sports are a vital part of his life. He has an activity for every season and most days of the week. Sailing, sculling, tennis, bicycling, snow skiing and open-water swimming keep him busy year-round.

So, when he developed arthritis, he wasn’t about to let that stop him. “In my late 30s I felt the first twinge of pain in my right hip. Within a couple of years, it had worsened to the point that I needed care. I was told that I had arthritis likely from one of two serious falls as a young man,” he explained. “Because I was still young and active, I held off surgery until I hit 50, by which time I was using a cane.” He had his first hip replacement at HSS more than 20 years ago, and it’s still holding up.

Years later, at age 66, he felt the same pain in his other hip, and he had a second hip replacement at HSS. This time, with advances in surgical technique and technology, the former attorney says, “I was up and about the following day, and in six weeks I had forgotten all about it.”

“More aging meant more arthritis,” he explained, and in 2024 he had both knees replaced in two separate surgeries by Fred D. Cushner, MD, a knee and hip surgeon at HSS. Four months after his second knee replacement, he went skiing in Vermont. "I am now back to all my activities, and best of all, just being able to walk around town without pain,” added Mr. Hanlon.

Read the full article at newswise.com.

New ACR guidelines for juvenile idiopathic arthritis favor DMARDs over NSAIDs

Fri, 05 Jun 2026 16:13:21 -0400

Healio reported on new 2026 guidelines from the American College of Rheumatology featuring insight from Karen Brandt Onel, MD, pediatric rheumatologist at HSS.

The American College of Rheumatology recommends early and aggressive treatment for juvenile idiopathic arthritis, and disease-modifying therapies are recommended over NSAIDs and glucocorticoids.

“If a child has damage from untreated or undertreated arthritis, that will follow them forever,” said Dr. Onel. "We know that some children with get off medication over time as the arthritis regresses. However, if damage has already happened that cannot be fixed.”

Read the full article at healio.com.

Young Adults With Juvenile Arthritis Need Specialized Care, with Karen Onel, MD

Thu, 31 Jul 2025 15:54:00 -0400

Karen Brandt Onel, MD, chief of the Division of Pediatric Rheumatology at HSS, emphasizes the need for specialized care for young adults transitioning from juvenile to adult arthritis. In a recent interview with HCPLive, Dr. Onel discusses the complexities of this transition, highlighting challenges such as evolving medical classifications, insurance changes, and the loss of regular healthcare relationships.

Read the full article at hcplive.com.

The Top 3 Nondrug Treatments for Knee Pain

Wed, 02 Jul 2025 09:22:00 -0400

AARP reports that more than 70 percent of adults 50 and older say they experience pain in their joints from arthritis. And for many older adults, that pain occurs in the knees.

But a new study finds that a few simple tools can help tame these aches. When researchers combed through existing studies on nondrug treatments that provide the most relief for knee osteoarthritis, knee braces, water therapy (or water exercise) and traditional exercise came out on top.

David A. Wang, MD, sports medicine physician at HSS, says he isn’t surprised that knee braces, hydrotherapy and exercise were the top performers in the meta-analysis. They all put less pressure on the knee, which can ease pain and improve function, he explains. But just because these therapies ranked high in the research doesn’t mean they will work for everyone.

“There’s no one-size-fits-all for arthritis,” Dr. Wang says.

It’s important to note that there’s no cure for knee osteoarthritis other than a total knee replacement. For those looking to avoid or delay surgery, all you can do otherwise is manage symptoms, Dr. Wang says.

Read the full article at AARP.org.

Study Uses High-Tech Golf Simulator to Determine How Joint Replacement Surgery Affects Players’ Game

Fri, 07 Mar 2025 13:40:00 -0500

Golf Central reports on a novel study at HSS Florida, the West Palm Beach location of HSS, that is utilizing a high-tech golf simulator to evaluate players with arthritis both before and after joint replacement surgery.

The study is recruiting patients with knee, hip or shoulder arthritis to determine how the disease affects club swing and other components of the golf game. Participants will be assessed again following joint replacement and subsequent rehabilitation to determine the effect of surgery on their ability to play golf.

“High-end golf simulators have optically enhanced radar tracking technology that provides a considerable amount of data in terms of golf swing, ball launch and ball flight,” explained Ryan W. Simovitch, MD, director of the shoulder division and co-medical director at HSS Florida, and the study’s principal investigator.

This article was published in the print edition of Golf Central (Volume 25, Issue 11).

New Study from HSS Reveals Minimally Invasive Procedure Can Delay Arthritis in Select Patients with Hip Impingement

Wed, 17 Apr 2024 13:30:00 -0400

A new study by surgeon-scientists at Hospital for Special Surgery (HSS) found that 25% of patients with hip impingement who underwent modern arthroscopy for their condition experienced a delay in the natural progression of osteoarthritis. The retrospective study, published online on March 8, 2024, in The American Journal of Sports Medicine, is the first to link hip arthroscopy with a reduced risk of developing hip arthritis over the long term.

“I’m very proud of our team for publishing this work, which validates hip arthroscopy as a longer-term joint-preserving procedure in carefully selected patients,” says Bryan T. Kelly, MD, MBA, President and CEO of HSS and a world-renowned pioneer in the field of hip arthroscopy who also served as senior author on the study. “At HSS, we focus on providing excellence in clinical care through innovation and evidence-based research. This paper is a prime example of the benefits of advancing innovations in surgical techniques and analyzing patient data collected over many years so we can understand and share the factors associated with optimal results.”

Hip impingement, also called femoroacetabular impingement (FAI), is a condition that typically arises between the teenage years and middle age, and is the underlying cause of hip pain in about 40% of patients in this age range. Hip impingement occurs when the bones of the hip joint are not shaped properly, causing them to rub against one another. Over time, the persistent friction can lead to pain and stiffness, eventually progressing to advanced arthritis.

Prior studies have shown that 85-90% of patients with hip impingement who undergo modern arthroscopy return to their usual activity level. However, until now, little has been known about whether modern arthroscopy can slow the progression of arthritis in these patients. To explore this connection, investigators examined X-ray images of 200 hips from 100 patients who exhibited signs of impingement in both hips but only underwent arthroscopy for their symptomatic hip between 2010 and 2012. The severity of arthritis in each hip was assessed retrospectively using X-ray images taken before surgery and at least 10 years later. Notably, the researchers were unaware of which hips had undergone surgical correction during the assessment.

The resulting analysis revealed only 28% of operative hips showed an increase in arthritis progression at a minimum of 10 years after surgery in comparison to 48% of nonoperative hips. This difference translated to a relative risk reduction of 42% across all patients.

While there was no difference in the natural development of arthritis between the operative and nonoperative hips for 70% of patients, one in four, or 25%, had less arthritis in their operative hip compared to their nonoperative hip 10 years later.

“Previous studies by other centers have reported underwhelming 10-year arthroplasty outcomes for patients with hip impingement. However, those studies reported on older surgical indications and older surgical techniques,” explains lead author and former HSS fellow Prem N. Ramkumar, MD, MBA, now an orthopedic surgeon at Long Beach Lakewood Orthopedic Institute, in Long Beach, California. “By contrast, we studied the effect of modern arthroscopic methods by comparing the degree of arthritis in each patient’s operative hip versus their nonoperative hip. Our research design controlled for variables such as age, medical history, lifestyle, and individual mechanics like rotational profile, spinal alignment and gait—leaving history of arthroscopy as the single factor driving any resulting differences in arthritis progression.”

In addition, the investigators identified a small subset of patients whose arthritis progressed more rapidly in the operative hip as compared to the nonoperative hip. Specifically, older age, a higher arthritis grade, an alpha angle greater than 65 degrees and evidence of borderline hip dysplasia before surgery were the primary risk factors associated with the 5% of hip impingement patients whose arthritis in the operative hip worsened more quickly after surgery.

“We can now identify patients most likely to benefit from arthroscopy for hip impingement and inform patients about their anticipated odds of successful outcomes based on their personal risk factors. For ideal candidates, the evidence shows that hip arthroscopy may delay or prevent arthritis for one in four patients. That’s very powerful information,” says Danyal H. Nawabi, MD, FRCS, an HSS orthopedic surgeon and an author on the study.

Dr. Nawabi also points to the importance of the modern techniques used to care for patients in the study, all of whom were patients of Dr. Kelly. These methods include labrum repair, removal of bony abnormalities on the ball and socket, and proper closure of the joint capsule enveloping the hip joint. “This study is a testament to the fact that where you go for orthopedic care truly matters,” he adds.

Thus far, the paper has garnered two awards: the 2024 American Orthopedic Society for Sports Medicine Fellow Research Award for Clinical Science, which will be presented at the AOSSM Annual Meeting in July, as well as the Philip D. Wilson, MD, Award, presented by HSS in honor of the hospital’s fifth Surgeon-in-Chief to a fellow who has demonstrated excellence in orthopedic surgery research.

6 Types of Arthritis That Can Cause Back Pain

Wed, 06 Mar 2024 15:46:54 -0500

SELF.com highlights different types of arthritis that can cause back pain according to experts including Elizabeth Schulman, MD, rheumatologist at HSS.

Throbbing from Axial spondyloarthritis tends to center on your lower back, and it might be worse during the night or when you first wake up because you’ve been lying still in bed for so long, said Dr. Schulman. Important to note: Some primary care docs can mistakenly believe people with nonradiographic axSpA have mechanical back pain. That’s because there’s often no visible damage to your spine with the condition when viewed on an X-ray, Dr. Schulman says, and you have to spot it through an MRI. A lot of the time it takes a rheumatologist trained in treating axSpA to recognize (and accurately test for) it, Dr. Schulman explained.

If you have psoriasis, there’s a roughly 30% chance you’ll also develop psoriatic arthritis (PsA)—and then have a 20% chance of having spinal issues that stem from it, Dr. Schulman said. Because PsA is an inflammatory condition, your immune system kicks into high gear, and your body might mistakenly attack healthy cells and tissues all over your body—and that includes your back.

Read the full article at self.com.

A Positive Outlook Is Key for a Healthier, Longer Life

Thu, 25 Jan 2024 22:19:47 -0500

Health Radar reports that a healthy lifestyle — a nutritious diet, exercise, adequate sleep, and such — can extend our life span. While there’s plenty of evidence to support this, there’s another critical factor that influences how we age and how long we live: a positive or negative outlook.

Many people with arthritis don’t get enough physical activity, which is known to alleviate symptoms. And a recent study of 99 men and women with arthritis helps to explain why. Those who have a more positive view of their health and aging are more likely to be physically active.

“A negative perception of the aging experience is correlated with lower self-reported physical activity levels in older adults with arthritis,” said lead study author Sarah B. Lieber, MD, MS, rheumatologist at HSS.

This article was published in the January 2024 print edition of Health Radar.

10 Best Products for Arthritis in Hands

Sat, 13 Jan 2024 13:08:00 -0500

Good Housekeeping highlights products that can help patients with arthritis live with less pain and more mobility.

John Dowdle, MD, hand and upper extremity surgeon at HSS says for some people, arthritis pain and stiffness comes and goes and an occasional non-steroidal anti-inflammatory drug will keep them comfortable.

Braces or splints can also be helpful. While these can be purchased over the counter, Dr. Dowdle recommends consulting a hand specialist before you invest in one because some are more effective than others and it depends on your specific needs.

In addition, Dr. Dowdle recommends at-home paraffin baths to people with arthritis in their hands.

Read the full article at goodhousekeeping.com

New Study Shows Perception of Aging is Linked to Level of Physical Activity in Arthritis Patients

Mon, 13 Nov 2023 13:05:00 -0500

People with arthritis who report more negative feelings about how they are aging tend to get less physical activity and perceive themselves as less healthy, according to a new study by researchers at Hospital for Special Surgery (HSS) and Weill Cornell Medicine. However, self-perception of good health explained the effect of negative thinking – providing an opportunity for clinicians to focus on a patient’s outlook on aging as well as their overall health.

“Physical activity is essential for older adults with arthritis, as it can help to reduce pain and stiffness, improve mobility, and maintain independence,” said Sarah B. Lieber, MD, MS, a rheumatologist at HSS and leader of the study. “However, many older adults with arthritis do not get recommended levels of physical activity. Our study suggests that self-perceptions of aging and general health may at least partly explain why.”

For clinicians, the new study could serve as a conversation starter with older patients, Dr. Lieber says. “I think this study and others like it can help doctors begin or continue a discussion with their patients about the factors that may challenge them to be physically active.”

Dr. Lieber and her colleagues presented their findings at the 2023 ACR Convergence meeting of the American College of Rheumatology, held November 10 to 15 in San Diego.

The study enrolled 99 men and women 60 years of age and older with self-reported arthritis in New York and Florida. Survey participants were asked to respond to questions about comorbid conditions.

Participants also were asked about their weekly levels of physical activity and completed a validated 10-item questionnaire about how they felt about their aging process. Questions on the survey explored both positive aspects (gains) associated with aging, as well as negative aspects (losses), covering topics such as motivation, limitations to daily activities, and a sense of physical energy.

Dr. Lieber and colleagues found that the amount of physical activity people reported was strongly associated with their self-perception of general health, the amount of social support they had, and their feeling that aging was negatively affecting them (P <0.01 for all). However, the strength of the relationship between negative self-perceptions of aging and physical activity was weaker when self-perceptions of general health were taken into consideration.

As a rheumatologist whose patients already may be less likely than others to be getting the recommended amount of physical activity, Dr. Lieber says anything that can encourage exercise is welcome. “Everyone benefits from activity, but people with rheumatic conditions benefit particularly,” she says.

“Our findings suggest that interventions to improve physical activity in patients with arthritis may need to target self-perceptions of aging, as well as general health,” Dr. Lieber says. “For example, interventions could help older adults to challenge negative feelings about aging and to develop more positive views of their own aging process. Interventions also could help older adults to identify and address factors that are affecting their general health, such as chronic pain or fatigue.”

Self-Perceptions of Aging and Physical Activity in Older Adults with Arthritis: Does General Health Matter? Authors: Sarah B. Lieber, MD, MS, Jerad Moxley (Weill Cornell Medicine), Lisa A. Mandl, MD, MPH, M. Carrington Reid (Weill Cornell Medicine), Sara Czaja (Weill Cornell Medicine).

What Integrated Treatment Looks Like For RA

Wed, 23 Aug 2023 16:35:00 -0400

Health Central discusses complementary steps you can take to help make life with rheumatoid arthritis (RA) even better.

When it comes to managing RA, experts have long agreed that complementary therapies can bring something extra to the table.

First, know that integrative therapies can support conventional prescribed RA treatments, not replace them. The ACR’s guidelines start off by emphasizing that RA should be treated with disease-modifying antirheumatic drugs (DMARDs), which slow joint damage progression by suppressing inflammation. “In a disease like RA where there are very well-proven benefits that result from conventional disease modifying therapy, it is not appropriate to forego medications,” said Susan M. Goodman, M.D., a rheumatologist at HSS.

That old adage about rusting from resting? It seems to be true when it comes to RA. “The strongest recommendation in the ACR’s guidelines is consistent engagement in exercise, because evidence demonstrated that regular exercise improves physical function and decreases pain,” Dr. Goodman says. Aerobic exercise (like walking or bicycling), resistance exercises, aquatic exercise (like swimming), and even mind-body exercise (like yoga or Tai Chi) can all help your joints (and the rest of you) feel good. So find what you enjoy—and what’s comfortable—and make it a point to move most days of the week.

Read the full article at healthcentral.com.

Hip Pain While Sleeping? Here's What Your Body's Trying to Tell You

Mon, 24 Jul 2023 11:46:00 -0400

Livestrong.com reports on the causes of hip pain while sleeping and what you can do about it in an interview with Angelie Mascarinas, MD, physiatrist at HSS.

Hip pain when sleeping often stems from a hip condition or an injury, said Dr. Mascarinas. When that happens, "lying on your side can put pressure on the area and cause stress or discomfort," she added.

Hip bursitis, a condition that happens when the small, fluid-filled sacs that provide cushioning around the joints become inflamed, is among the most common causes of hip pain at night, Dr. Mascarinas said.

In addition, arthritis in your hip joint can make your hip stiff and uncomfortable during the day and cause aching or soreness when you sleep on it, Dr. Mascarinas explained.

To help alleviate pain while sleeping, Dr. Mascarinas recommends switching positions, tucking a pillow under your knees to take pressure off your hip flexors, adding a mattress topper or trying a pain reliever before bed.

Read the full article at livestrong.com.

Low-Dose Colchicine Might Prevent or Delay Knee, Hip Replacements

Wed, 31 May 2023 18:58:00 -0400

Health Day speaks to experts including Linda A. Russell, MD, rheumatologist at HSS about a study published on May 30 in the Annals of Internal Medicine indicating colchicine might deliver relief and delay surgery for those with knee and hip arthritis.

The study, published May 30 in the Annals of Internal Medicine, does come with a big caveat, researchers noted: The patients were part of a trial testing colchicine for warding off heart trouble — not joint replacements.

Dr. Russell noted that colchicine has a long history of use, and it is “relatively safe and well-tolerated.” She continued to say the new findings are not enough to prove that colchicine delays joint replacements. For one, it's not clear how many patients already had surgery planned before they entered the trial.

For now, Dr. Russell said that people with osteoarthritis can do some things to prevent or delay a joint replacement: lose weight, if needed, and strengthen the muscles supporting the affected joint.

Those tactics, according to Dr. Russell may both slow the underlying disease progression and ease chronic pain — the key reason that people opt for surgery.

Read the full article at consumer.healthday.com.

Exercising With Psoriatic Arthritis? No Sweat!

Wed, 24 May 2023 12:24:00 -0400

Health Central interviews experts including Wai-Kwong Hui, PT, DPT, MS, physical therapist at HSS on tips for exercising with psoriatic arthritis (PsA), an inflammatory autoimmune disorder that attacks your joints and skin.

The foundation of any PsA workout program is cardiovascular exercises like walking and swimming to get your heart pumping, plus strength training and range-of-motion or flexibility exercises to keep your muscles strong and your joints limber, explained Hui. In the real world, he continued, the best exercise is whatever will motivate you to get moving.

Hui recommended starting with a gentle form of exercise to get you going. If you’re not sure where to begin, a physical therapist can help you design a workout program that’s achievable and safe on your joints.

Read the full article at healthcentral.com.

6 Surprising Factors that Contribute to Physical Pain

Mon, 15 May 2023 17:37:00 -0400

Psychology Today interviews experts including Vijay B. Vad, MD, physiatrist at HSS about factors that contribute to pain as we age.

One factor is not enough estrogen, which lowers pain thresholds. Dr. Vad recommended taking 2,000 mg daily of curcumin. A compound in turmeric, curcumin is a potent anti-inflammatory, but it is hard to absorb in a powder, unless it is combined with a constituent of black pepper. But some formulations, including curry dishes, address that problem.

A low thyroid can also contribute to pain. Dr. Vad advised that anyone with arthritis or any type of joint or muscle pain that has taken a turn for the worse ask for a “thyroid function panel,” which measures levels of thyroid stimulating hormone (TSH) and other hormones in your blood. A normal TSH is between 0.4 mlU/L and 4.0 mlU/L. Medication can relieve pain within a month, even if your level is considered “borderline.”

Read the full article at psychologytoday.com.

How Do Hormones Affect Arthritis?

Wed, 10 May 2023 17:33:00 -0400

Getmegiddy.com interviews experts including Caroline Siegel, MD, rheumatology fellow at HSS about how hormones affect arthritis.

A majority of people with arthritis are women, and many experience worse symptoms during certain hormonal phases and relief during others. Significant transitions can even coincide with disease onset.

Sex hormones such as estrogen and progesterone influence immunity and immune system response. However, the mechanisms through which they do so—and the ultimate effects—aren’t quite clear, according to Dr. Siegel.

For example, some lupus research has demonstrated estrogen may exert a pro-inflammatory effect, contributing to disease occurrence and flare-ups, while progesterone may suppress inflammation, she said.

"To whatever extent hormonal differences contribute to women’s disproportionate susceptibility to autoimmune conditions, this is clearly not the whole story," noted Dr. Siegel. "It is important to recognize that sex differences are not only explained by differences in hormone profiles. There are differences in sex-specific genetic and epigenetic factors, environmental exposures and other factors that play an important contributory role in disease development."

Read the full article at getmegiddy.com.

Having Asthma, Eczema Might Raise Arthritis Risk

Tue, 28 Mar 2023 11:38:00 -0400

HealthDay reports on the findings from a new study published in the Annals of Rheumatic Diseases that examined the risk of developing osteoarthritis among people with asthma or eczema conditions.

The connection between osteoarthritis and allergic diseases could be the low-grade inflammation, said Theodore R. Fields, MD, FACP, rheumatologist at HSS, who was not involved in the study, but commented on the findings.

"If treatment of atopic disease helps prevent or lessen osteoarthritis, there are a lot of options and will be more," said Dr. Fields.

"For patients with eczema or asthma, this data can make them aware that they might be more likely to get osteoarthritis," he continued.

If you have an allergic disease and develop aches and pains in your joints, see your doctor, advised Dr. Fields.

"We have many strategies to improve the symptoms of osteoarthritis but don't yet have a disease-modifying treatment," said Dr. Fields.

"There can be some hope in this study for patients with eczema or asthma that their treatment for atopic disease might prevent or diminish their potential to develop osteoarthritis," he added.

Read the full article at healthday.com.

How Arthritis Impacts Your Overall Health

Mon, 13 Mar 2023 11:51:00 -0400

Getmegiddy.com interviews experts including Caroline Siegel, MD, rheumatology fellow at HSS about how different forms and stages of arthritis can impact overall health in various ways.

Hormonal changes can alleviate or exacerbate arthritis symptoms, said Dr. Siegel. Although these effects apply to people of all sexes and genders, people assigned female at birth (AFAB) are most likely to be affected.

However, because levels of corticosteroids, estrogen and progesterone increase during pregnancy, Dr. Siegel noted about half of birthing people experience improvement or remission in their arthritis. Postpartum flare-ups are extremely common. Arthritis symptoms also tend to worsen during and after menopause, again because of changing hormone levels. There's some indication people with rheumatoid arthritis (RA) have lower testosterone levels than people without, though the reason is unknown, Dr. Siegel cited.

"Different studies have found that postmenopausal women and men with lower testosterone levels may have an increased risk of a specific subtype of RA, known as 'seronegative' RA because it is defined by the absence of certain autoantibodies seen in typical, or 'seropositive,' RA," she explained. "Overall, there is substantial scientific evidence supporting the general idea that sex hormones play a role in the development and evolution of RA, but neither their specific role nor the underlying reasons for these associations are fully understood."

Sexual health is imperative to overall health and well-being, and can help regulate the nervous system, promote stress reduction, stimulate endorphin release and improve mood. However, people with arthritis encounter problems with sexual and reproductive health due to the disease itself, physical and psychiatric comorbidities, and the side effects of medications used to treat the condition, Dr. Siegel said.

Read the full article at Getmegiddy.com.

Get Ready to Reach Your Flexibility Goals

Fri, 23 Dec 2022 13:18:00 -0500

HealthCentral.com highlights how continuously working on balance and flexibility movements will improve your mobility for weeks, months, and even years to come.

HSS physical therapist Wai-Kwong Hui, PT, DPT, MS, noted “If you’re not challenging yourself, you get stagnant."

Challenging yourself physically doesn’t mean taking on big athletic feats that could land you on the couch with really bad back pain. It can be as simple as mixing up the balance activities you do so that you’re not always moving in the same way. For example, if you always do one type of yoga pose to work on balance, switch it up by adding another option to your repertoire. “It changes the position of balance all of a sudden,” said Hui . The best way to train for life is to train your body in all the ways that you might move, so that nothing takes you by surprise. For example, twisting moves can prep you for the motions required for putting away groceries or pulling laundry out of the dryer. Working your squatting muscles can build your ability to get up and down from seated or lying-down positions.

Read full article at healthcentral.com.

Boost Your Balance and Flexibility by the End of This Month

Fri, 16 Dec 2022 15:08:00 -0500

HealthCentral.com highlights how recommended movements by experts including HSS physical therapist Wai-Kwong Hui, PT, DPT, MS, can improve balance and flexibility in a way that allows people to alleviate pain and stiffness that limit movement.

Maintaining your balance and flexibility are important for a few reasons, said Hui. First, when you have inflammatory arthritis, your joints can get stiff. “Once you stop moving, you’re creating rust. That’s going to make it harder to move,” noted Hui. As the old saying goes, “motion is lotion,” he added. Second, the pain and stiffness caused by these conditions tends to lead people to alter their movement patterns and move in ways that limit balance and mobility. Improving these skills requires working on them often—every day if possible, even if it’s just for a few minutes at a time—by doing exercises that challenge your body.

Hui recommends stretching in small amounts throughout the day, which has the added benefit of building in movement breaks. “If you’re sitting at a desk a lot, getting up and moving and stretching what’s tight is a great thing to do to change your position,” Hui says. Sitting in one position all day long contributes to stiffness and reinforces bad posture, so the more you can stand up and reset, however briefly, the better.

Hui suggests stretching the body parts that feel particularly tight—likely, different areas of the spine, shoulders, and neck, though the lower body can also contribute to overall stiffness and discomfort—and holding each stretch for 30 to 60 seconds to really feel the stretch response of the muscles and tendons. “You can work your way up even longer to really feel that stretch over time,” he adds.

Read the full article at healthcentral.com/.

After Years of Ankle Pain and Limited Mobility, Life-Changing Surgery at HSS

Tue, 06 Dec 2022 17:08:24 -0500

After years of searching for answers and numerous doctor consultations, 59-year-old Kathleen Kaler finally found relief from the severe ankle pain and instability that had plagued her for years. At Hospital for Special Surgery (HSS), Constantine Demetracopoulos, MD, performed successful ankle replacement surgery.

Kaler, who is from Long Island, says the surgery changed her life. She can now engage in activities most people take for granted – walking normally without pain, wearing shoes she likes, being able to do her job, working in her backyard.

“You have no idea how grateful I am. Before the surgery, my left ankle was collapsing, it could barely support my weight,” says Kaler, a slim 5 foot 7. “All my shoes were worn out on one side.” Her ankle was so unstable, she lived in fear that she would fall or break it, despite the rigid plastic brace she wore from her foot to her knee, day in and day out. She could only wear one type of shoe that she needed to replace every three months.

As a child, Kaler recalls constantly twisting her ankle. Her parents took her to several doctors, and she was given a shoe insert to help with her high foot arches. Years later, arthritis set in, and the pain worsened and became more debilitating. Cortisone shots could only do so much, and she resumed the search for a long-lasting solution. Four doctors said nothing could be done. One orthopedic surgeon said the problem might be corrected with four separate surgeries, which she declined.

Then she learned about total ankle replacement during an appointment with a doctor at HSS Long Island. It’s a complex surgery performed by relatively few orthopedic surgeons, and she was referred to Dr. Demetracopoulos, director of the HSS Total Ankle Replacement Center at the main hospital in Manhattan.

“One of the few centers of its kind, we have a team of foot and ankle specialists, anesthesiologists, radiologists, nurses and physical therapists who have extensive experience in ankle replacement,” he explains. “We strive to provide the best possible care for each of our patients and have grown our volume to become one of the top institutions nationwide in ankle replacement.”

Kaler says her consultation with Dr. Demetracopoulos gave her hope, and she would not be disappointed. She had the surgery in April 2021. “He saved my life. I never cry, but I cried in front of him, I was so grateful,” she says.

“Ankle replacement is considered when patients are no longer able to manage arthritis pain with nonsurgical treatments such as physical therapy, appropriate footwear, an ankle brace or anti-inflammatory medication,” Dr. Demetracopoulos explains. “They have consistent pain that limits their activities and affects their quality of life.”

Like other types of joint replacements, the surgery involves replacing the damaged bone and cartilage in the ankle with a prosthesis. The implant, made of metal and plastic, has the shape of a natural joint and seeks to provide normal, pain-free movement.

The last 15 years have brought vast improvements in ankle replacement implants, technology and surgical techniques, making it a viable option for many patients suffering from severe arthritis, says Scott Ellis, MD, another orthopedic surgeon specializing in foot and ankle surgery at HSS.

One of the most noteworthy advances in ankle replacement is patient-specific instrumentation, or PSI, Dr. Ellis says. It entails obtaining a CT scan of the patient’s ankle and developing a customized presurgical plan tailored to the individual’s anatomy. “PSI has been a game changer. It enables us to choose an implant that is the perfect size and map out a very precise surgery for optimal alignment and positioning,” he says.

For people considering an ankle replacement, the first step is a thorough assessment of the ankle and the foot, and a discussion of patient goals and expectations. Imaging and other tests determine if a patient is a candidate. For someone whose ankle is very stiff with limited mobility or a severe deformity, a fusion of the ankle bones might be a better option and is also very successful in relieving pain, the HSS experts say. An ankle fusion would also be a better option for someone with weakened bones or osteoporosis. The benefit of ankle replacement over fusion is better movement after surgery.

Sometimes an ankle replacement needs to be combined with another procedure, as it was in Kaler’s case. “Hers was a complex surgery. She had a type of foot that predisposed her to ankle instability,” Dr. Demetracopoulos explained. “In addition to treating her arthritis with the ankle replacement, we needed to treat the instability by repairing the ligaments in her ankle and by correcting the alignment in her foot, so it was in the right position.”

Kaler says she experienced no pain after surgery, which Dr. Demetracopoulos attributes to advances in nerve block anesthesia and pain management protocols after the procedure. He notes that each patient experiences pain differently, though.

The HSS doctors expect 90 percent of ankle replacements to last 10 years. If the implant wears out, patients could be candidates for a revision ankle replacement or an ankle fusion. The physicians follow and monitor patients in a joint replacement registry at HSS. “One of our core missions at HSS is not only to deliver the care and do the best surgery we can for our patients, but to collect data over time that we can share with other surgeons and clinicians,” Dr. Demetracopoulos says.

Kaler says the surgery has enabled her to regain her confidence. She can now drive her stick-shift Mini Cooper and carry out her demanding job responsibilities at a major home improvement store. “I’m all over the place, to the point where my friends and colleagues are saying, ‘slow down,’” she adds, making up for lost time and living life to the fullest.

Study Finds Chronic-Pain Management, Falls and Limited Access to Care Are Critical Issues Among Medically Underserved

Sun, 13 Nov 2022 09:00:00 -0500

To improve the health of a community, the first step is to identify its most pressing needs. To that end, in 2022 Hospital for Special Surgery (HSS) implemented a community-based participatory research (CBPR) approach to assess musculoskeletal health needs, identify health disparities and support the development of initiatives to address unmet needs.

Critical issues included a lack of health education and awareness in managing arthritis and other painful conditions; a high incidence of falls in the community; and limited access to care among underserved populations.

The study, “Assessing Musculoskeletal Health Needs of Underserved Patients & Community Members Using a Community Based Participatory Research Approach,” was presented virtually at ACR Convergence 2022, the annual meeting of the American College of Rheumatology in Philadelphia.

“Musculoskeletal disorders are the most prevalent health conditions in the United States, resulting in financial and social burdens, especially in underserved communities,” explained Titilayo Adeniran, MPH, director of outcomes & data analytics at the HSS Education Institute. “Studies show that musculoskeletal health disparities disproportionately affect women, older adults and racial/ethnic minorities.”

HSS researchers used a mixed-method approach to develop a Community Health Needs Assessment (CHNA). “For quantitative data, we distributed a community survey in four languages—English, Spanish, Chinese and Russian—to assess the socio-demographic characteristics of the populations we serve; health status and quality of life; health behavior and lifestyle; use of and access to care; and health education needs,” explained Adeniran. “For qualitative data, we conducted interviews with 22 community partners, including community-based organizations, city and state agencies and universities.”

The survey was distributed in various ways, including online, via email, using Alchemer panels, in person, and through the mail over a four-week period from January 15 to February 15, 2022. A total of 18,248 patients and community members completed the surveys, with 57% representing a diverse and underserved population.

In addition to the surveys, interviews with community partners provided valuable insights into unmet health needs, Adeniran noted. Community organizations represented all five boroughs of New York City, as well as surrounding areas serving racially/ethnically diverse populations. They represented all age, gender, and socioeconomic groups.

Key findings:

- Chronic pain, osteoarthritis or another form of arthritis were the most common musculoskeletal conditions reported in the survey.
- Among respondents with a musculoskeletal condition, a lack of confidence in managing symptoms emerged as a health need, particularly among medically underserved community members.
- Almost one-third of all respondents reported falling in the past year.
- Those with chronic pain, fibromyalgia or lupus were more likely to report two or more weeks of poor physical and mental health.
- Medically underserved respondents diagnosed with lupus, chronic pain or rheumatoid arthritis were more likely to have used a prescription opioid to manage pain.
- Health education emerged as a major need, with 70% of respondents reporting no participation in health education in the past 12 months. The top reasons were fear of COVID-19 and not knowing about educational programs.
- The top issues impacting respondents’ health and well-being were COVID-19 related issues, social isolation/loneliness, limited places to exercise, and limited access to healthy foods.
- The survey identified a need to address access to healthcare, with 42% of respondents reporting they could not access healthcare in the past 12 months, compared to 8% in a previous survey conducted in 2019. The top barriers were difficulty getting an appointment, lack of affordability or a service not covered by insurance. The need for transportation was also cited among the medically underserved.
- The most common type of discrimination reported in medical settings was that a doctor or nurse was not listening to the respondent. More than half of those taking the survey cited this issue.

“Broad community engagement is crucial to the success of any CBPR approach when assessing the health needs of the community and identifying health disparities,” said Sandra Goldsmith, MA, MS, RD, assistant vice president at the HSS Education Institute. “The results of our study will enable us to raise awareness about disparities that continue to affect our diverse and underserved populations and help us develop community-based initiatives to promote health equity.”

Authors: Titilayo Adeniran, Bertilia Trieu, Sandra Goldsmith and Laura Robbins, Hospital for Special Surgery, New York, NY

Got back pain? It could be caused by arthritis. Here's how to tell

Fri, 28 Oct 2022 16:24:00 -0400

Yahoo! Life interviews HSS rheumatologist Ashira D. Blazer, MD, MSCI, on how to tell if arthritis is causing your back pain and how to get relief.

According to Dr. Blazer, there are a few signs to tell typical back pain from arthritis pain including stiffness in the morning. “Most people who have everyday back pain don't have too much stiffness in the morning," said Dr. Blazer says. “People with typical back pain may feel slightly stiff for 20 to 30 minutes in the morning, but those with pain from arthritis may have pain that lasts more than an hour or two.” She continued “If you have back pain that's waking you up at nighttime, that might be suggestive [of arthritis].” Additionally, it's possible to just have arthritis in your back, however if you have a form of autoimmune arthritis like rheumatoid arthritis or psoriatic arthritis, you may also have a rash. "A lot of times our arthritis syndromes go along with more than just back pain," said Dr. Blazer.

In general, back pain is treated "holistically and with supportive care," noted Dr. Blazer, which include moving regularly, taking over the counter medicines like acetaminophen or ibuprofen and even acupuncture. Additionally, moving regularly and eating a healthy diet can help lower the risk of developing arthritis, added Dr. Blazer, as well as having injuries properly treated. "One of the biggest causes for osteoarthritis progression is injury," stated Dr. Blazer. "We can have injuries or some sort of accident, and that can upset the support tissue in our joints. And often we don't go to physical therapy, we just sort of keep moving." Not taking the time to heal properly after an injury or making sure that your joints are moving well can raise the risk of developing arthritis later in life, she concluded.

Read the full article at Yahoo.com.

What Rheumatologists Want You to Know on World Arthritis Day (and Every Day)

Wed, 12 Oct 2022 13:41:00 -0400

CreakyJoints acknowledges the 26^th annual World Arthritis Day, featuring insights from experts including Iris Navarro-Millan, MD, rheumatologist at HSS, on what patients should know and remember about living with the condition.

Dr. Navarro-Millan emphasized the need to take care of your mental health and heart health, noting the added risk patients with rheumatoid arthritis (RA) have for atherosclerotic cardiovascular disease. “Your mental well-being is as important as your physical. Also, if you have rheumatoid arthritis, taking care of your heart is part of taking care of your RA, too,” said Dr. Navarro-Millan.

Read the full article at Creakyjoints.org.

The 2022 Lee C. Howley Sr. Prize Recipient

Fri, 24 Jun 2022 14:19:35 -0400

Arthritis Foundation presents the 2022 Lee C. Howley Sr. Prize to Mary K. Crow, MD, Physician-in-Chief Emerita at HSS, for her outstanding contributions to arthritis research and for her recent efforts as an expert on the Arthritis Foundation Medical & Scientific Advisory Community (MSAC), which she co-chairs.

This highly coveted award is given annually by the Arthritis Foundation to a researcher whose contributions to the organization’s scientific agenda have led to significant advances in the understanding, treatment or prevention of the various forms of arthritis and related diseases.

Over the years, Dr. Crow’s research has focused on the induction and regulation of human autoimmune diseases and continues to investigate the cellular and cytokine mediators of immune system activation and inflammation in those disorders. Please join us in congratulating Dr. Crow on this honor.

Read the full announcement at Arthritis.org.

Breaking Point: Orthopedics and Weight

Tue, 03 May 2022 16:02:00 -0400

Intellihealth interviews HSS hip and knee surgeon Michael L. Parks, MD, in a “Weight Matters” podcast episode about the link between orthopedics and weight and the correlation between obesity and arthritis.

According to Dr. Parks, “[Arthritis] is multifactorial. Some people are just going to get it, they’re outliers and get it for no reason. There are other people who may get it because it’s been inherited through their parents, their siblings, they have it, and there’s some genetic component. There’s also a mechanical component, whether people were runners or athletic in the past."

He continued, “If you’re just mildly obese — that would be a BMI over 30 — you’re about 8-10 times more at risk. But as your obesity increases, you go up to about 32 times more likely to develop arthritis and the need for a total knee replacement,” Dr. Parks explained, citing data from the Canadian Registry. “That shows to me that there is a pretty clear relationship between the magnitude of obesity, the development of arthritis, and then the progression to a need for total knee replacement.”

He explained, “30% of obese patients undergoing total knee replacements have at least three medical problems like diabetes, coronary artery disease, hyperlipidemia, hypertension, sleep apnea, compared with only 7% of non-obese patients. So they have these medical problems that we have to contend with, and they could have postoperative complications related to their medical issues that they have.”

Dr. Parks said, “I stress to the patients that they don’t have to come in and be thin, this is about them 1) being engaged, and 2) about the change, about them losing weight.”

He continued, “Generally patients will lose 5, even 10% of their body weight, and it allows us then to meet the requirements of many insurance companies, of our own hospital, and to proceed with surgical treatment.”

Dr. Parks advised that weight loss is the most important tool at someone’s disposal to decrease their risk for arthritis or slow down its progress in the early stages.

“Patients often come to me and they say, ‘I can’t lose weight because I have a bad knee or hip and I can’t exercise.’ And I like to tell them right then, that that’s not, in many cases, how you’re going to lose weight. I’ve found with the patients that I see and in my own experience, that it’s going to be dietary,” he explained.

“I also tell them, probably most importantly, to listen to their body. If they’re doing something that’s bad for their joints, it’s probably painful,” he added. “If they’re uncomfortable, they’re probably doing something they shouldn’t be doing.”

Listen to the full episode at Intellihealth.co.

EPISODE 56: TACKLING ARTHRITIS CHALLENGES FOR PATIENTS OF COLOR

Tue, 03 May 2022 11:01:00 -0400

Live Yes! with Arthritis Podcast by the Arthritis Foundation interviews HSS rheumatologist Ashira D. Blazer, MD, MSCI and hip and knee surgeon Michael L. Parks, MD, on-air for an episode about how health disparities impact arthritis care and their origins.

The episode discusses how people of color face more challenges when it comes to managing arthritis, including delayed diagnosis, ineffective doctor-patient communication, mistrust and under-treatment of pain.

Drs. Blazer and Parks provide potential solutions to help minority patients better take control of their arthritis.

Listen to the full episode at Liveyeswitharthritis.fireside.fm.

Is Glucosamine Good for Tendonitis?

Thu, 17 Mar 2022 18:00:00 -0400

Livestrong explains the effectiveness of glucosamine for treating tendonitis according to experts including Dena Barsoum, MD, physiatrist at HSS.

According to Dr. Barsoum, “Research studies on its effectiveness in treating joint pain — specifically related to arthritis — are mixed, with [some] studies showing it is no better than placebo.”

She continued, “I typically do not recommend glucosamine based on these studies. However, when patients ask about glucosamine to treat joint pain (usually in the context of arthritis), I advise that while studies show mixed results, some patients do find it helpful."

"The most common side effect is mild GI upset, which is usually alleviated by taking glucosamine with food," Dr. Barsoum noted.

Dr. Barsoum also suggested alternatives to glucosamine for tendon health. “Supplements with anti-inflammatory effects, such as turmeric and fish oil, can be helpful for joint and tendon pain and inflammation,” she added. "Prior to taking these, however, it is important to discuss with your primary care physician as they can also thin a patient's blood and could interact with other medications."

She underscored, “Maintaining a healthy weight and living an active lifestyle are the most important steps we can take to improve bone, joint and tendon health.”

Read the full article at Livestrong.com.

Menthol for Arthritis: Can It Treat Arthritis Pain?

Thu, 27 Jan 2022 16:10:00 -0500

CreakyJoints discusses the use of menthol to ease joint pain associated with arthritis with guidance from experts including Faye Rim, MD, FAAPMR, physiatrist and pain management specialist at HSS.

Dr. Rim explained, “Menthol works [for pain relief] in two ways. One is as a counter-irritant. When you rub it in, it causes another sensation that distracts from your underlying pain. Menthol also creates a cooling sensation, like an ice pack, that can desensitize nerve endings.”

Dr. Rim said, “It doesn’t provide long-lasting relief, but it may be beneficial to use right before painful activities.” However, she advised checking with a doctor first to make sure that it’s okay to engage in an activity that would otherwise be too uncomfortable.

People with any kind of arthritis can try menthol. “That said, autoimmune or inflammatory arthritis, such as rheumatoid arthritis, is more complex than osteoarthritis, so patients will need to use stronger medications in general,” advised Dr. Rim.

Menthol products come in a variety of formulations. Choosing one may depend on where it will be used and how often. “Some people like the convenience of a patch, some like to rub in creams or gels,” added Dr. Rim.

Read the full article at Creakyjoints.org.

4 Gentle Arthritis-Friendly Exercises to Do in Bed When You’re Fatigued or in a Flare

Wed, 26 Jan 2022 15:09:00 -0500

CreakyJoints features guidance from HSS experts about exercising while experiencing a flare or fatigue from inflammatory arthritis experts including Anna Balakrishnan, LMSW, social work coordinator, and Zachary Rogers, PT, DPT, OCS, CSCS, physical therapist, as part of a video series presented by the Inflammatory Arthritis Support and Education Program at HSS for the Latinx community in collaboration with CreakyJoints Español.

Balakrishnan explained, “In social work, we always think about meeting people where they are. In this case, it’s meeting yourself where you are — and being okay with starting there.”

Rogers shares steps for gentle mobility exercises that can be performed while lying down, including a side-to-side motion, clamshell, double-leg bridges and a knee pull.

According to Rogers, “Every patient knows their body best. If you’re having a flare-up and feeling more pain than you’re used to, but the pain is manageable and not sharp — then yes, you can continue to exercise.”

He said that if the flare is much higher than baseline discomfort — and/or the pain is sharp — then don’t push through it and exercise. In this case, monitor symptoms and reach out to a health care provider for guidance.

Read the full article at Creakyjoints.org.

12 Little Healthy Eating Tips from Nutritionists Who Work with Arthritis and Chronic Pain Patients

Fri, 21 Jan 2022 14:24:00 -0500

CreakyJoints discusses healthy eating habits to help manage arthritis and chronic disease according to experts including Jason Machowsky, RD, CSSD, ACSM-CEP, CSCS, sports dietician and exercise physiologist at HSS.

Machowsky said that seasonings like garlic, ginger, cinnamon, and chili pepper can with flavor and nutrition. “Many spices have components that may have anti-inflammatory properties,” he noted.

Eating fish may help with pain and swelling and help manage disease activity because it is rich in omega-3 fatty acids, “which have been shown to be potentially helpful in reducing inflammation,” Machowsky added.

The American Heart Association recommends eating fish at least twice per week for cardiovascular health. Machowsky noted that options like salmon, sardines, mackerel, and herring are good choices since they are relatively high in omega-3s, but lower in mercury.

Upgrading kitchen tools may help increase comfort when preparing a meal. Machowsky recommended a mezzaluna as a chopping tool to consider, “It’s not as precise, but it gets the job done.” Additional tools that might be helpful include: an electric can opener, rubber grippers to open jars, and two-handled pots and pans. Get more tips here on creating an arthritis-friendly kitchen.

Read the full article at Creakyjoints.org.

7 Hand Exercises to Prevent Arthritis

Tue, 14 Dec 2021 17:53:00 -0500

AARP discusses hand exercises to help prevent arthritis according to experts including Michelle G. Carlson, MD, hand and upper extremity surgeon at HSS.

According to Dr. Carlson, osteoarthritis (OA), the most common type of arthritis, is a condition caused by the natural wearing away of the cartilage that covers the bone. In healthy joints, the cartilage coverings at the ends of the bones match up and glide smoothly against one another.

Cartilage cannot not be built back, but motion can be preserved by keeping the soft tissue in the joint as supple as possible.

Dr. Carlson advised incorporating moves to help maintain hand function, such as a shoulder stretch. She noted the impact of tense shoulders, “Stiffness in your shoulders can lead to all sorts of problems in your extremities.”

Other recommended moves include elbow flexion and extension, prayer and reverse prayer, finger spread, finger touch, thumb stretch and a knuckle bend.

However, some exercises, like squeezing a stress ball, can irritate joints by causing rough cartilage to rub together, noted Dr. Carlson.

Read the full article at AARP.org.

How to Handle an Arthritis Flare, According to Patients and Rheumatologists

Thu, 18 Nov 2021 18:02:00 -0500

CreakyJoints discusses how to manage an arthritis flare and includes guidance from Dee Dee Wu, MD, rheumatologist at HSS.

According to Dr. Wu, “It’s important for patients to report their symptoms accurately to their rheumatologists. From there, it’s up to the rheumatologist to determine what may be causing the flare and the best course of action.”

She explained, “When people are sick with viral or bacterial illness, that can trigger their immune system, causing a flare. And, on top of it, a lot of the patients have to stop their meds when they’re sick, which only fuels the flare.”

Dr. Wu said that flares are rarely a sign of disease progression. She continued, “[A flare] is not necessarily indicative that the disease is progressing. If flares happen frequently, then I would say, more often than not, the medication is not completely controlling the disease and there is room for adjustment.”

Finally, she advised being in touch with a doctor when experiencing a flare. “Being in touch with the doctor earlier rather than later, is, I think, the most important thing to do when you experience a flare. I usually tell my patients not to handle this on their own. I’d rather they come to me than dabble in herbal remedies and things like that,” she noted.

Read the full article at Creakyjoints.org.

Theater dancer recovers from career-threatening injury

Tue, 12 Oct 2021 14:58:00 -0400

Brooklyn Reporter highlights the recovery of professional dancer Erin Eloise Tulberg, who experienced arthritis and hip dysplasia, and received a successful hip replacement performed by Alexander S. McLawhorn, MD, MBA, hip and knee surgeon at HSS.

Tulberg said of the experience, “[Dr. McLawhorn] was great. HSS was very conservative in their approach, which I liked.”

Tulberg tried physical therapy, dry needling and acupuncture, and finally made the personal decision to schedule replacement surgery in September 2020.

Just three months after surgery, she was performing splits, and a year later she feels better than she has in years.

Tulberg said, “Now I’m auditioning again for shows. I’m having callbacks for shows, on hold for a couple of projects. I feel like I’m able to dance better than I was before. I have a full range of motion, if not better than before I had the replacement done.”

She continued about the shattering the stigma of injury in her field of dance, “The strangest thing has been figuring out who to talk to, if I should be vocal about having this surgery. There is certainly a stigma in the dance world that once you have a hip replacement, your career is over. That was my fear.”

Read the full article at Brooklynreporter.com.

New Research into Preventing Post-Traumatic Arthritis After Knee Ligament Injury

Fri, 03 Sep 2021 12:00:00 -0400

The 20 laboratories and 300 personnel that comprise the HSS Research Institute are subspecialized in research that can improve outcomes and quality of life for people with orthopedic and rheumatic conditions. This week, I discussed new and exciting ways we are looking into the prevention of arthritis after knee ligament injury in several sessions at the American Academy of Orthopaedic Surgeons 2021 annual meeting.

Four bands of connective tissue called ligaments support the knee joint: the anterior cruciate ligament (ACL), posterior cruciate ligament, medial collateral ligament and lateral collateral ligament. Ligament damage, such as a tear from a sports injury, makes the knee joint unstable. About half of patients who experience injury to the ACL develop degeneration of cartilage that can lead to knee arthritis over about 15 years. This late effect can be particularly life-altering for young athletes.

HSS research is driven by the fact that we are seeing an increasing number of patients with these problems. Surgery can fix the initial problem of a torn ACL or cartilage and stabilize an injured knee, but we are striving to develop new treatments to prevent post-traumatic arthritis that happens later.

Our researchers have unparalleled access to patient data and tissue samples, making HSS a living laboratory for translating basic research insights into cutting-edge treatments. We’re investigating ways to prevent the development of arthritis after knee ligament injury from three different angles. First, we are analyzing changes at the tissue and cellular level in basic laboratory studies and with use of state-of-the-art quantitative magnetic resonance imaging (MRI) techniques that provide unparalleled information on changes in the microscopic structure of cartilage, going far beyond the diagnostic capability of standard MRIs.

Second, we are conducting biomechanical studies using knees from human cadavers, simulating typical gait and loads on joint surfaces and seeing how injury to ligaments and cartilage damage affects movement of the joint. Simulator technology makes it possible to perform thousands of repetitive movements in a much shorter period than observing changes in patients. The biomechanical studies are being paired with 3D computer modeling, helping us to better understand and predict abnormal stresses on the cartilage that lead to arthritis. There are numerous factors that can lead to post-traumatic arthritis, and our hope is that these models will provide insights into why some patients develop arthritis while others do not.

Third, I am leading a new, multi-institutional clinical research study evaluating the use of platelet-rich plasma (PRP) injections as a potential treatment for reducing the risk of developing knee arthritis after an ACL injury. PRP injections contain platelets concentrated from the patient’s own blood. These platelets provide a rich source of anti-inflammatory chemicals and growth factors known to stimulate repair processes. We want to determine if it can combat the inflammation that is a big culprit behind progressive degeneration in the joint.

We plan to recruit patients with ACL injuries. Patients will be randomly assigned to receive one PRP injection at diagnosis and another during surgery to repair a torn ACL or to receive placebo injections instead and will be followed for two years.

Joint fluid samples will be analyzed over time to look for inflammatory markers by using state-of-the-art laboratory techniques and quantitative MRI techniques that will allow us to detect biochemical changes in cartilage tissue within a year or two, much faster than the development of changes on routine x-rays, which can take up to 15 years. We will combine this information with patients’ symptoms and measures of function, pain and strength.

PRP has great potential, but one of the biggest challenges to date is its variability. As a blood product, the components vary greatly between patients and even on different days from the same patient. To address this issue, we will analyze a small sample of each patient’s PRP in the lab to look for common characteristics that lead to a positive response in warding off the development of arthritis.

We are proud to be leading multiple avenues of research into new ways to prevent knee arthritis in patients with knee ligament injuries.

- Scott A. Rodeo, MD, sports medicine surgeon, Vice Chair of Orthopaedic Research and Co-director of the Orthopaedic Soft Tissue Research Program at HSS

Do You Have Arthritis or Sciatica? Understanding the Difference

Mon, 30 Aug 2021 10:08:00 -0400

CreakyJoints discusses the differences in lower back pain due to arthritis and sciatica according to experts including Dena Barsoum, MD, physiatrist at HSS.

Dr. Barsoum explained, “The medical term [for sciatica] is lumbar radiculopathy, and it often happens when the S1 nerve root in the low back gets pinched.”

She recommended seeing a healthcare provider for a diagnosis, who will “do an extensive [manual] neurological exam so they can assess strength, sensation, and reflexes, and try to understand which nerve or nerves might be pinched.”

Surgery is usually uncommon for sciatica. “More often than not, a patient can get completely better without surgery,” Dr. Barsoum added.

Read the full article at Creakyjoints.org.

Arthritis linked to sleep disruption

Thu, 26 Aug 2021 22:16:00 -0400

CBS News discusses the connection of arthritis and sleep disruption and features management tips from George Cyril, MD, FAAPMR, physiatrist at HSS.

Dr. Cyril explained, “Sleep is so important for people with arthritis because sleep can dictate how you interpret your pain. Poor sleep can cause a vicious cycle with your pain, like dropping your pain threshold.”

From a mental health perspective, Dr. Cyril continued, “Just like pain, sleep can have a direct effect on your pain and your mood, including depression and anxiety, and can create a vicious cycle. It is important to seek help if you have problems you cannot handle yourself.”

He recommended simple ways to try to reduce inflammation in the body, such as avoiding pro-inflammatory like refined sugars, getting moderate exercise and rest, and walking 20-30 minutes a day.

Dr. Cyril strongly advised getting into a routine before bedtime. “It is important to get a great routine with your sleep as far as your hygiene: get into a dark room of a temperature at 68-69 degrees, avoid screens 30-60 minutes before bedtime. Something that could help if you are having a lot of pain is to ice joints and stretch if you have a lot of tension.”

On losing mobility, Dr. Cyril said, “If you get poor sleep it spirals to point you can be disabled, and that happens in half the cases of arthritis.”

Watch the full segment at CBSNews.com.

How to Create an Arthritis-Friendly Bathroom That Makes Life Just a Little Easier

Mon, 26 Jul 2021 17:44:00 -0400

CreakyJoints interviews experts including HSS occupational therapist Daniel Crowe, OTR/L, CHT, who offered tips for creating an arthritis-friendly bathroom to make daily routines easier.

Crowe recommended creating a bathroom that improves daily function, reduces stress on the body, and decreases the risk of falling. “This can have a big impact not just on your performance but also on your confidence and independence for years to come.”

Crowe explained that arthritis can cause deficits in strength, endurance, and balance, which can make it difficult to get in and out of a shower-tub combo and maintain a standing position while showering. He suggested an adjustable shower bench, noting, “The transfer bench provides you with support as you bring your legs into the shower from a seated position, eliminating the need to step up and over the tub.”

He also said to consider installing grab bars where needed. “Grab bars provide a stable point at which a person can utilize not just their lower extremities but also their arms. Instead of having two points of contact (right foot and left foot on the floor), you now can have three or four depending on the setup with the addition of one or both arms being involved.”

On the toilet, lowering down or raising from a low seat can put a lot of stress on load-bearing joints. “The lower the seat, the more the body must work and the more stress is involved to accomplish this task,” he said. Investing in an elevated toilet seat can provide an extra two to six inches, which will reduce the effort of going up and down. “While it doesn’t seem like much, this extra height can make all the difference,” he added.

Another easy addition is adding non-slip mats. He advised, “[Placing] non-slip mats in the tub, by the toilet, and by the sink is an easy and effective ways to prevent falls in areas that can easily have moisture build-up or spills on the floor resulting in a slip.”

When it comes to small tasks like gripping a toothbrush and brushing hair, “Gripping and pinching can create forces that may result in symptoms in the joints within the fingers and thumbs,” said Crowe. “Adding grips [to commonly used bathroom tools] can decrease the amount of force needed to grip and manipulate these items and therefore decrease the amount of stress placed on the joints.”

There’s no one solution for making a bathroom more arthritis-friendly, and “Many incidents can be avoided by slowing things down and being aware of your environment and what you’re trying to accomplish,” advised Crowe.

Read the full article at Creakyjoints.org.

What Is an Occupational Therapist, and How Do They Help People with Arthritis?

Tue, 20 Jul 2021 09:29:00 -0400

CreakyJoints explains how occupational therapists (OTs) help people with arthritis according to experts including Theodore R. Fields, MD, FACP, rheumatologist at HSS.

A rheumatologist may suggest seeing an OT to help make everyday tasks easier and cut down on the pain, stress, and fatigue that comes with having an inflammatory or degenerative condition.

When it comes to pain relief, Dr. Fields said that OTs may engage in pain-reducing treatments such as wax baths and heated corn husks for painful hands.

Read the full article at CreakyJoints.org.

Arthritis and Tendonitis: What’s the Difference?

Wed, 14 Jul 2021 08:37:00 -0400

CreakyJoints discusses the differences between arthritis and tendonitis according to experts including Dena Barsoum, MD, physiatrist at HSS.

Dr. Barsoum explained what to expect with a physical exam and that is important to pay attention to the specific location of pain. She said, “Tendonitis can happen almost anywhere in the body, but it often happens around the joints at the hip or in the hamstrings, shoulder, elbow, or around the foot and ankle.”

For tendonitis treatment, Dr. Barsoum advised caution with injectable corticosteroids. “We never want to inject steroids into a tendon because it can cause it to tear,” she noted.

Another newer treatment is platelet-rich plasma (PRP). “Tendons have a poor blood supply, so when a tendon gets injured, it tends to stay that way for a while. We don’t really know if PRP can heal a tear, but we do have evidence that it’s helpful for pain,” added Dr. Barsoum.

Read the full article at CreakyJoints.org.

How to Create an Arthritis-Friendly Kitchen That Makes Meal Prep and Cooking a Little Easier

Tue, 06 Jul 2021 18:37:00 -0400

CreakyJoints interviews experts including HSS occupational therapist Preston Lockwood, OTD, OTR/L, CHT, who offer tips for creating an arthritis-friendly kitchen to make meal prep and cooking easier.

Lockwood recommended using lightweight pots and pans, with two handles, to ensure the weight is more evenly distributed across the joints as you lift and carry cookware.

Additionally, using kitchen tools with wide, lighter handles for a better grip can be helpful, however you don’t have to always buy a new set of utensils. Lockwood suggested taking a washcloth and wrapping it around the handle of the tool to increase the diameter by ¼ inch or so. “By increasing the diameter, you’re easing the pressure and offloading the tension across the joint space,” he said.

“Any time you can cut out an entire step and save your joints, it’s always a good idea,” he continued, such as purchasing precut and pre-peeled produce. If unable to purchase everything precut or pre-peeled, prioritize the fruits and vegetables you eat the most often or that give you the most trouble to cut or peel.

Lockwood also mentioned some of his clients have trouble opening the knob on their dish soap. He suggested transferring the detergent to a container with a pump dispenser, and using the palm and force from the shoulder and arm verses small finger joints. Opening a jar with arthritis can also be tough, which Lockwood recommended investing in a mounted jar opener that rotates and pops it open for you.

Read the full article at Creakyjoints.org.

How to Create an Arthritis-Friendly Bedroom That Makes Life Just a Little Easier

Tue, 29 Jun 2021 11:28:00 -0400

CreakyJoints shares arthritis-friendly tips for creating a safer and more comfortable bedroom according to experts including Varsha Seemangal PT, DPT, MST, USATF-L1, RRCA Coach, physical therapist at HSS.

According to Seemangal, symptoms such as achy, stiff, swollen joints can make it hard for people with arthritis to find a comfortable position and fall asleep. She said it is common to wake up frequently through the night due to discomfort, and this can be known as painsomnia, or the inability to sleep due to pain in your body.

“A firm mattress is advised because it supports the joints of the body better than a soft mattress, which will allow the body to sink into it, thus creating an unsupportive environment for the joints while the body is relaxed,” added Seemangal.

Consider height when selecting a new bed. “Selecting a bed that is too low would also make it difficult to go from sitting to standing in the morning, when most arthritis sufferers awake with increased stiffness in their joints,” she said.

Seemangal also recommended lightweight bedding. “Sheets and blankets, as well as sleepwear, are all recommended to be a breathable fabric to allow for air flow from the body throughout the night.”

And for pillows, “In general, you want your pillow to be a height that supports a neutral spine position, especially for people with arthritis in their neck.”

Finally, the room temperature should be considered. People with arthritis should consider sleeping in a slightly warmer room because, “colder temperatures can cause the joints to stiffen and tighten up even more, leading to a more uncomfortable sleep,” noted Seemangal.

Read the full article at CreakyJoints.org.

How to Make Exercising with Arthritis a Whole Lot Easier

Tue, 08 Jun 2021 17:51:00 -0400

CreakyJoints features tips on how to make exercising with arthritis easier according to experts including HSS exercise physiologist Kelyssa Hall CSCS, CES.

Staying active is an important management tool for arthritis. Hall explained, “Lack of exercise can cause arthritic joints to become more stiff and painful. People [with arthritis] who avoid exercise are setting themselves up for more discomfort and possible injury down the road.”

A key benefit of exercise is stronger bones. According to Hall, “Maintaining bone strength is important in preventing weaknesses in the body that can lead to falls and possible fractures.”

It’s also important to listen to your body if you feel persistent pain, and not to over-exercise. Hall noted, “It is very important to not over-exercise because too much repetitive stress on the joints and muscles can cause flare-ups of arthritis symptoms. Over-exercising can cause the muscles to be overly fatigued and less supportive to the joints resulting in more wear and tear.”

Hall recommended investing in comfortable workout wear that is not too restrictive and allows you to move through a comfortable range of motion in a variety of positions.

Pre-and-post workout steps can help with a successful workout. Hall explained, “Pre-exercise stretching can be done after about five minutes into the warm-up and should include stretches that focus on several different muscles including the hamstrings, quadriceps, calves, glutes, torso, chest, and shoulders.”

Hall offered additional tips and exercises for working out, and advised not to force a stretch or movement pattern or to work through pain. “Always move through a comfortable and pain-free range of motion during all exercises and mobility work,” she advised.

Hall also recommends applying cold packs after a workout to help prevent inflammation and sooth joints.

Read the full article at CreakyJoints.org.

Risks From Common Heartburn Drugs

Mon, 07 Jun 2021 17:55:00 -0400

Arthritis Foundation discusses risks and alternatives for proton pump inhibitors (PPIs), drugs commonly used to treat heartburn and acid reflux disease, and are also prescribed for some people with arthritis and other conditions who regularly take nonsteroidal anti-inflammatory drugs (NSAIDs).

Some experts think PPIs are overprescribed and should be reserved for the most serious conditions like erosive esophageal disease and bleeding ulcers.

According to HSS rheumatologist Theodore R. Fields, MD, FACP, acid-blocking drugs called H2 receptor blockers are a safer choice for people with arthritis who use NSAIDs.

He said, “Since data came out increasing the list of potential side effects of PPIs, such as low magnesium, increased kidney risk, and increased fracture risk … many [doctors] will substitute [H2-blockers] for PPIs.”

Read the full article at Arthritis.com.

New York Red Bulls Expand Medical Staff with Additional Team Physicians from Hospital for Special Surgery

Fri, 04 Jun 2021 18:10:00 -0400

The New York Red Bulls announced today the expansion of their Medical Staff with additional Team Physicians from Hospital for Special Surgery (HSS). Three orthopedic surgeons have joined the club’s Medical team led by Dr. Riley J. Williams III, Medical Director, and head orthopedic surgeon. HSS has served as the official hospital of the major league soccer team since 2006.

“We are dedicated to providing outstanding medical care to elite athletes, and our designation as a FIFA Medical Centre of Excellence by the Feder the Fédération Internationale de Football Association recognizes our expertise and enthusiasm in treating professional soccer players,” said Dr. Williams. “With the new members of the medical team, we will continue to provide the high level of care Red Bull players depend on to be their best on the field and to get back in the game if they sustain an injury.”

A nationally recognized leader in cartilage repair and restoration, Dr. Williams specializes in knee, shoulder, and elbow surgery at the HSS Sports Medicine Institute. Along with the Red Bulls, Dr. Williams serves as medical director and head team physician for the Brooklyn Nets (NBA), Long Island Nets (G-League), and New York Liberty (WNBA), and as a team physician for USA Basketball.

The new members of the medical team are highly specialized in treating a wide range of orthopedic injuries.

Danyal H. Nawabi, MD, an orthopedic surgeon in the HSS Sports Medicine Institute, specializes in knee, shoulder, and hip surgery, including arthroscopic procedures and joint replacement.

Orthopedic surgeon Andrew J. Elliot, MD, treats conditions of the foot and ankle, including athletic injuries, bunions, tendon tears and ruptures, hammertoes, osteochondritis dissecans, fractures and arthritis.

Benedict Nwachukwu, MD, is an orthopedic surgeon and specialist in hip, knee and shoulder surgery at HSS. Along with the Red Bulls, Dr. Nwachukwu serves as a team physician for the New York Liberty and medical consultant for the National Basketball Players Association.

About the New York Red Bulls

The New York Red Bulls are one of 27 teams in Major League Soccer (MLS). RBNY, one of the ten charter clubs of MLS, have competed in the league since its founding in 1996. The Red Bulls play home matches at Red Bull Arena (RBA) in Harrison, New Jersey.The three-time MLS Supporters' Shield Winners are owned by the Austrian beverage company Red Bull for which the team is named. The New York Red Bulls offer one of the nation's premier youth soccer development programs, from local soccer partnerships across New York and New Jersey to Regional Development Schools and the Red Bulls Academy teams.

9 Tips That Make Cleaning with Arthritis Much Easier

Tue, 25 May 2021 08:00:00 -0400

CreakyJoints discusses practical solutions to make house cleaning less difficult or discouraging for people living with arthritis with experts including HSS physical therapist Alexis DiClemente, PT, DPT, OCS.

DiClemente explained, “Pain and swelling in the joints can limit a person’s range of motion, making certain positions difficult or painful.”

She said, “If someone is already experiencing arthritis pain in their day-to-day life, cleaning with arthritis can be very overwhelming, especially since it may cause the person to feel more pain and fatigue afterward. Persistent pain and fatigue can impact a person’s quality of life, as well as their emotional well-being.”

According to DiClemente, there are many arthritis-friendly gadgets and tools available that can help people with arthritis pain to be more independent and make everyday tasks less challenging.

When moving around, DiClemente recommended using proper body mechanics for lifting and bending: “Bend the knees and hinge at the hips instead of rounding your back, which can put adverse strain through the spine.”

Most importantly, DiClemente advised to do things at your own pace and, “Remember that it is okay to take breaks, reschedule cleaning tasks for a day when pain is less, and ask for help. Be kind to your body and try not to get upset if everything isn’t perfect.”

Read the full article at CreakyJoints.org.

Hand Surgeon Designs New Wrist Implant

Fri, 21 May 2021 11:28:00 -0400

The Greenwich Sentinel highlights Scott W. Wolfe, MD, chief emeritus of the Hand and Upper Extremity Service at HSS, for performing the first wrist-replacement surgery using a new implant he co-designed cleared by the Food and Drug Administration (FDA), called KinematX™.

Dr. Wolfe explained the “dart-throwers motion” and its significance for successful implants, after decades of studying the movement of the human wrist, he attributes this key movement as a reason why older wrist implants have failed.

One reason the human wrist is capable of such complex motion is that it is actually comprised of two joints…the radiocarpal joint…that needed to be duplicated in order for the new implant to succeed – which was a big a-ha moment for Dr. Wolfe. “And so the design of the prosthesis basically emulates that particular joint, and, in so doing, it allows the dart throwing motion.”

Mark Eisen, who suffered from severe arthritis in his right wrist, traveled to HSS for the successful surgery. “Pretty early on, I realized, you know, this guy is one of the top guys in the world for this,” said Mr. Eisen about Dr. Wolfe.

Dr. Wolfe is optimistic that Mr. Eisen will one day get back to golfing and other activities, and concluded, “We have every reason to believe that this will be an important contribution to science and to clinical practice.”

Read the full article in Greenwich Sentinel.

Additional coverage: Greenwichtime.com and Westfaironline.com.

12 Ways to Make Getting Dressed with Arthritis a Whole Lot Easier

Thu, 22 Apr 2021 18:54:00 -0400

CreakyJoints features tips to make getting dressed easier for patients with arthritis according to experts including HSS physical therapist James Gallegro PT, DScPT, MSPT, CMP, OCS, CSCS.

In general, you’re going to have a harder time with stiffer or tighter clothing that’s tough to pull up over or slide your legs and arms through, explained Gallegro, suggesting to opt for clothing made of soft stretchy fabric.

Gallegro advised to take advantage of dressing aids. “There is no shame in using devices that make your life easier,” he noted. “It takes initiative to manage your condition and get the help you need to cut off the frustration on top of the pain and stiffness.” In addition to searching the internet, he recommended checking medical supply websites to uncover even more helpful gadgets and dressing aids that may be covered by your insurance.

Safety is key, so you want to put yourself in a position where you can maintain your balance and move with purpose. Gallegro recommended sitting down when putting on pants and shoes. “It might take a little extra time,” he cited, “but you’ll have success in a much more organized way instead of feeling like you are losing your balance when you put your leg in your pants or stumbling because you couldn’t get your shoe on.”

Gallegro also advised to allocate enough time to get dressed to prevent the added frustration that can result from being rushed, stretch and move for a half hour to loosen stiff joints in the morning, and ask for help when you need a hand.

Read the full article at CreakyJoints.org.

HSS Hand Surgeon Performs First Surgery with FDA-Cleared Wrist Replacement Implant He Designed

Tue, 20 Apr 2021 10:00:00 -0400

Sixty-nine-year-old Mark Eisen says he waited seven years for a surgery he hopes will change his life. Last week, he had the first total wrist replacement with KinematX™, a new implant co-designed by Scott W. Wolfe, MD, chief emeritus of the Hand and Upper Extremity Service at Hospital for Special Surgery (HSS). Dr. Wolfe performed the surgery on April 15.

Severe arthritis in his right wrist caused ongoing pain and prevented Mr. Eisen, who lives in Atlanta, from engaging in activities he enjoys. He is right-handed, which makes it even more difficult. Seven years ago, he started to investigate treatments and learned about total wrist replacement surgery. But unlike knee and hip replacements, which are common and have excellent outcomes, wrist replacement surgery has not enjoyed the same degree of success.

Mr. Eisen’s online research prompted him to take his first trip to New York for a consultation with Dr. Wolfe in 2014. Mr. Eisen had read about Dr. Wolfe’s extensive research into how the wrist moves and learned that he and his long-time colleague and co-inventor, Joseph J. (Trey) Crisco, III, Ph.D., Director of Bioengineering at the Warren Alpert Medical School, Brown University and Rhode Island Hospital, were working on designing a new, more durable wrist replacement. Mr. Eisen has been following their progress for the past seven years.

Last year, the KinematX™ Total Wrist Arthroplasty System, which is manufactured by Extremity Medical, LLC, received 510(k) clearance from the US Food and Drug Administration (FDA). The design is the culmination of three decades of award-winning research by Dr. Wolfe and Dr. Crisco. Over the years, they and their colleagues have received more than $10 million in research grants from the National Institutes of Health to study the wrist.

Mr. Eisen is looking forward to regaining the use of his wrist. “It had become more painful over the years, with the pain often radiating up to my forearm,” he explains. “My wrist movement was severely restricted, making it difficult to do anything that required me to bend my wrist. Everyday activities like cooking, working around the house or picking up a pot of coffee with my right hand were difficult and painful.”

Dr. Wolfe believes the KinematX™ has advantages over traditional implants. “Our extensive research into how the wrist moves helped us design a device that more closely matches the anatomy and motion of a normal wrist,” he explains. “This should allow for more natural movement and increased durability compared to currently available implants. Some studies report failure rates of 50% within 5 to 10 years, mainly due to loosening of the implant components.”

“In our view, the KinematX™ will be a game changer in the field of wrist replacement surgery,” said Doug Leach, managing director of Biomechanical Innovation at the HSS Innovation Institute. “Current wrist replacement devices are relatively dated. The new implant design leverages the clinical and bioengineering experience of Drs. Wolfe and Crisco, their seminal research, and modern-day engineering and design principals of total joint replacement in general.”

Wrist arthritis is one of the most common and debilitating conditions treated by hand surgeons, affecting about 5 million people in the United States, according to Dr. Wolfe. A fusion of the wrist bones can alleviate pain, but patients are often limited in performing some activities. Wrist joint replacement surgery was proposed five decades ago as an option to relieve pain and restore function.

When Drs. Wolfe and Crisco set out to design a better wrist replacement, the first step was to unravel the complexity of how individual bones move in a normal wrist and in one that has sustained an injury. Their research led to the design and validation of a noninvasive three-dimensional motion analysis system to measure wrist kinematics, which describes the wrist motions necessary for a wide range of activities. Armed with that information, they sat down at Dr. Wolfe’s kitchen table and started sketching out their idea for a novel wrist replacement.

The wrist is highly complex, made up of more than a dozen individual joints formed by eight small bones that collectively make up the wrist. It was previously believed that the wrist moved the hand in two different planes – up and down or side to side. The research by Drs. Wolfe and Crisco demonstrated that during many activities, such as throwing a ball, hammering a nail or pouring a glass of water, the wrist doesn’t move in just one of these directions. It accomplishes the action by combining movements in both planes.

“Traditional wrist replacements often constrain the wrist to move in one plane at a time, and this puts stress on surrounding joints," said Dr. Wolfe. “The increased loads on the implant-bone interface often lead to prosthesis loosening and mechanical failure. In addition, traditional implants often make it difficult or impossible to return to some activities, such as tennis or golf.”

The KinematX™ is the only wrist replacement that is computer-designed to mimic the kinematics, or motion, of a human wrist – movements that are instrumental in throwing, hammering and other high-performance activities, according to Dr. Wolfe. The unique design should enable the implant to be more durable than traditional wrist replacements.

Surgery with the KinematX™ entails replacing the proximal carpal row bones of the wrist, which are those most severely affected by osteoarthritis. The device utilizes modular components in various sizes to replicate the complex anatomy of the wrist and allow the motion necessary for occupational, recreational and household activities.

The Innovation Institute at HSS played a key role in the development of the new wrist replacement, working closely with Drs. Wolfe and Crisco to obtain a patent for their research and design ideas. The patent for the wrist replacement was licensed to Extremity Medical, LLC, a privately funded medical device company in New Jersey.

“Our goal is to work with talented HSS physicians, inventors and entrepreneurs to empower them to develop innovations in musculoskeletal health that could improve or even revolutionize patient care,” Mr. Leach said.

A patient registry will be established at HSS and other leading medical centers across the country to track data on outcomes. Mr. Eisen says he will gladly report his progress. After recovery, he looks forward to going back to playing golf, fishing, working around the house and waxing his car.

To see a video of Dr. Wolfe discussing the new wrist replacement, visit: https://www.youtube.com/watch?v=BWgd-NtW5PI