No bones about treating joints

While people with aching limbs or joints are not necessarily candidates for joint replacement surgery, there is a place in Minot where they can go that’s devoted to the non-surgical care of osteoarthritis and osteoporosis. Trinity Orthopedic Associates recently launched a special clinic renamed the Trinity Bone Health Clinic, formerly the Osteoarthritis & Osteoporosis Clinic.

According to Dr. E. Dexter Scott, orthopedic surgeon at Trinity Hospital, the clinic’s name was changed to help make people aware of how to keep their bones healthy and as a way to be proactive with bone health. The O&O Clinic name was also confusing to people, he added, but both osteoarthritis and osteoporosis will still be treated at the clinic.

Osteoarthritis is a degenerative condition characterized by the wearing away of cartilage inside the joint. Osteoporosis is a disease of the bones that increases the risk of fractures. While Trinity’s orthopedic specialists have always provided non-surgical treatment for these two conditions, the Bone Health Clinic will be unique.

“Until now we haven’t had a clinic dedicated to the care and management of osteoarthritis and osteoporosis, two very common conditions that can occur together or separately,” Scott said. “With people living longer and adopting more active lifestyles, we see these conditions developing in more people. What this clinic intends to do is provide people a clear and efficient pathway to diagnosis, and then to offer a full range of non-surgical treatments before joint replacement becomes an option of last resort.”

The Bone Health Clinic serves baby boomers and others with orthopedic complaints, such as people with a past fracture, Scott said. If a person has had a fracture, he or she is more likely to have another. If a healthy person falls from a standing position, he or she should not suffer a fracture, Scott said, so a fracture from a fall is a warning sign.

Fractures in this country are a huge issue, Scott said. “The cost is astronomical and the cost to their lives is also astronomical. There has been a huge increase in numbers of fractures and the cost for caring for people with fractures has increased,” he said. “It would be considered an epidemic.”

Patients who visit the Trinity Bone Health Clinic will receive a medical assessment that includes a health history and examination. Patients who are positively diagnosed will be offered a wide range of conservative treatments, including medications, injections, physical therapy and recommendations for lifestyle change such as weight loss or exercise.

Prevention is a big focus with osteoarthritis and osteoporosis, and screening for them is a big part of prevention. Screening helps identify people who are at risk and health care providers are able to offer treatment options. Prevention also starts with a healthy lifestyle, such as avoiding smoking, alcohol and drugs; getting fresh air and exposure to sun; and drinking water, maintaining a healthy weight and eating healthy food. Also included in that healthy lifestyle is having a safe home for the elderly, a place that is free of tripping hazards or slippery floors.

Scott said that with so much focus on joint replacement, people may not be aware of the many good options available that do not involve surgery. “We have new medications available for osteoporosis, and a number of companies have come out with improved orthotic devices,” he said. Some are designed to add heat to a joint, while others have special packs with medication that can be absorbed into the joint to provide support and give relief to limbs and joints.

Television and other media are being swamped with advertisements for treatment options of osteoarthritis or osteoporosis, but not everyone qualifies, and the treatments are often expensive, Scott said. “We try to make sure all options are fully considered before giving people medications,” he said. “We have to be careful and monitor the treatment.” With any new treatment, there needs to be knowledge and experience, he said, and part of the time spent with patients is weighing the pros and cons of a treatment option.

According to Scott, government regulation is another key reason for establishing the Bone Health Clinic. The Centers for Medicare and Medicaid Services has tightened reimbursement for major joint replacement surgery, requiring documentation of medical necessity. “Patients now have to be properly screened and diagnosed, and all other treatment avenues must be exhausted before a joint replacement will be approved through Medicare,” he said. “Not only do we want to make people aware of their non-surgical alternatives, we want to make sure that if they do decide to have a joint replacement down the road, appropriate documentation is in place.”

“There is no cure-all to strengthen people’s cartilage for a lifetime,” Scott said. “But there is a lot of research being done and new treatments.”

The bone health clinic will be offered Thursday afternoons twice a month, but will expand as the need arises. To access the clinic, people can seek a referral from their primary care provider or call Trinity Orthopedic Associates at 857-5500.