Interview Transcript

The Centers for Disease Control reports that 30 million people in the United States have osteoarthritis. And joining us is Dr. Karl Koenig, he’s an orthopedic surgeon and medical director at the UT Health Austin Musculoskeletal Institute.

Thank you so much for joining us. Can you explain what this condition is?

Sure, Tom, thank you very much for having me. So, this is a very good question and many of our patients have the same one. Arthritis comes in two major classes, one of them is inflammatory arthritis which is when a person’s immune system goes awry and the cells begin to attack the cartilage in their joints. You might have heard this referred to as rheumatoid arthritis or psoriatic arthritis. That is a more rare cause. The much more common cause is what’s called osteoarthritis or the general wear and tear that you see on a joint.

At the end of every bone, there is a smooth surface called cartilage, which you can see here. You can see what the cartilage is supposed to look like and allows two bones to glide past each other. without having any friction. And that works really well for quite a while, but over your lifetime you can have damage to your cartilage, you can start to have aged, and the cartilage can start to wear away and can actually start to cause pain. This is what osteoarthritis is and many people experience it over the course of time.

The causes are a combination of things, while it can be due to your genetics, some people are more prone to getting osteoarthritis than others. There is no specific gene or test that we can do to say, “Oh your going to have it.” It certainly happens to everyone as we age. The Cartilage wears away and there are mechanical forces that have a lot to do with it. Being overweight, doing really hard labor, or those kinds of things can cause the cartilage to wear out a little bit faster. Though the combination of all those things is what can really lead to the condition.

So if you get this condition, are diagnosed with it, what can you do about it?

It’s a great question, so a lot of people think, “well my joint hurts so I should do less,” and it’s kind of the opposite that is true. You really need to stay active and do things, so what we really like to do is make sure to stay healthy and active in their lives. The cartilage is surrounded by something called synovial fluid, which is actually how it gets its nutrition. So moving the joint actually move that fluid around and allows the cartilage to stay healthy, slowing down the degeneration. Also strengthening the muscles around the joint very specifically with exercise can prevent the symptoms and slow the condition as you move forward. And there are other things we can offer such as medications to help with the inflammation. If things get really severe, sometimes you might want to have an injection of medication into your joint and then at the real end stage, if it’s interfering with your quality of life, things like joint replacement surgery can be helpful.

If you think you have this should you see your doctor and then if they recommend them to you, I guess what’s that initial process?

Absolutely, it depends a lot on how much it’s affecting you. Because, simple when I get up in the morning and my joints are a little stiff, then I can walk around and they loosen and feel better, then, I don’t know if you necessarily need to see your doctor for that. But if you find your symptoms are interfering with your quality of life, your ability to go out and walk and be healthy and do the activities you like to do then that’s when you really want to seek care. At the musculoskeletal institute at UT Health Austin, we actually have a whole team of people who are dedicated to doing this, because the things you can do for treatment are provided by different specialists and so we have a physical therapist on our team, if you decide to do exercises, we actually have a dietitian on our team if your going to try to work on your weight and try to lose that. If you have a problem that is so bad it needs surgery then we have a surgeon on our team. That’s when you should seek care, if you find that you’re not able to do the things that you need to do then we really want to help you with that.

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