Dr. Emran is joined by his nurse, Sarah, who is on the show to talk about her 23-year-old sister’s battle with Rheumatoid Arthritis.

Rheumatoid Arthritis is an Autoimmune Disorder which means the body is attacking itself. Rheumatoid means that the body is creating antibodies against itself which include organs, blood, joints, or muscles. In this case, it manifested itself in her right knee. The antibodies are destroying her knee to the point that she can not extend it and has trouble walking.

To treat the Rheumatoid Arthritis, Sarah’s family has tried many different tactics. One was a “scope” which shaved off the inflammation in her knee, but this treatment did not work. Her Rheumatologist then suggested that she start taking steroids. This is because steroids are immunosuppressants which can be combined with biological agents to calm down the antibodies. The struggle is that Rheumatoid is progressive and over time steroids may not work. Sarah’s sister has been through a variety of treatments including physical therapy, splints, and surgeries, all to no avail. Upon consultation with an Orthopedic Surgeon, it was suggested that she have knee replacement surgery as a last resort.

Knee Replacement Surgery or Knee Arthroplasty is an intensive surgery that removes bones in the knee. This includes removing the thigh bone, the kneecap, and the shin bone and replacing it with a “new knee” fit to the body. The new knee is made of titanium and other polymers to serve as a cushion.

Rheumatoid Arthritis is the second most common reason for knee replacement surgery.

Sarah’s family was a bit reluctant to rush into surgery because of the intense healing process. Dr.Emran pointed out that 600,000 knee replacement surgeries are performed each year and most result in significant improvement. However, the healing process will involve physical therapy and other risks such as blood clots or infections.

Sarah was concerned about her Sister’s steroid use and if it would need to continue after surgery. Dr. Emran addressed that steroid use over a long period of time can cause brittle bones, so her doctor will probably try to get her off them. She also runs the risk of having Rheumatoid flare-ups in the future.

Sarah was also curious about how long a knee replacement lasts. Dr. Emran said that doctors will often delay surgery as long as possible because, just like regular bones, the orthopedic hardware wears out. Knee Replacements usually last 20-30 years. Because Sarah’s sister is so young, she will likely have to get another knee surgery in the future.


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