Osteoarthritis: A Growing Epidemic

Osteoarthritis is the leading cause of disability in the United States. More than 33 million Americans are living with this progressive condition which is triggered by the gradual deterioration of the cartilage that cushions the joints leading to significant pain and disability. Many people incorrectly assume that joint pain simply comes with age, but reduced mobility, independence, and quality of life doesn’t have to be your fate.

Osteoarthritis may be common, but living with pain doesn’t have to be.  Dr. Noelle Guthrie, an orthopaedic surgeon specializing in hip and knee arthritis, helps patients understand all their options – from prevention and lifestyle modifications to injections to advanced surgical treatments when indicated.  Her focus is on helping patients stay active, maintain independence and do the activities they enjoy. 

Understanding Degenerative Joint Disease

Osteoarthritis, sometimes called degenerative joint disease (DJD), occurs when the

cartilage that cushions the end of the bones wears away. As that protective layer breaks

down, the bones will begin to rub against one another, leading to pain, swelling and loss

of function.  This final stage is referred to as “bone-on-bone.” Since this process is

gradual, early evaluations are important in order to slow down the process.  

While arthritis has traditionally been associated with older adults, today's patients are

developing symptoms and seeking treatment earlier than previous generations. In fact,

adults ages 50 to 65 now represent one of the fastest-growing groups undergoing joint

replacement surgery. 

As people live longer, remain active later in life, and rates of obesity continue to rise,

more individuals are experiencing joint pain that affects their ability to stay independent,

exercise, travel and enjoy daily activities.  

As Americans live longer and stay

active later in life, demand for joint

replacement continues to grow. By

2040, annual knee replacements

are projected to exceed 3.4 million

and hip replacements nearly 1.5

million.

Dr. Guthrie's approach focuses on

helping patients maintain mobility

and independence through a

combination of prevention, lifestyle

changes, exercise, weight

management, physical therapy, injections, and other non-operative treatments, while offering joint replacement surgery when appropriate. She begins by asking a simple question:"What matters to you?" Understanding a patient's goals helps guide treatment decisions and ensures care is

focused on preserving the activities that bring meaning, purpose, and enjoyment to daily life.

Symptoms You Shouldn't Ignore

One of the biggest mistakes patients make is delaying an evaluation.

Pain is the most common symptom of arthritis, whether it affects the entire joint or only part of the

joint.

Other symptoms include:

• Stiffness and swelling

• Grinding, clicking, or popping sensations

• Difficulty going up and especially down stairs or hills

• Limping

• Bow-legged or knock-kneed deformities

• Difficulty performing daily activities

  
  

Early evaluation creates opportunities for prevention, allowing patients to explore lifestyle changes, exercise programs, injections, and other treatments before symptoms progress and function declines.

Don’t ignore these symptoms–persistent pain or loss of function are serious concerns to share with a doctor.

The Ripple Effect of Arthritis 

Untreated arthritis affects far more than the joint itself. As mobility declines, everyday activities become harder, and you become less active. This loss of movement can contribute to falls, weight gain, diabetes, heart disease, osteoporosis, and loss of independence. Early evaluation helps slow down the wear, preserve mobility, overall health, and quality of life.

"Osteoarthritis is progressive, and not all or nothing," Dr. Guthrie explains. "The earlier patients understand their condition and treatment options, the more opportunities they have to reduce pain and slow the progression."

Can You Delay Joint Replacement Surgery?

Healthy habits are key for reducing symptoms of arthritis and slowing cartilage deterioration.  

“It’s never too late to get stronger, become more active, lose a little weight, and focus on an anti-inflammatory diet,” says Dr. Guthrie. “The best thing you can do for your joints is increase muscle strength around them which will help protect your joints and act as “shock absorbers”. Movement is medicine, and strength is protection.” 

Weight management and regular exercise play

a major role in joint health. Every additional pound of body weight increases the force placed on the hips and knees. For example, every pound of body weight causes your hips and knees to experience 5-6 pounds of pressure. So losing 10 pounds can remove up to 60 pounds of pressure on your joints. Strong muscles also help absorb stress and protect joints. Low-impact activities such as walking, swimming, cycling, yoga, and Tai Chi can improve strength, balance, flexibility, and mobility. 

Dr. Guthrie also encourages patients to seek care early. Early evaluations are key to know “where you stand” as far as how much cartilage you have and ways to slow down the progression to the end stage of bone on bone. Remember that not everyone needs joint replacement surgery to start with, and there are an increasing number of non-operative treatments—including injections such as PRP – a natural anti-inflammatory- and newer cryotherapy—that can provide meaningful pain relief, improve function, and help patients stay active longer before surgery is needed.

When Is It Time for Joint Replacement?

For some patients, even the most tried and true non-operative treatments eventually stop providing adequate pain relief. When X-rays show little to no cartilage, and pain stops responding to non-operative treatments and lifestyle changes, it’s likely time to consider joint replacement surgery.  

The leading factor in deciding about surgery is pain.  When pain starts affecting sleep, limiting independence, or preventing participation in daily activities. This is the time when joint replacement becomes the best option to restore function and improve quality of life. Ultimately patients are the ones that tell us when it’s time for surgery, since in the end, it’s a pain driven decision and this is why shared decision making is such an important process with your providers.

Total hip and knee replacement surgery remains the most effective treatment for pain from arthritis, offering patients the opportunity to eliminate pain, regain mobility, and return to the activities they love. We can “cure” you of your arthritis by removing all of the arthritis and resurfacing the joint. After surgery, most of our patients say that the process was “life changing”.

If the thought of surgery brings concerns about recovery, it's important to know that advances in joint replacement have transformed the patient experience. Our team not only prepares patients for surgery, but also provides the most up to date surgical and pain management techniques.  Remember that the best prepared patients (and families) have the fastest recoveries and best outcomes. 

One unique service offered by Dr. Guthrie is pre-operative cryotherapy (cold therapy) that is an advanced pain management technique available through only a small number of orthopaedic surgeons nationwide offer. Dr. Guthrie is one of the only surgeons in our region to provide this kind of pre-operative pain management treatment.

In addition, with the newer rapid rehab and multi-modal pain management programs, most patients now return home the same day of their surgery or after a single overnight stay, allowing them to recover comfortably and safely in the comforts of their homes. 

Women Face Unique Challenges

Women are disproportionately affected by osteoarthritis, accounting for the majority of joint replacement patients. In fact, 26% of women have osteoarthritis compared to 18% of men. Research has shown that women often report greater pain and lower function than men, even when X-rays show similar levels of arthritis.

Women are also more likely to delay evaluation and treatment.

"One thing I encourage women to remember is: don't minimize your pain or delay seeking help," says Dr. Guthrie. "Early evaluation gives patients more options and can help preserve function and quality of life." 

Geographic and Economic Barriers

Where a person lives can also influence access to care. Rural communities often have fewer specialists, longer travel distances, and transportation challenges that can delay diagnosis and treatment.

Economic barriers, including insurance limitations and difficulty accessing specialty care, can further prevent patients from receiving timely evaluation.

Bringing Prevention and Care Into the Community

Despite the prevalence of osteoarthritis, public awareness and understanding of the disease is surprisingly low. "Bone and joint health is a “low-awareness, high-impact” sector of healthcare," says Dr. Guthrie. "Unlike diabetes, and heart and lung conditions, most people don't think about their bones and joints until they're in pain, develop a “fragility” fracture from osteoporosis or lose mobility. Increasing awareness is essential."

Preventing and addressing bone and joint conditions require more than treating patients once symptoms become severe. Education, community outreach, and early intervention are key in helping those who are suffering.

Many of the factors that contribute to loss of mobility and independence—including arthritis, osteoporosis, poor balance, muscle weakness,

and fall risk—can be identified early and addressed before they lead to more serious problems.

The Wellness Center for Bone and Joint Health, of which Dr. Guthrie is the co-medical director, in conjunction with the not-for-profit, AMD3 Foundation, holds free community screenings and public education events that help individuals recognize symptoms sooner and understand available treatment options.

These screenings are designed not only to identify arthritis, but also to detect other risk factors that can contribute to pain, falls, fractures, loss of mobility and declining independence.  By identifying warning signs early, patients have more opportunities to take preventive action before problems become more serious.  

Our FREE five-point screening program designed to identify bone and joint health concerns before they become debilitating. The program focuses on:

• X-ray evaluation of knee and hip arthritis

• Bone density screening for osteoporosis

• Fall-risk assessment to prevent fractures

• Nutritional assessment for healthy bones and joints

• Grip-strength testing to evaluate overall muscle strength

  
  

These screenings help raise the awareness of bone and joint wellness, identify issues earlier, provide non-operative treatment options, improve prevention, and increase access to bone and joint care in communities where health disparities are more common. Upcoming events can be found at https://www.boneandjointhealth.org/

Bridging the Gap Through Outreach

By providing underserved communities with education, screenings, and care, Dr. Guthrie and her team can help identify bone and joint issues earlier and intervene and prevent these conditions before they cause pain and disability. Early evaluations provide more options—from lifestyle changes and exercise programs to injection and other non-operative treatments that can maintain function and independence.    

Patients who otherwise wouldn’t have access to care are now evaluated sooner and have more prevention and treatment options, better pain control, and less functional decline than those who wait until the problems become severe.

Community outreach programs also help address disparities by bringing education and screening opportunities directly to underserved populations, creating a pathway to earlier diagnosis and more equitable care.

Why This Moment Matters

Whether you are 50 or entering your 90’s, growing older does not mean accepting pain and loss of the ability to enjoy life.

Protecting your joints starts with staying active, maintaining strength, managing weight, and seeking evaluation when symptoms first appear. Persistent pain, swelling, stiffness, or loss of function should never be ignored.

Through education, outreach, and patient-centered care, Dr. Guthrie and her team are committed to helping individuals preserve mobility, maintain independence, and continue doing the things they love.

Their goal is simple: helping people maintain the mobility, strength, and independence needed to keep doing the things they love. 

www.pittsburghboneandjoint.com

UPMC Magee-Womens Hospital

300 Halket St. | Pittsburgh, PA, 15213

412-683-7272

Bone and Joint Center

The wellness Center for Bone and Joint Health