Weight loss

■ Regular telephone contact

■ Additional modalities, such as canes, braces, shoe inserts, TENS units, and acupuncture, and thermal techniques, such as heat and ice

When all of these interventions, medications, and interventional options fail, surgery is the final consideration. There are many patients who choose a total joint replacement as an option for reducing pain and increasing functionality.

OARSI recommends the following surgeries as options for patients with osteoarthritis:

■ Total knee or hip replacement

■ Unicompartmental knee replacement

■ Osteotomy and joint preserving procedures

■ Joint lavage and arthroscopic debridement

■ Joint fusion when joint replacement fails

No matter which therapeutic option a patient with OA chooses, the relationship with the health care provider is paramount to the success of the intervention. Losing weight and exercising may be a big undertaking for the patient with OA, but positive reinforcement from the health care provider and use of techniques, such as water exercises or water aerobics, can help the patient get a start on a difficult process. Being sensitive to the patient's pain and using a variety of multimodal pain relief options will also make the entire process more tolerable to the patient. Measuring patient outcomes and showing improvement in function will help patients understand the benefit of the treatment plan.

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