Surgery rarely helps arthritis

jkoch

By Dr. John Koch

Question: I have an older dog that suffers from arthritis. As I understand it, arthritis is the formation of bone spurs in and around a joint. When the joint is being used, these spurs dig into the bone, causing pain. Why can't these spurs be surgically removed?

Answer: Osteoarthritis is a common malady in the older pet. It is routinely treated with medication and rarely with surgery. There are many different types of osteoarthritis. When most people think of this ailment, they are thinking of the traumatic variety.

Symptoms are dull, aching joints. Increased activity usually will lead to increased discomfort which is relieved by rest. Pets often show stiffness for several minutes after arising, especially in the morning. Once these patients overcome their initial stiffness, they do well most of the day. In the evening, as the pet tires, some will again show stiffness and not move around as well.

When surgeons open arthritic joints, they rarely see bone spurs. What is found are more accurately described as bony plaques. These plaques form around joints where trauma has occurred. In many instances, the trauma is nothing more than the wear and tear that occurs with normal, everyday use. The wear and tear may be worse if a joint is loose, such as in animals that have hip dysplasia or torn ligaments.

When cartilage around the joint is even slightly insulted, small microscopic areas of hemorrhage appear between it and the bone. These small areas of hemorrhage calcify. As time elapses and more insult occurs, more and more calcium is added to the area. Eventually the cartilage is pushed up above its normal position on the bone and a plaque is born. These plaques yield the inflammation and dull aching sensations previously described.

If the surgeon removes these plaques, the bone underneath bleeds and calcification reoccurs within a short time. Since cartilage does not regenerate, the new bone growth has no protection layer covering it. The overall effect of removing the plaque of bone would be to make the problem much worse. There are special exceptions to this, such as loose cartilage that may be floating or flapping in a joint.

There are many good medications and techniques for treating osteoarthritis, but surgery to remove the so-called bone spurs is rarely helpful.

Dr. Koch is a Cape Girardeau-area veterinarian.