Age
The risk increases with age, though osteoarthritis is not an inevitable part of aging
Dr. Leo Zalikha specializes in managing osteoarthritis of the hip and knee, from early-stage disease that responds to conservative treatment to advanced arthritis that requires joint replacement.
Osteoarthritis: The Most Common Type
Osteoarthritis (OA) is the wear-and-tear form of arthritis. It occurs when the cartilage that cushions the ends of bones in a joint gradually deteriorates. As the cartilage thins and eventually wears away, the bones begin to rub against each other, causing pain, swelling, and stiffness.
Osteoarthritis most commonly affects the knee, hip, hand, and spine. It is the most frequent reason for joint replacement surgery.
Prior injury
A fracture, ligament tear, or other joint trauma increases the risk of developing arthritis in that joint later (post-traumatic arthritis)
Excess weight
Higher body weight increases stress on weight-bearing joints, particularly the knee
Genetics
Family history plays a role in susceptibility
Joint alignment
Abnormal mechanics (bow-legged or knock-kneed alignment) concentrate stress on certain areas of the joint
Occupation and activity
Jobs or sports involving repetitive joint stress may contribute
How Osteoarthritis Progresses
Osteoarthritis is typically a slowly progressive condition. Symptoms may fluctuate, with good periods and flares, but the general trend is gradual worsening over years. The rate of progression varies widely. Some patients live with manageable arthritis for decades. Others progress to severe disease in a shorter timeframe. Understanding that arthritis is a progressive condition helps with planning. Dr. Zalikha works with patients to develop a long-term management strategy that evolves as the condition changes.
Other Types of Arthritis
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system attacks the joint lining (synovium), causing inflammation, pain, and joint destruction. Unlike osteoarthritis, RA typically affects joints symmetrically (both hands, both knees) and can occur at any age. RA is primarily managed by rheumatologists with disease-modifying medications. However, when RA causes severe joint destruction in the hip or knee, joint replacement may be appropriate. Dr. Zalikha treats patients with RA-related joint damage, working in coordination with their rheumatologist.
Post-Traumatic Arthritis
Arthritis that develops after a joint injury (fracture, ligament tear, dislocation) is called post-traumatic arthritis. It can develop months to years after the original injury, even if the injury was treated successfully. Post-traumatic arthritis is managed the same way as osteoarthritis: conservative treatment first, joint replacement when symptoms warrant it.
Avascular Necrosis (Osteonecrosis)
Avascular necrosis occurs when the blood supply to the bone is disrupted, causing the bone to die and eventually collapse. It most commonly affects the femoral head (the ball of the hip joint). Risk factors include corticosteroid use, alcohol use, certain medical conditions, and prior trauma. When the femoral head collapses and the joint becomes arthritic, hip replacement is usually the treatment.
Inflammatory Arthritis
Conditions such as psoriatic arthritis, ankylosing spondylitis, and lupus-related arthritis can affect the hip and knee. These are managed primarily by rheumatologists, but joint replacement may be needed when joint destruction is advanced.
Treatment Spectrum for Arthritis
Arthritis management is not binary (do nothing vs. surgery). There is a spectrum of treatments, and Dr. Zalikha helps patients navigate it based on the severity of their disease.
Conservative Management
Physical therapy:
Strengthening muscles around the joint to reduce stress and improve function
Weight optimization:
Reducing mechanical load on the joint
Medications:
Anti-inflammatory drugs (oral and topical), acetaminophen
Injections:
Corticosteroids, hyaluronic acid, PRP and biologics
Activity modification:
Shifting to low-impact activities
Bracing and assistive devices:
Unloader braces, canes, supportive footwear
Surgical Treatment
Total hip replacement:
For advanced hip arthritis
Total knee replacement:
For advanced knee arthritis affecting multiple compartments
Partial knee replacement:
For arthritis limited to one compartment of the knee
Dr. Zalikha evaluates each patient's position on this spectrum and recommends treatment accordingly. Most patients start with conservative management. Many stay there successfully for years. When conservative treatment is no longer effective and quality of life is significantly affected, surgery enters the conversation.
Explore related pages to learn more about specific conditions and treatment options:
- Hip Arthritis: Symptoms, diagnosis, and treatment specific to the hip
- Knee Arthritis: Symptoms, diagnosis, and treatment specific to the knee
- Knee Injections: Detailed information on injection options
- Physical Therapy for Arthritis: How targeted exercise helps arthritic joints
To discuss your arthritis management, Schedule a consultation with Dr. Zalikha or call (562) 362-5024. A Virtual Second Opinion is available for patients outside the area.