What is osteoarthritis?
Osteoarthritis (or wear-and-tear arthritis) is the most common type of arthritis and will affect approximately 2 million Australians in 2018.
Osteoarthritis is a disease which affects the otherwise smooth and shiny cartilage within joints, and makes these surfaces rough, porous, thin, crumbly or bumpy.
Most commonly, osteoarthritis affects weight-bearing joints such as the knees, hips and spine.
However, arthritis can also affect smaller and more nimble joints like those in the hands, fingers, elbows and toes.
How do I find out if I have osteoarthritis?
Osteoarthritis affects people of all ages but the disease is more common amongst men and women above the age of 45 years and is especially prevalent in older women.
Your general practitioner (GP), orthopaedic specialist or rheumatologist can screen you for osteoarthritis.
To be accurately assessed, your doctor will likely need the following for a diagnosis:
- Basic medical history
- X-ray, CT or MRI scan
(Note: A blood test is sometimes recommended to rule out other possible types of arthritis e.g. rheumatoid arthritis).
What are my options if I’m diagnosed with joint osteoarthritis?
There are three primary goals when treating osteoarthritis: 1) control the pain, 2) preserve joint function and 3) slow further osteoarthritis progression.
The following osteoarthritis treatments have a few key benefits and limitations:
1) Over-the-counter pain medication:
Over-the-counter pain relief (e.g. paracetamol) and anti-inflammatory medications (e.g. ibuprofen) are sometimes enough to control mild soreness and restore pain-free movement. For early-stage arthritis, it’s generally most important to maintain an active lifestyle through low-impact exercise and activities.
2) Prescription pain medication:
Some stronger pain relievers (e.g. hydrocodone and tramadol) may have more long-term usage risks. Subsequently, these medications require a prescription and can help manage pain and restore joint function in more severe cases of osteoarthritis. Corticosteroids (e.g. prednisone) also require a prescription but may provide a more potent therapeutic benefit for patients in considerable pain. Long term use of these drugs may lead to side effects and their suitability should be discussed with your doctor.
3) Exercise and physiotherapy:
Although pharmaceutical relief might be necessary to begin or continue exercising with sore joints, benefits of exercise include strengthening the muscles that surround the joint(s), maintaining bone strength, improving flexibility, achieving good quality sleep, managing weight and improving your overall mood and confidence – key factors in reducing your risk of osteoarthritis-related debilitation long-term.
4) Non-surgical regenerative therapy:
Regenerative medicine is a rapidly developing field of medicine with the approach of repairing the damaged joint. The purpose of regenerative medicine is to restore the quality of cartilage in order to slow or reverse disease progression, reduce pain and restore joint function. These therapies include stem cell joint repair, platelet rich plasma and ligament prolotherapy.
Although the majority of regenerative medicine treatments are relatively new in Australia, other countries have researched, developed and incorporated some of these non-surgical treatments into standard practice for orthopaedic patients over the last 15 years. According to the results released from these clinics and hospitals, regenerative therapies are more effective against early-stage osteoarthritis, and are often considered by patients who are too young for joint surgery. These therapies can be quite expensive, starting from $15,000-30,000 per joint. If you’d like to discuss these treatments, SkyGen Australia have coordinated patient treatment at these centres for the better part of a decade (www.SkyGen.com.au).
5) Orthopaedic surgery/Joint surgery:
For most patients with debilitating pain caused by moderate-severe osteoarthritis, joint replacement surgery is often the most appropriate option. Joint replacement surgery has been performed for over 60 years, and can significantly reduce pain and restore a joint’s range of motion in approximately 80 % of patients. After the first joint replacement, a once-off “revision” is generally required 10-15 years later. Revision surgery does have a higher risk of complication. Revision implants are typically cemented in place to help withstand the remainder of a patient’s life. This is one of the reasons why orthopaedic surgeons prefer a patient to be at least 55-65 years old before joint replacement is considered.
Diagnosed with Osteoarthritis? What to do next
If your doctor has diagnosed you with knee, hip or spinal (vertebral) osteoarthritis there are a few key questions to ask yourself and/or discuss with your doctor:
Q1. Does my osteoarthritis affect my mood/sleep/day-to-day life?
If not, anti-inflammatory and/or anti-pain medication and light exercise may be most appropriate. If yes, continue to Q2…
Q2. Am I under 55? Do I want to avoid surgery? Is the pain still bearable?
If the answer is “yes” to any of these questions, you may want to explore non-surgical/regenerative medicine options such as stem cell therapy. If you answered “no” to all, continue to Q3…
Q3. Do I already have private health cover for joint replacement surgery?
If yes, you may consider booking an appointment with a private orthopaedic surgeon to discuss joint replacement surgery through a private hospital or surgery centre. We recommend discussing all of your medical and financial risks, including potential out-of-pocket costs and extent of your coverage (contact your insurer for more information). If not, continue to Q4…
Q4. Does my osteoarthritis prevent me from working or earning an income (effectively already costing you money)?
If not, then you may want to consider joining a public waiting list (1-3 years depending on your location, joint type and disease severity). If yes, continue to Q5…
Q5. Can I afford to wait the mandatory 12 month waiting period once joining a private health insurer?
If yes, then contact a private health insurer to discuss the details of cover for joint replacement surgery and find the best solution for you. Make sure to openly discuss all underlying health conditions honestly. You don’t want to get to the end of 12 months of paying premiums only to find out you’ve been excluded from coverage and sent back to square one. If you can’t afford to wait 12 months, continue to Q6…
Q6. Can I afford $25-45,000 for private orthopaedic surgery?
Book private surgery within 3-6 months and pay the private surgery prices. If this is beyond your budget or you can’t wait any longer, continue to Q7…
The Secret to Skipping the Waiting List and Saving Over 50% on Orthopaedic Surgery
Q7. Do I have affordable high-quality options elsewhere?
Yes, we all do! In fact, more than 22,000 Australians travel around the world to receive high quality private surgery each year for less than half the price of comparable surgery in Australia. Large International hospitals in destinations like Düsseldorf (Germany) and Bangkok (Thailand) specialise in treating international patients from Australia, New Zealand, the USA, Europe and the Middle-East. In Thailand alone, orthopaedic surgeons and speciality hospitals routinely perform joint replacement surgeries and provide specialised aftercare for hundreds of thousands of medical travellers each month.
Q8. Why would people travel overseas for surgery?
Apart from the appeal of top-tier care in countries renowned for their hospitality and patient care, private international hospitals in destinations like Bangkok have very short waiting lists and save patients up to 50% (and more) off the price-tag of private knee surgery and hip surgery in Australia. For expert guidance on picking the right hospitals and pricing, contact a reputable medical travel facilitator here in Australia. Facilitators are key to making sure all the important items are included in packages with their partnered hospitals, removing the guess-work and helping to ensure your ongoing care through the Australian medical system after your safe return home.
Important: No two people with osteoarthritis have the same exact condition or medical needs. The most severe osteoarthritis may cause little to no pain in some while others suffer immense pain from the early onset. If you think you may have osteoarthritis, ask your doctor about assessment today and start the discussion about a personalised long-term treatment plan which considers all of your options.
Photograph by Kues
We all have that one friend who has an uninformed opinion about everything, and supports their every argument by referring to something they saw on the morning show or “in this article I read [on Facebook]”.
Orthopaedic surgeons, much like our opinionated friends, are only human. They’re not immune to the hype presented on TV – they buy just as many Nutribullets, Ab Swings and Dust-collecting Extendable Ladders as the rest of us. But sometimes they get away with saying far more than they should to the patients that trust them – even though some of it does eventually sound quite ridiculous.
The following are the 6 most embarrassing lies that orthopaedic surgeons have legitimately passed onto their Australian patients:
(Disclaimer: These are actual statements reported to us by our patients over the last 5 years)
1. “The orthopaedic surgeons in Thailand aren’t as qualified”
Thai orthopaedic surgeons are some of the most respected in the world. Just within our network of surgeons alone, each specialist holds a fellowship in at least one of advanced orthopaedics, microsurgery or sports medicine at either the University of London, University of Birmingham, University of Kyoto or John Hopkins University in the USA.
One of our surgeons completed his orthopaedic surgical training in Sydney, but that’s buried deep at the bottom of his resume.
2. “The hospitals overseas are found in shady back streets”
I’m sure you’ve at least driven past a hospital before, and you’ll have noticed that they’re not exactly back-street coffee shop-sized. Our Thai hospitals have their own precincts and each week thousands of patients from around the world wheel in and walk out their doors, foyers, emergency departments, wards and (get this) many coffee shops.
Sure, there are small hospitals in existence, but the only time we seem to think that a converted home-office-clinic-surgery is acceptable, is if it has a colourbond roof.
3. “They use contaminated tap water in open surgery”
With the earliest uses of water filtration originating back in the 1600’s, it’s incredible that some educated people still believe that these filtration systems are not used in hospitals. Even more amazing is the notion that stormwater is cleaner back home.
This statement was actually said on live Australia television by a less-than-coherent local Orthopaedic Surgeon gripping at straws in late 2016. The shame. Thankfully, most orthopaedic surgeons in Australia are far more sensible, smart and feel less of a need to be defensive about their speciality’s future.
4. “The implants used in Thailand are old and made from cheap metals”
A lot of things are made in Asia, but orthopaedic implants really isn’t one of them.
There is one interesting difference between the orthopaedic implants used in Australia and Thailand, but it’s not what your surgeon may think.
The surgeons in Thailand can and do purchase the absolute best, latest generation implants for their patients at a fraction of the price that they’re sold to Australian hospitals for. Thanks to this economic slope, local Thai patients are provided orthopaedic surgery without it costing an arm and a leg – ironic pun definitely intended.
In fact, the cost of hip replacement in Australia is more expensive than hip replacement surgery anywhere else in the world, second only to the USA.
If anyone is skimping on implant quality, it won’t be Thai surgeons.
5. “There’s no aftercare in cheaper hospitals”
In Australia, we’re used to being kicked out of hospital only a few days after surgery. And sure, many knee surgery and hip replacement patients worldwide are back on their feet within a couple of days.
But Thai hospitals don’t shoo you out the doors just as soon as you can stand again – their aftercare is incredible.
Our patients are encouraged to stay at our preferred international hospitals for at least 10-14 days following surgery in Thailand. As an inpatient, they’re provided all of the postoperative care, medications and physiotherapy rehabilitation you would expect from a large private hospital and spend the rest of their recovery within metres of support from nursing, medical and rehabilitation staff.
6. “International hospitals don’t have acceptable hygiene standards”
The healthcare industry in Thailand tries to turn a blind eye to these sorts of racist remarks, but they still appreciate the skewed perspective Australians have of Thai hospitals.
Similarly, I once heard a surgeon from the US ask an Australian surgeon if he wore thongs in theatre. But you wouldn’t hear this same harmless query stated as damning attack on Australian health standards an American morning show.
In actual fact, our partnered hospitals have less than half the incidence of infection than the global first-world average. And the dreaded methycillin-reistant staphylococcus aureus (MRSA or Golden Staph) infection is almost unheard of in these hospitals – that’s ironically more prevalent in Western hospitals.
7. “Things can go wrong when you get home and your Australian doctor won’t be able to help you”
Actually this one’s almost half-correct, things can go wrong after orthopaedic surgery, no matter where it’s performed. But if this happens the symptoms almost exclusively present themselves in the first few days to a week after surgery.
For those having surgery back in Australia, if you’ve already been marched out of your hospital and sent home, you’ll have to make another appointment and get yourself back to your hospital just to ask a question every time something doesn’t feel right.
For those having surgery in Thailand, if you’re still relaxing in your private hospital suite after surgery (remember 10-14 days of in-hospital recovery), you’re just a press of a button away from a nurse or doctor addressing even the simplest of concerns.
Rest assured, just like in Australia, in the unlikely event that revision surgery is required due to any fault of the surgeon or implant this is generally covered offered by your surgeon for free.
Thought-provoking exercise: If you were to break your leg skiing in Switzerland and a Swiss surgeon pinned your leg back together, do your Australian GP would force you to travel back to Switzerland for all of your follow-ups? Of course not.
Orthopaedic surgery is often quietly referred to as the “woodwork of medicine”. It’s one of the few surgical areas where the majority of long-term follow-ups are generally left in the capable hands of your general practitioner.
If your GP doesn’t agree to help you anymore because you had surgery overseas, or doesn’t discuss surgery overseas as an option for you – it might be time to find a new GP.
If you’ve heard any of these “porkies” from your surgeon, or others that should be included in this list, write them in the comments below.
Thai Airways is our preferred full-service provider of luxuriously comfortable air travel for orthopaedic patients travelling to Bangkok.
When our patients choose to have surgery in Thailand, we book with Thai Airways because their staff understand the needs of our patients. Although we often organise flights with budget airlines at the request of our patients, we recommend flying with Thailand’s most reputable airline, Thai Airways.
As an added benefit, once you step aboard a Thai Airways plane, be it a new Boeing 777 or Airbus A380, you’ll feel like you’ve already landed in Thailand right from the first time you hear “Sawat-dee”.
All airfares booked through Thai Airways include:
- Wheelchair Assistance
- Priority Boarding
- Meals & Snacks while on-board
- Pillows & Blankets as required
- Movies & In-flight Entertainment
- Priority Customs Clearance through Bangkok Airport
Once you’ve flown to Bangkok with Thai Airways, you’ll never fly with a budget airline again!