Issue link: https://www.massageandbodyworkdigital.com/i/70065
pathology perspectives BY RUTH WERNER BABY BOOMERS AND JOINT REPLACEMENT SURGERY Close to 800,000 people in the United States will have a joint replaced this year. Osteoarthritis is the main—but not the only—reason. Joint replacements have become so common that most massage therapists can expect to see clients who are in various stages of recovery from this procedure. But just because it's common doesn't mean it's risk-free, and a person who has had a joint repaired has a significant chance of complications that impact bodywork choices in both the near and long-term. "I have a friend in her 60s who had hip surgery. She seemed to do fine, but two weeks later she had blood clots in her legs. They caught them early, but she ended up spending a long time in the hospital to treat them. Of course, that interrupted her physical therapy. Now her scar is all puckered, and she never really fully recovered the use of her hip." WHAT IS ARTHROPLASTY? Joint replacement surgery, also called arthroplasty, is a procedure designed to repair articulating surfaces within a synovial joint. The precipitating factors are chronic and progressively worsening pain and loss of function. The goal of the surgery is to restore pain-free (or at least pain-reduced) movement. WHY JOINT REPLACEMENT? Osteoarthritis is the condition behind most joint replacements. This form of inflammation is specifically related to wear and tear of synovial joints, especially the weight-bearing joints. As the baby-boomer generation abandons the Age of Aquarius for the Age of Arthritis, the interest in this condition has grown, and the health-care industry's investment in preventing and treating arthritis is at an all-time high. This article will focus on what happens after the joint has been irretrievably damaged, but it is worth looking at the factors that lead up to joint replacement and what role massage might have in that context as well. Osteoarthritis, or wear-and-tear arthritis, develops when the articular cartilage in synovial joints begins to degrade. Articular cartilage is structured differently, depending on its proximity to the attached bone, and each cartilage zone has the capacity to absorb either compressive or shearing mechanical forces. Articular cartilage is invested with chondroblasts—cells that can produce new material to repair damage. However, these cells are limited in their activities. Unlike other connective tissue fibroblasts, chondroblasts don't migrate or reproduce in areas where damage has occurred. In other words, cumulative damage related to overuse, trauma, dehydration, or inadequate nutrition can simply overwhelm the chondroblasts' ability to repair tissue. It appears that once connect with your colleagues on massageprofessionals.com 97