A Lecture with Dr. Stephen J. Kelley, M.D.

Piper Shores residents recently gathered in the Great Room to listen to Dr. Stephen J. Kelly speak about various options for managing joint pain. Dr. Kelley is a surgeon at OA Centers for Orthopaedics, as well as the Medical Director for the Mercy Joint Replacement Program. He specializes in knee and hip replacement surgery.

Dr. Kelly began his lecture by talking to residents about the causes and symptoms of joint pain. He explained that both osteoarthritis and rheumatoid arthritis can cause joint pain, but that their other symptoms are distinctly different. Osteoarthritis is often characterized by a dull aching pain, while rheumatoid arthritis is notorious for stiffness, difficulty walking, swelling, loss of motion and even joint deformity. Treatments for both diseases vary – but surgery is not always the best option.

“Our ultimate goal is to improve quality of life for each patient. One size certainly doesn’t fit all in terms of treatment,” said Dr. Kelly. “For example rheumatoid arthritis can be very well managed by medicine. The drugs can be expensive, but they keep you out of the hospital.”

One thing that Dr. Kelly emphasized many times during his lecture was the importance of exercise in preventing, treating and managing joint pain. Dr. Kelly explained that low impact exercise such as walking, swimming and cycling helped patients to reduce stiffness, increase mobility and range of motion, as well as maintain a healthy weight – one of the key treatments for joint pain. Dr. Kelly also noted that the use of assistive devices such as braces, canes, crutches and walkers can also be very helpful in increasing mobility and maintaining an active lifestyle.

Other non-surgical treatment options that Dr. Kelley presented included aspirin-free pain relievers, non-steroidal anti-inflammatories, cortisone injections and physical therapy.

“I’m a big fan of rehabilitation physical therapy,” said Dr. Kelly. “It helps patients to improve mobility and gain strength. The coaching that a physical therapist provides also helps people move forward on the road to fitness.”

Other tips that Dr. Kelly offered for making exercise more comfortable for patients with joint pain included buying new shoes more frequently (the padding on the inside breaks down over time) and buying either custom or OTC orthotics.

For patients that are not able to find any relief through non-surgical interventions, Dr. Kelly discussed the pros and cons of various types of joint replacement surgery. He emphasized that the most important part of the surgery is the preparation, and setting realistic recovery goals.

“Your age, activity level, weight, and personal motivation are all factors in how well the surgery will work and how quickly you can expect to recover,” said Dr. Kelly. “It’s very important that doctors help patients set realistic expectations, and provide them with pre and post operative therapy.”

While knee and hip replacement surgery today is substantially less invasive than it was 10 years ago and can deliver excellent long term results, Dr. Kelly emphasized that it is still a major surgery and requires significant recovery time.

“Today we are able to perform knee and hip replacements with smaller incisions, shorter hospital stays and better pain management,” said Dr. Kelly. “We are seeing less post-op pain, earlier mobilization and faster rehab. But the surgeries are longer and technically difficult. It certainly isn’t the right option for every patient, or every surgeon.”

To conclude his lecture, Dr. Kelly reminded Piper Shores’ attendees that joint replacement surgery is a business – and that drug companies put a lot of money into advertising their replacement joints, just like other retail businesses.

“Sometimes the advertising exceeds the science,” said Dr. Kelly. “So before you choose a specific joint replacement, be sure to consult with your physician about the best options available for you, and complete a patient education program. Many people think that a new replacement part will come out next week and it will be 100 times better than what we have now. Joint replacement surgery has certainly changed and improved over the last decade, but it’s a gradual change. There are no miracle cures when it comes to joint replacement.”