Clearing Up the Most Common Joint Health Questions

People hear “bone on bone” and immediately picture an operating room, months of misery, and a life on hold. We slow that story down and replace it with something more accurate: a careful joint evaluation, clear choices, and a plan built around your goals. From the first visit, we walk through what actually happens in a bone and joint appointment, why we spend so much time on your medical history, and how X-rays fit into the bigger picture of osteoarthritis, arthritis pain, and daily function.

We also demystify joint replacement surgery and recovery. Surgery is elective for most people, which means we focus on safety and pre-op optimization, including medication review and coordination with your primary care doctor, cardiologist, or other specialists when needed. Just as important, we talk about the “coach” role, the caregiver support that helps with everything from remembering instructions to navigating stairs and dressing changes. If you live alone, we share why that matters and how a care team can help connect you with support resources.

Along the way, we tackle common bone health myths, including the misconception that men do not get osteoporosis. We explain why osteoporosis screening and DEXA scans can matter regardless of gender, and how non-surgical options like physical therapy, lifestyle changes, and injections may provide real relief before surgery is ever on the table. If you want clearer expectations, less fear, and better mobility, subscribe, share this with a friend who needs it, and leave a review with the question you want us to answer next.

To learn more about The Bone and Joint Center at Magee-Womens Hospital visit:  https://www.pghbjc.com
Dr. Noelle DiGioia Guthrie
300 Halket St. 
Pittsburgh, PA, 15213 
412-683-7272  

To learn more about The Wellness Center for Bone and Joint Health visit:  https://www.boneandjointhealth.org
Tiffany Belculfine
300 Halket St., Suite 1601 
Pittsburgh, PA, 15213 
412-641-8594  

Transcript

Welcome And Why Myths Persist

SPEAKER_00 0:04

Welcome to the Joint Effort Podcast, where mobility meets reality and your future self says thank you. Your host, Dr. Noel DeJoy Guthrie of the Ponent Joint Center of the Key Women's House, and Tiffany Belkafine, position assistant at the Wellness Center of the Bonin Joint House, serving the dogs across Western. If you're putting on your side, you're in the right place. Every day, help break it down and build you back up with a personalized plan for real life. Now, let's get you moving. Here are Dr. Noelle and Tiffany.

SPEAKER_01 0:54

Patients and caregivers ask great questions and sometimes hold on to persistent myths. Today we're clearing up some common misconceptions in bone and joint health. Welcome everyone. I'm Julie Schwenzer, co-host and producer, back with our experts, Dr. Noel DeJoya Guthrie and Tiffany Belkafine. Ladies, it's great to be back with you.

SPEAKER_03 1:13

Hi, thank you.

SPEAKER_01 1:15

So if you could walk us through some of the frequently asked questions that you hear when people first enter your office, that would be great. And maybe set the record straight. Like what really happens when you go in to get a checkout?

SPEAKER_02 1:27

Well, go ahead.

What A First Visit Looks Like

SPEAKER_02 1:34

Second of all, we take a pretty in-depth history as far as medical history, orthopedic history, if you've had any surgery on any of your joints or body, if you've had any fractures, if you have any issues as a child. So a lot of it is getting to know that basic information and also getting to know each other, asking about, you know, those kind of things as well as things that you've done to help with any pain that you've had or any intervention you've had. So it's a lot of talking. I think for our new patient appointments, you know, I spend a good 30 minutes, maybe, you know, plus or minus with patients. Um, number one doing that, number two, reviewing x-rays with them, number three, talking about things that they've done. And then, you know, next step is moving forward with talking about where do we go from here? You know, where where are you as far as your arthritis or, you know, osteoporosis, what things we can do to help you right now to be live pain-free. Um, you know, talking about non-surgical options, talking about surgical options. Um, so a lot of it's, you know, x-rays are really important. And then secondarily, you know, discussion between, you know, your physician, your PA, the whole uh clinical team, um, as far as what steps that we do next. Um, so and you know, Tiffany kind of said a lot of patients think they come in and they're having surgery that day. There's a lot of patients who wish they were having surgery that day because they're in so much pain. But, you know, the surgical process is a process. You know, it starts with that first step, but it's a lot of education, a lot of prep work, you know, some more than patients realize in to get ready for joint surgery. Um, so you know, the the process starts then. It's not going to be a process that happens that day. Um, it's, you know, not intimidating. It shouldn't be intimidating, you know, it should be a comfortable process with, you know, a patient and physician. Um, and obviously, you know, developing a relationship or rapport with with between each other.

SPEAKER_03 3:18

I don't know if you have anything to add.

Why You Need A Coach

SPEAKER_03 3:20

Um, so definitely it's also important when people come in for that appointment that they know that they need to have someone with them. Um, because first and foremost, it's a lot of information and it can be very overwhelming. So having that extra set of eyes and ears, someone to write things down or someone to, you know, say, oh, can you repeat that, please? I didn't catch that. That's really helpful. And also when patients are going through a surgery, they're going to have a coach in our practice, you know, one of their family members or friends to assist them anyway. So that person needs to know what to look out for. They need to know, you know, how do I get them in and out of the car? How do I get them up and down the stairs? How often do I have to change a dressing? Um, you know, when do we have to call about physical therapy or does someone call and do that for us? Like there's so many little things that happen behind the scenes that people don't always think about as part of a surgical plan of, you know, are you going home that day? Are you staying somewhere? Like what, you know, you have too many steps in your house. Do you have someone you can stay with who has a ranch style home? All of those types of things are really

Osteoporosis Myths And Same Day Relief

SPEAKER_03 4:15

important. And then from my non-surgical perspective, um, you know, I get a lot of questions about a lot of things, a lot of different concerns about osteoporosis and osteoarthritis, the big ones. Um, one of the biggest things that people have misconceptions over is that men don't get osteoporosis. And they do. They can still get osteoporosis, so they still need to have a DEXA scan. They still need to talk about, you know, any of their risk factors with their doctors and their PAs and their providers. They need to make sure that they all know what their risk factors are, regardless of what their gender is.

SPEAKER_02 4:48

And also to add, sorry, just a setback, there are things we can do in the office that day if you pre-initial appointment, you know, as far as injections, stuff like that. So patients don't have to be scared about that because that's a decision that we make together if that's something you want to do that day. But it's not like stuff all stuff has to be planned for far in advance. You know, we can do stuff in the office, injections mainly, um, that can help you right then and there to see if we can get you some pain relief.

SPEAKER_01 5:14

And I know with having um people that have undergone operations that you guys perform in my family and you know, extended family, that um what I've seen, and I don't know if this happens a lot in the practice, is that they come in and they might not have enough medical information to share, like from their cardiologist, whether they, you know, can have an operation or um because of you know, what state is their heart in, and then the other things, like maybe maybe neurologists and things like that. So how is that? How is

Medical History And Surgery Readiness

SPEAKER_01 5:43

collecting the information? And do you feel like patients come in prepared with the other information that they need with their medical history? Is that something hard to get?

SPEAKER_03 5:53

I do think sometimes people don't realize how closely things are connected and related. Um, you know, when we're taking a history and we're asking about other health conditions, they're like, well, I had thyroid trouble, but you don't need to know that. Well, I also need to know that. Uh, that's really important because, you know, certain medicines have to be stopped before surgery. So we have to know what to tell people about those kinds of things. So I think it it is really important for them to know that everything is important. We're not asking you just for no reason, like there's a real purpose of us knowing these types of things.

SPEAKER_02 6:21

No, I agree. I think, you know, that's why we take a pretty intense physic history and physical. So we know those things because if you are deciding to proceed with surgery, you know, it is a process. We usually make sure, you know, joint surgery is elective. So it's not like we have to do it at any point. So we do have patients be optimized before surgery, you know, whether that be um talking to their primary care doctor, seeing their cardiologist if they have a history of heart issues, neurologist, you know, all the down the line. So we make sure patients are first and foremost safe for surgery. Um, and second, secondarily, they're optimized for surgery so that the best outcomes that they can have, they do have. Um, so that's definitely a huge part. And I think patients don't realize that process until it's actually, you know, they're undergoing it. But, you know, we have very good people as part of our team who help guide them through that and we help you with that. It's not like we send you off into, you know, the community to do that all on yourself. We support you in the process. Um, so and we do it a lot. So it's kind of routine for us to have patients go to other providers and, you know, constant correspondence with them and making sure that from our end everything's safe and clear. Um, I think we can't emphasize enough that having surgery is a process and it's a, you know, there's a lot of education that goes to it. It's it does take some, you know, work to prepare for surgery as far as the patient and the coach and the family. Um, so, but we're all here to support you and help you in that process. Um, that's really important for us so that you know we can have our patients do the best that they can. That's everyone's goal, you

Surgery Is Not The Only Path

SPEAKER_02 7:52

know.

SPEAKER_01 7:52

So have you both found that uh perhaps a misconception that some people have is that they're just surgery is the only option. And then they come in and they find that, you know, be even before the shot, maybe therapy is the way to go. Does that happen a lot?

SPEAKER_03 8:08

Yeah, I think it does. I think people automatically assume that when they hear certain words about certain health conditions, that they just assume that that's what's going to happen. Oh, it's bone on bone, that's what I have to do. But I think it's also really important to realize that some people are bone on bone and have no symptoms. They're functioning perfectly fine. So, yes, that may be an accurate part of their physical exam and their x-ray presentation. But if they're not bothered by it, no one is going to force them to have surgery if they don't need to.

SPEAKER_02 8:38

Totally I agree. I mean, there's some patients who don't want to have surgery, you know, or can't have surgery for medical reasons. So I think it's, you know, it's always a discussion as far as what we can do non-surgically. If you want to proceed that route, if we can do surgery, you know, if that's important for you. Um, so definitely a very um dynamic discussion between patient and and the care team about, you know, what's best for the patient, what's what what timing's best for the patient. So that's very important, I think, in the decision uh process.

SPEAKER_01 9:06

And then for the caregivers, and Tiffany, you were mentioning this too. The caregivers, I've heard this a lot too, um, is that some people may expect their relative or friend to be able to drive a car, you know, the next day or start running the next week because they've heard stories about other, you know, friends that are older friends that have been able to do this, but it seems so different for everyone. I mean, is that the case? How unique is each recovery for each patient?

Recovery Timelines And Mindset

SPEAKER_03 9:32

So there are certain factors that are going to be pretty standard restrictions for every patient. Um, driving is one of them, especially if it's their right leg that is affected. That's that's a concern. Or if they drive a stick shift, that's another concern. Um, that is a, you know, that is a fairly standard one that we want to make sure. But different people are going to be off of crutches or off of a walker or off of a cane at different points in their recovery. And that's just part of how their bodies are prepared for the surgery. And definitely, you know, people think like, oh, she's getting around great. She doesn't need pain medicine anymore. Like, she's fine. She doesn't need to come back, right? No, no, you still need to come back, you still need to make sure you're following up with everything because as Dr. Guthrie said, it is so much a process. It is not something that the instant your knee is replaced, that you're like back to normal and back to your life. No, there's a, you know, a couple weeks checkup and a month checkup and a several months later checkup and a year checkup. It is we have to give time for the body to heal. We have to give time for everything to adjust and adapt and get back to what your new normal is and make sure that you're able to do all of the activities that are most important to you.

SPEAKER_02 10:34

No, I I to echo that. I think, you know, I have a lot of patients who are on Facebook and there's groups about patients who've had knee replacements and they just say it's the worst thing ever, you know, the pain is terrible. And of course, I think knee replacements, you know, historically are, you know, very painful. They're hard to recover from. But um, you know, I always try to tell patients everybody's different, everyone's experience is different. Um, you know, we we do the same thing for every single patient, but every single patient has a different experience. Um, and we do our best to help minimize the pain and help you deal with the pain. But I think, you know, going off of it's just human nature to kind of hear people's stories and share your stories too, which I think is good in a way, but also I think it scares people at sometimes to the point where, you know, they're living in so much pain, they become so debilitated and they can't have surgery just because they were scared. Um, so I think um, you know, demystifying that is that, you know, your care team's here to help you. If you want to do it, we're here to support you in that way and help you provide um, you know, good outcomes and pain relief. Um, so I think that's really important. Even patients who've had one knee and have another knee done, I kind of say try to wipe that experience from your memory because it's always different. You know, you might be older or younger, or arthritis might be different, you know. So I think um that's important as well.

SPEAKER_03 11:53

Yeah, the the mindset factor is huge. Um, if people come in expecting the worst, they're probably gonna have a harder time processing everything. Yeah. And if they come in optimistically, they're going to do better.

SPEAKER_02 12:03

And expectation, setting expectations. And um, I think that's important as well.

SPEAKER_01 12:08

And I like how you both referred to like that team mentality, like you guys are a team. Tiffany was mentioning the, you know, what the caregiver provides. So I think another misconception that I've heard, and maybe you could agree or disagree, but is that some people come in and think, well, I'm I'm really gonna do this alone. Like I'm gonna go through this, this pain, and you know, I'm gonna, I'm gonna I mean, obviously they're the one dealing with the pain, but but after that, if they have a great like caregiving coach and a great um or you know, clinic that they're going to, it can be a smoother recovery.

Support For Patients Living Alone

unknown 12:42

Yeah.

SPEAKER_01 12:42

And that's really important.

SPEAKER_03 12:43

It breaks my heart if people feel that they have to go through something so big alone. Um, and unfortunately, many people don't have somebody. You know, they don't have a close family friend or a neighbor or anyone who lives with them. They live by themselves, whatever the circumstances are, it's very challenging to help those patients because we want to. You know, we don't want them to go alone. We want to find ways for them to have, you know, support from their church or some other outside resource that can be there to help them and, you know, get them meals on wheels or whatever we can do to kind of make things easier on them because this is a big deal and we don't want them to go through it alone.

SPEAKER_02 13:15

Yeah, we require them to have a coach at at least at their pre-testing, which is a month before, usually during their education, we we recommend it. And then, you know, their understanding the experience, how they can be supportive, what they can do. Um, so it's a requirement in our program to do that. And if someone doesn't have a coach, we, you know, try to help them f you know, reach out to resources they have. You know, there's other ways that we can support them as well. But yeah, it definitely should not be something that someone has to go through alone. And it's hard to do alone. So um, you know, on that side of things. And then like we've said, you know, consistently, I think team is a big word in our program, you know, team from every touch point of who you see between the operating room, the clinic. I think that really um makes our program stand out for sure.

SPEAKER_01 14:03

Well, thank you both for clearing up some of you know what actually happens when you go in and if you do go ahead with uh an operation. So we appreciate you guys. And I know if I had any replacement, I would want to come to you. So thank you. Thank you for your time.

How To Book Care

SPEAKER_00 14:24

That's today's dose of strength, balance, and better movement from the Joint Effort Podcast. Ready for care that fits your life and gets you moving? To schedule an appointment with Dr. Noel for your surgical and injection needs, call 412-683-7272, or visit PGHBJC.com. Or if you are looking for lifestyle changes that are not searched, contact Tiffany Belgifine. Call 412-641-8594 or visit bone at jointhelp.org. Healthy bones and happy joints make every day better. Until next time, keep moving, stay steady, and take care of yourself.