Widow will need someone to help her after hip replacement surgery

March 18, 2010 — admin

I’m going to have my first hip replacement next month. The surgeon tells me if all goes well I should be home in 12 hours. I am widowed and live alone. How will I know what to do or how to care for myself?

With the new minimally invasive operations patients are able to go home quickly after joint replacements. The incision is smaller and the blood loss is less. The time under anesthesia is much less, too. Patients are up and walking with the therapist much faster.

One way to accomplish this is through pre-operative training. That means you’ll see a physical therapist before the operation. The first visit takes place about two weeks before the surgery. Then three to five days before your hip replacement, you’ll see the therapist again.

The therapist will teach you the exercises you’ll need to know. You’ll learn how to walk with crutches. In fact you’ll be required to practice both the exercises and the crutch walking before the operation.

You will need someone to help take care of you for a few days after the surgery. A nurse and a therapist will visit you in your home. You’ll be reminded of the dislocation precautions. Your blood levels will be checked. Your doctor will be notified if there are any problems. Most patients do very well with this approach.

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What to do about a hamstring injury

March 16, 2010 — admin

I play adult-league baseball in the summers. Every year I tear my hamstring muscle on the right side. I have done everything to prevent this from happening. I’ve used heat, cold, taping, stretching, and so on. What else can I do?

Hamstring injuries are common among athletes at all levels from amateur to professional. Once the hamstring muscle has been torn, it’s more likely to tear again. Some athletes report five or six injuries on the same side.

Researchers at the Monash University Department of Physiology in Australia studied this problem. They found when injured hamstring muscles heal the optimum length of the muscle needed for contraction changes. The muscle that was injured now operates at a shorter length. This can lead to microscopic damage from certain types of muscle action. These contractions are called eccentric contractions.

The answer to your problem may be to focus on eccentric activity. Instead of exercises to tighten up the hamstrings, it may be better to exercise while slowly lengthening the muscle. The eccentric contractions can shift the optimal angle toward a longer length in the hamstrings muscle.

An athletic trainer or physical therapist can help you with this type of rehab program.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Should you have bilateral total hip replacement?

March 15, 2010 — admin

My father has arthritis in both hips. This limits his travel and activities. He wants to have them both replaced at the same time to “get it over with quickly.” We’re concerned about this idea. Isn’t it better to do one at a time?

Researchers are always trying to find ways to predict which patients will have the best results after surgery. A group of surgeons from The Center for Hip and Knee Surgery in Indiana followed 900 patients with total hip replacements (THRs) for nearly 30 years. They compared single THRs to both THRs being done at the same time. Here’s what they
found out.

The death rate was higher in older adults. Patients having the bilateral THRs had fewer total days in the hospital. This was a cost savings. They had less time out of work (or play). They only had to have anesthesia one time.

Overall outcomes in terms of physical function and life of the implant were the same between the two groups. Implants with the most post-operative problems were identified and reported. Surgeons can avoid using the most problematic implants when doing bilateral THRs.

All patients thinking about having bilateral, simultaneous THRs should be advised about the risks of having both hips done at the same time. Older adults in poor health and without family support at home may want to reconsider and have one hip done at a time.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Three professionals = three diagnoses for shoulder pain. Who’s right?

March 12, 2010 — admin

I saw two orthopedic surgeons and one physical therapist about a shoulder problem I’m having. All three gave me different explanations for the problem. None of them was the same problem. What’s going on here?

Shoulder pain is a common problem especially as we get older. The way the shoulder is examined isn’t the same from doctor to doctor or therapist to therapist. It’s not uncommon to get a different diagnosis from each specialist who sees a patient.

The shoulder joint itself is very complex. The way it works often causes more than one soft tissue structure to get pinched or pulled. This makes it hard to find out the actual cause of the problem.

Experience and training go a long way in making a correct diagnosis of shoulder pain. Besides musculoskeletal problems, shoulder pain can be caused by cancer, infection, or problems in other parts of the body. For example, a kidney infection or ruptured spleen can cause shoulder pain.

Researchers are trying to find a reliable way to test the shoulder. One model being studied is the selective tissue test (STT) first developed by an orthopedic surgeon (James Cyriax, MD). Many doctors and therapists use this skillfully and successfully to make a shoulder pain diagnosis.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Do injections to lubricate the knee really work?

March 11, 2010 — admin

I heard a report that knee injections to lubricate the joint are more and more popular. Do they work? And how?

Hyaluronic acid (HA) can be injected into the knee to restore the joint’s ability to move and glide easily. The knee already has some of its own HA. By injecting more, the HA already in the joint improves the flow of the synovial fluid. Injected HA also helps keep the naturally present HA from breaking down.

Overall, studies show that HA is both safe and effective. It seems to work better for younger patients (under 65 years) and for patients with only mild to moderate disease. Patients with severe osteoarthritis may not have any natural lubrication left in the joint. It seems without some HA, the injection doesn’t work as well.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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How can having a total hip replacement improve my sleep?

March 10, 2010 — admin

I’ve been dealing with an arthritic hip for years. Now it’s affecting my sleep. I heard that having a total hip replacement could help me sleep better. How does that work?

Arthritis sufferers are known to have poor sleep patterns caused by pain. Conditions such as osteoarthritis are a common source of hip pain in the older adult.

A recent study in New Zealand showed that sleep is improved after hip joint replacement. All patients had painful symptoms from arthritis that woke them up at night. Less hip pain after the operation meant better sleep. If the patients were awakened from sleep, it was for some other reason than from hip pain.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Steroid injections for pain relief – how long do they last?

March 9, 2010 — admin

I had a steroid injection into my shoulder for a problem with bursitis. I got immediate relief that lasted about a week. Now my symptoms are starting to come back. How long do steroid injections usually work?

There aren’t too many studies just on the duration of pain relief with steroid injections into the joints. Results range from one week as in your case up to 13 weeks.

It’s clear that steroid injections work better than placebo injections with saline solution. And studies show that some steroids work better than others. Long-term pain relief may require a higher dose of the steroid.

In some cases steroid injections are used to control pain and reduce rehab time after arthroscopic surgery. In a patient with recurring bursitis there may be other factors such as posture and overuse to be addressed. The injection may help calm the joint enough to work on improving alignment and motion. Combining physical therapy with steroid injection may be one way to improve overall results.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What does “advanced” osteoarthritis mean?

March 8, 2010 — admin

My doctor told me I have advanced osteoarthritis. What does this mean?

Osteoarthritis (OA) is staged according to how much damage has occurred in the joint and how much joint space is left. X-rays are used most often to stage OA. In advanced stages of OA, there is a complete loss of joint space.

The femur (thigh bone) and the tibia (lower leg bone) have no cushion between them. When you use the knee, the bones slide across each other without any protection or lubrication. We call this bone-on-bone.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Uneven wear in hip joint replacement result of third-body wear.

March 5, 2010 — admin

I had a joint hip replacement for severe arthritis three years ago. The doctor tells me that “third-body wear” is likely the cause of some uneven wear in the joint. What does this mean?

When patients with hip joint replacements are compared, there are very different results in wear patterns of the new joint. This is true even when the same replacement parts are used from patient to patient.

In fact, one study looked at patients with both hips replaced using the same implant. The researchers compared one side to the other and found that the wear pattern was different from side to side. One of the reasons for this is third-body wear.

This is the presence of tiny particles in the joint. These pieces may be bits of bone or fragments of glue or cement used to hold the new joint in place. Even metal debris from the coating around the joint implant can cause the joint liner to be scratched and roughed up. Joint wear and tear is increased when the surfaces are roughened.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Still have pain 3 weeks after shoulder surgery?

March 4, 2010 — admin

I had some shoulder surgery three weeks ago. I am doing my exercises faithfully, but there’s still quite a bit of pain. Is this normal?

Pain is a normal sign at certain points in the recovery process. This is most common during the early phase after an operation. Drugs to control pain and inflammation are used from one to three weeks after surgery.

At the same time, physical therapy to stretch and move the tissue is begun. The therapist will include exercises to retrain the muscles, restore normal posture, and begin motion. The program is progressed from three to six weeks postop.

Throughout this time, it’s best to complete the exercises without pain. Pain is a sign that something is wrong. Either the exercise is being done too soon or improperly. It’s better to do a little often than doing a lot occasionally.

Keep at it with the help of your therapist. Quality is more important than quantity. Good muscle control comes first before the ability to do many repetitions. Stop when the muscle gets tired. You’ll know you’ve reached this point when the muscle starts to shake or you can’t go through the same motion as during the first few repetitions.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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