| There seems to be quite a few older adults in my family with hip fractures from osteoporosis. Is this a hereditary disease?
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| There is new evidence that genetics plays a role in osteoporosis. Many different genes affect bone growth. Genes to code the structure of proteins that help build bone are important. Genes involved in making sex hormones are involved. Estrogen and testosterone are key factors in bone growth.
Vitamin D is needed for calcium to be used in forming bone. A special gene is linked with this activity, too. In general these kinds of genes are called osteoporosis candidate genes. Any changes in these genes can cause a problem with bone growth. Men seem to be more affected by genetic factors than women. A study of families show bone mass is lower in relatives of men with osteoporosis. Increasing age seems to be related to increased bone loss in men with certain types of gene structure. More research is needed in this area to know what and how genetics plays a role in osteoporosis. There may be some major differences between genetic factors in men versus women. 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. For more information on this subject, visit www.zehrcenter.com. |
Naples Orthopedic Surgeon – Dr. Robert J. Zehr The Zehr Center
Is osteoporosis hereditary?
October 23rd — adminGet your hip replacement surgery done at a high-volume hospital!
October 22nd — admin| My son-in-law is a doctor. He told me to get my hip replacement done at a high-volume hospital. What does this mean?
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| Generally it means the hospital does more than just a few total hip replacements (THRs) each year. Researchers often set 100 as the point at which a hospital is called high-volume.
A recent study of Medicare patients getting THRs in a high volume hospital reported a death rate of less than one percent. This was compared to a 1.3 percent rate in hospitals doing less than 10 joint replacements each year. The research supports finding both a high-volume facility and an experienced doctor. Doctors who do more THRs also have lower rates of complications. Be aware that increased experience and volume can lower complications but not to zero. Problems still occur even with the most skilled surgeons. This may have to do with the age and overall health of the patient. 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. For more information on this subject, visit www.zehrcenter.com. |
Obesity may be a factor in hip replacement surgery technique
October 21st — admin| I saw a videotape in my doctor’s office showing two ways to do a total hip replacement. One had a much smaller incision than the other. How do they decide which method to use?
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| The small incision is a fairly new method for hip joint replacement. It’s called a mini-incision. Many studies are being done to compare the mini-incision method with the standard way to replace the hip joint.
Right now doctors choose patients who aren’t overweight. Compared to the standard-incision group the mini-incision group is more likely to be male, taller, and thinner. In fact, the standard-incision group is six times more likely to be obese than the mini-incision patients. The mini-group also has fewer problems in general after surgery. Researchers are working to find out what type of patients is best suited for each method. That information will help doctors guide their patients in choosing the right operation for each one. 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. For more information on this subject, visit www.zehrcenter.com. |
How long will I need to exercise following hip replacement surgery?
October 20th — admin| My doctor advised me to keep doing my exercises for a year after my total hip replacement. Is this really necessary? I feel fine.
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| Many studies show decreases in muscle strength around the replaced hip even two years after the operation. With an exercise program, muscle strength improves from before to after the operation. An even better measure is to compare muscle strength from side to side before and after the hip replacement.
The joint implant can come loose when muscles are weak or when they function poorly. Muscle weakness leaves the joint unstable and unprotected. A supervised exercise program is advised for as long as possible even up to two years after the operation. This will protect the joint and improve function. Doing the same exercises may not be best. A recent study showed exercises given early after hip replacement should be advanced to weight-bearing exercises. The best time to move on to this phase is four months after the operation. The patient must be able to stand on one leg without pain. The leg shouldn’t give way or collapse. 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. For more information on this subject, visit www.zehrcenter.com. |
Sidelined by hip pain, but told "too young" for hip replacement surgery?
October 19th — admin| I’ve been told repeatedly that I’m “too young” for a hip replacement. I’m 51-years old and can no longer enjoy the activities I once did for fun because of severe hip pain. Isn’t what I’m missing out today important enough to warrant a hip replacement now?
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| Good point. Doctors know that with today’s current implant materials, the hip replacement may only last 10 to 15 years. It may be less if you are highly active in sports and other physical activities.
This means you’ll likely need another hip replacement when you are only 65 years old and maybe a third before your 75th birthday. You’ll lose some bone and height with each operation. There are many other problems that come with revision operations. On the other hand, pain and disability are hard to live with. If you wait too long, you may not gain back what you’ve lost in terms of strength, function, and physical ability. The patient’s symptoms and ability to tolerate pain for a long time should be considered. |
For complete information on advancements in hip replacement surgery including the anterior approach, visit: https://www.zehrcenter.com/total-hip-replacement.php.
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. For more information on this subject, visit www.zehrcenter.com.
Best form of surgery for torn rotator cuff depends on location
October 15th — admin| I have a moderate rotator cuff tear. I haven’t had relief from physical therapy and medications. Now we’re talking about surgery. My doctor says there are a couple of ways to approach surgery for tears like mine. What type of surgery is best?
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| There are a few ways to operate on rotator cuff tears. The most extensive surgery is open repair of the rotator cuff. With this procedure, surgeons use a large incision to operate. During surgery, they suture the tear to help the shoulder function properly. This approach is the best option for severe tears, or those that affect more than half of the rotator cuff tendon.
An alternative for minor tears is called acromioplasty. With this procedure, surgeons shave part of the acromion bone on the point of the shoulder. A ligament over the top of the shoulder is cut, and injured tissues are removed. This takes pressure off the injured rotator cuff and promotes healing. For patients with tears that affect less than half of the tendon, this procedure usually have good, lasting results. For patients whose tears go through about 50 percent of the tendon, repair of the rotator cuff may offer better results than acromioplasty. This choice also depends on where the tear is located. Ask your doctor which surgery is best, given the size and location of your injury. |
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. For more information on this subject, visit www.zehrcenter.com.
What is meant by a separated shoulder?
October 14th — admin| I recently separated my shoulder in a car accident. Can you explain what exactly this means?
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| There are many parts to the shoulder complex. Most people think of the shoulder as the upper arm bone in a socket. That’s technically correct, but the “socket” is just a small part where the arm moves and turns. Above the socket, the collarbone attaches to the shoulder blade as it comes around from behind. A band of strong ligament holds these two bones together. Where these two bones meet is called the acromioclavicular or AC joint.
A shoulder separation occurs when the ligaments at the AC joint are torn or damaged, and these two bones are disrupted. Shoulder separations are graded as I, II, or III depending on the seriousness of the tear. An X-ray determines this. For example, if the ligaments are completely ruptured, the collarbone becomes dislocated. This is a grade III shoulder separation. A grade I is a minor ligament tear, and the bones stay in place. Grades II is in between these two extremes. 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. For more information on this subject, visit www.zehrcenter.com. |
Dislocated shoulder may require surgery
October 13th — admin| I dislocated my shoulder. Should I have surgery?
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| Traditionally, doctors have treated dislocated shoulders with slings and physical rehabilitation. Unfortunately, this approach isn’t very effective in preventing repeat dislocations. This is especially true if you’re young. Studies show that athletes under age 25 re-injure their shoulders up to 94 percent of the time.
Surgery to stabilize the shoulder is a more aggressive approach. A new procedure uses an arthroscope– a camera-like device that lets doctors see inside the joint. With this instrument, doctors don’t have to make big incisions in the skin. This makes surgery less invasive. Doctors implant special tacks to hold the shoulder in place. How effective is this procedure? It was recently tested on cadets at West Point. In this group of young, highly active patients, surgery resulted in stable shoulders 88 percent of the time. These patients had no complications from surgery. They were able to return to all their activities. Twelve percent of the patients had another injury within a year and a half of surgery. Still, this re-injury rate was felt to be small compared to that of patients who didn’t have surgery. Talk to your doctor about your options for surgery, given your age and history. |
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. For more information on this subject, visit www.zehrcenter.com.
Why do I need physical therapy before knee surgery?
October 9th — admin| I am facing knee surgery for a torn anterior cruciate ligament (ACL). When I went to see a knee specialist, I felt rushed. I was told I needed surgery right away. My family doctor thinks I should have some physical therapy before surgery, but the specialist is adamant that I have surgery right away. Is it usually helpful to have some PT before having surgery?
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| Some doctors prescribe up to 12 physical therapy visits before scheduling ACL surgery. Doing some physical therapy first can help prepare you for the surgery. The visits help by getting control of the swelling, restoring knee movement, and improving knee stability. Getting the swelling down before surgery may keep scar tissue from developing after surgery. Improving knee movement and joint stability before surgery can also affect your progress after surgery. Your physical therapist can use the visits before surgery to answer your questions. He or she can train you to use crutches, and go over the exercises you’ll do after surgery. |
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. For more information on this subject, visit www.zehrcenter.com.
Is arthroscopy the best way to diagnose source of knee pain?
October 8th — adminMy doctor is trying to find the cause of the pain in my knee. What’s the benefit of doing knee arthroscopy instead of MRI?
Knee arthroscopy may be the most common orthopedic procedure done today. It is a highly safe and reliable way to locate the source of knee pain. Researchers estimate that it is accurate over 90 percent of the time. Also, arthroscopy is more readily available to most patients than some other diagnostic procedures, such as MRI. While MRI may be less invasive, it’s also more costly and, in some cases, harder to get. Some doctors worry that MRI may be less accurate than arthroscopy. If both kinds of procedures are available to you, you may want to ask your doctor whether he or she prefers one method over the other. It may be that, in your case, one of the procedures would do a better job of finding the source of your knee pain.
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. For more information on this subject, visit www.zehrcenter.com.
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