Compare these two total hip replacement surgeries

December 31st — admin

I’ve had two total hip replacements. The first was a full incision and took me six months to get back on my feet and up to speed. The second one was three weeks ago with two tiny cuts. I’m already walking without a walker for up to 30 minutes. I still have a little trouble with stairs but that seems to be coming. Is a smaller incision really all that makes the difference?

The operation you had is called a minimally invasive total hip replacement (THR). Two small incisions are made: one in the front of the hip and one to the side. Besides the small cuts, there are other important differences from the standard THR.

No muscles or tendons are cut in a minimally invasive THR. The joint capsule is cut, but not removed. The joint itself is removed in several pieces. No cement is used to hold the new implant in place.

Overall, less trauma to the soft tissues and joint mean less pain and a faster recovery time. Patients can stop taking pain killers and get back to normal function faster. In fact most patients are able to put weight on the operated leg the same day as the surgery. Many go home in the first 24 hours.

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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Is total joint replacement a preventative option?

December 30th — admin

I need part of my shoulder replaced (the ball portion but not the socket). Will I just develop arthritis in the socket later and need to have it replaced eventually? Maybe I should just have the whole shoulder replaced now. What do you think?

As the old saying goes, “If it’s not broke, don’t fix it.” Joint replacements don’t last forever. Just removing the damaged part and replacing it can cause problems. The muscles around the joint must be cut and a certain amount of bone removed.

Many doctors would agree when only half the joint is a problem then a hemiarthroplasty is the way to go. This operation only replaces the part of the joint that is damaged. This is usually the head of the humerus or ball portion that fits into the socket. Any part of the joint that is still in good health should be saved.

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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Surgery preferred for double-ligament knee injury

December 29th — admin

I frequently read in sports journals about the two main ligaments in the knee. I understand the anterior cruciate ligament is the one that’s most often injured. Is it possible to tear both ligaments at the same time?

Yes. High-velocity or high-energy accidents in contact sports can cause damage to both ligaments in the knee. This can also happen in car accidents if the knee impacts the dashboard. Injuring both ligaments makes the knee very unstable. This causes problems walking and using the knee.

With this much damage, surgery is the preferred treatment. The surgeon will repair as much as possible at one time, but these are time-consuming operations. Sometimes a second surgery is needed to finish the repair. The first and most important surgery is to repair the posterior cruciate ligament and surrounding structures. These must be repaired at the same time because these tissues work together to help stabilize the knee.

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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Obesity a factor in total hip replacement surgery

December 28th — admin

I have been overweight all my life and now my hips are so bad with arthritis I need replacements. The doctor has told me to lose weight, but how much is enough?

A recent report on 851 cases of total hip replacement included information on patient demographics. This refers to data about the patients’ ages, gender, diagnosis, and body mass index (BMI).

BMI is calculated based on height and weight. It helps show how much body fat you have. Health risks from carrying too much weight include heart disease, diabetes, and arthritis.

A BMI in the “healthy” range does not always mean the person is fit and healthy. Poor diet and genetics can put an average person at risk for health concerns. Keep in mind the BMI does not take into account body frame. A muscular, large-framed person’s BMI could indicate obesity, but this may not be the case.

The Centers for Disease Control and Prevention (CDC) offer a website with easy calculations of your BMI. You can do this by going to:

http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm

Once you’ve found your BMI ask your doctor about a reasonable weight loss plan. Studies show results after a hip replacement are best in patients with a BMI of 30 or less.

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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Osteoporosis may cause rotator cuff repair to fail

December 24th — admin

I’m 78-years old and have been diagnosed with a rotator cuff tear and osteoporosis. I’ve been told the osteoporosis puts me at risk for a failed rotator cuff repair. If the muscle is the problem, what difference does it make if the bones are brittle?

The tendons attach to the bone and must be reattached after injury in order to give you back shoulder motion and strength. Some of the newer ways of repairing rotator cuff tears involve drilling holes through the bone. Then the doctor threads the sutures through the tunnel to the other side. This gives the repair strength and the shoulder stability.

The sutures may not hold if the bone is soft or brittle from osteoporosis. In cases of bone problems, they can use special anchors that look like buttons to help hold the stitches in place.

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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Is a popliteal cyst the same thing as a Baker’s cyst?

December 23rd — admin

What’s a popliteal cyst? Is it the same thing as a Baker’s cyst?

Popliteal and Baker’s cysts are indeed the same thing. Both refer to a fluid-filled sac behind the knee. This was first observed and recorded by Dr. Baker (hence the name) in 1877.

Since that time, physicians have learned there is a channel that forms between the joint and the cyst. Fluid passes through this channel from the knee joint to create the cyst in the back of the knee.

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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Pinning vs. total hip replacement

December 22nd — admin

I’m writing to you from a hospital bed after tripping over a shoe lace and breaking my hip (a femoral neck fracture). I don’t have much time before the nurses come in and scold me for being on the computer. Please tell me the pros and cons of having the bone pinned together versus having the joint replaced.

You didn’t mention your age or bone status, two important points in making these choices. Older patients (65 years old and older) with poor bone density may not be able to grow enough new bone to heal a fracture that’s pinned. The hip replacement may be the best option.

Is the fracture stable (fracture line hasn’t moved), separated (bone has drifted apart) or impacted (one side of the fracture is pushed into the other side)? A stable fracture that hasn’t moved or shifted is often treated by internal fixation. This means screws are used to hold the bone together until it heals.

If the fracture can’t be pinned together or if there are serious arthritic changes in and around the bone and joint, then a joint replacement may be needed. According to the results of a recent study, older adults have better results with a total hip replacement.

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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What is “shoulder instability”?

December 21st — admin

What is “shoulder instability?”

Shoulder instability refers to a range of disorders. Instability can occur when soft tissues like ligaments, capsule, and tendons are damaged around the shoulder joint. The result may be a partial dislocation. This means the head of the humerus (upper arm bone) comes out of the socket but can go back in by itself. This is called a subluxation.

The other end of the spectrum occurs when the shoulder completely dislocates and must be put back in or reduced under anesthesia. Most shoulder instabilities are caused by trauma. If the damaged tissue doesn’t heal properly, the shoulder can dislocate many more times.

The treatment for chronic shoulder instability is usually surgery to repair the damage. This operation is done as an outpatient. The doctor puts a tiny lighted telescope and small instruments into the shoulder joint. Small anchors with suture attached are inserted right into the socket of the shoulder. The torn ligaments are reattached to the socket. Complete healing takes about four to six months.

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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Splinting, bracing, wrapping injured knees is controversial treatment

December 18th — admin

I often see people wearing braces on their knees. I hurt my knee in a skiing accident last week. Should I be wearing a brace?

The use of splints, elastic bandages, neoprene sleeves, and various braces for knee injuries is controversial. When to wear these devices and for how long are subjects of current research.

 

A proper diagnosis is the first step in knowing how to treat an injury. For example, elastic ace wraps are used for sprains to help reduce swelling in the first 24 hours. Knee support is sometimes recommended for anterior cruciate ligament injuries, especially if surgery is delayed. Talk with your doctor to find out whether extra support is necessary in your case.

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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Specialists undecided on treatment for displaced femoral fracture

December 17th — admin

My 82-year old father is in an assisted living center. He was hospitalized two days ago for a broken hip bone. I guess it’s what’s called a displaced femoral fracture. He’s had three specialists consult on the case. They can’t seem to decide what’s the best way to treat the problem. Is this unusual? Should we move him to a different hospital?

A displaced fracture of the femur (thigh bone) means the bone broke and the two ends either separated or shifted. In other words, the broken pieces of the bone don’t line up anymore.

Femoral fractures are very common in the United States, especially with the aging of America. The type of fracture you’re describing can cause quite a bit of disability for the patient. Some patients are unable to get back to their former level of function. They may have to give up independent living. They may go from being able to walk to being confined to a wheelchair.

The goal of treatment is always to get the patient back to a prefracture level of function. Treatment is usually an operation to repair or replace the bone. Repair may be done using screws to hold the two ends of bone together until healing takes place. This is called internal fixation. It may be necessary to replace part or all of the hip joint.

There are many factors to consider when choosing the right treatment. The patient’s age, bone density, mental status, and other health issues are important. Most likely the doctors are meeting to confer on which treatment would give your father the best chance for recovery based on his individual factors.

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.

Posted in Hips. Tags: , , . No Comments »
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