Does a surgeon’s volume affect quality of work?

March 30th — admin

I am having a hip replacement. My surgeon has good training but said he doesn’t do a lot of these procedures. Should I be worried?

Research has shown that patients have better outcomes from hip replacement when their surgeons do many of these procedures per year. This may be especially important in smaller hospitals, where there are fewer hip surgeries overall.

A recent study looked at 59,000 Medicare patients who had hip replacements. Researchers examined the results 90 days later. Complications were rare. But patients whose hip replacements were done by surgeons who did more than 50 procedures a year had fewer dislocations than those operated on by surgeons who did fewer than five procedures a year. Patients with “high load” surgeons also had less infection and pulmonary embolism.

It’s important that you’re comfortable with your surgical care. Talk with your doctor about your options.

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 a 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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Can taping knees affect pain in sports activities?

March 29th — admin

I have been working as a parent volunteer for our girls’ softball team. The coach has been doing some taping of the girls’ knees who have pain during squatting. I notice it seems to help some girls right away. Others don’t really seem to benefit. Why is that?

Taping has been used by many coaches, trainers, and therapists working with athletes who have ankle, knee, or shoulder pain. Taping usually stabilizes a joint and holds it in place. This takes pressure off the joint and nearby structures. It forces the muscles to respond more normally.

Studies definitely show a wide range of responses to taping. It would be very helpful if it were known who could benefit from taping rather than spending time trying out taping on a trial-and-error basis.

Pain during squatting may be caused by a problem called patellofemoral pain syndrome (PFPS). A recent study from Australia found two patient characteristics that may help predict which athletes with PFPS can benefit from knee taping.

The first is the patellar tilt test. The examiner glides the patella toward the outside of the knee, and then tries to lift the outer border of the patella up. In the normal knee, the patella should stay flat and should not lift up. Too much lift means the patella is very mobile and unstable.

The second is the angle of the tibia (lower leg bone). Bowing of the leg past five degrees seems to contribute to the problem of PFPS. Patients with these two positive tests often get immediate pain relief with taping.

The girls on your team who don’t get any pain relief from this type of taping may have some other problem that needs to be identified. Some other form of treatment may work better for them.

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 a 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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Does a hip replacement affect a pregnancy?

March 28th — admin

I’ve had a hip problem since birth called congenital hip dysplasia. The hip socket was not formed completely, and my hip slips in and out of the joint. This causes a lot of pain and affects my walking. My doctor is advising me to have the hip replaced, but I’m only 26 years old. If I have a hip replacement, should I not get pregnant?

Improved materials and technology have made it possible for younger women to have hip joints replaced. In 1996, 138,000 total hip replacements were done in the United States. Three thousand of them were in women under 45 years of age.

It appears safe to have one or more pregnancies after a hip replacement. In the small group of women studied, no damage to the replaced hip was observed after pregnancy.

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 a 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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Does knee repair always require rigorous rehab?

March 27th — admin

I’m planning to have an operation called microfracture to repair an old football injury to my right knee. I’ve been told to expect a rigorous rehab program. I’m not much of an exerciser anymore now that I’m not playing ball. Can I get by without this part?

Microfracture is a method of treating defects in knee cartilage that go clear to the bone. The surgeon drills tiny holes through the cartilage into the bone. This allows the blood from inside the bone to seep into the cartilage layer. Blood clots are formed and start a healing process.

Studies show that results after microfracture are best when the patient follows a four- to six-week postoperative program. The rehab includes protected weight bearing on that leg and continuous passive motion (CPM).

With CPM, your leg is strapped into a machine that slowly bends and straightens your knee. You can expect to spend six to eight hours (or more) each day on CPM. Based on the results of studies done so far, some surgeons consider patients at too great a risk for failure if they don’t want to follow the expected post-op rehab program.

This program is not strenuous, just time consuming. Talk to your surgeon about your concerns and let him or her know your thoughts on the subject. More information about what to expect on a daily basis may help you in your decision-making process.

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 a 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 affects the chances of getting hip arthritis?

March 26th — admin

I’ve heard that my chances of getting hip arthritis are less if I live in the South. Is this true?

The number of people with arthritis of the hip (called primary osteoarthritis) is not related to latitude or longitude. Ethnic background and genetics (passed down in families) seem to be much stronger factors. Compared to Blacks, Hispanics, Native Americans, and Asians, Whites (Caucasians) are much more likely to have hip osteoarthritis. Specifically, if you are white and have a mother, father, sister, or brother with primary osteoarthritis, your chances of getting hip osteoarthritis are much greater than those of other groups.

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 a 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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Can knee replacements set off airport security detectors?

March 23rd — admin

I have a brand new knee replacement (this year). When I travel, I notice some airport detectors go off and others don’t. Why is that?

Many people have reported differences not only from airport to airport but even from time to time through the same security detector. To solve this puzzle, Dr. Robert F. Ostrum, Chief Orthopaedic Surgeon at Cooper University Hospital in Camden, New Jersey did a little research on the topic.

He found that airport metal detectors generate a brief magnetic field. When a metal object passes through the detector, the magnetic field is reversed and a sharp electrical spike sets off the alarm. Many other factors come into play as well.

For example, the more metal you have (say from multiple implants) or the larger the pieces (mass), the more likely it is that the detector will sound the alarm. The type of metal can also make a difference. Anything with iron in it or other type of metal that can be magnetized increases your chances of detection.

Detection units can also be set for higher sensitivity. So on high alert days, you are more likely to set off the alarm when you walk through the archway compared to a low-alert status.

Some of the walk-through archways only have a detection device on one side. If your implant is on the opposite side, you are less likely to set off the alarm. The handheld wand detectors are more likely to detect metal implants but these are not used routinely.

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 a 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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Why are people with osteoarthritis encouraged to exercise?

March 22nd — admin

Why are people with osteoarthritis of the knee or hip encouraged to exercise?

Sometimes people who have knee or hip pain from osteoarthritis are hesitant to do exercise. Along with weakening of the joints and the muscles around these joints, inactivity also leads to poor fitness. Exercise is a way to ease pain and improve ability to do daily activities, even for people who have knee or hip osteoarthritis.

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 a 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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Can knee pain/stiffness due to aging be alleviated?

March 21st — admin

As I get older I notice more and more knee pain and stiffness. What are some simple things I can do to help with this problem?

Exercise has really been shown over and over to be most effective for mild to moderate osteoarthritis. A walking program is used by many people because it is easy to do and doesn’t require special equipment. A good pair of walking shoes and comfortable clothing are all you need.

Many communities offer walking clubs for those who don’t want to walk alone. Groups may meet at the local mall each day. Some combine walking and hiking for those who prefer an outdoor experience.

If walking isn’t possible but you have access to a pool, then consider a pool therapy program. The warmth and buoyancy of the water offer gravity-free exercise for painful joints.

Strengthening exercises for the quadriceps muscle may be helpful, too. The quadriceps muscle is the large four-part muscle along the front of the thigh. Resistive training exercises to improve strength have been shown effective.

Finally, some experts advise a good diet with adequate hydration. Clear liquids (especially water) may help lubricate joints.

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 a visit with your health care 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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Is it possible to kneel after a hip replacement?

March 20th — admin

I am going in to have hip replacement surgery. Will I be able to kneel down to work in my garden once my hip heals? What about getting on my hands and knees in the garden?

If your doctor does your surgery from the back part of the hip, called a posterior approach, you need to avoid bending your hip more than 90 degrees. You can kneel down, but try to avoid kneeling directly onto the operated side. If you must kneel, keep your weight even on each side. While kneeling, avoid bending too far forward at the hip because you could bend your hip past the safe limit of 90 degrees.

Do not get onto your hands and knees. This position immediately puts your hip at a 90-degree angle, and the added pressure of your body weight on your hip could force the hip to dislocate out of the socket.

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 a 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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Is there a hereditary link to ACL injuries?

March 19th — admin

Two of our four sons have had to have an ACL repair from injury while playing sports. Their father had both ACLs repaired from different football injuries. Is there a genetic link or is it just the dumb luck of sports injuries?

You pose a good question. There may be a hereditary connection but researchers haven’t addressed this topic directly. In a recent study from Australia, the results of 50 patients with revision ACL repairs are reported.

All 50 patients had the first ACL repair, which failed. A second (revision) operation was performed. Five of the 50 patients (10 per cent) had a failed revision surgery. The data collected from the patients showed that 16 of the 45 patients had a positive family history. That amounts to more than one-third (36 per cent) of the group.

Soft tissue such as muscles, ligaments, and fascia are made up of collagen fibers. The pattern of the collagen tissue as it forms each of these structures helps determine its strength. There are more than a dozen types of collagen fibers that determine how elastic the tissue is.

Variations in collagen length and elasticity are likely genetically determined. A positive family history of ACL injuries in your family may be the key factor here — more than luck! Participating in contact or collision sports also increases the chances of trauma and injury.

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 a 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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