After knee replacement are there alternatives to drugs for pain control?

June 29th — admin

I am very allergic to most of the narcotics used after surgery. But I’m scheduled to have a total knee replacement. How can I manage the pain without using these drugs alone?

There are some alternative ways to control pain that don’t involve any medications. Acupuncture, hypnosis, and electrical stimulation are three of the more commonly used non-drug ways to manage pain. Sometimes they are used together.

There are also other ways to control or manage your pain using medications. A new pain control method is called the periarticular cocktail injection. Periarticular refers to anything near or around the joint. Cocktail describes a mixture of medications combined together.

These drugs are injected into the joint space after the old bone is removed but before the implant is put in place. A second injection is done into the soft tissues around the joint after the implant is inserted.

The results of the first study suggest this may help improve function faster. And for those who can only tolerate a small amount of narcotic, it contains an antibiotic, anti-inflammatory, and numbing agent. Results after three months of follow-up are just as good as for patients receiving the more standard drugs.

It’s important that you discuss this problem with your surgeon. Reducing and controlling pain and other problems after surgery is as important as the operation itself.

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 the new tiny incision hip replacement shorten the hospital stay?

June 28th — admin

I’m going to have a total hip replacement next week. The doctor is using the new tiny incision to do the operation. Will I be able to go home sooner with this type of incision?

There’s still quite a bit of debate over the advantages and disadvantages of a shorter incision for total hip replacement (THR) surgery. Some studies show patients walk sooner and get out of the hospital faster. Other studies show no difference between the standard incision and the new mini-incision.

A recent study was done comparing 104 patients with a mini-incision to 105 patients with a standard incision. The surgeon was used to doing many THRs each year. There were only small differences in the two types of surgeries.

Surgery time and blood loss was the same for both groups. Pain levels and medication used for pain was the same between groups. Pain levels and walking ability were measured six weeks later. There was no difference between the two groups.

More studies are needed to compare short-term and long-term results with both types of incisions. For now it’s clear that you may not go home any sooner but you won’t be delayed either. The hospital stay seems to be linked more closely to anemia present before the operation and made worse from blood loss during the operation.

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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Do knee joint replacements come in sizes?

June 27th — admin

How does it work with knee joint replacements? Is it a one-size-fits-all joint? Do they come in small, medium, and large? I’m a pretty big guy, and I don’t want to get something that won’t hold me up.

Implants do come in various sizes as well as different shapes and designs. All three are important factors for good knee motion and function.

But it wasn’t always this way. In the beginning, there were only a few sizes. And there wasn’t any difference between implants used for the right knee versus the left knee.

Over time, researchers helped the manufacturers come up with better designs to fit the anatomy. They found ways to improve how the patella (knee cap) moves up and down over the joint. The implants came with parts that could be sized individually for each patient.

Then in the 1990s, improved materials came out on the market. At the same time, surgeons found better ways to do the surgery. They could use a smaller incision and cut much less of the muscles and soft tissues around the knee.

In the last few years, implant designs have improved for women. Scientists have used CT scans and computer analysis to map out the size, shape, and dimensions of the female knee. This has made it possible to prevent some of the more common problems with implants that are too large or too small.

This same research has also led to improvements for men. We know that a man’s knee is more of a rectangular shape than the woman’s knee. Shaping the implant to fit the contour of the patient’s bone has also helped improve the results.

Your surgeon will take all of these things into consideration when choosing and modifying the right implant for you. But don’t hesitate to ask this question. It’s always good to feel confident that you are getting exactly what you need.

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 type of activity can I do after my hip joint replacement?

June 26th — admin

I’m a retired nurse about to have my first hip joint replacement. I’d like to stay active after surgery. What can I do after the operation?

Your doctor and physical therapist will guide you in the postoperative rehab. Generally, patients are told to put as much weight on the leg while walking as they can tolerate. Most likely, you’ll start out with a walker. This will be replaced by one or two canes. By the end of six weeks, you should be walking without assistance. You can start to put full weight on the leg at that time.

A program of exercises will be prescribed from day one. It’s best to do these everyday during the first two months. The therapist will advance the exercises as you progress.

Water aerobic activity is a helpful tool for rehab. This can be started when your physician approves it. The activities in the water help strengthen the muscles while limiting the weight on the leg.

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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How can I minimize the risk of knee injury?

June 25th — admin

Knee injuries seem to be quite common. What can an active person do to minimize the risk of hurting a knee?

Many knee injuries happen because the person doesn’t do a thorough job of warming up and letting the muscles get ready for action. Stretching should always be done before exercising or playing sports.

Strong leg muscles help take the burden off the knee. When someone is active, one way the knee gets injured is through sudden change in velocity or motion. Someone who is running in one directions, stops, and then turns is putting the knee at risk. Jumping and landing hard is also very hard on the knee.

Ensuring that you wear good, supporting shoes will help your knees act well. Be sure that you are wearing the proper shoe for the activity. Finally, some people who have already injured a knee will wear a brace on their doctor’s recommendation. If this has been advised, be sure to wear the brace as needed.

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, after two years, why do I still have pain after my total hip replacement?

June 22nd — admin

Two years ago, I had a total hip replacement. Within six months of the surgery, I started having thigh pain on that side. It has never gone away. Can anything be done about this?

Thigh pain after a total hip replacement (THR) is not uncommon. In fact, up to 40 percent of patients may complain of this problem. It’s more common with implants without cement. These are called cementless total hip arthroplasty or replacement.

Doctors aren’t sure why this happens, which makes treatment difficult. If there isn’t any infection, then the patient is usually given pain medication. Physical therapy can be helpful. If severe pain lasts more than two years, the doctor may suggest a second surgery to repair or replace the THR.

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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How does one hurt their ACL?

June 21st — admin

I hear a lot about athletes tearing their ACL, but my sister did it and she wasn’t playing sports at the time. How does one hurt their ACL?

The ACL tear is a common injury and, while it happens most often in sports, it is the result of a sudden stop and twisting motion, or if the front or side of the knee receives a sudden blow.

In sports, it’s often the result of an athlete running and coming to a quick stop and then changing direction at the same time. Pivoting on one leg, overextending the knee joint, or a hard landing from a jump can also cause the damage.

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 dementia hinder recovery of a hip fracture?

June 20th — admin

My 83-year old mother has been diagnosed with dementia. She has slowly declined in mental and physical abilities. She can no longer walk without a cane (indoors) or walker (outdoors). I’m worried about what will happen if she falls and breaks a hip. Will her dementia keep her from recovering?

Dementia is a risk factor for poor outcome after hip fracture.

Often patients without dementia who are using a cane or walker don’t regain the ability to walk after hip fracture. A study in Japan showed that walking does make a difference after hip fracture. Those patients who are able to regain the ability to walk two months after surgery have a better outcome.

Dementia doesn’t affect the ability to walk. In other words, adults with dementia don’t forget how to walk. Instead, they show poor response to rehab or physical therapy after a fracture. This makes recovery slower with more complications. The death rate is higher for patients after hip fracture who don’t walk again.

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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Prior to a knee replacement, how can I relieve the pain from osteoarthritis?

June 19th — admin

I’m working my way through different treatments for knee pain from osteoarthritis. If I can hold off five more years, I’ll be able to get a total knee replacement. So far, I’ve tried anti-inflammatories, exercise, acupuncture, and injections. I really don’t want to take narcotics. Is there anything else I can try?

Your orthopedic surgeon is the best person to advise you on this. Your age, general health, and severity of the osteoarthritis (OA) are factors to consider. Many experts recommend a management plan for this type of problem. Many methods are included such as weight loss and regular exercise. Studies show reduced knee pain with these two approaches.

Finding the right pain reliever or combination of drugs to control your pain should be part of the program. For most patients, this can be done without narcotics. Sometimes it takes a period of trial and error before you find the best choice for you. If you haven’t been using a glucosamine and/or chondroitin product, ask your doctor about this option as well. These supplements can be purchased over the counter. They can be taken along with anti-inflammatories and analgesics.

There are new pain control devices being investigated that might be helpful in the near future. For example, Deepwave, a form of deep tissue electrical stimulation has been shown effective with knee OA.

This type of electrical stimulation reaches deeper tissues compared to regular electrical stimulation. It blocks pain signals and releases endorphins and serotonin. These are chemicals that work together to reduce pain.

The results of the first pilot project using Deepwave have been reported. The device was very effective in reducing pain and stiffness. As a result, patients were able to increase function and activity.

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 kind of a scar can I expect from my hip replacement?

June 18th — admin

I had a minimally invasive total hip replacement about a month ago. The doctor showed me photos of what to expect the scar to look like. I was expecting a two to three inch straight scar. Instead mine is curved and about four inches long. Why is my scar different from the photos I saw?

You’ll need to ask your surgeon this question to know for sure. Every patient and every scar is slightly different. Sometimes the anatomy determines where and how an opening is made. Before cutting the patient open, X-rays are taken and the surgeon uses his or her hands to feel where each muscle, tendon, and bone is located.

A curved incision is often used to help the surgeon remove the diseased joint. The capsule around the joint must be cut and the hip dislocated first before removal. A curved incision helps with this process. If the head of the femur is larger than expected, the incision may have to be made longer to get it out.

Sometimes the size of the surgeon’s hands makes a difference. Doctors joke about finding a surgeon with small, but strong hands. There is some truth to this idea!

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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