Will surgery fix trick knee?

June 27th — admin

I have a trick knee that goes out on my every now and then. It’s from a torn ACL from an old football injury. If I have it repaired surgically will that stop it from giving way?

It should but there are no guarantees. It may depend on the condition of the rest of your knee joint. Are the other ligaments okay? What about the cartilage? Are there any signs of advancing arthritis? How much strength do you have in the muscles around the knee joint? These are all important factors.

There are two popular ways to repair a torn anterior cruciate ligament (ACL). One of these methods called the bone-patellar tendon-bone graft has been shown to be 22 percent more stable. In other words, it’s less likely to give way because of joint laxity. The increased graft strength may come from the small piece of bone plug that’s used along with the tendon tissue to make the repair.

The choice of graft material must be made on a case-by-case basis. It’s an educated decision based on the condition of your joint, your activity level, your goals, and the surgeon’s level of expertise.

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 many patients who have surgery for shoulder dislocation develop arthritis?

June 24th — admin

About five years ago, I dislocated my shoulder repeatedly. Eventually I had surgery to clean out the joint and tighten it up. I’m starting to notice some crackling noise in that joint when I move my arm overhead. Does this mean something has come loose? Do I need to do something for this before it becomes a problem?

You may be noticing some early signs of joint degeneration. Arthritic changes aren’t uncommon after shoulder surgery for recurrent shoulder dislocations. In fact, some studies show up to 20 per cent of patients who have surgery for shoulder instability develop postoperative arthritis.

Sometimes early arthritic changes are already present in the shoulder before the surgery. This has been observed in about nine per cent of patients with chronic shoulder instability. Loss of shoulder motion and function seem to be linked with deficiencies leading to arthritis.

A follow-up visit with your orthopedic surgeon may be in order. At the very least, an X-ray of the joint will be done to rule out fracture or loose fragments in the joint. The X-ray can also confirm the presence of arthritic changes.

Early diagnosis of orthopedic problems is always recommended. Taking care of a minor problem can help prevent major problems later.

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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Hip joint resurfacing vs. hip joint replacement

June 23rd — admin

I thought I was going to be spared having a total hip replacement by going for joint resurfacing. But I ended up with a hip fracture and a second surgery to replace the hip anyway. No one seems to know what caused the problem. What are some possible reasons for this happening to me?

Hip joint resurfacing instead of a total hip joint replacement is fairly new. Resurfacing replaces the arthritic surface of the joint but removes far less bone than the traditional total hip replacement. It saves bone in the femoral neck but can put strain on the femoral neck leading to fractures.

There are two main groups of risk factors for fracture after joint resurfacing. The first has to do with the patient. Bone quality is important. Decreased bone-mineral density and cystic bone changes can contribute to weakened bone. The bone has a decreased ability to withstand forces leading to fracture. Any changes in natural alignment of the hip can result in mechanical abnormalities. The most common of these malalignments are coxa varus (angled inward) and coxa breva (short femoral neck).

The second group of risk factors is related to the surgical procedure. Placement of the component is important. If the implant is tilted or angled too far in any direction, loading patterns change. The risk of fracture increases. The surgeon also uses a special technique called notching as part of the procedure. Studies show that notching reduces the bone’s resistance to fracture.

Sometimes it isn’t clear what went wrong. Efforts are being made to identify patients who are good candidates for joint resurfacing. Bone quality, general health, and past medical history are important features to consider. At the same time, surgeons are looking for ways to improve the implant and surgical techniques used.

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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Are rehab and recovery the same for joint resurfacing as for joint replacement?

June 7th — admin

I’m 59-years old. I’ve had one total hip replacement on the right. Now I’m looking at a joint resurfacing procedure for the left. I understand this new procedure is less invasive. Will the rehab and recovery afterwards be easier, too?

Hip joint resurfacing is a type of hip replacement that removes the arthritic surface of the joint but takes far less bone than the traditional total hip replacement. Recovery may be faster after joint resurfacing for some patients.

The rehab protocol remains the same. The main difference is how fast you move through the progression from range-of-motion to strengthening and beyond. In some places, physical therapy begins pre-operatively. You are evaluated for strength, motion, and function. And while you are free from the effects of anesthesia and post-operative pain, the therapist will teach you how to manage crutches (including stairs). This may be a review for you since you’ve had hip surgery before.

Even if you aren’t seen pre-operatively, you will be in physical therapy on the first postoperative day. Ankle and knee movements are used to help pump swelling out of the leg and to prevent the formation of blood clots. You’ll be wearing compressive stockings placed on your legs right after the surgery. Exercises and walking with assistance are initiated.

You probably won’t be putting your full weight yet on that leg, so you’ll need a walker, crutches, or canes at first. Eventually, you’ll progress to full weight-bearing without the use of any aids. Hip strengthening exercises, endurance activities, and a program to restore joint proprioception (sense of position) will be added. When you are safe in putting full weight through the leg, several types of balance exercises can be chosen to further stabilize and control the hip. This usually happens around six weeks post-op. Since you are familiar with a rehab program for total hip replacement, you won’t have any trouble adapting to a similar program following a joint resurfacing procedure.

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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Reader asks why U.S. lags in joint resurfacing

June 2nd — admin

Why is the U.S. so far behind in the treatment of hip arthritis? I’m finding all kinds of doctors in England, Australia, and Europe who do joint resurfacing. It seems to be very limited here in our country. I want this procedure done but I really don’t want to have to travel so far. What do you suggest?

You can have this operation done in the United States. But depending on where you live, you may have to do a little traveling. Surgeons at specialty centers such as at a joint replacement institute or institute for advanced joint procedures offer joint resurfacing.

Hip joint resurfacing is a type of hip replacement that removes the arthritic surface of the joint but takes far less bone than the traditional total hip replacement. Special powered instruments are used to shape the bone of the femoral head so that the new metal cap will fit snugly on top of the bone. The cap is held in place with a small peg that fits down into the bone. The acetabulum (hip socket) may remain unchanged. But more often it is replaced with a thin, metal cup. The acetabular component is pressed into place in the socket.

Some of the holdup in the U.S. can be attributed to the U.S. Food and Drug Administration (FDA) regulations. Devices from U.S. manufacturing companies must be approved by the FDA before they can be used routinely. This requires many studies on cadavers (joints preserved after death for study) and on humans via clinical trials. Not until they are deemed safe and effective are these implants released for use in the general population.

At the present time, there are at least two implants that have full FDA approval. Others are in line awaiting approval. Once that road block has been set aside, more surgeons around the U.S. will have the necessary training to perform this procedure.

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.

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

Do more people have cancer than have arthritis?

May 27th — admin

I see the news focused on cancer all the time. None of my friends have cancer but we all have arthritis. Do more people really have cancer than arthritis?

You and your friends are in the majority. Osteoarthritis (OA) is two and a half times more common than heart disease and six times more common than cancer. The incidence of both OA and cancer increase with age.

Since Americans are living longer with more active lifestyles, OA is expected to affect many more adults in the years ahead. An active lifestyle may be preventative for cancer. The odds are that cases of OA will continue to outnumber cancer in the near future.

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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Arthritis affecting hip range-of-motion, what can be done?

May 25th — admin

We are really concerned that Dad’s hip range-of-motion is getting worse instead of better. He has fairly severe hip arthritis. Each time a therapist measures him, it seems to slip a few degrees. What can we do to help him at least maintain his motion?

The first thing to be sure is that the testing is accurate. Testing joint motion can be very subjective depending on how it is done and who does it. If the same person measures joint motion each time, intrarater reliability of the test is important. Intrarater reliability refers to the ability of a single individual to complete the test the same each time.

If different people are testing your father’s hip joint motion, then interrater reliability is important. This refers to the test being done the same way from person to person. Interrater reliability is the term used to describe test-retest when performed by different individuals on the same patient. Patient pain levels can vary from day-to-day, too. A measurement on one day may not be the same as on the next if the pain goes up or down.

Assuming there is a true general trend of joint motion loss, the first step is to see his doctor. There may be an adjustment needed in medication that can help make a difference. Or there could be some other explanation for what’s going on. If no medical treatment is warranted, then referral to a physical therapist may be needed. The therapist is well acquainted with ways to help arthritis patients maintain and even regain range of motion. Not only that, but they will pay attention to strength, motor control, and joint proprioception (sense of joint position). Each of these components is important to function and preventing disability.

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.

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