After a hip replacement, can one become too active?

May 22nd — admin

My husband had a total hip replacement about six months ago. He’s back to running and playing tennis as if nothing ever happened. Is there any danger of being too active after with a joint replacement?

There isn’t a simple yes/no answer to this question. Many doctors caution their patients to avoid high-impact activities such as running and tennis. There’s some concern that the implant won’t last more than 10 to 15 years. That could mean another surgery on the same hip.

On the other hand, it’s clear that weight-bearing activities are important to maintain good bone strength and density. Studies show that patients who are less active and more sedentary actually lose bone. Bone loss around the implant can cause it to loosen and require revision surgery.

Your husband’s surgeon is probably the best one to ask this question. Knowing the type of implant and surgical procedure used can make a difference, too. When patients are educated and informed about their joint replacements, then they can make the best decisions about activity and lifestyle.

For active, healthy adults, being more active than is advised may improve their quality of life enough to make it worth the risk.

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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After hip replacement, is it bad to not be active?

May 20th — admin

My mother had a total hip replacement for her very bad arthritis. The pain seems much better but she’s really not any more active. She just seems to sit a lot. Is that bad for her hip?

Activity, especially weight bearing is needed to maintain bone strength with or without a joint replacement. But after a total hip, the load and compression from activity becomes even more important.

This is because the implant itself changes the force and direction of load through the bone. The effect is called stress shielding. Studies show that the shape and density of the bone can even change as a result of stress shielding. Bone loss can occur, which would be a problem if your mother ever needed further surgery on that hip.

In general, there are so many health benefits from activity your mother should be encouraged to resume former activities and regain more function. She may need some help in this area. Perhaps there is an exercise group she could attend. Or maybe a membership at a local health club or YMCA would get her going in the right direction.

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 is hip osteoarthritis?

May 16th — admin

My doctor thinks I have the start of hip osteoarthritis. What is this disease anyway?

Osteoarthritis (OA) is more of a condition than a disease. It occurs slowly over time as the loss of cartilage begins. The layer of bone just under the cartilage starts to harden, a process called sclerosis. Bone spurs start to form around the edges of the joint.

Patients affected by OA report pain, loss of motion, and loss of function. Hip OA can cause pain in the groin, thigh, and upper outer part of the leg. Pain can go from the hip down to the knee. Morning stiffness is common. Patients often have trouble putting weight on the affected leg.

Early identification and treatment may help patients stay active and avoid surgery for years. Exercise has been shown to reduce pain and disability. The use of manual physical therapy combined with exercise seems to give patients greater return of function that lasts longer.

If you haven’t already, talk with your doctor about the various treatment options. Find out what is recommended for you.

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 long does physical therapy for arthritis take?

May 14th — admin

I’ve been seeing a physical therapist for hip pain from arthritis. How long before I can expect to see some improvement?

Each patient is different. The therapist will examine you and design a program to meet your specific needs. This can be based on your pain levels, range of motion, strength, and/or flexibility. Your personal goals will be taken into consideration, too.

Recent reports from physical therapists using manual therapy (mobilization and manipulation of the joint) show measurable changes right away. The therapist uses a combination of measures to know when to discharge the patient.

For example, patients are often discharged with a home program when the motion is the same on one side to the other or when the end of the motion feels ‘normal’.

If no change is seen after three sessions, the therapist may send the patient home with an exercise program. Progress may be rechecked in one to three weeks. Patients may decide for themselves if the pain is completely gone and they are able to get back to their daily activities.

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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After my hip replacement, why do I need this brace?

May 10th — admin

I had a total hip replacement about two weeks ago. I have to wear a special brace that keeps my legs apart. It’s supposed to prevent the hip from dislocating. It feels like I could get around a lot better without this contraption. Do I really need this thing?

Only your surgeon can discontinue the use of your abduction brace. As you said, it is designed to help prevent a hip dislocation. After all you’ve been through, you don’t want to end up with a hip dislocation and another operation.

When the hip is replaced, many of the muscles around the hip are cut. This leaves your joint unstable and at risk for dislocation until everything heals.

Some doctors advise using an abduction brace for daytime wear. Most require an abduction pillow for sleeping at night. Keeping this position prevents the hip from popping out of the socket.

However, some new research has called the use of abduction braces and pillows into question. It seems that patient function is less with these devices. They may not be needed as much as was once thought.

New, less invasive surgery with smaller incisions and less damage to the muscles may be helping. Depending on the type of surgery done, some surgeons are doing away with this device. Even so, it’s best to check with your doctor before leaving the brace off.

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 it common for a partial hip replacement to cause a hip fracture?

May 8th — admin

My mother just had a partial hip replacement. I guess it was like having a tooth capped. Just the top of her femur was replaced. She ended up with a hip fracture afterwards. Is this common?

It sounds like your mother had an operation called joint resurfacing. This type of operation has been around since the 1930s. It has come and gone based on problems afterwards and materials available. Most recently, new metals have made it possible to resurface the head of the femur (thigh bone) with good results.

Fracture (usually of the femoral neck) is the most likely complication of hip joint resurfacing. It happens in up to four per cent of the cases. Studies show fracture occurs most often in the first 100 cases done by a surgeon. Fracture rates go down as the surgeon becomes more familiar with this technique.

Causes of fracture are both patient and technique-related. Obesity, decreased bone mass, and arthritis make a difference on the patient side. Anyone with a femoral neck cyst should get a total hip replacement instead of resurfacing. Putting the implant in with too much of a tilt or twist can also result in fracture.

Women seem to have a higher risk of fracture after hip joint resurfacing. The reason for this remains unknown at this time. Short-term results of hip joint resurfacing are good to excellent. Long-term studies aren’t available yet. Total hip replacement may be needed by patient who have a fracture after resurfacing.

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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If part of my hip is damaged, do I need a whole hip replacement?

May 6th — admin

I just got the results of my hip X-rays. One hip has arthritis but just at the top of the thigh bone. The round ball in the socket is all broken down. It’s not really round anymore. Do I have to have a whole hip replacement just for one part?

Maybe not! You may have a couple choices. The first is called a hemiarthroplasty. The surgeon removes the round top of the femur (thighbone) and drills out some of the bone down inside the shaft. Then a replacement top and stem are inserted down into the bone.

Or if you are younger than 60 and have good bone stock, you may be able to have a hip resurfacing arthroplasty (HRA). In this operation, just the top or cap of the femoral head is removed and replaced. It’s a lot like having a tooth capped by the dentist.

Your surgeon will be able to tell you both what is possible and what he or she can do. Not all surgeons perform all types of joint implants. Experience is important so it’s a good idea to go with what your surgeon is skilled at doing. If you are a good candidate for a HRA, then you may want to go to a center where this operation is done 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 would an otherwise healthy 33 year old have chronic hip pain?

May 2nd — admin

I’m 33 years old and having chronic hip pain. X-rays are negative. I can’t recall doing anything to hurt myself. Where do I go from here?

If X-rays were the only imaging tests done, then you may need additional testing. Studies show that 75 percent of patients with hip pain have no X-ray findings. CT scans are used if there’s been an injury and the doctor suspects a bone fragment. Other conditions show up better with an MRI.

Labral (cartilage) tears may be seen best with a special gadolinium enhanced MRI. One other useful X-ray to detect labral tears is a fluoroscopically-guided injection of dye into the hip joint. If your doctor is unable to find the cause and symptoms persist despite conservative care, there’s one more test available.

Hip arthroscopy has been shown especially useful in identifying hip joint problems in young adults who do not have arthritic joint changes. Your next step should be to make a follow up appointment with your physician. Be patient as it may take a little time to find the underlying cause of your symptoms. A step-by-step approach is cost-effective and usually fairly accurate in the long-run.

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 a hip arthroscopy possible?

April 30th — admin

I had a knee arthroscopy to repair a torn medial meniscus. Now I see they can do this on the hip, too. I’m having some hip pain. Can they do an arthroscope and see what’s wrong?

Hip arthroscopy has actually been around since the late 1980s. As technology has improved, arthroscopy has improved. Hip arthroscopy is easier to do now and less invasive than even five years ago.

Surgeons are starting to narrow down which patients are the best ones to have a hip arthroscopy. It works well for problems inside a joint that has very little arthritis. Any loose pieces of bone or cartilage can be removed with a hip arthroscopy. Tears of the cartilage called the labrum can be identified and repaired.

Other hip conditions investigated and treated arthroscopically include synovial problems, bone lesions, and septic or infectious arthritis. In the future, we may expect to see even more conditions diagnosed and treated arthroscopically.

Research will help show which patients have a good or poor response to this procedure. Patients can be chosen more carefully for a successful outcome.

It may be best for you to start by making an appointment with an orthopedic surgeon. Since some conditions are clearly identified with a physical exam or seen on X-ray, arthroscopy may not be needed at all.

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 second hip replacements a common occurrence?

April 26th — admin

Both my parents have had total hip replacements. Both have had to have a second operation on the same hip. Is this a common thing or just a coincidence?

Re-operations after total hip replacement (THR) are not uncommon. The most common reasons for re-operation are loosening of the implant, repeated dislocation, or bone fracture around the implant.

Most patients report minor trauma before bone fracture. Spontaneous fracture (no known cause) is more likely after revision surgery. Revisions are done to repair or replace the primary (first) THR.

Other reasons for re-operation can include nonunion of the fracture or re-fracture. Sometimes infection or fracture of the implant can occur.

Researchers are collecting data to help sort out who is at risk for implant failure or re-operation. One way to do this is to create a national patient registry. For example in Sweden, anytime someone has a total hip replacement, the surgeon must report information about the case to the Swedish National Hip Arthroplasty Register.

This registry has three separate databases. Each one collects slightly different bits of information. This allows researchers to group data together for easier analysis. Information can be used to identify who has a re-operation, fracture or re-fracture, or other complications.

Patient selection, implant choice, and experience of the surgeon all seem to be important factors in THR surgery. Your parents’ situation could be the result of one of these factors — or it could indeed be just a coincidence. We still don’t always know how to tell exactly what caused the problem in order to prevent it.

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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