What makes a surgery count as “minimally invasive?”

September 27th — admin

What makes a surgery count as “minimally-invasive”? It seems like surgery is a major trauma to the body no matter how short the time it takes.

Minimally invasive refers to several factors. A shorter operating time as you suggest is one measure. A shorter operation means less anesthesia. Sometimes there’s less blood loss. Those two things alone can also mean “less invasive” to the pocketbook.

According to a task force of surgeons there are several ways to tell if an operation is minimally invasive. First, the size of the incision is half the length of the standard approach.

Second the location of the cut is often different. The goal is to avoid disrupting the joint capsule or some of the muscles. If the capsule is cut, a smaller incision is used.

Third, fewer muscles are cut or detached.

During knee surgery anytime the surgeon can avoid cutting the extensor mechanism, it’s considered “less invasive.” The extensor mechanism is made up of the quadriceps muscle as it comes down over the front of the thigh and attaches around the patella or kneecap.

Disrupting this muscle can cause weakness in knee extension. The patient may not be able to fully extend the knee, a condition called extensor lag.

There isn’t one single way to define minimally invasive but rather, a group of factors.

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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Am I at risk for shin splints?

November 3rd — admin
I want to train for a marathon. I’ve heard that long-distance runners can get shin splints from the constant strain on the leg muscles. How do I know if I’m at risk?

 
It’s true that injuries are fairly common among distance runners. Up to 57 percent of recreational runners get injured over the course of a year. Most of these injuries (up to 75 percent) are from overuse.

A recent study identified gender and foot posture as risk factors for medial tibial stress syndrome (MTSS), commonly known as shin splints. In a group of 125 high school cross-country runners, 12 percent showed signs of MTSS. Injured runners were overwhelmingly female. They also tended to be pronators.

How do you know if you’re a pronator? A doctor or sports trainer can do tests to find out. If pronating seems to be a problem in your case, you may want to look into orthotics. These shoe inserts can be designed to support your feet against pronation as you run. Preventive measures like these can improve your chances of avoiding overuse injuries for the long run.

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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How can I control the pain after hip replacement surgery?

October 1st — admin
I had a total hip replacement last year. The first few days after the operation were very painful. I don’t like using drugs. Is there any other way to control the pain?

 
Pain control is one of the biggest challenges after surgery of any kind. Some doctors are using a much smaller incision to do some hip replacements. It depends on the type of hip implant being used. With a small incision there’s less damage to the muscles and less pain. Ask your doctor if you might be a candidate for this mini-incision operation.

Other methods of pain control are used such as acupuncture, electrical stimulation, hypnosis, and patient controlled analgesia (PCA). A recent study from Japan suggests using constant cold therapy for the first four days. A cooling pad is placed over the surgical site. A computer keeps it at a constant temperature.

More than half the patients were pain free by the end of the third day. This reduced painful days by at least two full days. Tell your doctor about your concerns. Find out what’s available at your hospital or surgery site.

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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How did I get adhesive capsulitis – a frozen shoulder?

September 25th — admin
My doctor diagnosed my tight shoulder as “adhesive capsulitis.” What is this, and how did it happen?

 
Adhesive capsulitis, also called “frozen shoulder,” is a condition in which the shoulder becomes tight and painful, making it difficult to do daily activities.

With frozen shoulder, inflammation in the joint causes the lining surrounding the joint to stick together. This causes the shoulder to “freeze” and seriously limits movement.

It’s hard to say how you got a frozen shoulder. Most cases can’t be traced to one event. One theory is that this condition is caused by an auto-immune reaction. An auto-immune reaction happens when the body’s defense system, which normally protects it from infection, mistakenly begins to attack the tissues of the body.

A frozen shoulder may arise gradually, with no injury or warning. It sometimes happens to people who’ve had past shoulder problems, such as rotator cuff tendonitis or bursitis. Others are affected after surgeries unrelated to the shoulder–even after heart attacks. The condition likely results when pain or inflammation in the shoulder causes a person to start using the shoulder less, setting the stage for a frozen shoulder.

 
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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Where exactly is the posterior cruciate ligament (PCL)?

September 15th — admin
Where exactly is the posterior cruciate ligament (PCL)? Why don’t I hear about it as much as the anterior cruciate ligament (ACL)?

 
The cruciate ligaments are two ligaments that cross inside the knee joint. (“Cruciate” means cross). By connecting the thighbone (femur) with the shinbone (tibia), they help stabilize the knee. The ACL is in front. It protects the tibia from going too far forward in relation to the femur. The PCL crosses behind the ACL. It’s made up of two bands that work together to stabilize the knee when the lower leg is moving backward or rotating outward.

You hear more about the ACL because ACL injuries are more common. They also tend to result in more pain and symptoms than PCL injuries. However, recent studies suggest that PCL injuries may be more common than previously thought, accounting for roughly 20 percent of all knee injuries. Researchers have recently turned more of their attention to PCL injuries, to develop more effective treatments.

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 42-years old too young for a hip replacement?

September 10th — admin
I’m 42-years old and have one very bad hip. For some unknown reason my right hip is deteriorating. I know I’m too young for a hip replacement. Is there anything that can give me relief from the pain and a chance to keep my active lifestyle?

 
If you’ve been turned down by your surgeon for a hip joint replacement, then you’ve probably been advised about pain medications. If not, be sure and ask your doctor what over-the-counter or prescription drugs would be helpful.

Research continues to look at joint replacement in younger patients. In the meantime, hip fusion is emerging as a possible alternative operation. When hip fusion is done with the hip in a good position, pain relief and improved function are the results. With a solid fusion you’ll have steady pain relief.

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 it safe to play tennis after tearing one of my rotator cuff tendons?

August 7th — admin

August 7, 2009 I tore one of the rotator cuff tendons in my left shoulder six months ago. I faithfully went to physical therapy and did my exercise program for the first two months. Once the pain was gone and I could move the arm freely, I stopped doing the exercises. Is it safe now to sign up for tennis lessons?

If you still have full motion without pain or other symptoms, you are probably safe to begin tennis. There is a risk of future injury, but there is no way to predict this. Warming up before exercise or activity (including tennis) is always a good idea. Spend about five or 10 minutes stretching the muscles of both shoulders, and move your arms through various tennis motions gently and slowly. Your therapist can retest the strength of your shoulder and prescribe a specific warm-up and exercise program for you. This may be a good way to prevent future injuries while still enjoying the fun of tennis.

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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Why can't I lift my arms fully over my head?

August 6th — admin

At 69 years old, I’m in relatively good health. But ever since I was in my mid-40s, I have noticed increased joint stiffness, and now I can’t lift my arms fully over my head. Is this normal? What’s preventing me from having full motion?

Muscle and joint stiffness is very common in older adults. It is not clear whether this occurs as a consequence of aging, inactivity, degenerative disease, adhesion (glue-like) molecules in the tissues, or a combination of all these things. Having enough muscle bulk and strength is necessary for full joint motion. This requires healthy muscles and tendons with a good blood supply. Without these, raising the arms completely overhead becomes a challenge. Nutrition is important, and a strength-training program is recommended. Exercises will help offset the loss in muscle mass and strength typical of normal aging. Discuss this situation with your doctor. It is important to make sure nothing more serious is causing these changes. Ask about seeing a physical therapist for a muscle-strengthening program. This can improve your movement and flexibility while preventing reconditioning. Taking these steps now can help prevent future injuries.

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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How old is "old"? There is a biologic age.

July 30th — admin
I read an article about hip fractures in the elderly. No specific ages were mentioned. What is considered “elderly” these days?

 
Some say you are as old as you feel. Still, there’s a biologic age that defines “old.” With the continued aging of America, the term “elderly” is being replaced with the word “aging.”

People who study aging adults are trying to define new age categories. This will help researchers identify risk for illnesses and injuries (like hip fractures) at each age level. Prevention programs can begin before adults reach the age with the greatest risk.

At the present time, the National Institute on Aging (http://www.nih.gov/nia/) has identified the following age categories. These may change slightly with more research:

Pre-elderly: 55-64 years
Young-old: 65-74 years
Middle-old: 75-84 years
Old: 75-84 years (Note: Whether someone is “old” or “middle-old” depends on health status.)
Frail-old: 75 years and up
Oldest-old: 85 years and up
Elite-old: 95 years and up

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, Uncategorized. No Comments »

How does my hip function compare with other guys'?

July 29th — admin
I’m a 46-year old man with severe hip osteoarthritis. I’ve always been active, but now the pain gets in the way. I can’t help but wonder how my hip function compares to other guys my age without arthritis. Is there any way to find out?

 
Maybe not directly, but we may have some information to offer. A recent study from Finland compared 27 men with hip osteoarthritis (OA) to 30 men of similar ages without OA. Hip motion and function were measured and compared.

Everyone was tested twice (on two separate days) with two to six weeks time in between the first test and the retest. Subjects stood on one leg to test standing balance. Marching in place with the knee lifting up to the hip level was another test. Stair climbing, knee bending and hip range of motion were also included.

It turned out that the men without OA were much more flexible than the men with OA. They had more hip motion, especially moving the legs out and rotating the hip in or out. Men with more hip deterioration had less motion. Men without OA also had better function when walking, climbing stairs, standing on one leg, or moving the hip.

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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