Uneven wear in hip joint replacement result of third-body wear.

March 5, 2010 — admin

I had a joint hip replacement for severe arthritis three years ago. The doctor tells me that “third-body wear” is likely the cause of some uneven wear in the joint. What does this mean?

When patients with hip joint replacements are compared, there are very different results in wear patterns of the new joint. This is true even when the same replacement parts are used from patient to patient.

In fact, one study looked at patients with both hips replaced using the same implant. The researchers compared one side to the other and found that the wear pattern was different from side to side. One of the reasons for this is third-body wear.

This is the presence of tiny particles in the joint. These pieces may be bits of bone or fragments of glue or cement used to hold the new joint in place. Even metal debris from the coating around the joint implant can cause the joint liner to be scratched and roughed up. Joint wear and tear is increased when the surfaces are roughened.

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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I had total hip replacement surgery, how long will I limp?

February 26, 2010 — admin

I’m very self-conscious that I still limp after a total hip replacement I had five months ago. Will this ever go away?

Muscle weakness is the usual cause of a limp while walking. Three to six months after a total hip replacement, the muscles around the hip are still only at 50 percent of normal. Limping is not unusual up until six months after the replacement.

Limping may even go on up to one year later. This is because joint strength and function are still only at 80 percent of normal. It’s important to keep doing your rehab exercises. By five months you should be able to move past the basic program and continue to improve your strength.

Try to get back to your favorite physical activities. Any nonimpact sports you enjoy will help keep you on track for full recovery. If you aren’t seeing some gradual improvement over time, ask your doctor if there are any special or unusual reasons why you are still limping. Perhaps you’re a good candidate for an updated rehab program.

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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Dehydration can complicate recovery from total hip replacement surgery

February 15, 2010 — admin

My older sister had a total hip replacement 2 months ago. She has had set backs and delays from the beginning. Dehydration seems to be the central problem. What causes this?

Even healthy older adults are at risk for dehydration (fluid loss). There is a decrease in thirst as we age and thus, a tendency to stop drinking liquids as much. Many Americans confuse thirst with hunger and eat instead of drinking.

Older adults who have hip joint surgery are also at increased risk of dehydration. There is blood loss with this operation. The problem gets worse if the patient has nausea and vomiting from medications. The presence of any other medical condition such as diabetes, high blood pressure, or thyroid problems adds to the mix.

Even mild to moderate dehydration can slow a patient down. Dizziness, weakness, and fatigue are common. Just getting through the daily activities or dressing, eating, and personal care can zap a patient’s strength. There may be no energy left for exercise needed after this 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 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’s the most important factor in a successful total hip replacement?

February 10, 2010 — admin

What’s the most important factor in getting a hip joint replacement that lasts?

There are many things affecting the life of a joint implant. The first is bone density. The bone must be strong enough to handle the surgery and support an implant. Probably the most important step is to get a good fit of the implant stem into the bone canal. This is crucial for long-term implant results.

The doctor also chooses the implant carefully. There are many different hip joint replacements available. Matching the right size, shape, and style to each patient is important.

The patient must also follow the doctor’s and the physical therapist’s advice carefully. Doing too much or moving the wrong way too soon can have disastrous results.

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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Is Grandma too old for total hip replacement?

February 5, 2010 — admin

My 83-year old grandma is going to have a total hip replacement. We’re all worried that she’s too old for this. What do you think?

Americans are living longer and in better health. This means they are more likely to need a major joint replacement as they reach their 80s. Joint replacements are available for the shoulder, hip, or knee.

These operations do put older adults at increased risk of problems.

Studies of 80-year old (and older) adults compared to younger adults show there is an increase in the number of serious problems that occur. But the overall rate is low, and it’s more likely to happen in elderly patients with other health problems.

Results should be good if your grandmother is in good health and the doctor has approved the surgery.

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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Short reader needs total hip replacement that fits

January 22, 2010 — admin

I am a small woman (5 feet 1 inch) with small bones. My doctor has advised me to have a total hip replacement for severe arthritis. Do they make new hip joints to fit people like me?

The implants are made in a wide range of shapes and sizes. The stem of the implant is placed inside the center of the thighbone. This is called the femoral canal. The size of the femoral canal varies in patients as well.

The doctor will choose the right implant for you. This is decided at the time of surgery when the doctor can see the size of your bones and the size and shape of your femoral canal.

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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Full disclosure important when facing total hip replacement surgery

January 14, 2010 — admin

I’m filling out a form for my doctor before having a total hip replacement. It asks me to list all drugs (prescription and over-the-counter). Do I need to report vitamins and herbal supplements too? There’s no place on the form for that, but it seems important.

You’re right. Vitamins and herbal supplements can have dangerous interactions with prescribed drugs. They must be reported. Sometimes these products are called nutraceuticals. Nutraceuticals refers to any food, supplement, or dietary substance that improves health or offers medical benefit.

This can include herbs like ginkgo biloba, ginseng, Echinacea, and St. John’s wort. Antioxidants such as lycopene, Vitamins E, A, and C, and supplements like calcium are also included.

Anyone planning surgery of any kind should go over their complete list of drugs and nutraceuticals with the doctor. This is important because some over-the-counter products can cause bleeding or decrease the effect of the prescribed drug.

For example you may have heard that grapefruit juice shouldn’t be taken with cholesterol lowering drugs, calcium channel blockers for high blood pressure, and some migraine medications. The juice keeps the body from using and getting rid of these drugs from the body.

Vitamin K should not be taken by anyone who is also taking Coumadin (warfarin) to prevent blood clots. Warfarin works by stopping vitamin K factors needed to make blood clots. Too much vitamin K can keep the warfarin from doing its job.

These are just a few examples of drug-herb interactions. Your doctor will be able to see if you’re taking anything that could be a problem.

Considering a total hip replacement? Choose an experienced surgeon. Dr. Zehr is one of the few surgeons in Southwest Florida using the minimally invasive anterior approach. In fact, it is estomated that fewer than 5% of the orthopedic surgeons in the United States employ this approach.

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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Taking gingko biloba and planning hip surgery? Tell your surgeon!

January 11, 2010 — admin

Have you ever heard of this? My aunt had hip surgery and then developed a weeping, oozing wound. The doctor said it was from taking ginkgo biloba.

There have been a few cases of persistent bleeding after surgery caused by herbal self-medication. Usually the patient forgets to tell the doctor that he or she is taking a supplement such as St. John’s wort, ginseng, or ginkgo biloba.

Gingko biloba has an anticoagulant property much like aspirin. This means it prevents the blood from forming clots. That’s important for patients at risk for heart attack or stroke, but it’s a risk factor for anyone who’s just had surgery or who has a bleeding disorder.

The most recent report of gingko biloba causing oozing from a wound after surgery comes from Wales. A 77-year old woman had a hip replacement without problems. Afterwards, the wound site drained blood and a clear fluid for three weeks. When it was finally discovered she was taking gingko biloba and she stopped taking it, the problem cleared up within 10 days.

Visit The Zehr Center online for more information on total hip replacement surgery.

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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Compare these two total hip replacement surgeries

December 31, 2009 — admin

I’ve had two total hip replacements. The first was a full incision and took me six months to get back on my feet and up to speed. The second one was three weeks ago with two tiny cuts. I’m already walking without a walker for up to 30 minutes. I still have a little trouble with stairs but that seems to be coming. Is a smaller incision really all that makes the difference?

The operation you had is called a minimally invasive total hip replacement (THR). Two small incisions are made: one in the front of the hip and one to the side. Besides the small cuts, there are other important differences from the standard THR.

No muscles or tendons are cut in a minimally invasive THR. The joint capsule is cut, but not removed. The joint itself is removed in several pieces. No cement is used to hold the new implant in place.

Overall, less trauma to the soft tissues and joint mean less pain and a faster recovery time. Patients can stop taking pain killers and get back to normal function faster. In fact most patients are able to put weight on the operated leg the same day as the surgery. Many go home in the first 24 hours.

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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Obesity a factor in total hip replacement surgery

December 28, 2009 — admin

I have been overweight all my life and now my hips are so bad with arthritis I need replacements. The doctor has told me to lose weight, but how much is enough?

A recent report on 851 cases of total hip replacement included information on patient demographics. This refers to data about the patients’ ages, gender, diagnosis, and body mass index (BMI).

BMI is calculated based on height and weight. It helps show how much body fat you have. Health risks from carrying too much weight include heart disease, diabetes, and arthritis.

A BMI in the “healthy” range does not always mean the person is fit and healthy. Poor diet and genetics can put an average person at risk for health concerns. Keep in mind the BMI does not take into account body frame. A muscular, large-framed person’s BMI could indicate obesity, but this may not be the case.

The Centers for Disease Control and Prevention (CDC) offer a website with easy calculations of your BMI. You can do this by going to:

http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm

Once you’ve found your BMI ask your doctor about a reasonable weight loss plan. Studies show results after a hip replacement are best in patients with a BMI of 30 or less.

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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