Naples Orthopedic Surgeon - Dr. Robert J. Zehr » hip replacement surgery

Could soccer playing wear out my hip?

admin — Wed, 23 Jun 2010 18:20:49 +0000

I’m 45-years old and need a hip replacement because of arthritis. I played soccer from the time I was in pre-school all the way through college. Even as an adult I played on coed rec teams. Could the soccer playing wear my hip out?

Playing soccer may not be the issue. Studies show it’s the sports injuries players get that increase the risk of osteoarthritis. Ankle and knee injuries are common among soccer players. Since these two joints are in a direct line-up with the hip, it makes sense that such injuries can lead to arthritis later.

Another risk factor for injury and thus arthritis is left-leg dominance. At this point we know more about what isn’t a risk than what is. In studies of soccer players ages 12 to 18, there was no apparent increase in risk of injury linked with body size or type, balance, strength, or flexibility. Preseason play didn’t seem to make a difference either.

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.

MRA more accurate than MRI for ddetermining cause of hip pain

admin — Fri, 18 Jun 2010 16:32:59 +0000

What is magnetic resonance arthrography (MRA)? I’ve heard of MRI but not MRA. My doctor wants me to have an MRA to help figure out what’s wrong with my hip.

Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) are very similar tools. MRA is basically MRI for the joints. It is more accurate in detecting joint problems. MRI can confirm there’s a problem in the joint. MRA shows exactly what is the abnormality.

CT scans work well for bone lesions around the hip. CT scan shows places where the bone might have a tumor, abnormal anatomy, or necrosis (dead cells).

If you ever need surgery on the hip, advanced imaging studies of this type are very important. The more details the surgeon can see ahead of time, the better the surgical plan with no (or very few) last minute surprises.

Double hip replacement an option?

admin — Mon, 07 Jun 2010 12:01:38 +0000

I have pretty bad hip arthritis. The doctor is going to do a hip replacement on the worst side first. The other side isn’t really too good. How will I manage with one bum hip and the other one just operated on?

You may want to ask your doctor about having both hips done at the same time. If you are in good health and qualify, this may be the best option for you. Without the stiffness and pain on the nonoperative side after a single replacement, you can move along faster in rehab, too!

There’s also a cost savings. Even though you’ll be in the hospital longer than if only one hip was done at a time, the overall number of days is less when both hips are done together.

You can have bilateral hip replacements in one of three ways. First, they can both be done in the same surgery. Second, you could do one and finish rehab before having the second one done. There’s usually at least six to eight weeks between operations. Some people wait longer. Third, you could have one hip done and wait five to seven days. If your health is stable and you’re up for it then have the second one done. With this third method, you don’t leave the hospital between operations.

If you still opt for one hip replacement at a time, then a physical therapist will help you. Your home may need to be adapted to make toileting, bathing, sleeping, and household chores easier. You will likely need a family member or live-in assistant for a few days to weeks, depending on the speed of your recovery.

Mini-incision hip replacement can mean shorter hospital stay

admin — Wed, 02 Jun 2010 16:37:30 +0000

I heard the new mini-surgery for hip replacement takes less time and fewer days in the hospital. How much less?

The answer to your questions really depends on the surgeon. If the mini-incision method is fairly new to the surgeon, the operation itself can take longer. If all things are equal (the doctor has done the same number of both operations: open and mini), then the time is about the same.

Length of hospital stay also varies. The hope is that the newer mini-incision method will mean a shorter hospital stay. But hospitalization may be longer if there are any complications during or after the operation. For example, fractures and dislocations may happen more often when a surgeon is learning a new technique.

A recent study from the University of Missouri reports on this. An experienced surgeon had an overall rate of 42 percent for problems after a two-incision mini-invasive hip replacement. That was compared with six percent for the single-incision method. The surgeon also reported a 25 percent rate of nerve injuries. Any of these (or other) problems can extend a patient’s stay in the hospital.

Total hip replacement invasive no matter how it’s done

admin — Tue, 25 May 2010 19:02:08 +0000

My orthopedic surgeon has explained to me that my hip replacement will be done with the new minimally invasive method. I don’t get it. How is this any less “invasive” than a regular hip replacement? They’re still going to cut me open, saw the bone in half, and take the old hip out. I understand there’s a lot of cutting, drilling, and reaming of the bone. What’s not invasive about that?

You ask a very good question. Perhaps only a surgeon can really appreciate the difference between the two operations. A total hip replacement is invasive no matter how it’s done. A better way to look at it is to say it “minimizes the invasiveness”. From a patient’s point of view, it certainly does sound invasive.

The first difference and reason why it’s called “minimally invasive” (MI) is the length of the scar. MI means the incision is about two inches long. A full incision can be up to eight or 10 inches long.

During the operation fewer muscles are cut. New tools allow the surgeon to gently move structures out of the way to get to the hip. Anything that is cut is carefully repaired and put back in place.

More and more surgeons are getting trained in this new technique. We can expect it to improve even more over the next few years.

Is your weight going to affect your hip replacement?

admin — Thu, 20 May 2010 20:15:10 +0000

I’m slightly overweight and worried about the effect of that on my new hip replacement. How much overweight is “too much”?

First of all, the new hip joint is likely to reduce your pain and improve your function. It’s up to you to now increase your activity level.

If you can keep your intake of calories the same while increasing your activity, then you might be able to lose some weight. At the very least, you should work toward not gaining any more weight.

Studies do show that obese patients put increased loads on their joints. Grossly obese people may reduce their activity enough to balance out load on the joint.

A recent study was done looking at body mass index (BMI) and hip motion and function after hip replacement. Hip function was less as body weight increased but overall the change was minimal.

Why does hip dislocate after total hip replacement surgery?

admin — Mon, 17 May 2010 11:39:33 +0000

I’m very worried because I dislocated my hip two months after a total hip replacement. What are my chances this will happen again?

Recurrent dislocation depends on several things. First, was the doctor, surgeon, or emergency staff able to put the hip back in place without another operation? If yes, that’s in your favor. The hip is more likely to remain stable if it was reduced without surgery.

Second, how long has it been since the dislocation? If you are still within the early postoperative period, your risk is higher than if you are several years past the total hip replacement.

Third, are you having any symptoms to suggest the joint is unstable? Does your leg give out from underneath you? Is there any pain? Any clicking or popping of the joint? If the answer is ‘no’ to all these questions, then your risk of another dislocation is less.

Make sure you talk with your surgeon about these concerns. The knowledge an exam and an X-ray can give goes a long way in reducing your fears.

What’s more important in the success of a hip replacement: age or attitude?

admin — Wed, 12 May 2010 11:46:56 +0000

What’s more important in the success of a hip replacement: age or attitude?

Good question. At least one study shows that motivated patients can have a rapid recovery after total hip replacement. That IS a matter of attitude. But the same study showed that younger patients were more motivated than older patients.

The same study pointed out that recovery may be faster and easier for patients of all ages if pain is managed after the operation. Some new ideas are being put forth to help reduce tissue trauma through pain management techniques.

For example, several different ways are used to help control pain. First a local numbing agent can be injected into the operative site and around the scar. Pain medications can be used after that to help the patient get up and moving.

The goal is to have no pain, walking without a limp at the end of six weeks. The patient can be walking one to two miles without support by the end of the three months.

Again, younger patients tend to meet these goals more often than older patients. A good attitude goes a long way in rehab at any age.

Best exercises for strengthening hip abductor muscles

admin — Thu, 29 Apr 2010 15:25:32 +0000

I’m 74-years old and fit as a fiddle. I want to keep up my leg strength. What’s the best way to strengthen the muscles along the sides of my hips?

Hip exercises are commonly prescribed for older adults after hip injury or surgery. Even without hip problems, it’s also a good idea to maintain muscle strength as we get older. Keeping muscles and balance tuned can help prevent falls and fractures.

Physical therapists at the University of Kentucky compared six different hip exercises for the gluteus medius muscle. This is a hip abductor (moves the leg away from the body). It’s located on the outside of the hip.

Three of the exercises were done without putting weight on the leg. Three were done in the standing position while putting full weight on the leg. It turns out that the standing weight-bearing exercises activate the muscle the most.

How often do total hip replacements dislocate?

admin — Mon, 26 Apr 2010 12:02:30 +0000

I heard that total hip replacements dislocate easily. How often does this happen?

Loosening and dislocation of the implant are the two most common problems faced by patients after a total hip joint replacement. The rate of dislocation varies from study to study. One study reports 0.6 percent (fewer than one patient every 100).

Other studies report up to seven percent. A very large study placed this closer to 2 percent. The wide ranges in figures may be explained by who did the surgery. Doctors in large centers or hospitals who do more hip joint replacements have lower rates of dislocation.

Most studies report numbers from these large reviews. However, most hip replacements are done by surgeons who treat fewer patients.