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

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.

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.

Compare these two total hip replacement surgeries

admin — Thu, 31 Dec 2009 20:49:20 +0000

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.

How could I have dislocated my hip after a total hip replacement?

admin — Fri, 11 Sep 2009 11:14:25 +0000

A year ago I had a total hip replacement done. Last week I was out gardening on my hands and knees and it dislocated. I thought I was all healed. What happened?

Many factors can play a part in hip dislocation after replacement. For example, which side of your hip is the scar located? Any position you get in that can push the hip in that direction has the potential to cause a dislocation.

When you are on your hands and knees, you have your body weight against that hip. If you twist or angle your body against the hip, injury can occur. Your weight and bone density are also important factors. Being overweight means that much more pressure through the hip. Having osteoporosis (brittle bones) or decreased bone density makes it harder for the bone to grow around the new implant and hold it in place. Bone or muscle weakness can also lead to injury.

Most patients are given positioning precautions for the first 12 weeks post-op. In theory at 12 months you should be free to assume any position possible. In practice, sometimes our theories (and hips) don’t hold up.

Is 42-years old too young for a hip replacement?

admin — Thu, 10 Sep 2009 14:29:45 +0000

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.

Surgery sometimes needed to find cause of hip pain

admin — Fri, 28 Aug 2009 13:34:58 +0000

Even with the best imaging equipment, sometimes the surgeon doesn’t really find out what’s causing the patient’s hip pain until he or she is looking inside the joint during surgery. Here’s one reason why

Can cryotherapy ease the pain after hip surgery?

admin — Thu, 27 Aug 2009 11:50:20 +0000

When I had my knee replaced the therapists used cold therapy on it everyday. It really seemed to help with the pain and swelling. I just had a hip replacement. The cold treatment was never used on the hip. How come?

Cold therapy, also known as cryotherapy is thought to help joints that are closer to the surface of the skin. The knee doesn’t have much soft tissue, fat, or muscle covering the joint. The cold can get down into the joint easier.

Large muscles and at least one layer of fat cover the hip. It’s always been thought unlikely that the cooling action would reach deep into the hip joint.

However a new study from Japan may prove this idea wrong. They used cryotherapy with a group of 23 total hip replacement patients. The group was compared to another group who had a hip replacement but without cold therapy afterwards.

The researchers report good success with the cold therapy. Patients got pain relief faster. They used fewer pain meds. They could begin rehab sooner. Based on this study, the use of cold after hip surgery may become more popular in the months and years ahead.

Is there a link between leukemia and metal joint implants?

admin — Mon, 24 Aug 2009 13:09:10 +0000

Is there any connection between leukemia and metal implants used for joint replacement? I know it sounds like a long shot but my father was just diagnosed with leukemia. His blood work has shown elevated levels of chromium in the past. The doctor always thought this was from his metal hip joint replacement but didn’t think it was a problem. Could there be a link?

Implants made of metal have a thin coating around them to prevent flecks of metal from going into the body and blood stream. This coating can breakdown, releasing potentially toxic chemicals into the body.

Several studies have been done that show an increased number of patients with metal hip implants developing cancer. Leukemia and lymphoma are the two types of cancer seen in patients with cobalt-alloy total joint replacements. The same has been reported for metal-on-metal hip replacement.

There’s no proof yet that the metals are the problem. More study is needed before we know for sure.

Walking hurts – is it aging or is it osteoarthritis?

admin — Tue, 28 Jul 2009 11:09:26 +0000

I am only 54 years old, but already I’m noticing changes in the way I walk. I can’t seem to put my full weight into my left hip without twinges of pain. Is there anything I can do about this? I don’t want to lose any more ground.

The natural aging process does cause increased stiffness throughout the body, but usually this is equal on both sides. When you have pain or symptoms in one joint, you may be experiencing more than just natural aging.

Early degenerative arthritis of the hip, called osteoarthritis, can bring about changes in the way a person walks. The body compensates in order to take pressure off the problem joint. The stride gets shorter, so the person takes shorter steps at a slower speed. Sometimes the number of steps taken per minute decreases, too.

It may be wise to bring these changes to your doctor’s attention. He or she will evaluate you and determine if anything more serious is going on. If you have early arthritis, it is important to keep up exercise and physical activity. Your doctor may recommend a physical therapist who can help you find just the right program for your condition.

Are Southerners more likely to have hip osteoarthritis?

admin — Thu, 09 Jul 2009 12:32:27 +0000

I’ve heard that my chances of getting hip arthritis are less if I live in the South. Is this true?

The number of people with arthritis of the hip (called primary osteoarthritis) is not related to latitude or longitude. Ethnic background and genetics (passed down in families) seem to be much stronger factors. Compared to Blacks, Hispanics, Native Americans, and Asians, Whites (Caucasians) are much more likely to have hip osteoarthritis. Specifically, if you are white and have a mother, father, sister, or brother with primary osteoarthritis, your chances of getting hip osteoarthritis are much greater than those of other groups.