Why are women less likely than men to get a knee replacement?

May 13th — admin

I saw a report on TV that women are much less likely to get a knee replacement compared with men. Is this because women aren’t offered the option? Or do they just refuse?

There is much debate around this question. It is clear that women are more likely to have knee osteoarthritis (OA) compared to men. And their symptoms are usually worse. They are also more likely to be disabled from this condition compared to men.

Researchers are trying to account for the differences. They have looked at male versus female anatomy as one possible cause. Even though there are differences in the knee joint between men and women, no one has been able to show that it’s these anatomical variations that make a difference.

Studies also show that women are much less likely to have a knee or hip replacement compared with men. In fact, it’s estimated that women are four times more likely to need a joint replacement but don’t have one.

It does not appear to be because women are unwilling to have surgery. It may be more likely that the option is not offered to women as often as it is to men. This may be a gender bias on the part of physicians. It could be the way men communicate with their doctors compared with women.

The pattern of gender differences extends beyond joint replacement. Studies also show that women who need coronary artery bypass surgery or kidney transplant are also less likely to have these operations compared with men.

Some experts think these differences can be changed with patient education. Teaching women what to say to their doctors or what questions to ask may help. Better understanding of their own health and treatment options available for any condition may also help.

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 does the U.S. have the highest cost for surgeries?

April 18th — admin

I’ve heard that the United States has the highest cost for surgeries like total hip or total knee replacements. Why is that?

Comparing the cost of operations like joint replacement from country to country is truly like comparing apples to oranges. First of all, when costs are reported they may include all costs. This can include the surgeon, hospital, anesthesiology, drugs, and rehab. Other registries with collected data don’t include the surgeon’s fees.

There is a difference in costs and billing between private and public systems. National health care is available in some countries, but not all. University hospitals may receive more funding to help offset the more complex patients they see.

And finally, the cost of the implants used varies from country to country. Studies show that at a time when overall hospital costs have gone down, the price of the implants has gone up. Some hospitals are even buying implants by the case to help keep the cost down.

As the number of adults needing joint replacements increases, the total cost is going to go up and up. Finding ways to avoid joint replacements and especially revision surgeries is the next goal of many researchers.

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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Can a joint replacement get arthritis?

April 16th — admin

Have you ever heard of getting arthritis in a joint replacement? That’s what my doctor tells me is causing my hip pain. How is that possible?

Prosthetic arthritis is a very real condition. It is caused by erosion or damage to the joint cartilage. This type of problem occurs with a joint implant called a unipolar hemiarthroplasty.

The unipolar implant is one of the first type of partial hip replacements designed. It replaces the round head of the femur (thigh bone). It has a stem attached to it that goes down inside the shaft of the femur to hold it in place.

Younger, more active patients are more likely to develop this kind of problem. The implant moving inside the hip socket chips away small pieces of bone and cartilage leading to cartilage erosion also known as prosthetic arthritis.

A newer type of implant was made to try and avoid this problem. It’s called the bipolar prosthesis. Besides the femoral implant, a plastic-lined, metal cup is inserted into the patient’s own natural acetabulum (hip socket). Instead of just the femoral head moving in the acetabulum (unipolar implant), the bipolar allows for two points of motion. The femoral head moves and rotates inside the cup and the cup moves and rotates inside the acetabulum.

The bipolar hemiarthroplasty is more expensive but recommended for active patients younger than 65.

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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Does having osteoarthritis in one knee mean the other knee will get it?

April 15th — admin

My father was just diagnosed with osteoarthritis in his left knee. Our family doctor says it’s likely his other knee will develop symptoms at some point, too. Should we take Dad to see a specialist for this problem?

Only a small number of patients with knee OA need to see a specialist. Most often it’s to see an orthopedic surgeon for a joint replacement. In the early stages of osteoarthritis (OA), a management program is advised. Your family doctor or primary care physician is best for this.

A management program will include patient education, exercise, and sometimes, over-the-counter drugs. Prescription drugs may be needed for severe pain or major disease flare-ups. Patient education starts with giving the patient information about the condition, what to expect, and what to do.

Weight loss and exercise are the two most important steps in treating and managing OA. A physical therapist can help your father match his interests with the right kind of exercise for OA. A program of low-impact exercise combined with moderate resistance training is best.

Your family doctor will continue to follow his progress and make adjustments as needed. If a specialist is needed, he or she will direct you to the right one at the right time. Don’t hesitate to ask if and when this might be needed.

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 osteolysis?

April 1st — admin

Can you tell me what osteolysis means? My husband’s knee replacement went bad because of this problem. Now he has to have another operation to replace the replacement.

Osteolysis is a term used to describe a problem common to artificial joint replacements. It refers to an active process of bone breaking down and dissolving. Particles called debris wear off the implant. This starts a process of bone degeneration.

As the body tries to clean up the loose particles of plastic or metal, the bone grows away from the implant, causing it to loosen. A second or revision surgery may be needed. The surgeon will remove the damaged implant, smooth the bone, and reinsert another (new) implant.

Osteolysis caused by wear debris occurs for a variety of reasons. Patient activity is probably the most important one. Increased activity puts greater load over time on the joint replacement.

The implant itself is part of the problem. Manufacturers are working to improve implant materials and design. And finally, the surgery is a factor. Balancing the ligaments and restoring normal joint alignment are important in the long-term wear and tear on the joint.

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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Can I do anything to lessen my hip pain from Perthes disease?

March 29th — admin

When I was a child, I had a hip problem called Perthes disease. As an adult, sometimes I have hip pain but not always. Should I do anything special to keep this from getting worse?

The natural history and long-term results of Perthes disease (also known as Legg-Calvé-Perthes) are still largely unknown. Some studies following children with this condition into their later years have been done. Our current treatment for this condition is based on the results of those studies.

We know that the duration of the disease from start to complete healing depends on the extent and severity of the condition. As you might expect, the children with the greatest amount of damage to the growth plate have the worst results.

Age makes a difference, too. Younger children (less than six years old) with Perthes tend to have milder deformity compared with older children (10 years old or older).

One study from the University of Iowa showed that patients treated with range of motion programs had better motion and function at age 45. But 10 years later, there was significant deterioration of the hip. By the time these patients were 55 years old, 40 per cent of the group had a total hip replacement. And another 10 per cent had enough pain and arthritis to need a joint replacement, too.

Individuals who receive physical therapy do show improvement in hip motion and strength. Whether or not lifelong exercise makes a difference has not been studied.

It might be a good idea to see an orthopedic surgeon. An X-ray can show the current condition of your hip. A physical therapy exam can establish your levels of motion and strength. Any other loss of function or disability can be addressed with a specific rehab program.

Regular follow-up visits with both the surgeon and the therapist may help identify any developing problems and nip them in the bud.

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 are some infections so hard to cure?

March 20th — admin

My mother’s knee replacement got infected and now it’s a huge problem trying to get it cleared up. How can an infection be so hard to cure?

Infections can happen any time to anyone. Unfortunately, infections in joint replacements can be hard to treat for a variety of reasons. First, it isn’t always easy to tell what type of bacteria is causing the infection. This means that it can be difficult to choose the best type of antibiotic.

When deciding how to treat an infection in an artificial knee, the doctor has to take into consideration the condition of the patient, how long the infection has been present, how much damage may have been done, and what the options are. In some people, opening up the knee and clearing out the infected tissue may do the trick, along with antibiotics. However, in others, the knee may have to be completely removed and replaced with a new one.

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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Isn’t 46 too young for a hip replacement?

February 21st — admin

My brother is only 46, but his doctor is telling him that he should think about having a hip replacement. Isn’t he kind of young for that?

Hip replacements are associated with older people, most of the time. It only stands to reason because their hips are wearing out because of osteoarthritis, injury, or other reasons. However, some younger people also have osteoarthritis or a problem that causes their hips to degenerate faster than they should.

While in most types of surgeries, being young would be an advantage, when it comes to weight-bearing joint replacements, it actually works against you. Artificial joints have a limited life span and when they are placed in people who are in their 60s, 70s, and older, doctors believe that the chance of outliving the replacements is smaller than the other way around. But, if you are only 46 when you need a replacement, doctors are looking at replacing it again when you are in your 60s. While it may seem that if a patient needs a hip or a knee replacement, he or she should get it, the doctors have to weigh other issues as well, such as the seriousness and risk of such surgeries.

Newer treatments are being tried for younger patients. One such treatment doesn’t replace the whole hip but just a part of it. This procedure, called metal-on-metal resurfacing, is showing good results so far.

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 does a knee replacement attach to the bone?

February 8th — admin

When a knee replacement is done, how are the replacements attached to the patient’s bone?

Many times, orthopedic surgery – bone surgery – is compared to carpentry. When doing a joint replacement, the surgeon has to cut out the joint that is to be replaced and insert the prosthesis, the replacement.

To attach the replacement, there are pieces of hardware that are specific to each type of prosthesis and the type of bone to which it is to be attached. There is also surgical cement that is used to stabilize the replacements.

Most of the time, these pieces of hardware hold the prosthesis as they are intended to do, but there are situations where the hardware can fail or break, causing pain and mobility problems. When this happens, revision surgery is usually needed.

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 there plans to use computer technology in joint surgery?

February 6th — admin

With the advent of computer technology in medicine, are there plans to use this in surgery such as joint replacements to ensure that the joints are put in as they should be? I had a joint replacement in my knee, which turned out to cause problems because there were issues with the angles after the surgery was complete.

Computerized technology is all over medical and surgical procedures throughout the developed world. In the case of joint replacements, computer programs have been used for a while to help place the proper angles in the joints as they are being inserted into the patient.

Currently, computer-navigated total knee arthroplasty (replacement) is used to help in improving the accuracy of the joint position. The position and orientation of the replacement and the patient’s bones are measured and assessed before and during the surgery.

That being said, the technology is not foolproof and surgeons and technicians still need to find ways to improve their use of the technology to limit errors even more.

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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