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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What should I do about knee arthritis?

April 3rd — admin

I’ve been a faithful exerciser to help my knee arthritis for the last five years. Now my pain is starting to get worse so the doctor has advised me to try the knee injections to put fluid in there. If this works will I still need to do the exercises?

Joint fluid therapy sometimes referred to as viscosupplementation or hyaluronan injections is a thick, elastic substance made from hyaluronan. Hyaluronan, also known as hyaluronic acid or hyaluronate (HYL) is found in normal joint fluid.

When injected directly into the knee joint, HYL helps restore the cushioning and lubricating properties of normal joint fluid. Three to five injections are used for knee osteoarthritis in patients who have not responded to more conservative therapy.

A recent study from the New Jersey Medical School suggests that combining HYL with a home exercise program is actually better than just HYL alone. Exercise by itself seems to benefit knee OA. Biochemical changes in the synovial fluid have been reported with exercise alone and with HYL alone.

Combining the two together may help increase the amount of hyaluronan that moves into the cartilage. Exercise seems to have the added benefit of helping expand and cleanse the cartilage to keep it in good condition. All indications are that exercise is very helpful for osteoarthritis and should be continued on a daily basis.

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 can I avoid hip or knee replacement?

February 1st — admin

I notice all the older women in my family either have their hip or knee (sometimes both!) replaced. What can I do to avoid this myself?

Although there may be a genetic link to joint problems like arthritis, obesity remains the biggest risk factor for hip and knee osteoarthritis (OA). Aging with the degenerative changes that come with aging is the second biggest risk factor.

Women seem to be affected by knee OA more often than men. Although you can’t do much about your age or your gender, risk factors like body weight, activity level, and habitual positions can be modified.

A recent study of sitting positions while on the floor linked bent-knee floor activities with an increased risk of knee OA. Daily use of the lotus position, squatting, and side-knee bending does put increased stress on the knee joint leading to cartilage break down and arthritis. Kneeling does not seem to have the same effect.

Monitoring your weight and avoiding too much knee flexion for long periods of time are two risk factors within your control. Other risk factors such as knee alignment can be evaluated, too.

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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Is there a genetic link between osteoporosis and osteoarthritis?

July 3rd — admin

Is there any link between having osteoporosis and knee osteoarthritis? I’ve just been told I have osteoporosis. My mother had knee arthritis pretty bad. I don’t know if she had osteoporosis. I was wondering if there’s some kind of genetic connection.

Genetics may very well be a part of developing either osteoporosis (brittle bones) or osteoarthritis (OA). And there may be a link between osteoporosis and OA. It isn’t clear yet if there is a genetic link here.

The relationship between OA and osteoporosis may surprise you. Some studies show that women with low bone mass from osteoporosis may be less likely to have OA. But once OA is found, a higher bone mass density (no osteoporosis) means a milder case of OA. Just what all this means and what the actual connections are between OA and osteoporosis remains unclear.

One important risk factor for knee OA (such as your mother had) is a previous knee injury. Men and women are both more likely to develop knee OA after an anterior cruciate ligament (ACL) tear. And women are twice as likely to develop an ACL injury compared with men.

All in all, it looks like osteoporosis may have a protective effect. It may actually prevent OA from developing. Scientists are studying this phenomenon carefully. It’s possible they may discover something that could help prevent either or both of these conditions.

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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On what basis do doctors decide to do a knee replacement?

June 13th — admin

My mother has been having a lot of knee pain recently and difficulty walking. Her doctor is trying to convince her to have a knee replacement. On what basis do doctors decide to do a replacement?

Total knee replacements are usually done because a patient has severe osteoarthritis or rheumatoid arthritis of the knee, or has had a severe trauma or injury to the knee that is causing a lot of pain and difficulty with movement.

Your mother’s doctor may have looked at the amount of pain she is experiencing when she walks and how it may be limiting her life. If she can’t walk without a significant amount of pain, or has difficulty going up and down stairs, or getting in and out of chairs, this can be affecting her quality of life. If her pain is severe even when resting and she’s not responding to pain relievers, this can affect how she sleeps and even how she feels about herself.

It could be that other treatments, like physiotherapy, have also been tried but without much success.

Immobility and social isolation are big problems among our older citizens and it’s important for them to be able to maintain their independence as long as possible.

Of course, your mother’s doctor will also ensure that she is healthy enough to undergo such a 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 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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Questions to ask about bilateral knee replacement

August 22nd — admin

I have severe osteoarthritis and need both knees replaced. How soon after the first one can I have the second one done?

This is entirely up to you and your surgeon. Some people have both knees replaced at the same time. Others wait anywhere from three weeks to three years or longer.Your decision may be based on some personal factors. For example if you have both knees done at the same time, is there someone who can help you at home for a few weeks after the operation? This is very important. How is your overall health? Can you withstand two replacements at the same time or two major operations in the same month? Same year? Is one knee much worse than the other or are they pretty much the same in terms of pain, stiffness, and loss of motion?

Some patients choose to have the worst knee done first. They depend on the “better” knee during rehab. When the first knee replacement can support them, then they have the second knee done. Talk to your doctor about his or her suggestions for you.

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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Biggest Success Factor in Total Knee Replacement is Pain

August 1st — admin

I’m trying to get up enough courage to have one of my knees replaced. Are there any studies to show who should really have this operation? Maybe I’m not a good candidate.

Lots of studies have been done on the results of total knee replacements (TKRs). Unfortunately, most surgeons focus on which operation works best and which implant has the fewest problems.

Very few studies look at the characteristics of patients. Does age make a difference? Do patients with rheumatoid arthritis do better or worse than patients with osteoarthritis? Does it matter if you’re overweight when you have the operation?

These are just a few of the questions patients raise when thinking about having a TKR. A recent review conducted by the University of Minnesota reported no evidence that age or type of arthritis was linked to results.

The biggest factor in success was how much pain the patient had before the operation. Those with the greatest pain had the best improvement in function.

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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If torn ACL is not repaired, will a total knee replacement be required?

May 16th — admin

I’ve been told if I don’t have my torn ACL repaired I could end up with a total knee replacement. Is that true?

Well, there’s some truth to your statement but there are many factors in between those two points. First it depends on how severe the damage is to your anterior cruciate ligament (ACL). A minor tear can be treated with rehab. This is especially true if you’re not an athlete or exercising at intense levels.

Studies do show a tendency toward cartilage damage in unstable knees. This means the ACL is deficient and not doing its job. The joint slides around more than it should, putting stress on the meniscus and other joint cartilage. Under the increased load, wear and tear on the meniscus could end up in a tear.

Only one study has been done that shows the need for a total replacement (TKR) after ACL injury without repair. A small group of olympic athletes in the former East Germany were treated without surgery and returned to training. Doctors followed them 35 years later and found out that all of them had a torn meniscus. Half had a total knee replacement.

Long-term studies of everyday average people with an unrepaired ACL have not showed these kinds of results. They do report an increased pattern of osteoarthritis in the unstable (unrepaired) knees. The risk of a TKR is present but not a certainty.

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 amputee really walking faster?

December 29th — admin

It’s a funny thing but ever since my husband had his leg amputated, he walks faster. I have a hard time keeping up with him. Can you explain this to me?

Increased walking speed isn’t uncommon in leg amputees using a prosthesis. A prosthesis is an artificial limb or part of a limb. Changing the walking speed may be a way to compensate for the uneven gait pattern that develops when using a prosthetic device. By walking faster, the person shortens the stride length and equals out both sides.

When walking, the person with a prosthesis tends to shift the weight over to the normal or intact leg. The problem with this strategy is that over time, the nonamputated knee absorbs the force and is at increased risk for osteoarthritis.

Gait training and/or adjusting the prosthesis may help your husband even out the load on both legs and avoid future injury. A physical therapist can help you with this problem.

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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Get a new kneecap or keep the old during total knee replacement?

September 27th — admin

I’m going to have my left knee replaced because of severe arthritis. The doctor has told me I can keep my own kneecap or get a new one. Which is better?

Studies show a general trend toward better results with kneecap (patellar) replacement during total knee replacement (TKR). Replacing the patella is called resurfacing. Patients with their own patellas (nonresurfaced) are more likely to have knee pain afterwards. The pain is worse when going up and down stairs.

Anyone with good cartilage can keep the patella. Young, active adults who are not obese are good candidates for nonresurfacing. Difficulty tracking the patella up and down over the knee joint is one reason to replace it. Inflammatory changes, abnormal shape, or bone spurs are all good reasons to replace (resurface) the patella.

Ask your surgeon to give you his or her best opinion based on the condition of your kneecap now and the type of implant you’ll be getting.

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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