Is it possible my husband is too active with his hip replacement?

My husband had a total hip replacement about six months ago. He’s back to running and playing tennis as if nothing ever happened. Is there any danger of being too active after with a joint replacement?

There isn’t a simple yes/no answer to this question. Many doctors caution their patients to avoid high-impact activities such as running and tennis. There’s some concern that the implant won’t last more than 10 to 15 years. That could mean another surgery on the same hip.

On the other hand, it’s clear that weight-bearing activities are important to maintain good bone strength and density. Studies show that patients who are less active and more sedentary actually lose bone. Bone loss around the implant can cause it to loosen and require revision surgery.

Your husband’s surgeon is probably the best one to ask this question. Knowing the type of implant and surgical procedure used can make a difference, too. When patients are educated and informed about their joint replacements, then they can make the best decisions about activity and lifestyle.

For active, healthy adults, being more active than is advised may improve their quality of life enough to make it worth the risk.

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.

How rare is it to have rheumatoid arthritis and need a hip replacement?

I have rheumatoid arthritis in my hips and will probably have one of them replaced in the spring. I’ve gotten the impression that we are fairly rare and that most patients who need hip replacements have the other kind of arthritis. Just how rare is my situation?

Keeping track of number and type of joint replacements can be done in several different ways but in the United States, we don’t have every patient entered into a database like some other countries do. We can get information from hospital discharge data and Medicare part B that is helpful. Many times, this is limited to patients over the age of 65. It doesn’t include younger patients or people who have their replacements done in private orthopedic surgical clinics.

Some of the other countries such as Finland do have a national registry. This type of information is routinely collected and has been a clinical feature for over 30 years. Because their patient population isn’t so different from ours (socioeconomic, educational background, lifestyle), we can often make comparisons that could easily apply to our country.

A recent report was published using data from the Finish Registry that might answer your question. They ran a software program that pulled out how many hip replacements were done just for patients with rheumatoid arthritis. The time period information was collected from was from 1980 to 2006. There were a total of 132,540 primary (first-time) hip replacements in the whole study (all diagnoses such as osteoarthritis, traumatic arthritis, rheumatoid arthritis). Breaking that down by age, the majority of those (86 per cent) were in adults 55 years old or older. That’s approximately 114,600 of the 132,540. And of the people in the 55 years and up group, only five per cent (about 6,000 patients) had rheumatoid arthritis as their main diagnosis. So you can see, this isn’t a rare group but fairly uncommon. Those overall figures are lower than in the United States where over half a million hip replacements done each year. About five per cent of those will be in patients with a primary (main) diagnosis of rheumatoid arthritis (RA). With the new, more effective medications to control the progression of joint destruction associated with RA, this percentage may not increase over time — even though more adults with RA are living longer with their disease. Over time, better control will yield better results and outcomes with less invasive treatment.

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.

I was a marathon runner prior to my knee replacement as a result of arthritis. How long will it take to repair?

I was a marathon runner all my life until arthritis laid me up. I’ve had a total knee replacement. I’m working to get back to running. It’s been a year and I still can’t run up and down stairs as part of my training. The doctor says to “give it some more time.” How much more time is needed?

Total knee replacement (TKR) has some very positive outcomes. Besides pain relief, patients often report improved motion and increased function. Most of these patients started from a place of severe disability. Having come from a very inactive lifestyle, their expectations may be less than yours.

Despite good outcomes research shows there are some long-term problems after TKR. Walking speed and stair-climbing speed are as much as 50 percent slower in patients with TKR compared to those without a TKR. Quadriceps weakness and atrophy may account for these changes.

Long-term studies of patients with TKR show continued improvement of muscle activity up to three years later. Even so, the level of voluntary muscle contraction doesn’t seem to come up to the level of healthy adults of the same age without a TKR. You may be having this problem.

Perhaps it’s time for some formal muscle strength testing if this hasn’t already been done. Ask your doctor for a more precise time frame for expected recovery and request muscle testing with a physical therapist. Getting a baseline even now can help you track your progress and find the right exercise program 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.