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

Should West Point cadet have open or closed shoulder surgery?

admin — Fri, 09 Jul 2010 14:00:33 +0000

I’m a West Point cadet with a torn shoulder labrum in need of surgery. The doctors have told me about open versus closed methods of repair. Which is best to get me back to full speed ahead?

There are plusses and minuses for both operations. Closed surgery with an arthroscope is less invasive. There’s a reduced risk of getting osteoarthritis in that shoulder later.

The down side of the closed repair is a higher rate of recurrent dislocations or subluxations (partial dislocation). Researchers report about seven to 17 percent of the closed cases have this problem. Only three to five percent of the open repairs partially or fully dislocate.

Many surgeons advise using the closed repair for young patients or extremely active patients. It sounds like you might be in this group. Your surgeon will probably make a recommendation for you based on your age, the injury, and your goals for rehab.

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.

Source of knee pain best discovered by MRI

admin — Mon, 21 Jun 2010 11:42:36 +0000

I am only 48 years old, but I have severe knee pain from years of running marathons and participating in triathlons. The first doctor I saw took an X-ray and said there’s some narrowing of the joint space, but nothing to worry about. Would an MRI (magnetic resonance imaging) show anything else the X-ray didn’t show?

For years doctors have used X-rays to help diagnose osteoarthritis (OA). Recently, researchers have started to call this practice into question. An X-ray reading of the joint may not be valid in predicting pain and function. In other words, the joint looks fine but the pain is very limiting all the same.

More and more doctors are using MRIs to find OA. MRIs can image cartilage and soft tissues. The more the doctor knows about the soft tissues involved, the more direct and specific treatment can be.

Ask your doctor about having an MRI. You may be a good candidate.

Do you have arthritis of the collarbone? More than 50% of adults over 60 do.

admin — Wed, 31 Mar 2010 13:16:52 +0000

Of all things, I’ve come down with arthritis of the collarbone (where it attaches to the chest). I’ve never heard of this before. Most of my friends have arthritis of the shoulders, hips, or hands. Am I a rare case?

Not too rare. The most common problem affecting this joint (called the sternoclavicular joint or SCJ) is osteoarthritis. Degenerative changes from aging make this a disease of the older adult.

Studies show more than half of all adults age 60 or older have moderate to severe arthritic changes in the SCJ. Part of this may be due to the fact that the SCJ is the only place where the bones attach the arms to the main skeleton. Anyone with a history of manual labor or overuse of the arms is at risk for this condition.

Some have painful symptoms, while others do not. Treatment is only needed when pain and loss of motion occur. Surgery is rarely needed. Most patients do well with rest, anti-inflammatory drugs, or local steroid injection.

How can having a total hip replacement improve my sleep?

admin — Wed, 10 Mar 2010 19:27:27 +0000

I’ve been dealing with an arthritic hip for years. Now it’s affecting my sleep. I heard that having a total hip replacement could help me sleep better. How does that work?

Arthritis sufferers are known to have poor sleep patterns caused by pain. Conditions such as osteoarthritis are a common source of hip pain in the older adult.

A recent study in New Zealand showed that sleep is improved after hip joint replacement. All patients had painful symptoms from arthritis that woke them up at night. Less hip pain after the operation meant better sleep. If the patients were awakened from sleep, it was for some other reason than from hip pain.

What does “advanced” osteoarthritis mean?

admin — Mon, 08 Mar 2010 15:36:59 +0000

My doctor told me I have advanced osteoarthritis. What does this mean?

Osteoarthritis (OA) is staged according to how much damage has occurred in the joint and how much joint space is left. X-rays are used most often to stage OA. In advanced stages of OA, there is a complete loss of joint space.

The femur (thigh bone) and the tibia (lower leg bone) have no cushion between them. When you use the knee, the bones slide across each other without any protection or lubrication. We call this bone-on-bone.

How can I tell if I have arthritis?

admin — Tue, 17 Nov 2009 11:52:35 +0000

How can I tell if I have arthritis? Seems the older I get, the stiffer I am, and the more joint pain I notice.

Aging is linked with osteoarthritis (OA) of the joints. The hip and knee are affected most often.

Stiffness is also common as we get older. There are many reasons for this. Tendons and ligaments have less water in them. The drying effect makes the joints seem stiff. The cells that make up soft tissues are called collagen. Fewer new collagen cells are formed so we lose some elasticity in the joints and muscles.

There are other changes going on in the joints. The cartilage loses strength. Changes in the cells of the cartilage lead to OA. There is a thinning of the joint space as the cartilage breaks down. This loss in joint space can be seen on X-ray. It’s the most common way to diagnose OA.

A medical doctor will use tests of motion and strength along with X-rays to make the diagnosis. An early diagnosis is best so that early treatment can limit problems.

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.

Osteoarthritis and obesity a "catch-22"

admin — Wed, 02 Sep 2009 12:46:04 +0000

I have osteoarthritis in my knees. I have been trying to loose weight because my doctor told me it could help relieve some of the pain. But whenever I go for a walk, my knees hurt even more. It feels like I’m making the problem worse, so I have stopped exercising altogether. I’m worried that I will keep gaining weight if I don’t exercise. Any suggestions?

This is a “catch-22″ situation. It is nearly impossible for most people to loose weight without exercising. Weight gain, in turn, can worsen arthritis pain in the lower body due to the added pressure on the knee joints. You need to find activities that you can tolerate. Walking is great for most, but not all, patients with knee arthritis. You might try water aerobics, bicycling, or yoga instead. You may also want to work with a physical therapist who can help you ease into an exercise program that is right for you.

How does my hip function compare with other guys'?

admin — Wed, 29 Jul 2009 11:24:49 +0000

I’m a 46-year old man with severe hip osteoarthritis. I’ve always been active, but now the pain gets in the way. I can’t help but wonder how my hip function compares to other guys my age without arthritis. Is there any way to find out?

Maybe not directly, but we may have some information to offer. A recent study from Finland compared 27 men with hip osteoarthritis (OA) to 30 men of similar ages without OA. Hip motion and function were measured and compared.

Everyone was tested twice (on two separate days) with two to six weeks time in between the first test and the retest. Subjects stood on one leg to test standing balance. Marching in place with the knee lifting up to the hip level was another test. Stair climbing, knee bending and hip range of motion were also included.

It turned out that the men without OA were much more flexible than the men with OA. They had more hip motion, especially moving the legs out and rotating the hip in or out. Men with more hip deterioration had less motion. Men without OA also had better function when walking, climbing stairs, standing on one leg, or moving the hip.

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.

Can using a cane cause low back pain?

admin — Mon, 27 Jul 2009 14:00:16 +0000

Last year I was diagnosed with hip osteoarthritis. The X-rays show it is in the early stages. Even so, I have had considerable hip pain and can’t walk without limping. I started using a cane, which seems to help with the hip pain, but now I am having low back pain. Could the cane be causing this?

Probably not. Canes and other walking aids actually dampen forces that act on the joints. It is more likely that the low back area has absorbed some of the stress normally taken by the hip.

When the hip is painful, it is not always possible to put full weight through the joint. The body compensates for this by transferring some of the normal forces generated through the hip to the pelvis (the bones between the hips). Pelvic motion is altered to help the hip. This in turn increases the load on the low back.

You should report your symptoms to your doctor. It may be that exercises prescribed by a physical therapist can help you balance out the stress on the back, pelvis, hip, and knee. Dealing with your symptoms now can help prevent other injuries.