Can I get arthritis pain relief any other way than knee surgery?

May 18th — admin

I have painful knee arthritis but I don’t want surgery for a joint replacement. What else can I do to get pain relief?

Patients often want to delay or avoid joint replacement. Many doctors suggest pain relievers or nonsteroidal anti-inflammatory drugs combined with exercise as an early treatment program. Patient education for improving posture and reducing biomechanical imbalances may be provided by a physical therapist.

Other treatment options can include steroid injections, glucosamine supplements, or bracing. Minor surgery such as arthroscopic debridement may be advised. The surgeon removes any frayed edges or loose fragments of cartilage.

This type of treatment is not routinely advised for all patients but may be most effective for low-grade OA.

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?

May 10th — 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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Which surgery is best for a broken hip?

May 7th — admin

My 80-year old mother broke her hip this morning. She’s in the hospital waiting for surgery. When I looked on-line it seems there are two ways to treat this. One is with surgery to pin the fracture. The other is to replace the hip joint. How do we decide which is better?

Your mother’s orthopedic surgeon will help you with this decision. It depends on the type of fracture and condition of the bone. Some areas of the bone have less blood supply and won’t heal easily. Thin or osteoporotic bone may not heal either. A pin or plate to hold the bone until the fracture heals may not work.

An X-ray will show the doctor if the hip joint is stable. The key is to see if the head of the femur (thigh bone) is secure inside the hip socket. If it isn’t, then the joint is considered unstable. There’s a much greater chance for a poor result pinning an unstable joint. In such cases hip joint replacement is 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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Why is my total hip replacement still painful?

May 3rd — admin

After seeing my two sisters get a total hip replacement I decided to take my doctor’s advice and have mine done, too. They both seem to have had such a good result, while I’m still struggling with pain and stiffness. Why the difference?

There are many possible reasons for the difference. You didn’t mention how long it’s been since your surgery compared to your sisters’ operations. Many patients expect results too soon. Total hip replacement is a major operation. It takes weeks to months for bone to grow around the implant and help seal it in place. Some of the hip muscles are cut during the operation and must knit back together, too.

The type of implant and method used to put it in place can vary too. Both of these factors can make a difference. Rehab and a home exercise program must be followed carefully for a good result.

Tell your doctor about your concerns at your next follow-up visit. It may just be too early to know what your final outcome will be.

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 baja of the kneecap?

May 2nd — admin

What is baja of the kneecap? My surgeon has identified this as the main reason my total knee replacement is so stiff.

Patellar baja refers to the position of the patella or kneecap. In patellar baja, the kneecap rides down low over the femur (thigh bone).

This can just be the way you were born. More often it occurs as a result of the patellar tendon shortening after surgery or injury. Either way, a patellar tendon that is too-short can pull the patella downwards.

A recent study of stiff knees after total knee replacement (TKR) identified patellar baja as a possible cause. Women were at higher risk of patellar baja. Younger age was also a factor but age was linked with joint stiffness after TKR, not the patellar baja.

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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Where is my ligamentum teres?

May 1st — admin

I was in a car accident and broke my pelvis in two places. After the injury finally healed, I still had deep groin pain and my hip kept giving way. I had MRIs, X-rays, and CT scans done for my pelvis and nothing ever showed up. Finally I had arthroscopic surgery and the doctor found a tear in the ligamentum teres. Where is this and why doesn’t it show up on all these tests?

If you pull a chicken leg out of its socket, you’ll see a fibrous white ligament. That’s the equivalent of the ligamentum teres in the human. It helps hold the head of the femur (thigh bone) in the hip socket.

Traumatic or twisting injuries can cause this ligament to tear. Hip dislocation can stretch it to the tearing point, too.

Doctors don’t have a test to help them find this type of tear. In fact, it wasn’t until arthroscopic surgery came along that they even knew it occurs as often as it does. Now that we know it’s a problem, more studies will be done to find easier ways to diagnose it.

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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Which type of surgery is best for an ACL tear?

April 26th — admin

I tore my left ACL in a skiing accident three years ago. Last month I injured my ACL on the other side while playing beach volleyball. I had a hamstring graft the first time. Should I have the same surgery this time?

Anterior cruciate ligament (ACL) repairs are still done using either a patellar tendon graft or a hamstring tendon graft. Results have been equally good with both in terms of pain relief and knee stability. Just as many athletes return to their pre-injury level of play with either method.

There is one major difference to be aware of. A five-year study comparing patellar to hamstring tendon graft repair showed a significant increase in osteoarthritis (OA) with the patellar tendon graft. Patients with patellar tendon ACL grafts had a narrower joint space and more bone spurs on that side.

Based on the results of this one study, you may want to stick with the hamstring tendon graft for both sides. Ask your surgeon about this. Graft choice may be a more important consideration in the big (long-term) picture than previously thought.

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 cold therapy used after a hip replacement?

April 23rd — admin

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 medications. 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.

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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Should an older adult get a partial or complete knee replacement?

April 18th — admin

Please help me out. We are trying to advise my father about knee replacement surgery. He’s 78-years old and not very active. The doctor has advised just replacing the side of the joint that’s worn out. At his age, wouldn’t it make more sense to replace the whole joint and be done with it?

Replacing one compartment of the knee joint is called a unicompartmental knee arthroplasty (UKA). Most often it’s the inside (medial) half of the joint that wears down first and becomes arthritic.

There are several pros and cons to this operation. Operative and recovery time are less. The cost is less, too. But there are some concerns, too. Studies show the UKA doesn’t last as long as the TKR. Other studies show function is improved more with the UKA compared with the TKR.

There may be an increased need for revision if the one-sided implant comes loose or the other compartment wears out. Then the patient would need a total knee replacement (TKR) after all. Overall, the UKA has become more popular as surgical implants and techniques improve.

A recent analysis of the cost versus benefit of UKA and TKR for low-demand patients confirmed the usefulness of the UKA. Low-demand means the person is fairly inactive and unlikely to put much stress on the new implant. Your father may fall into this category.

If the UKA gets him back on his feet sooner he may become more active. Many older adults find that pain relief from the implant makes their daily activities so much easier. They weren’t looking for a game of tennis or to take up jogging again, anyway. Many elderly patients die of unrelated causes before the UKA ever wears out or needs revision.

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 young is too young for a hip replacement?

April 13th — admin

I’m 40-years old and in need of a hip replacement. My doctors says I must wait until I’m at least 50 because the implants don’t last more than 15 0r 20 years. Is there really that much difference in the results between patients my age and older patients?

Only a few studies have been done to look at age differences with total hip replacements. Since most patients do wait until age 50 or older, finding out how younger patients fare isn’t easy.

Doctors at the Anderson Orthopaedic Research Institute in Virginia have given us some answers. They looked at 561 hip replacements done over a period of 20 years. All patients were 50 years old or younger. This group included 256 hips in patients who were 40 years old and younger.

The authors were surprised to find no difference in wear rates between the two groups. They followed the patients for five, 10, and 15 years. Wear rates were calculated using repeated X-rays over the years. They found implants lasted five years in 97 percent of patients under 40. This is called the five-year survivorship rate.

The 10-year survivorship rate in the same group was 85 percent. And at 15 years the survivorship rate was 54 percent overall. That last figure means about half the implants had failed by 15 years, but the researchers found only part of the implant failed. The whole implant didn’t need to be replaced. Revision surgery could be done just to replace the worn part.

Studies like this are very encouraging. Your chances of an earlier operation may improve as more information is reported.

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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