What is cement disease?

What is cement disease? I’ve heard you can get it from a hip replacement. Is that true?

Joint replacements can come loose and fail. Two reasons for this are infection and wear. Antibiotics mixed in with cement used to hold the implant in place have reduced the rate of infection.

Now, the most common cause of loosening is due to wear of the implant surfaces. Tiny bits of metal or plastic called debris flake off the implant. The bone around the implant starts to weaken. On an X-ray, it can look like there are holes in the bone around the implant.

At first doctors thought this problem was caused by the cement used to hold the implant in place. They called it cement disease. Today we know that the microscopic debris from joint replacements irritates the tissues around the implant. The result is a weakening of the bone. This condition is now called osteolysis.

Osteolysis (not cement disease) causes the implant to loosen over time. Movement of the implant inside the bone can cause hip and thigh pain and loss of hip motion. Research is ongoing to find a design for the implant that will stop the problem of osteolysis.

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.

Why am I still having hip pain after its replacement?

I’m having quite a bit of thigh pain that I’m afraid might be coming from my hip replacement. I thought it would go away with a little rest, but it hasn’t. What could be causing this to happen?

There are many possible reasons for thigh pain. A problem with the implant (also called a prosthesis) is only one. Loosening of the prosthesis is the most common cause of thigh pain linked with a total hip replacement.

Other medical causes such as urinary tract infection, kidney stones, or disc herniation must be ruled out. Your surgeon is the best one to diagnose the problem. After taking a history and performing an exam, a simple X-ray may be all that’s needed.

If the problem is not coming from the implant, then other imaging and/or lab tests may be needed. Early diagnosis and treatment are always advised. Waiting too long can sometimes add complications that may be avoided with early intervention.

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.

Why, after two years, why do I still have pain after my total hip replacement?

Two years ago, I had a total hip replacement. Within six months of the surgery, I started having thigh pain on that side. It has never gone away. Can anything be done about this?

Thigh pain after a total hip replacement (THR) is not uncommon. In fact, up to 40 percent of patients may complain of this problem. It’s more common with implants without cement. These are called cementless total hip arthroplasty or replacement.

Doctors aren’t sure why this happens, which makes treatment difficult. If there isn’t any infection, then the patient is usually given pain medication. Physical therapy can be helpful. If severe pain lasts more than two years, the doctor may suggest a second surgery to repair or replace the THR.

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.

What’s a simple hip dislocation? That’s a term being used for my hip fracture and it seems like anything but simple.

What’s a simple hip dislocation? That’s a term being used for my hip fracture and to me it seems like anything but simple.

A simple hip dislocation refers to dislocation without a fracture. Complex fracture-dislocations involve popping the round head of the femur (thigh bone) out of the acetabulum (socket) with a fracture of the acetabulum at the same time. Acetabular fractures affect the joint surface where the head of the femur moves against the joint surface to provide joint motion.If you can look at it this way, a simple dislocation has some long-term benefits, too. Only one out of every four patients with a simple dislocation results in hip arthritis later. It’s the dislocations accompanied by an acetabular fracture that present later with problems including arthritis. About 88 per cent of those complex fracture-dislocations damage the joint resulting in death of the bone (osteonecrosis) and osteoarthritis.Simple dislocations are often easier to reduce (set back in place) without major surgery. The patient is still sedated to achieve deep relaxation of the surrounding muscles. But with a few quick and easy techniques, closed reduction is possible. The more complex dislocations with fractures or other injuries often require arthroscopic or even open-incision surgery. There is a greater risk of complications with loss of blood flow, osteonecrosis (death of bone), infection, and poor outcomes with complex dislocations.

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.

Thigh pain may not be a result of recent total hip replacement

My mother has been complaining of thigh pain after her total hip replacement. Could this be caused by a problem with the new hip? Or is something else going on?

Thigh pain can be caused by a wide range of problems. Pain can be referred to the thigh from a problem in the abdomen, low back, hip, or knee. For example, kidney stones, tumors, or blood clots can cause thigh pain.

But muscle strains, bursitis, pressure on the nerve, and hernias can also cause thigh pain. It is also possible that a problem with the implant can send pain to the thigh. Loosening of the implant, infection, and wear debris from the implant can cause thigh pain.

A simple X-ray can help show what might be going on. First, the radiologist will look for fractures. Rotation of the femur (thigh bone) indicates loosening of the implant. The X-ray can also show subsidence or sinking of the implant down into the bone.

Don’t put off having this problem checked. Early diagnosis and treatment can prevent more serious problems later. It could be something as simple as muscle weakness or even a problem with posture. If this is the case, a physical therapist can help your mother with a program of exercise and posture awareness. More serious problems can be addressed by the surgeon.

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.