Widow will need someone to help her after hip replacement surgery

March 18, 2010 — admin

I’m going to have my first hip replacement next month. The surgeon tells me if all goes well I should be home in 12 hours. I am widowed and live alone. How will I know what to do or how to care for myself?

With the new minimally invasive operations patients are able to go home quickly after joint replacements. The incision is smaller and the blood loss is less. The time under anesthesia is much less, too. Patients are up and walking with the therapist much faster.

One way to accomplish this is through pre-operative training. That means you’ll see a physical therapist before the operation. The first visit takes place about two weeks before the surgery. Then three to five days before your hip replacement, you’ll see the therapist again.

The therapist will teach you the exercises you’ll need to know. You’ll learn how to walk with crutches. In fact you’ll be required to practice both the exercises and the crutch walking before the operation.

You will need someone to help take care of you for a few days after the surgery. A nurse and a therapist will visit you in your home. You’ll be reminded of the dislocation precautions. Your blood levels will be checked. Your doctor will be notified if there are any problems. Most patients do very well with this approach.

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Should you have bilateral total hip replacement?

March 15, 2010 — admin

My father has arthritis in both hips. This limits his travel and activities. He wants to have them both replaced at the same time to “get it over with quickly.” We’re concerned about this idea. Isn’t it better to do one at a time?

Researchers are always trying to find ways to predict which patients will have the best results after surgery. A group of surgeons from The Center for Hip and Knee Surgery in Indiana followed 900 patients with total hip replacements (THRs) for nearly 30 years. They compared single THRs to both THRs being done at the same time. Here’s what they
found out.

The death rate was higher in older adults. Patients having the bilateral THRs had fewer total days in the hospital. This was a cost savings. They had less time out of work (or play). They only had to have anesthesia one time.

Overall outcomes in terms of physical function and life of the implant were the same between the two groups. Implants with the most post-operative problems were identified and reported. Surgeons can avoid using the most problematic implants when doing bilateral THRs.

All patients thinking about having bilateral, simultaneous THRs should be advised about the risks of having both hips done at the same time. Older adults in poor health and without family support at home may want to reconsider and have one hip done at a time.

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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Uneven wear in hip joint replacement result of third-body wear.

March 5, 2010 — admin

I had a joint hip replacement for severe arthritis three years ago. The doctor tells me that “third-body wear” is likely the cause of some uneven wear in the joint. What does this mean?

When patients with hip joint replacements are compared, there are very different results in wear patterns of the new joint. This is true even when the same replacement parts are used from patient to patient.

In fact, one study looked at patients with both hips replaced using the same implant. The researchers compared one side to the other and found that the wear pattern was different from side to side. One of the reasons for this is third-body wear.

This is the presence of tiny particles in the joint. These pieces may be bits of bone or fragments of glue or cement used to hold the new joint in place. Even metal debris from the coating around the joint implant can cause the joint liner to be scratched and roughed up. Joint wear and tear is increased when the surfaces are roughened.

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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What position is best for sleeping after a total hip replacement?

March 3, 2010 — admin

What position is best for sleeping after a hip replacement?

It depends how long ago you had the operation. During the first weeks-to-months, patients are restricted to lying on the back. Many doctors request they use a special abduction pillow between the legs with another pillow under to knees to keep the hips slightly bent.

When the doctor gives you the go ahead you can sleep on the “good” side. This means the hip replacement is up facing the ceiling. You’ll still need a firm pillow that goes between the legs from the hips down to the ankles.

Lying on your stomach is not advised. If your doctor approves this position, you may need a pillow under the hips to keep them in a slightly flexed or bent position. It’s usually many months (if ever) that stomach sleeping is comfortable or safe.

Sleeping on the operated side is also delayed by many months if it is resumed at all. Most patients find this position too uncomfortable to rest well at night.

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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I had total hip replacement surgery, how long will I limp?

February 26, 2010 — admin

I’m very self-conscious that I still limp after a total hip replacement I had five months ago. Will this ever go away?

Muscle weakness is the usual cause of a limp while walking. Three to six months after a total hip replacement, the muscles around the hip are still only at 50 percent of normal. Limping is not unusual up until six months after the replacement.

Limping may even go on up to one year later. This is because joint strength and function are still only at 80 percent of normal. It’s important to keep doing your rehab exercises. By five months you should be able to move past the basic program and continue to improve your strength.

Try to get back to your favorite physical activities. Any nonimpact sports you enjoy will help keep you on track for full recovery. If you aren’t seeing some gradual improvement over time, ask your doctor if there are any special or unusual reasons why you are still limping. Perhaps you’re a good candidate for an updated rehab program.

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 Grandma too old for total hip replacement?

February 5, 2010 — admin

My 83-year old grandma is going to have a total hip replacement. We’re all worried that she’s too old for this. What do you think?

Americans are living longer and in better health. This means they are more likely to need a major joint replacement as they reach their 80s. Joint replacements are available for the shoulder, hip, or knee.

These operations do put older adults at increased risk of problems.

Studies of 80-year old (and older) adults compared to younger adults show there is an increase in the number of serious problems that occur. But the overall rate is low, and it’s more likely to happen in elderly patients with other health problems.

Results should be good if your grandmother is in good health and the doctor has approved the 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 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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Taking gingko biloba and planning hip surgery? Tell your surgeon!

January 11, 2010 — admin

Have you ever heard of this? My aunt had hip surgery and then developed a weeping, oozing wound. The doctor said it was from taking ginkgo biloba.

There have been a few cases of persistent bleeding after surgery caused by herbal self-medication. Usually the patient forgets to tell the doctor that he or she is taking a supplement such as St. John’s wort, ginseng, or ginkgo biloba.

Gingko biloba has an anticoagulant property much like aspirin. This means it prevents the blood from forming clots. That’s important for patients at risk for heart attack or stroke, but it’s a risk factor for anyone who’s just had surgery or who has a bleeding disorder.

The most recent report of gingko biloba causing oozing from a wound after surgery comes from Wales. A 77-year old woman had a hip replacement without problems. Afterwards, the wound site drained blood and a clear fluid for three weeks. When it was finally discovered she was taking gingko biloba and she stopped taking it, the problem cleared up within 10 days.

Visit The Zehr Center online for more information on total hip replacement 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 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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Pinning vs. total hip replacement

December 22, 2009 — admin

I’m writing to you from a hospital bed after tripping over a shoe lace and breaking my hip (a femoral neck fracture). I don’t have much time before the nurses come in and scold me for being on the computer. Please tell me the pros and cons of having the bone pinned together versus having the joint replaced.

You didn’t mention your age or bone status, two important points in making these choices. Older patients (65 years old and older) with poor bone density may not be able to grow enough new bone to heal a fracture that’s pinned. The hip replacement may be the best option.

Is the fracture stable (fracture line hasn’t moved), separated (bone has drifted apart) or impacted (one side of the fracture is pushed into the other side)? A stable fracture that hasn’t moved or shifted is often treated by internal fixation. This means screws are used to hold the bone together until it heals.

If the fracture can’t be pinned together or if there are serious arthritic changes in and around the bone and joint, then a joint replacement may be needed. According to the results of a recent study, older adults have better results with a total hip replacement.

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.

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Specialists undecided on treatment for displaced femoral fracture

December 17, 2009 — admin

My 82-year old father is in an assisted living center. He was hospitalized two days ago for a broken hip bone. I guess it’s what’s called a displaced femoral fracture. He’s had three specialists consult on the case. They can’t seem to decide what’s the best way to treat the problem. Is this unusual? Should we move him to a different hospital?

A displaced fracture of the femur (thigh bone) means the bone broke and the two ends either separated or shifted. In other words, the broken pieces of the bone don’t line up anymore.

Femoral fractures are very common in the United States, especially with the aging of America. The type of fracture you’re describing can cause quite a bit of disability for the patient. Some patients are unable to get back to their former level of function. They may have to give up independent living. They may go from being able to walk to being confined to a wheelchair.

The goal of treatment is always to get the patient back to a prefracture level of function. Treatment is usually an operation to repair or replace the bone. Repair may be done using screws to hold the two ends of bone together until healing takes place. This is called internal fixation. It may be necessary to replace part or all of the hip joint.

There are many factors to consider when choosing the right treatment. The patient’s age, bone density, mental status, and other health issues are important. Most likely the doctors are meeting to confer on which treatment would give your father the best chance for recovery based on his individual factors.

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.

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Muscle testing may be necessary years after total hip replacement

December 9, 2009 — admin

I had a hip replacement about two years ago. I notice I’m having more trouble now doing simple things like putting on my socks and shoes than even right after the surgery. What can I do about this?

You may be experiencing some loss of strength. This happens in many patients one to two years after recovery from a total hip replacement (THR). Sometimes an exercise program is all you need.

Your muscles can be tested and a specific program of exercises given for any weakness. A regular program of walking 30 minutes at your own pace each day has also been shown to help. Patients do best when they combine an exercise program with daily walking.

It’s a good idea to have your doctor check you over for any medical causes of this change in your function. If you get the all-clear signal make an appointment with a physical therapist for muscle testing and an exercise program. Most programs of this type can be done on your own at home.

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.

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