Will total knee replacement stop senior marathon runner?

August 27th — admin

I’ve been a marathon runner all my adult life. At age 66 I’m going to have my right knee replaced. What are my chances of being able to run again?

There’s much interest and debate around this topic. The materials used in a total knee replacement (TKR) are designed to give the implant movement like a normal joint. The implant is usually made of sturdy materials such as stainless steel, alloys of cobalt and chrome, and titanium. Plastic liners may be part of the implant. These are durable and wear resistant.

Orthopedic surgeons, engineers, and other scientists are working together to improve the surgery and implant materials. Right now these materials are not made to withstand the stresses of running, heavy physical work, or contact sports. Engaging in these types of activities after TKR may lead to damage or early wear of the implant. The estimated lifespan of a knee implant is 10 to 15 years.

Impact sports like running are not usually advised. No-impact or low-impact sports are acceptable. Be sure to tell your doctor your interests in activities. Sometimes the type of implant used can make a difference. Find out what to expect. Your implant last the longest if you follow your doctor’s advice.

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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Unicompartmental knee arthroplasty not always the answer

August 19th — admin

I had a unicompartmental knee joint replacement last year. That means they only replaced the inside half of my left knee. I thought it was going to be the answer to all my problems. Instead I ended up with more problems. Would it have been better to have a total knee replacement?

Many studies support the use of the unicompartmental knee arthroplasty (UKA). It’s been shown to have a faster rehab time, give better function, and cost less than a total knee replacement.

Failure in a small number of cases does occur. There are several reasons why this can happen. Sometimes the arthritis continues to get worse. The bone around the implant wears away and the implant loosens.

In other patients the hip, knee, and ankle don’t line up as well as they used to. Finally, overcorrecting a deformity at the time of surgery can cause too much load on the knee joint. The wear and tear on bone and ligaments can lead to failure of the implant.

It may still be possible to salvage your “new” knee. Sometimes surgery to revise the implant is the answer. In other cases, replacing the unicompartmental implant with a total knee replacement is the next step. Be sure and ask your doctor what are your options. Perhaps get a second opinion from another 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.

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Best options for treating knee osteoarthritis

August 16th — admin

My doctor has given me several options for treating the moderate osteoarthritis in my right knee. I can keep active and “do nothing” while waiting to see what will happen. I can have the joint scraped of any rough edges and torn pieces of ligament. Or I can have the joint replaced. Any advice for me?

All of those options are possible. In fact, you may want to use them all one at a time. Usually the wait-and-see approach is accompanied by an exercise program to keep the muscles around your knee toned and strong. Some of the medications available control both the pain and the disease.

If the joint starts to deteriorate more, then surgery to keep the joint surfaces clean and smooth may be the next step. The doctor may put a special fluid called hyaluronan in the joint to keep the tissue from sticking together.

When the joint space narrows too much and the bone is in danger of rubbing against bone, a joint replacement will be needed. Today’s treatment approach for osteoarthritis is to save the bone and joint for as long as possible. Taking it one step at a time is a good way to accomplish this goal.

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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Obesity a factor in failed knee replacements

June 29th — admin

My brother-in-law is very overweight. His knees are bad but he refuses to lose weight. He says he’ll just have them replaced when they wear out. Is it really that simple?

The rising cost of health care has taken “simple” out of almost every picture today. Obesity is linked with degenerative disease of the hips and knees. A high body weight is also linked to a poor result after the joints are replaced.

A recent study at The Good Samaritan Hospital in Baltimore, Maryland compared total knee replacements (TKRs) in obese and nonobese adults. The patients all got the same joint implant (one that has been used successfully for many years).

Results were reviewed after five years. Being overweight had a negative impact on the success rate of TKRs. More implants failed in the obese group than in the nonobese group. Obese patients with failed implants had lower satisfaction rates.

There are improved medical treatments for obesity today. Encourage your brother-in-law to see his doctor and find out what are his options. He may be able to at least improve his health before his knees wear out and he faces the risks of 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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Exercising on your own after total knee replacement surgery

June 24th — admin

I had a total knee replacement six months ago. After physical therapy in the hospital, I had more therapy at home. Now I’m doing my own exercises everyday. How long should I keep this up?

It might be time for a follow-up visit with your doctor or therapist. Tests of motion, strength, balance, and coordination can guide you. Patients exercising on their own can still show major weakness even years after a total knee replacement. This can put you at risk for falls and other injuries.

Every person is different and has his or her own unique needs for rehab after joint replacement. A closer look at what you’re doing and how you doing can lead to an answer to your question.

It’s likely that some form of exercise will be advised. Regular exercise and physical activity has been shown to keep joints healthy, even joints already affected by arthritis. Make it worth your while to exercise. Find out what’s best for you in this phase of your recovery.

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 a nerve block safe for total knee replacement surgery?

June 16th — admin

I’m going to have a total knee replacement next week. The doctor asked me if I want a nerve block before the operation to help stop the pain after the operation. What are the chances of ending up with permanent nerve damage from this?

It’s possible but not likely. Studies show permanent nerve damage after nerve blocks is very low. In fact when nerve damage occurs, most patients recover completely within three months’ time. Minor long-term problems can occur such as mild muscle weakness or a small patch of numbness.

Ask your doctor what his or her experience has been using nerve blocks. Find out what other problems can occur and how often this happens. Consider the benefits of a preoperative nerve block: less pain and less use of morphine or other painkillers after the operation.

Studies show a single-injection femoral nerve block is a simple and safe way to reduce pain after total knee replacement.

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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Best rehab strategy following total knee replacement surgery

May 5th — admin

What’s the best strategy to follow for rehab after a total knee replacement? I’ve been saving all my energy for physical therapy. After that I’m too tired to do anything else the rest of the day.

You may want to discuss this with your therapist. It’s best to work out a schedule that will enable you to exercise throughout the day at regular intervals. It’s understood that early on in the rehab program patients are still recovering from the operation. This is also the crucial time for getting as much motion as possible.

Maintain a good diet and get plenty of sleep at night. Check with your doctor about your fatigue level if it seems excessive. It may be drug-induced or you could have some other medical reason for it.

Some patients choose two times during the day when they set aside what they are doing and carry out their exercises. Others prefer to set a timer and do one or two exercises every hour. Your therapist will be able to advise you on which is best for you depending on how much joint motion you have.

Find out what your joint motion is and how much you need to increase it for each day, week, and over the next month. Make that your goal and work towards it everyday.

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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Does cryotherapy help after hip replacement surgery?

April 6th — 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 meds. 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 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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Pace of rehab after total knee replacement varies

April 1st — admin

I had a total knee replacement six weeks ago. I’m a young (65-years old), active athletic-type. I’d really like to push my rehab ahead and get more aggressive. Is this possible?

Most patients have a fair amount of pain, swelling, and stiffness the first eight weeks. They aren’t always able to advance their rehab program. The first two weeks are usually focused on warm-ups, specific exercises to strengthen the muscles, followed by a cool-down exercise period.

From two to six weeks more time is spent on functional skills like walking and stair climbing. Exercises get harder and last longer starting at five minutes and moving up to 20 minutes. By the end of six weeks the knee joint is ready to handle more demanding activity and exercise.

You’ll want to check with your doctor about how far and how fast you can go now. Having a physical therapist to supervise your home program is often a good idea.

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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Losee maneuver can detect ACL injury

March 24th — admin

What is the “Losee maneuver?” I’ve heard it can be used to detect a torn anterior cruciate ligament.

Dr. Ron Losee from Ennis, Montana, was the first to describe a test for ACL instability. It was called the Losee maneuver for many years. Now it’s sometimes referred to as the “pivot-shift” test.

When the test is done, the patient is asked, “Is this how your knee feels when it gives out?” The doctor doesn’t always feel a change in the knee during the test, so the patient’s report is important.

A positive pivot-shift may be a sign that surgery is needed to repair the torn ligament. There is a device that measures laxity between the two knees (a KT-2000). The results of one test usually aren’t enough to tell which patients need an operation. Tests like the pivot-shift, along with several others, are still important.

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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