Customized Knee Replacement in Arizona

The knee is a complex, mobile joint. Knee joints are the largest joints of the body, and they differ in shape and size from other joints. A customized knee replacement uses specially designed implants that are made to fit the unique knee of the patient. Traditional knee replacement requires the surgeon to attempt to match prostheses to fit the knee.

How many knee replacements are performed each year?

In the United States, around 4.7 million people have a total knee replacement. Prevalence increases with age, with around 8% canstockphoto11809008have a history of total knee replacement. Women are more likely to have this operation than men (3 million: 1.7 million).

Why are customized knee implants important?

Once the Arizona knee surgeon selects the implant, the technique requires precision structuring so the implant fits snugly with your individual bone structure. An improper implant fit could result in residual issues that may cause problems after surgery.

Customized knee replacements are an innovative approach to correctly knee problems. The need for a precision implant fit has driven this new trend. Manufacturers now offer customized and personalized implants that are appropriate for gender and the individual knee. In a 2010 study, customized implants were found to reduce sizing problems during surgery, and also, found to replicate the curvature of the patient’s knee, giving a more natural feel to the replacement.

How are customized knee prostheses made?

Customized knee implants are created from CT and MRI scan data obtained from the patient. This assures the implant iFit-Designmatches the natural curves and shape of the knee. Knee implant manufacturers use specific technology to change the images of the knee into a 3D model, which is used to make an implant that matches the patient’s knee. Using scan data, the manufacturer can customize the implant using computer-assisted surgical instrumentation utilized by the surgeon during the procedure.

Why are women’s implants different than men’s?

Called gender-specific knee replacement, women are more petite and require special sized implants. A regular, traditional implant is designed for men, which means the implant for a woman could overhang on the bone at the sides. This could cause soft tissue interference or mid-flexion instability. For some patients, over-sized implants may cause pain and discomfort long after healing is complete. For this reason, new implants are used to accommodate the knee, which is smaller top-rightin women from side-to-side and from front-to-back. This reduces implant misfit and persistent knee pain.

Why do the differences between men and women make knee replacement difficult?

Researchers have found many differences between women’s knees and men’s. The gender-specific implants are based on research that shows:

  • Women’s knees have a thinner profile at the front.
  • Women’s knees have a distinct shape that accommodates the different angle between the knee and hip.
  • Women’s knees have a different contour.

Some researchers believe the differences in knee shape and size have less to do with gender and more to do with genetics. Certain ethnic influences tend to determine knee joint sizes.

Orthopedic and Sports Performance Institute offers customized knee replacements that have an amazing fit with exceptional outcomes. The total knee replacement surgeons in Arizona work with patients from all over the Valley including Gilbert, Mesa, Chandler, Queen Creek and Maricopa AZ.

Most insurance is accepted, call today to meet with the top knee specialists in AZ!

Resources

Bourne, et al; Patient Satisfaction after Total Knee Arthroplasty. Who is Satisfied and Who is Not? Clinical Orthopedics and Related Research; 2010, 468: 57-63.

Mahoney, et al; Overhang of the Femoral Component in Total Knee Arthroplasty: Risk Factors and Clinical Consequences. The Journal of Bone and Joint Surgery; 2010, 92: 1115-1121

 

Minimally Invasive Total Knee Replacement vs. Traditional Total Knee Replacement

Total knee replacement has been a successful procedure for the treatment of end-stage, severe knee arthritis. According to clinical studies, long-term results for functional improvement and pain relief are excellent using total knee replacement. However, the traditional approach to knee replacement requires a large incision and a long recovery period. Many patients suffer from permanent quadriceps weakness after knee replacement.

Benefits

The mini-incision technique, also called minimally invasive total knee replacement, is an alternative to total knee arthroplasty canstockphoto11809008(TKA). The minimally invasive procedure is a true quadriceps-sparing surgery. The proposed benefits of the mini-incision procedure include:

  • Gain of early knee flexion (bending)
  • Decreased pain and need for analgesics
  • Improved quadriceps function
  • Decreased blood loss
  • Shortened length of hospital stay
  • Cosmetically better smaller incision
  • Early recovery
  • Rapid rehabilitation

To evaluate the short-term clinical and functional outcome of minimally invasive surgery TKA compared to traditional total knee replacement, researchers evaluated 80 knees. They found that patients in the minimally invasive TKA group had significant decrease in post-operative pain, hospital stay, and blood loss. The study showed that the mini-incision technique offered many benefits.

In another study comparing the two procedures, researchers compared 50 total knee arthroplasties performed with the traditional method with 50 that were performed using the mini-incision technique. The found that overall, the minimally invasive canstockphoto10845760surgery took significantly longer to perform. The traditional approach was found to be easier for the surgeon, and a substantial learning curve may be required for the surgeon to perform minimally invasive knee replacement.

Incision Size

With traditional knee replacement, an incision of 6-8 inches is required. The patient’s size and the extent of joint damage will also determine the length of an incision. The doctor must have a large incision to fully visualize the joint, the implants, and the disease tissue.

With the minimally invasive technique, the incision is only 4 inches long, which is half the length of a traditional TKA incision. Surgeons perform surgery using special instruments that are designed to move around muscle and soft tissue rather than cut through it. A smaller incision is more aesthetically pleasing to the patient.

Recovery

Recovery after total knee replacement from traditional techniques takes around 6-8 weeks, depending on age, health status, and previous knee injury. Each person’s recovery time will vary, but most patients drive after 3 weeks, garden after 4-6 weeks, canstockphoto1903417and golf after 8 weeks. The surgeon will determine what activities you can participate in and which ones you must avoid.

After a minimally invasive knee replacement, recovery takes half as long than traditional surgery. While every patient is different, most people are driving after 2 weeks, gardening after 4 weeks, and golfing after 6 weeks. Regardless of which procedure you have, certain high-impact activities are not permitted, as they place extreme pressure on the new knee joint.

Considerations

The minimally invasive approach is may not be an option for an overweight or obese person, as well as for very muscular people, those who require a complex replacement, and people with severe knee deformity or instability. The mini-incision procedure requires specialized instruments and is more technically challenging to the surgeon. According to some studies, the risks of complications is higher with the minimally invasive TKA, which can be detrimental for the final outcome of surgery.

While the minimally invasive total knee replacement is a good alternative in the hands of an experienced orthopedic surgeon, you should work with your surgeon to decide which procedure is best for you. Choose an Arizona total knee replacement surgeon who is experienced if you wish to have the mini-incision procedure, and work with your doctor to lose weight before surgery.

Study Background:

Minimally invasive surgery has gained popularity over the past several years. Early results have shown better functional outcome with early recovery and rapid rehabilitation.

Aim:

Evaluation of the short-term clinical and functional outcome of minimally invasive surgery total knee arthroplasty (MIS-TKA) compared with the traditional total knee arthroplasty (TKA).

Materials and Methods:

During 2009, all cases scheduled for primary TKA through the modified mini-mid-vastus approach (MIS group) were studied. This group included 40 knees and was compared to a cohort control group of similar number of patients (40 knees) that underwent the procedure through the standard conventional technique (standard group).

Results:

Patients in the MIS group showed significant decrease in postoperative pain, blood loss in first 24 hours, and in hospital stay. Furthermore, they achieved motion considerably faster than the standard group with earlier return of quadriceps function and greater early flexion.

Conclusion:

This study proved that MIS-TPA has the ability to couple the benefits of less invasive surgical approach.

 

Resources

Dabboussi N, Sakr M, Girard J, & Fakih R. (2012). Minimally Invasive Total Knee Arthroplasty: A Comparative Study to the Standard Approach. N Am J Med Sci, 4(2), 81-85.

King J, Stamper DL, Schaad DC, & Leopold SS (2007). Minimally invasive total knee arthroplasty compared with traditional total knee arthroplasty. Assessment of the learning curve and the postoperative recuperative period. J Bone Joint Surg Am, 89(7), 1497-1503.

Preparing for a Total Knee Replacement in Arizona

Preparing for a total knee replacement begins weeks to months before the actual surgery date. Good physical health is important for a successful operation. Getting the upper body strong will improve your ability to use crutches or a walker, and performing leg-strengthening exercises will improve ability to walk on your new knee. In addition, you should follow the Arizona knee replacement doctor’s orders explicitly before undergoing a total knee replacement.

Meeting with the Gilbert Orthopedic Surgeon

To prepare for the total knee replacement, you will meet with the AZ orthopedic knee surgeon. The doctor will ask you Knee pain 3questions about your past medical history, inquire about your current knee problems, and perform a physical examination. In conjunction with an internal medicine evaluation, you may have x-rays, laboratory tests, and an electrocardiogram (heart rhythm test). If you are a smoker, many doctors require that you refrain from smoking for 6 weeks before surgery.

The orthopedic surgeon will discuss your current medications and allergies. Certain agents that thin the blood must be held for several days before surgery. In case you require blood transfusions during surgery or right after, you may want to store your own blood at the hospital’s blood bank. In addition, you should see your dentist to evaluate for infected teeth or gums, which could cause problems with the new knee.

Meeting with the Physical Therapist

Before you undergo surgery, you may see the physical therapist and start an exercise program. The therapist will work with you 2-3 times each week to perform strengthening and flexibility exercises. The work out helps prepare your muscles and soft tissue structures for surgery and recovery.

The physical therapist may either come to your home to assess your recovery environment or simply discuss it with you. If you have stairs, problems with hallways, and other issues, the therapist may recommend that you recover for the first couple of weeks in a skilled nursing facility. This will depend on your unique situation and health conditions.

canstockphoto10845760Preparing your Home and Assistance after Surgery

When you are preparing for surgery, you should begin thinking about recovery after surgery. You will go home from the hospital 2-5 days after the total knee replacement. Since you cannot drive, you should arrange to have a ride home. In addition, you will need someone to help you at home for a few days (getting meals, dressing, follow-up appointments, etc.)

Right Before Surgery

The morning of your surgery, you can brush your teeth and take necessary medications with a small sip of water. You are not to eat solid food within 8 hours before your surgery, and should not drink or eat after midnight. We recommend that you shower the morning of your surgery using an antibacterial soap.

When you arrive at the hospital, you will register at the surgical center. A nurse will have you change into a procedure gown. After discussing the procedure, you must sign a consent form. The nurse will attach monitoring devices to assess blood pressure, pulse, and oxygen level. In addition, an intravenous (IV) catheter is placed in your arm.

Orthopedic and Sports Performance Institute offers the top knee replacement surgeons in Arizona. Often times outpatient knee replacement is performed, and most insurance is accepted at the practice. Call us today to discuss your options with our Gilbert and Chandler knee specialists!

Life after a Total Knee Replacement

Pain and suffering from severe degenerative joint disease of the knee can compromise a person’s ability to maintain gainful employment, as well as perform usual activities of daily living. A total knee replacement (TKR) is a successful procedure for keeping people active and working. Returning patients to a higher level of functioning is the goal of knee arthroplasty, along with eliminating the chronic knee pain.

Returning to Work after Surgery

Around 98% of total knee replacement patients who were working before their surgery are able to return to work after surgery. Knee pain 3In addition, 90% of these patients are able to resume their previous position. A total knee replacement, also called total knee arthroplasty (TKA), is one of the most widely performed procedures in the world, and it is used to relieve pain and restore function in patients with advanced knee arthritis.

According to an independent survey center that interviewed more than 660 TKR patients 1-5 years after surgery, patients resume normal activities after the procedure. Their finding revealed that around 75% of patients were employed before surgery, and almost all of these people returned to work after the procedure. Men were more likely to have worked during the 3 months before surgery than women (83% vs. 70%), but of those patients, the rates of work return after surgery were similar.

A recent study out of Sweden evaluated joint replacement patients through self-reported assessments and physician evaluation. The researchers found that at 5- and 10-years post-surgery, most patients reported an active lifestyle. Surgery durably and substantially improves physical activity levels for men and women of all age categories.

Quality of Life Studies

canstockphoto11809008In a review of studies regarding quality of life among people who underwent total knee replacement surgery, and the various associated factors that impact recovery, researchers found several factors that were associated negatively with an active lifestyle. These factors were obesity, comorbidities, advanced age, persistence of pain, and lengthy wait for surgery.

Another study evaluated the self-reported outcomes after a total knee replacement to determine factors that influenced quality of life at 6 weeks, 3 months, 6 months, and one year post-surgery. Of the patients, 162 females and 40 males had a mean age of 69 years. At 6 weeks post-surgery, physical function was satisfactory. However, significant improvement was noted at 3 months postoperatively. Patients had decreased VAS pain scores, as well.

This quality of life study has proved that patients can return to previous level of functioning and enjoy an improved functional status. Researchers found that at one year post-operative, most patients reported that they had a significant improvement in quality of life. The researchers concluded that quality of life after TKR was noticeably different, with patients experiencing significant improvement for all parameters measured.

Longevity of the New Knee

It is difficult to predict how long the total knee implant/prosthesis will last, as lifespan depends on several factors. For a few patients, surgical complications occur which affects the longevity of the new knee. However, the majority of new knees last for 20 years, giving patients pain relief and improved function.

Surgeons, researchers, and prosthesis manufacturers all continue to work to improve the long-term outcomes of total knee replacement. The life of an implant depends on the use and wear. In addition, uses of new high performance material had shown to decrease wear by as much as 60%.

Orthopedic and Sports Performance Institute offers top knee replacement surgeons in Arizona. The procedures are often able to be performed on an outpatient basis, with most insurance being accepted. Call the top orthopedic surgeons in Gilbert and Chandler today!

Resources

American Academy of Orthopedic Surgeons. (2013). 98 percent of total knee replacement patients return to life, work following surgery. ScienceDaily. Retrieved from: www.sciencedaily.com/releases/2013/03/130321082857.htm

Da Silva RR, Santos AA, de Sampaio CJJ, & Magos MA (2014). Quality of life after total knee arthroplasty: systematic review. Rev Bras Ortop, 49(5), 520-527.

Papakostidou I, Dailiana ZH, Papapolychroniou T, et al. (2012). Factors affecting the

quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet Disord, 13, 116.

How is a Hip Replacement Performed?

How do surgeons replace a Hip?

Total hip replacement is a successful and cost-effective surgery. This procedure offers relief of pain and improvement in function in patients with hip arthritis. Currently, a hip replacement can last for up to 20 years. According to a recent clinical study, the prevalence of total hip replacement in the United States is 1%, with 2.5 million people having a hip replaced each year. Total hip replacement is an excellent treatment option for many people.

Anesthesia

You may be able to choose which type of anesthesia given during surgery. The two options typically are:Hip pain

  • Epidural (spinal) anesthesia – Involves placement of a small catheter into the epidural space near the spinal cord that delivers medication to numb the lower body. This is often combined with administration of a sedative.
  • General anesthesia – This involves use of an intravenous medication to put the patient to sleep. The patient will have no pain or memory of the surgery.

The Procedure

Once you are moved to the operating area, you will be given anesthesia. The hip region will be shaved and cleaned with an antiseptic solution. Once you are asleep, the surgeon will make an incision on the top of the hip (anterior), on the side of the hip (lateral), or on the back of the hip (posterior). The surgeon then displaces, detaches, and/or manipulates the muscles and soft tissues to expose the joint.

One the hip joint is visualized, the upper aspect of the femur (thigh bone) is removed, and the natural socket (acetabulum) is hollowed out to fit the femoral head (top of femur bone). The socket is fitted into the hollow region of the pelvis, and a short, angled metal shaft with a smooth ball is fitted into the thigh bone. The ball will fit into the socket to move the thigh in a normal fashion. The cup and stem are usually fixed with a special cement.

Once all changes are made, the muscles and soft tissues are returned to usual position. This may require suturing and reattachment techniques. After the incision is closed using surgical staples or sutures (stitches), the area is covered with a sterile, dry bandage. The patient is usually placed in compression stockings that inflate to prevent blood clots.

Materials Used

Stryker-Hip-Revision-Surgery-Myositis-Ossification-ComplicationsProsthetic components may be cemented or uncemented. With the uncemeted method, the parts are made from a material with a rough surface. This allows bone to grow into the component to hold it in place (press-fit). The prosthetic parts may be held in place using acrylic cement.

Most prosthetic components are made using a high-density polythene (plastic) for the socket, titanium alloys for the femoral shaft (stem), and a ball made of chromium, cobalt, and/or molybdenum. Some surgeons use a metal ball and socket, because they do not wear as quickly as plastic components.

Choosing your Prosthesis

There are more than 60 different kinds of prostheses (implants). The options are usually only limited to around five, however. The surgeon will advise you won which type will best suit your health condition. The National Institute for Health and Care Excellence (NICE) recommends implants known to have at least a 95% chance of lasting 10 years. The orthopedic surgeon will discuss your options with you.

Recovery

After your total hip replacement, you will remain in the hospital for 2-6 days, depending on your health condition and progress. You will be discharged home or to a skilled nursing facility for rehabilitation. It takes around 3-6 weeks to recover from a hip replacement, and incisions and tissues are still healing after a year. It is important to participate in physical therapy and a strenuous exercise program to regain full hip function.

OSPI offers top orthopedic surgeons who are hip and knee replacement specialists in Gilbert and Chandler AZ. Patients are seen from all over the Valley including Mesa, Queen Creek, Maricopa, Scottsdale and Phoenix. Most insurance is accepted, call us for an evaluation today!

Physical Therapy After Total Hip Replacement

One of the most commonly performed orthopedic surgeries is a total hip replacement (THR). The surgical techniques and prosthesis used for a THR have improved over the years, allowing the patient to now achieve optimal recovery and less pain. Physical therapy is an important aspect in a successful, full recovery after hip replacement.

In the Hospital

Right after your total hip replacement, a physical therapist begins working with you to restore joint motion and strength. Initially, therapy begins in physical therapy1the hospital the day after surgery. A therapist shows you how to get in and out of bed, ways to get into the shower and car, and how to walk using a walker or crutches. In addition, the therapist has you perform simple exercises in bed to prevent blood clots, such as gluteal squeezes and tightening the thighs.

After a hip replacement, some patients received additional physical therapy in a rehabilitation facility before going home. This will depend on the age of the patient, what the home environment is like, and functioning when discharged from the hospital. The physical therapist works with the patient using exercise equipment for strengthening and mobility. Balance exercises are used to decrease risk of falling. In addition, the physical therapist uses heat to warm up tight muscles and ice to reduce soreness and swelling.

Avoiding Dislocation

After a total hip replacement, there are some considerations the physical therapist follows to help you decrease risk of dislocating the new hip. With the posterior approach hip replacement, you cannot bend the hip past 90 degrees, must avoid crossing your legs, and cannot rotate the hip inward. Maneuvers to assist with avoiding these activities include use of a raised toilet seat and shower chair, use of a pillow between the knees, and using an orthopedic device to put on shoes and socks.

Home Physical Therapy

Once you go home, the physical therapist will visit you 3-4 times each week to improve hip strength, mobility, and flexibility. Common therapy exercises include:

  • Buttock contractions – Tighten muscles and hold to a count of 5.
  • Abduction exercise – Slide leg out to the side as far as possible and then back.
  • Quadriceps set – Tighten thigh muscles and try to straighten knee. Hold for 5-10 seconds.
  • Straight leg raises – Tighten thigh muscles with knee straight. As muscles tighten, lift leg sever inches from bed and hold for 5-10 seconds.
  • Standing exercises – These include standing knee raises, hip abduction, and hip extensions.
  • Walking and full weight-bearing – These exercises are used to help you perform light everyday activities.

physical_therapy

Recovery at Home

Don’t be surprised if you feel fatigued right after surgery. This will improve over the next few weeks, however. You should arrange to have someone help you out for 1-2 weeks after your total hip replacement. The exercises given to you by your physical therapist are an essential part of recovery.

You should be able to stop using crutches or a walker, and resume normal leisure activities within 6 weeks of the surgery. However, it could take up to 12 weeks for pain to completely resolve. Your new hip is continuing to recover for up to 2 years after the operation, which involves scar tissue healing and restoration of muscles.

Orthopedic and Sports Performance Institute in Gilbert AZ offers top surgeons specializing in joint replacement (hip and knee), along with sports medicine too. Most insurance is accepted with patients being seen from all over the Valley including Mesa, Chandler, Queen Creek and Scottsdale too! Call us today.

Recovery after Anterior Approach Total Hip Replacement

Anterior hip replacement is a less invasive approach to hip joint surgery. With the anterior approach to total hip replacement, the orthopedic  surgeon in Gilbert AZ accesses the joint from the anterior (front) of the hip as opposed to the lateral (side) or posterior (back). The anterior approach allows the Arizona hip surgeon to make repairs and replacements without detaching tendons, muscles, or soft tissue.

Small Incision

The anterior approach to hip replacement was first described in the 1940s. This approach is gaining in popularity, and advocates for anterior approach total hip replacement consider its advantages to be earlier restoration of walking, low dislocation rates, and muscle-sparing ability. The ModularEndoprosthesisprocedure begins with the patient lying on his/her back. The surgical incision is slightly lateral to the front superior iliac spine of the pelvis. The 4- to 5-inch incision runs toward the lateral aspect of the ipsilateral knee. After moving soft tissue and muscle, replacement is made.

Because the anterior total hip replacement surgery uses a small incision, and muscles are moved rather than cut, the result is less trauma and damage to the hip soft tissues. Recovery time is usually faster with the anterior approach than traditional surgery, and patients report less post-operative pain. After only 2-3 weeks, patients begin walking without assistance, which is compared to 5-6 weeks with posterior hip replacement surgery.

Length of Hospital Stay

After the minimally invasive hip replacement, you will stay 1-4 days in the hospital. You may stay longer if you have serious health conditions, severe hip arthritis, and complications during the procedure. The length of stay varies from patient-to-patient, but the anterior approach to hip replacement is usually related to a shorter length of hospital stay than the posterior or lateral approaches.

Physical Therapy

Physical therapy begins the day of surgery. To strengthen the hip joint, you must do small exercises, such as contracting buttock and leg muscles and ankle pumps. The therapist works with you to learn exercises that help regain full hip movement. You will work with the therapist two times each day. Once you return home, the physical therapist will see you 3-4 times each week.

 

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Home Recovery

After you leave the hospital, you should have family or friends stay with you for a few days. You will need help with errands and household activities. In addition, you cannot drive for 2-4 weeks, so you will need transportation home from the hospital, to follow-up appointments, and to the pharmacy. It is also important to stock up on easy to prepare foods, such as frozen, canned, and premade meals.

Incision Care

Your anterior incision will be closed with staples or sutures, which are removed around 10-14 days after surgery. The surgical site will be numb, sore, bruised, and/or swollen for a few days. You may experience itching or pulling of the incision site as well. We recommend using an icepack for 10-20 minutes several times a day to relieve discomfort. In addition, avoid using any lotions or creams on the hip area. To keep the incision clean and dry, avoid showering until your wounds are healed. You can bathe, however.

Physical Activity

Being physically active is an important aspect for recovery. Within 2-4 weeks, you will be able to resume your daily routine and normal activities. During the first week, you will start walking with a walker and advance to using a cane. To avoid falls and injuries, you should only walk in areas where there are handrails, no loose rugs, and no cords. You may begin driving after 2-3 weeks, depending on how you progress.

 

OSPI offers the top hip specialists in Arizona, specifically the East Valley. Hip replacements done by the anterior approach need an expert to be done well. Call OSPI today, most insurance is accepted!

Do I need a Total Hip Replacement?

A total hip replacement is one of the most successful surgeries of modern medicine. This procedure is very effective for improving range of motion and relieving pain. The orthopedic surgeon in Chandler AZ follows certain guidelines to determine of you are ready for a total hip replacement.

The main goals of hip replacement are to stabilized the hip and offer pain relief. Leg-length equality is a Hip painpriority after the first two goals are established. Hip replacement parts in the U.S. are most often press-fit into the bone. To limit small cracks in the bone, the surgeon uses special implants and techniques.

Conservative Treatment Measures

Patients with hip arthritis or injury are often managed with conservative treatments. The orthopedic specialist will not perform a total hip replacement unless you have failed with these measures:

  • Physical therapy – Used to strengthen weak hip muscles and improve hip function, physical therapy involves strategic exercises. Many patients with hip arthritis often respond to physical therapy.
  • Corticosteroid injections – The doctor can injection the hip joint with an anti-inflammatory corticosteroid solution. These injections are usually given in a series of 3, which are spaced 3-4 months apart.
  • Anti-inflammatory drugs – Acetaminophen is the gold standard drug for arthritis. Anti-inflammatory drugs, such as ibuprofen and naproxen, can help alleviate the pain associated with inflammation.

Candidates for Total Hip Replacement

The Arizona orthopedic surgeon will decide if or not you are ready for a total hip replacement. Candidacy is based on:

  • Groin, hip, buttock, and knee pain – Patients with serious hip arthritis often have pain deep down in the groin region. This pain is relieved with a hip replacement. In addition, knee pain can occur because nerves that supply the knees run by each hip. When affected by inflammation, the nerves canstockphoto13092914can cause knee pain. Buttock and hip pain also can occur.
  • Bone-on-bone arthritis – The orthopedic surgeon will take some x-rays to see if the bone ends of the hip are touching. Pain occurs when the femur ball (thigh bone) does not fit properly in the socket.
  • Marked interference with daily activities – Surgery is considered when you have marked interference with daily activities. Patients will have trouble climbing stairs, putting on socks and shoes, and may need a cane for walking.
  • Trouble sleeping – Hip pain can affect ability to sleep, despite the use of pain medications.
  • Ability to participate in recovery – The patient having a total hip replacement must be able to participate in the rehabilitation program. Recovery takes around 3-6 weeks, and involves intense exercises and strengthening maneuvers. The doctor will consider a person’s ability to participate in the recovery process.

Total Hip Replacement Candidates

In years past, orthopedic surgeons in AZ reserve hip replacement surgery for persons age 60 years and older. This was because older people are less active and will not put stress on the artificial hip as a younger person would. In recent years, doctors have found that total hip replacement is useful for younger persons as well. New technology has improved surgical techniques and prosthetic components, allowing the new hip to withstand more strain and stress.

Hip replacement surgery involves a new hip that can last for as long as 20 years. A person’s overall health status and activity level are important in predicting the success of total hip replacement. A recent study shows that people who choose to have this surgery before advanced joint deterioration occurs tend to have an easier time with recovery.

The top orthopedic surgeons in Arizona at OSPI offer hip and knee replacements which are top notch. Often they are outpatient, allowing for rapid recovery getting people back to work and recreational activities fast! Call us today.

Resources

National Institute of Arthritis and Musculoskeletal Diseases (2016). Questions and answers about hip replacement. Retrieved from: http://www.niams.nih.gov/health_info/hip_replacement/

 

Recovery after Partial Knee Replacement

After a partial knee replacement, you are monitored in the recovery room for a few hours. After you wake from general anesthesia, you are moved to a hospital room. Most patients stay 2-4 days in the hospital after knee replacement.

Hospital Recovery

  • Deep breathing – To avoid lung and airway congestion, you should take several deep breaths every hour. This moves mucus from the airways and expands the lungs.Knee pain 3
  • Compression stockings – You will wear elastic or plastic compression devices to prevent formation of blood clots in your legs. This is done to improve circulation and prevent clot formation.
  • Physical therapy – Soon after you move to your hospital room, you will meet with the physical therapist. Physical therapy is used to prevent complications, improve mobility, and strengthen knee muscles. You will work with the therapist 1-2 times each day.
  • Continuous passive motion (CPM) – A CPM machine bends the knee in normal range of motion on a continuous level. This is used to keep the knee from getting stiff and prevent blood clots.
  • Physical activity – A nurse will help you move to and from the bathroom, and the physical therapist works with you on walking using a cane or walker. Physical activity is encouraged immediately after surgery.

Recovery at Home

Once you go home, you must continue with your recovery. This involves:

  • Preparation – Before going home, you must arrange to have someone drive you. In addition, you may want to have help around the house for a few days. Have some gauze, tape, and ice packs available, and stock up on frozen meals and canned foods. You need to have a raised toilet seat, a shower Unicompartmental knee replacementchair, and handrails on stairways before you go home.
  • Incision care – You will have sutures or staples along your incision at the front aspect of the knee. These are usually removed within 10-14 days. You may have bandages on the knee as well. You must keep the area clean and dry, and avoid soaking in a tub or pool until wounds are healed.
  • Physical activities – You are not permitted to drive for 3-6 weeks, so arrange to have someone drive you home and help at home for a few days. You are encouraged to move about your home using an assistive device. Avoid falling by removing all loose rugs and cords from walkways.
  • Physical therapy – A therapist will come to your home daily after your knee replacement. You must work with the professional to walk, climb stairs, and perform activities. The therapy is used to strengthen leg muscles and improve range of knee motion.

Same Day Discharge

It is possible that the Gilbert orthopedic surgeon discharges you on the same day of surgery. This depends on your existing health conditions, current health status, and surgeon’s choice. In a pilot study used to investigate discharging patients within the day of surgery, researchers evaluated patients undergoing knee replacement. Of the study participants, all had a partial knee replacement through a short incision, and no dislocation of the patella was involved. All patients were in the accelerated recovery program.

Follow-up assessments were performed at 1, 2, and 6 weeks after surgery. The average pain score for the first couple of weeks was a 2 on a 1-10 scale. In addition, knee flexion was 125 degrees for all patients at 6 weeks, and all patients could walk independently at the 6-week follow-up appointment. Researchers found that the fast-track recovery protocol was safe and effective for people undergoing partial knee replacement.

OSPI in Gilbert AZ offers the top knee specialists in AZ. They offer both total and partial knee replacements, often allowing patients to go home the same day! This allows for rapid recovery, with less downtime than if traditional methods were used. Call today!

Resources

Bard DJ, Murry DW, Rees JL, et al. (2002). Accelerated recovery for unicompartmental knee replacement–a feasibility study. Knee, 9(3), 221-224.

 

How does Surgical Approach to Hip Replacement affect Recovery?

Anterior hip replacement is an approach to surgery used to improved patient outcomes. Thousands of hip replacement surgeries are performed each year, but only 20% of surgeries in the United States are done using the anterior approach. The other 80% of surgeries are performed using the posterior or lateral approach.

Advantages of the Anterior Hip Replacement

Supporters of the anterior hip replacement approach believe it offers the following canstockphoto10503438advantages:

  • Less damage to major muscles – The orthopedic surgeon avoids cutting and manipulating major muscles during the anterior hip replacement. The surgeon works between the front muscles rather than severing muscle fibers or detaching muscle from bone.

 

  • Less post-operative pain – Because anterior approach does not require manipulation and cutting of muscles, the patient has less post-surgical pain and requires less medication.

 

  • Faster recovery – After surgery, the patient can bend at the hip and bear weight sooner. Most anterior hip replacement patients use walker or crutches soon after surgery. In a recent study researchers found that anterior hip patients walked unaided 6 days earlier than those who had the posterior surgery.

 

  • Decreased risk for dislocation – With the anterior surgery, the hip is not at risk for dislocation because soft tissue structures are not moved.

 

  • Improved range of motion – Patients can bend over, sit with legs crossed, and perform other movements without risking hip dislocation.

 

  • Shorter hospital stay – A patient who undergoes anterior surgery will not stay in the hospital as long as with the traditional approach.

 

Advantages of the Posterior-Lateral Hip Replacement

In a recent study comparing posterior and anterior approaches to hip replacement, researchers found that both groups had improvements in pain and range of motion, with no observable differences in gait or dislocation. Advantages to the posterior approach can include:

 

  • Less technically demanding – The posterior approach to hip replacement is easier to canstockphoto24182699perform. Anterior approach requires considerable training, skill, and experience by the orthopedic surgeon.

 

  • Simpler and easier – Many Gilbert orthopedic surgeons believe the posterior approach is the simplest and easiest, therefore providing the greatest safety margin for patients.

 

  • Minimal risk of femoral fracture or implant problems – Due to ease of this surgery, there is less risk to the patient for femoral fracture or poor positioning of the prosthetic component.

 

  • No special surgical equipment required – This procedure does not require the use of high-tech, specialized surgical equipment.

 

Disadvantages of the Anterior Hip Replacement

There are a few limitations associated with anterior hip replacement. These include:

  • Not suitable for obese or large patients – Muscular, overweight, or obese people are not good candidates for the anterior procedure.

 

  • More technically demanding – The Arizona orthopedic surgeon must be very experienced in performing the anterior hip replacement. This surgery is known to be quite technically demanding.

 

  • Potential for nerve damage – The lateral cutaneous femoral nerve runs down the front of the pelvis and past the hip to supply the thigh. There is more potential for damage to this nerve with the anterior approach.

 

  • Delayed wound healing – Some studies show that wound healing is delayed using the anterior approach, with 1.4% of patients having a wound complication compared to 0.2% with the posterior approach.

 

Disadvantages of the Posterior-Lateral Hip Replacement

  • Higher post-operative dislocation rates – Some studies show higher rates of dislocation with the posterior approach. However, with improved technology, these rates have declined.
  • Longer recovery – The posterior approach to hip replacement is associated with longer hospital stays and recovery. However, with full participation in physical therapy and rehabilitation, the recovery time has shortened.

OSPI offers state of the art approaches for hip replacement which minimize hospital stay and complications, while improving outcomes. Most insurance is accepted by the Gilbert and Mesa orthopedic surgeons, call today!

Resources

Kennon RE, Keggi JM, et al. (2013). Total hip arthroplasty through a minimally invasive anterior surgical approach. Journal of Bone and Joint Surgery, 85-A:39-48.

Petis S, Howard JL, Lanting BL, & Vasarhelyi EM (2015). Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes. Can J Surg, 58(2), 128-139.

Post, ZD, Orozco F, Diaz-Ledezma C, Hozack WJ, & Ong A (2014). Direct anterior approach for total hip arthroplasty: indications, technique, and results. Journal of the American Academy of Orthopaedic Surgeons, 22:595-603.

Taunton MJ, Mason JB, Odum SM, & Springer BD (2014). Direct Anterior Total Hip Arthroplasty Yields More Rapid Voluntary Cessation of All Walking Aids: A Prospective, Randomized Clinical Trial. J Arthroplasty. pii: S0883-5403(14)00340-4. doi: 10.1016/j.arth.2014.03.051.

 

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