What is knee replacement?
Knee replacement surgery replaces cartilage that has worn away over the years. Knee replacement can help relieve pain and get you back to enjoying normal everyday activities. For those who have become bow-legged or knock-kneed over the years, it can also straighten the legs into a more natural position.

Who should have a knee replacement?
When severe pain limits your everyday activities such as walking, going up and down stairs and getting in and out of chairs, you may want to consider knee replacement surgery. Other reasons you may benefit from surgery is if you have moderate or severe swelling of the knee that does not improve with rest or medication, bowing in or out of your knee, or the inability to bend and straighten your knee.

Is there an alternative to replacement?
Knee replacement surgery may be recommended after careful diagnosis of your joint problem. Other treatment options including medications, injections, physical therapy, or other types of surgery may be discussed and considered.

Should my knee be cemented?
Knee replacements can be successfully performed with all cemented components as well as with a combination of uncemented and cemented components. Your surgeon will discuss which technique is appropriate for you.

How long is the hospital stay?
The typical hospital stay after knee replacement surgery is three to five days. Walking and knee movement are important to your recovery and will begin the day after surgery. It is important to begin moving after surgery to get your blood flowing. This helps prevent blood clots and swelling in your legs, which can occur from lack of activity.

How long is recuperation?
Recovery varies with each person. It is essential that you follow your orthopedic surgeon's instructions regarding home care during the first few weeks after surgery, especially the exercise program you are prescribed. You'll most likely need crutches or a walker for three to six weeks, and then a cane for another three to six weeks. Many individuals are able to resume most normal light activities of daily living, including driving, within three to six weeks following surgery. Some discomfort with activity, and at night, is common for several weeks. Complete recovery can take from about three to six months.

While most people will gradually increase activities that may include recreational walking and biking, swimming, golf and ballroom dancing, you will be advised to avoid more active sports such as jogging, tennis, high impact aerobics, skiing, repetitive lifting exceeding 50lbs. and contact sports.

If you are a patient who lives alone, you may require a short stay in a rehabilitation center for a few days after you leave the hospital. This will depend on how you progress in the hospital. Keep in mind that healing and recovery times vary with each person.

Will I need a blood transfusion?
The need for blood transfusions after knee replacement surgery depends greatly on individualized factors. Many people will not require transfusion, while those that do usually have low blood counts. If your blood counts are high, it is much less likely that you will need a transfusion. Your blood count will be checked before surgery and while you are in the hospital. Blood transfusions are usually recommended if your blood counts get low enough to potentially put strain on your heart.

What about pain?
You can reserve a space at one of our upcoming knee and hip pain seminars. Call 561.659.1715 today for more information.

What is the success rate?
Knee replacement is one of the most important orthopedic surgical advances of this century. Each year, more than 450,000 Americans undergo knee replacement surgery that often helps them get back on their feet and resume active lifestyles.

Are there complications?
As with any surgery, there is a risk of complications after knee replacement surgery. However, they are relatively rare. Blood clots are the most common complication after surgery. Your orthopedic surgeon may prescribe one or more measures to prevent blood clots from forming in your leg veins, such as special support hose, inflatable leg coverings and perhaps blood thinners. You may also receive antibiotics to help prevent infection.

Other complications include implant loosening, fractures, and nerve or blood vessel damage. Your surgeon will be taking great care to reduce the risk of these and other complications.

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Osteoarthritis of Knee and Hip

What is arthritis?
Arthritis is not just a single disease. It is a term used to describe over 100 different conditions that affect the joints in the body. The word arthritis actually means inflammation of a joint. Almost every animal that can walk is susceptible to this inflammation.

Although many types of arthritis have some common aspects, each type has its own pattern of symptoms and affects different people in different ways. Two major forms of arthritis are rheumatoid arthritis and osteoarthritis. In cases of rheumatoid arthritis, the body's immune system appears to go awry and attacks healthy parts of the body, particularly the joints. In severe rheumatoid arthritis, the joints become deformed and internal organs can be adversely affected.

What is osteoarthritis?
Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear and tear" arthritis. Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight-bearing joints, mainly knees, hips and ankles. This form of arthritis gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may also form.

In osteoarthritis of the knee, the shape of the bone and appearance of the leg may change over the years. Many people become bow-legged or knock-kneed and in osteoarthritis of the hip, the affected leg may appear shorter.

What are the symptoms?
The number one symptom is pain, often described as "deep" and "aching". Osteoarthritis pain is typically of slow onset, initially occurring after activity, with relief after rest. As the disease progresses, pain may occur with even minimal motion - in severe cases, there is pain at rest. Joint stiffness is also common, usually occurring upon awakening or after inactivity. The stiffness lasts from 20 to 30 minutes. Other symptoms include crackling of the joint, joint tenderness, joint enlargement and limitation of motion in joints.

How is it diagnosed?
A simple weight-bearing x-ray and examination by your doctor will determine if you have osteoarthritis. Time-consuming and costly diagnostic procedures are not required.

What is the treatment?
There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain. Lack of mobility and fatigue are among its most disabling symptoms.

Hyaluronate - Hyaluronate is a natural element of joint fluid. These injections appear to be advantageous for patients with a history of NSAID intolerance, patients who are of advanced age, those with currently active lifestyles or a history of ulcer disease.

Medicines - Coated aspirin helps relieve pain and has few side effects. Non-steroidal anti-inflammatory drugs (NSAIDS), such as Voltaren®, Feldene®, Naprosyn® and Clinoril® are prescription drugs for pain and inflammation. Do not take aspirin if you are taking NSAIDS.

Cortisone Shots - Cortisone shots are given for inflammation and may provide pain relief for variable periods of time. Generally, repeat injections should be limited to three or four per joint, per year.

Thermal Therapy - In many cases, the use of either hot or cold therapy, or alternating heat and cold, is a matter of patient preference. Superficial heat such as heating pads, hot water bottles and saunas may relax the muscles to help decrease pain and stiffness. Cold therapy, such as ice packs, may help decrease muscle spasm and the associated pain and may help raise the pain threshold.

Diet - There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It's important to maintain a balanced, healthy diet because excess weight aggravates arthritis by putting added pressure on the knee and hip. Recent studies indicate that glucosamine can be an effective anti-inflammatory option. Speak with your physician to learn more.

Exercise and Rest - Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. "Motion is lotion" for arthritis! At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best.

What about surgery?
Surgery is usually done only in severe, disabling cases of arthritis for which other treatments have failed.

Arthrodesis - This procedure makes the affected joint permanently immobile by inserting a metal or plastic screw or using a special type of plaster to hold the joint in place. It is usually performed on smaller joints, such as those in the toes or fingers.

Osteotomy - In this surgical procedure, which is not frequently performed, the surgeon removes a small piece of bone near the affected joint. This may be a good solution for younger people with arthritis because it may delay joint surgery for years.

Arthroscopy - "Scoping a joint" is being used increasingly to diagnose and sometimes repair joints. A doctor may use a tube to remove damaged areas of cartilage that may be causing irritation. This may provide temporary relief. However, this may not stop the progression of arthritis.

Replacing a Joint - A successful joint replacement may relieve pain and restore most of the joint's movement. Damaged bone is removed from the joint and replaced with parts that are cemented to the healthy bone that remains.

How can I learn more?
You can reserve a space at one of our upcoming knee and hip pain seminars. Call 561.659.1715 today for more information.

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Hip Replacement

What is hip replacement?
Hip replacement surgery replaces cartilage that has worn away over the years. Hip replacements surgery can help relieve pain and get you back to enjoying normal, everyday activities.

Who should have a hip replacement?
Hip replacement surgery may be considered when arthritis limits your everyday activities such as walking and bending, when pain continues while resting or stiffness in your hip limits your ability to move or lift your leg.

Is there an alternative to hip replacement?
Hip replacement may be recommended only after careful diagnosis of your joint problem. You may benefit from surgery only if you have little pain relief from anti-inflammatory drugs, you have harmful or unpleasant side effects from your hip medications, or other treatments such as physical therapy do not relieve your pain.

Should my hip replacement be cemented?
Hip replacement may be successfully performed with all cemented components as well as with a combination of uncemented and cemented components. Your surgeon will discuss which technique is appropriate for you.

How long is the hospital stay?
The typical hospital stay after hip replacement surgery is three to five days. Most hip replacement patients begin standing and walking with the help of walking support and a physical therapist the day after surgery. It is important to begin moving after surgery to get your blood flowing. This helps to prevent blood clots from forming in your legs, which can occur from lack of activity.

How long is recuperation?
Recovery varies with each person. It is important to acknowledge that you will require time to recuperate. It is essential that you follow your orthopedic surgeon�s instructions regarding home care during the first few weeks after surgery, especially the exercise program you are prescribed. You should be able to resume most normal light activities of daily living within three to six weeks following surgery. Some discomfort with activity and at night, is common for several weeks. Complete recovery can take from about three to six months.

While most people will gradually increase their activities and play golf, doubles tennis, shuffleboard or bowl, you will be advised to avoid more active sports, such as jogging, singles tennis and other high-impact sports.

If you are a patient who lives alone, you may require a short stay in a rehabilitation center for a few days after you leave the hospital. Speak with our staff about your rehab options as many excellent options exist. This may depend on how you progress in the hospital. Keep in mind that healing and recovery times vary with each person and returning to "normal" will take some time. Give yourself permission to heal.

Will I need a blood transfusion?
The need for blood transfusions after hip replacement surgery depends greatly on individualized factors. Many people will not require a transfusion, while those that do usually have low blood counts. If your blood counts are high, it is much less likely that you will need a transfusion. Your blood count will be checked before surgery and while you are in the hospital. Blood transfusions are usually recommended if you blood counts get low enough to potentially put strain on your heart.

What is the success rate?
Hip replacement is one of the most important surgical advances of this century. This surgery helps more than 250,000 Americans each year to relieve their pain and get back to enjoying normal, everyday activities.

Are there complications?
As with any surgery, there is a risk of complications after hip replacement surgery. However, they are relatively rare. Blood clots are the most common complication after surgery. Your orthopedic surgeon may prescribe one or more measures to prevent blood clots from forming in your leg veins, such as special support hose, inflatable leg coverings and blood thinners.

You may also receive antibiotics to help prevent infection. Other complications include implant loosening, hip dislocation, fractures and nerve or blood vessel damage. Our surgeon will be taking great care to reduce the risk of these and other complications.

What about pain?
Thanks to advances in medication technology, we are able to keep you relatively comfortable after surgery. Still, you should prepare yourself for some discomfort and not be alarmed if it does happen.

How can I learn more?
You can reserve a space at one of our upcoming knee and hip pain seminars. Call 561.659.1715 today for more information.

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