Orthopedics
FAQ's
Frequently asked questions
Hip replacement
What is hip replacement?
It is a metal and plastic covering for raw, arthritic bone ends. It replaces cartilage that has worn away over the years. Hip replacement can eliminate pain and allow you to move easily with less discomfort.
Who should have a hip replacement?
When arthritis hip pain severely limits your ability to walk, work, or perform even simple activities, hip replacement may be considered.
Is there an alternative to hip replacement?
Hip replacement is only recommended after careful diagnosis of your joint problem. It is not likely that anti-inflammatory drugs or cortisone injections will give you the same long-term relief that hip replacement will.
Should my hip replacement be cemented?
Hip replacements are successfully performed with all cemented components as well as with a combination of uncemented and cemented components. Your surgeon will discuss which technique is best for you.
How long is the hospital stay?
The average hospital stay for a hip replacement patient is around 3-5 days. In some cases, fixing one hip reduces the stress on the other hip, thus giving another two or three years if the arthritis is not too advanced. Each individual case is different.
How long is recuperation?
Recovery varies with each person. You will use a walker for approximately 4 weeks after the operation. You can drive a car in 2-4 weeks. Most people gradually increase their activities and may play golf, doubles tennis, shuffleboard, or bowl in 12 weeks. More active sports, such as singles tennis and jogging are not recommended.
After discharge, there is usually no need for a nursing home. Some patients who live alone may require a short stay at a rehab center for a few days after they leave the hospital. This will depend on how you progress in the hospital, and keep in mind that healing and recovery times vary with each person.
Will I need a blood transfusion?
The need for blood transfusions after hip replacement surgery depends greatly on very individualized factors. The majority of hip replacement patients do not require a transfusion after surgery. Some patients may want to donate their own blood prior to surgery for use after surgery. Your surgeon will be happy to discuss these issues with you.
What is the success rate?
Hip replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider hip replacement to be the best method of handling arthritis in the hip. Hip replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.
Are there complications?
As with any surgery, there is a risk of complications after hip replacement surgery. However, they are quite rare … driving on an Interstate highway is probably more dangerous. To reduce the risk of infection, we take special precautionary measures in the operating room, and use powerful antibiotics. Our personnel are limited to fully-trained and experienced nurses and technicians.
What about pain?
Thanks to advances in medication technology, we are able to keep you very comfortable after surgery. After surgery, any temporary discomfort does not compare to the pain of arthritis endured by most people in months and years before surgery.
And because hip replacement patients are not “sick,” you will not be treated as such. You will wear casual clothing after surgery, not hospital gowns. You’ll also join other joint replacement patients for buffet lunches, television, cards and games.
Knee Replacement
What is knee replacement?
It is a metal and plastic covering for raw, arthritic bone ends. It replaces cartilage that has worn away over the years. Knee replacement can eliminate pain and allow you to move easily with less discomfort. For those that have become bow-legged or knock-kneed over the years, it can also straighten your legs to a more natural position.
Who should have a knee replacement?
When arthritis knee pain severely limits your ability to walk, work, or perform even simple activities, knee replacement should be considered.
Is there an alternative to knee replacement?
Knee replacement is only recommended after careful diagnosis of your joint problem. Arthroscopic or microscopic surgery is not helpful once arthritis is advanced. Also, it is not likely that anti-inflammatory drugs or cortisone injections will give you the same long-term relief that knee replacement will.
Should my knee replacement be cemented?
Knee replacements are successfully performed with all cemented components as well as with a combination of uncemented and cemented components. Your surgeon will discuss which technique is best for you.
How long is the hospital stay?
The average hospital stay for a knee replacement patient is around 3-5 days. The average stay for two knees is 5-7 days. If both knees require replacement, it is usually best to have both done at the same time. That way, the total disability will be only slightly longer than the operation for one knee and the problem will be solved in the least amount of time.
In some cases, fixing one knee reduces the stress on the other knee, thus giving another two or three years if the arthritis is not too advanced. Each individual case is different.
How long is recuperation?
Recovery varies with each person. You will use a walker for approximately 4 weeks after the operation. You can drive a car in 2-4 weeks. Most people gradually increase their activities and may play golf, doubles tennis, shuffleboard, or bowl in 12 weeks. More active sports, such as singles tennis and jogging are not recommended.
After discharge, there is usually no need for a nursing home. Some patients who live alone may require a short stay at a rehab center for a few days after they leave the hospital. This will depend on how you progress in the hospital, and 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 very individualized factors. The majority of knee replacement patients do not require a transfusion after surgery, but those having both knees replaced at the same time are more likely to need one. Some patients may want to donate their own blood prior to surgery for use after surgery. Your surgeon will be happy to discuss these issues with you.
What is the success rate?
Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.
Are there complications?
As with any surgery, there is a risk of complications after knee replacement surgery. However, they are quite rare … driving on an interstate highway is probably more dangerous. To reduce the risk of infection, we take special precautionary measures in the operating room, and use powerful antibiotics. Our personnel are limited to fully-trained and experienced nurses and technicians.
What about pain?
Thanks to advances in medication technology, we are able to keep you very comfortable after surgery. After surgery, any temporary discomfort does not compare to the pain of arthritis endured by most people in months and years before surgery.
And because knee replacement patients are not “sick,” you will not be treated as such. You will wear casual clothing after surgery, not hospital gowns. You’ll also join other joint replacement patients for buffet lunches, television, cards, and games.
Kneecap Problems
What is Patella Femoral Pain Syndrome?
Patella Femoral Pain Syndrome (PFPS) is a condition of the kneecap characterized by a rough or soft spot on its cartilage surface. In the past, it has been called chondromalacia patella, runner’s knee, or dashboard knee.
What are the symptoms of PFPS?
It causes pain, giving way, stiffness and a feeling of catching or grinding. Going up and down stairs is a bit difficult, and sitting with your knees bent or squatting is very uncomfortable. It makes the knee “give out,” grind, or pop loudly.
Who gets PFPS?
Many people may have PFPS, but only about 10 percent have a long-lasting pain or disability because of it — a fact not clearly understood by the medical profession. Over-activity, excess weight or injury sometimes initiate the symptoms. This condition is often seen in adolescents, manual laborers and athletes.
How is PFPS diagnosed?
Cartilage contains no calcium and as a result, cannot be seen by ordinary X-rays. A patient’s history and a physical examination suggest the diagnosis. If there is any doubt, we will suggest arthroscopy to look behind the kneecap and check to see that there is no other injury or abnormality.
How long does PFPS last?
It may last several months, but fortunately, is usually a self-limiting problem. If you are born with an abnormal kneecap, it may last indefinitely. You may even need an operation to correct it, though this is unusual.
What is the treatment for PFPS?
Small doses of anti-inflammatory medicines can often decrease swelling, stiffness and pain. Other treatments may include injections, ice, rest, and physical therapy. Taping and a brace to stabilize the kneecap also can be helpful.
Now for the good news …
The good news is that although PFPS can be uncomfortable, usually it is only a short term nuisance and inconvenience. It also generally does not lead to arthritis or any other joint condition.
Osteoarthritis of the Knee and Hip
What is Patella Femoral Pain Syndrome?
Patella Femoral Pain Syndrome (PFPS) is a condition of the kneecap characterized by a rough or soft spot on its cartilage surface. In the past, it has been called chondromalacia patella, runner’s knee, or dashboard knee.
What are the symptoms of PFPS?
It causes pain, giving way, stiffness and a feeling of catching or grinding. Going up and down stairs is a bit difficult, and sitting with your knees bent or squatting is very uncomfortable. It makes the knee “give out,” grind, or pop loudly.
Who gets PFPS?
Many people may have PFPS, but only about 10 percent have a long-lasting pain or disability because of it — a fact not clearly understood by the medical profession. Over-activity, excess weight or injury sometimes initiate the symptoms. This condition is often seen in adolescents, manual laborers and athletes.
How is PFPS diagnosed?
Cartilage contains no calcium and as a result, cannot be seen by ordinary X-rays. A patient’s history and a physical examination suggest the diagnosis. If there is any doubt, we will suggest arthroscopy to look behind the kneecap and check to see that there is no other injury or abnormality.
How long does PFPS last?
It may last several months, but fortunately, is usually a self-limiting problem. If you are born with an abnormal kneecap, it may last indefinitely. You may even need an operation to correct it, though this is unusual.
What is the treatment for PFPS?
Small doses of anti-inflammatory medicines can often decrease swelling, stiffness and pain. Other treatments may include injections, ice, rest, and physical therapy. Taping and a brace to stabilize the kneecap also can be helpful.
Now for the good news …
The good news is that although PFPS can be uncomfortable, usually it is only a short term nuisance and inconvenience. It also generally does not lead to arthritis or any other joint condition.
Shoulder Problems
Who gets shoulder problems?
After age 25, most problems are caused by the effect of repeated overhead motions for a long period of time. Weekend athletes and do-it-yourselfers are especially vulnerable to overuse problems in the shoulder. The leading causes of shoulder pain are bursitis, tendonitis, and irritated rotator cuff. This group of conditions is called shoulder impingement syndrome.
What is bursitis?
The bursa is a fluid-filled sac that cushions the rotator cuff tendons from the shoulder bone. An irritated bursa is caused by an inflamed rotator cuff. When irritated, the bursa produces extra fluid, the sac expands, and the pressure creates pain.
What is tendonitis?
Deep in the shoulder are a group of tendons and muscles called a rotator cuff. They help stabilize the upper arm bone in the shoulder joint and rotate the arm. The biceps tendon is also present in front of the shoulder. When the arm is raised repeatedly over the head, the tendons rub against the underside of the shoulder bone and become irritated. The tendons swell, leaving even less space between tendons and bone. The irritation creates more irritation. It is much like a rope being drawn again and again across a craggy rock.
What is an irritated rotator cuff?
Excessive wear on the rotator cuff can lead to severe irritation, roughening, and eventually ulceration and tearing of the cuff. An irritated rotator cuff is felt as a clicking or popping in the shoulder from a ragged piece of the cuff sliding under the shoulder bone, and arm weakness. Occasionally, injuries or infections can all lead to arthritis, although arthritis of the shoulder is less common than in the knee or hip. Arthritis in the shoulder causes a roughening of the joint from worn cartilage and loose fragments of bone.
What are the symptoms?
Bursitis, tendonitis, irritated rotator cuff and arthritis are all inflammatory reactions to overuse. With any of these problems, a continuous dull ache in the shoulder can become a sharp pain when you try to move your arm, especially over your head. The pain may be worse at night after a heavy day of activities using your shoulder.
What is the treatment for shoulder impingement?
• Rest - Avoid strenuous activity and any motion that causes
pain. In some cases a shoulder sling is helpful to rest
fatigued muscles and inflamed tendons.
• Ice - An ice pack on the affected shoulder can help ease
inflammation when combined with gentle motion.
• Oral Medicines - Anti-inflammatory medicines such as Motrin,
Feldene, Voltaren, Naprosyn or aspirin will help reduce
inflammation.
• Cortisone Injections - Cortisone is a natural hormone and a
very powerful medicine for inflammation. When injected
directly into the inflamed area, it can be effective in
decreasing swelling and inflammation that cause pain.
How can physical therapy help?
Once the pain and inflammation are under control, a program of exercise, ice, heat, electrical stimulation, ultrasound and massage is used to help you regain motion.
When is surgery helpful?
Thanks to recent advances in arthroscopy, many shoulder problems can be corrected using the same techniques that revolutionized the treatment of knee problems. Arthroscopy is an outpatient procedure requiring three tiny incisions closed with one stitch each. This procedure allows the surgeon to see and work inside the shoulder joint.
Problems that can be treated through arthroscopy include:
• impingement syndrome
• irritated rotator
• torn cartilage
• unstable joint
In some cases, however, if the rotator cuff is severely damaged and leads to arthritis, the only option for pain-free motion is a shoulder replacement. Shoulder replacement requires a 1-2 day hospital stay.
What kind of anesthesia is used?
For maximum comfort, general anesthesia is preferred. Regional anesthesia is an option for some patients. Your surgeon will discuss which type is best for you.
How long does it take?
Shoulder arthroscopies are performed as an outpatient procedure. The time from check-in to discharge usually is as little as two hours. Many people return to their normal activities within four to five days. People with physically demanding jobs can usually return to work in two to three weeks.
