Wednesday, 22 of November of 2017

Category » Joint Replacement

Joint Replacement Surgery May Help Reduce Heart Disease

 

 

249001_517150311655291_934451022_nGreat news for people with osteoarthritis undergoing joint replacement surgery may significantly reduce the risk for a serious cardiovascular event, such as heart attack, stroke, coronary artery bypass surgery, angioplasty, congestive heart failure or death related to heart disease.

According to a new medical study, knee replacement surgery may cut the risk for heart attack and stroke by as much as 54 percent, while hip replacement can reduce the risk by 39 percent. Even patients who had at least one risk factor for heart disease, such as high blood pressure or diabetes, benefited. After joint replacement, they had a 29 percent decreased risk of developing a serious cardiovascular event.

The study was published in the November issue of BMJ, an international medical journal for physicians, and reported in stories featured in New York Times and Arthritis Today, a publication of the Arthritis Foundation. Physician researchers compared 153 people who had moderate to severe osteoarthritis and had undergone either a knee or hip replacement, against a second group of 153 people who also had osteoarthritis and were of similar age, income level, weight, smoking status and other factors. However, the second group did not receive joint replacement surgery. All the individuals were then studied over a seven year period.

Although researchers are quoted saying they are not entirely sure exactly why joint replacement offers protective benefits, they suspect it is related to a combination of factors. With the surgery eliminating the pain, stiffness and swelling of osteoarthritis, stress levels are reduced and there is greater interest in exercising and physical activity, which helps maintain healthy weight and fosters a more positive outlook. Patients are also less likely to be frequent, long-term users of non-steroidal anti-inflammatory drugs, which can cause side-effects, such as increased risk of heart attack and stroke.

If you or a loved one are searching for treatment options to help manage your symptoms from osteoarthritis, please call our office at 239-936-6778 to schedule a consultation. Or, for more information, go to www.kaganortho.com


Update on the DePuy Hip Replacement Lawsuit

 

 

DePuy ASR

An Articular Surface Replacement, removed from a patient.
Photo Credit: The New York Times

Metal on metal implants for hip replacement surgery have been the subject of intense scrutiny and media attention for some time now. Bloomberg Business News and the New York Times recently reported that Johnson & Johnson has “tentatively agreed” to an estimated $4 billion settlement to settle some 7,500 lawsuits against its DePuy Articular Surface Replacement (ASR) hip implant device.

Metal-on-metal implants were initially thought to be a breakthrough product that would last longer, offer greater stability and improve bone conservation, but unfortunately that is not turned out to be the case. In January of this year, the FDA issued a safety bulletin, citing growing clinical evidence that shows a failure rate two to three times that of non-metal-on-metal devices.

In addition, the impact of metal rubbing on metal can cause tiny metal particles to flake off, causing damage to muscle and bone, as well as a high level of metal ions in the blood. Many patients have been forced to undergo hip revision surgery to remove the flawed implant and replace it with a different design.

Thousands of patients have filed lawsuits against DePuy and other manufacturers of metal implants, claiming the devices were defective and have harmed their health. When formal announcement in the DePuy ASR case is released some time this week, it is expected to be one of the largest product liability claims to be paid involving a medical device. The New York Times reports that only patients who have undergone revision surgery to replace the defective ASR implant will be included in the current settlement.

If you are dealing with chronic hip pain from osteoarthritis or are concerned about a hip replacement that you had in the past, please feel free to call our office at 239-936-6778 to schedule a consolation. For more information about joint replacement or other orthopedic-related conditions, go to www.kaganortho.com.


Early Stage vs. Advanced Disease for Osteoarthritis

For most people, it can take years before the pain and disability from osteoarthritis becomes extreme. That means treatment options for early stage disease are typically very different from late stage, advanced disease. Most of the time a variety of nonsurgical treatment options will be tried before surgery is recommended. Here’s what can you expect as the disease progresses.

Early Stage Disease

In early stage osteoarthritis, this degenerative disease is just beginning to damage the cartilage that covers and cushions the bone. The cartilage itself doesn’t have nerve endings, but as it thins and wears away, it leaves the bones unprotected, which causes friction when the bones rub together.

During this stage, if you’ve played a strenuous game of tennis, spent the day working in the yard or gone on a long run, you might feel some tenderness in your joints afterwards. Generally rest and over-the-counter anti-inflammatory medication like ibuprofen will take away any lingering discomfort.

Moderate Stage Disease

At this stage, there is more pronounced damage to the cartilage and inflammation of the tissues. You may have developed bony spurs, a benign bony growth that the body naturally creates in response to pressure, rubbing or stress, but which can also cause discomfort. Joint pain may be worse first thing in the morning or at the end of the day, especially after physical activity.

Your doctor may want to perform outpatient arthroscopy to evaluate the extent of damage to your cartilage and bone.  Besides taking non-steroidal anti-inflammatory drugs (NSAIDIs) such as Motrin, Advil, Aleve or Celebrex, the doctor also may suggest glucosamine and chondroitin supplements.  Steroid injections can help too, as can injections with hyaluronic acid or platelet-rich plasma (PRP) therapy.

To reduce pressure on your joints, switch from sports like tennis or running to swimming and walking.

Advanced Disease

By now, there is most likely considerably friction from “bone on bone” since the cartilage has been destroyed. Wearing a brace, applications of hot or cold, water therapy, as well as the treatments suggested for moderate level disease may offer limited relief. However, these treatment options are designed to reduce symptoms – not fix the problem. At this point, surgery may be the best solution if pain and stiffness limit your lifestyle.  Surgical options include arthroscopy to “clean the joint” and remove bone spurs and repair torn cartilage; partial joint replacement; or full joint replacement.  

For more detailed information about how joint replacement surgery is performed, go to www.kaganortho.com/learn-more.


New Medical Study Finds Vitamin D Doesn’t Help Arthritic Knees

Taking vitamin D supplements does not stop the progression of osteoarthritis in the knees, according to a new medical study published this week in the Journal of American Medical Association.

Because of vitamin D’s importance to bone health, it was thought that it might alleviate the pain of osteoarthritis and reduce damage to the cartilage. But results of a two-year study showed this was not the case. Physicians at Boston’s Tufts Medical Center directed the randomized, placebo-controlled trail that evaluated 146 people with advanced osteoarthritis of the knee.

However, there are a number of nonsurgical treatment options, including hyaluronic injections, prolotherapy treatment and platelet rich plasma (PRP) that can help reduce discomfort and improve quality of life for people with chronic knee pain until joint replacement surgery becomes necessary. To learn about these options, go to www.kaganortho.com/learn-more.


What Is MIS Joint Replacement?

The trend toward bigger is better may apply in some areas of popular culture, but definitely not in the field of medicine, especially for joint replacement surgery.

MIS joint replacement is a minimally invasive surgical technique in which the surgical incision used to open the body is very tiny, just 2.5- to 3.5 inches. In contrast, traditional joint replacement surgery calls for a much larger incision – typically 12- to 14-inches.

But here’s the interesting twist. Whether the surgeon uses traditional surgery or a minimally invasive technique, the device used to replace the arthritic hip, knee or shoulder is always a full-size, traditional plastic or metal implant.

How is that possible? Technology.

Standard operating procedure calls for the surgeon to make a large incision and then retract the tissue, giving him a large surgical field in which to operate and insert the new artificial implant.

The new MIS technique uses a completely different approach. First, miniature specialized surgical instruments have been developed that are small enough to inset through a tiny incision.

Then, to overcome the restriction of a dramatically reduced surgical field, the specialized surgical instruments are equipped with a light source and video capability. Video images of the interior structure are sent in real-time to a monitor, giving the surgeon highly magnified 3D images of the operating field.

Performing minimally invasive surgery not only requires the right surgical instruments, it also takes training and certification to learn the surgical skills and manual dexterity required to become proficient in minimally invasive techniques.

In addition, the surgeon has to have a successful practice and track record that allows him to consistently perform the technique to keep his skills up to date and his surgical outcomes good.

Not everyone is a good candidate for MIS joint replacement. But the advantages of this new advance are extensive. The benefits include less blood loss, reduced trauma to the body, fewer days of hospitalization and faster overall recovery. Minimally invasive techniques are definitely a positive trend for the future of orthopedic care.

Want to find out more about minimally invasive techniques to treat joint pain? Go to www.kaganortho.com/learn-more. If you have chronic osteoarthritis that doesn’t respond to nonsurgical treatment, ask your doctor if you a good candidate for MIS joint replacement.

The trend toward bigger is better may apply in some areas of popular culture, but definitely not in the field of medicine, especially for joint replacement surgery.

MIS joint replacement is a minimally invasive surgical technique in which the surgical incision used to open the body is very tiny, just 2.5- to 3.5 inches. In contrast, traditional joint replacement surgery calls for a much larger incision – typically 12- to 14-inches.

But here’s the interesting twist. Whether the surgeon uses traditional surgery or a minimally invasive technique, the device used to replace the arthritic hip, knee or shoulder is always a full-size, traditional plastic or metal implant.

How is that possible? Technology.

Standard operating procedure calls for the surgeon to make a large incision and then retract the tissue, giving him a large surgical field in which to operate and insert the new artificial implant.

The new MIS technique uses a completely different approach. First, miniature specialized surgical instruments have been developed that are small enough to inset through a tiny incision.

Then, to overcome the restriction of a dramatically reduced surgical field, the specialized surgical instruments are equipped with a light source and video capability. Video images of the interior structure are sent in real-time to a monitor, giving the surgeon highly magnified 3D images of the operating field.

Performing minimally invasive surgery not only requires the right surgical instruments, it also takes training and certification to learn the surgical skills and manual dexterity required to become proficient in minimally invasive techniques.

In addition, the surgeon has to have a successful practice and track record that allows him to consistently perform the technique to keep his skills up to date and his surgical outcomes good.

Not everyone is a good candidate for MIS joint replacement. But the advantages of this new advance are extensive. The benefits include less blood loss, reduced trauma to the body, fewer days of hospitalization and faster overall recovery. Minimally invasive techniques are definitely a positive trend for the future of orthopedic care.

Want to find out more about minimally invasive techniques to treat joint pain? Go to www.kaganortho.com/learn-more. If you have chronic osteoarthritis that doesn’t respond to nonsurgical treatment, ask your doctor if you a good candidate for MIS joint replacement.

 


When Is Knee Replacement Surgery The Right Decision?

If you have chronic knee pain caused by osteoarthritis, eventually, the progressive, degenerative nature of the disease may mean that surgery is the best solution to relieve pain and improve your quality of life. Surgery reshapes the damaged portion of bone caused by the wearing away of cartilage and replaces the joint with an artificial implant.

Even though knee replacement is a very common and successful surgery, making the decision to undergo this procedure is a very big step. How do you know when the time is right to make this important decision?

Many people think of knee replacement surgery as the last resort –that their knee pain must be bad enough to severely compromise their lifestyle before they agree to an operation. But today, most medical experts agree that there is no reason to live with chronic pain. When conservative treatment fails to help, it’s time to consider more permanent measures.

According to the American Academy of Orthopedic Surgery, there are several important signs that you may be a good candidate for knee replacement surgery:

You have tried a variety of conservative, nonsurgical treatments, such as exercise, anti-inflammation and pain-relief medication, hot and cold therapy, and injections. However, these methods have failed to control the pain and improve your condition.

Knee pain wakes you up at night or prevents you from falling asleep.

You find that knee pain makes it nearly impossible to participate in recreational activities that you enjoy – golf, tennis, dancing, walking, shopping.

Knee pain makes performing every day activities, from getting out of bed or a chair to climbing the stairs or standing for very long, even to cook meals, painful and challenging.

Learning more about knee replacement surgery can help you make a better decision about whether it’s for you. Find out how it’s performed and what to expect at www.kaganortho.com/learn-more.


Shoulder Rotator Cuff Repair

A rotator cuff tear is a challenging shoulder injury that can cause a throbbing ache when you try to raise or lower your arm or lift an object. You might wake up at night in pain if you happen to roll over onto the affected shoulder while you’re sleeping.

What exactly is the rotator cuff?

According to the American Academy of Orthopedic Surgeons, the rotator cuff is a group of tendons that form a covering around the top of the humerus or upper arm bone. These tendons keep the arm in the shoulder socket by attaching the humerus to the shoulder blade. They allow you move your arm and shoulder in various directions.

What causes the rotator cuff to tear?

An activity that repeatedly overstresses the shoulder joint to the point of fatigue can tear one or more of the tendons, causing them to pull away from the shoulder bone. Avid tennis players, baseball pitchers and bodybuilders, as well as painters, carpenters and workers who lift heavy objects are particularly at risk. Falling onto a outstretched arm can also tear the rotator cuff.

But the normal wear and tear that affects the joints with age, such as bone spurs and poor blood circulation, can also weaken the tendons and make them more susceptible to tearing.

The first line of treatment may be ice, rest, anti-inflammatory medication and steroid injections. More severe injuries will need surgery to reattach the tendon to the humerus. Call the doctor if you’ve sustained an acute, traumatic injury or you have significant weakness, loss of function and pain.

To learn more about treating rotator cuff injuries, go to www.kaganortho.com/learn-more


Treating Hip Fractures

Hip fractures are a serious concern for older Americans, especially if poor eyesight, medications, osteoporosis or loss of balance places them at risk for tripping and falling. But hip fractures can occur at any age due to a serious car, bicycle or motorcycle accident, a sports-related injury, or an illness like cancer that causes the bones to be weak.

A hip fracture is a painful and potentially disabling break of the upper part of the thighbone, known medically as the femur. Almost always, surgery will be required to mend the bone, promote healing and stabilize the area.

The type of surgery will depend on the area of the hip that is broken, the severity of the fracture, the person’s age and level of activity. The surgeon may use a combination of surgical “hardware” to repair the fracture and “pin” the hip, or joint replacement surgery may be recommended.

If there is already existing damage to the cartilage and the ends of the bone, especially from arthritis, or the bones are not properly aligned after the fracture, the surgeon may be concerned that the blood supply to the hip joint will not be sufficient. In this situation, the surgeon may recommend replacing part or all of the hip joint with a metal replacement prosthesis.

When joint replacement is not needed, the surgeon may use surgical screws to repair the break. Sometimes the screw is attached to a metal plate that is positioned inside the body next to the bone. Or, the surgeon may place a metal rod, known as a surgical nail, inside the thighbone. The rod is attached to the ball of the hip joint with a screw.

Rehabilitation is an important part of recovery from hip fractures. Physical and occupational therapy in the hospital and at home will accelerate healing and return patients to normal activities faster.

For more information about treating hip fractures or other orthopedic-related conditions, visit www.kaganortho.com/learn-more.


Shoulder Humeral Head Resurfacing

 If persistent pain, stiffness and limited range of motion are affecting your ability to use your shoulder due to arthritis or injury, your physician may recommend surgery. But instead of undergoing a total joint replacement, some patients may benefit from a technique called shoulder humeral head resurfacing or hemicap resurfacing.

 One of the biggest advantages of shoulder resurfacing is that less bone is removed compared to a more traditional shoulder replacement procedure. That means only the humeral head or “ball” of the shoulder joint is treated, rather than the surgeon replacing the entire shoulder joint. Shoulder resurfacing is often called a “bone-preserving” surgery. A partial or full resurfacing can be performed.

 If you and your physician choose this option, here’s what you can expect.

The surgeon will use an arthroscope to determine the extent of damage to the cartilage that surrounds and covers the humeral head. Then special instruments are used to prepare the surface of the humeral head and an implant is placed over the area, covering it like a cap. The implant takes the place of the damaged cartilage, allowing the ball of the shoulder to once again move smoothly and seamlessly without causing pain.

If you are considering surgery to relieve your shoulder pain, it is important to educate yourself about the various options. For more information, go to www.kaganortho.com/learn-more/.

 


Joint Resurfacing May Be a Good Alternative For Some Patients

Joint resurfacing is a relatively new orthopedic treatment for patients who have pain and limited mobility due to arthritis or other degenerative conditions of the knee, hip or shoulder. In some cases, it may be a good alternative to total joint replacement.

What’s the difference between the two? Total joint replacement replaces all of the damaged arthritic bone and cartilage in the knee, shoulder or hip joint with an implant. Joint resurfacing is just what it implies – it replaces only the surface of the joint. That allows more of the bone to be conserved. Because of that, some orthopedic surgeons feel joint resurfacing can be performed at an earlier stage of disease than is usually recommended for total joint replacement.

What can you expect during a joint resurfacing procedure? For shoulder resurfacing, the head of the arm bone is reshaped and a cap or implant is placed over it, leaving the shoulder socket in place.

With hip resurfacing, the head of the high bone is trimmed and covered with an smooth metal implant. Then, damaged tissue within the pelvic socket is removed and replaced with a metal shell implant, similar to a total hip replacement.

Partial knee resurfacing treats only the damaged surface of the knee joint in one compartment in the knee rather than replacing the entire joint.  For example, during patellofemoral knee resurfacing, only the worn patella (kneecap) and the trochlea, a groove at the end of the thighbone, are treated. Unicompartmental knee resurfacing repairs only the damaged arthritic tissue in the femur and tibia.

There are both advantages and disadvantages of joint resurfacing. Selecting the right patients for the procedure is one of the most important considerations. Often patients who are younger, with healthy bones, are considered the best candidates.

If you have arthritis pain in your knee, hip or shoulder and it with your normal daily activities, you might want to consider joint resurfacing. For more information, or to discuss your treatment options, please call 239-936-6778 or visit http://www.kaganortho.com/.



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