Thursday, 17 of January of 2019

Tag » joint replacement surgery

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

How to Prepare for Joint Replacement Surgery

Once you have made the decision to undergo joint replacement surgery, it will be helpful to plan ahead so you will be better prepared emotionally and physically. It’s often a good idea to write questions down as they arise so you can be sure to have them addressed by your doctor in advance of the surgery.

If you live alone, your doctor may recommend that you recover in a specialized rehabilitation facility rather than immediately return home after your surgery. Because your mobility will be limited at first, it is often helpful to have professional healthcare providers assist you.

If you do return directly home after the surgery, here are a few tips from the American Academy of Orthopedic Surgeons to make the experience easier for you.

1. Avoid climbing the stairs to get to your bedroom. Instead, set up a convenient temporary bedroom on the first floor.

2. Look around your home and remove any obstacles, especially throw rugs that might cause you to trip or fall. Eliminate clutter near walkways and rearrange furniture if needed. Make sure you can get around easily – remember you will be using a walker or crutches at first.

3. Stock your freezer with easy-to-prepare meals or cook food in advance and freeze it. You will want to eat healthy, but may not want to spend much time cooking during your recovery.

4. Designate a comfortable chair where you’ll spend time during recovery and place items that you may want within arm’s reach, such as the phone, reading materials, television remote control, laptop computer, water glass and footstool.

5. To avoid bending over or reaching during recovery, buy a long-handled grabbing device and place any items that you regularly use on the kitchen counter.

6. Consider acquiring an elevated toilet seat and shower bench, or have handrails installed by the toilet and shower.

Joint replacement surgery is a very common and successful procedure that can greatly relief pain and disability. With a good attitude and proper preparation you can look forward to a speedy recovery and return to an active life.

Preparing your mind for surgery

Last week I blogged about completing a “to do list” to get prepared for surgery. But just as important as getting pre-operative tests and paperwork complete, so is preparing yourself emotionally for surgery.

First, talk to your surgeon and understand your condition and treatment. If surgery is the next step, what does the procedure involve? How long will you be hospitalized and what can you expect the recovery to be like?  How will you manage pain? Understanding what to expect can help ease anxiety.

Next, identify a support system. Who will help care for you after surgery? How will you get home and to and from your follow up visits?  Establishing support from family and friends can also help you prepare emotionally for surgery. However, no matter how well your surgery goes, your emotional health matters too. Studies show that patients lacking support systems have less satisfactory results following joint replacement surgery, spine surgery and sports medicine surgery.

If you have concerns about how you are coping before or after surgery, talk to your doctor so we can provide the proper resources to help you manage anxiety, depression or other concerns you might have to best support your recovery.

If you have questions, please call 239-936-6778 or visit

Preparing for joint replacement surgery

If you are experiencing hip, knee, shoulder or other joint pain, the decision to proceed with joint replacement surgery is often a last resort. For many patients, non-invasive treatments and medication may relieve symptoms. However, when pain limits daily activities and quality of life is compromised, surgery may be the best option. Once you and your orthopaedic surgeon have decided that surgery is right for you, there are some steps you should take to prepare yourself. Below is a list of tips from the American Academy of Orthopaedic Surgeons:

Medical Evaluation
Before surgery, you may be asked to have a complete physical examination by your primary care doctor before your surgical procedure. This is needed to assess your health and identify conditions that can interfere with your surgery or recovery.

Your doctor may request that you have several tests done in advance of your surgery: blood and urine samples may be tested and a cardiogram and chest x-rays (radiographs) may be obtained.

Preparing Your Skin
Your skin around the surgical site should not have any infections or irritations before surgery. If either is present, contact your orthopaedic surgeon for a program to improve your skin before surgery.

Tell your orthopaedic surgeon about the medications you are taking. Your surgeon or your primary care doctor will advise you which medications you should stop or can continue taking before surgery.

Dental Evaluation
Although infections after surgery are not common, an infection can occur if bacteria enter your bloodstream. Because bacteria can enter the bloodstream during dental procedures, you should consider getting treatment for significant dental diseases (including tooth extractions and periodontal work) before your surgery. Routine cleaning of your teeth should be delayed for several weeks after surgery.

Urinary Evaluation
Individuals with a history of recent or frequent urinary infections and older men with prostate disease should consider a urological evaluation before surgery.

Social Planning
Following surgery, you will need some help for several weeks with such tasks as cooking, shopping, bathing and laundry. If you live alone, your orthopaedic surgeon’s office, a social worker, or a discharge planner at the hospital can help you make advanced arrangements to have someone assist you at your home. A short stay in an extended-care facility during your recovery after surgery also may be arranged.

Home Planning
Depending upon your condition, the following is a list of home modifications that will make your return home easier during your recovery:
• Securely fastened safety bars or handrails in your shower or bath
• Secure handrails along all stairways
• A stable chair for your early recovery with a firm seat cushion (that allows your knees to remain lower than your hips), a firm back and two arms
• A raised toilet seat
• A stable shower bench or chair for bathing
• A long-handled sponge and shower hose
• A dressing stick, a sock aid and a long-handled shoe horn for putting on and taking off shoes and socks without excessively bending
• A reacher that will allow you to grab objects without excessive bending of your hips
• Firm pillows for your chairs, sofas and car that enable you to sit with your knees lower than your hips
• Removal of all loose carpets and electrical cords from the areas where you walk in your home

For more information, call 239-936-6778 or visit



Questions to ask your doctor when considering joint replacement




If you are considering  joint replacement surgery or curious about alternative relief options, here are a few questions to ask your doctor:

  • Are there any pain relief options for me that could work as well as joint replacement?
  • If I have joint replacement, how much will it relieve my pain?
  • How is the procedure done?
  • What do you do to manage the pain after the surgery?
  • What are the risks or complications of joint replacement?
  • How long will I be in the hospital, and how soon after having the procedure can I get back to normal daily activities?
  • Is joint replacement covered by my insurance?
  • After the procedure, will I see you or my regular doctor for follow-up care?
  • If I decide to have joint replacement, which company’s product do you think will be best for me? Why?
  • If I have joint replacement, will you perform my surgery? How many of these procedures have you performed?
  • What kind of activities will I be able to participate in after joint replacement?

 For more information, call 239-936-6778 or join me for my next free seminar on Saturday, March 12, 10a.m. to Noon at Athletic Orthopedic and Reconstructive Center, 3210 Cleveland Ave., Suite 100, Fort Myers. For reservations, call 239-936-6778 ext. 2227. To register online and for more information, visit Space is limited.

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