Hip Replacements & Knee Replacements

What do you say about total joint replacement surgery?

Total joint replacement is the most promising orthopedic surgery of modern times with advancement in various disciplines such as treatment, implants, and minimally invasive operative techniques. Relieving pain and restoring the joint motion are the main objectives of this procedure. After the surgery, patients would be able to carry out their daily activities without any discomfort.

Is surgery a foremost option for every patient?

Not always. I recommend patients for joint replacement surgery only after all non-surgical approaches are exhausted in relieving joint pain. Healthy diet, regular exercise, and over the counter pain meds, such as ibuprofen and acetaminophen are the usual non-surgical approaches available. Steroid injections can also be a helpful option, but physicians often limit the use of steroids. In my opinion, use of over-the-counter nutritional supplements- glucosamine and chondroitin- is not recommended because, they are not regulated by the US. Food and Drug Administration and the evidence regarding their efficacy is scarce or none. Moreover, these nutritional supplements can also affect blood sugar and cause gastric problems. If, the patient is allergic to shellfish, Glucosamine can cause an allergic reaction.

What is your criterion in choosing patients for total joint replacement?

I use three criteria in selecting patients for total joint replacement surgery. The patient who meets all the three criteria are eligible for surgery. First, I inquire about joint pain with limited mobility due to which a patient can no longer perform even their daily tasks such as climbing stairs or stepping in and out of the tub. Then, I examine the painful knee or hip for range of motion and shape, as well as patient’s gait, or manner of walking. Finally, I review diagnostic imaging results to find out if the patient suffers from arthritic degeneration of the joint. The patient fulfilling all t three criteria will be considered for the procedure.

What do you advise a patient scheduled for total joint replacement?

In general, surgical candidates can remain active until the date of their surgery. Inactivity and limited muscle mobility might exacerbate the existing condition. Hence, I recommend the patients scheduled for surgery to remain active. Swimming is a preferred choice to maintain the muscle bulk and joint flexibility. It relieves the body weight while exercising. Water exercises are advised even to those patients who are unable to swim as it isn’t necessary to swim in order to participate. Cautious use of pain medications before surgery can ease post-surgery pain control.

What are the advantages of newer surgical options?

The latest minimally invasive surgical techniques offer a faster recovery and better maintenance of walking pattern. The anterior approach of reaching the joint from the front requires a small incision and avoids the cutting of muscle; unlike standard hip replacement, where the joint is approached from back side and requires muscles to be cut. Moreover, this anterior approach makes the patient pain free in shorter time, and reduces the recovery time and overall muscle disruption. Most of the patients resume walking at the earliest and have good strength. Further, the implants made from a combination of plastic and ceramic offer better results than those developed in the past. Newer implants provide more comfort as they match well with the natural anatomy, resist wear and tear, and give an enhanced range of motion and reduce risk of joint dislocation.

What do you suggest to patients to achieve optimal joint mobility after surgery?

I suggest physical therapy which is of prime importance. It is extremely necessary for patients to be proactive with their routine physical therapy. The range of motion that a knee replacement patient achieves within the first three months after surgery is likely the range of motion for the rest of life. The range of motion after hip replacement typically depends upon the structure of the hip joint.

Anterior Hip Replacement & Custom Knee Replacement

Total joint replacement surgery is one of the most advanced successful procedures in patients dealing with severe hip and knee pain. The goal of the surgery is to relieve pain and restore the normal functioning of the joint and help patients resume normal activities.

Over the past few years, there have been great advances in the treatment options, implants, and minimally invasive surgical techniques. The latest techniques in joint replacement such as Anterior hip replacement and custom knee replacement has resulted in a dramatic improvement in outcomes.

What is direct anterior approach hip replacement surgery?

Direct Anterior Hip Replacement is a minimally invasive hip surgery to replace the hip joint without cutting through any muscles or tendons.

Traditional hip replacement involves cutting major muscles to access the hip joint.

Normally, after a traditional hip replacement, your surgeon would give you instructions on hip precautions such as not bending over or crossing your legs to allow the cut muscles to heal.

However, for Anterior Hip Replacement patients, hip precautions are not necessary as no muscles are cut to gain access to the joint.

What is Custom knee replacement technique?

A custom knee replacement is a novel technology in total knee replacement that is designed specifically to match the natural shape of the articulating surfaces of the patient’s knee.

This technique helps to ensure accurate placement and alignment of knee implant components. The procedure is less invasive as it eliminates the need to drill holes in the bones.

The technique usually requires fewer steps during the surgical procedure leading to shorter operating time, and may help enhance surgical efficiency.

Advantages of both anterior hip replacement and custom knee replacement include:

  • Less postoperative pain
  • Minimal soft-tissue trauma
  • Smaller incision
  • Less scarring
  • Minimal blood loss
  • Shorter operative time
  • Quicker recovery
  • Early mobilization
  • Less postoperative restrictions
  • Quicker return to normal activities
  • Short hospital stay

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