Orthopedics is a medical specialty concerned with the diagnosis, care and treatment of patients with musculoskeletal disorders. The musculoskeletal system consists of the body's bones, muscles, tendons, ligaments and nerves.
topAlthough orthopedists may perform surgery to restore function lost as a result of injury or disease of bones, joints, muscles, tendons, ligaments, nerves or skin, they are involved in all aspects of health care pertaining to the musculoskeletal system. They employ medical, physical and rehabilitative methods.
topPain in the hip may involve injury to muscles, tendons, or bursae (small fluid-filled sacs that cushion and lubricate joints).
Some of the most common hip problems are:
There are a variety of treatment options available, ranging from rehabilitation to total knee replacement surgery. Specific treatment for knee problems will be determined by your physician based on:
If initial treatment methods do not provide relief and X-rays show destruction of the joint, your orthopedist may recommend total hip replacement surgery.
topIn a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. Total hip replacement offers:
The most common condition that results in the need for hip replacement surgery is arthritis. Osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults, causes the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, can cause damage to the articular cartilage of the hip.
The decision to replace the painful hip with an artificial one is a decision made by the patient and physician. Other, alternative treatments may first be used, including assistive walking devices and anti-inflammatory medications.
topIn addition to a complete medical history, your physician may perform a complete physical examination, including X-rays, to ensure you are in good health before undergoing surgery. In addition, you may also meet with a physical therapist to discuss rehabilitation after the surgery and undergo blood tests (or other tests).
topAlthough each procedure varies, generally, surgery to replace a hip usually lasts a few hours.
The two most common types of artificial hip prostheses used in replacement surgery are cemented prostheses or uncemented prostheses. Sometimes, a combination of the two types is used to replace a hip. A hip prosthesis is made up of metal and plastic. A cemented prosthesis is attached to the bone with a type of surgical cement. An uncemented prosthesis attaches to the bone with a fine mesh of holes on the surface, in order for the bone to grow into the mesh and attach naturally to the prosthesis.
The prosthesis (artificial hip) is comprised of the following two components:
While undergoing surgery, the patient may be under general anesthesia or awake with spinal anesthesia.
topHip replacement surgeries usually require an in-hospital stay of several days. Even while in the hospital, the patient usually begins physical therapy exercises to begin regaining range-of-motion in the hip. Physical therapy will continue at home. Pain medication also will be administered to keep the patient comfortable.
The incision will have stitches or staples that will be removed after a few weeks.
Making certain modifications to your home may help you during your recovery. These modifications include the following:
Many knee problems are a result of the aging process and continual wear and stress on the knee joint (i.e., arthritis). Other knee problems are a result of an injury or a sudden movement that strains the knee. Common knee problems include the following:
There are a variety of treatment options available, ranging from rehabilitation to total knee replacement surgery. Specific treatment for knee problems will be determined by your physician based on:
If initial treatment methods do not provide relief and X-rays show destruction of the joint, your orthopedist may recommend artificial knee replacement.
topThe most common condition that results in the need for knee replacement surgery is osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees. Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury can also lead to degeneration of the knee joint. In addition, fractures, torn cartilage, and/or torn ligaments also can lead to irreversible damage to the knee joint over the years.
The decision to replace the painful knee with an artificial one is a joint decision between you and your physician. Other, alternative treatments may first be used, including assistive walking devices and anti-inflammatory medications.
topIn addition to a complete medical history, your physician may perform a complete physical examination, including X-rays, to ensure you are in good health before undergoing surgery. In addition, you may also meet with a physical therapist to discuss rehabilitation after the surgery and undergo blood tests (or other tests).
topAlthough each procedure varies, generally, surgery to replace a knee usually lasts about two hours. After the damaged bone and cartilage of the knee is removed, the orthopedic surgeon will place the new, artificial knee in its place.
The two most common types of artificial knee prosthesis used in replacement surgeries are cemented prosthesis and uncemented prosthesis. Sometime, a combination of the two types is used to replace a knee. A knee prosthesis is made up of metal and plastic. A cemented prosthesis is attached to the bone with a type of epoxy. An uncemented prosthesis attaches to the bone with a fine mesh of holes on the surface, in order for the bone to grow into the mesh and attach naturally to the prosthesis.
The prosthesis (artificial knee) is comprised of the following three components:
While undergoing surgery, the patient may be under general anesthesia or awake with spinal or epidural anesthesia.
topKnee replacement surgeries usually require an in-hospital stay of several days. Even while in the hospital, the patient usually begins physical therapy exercises to begin regaining range of motion in the knee. Physical therapy will continue at home. Pain medication also will be administered to keep the patient comfortable. The incision will have stitches or staples that will be removed after a few weeks.
Depending on your progress, you may be transferred to a rehabilitation facility for a few more days. Your bandages and sutures will usually be removed before you leave the hospital. Your physical therapist will instruct you in proper home care, and may continue to work with you. It is important that you continue your exercises once you are at home.
topMost patients are able to bear weight immediately after surgery and return to everyday activities within six weeks after surgery. Most patients can drive a car within seven to eight weeks after surgery. Your normal daily activities should exclude contact sports or activities that put excessive strain on your joints.
topLongevity of an artificial knee depends on many factors:
It is important to know that an artificial knee joint is not as strong or durable as a natural, healthy knee. Although the artificial joint may last the rest of your life, there is no guarantee. Unlike your original knee, the artificial one does not have the ability to repair any damage. Since it is mechanical, it will wear with time. Given enough time and use, it will wear out just like tires on a car. You may have to change the types of exercises and sports you did in the past to help reduce wear. If components are worn out and require replacement, your surgeon can do what is called revision knee surgery. Revisions are typically not as successful as the first knee replacement, as such you should strive to reduce activities that will shorten the life of your artificial knee.
You should discuss the following topics with your surgeon and how they might affect the longevity and success of your knee replacement: