Posts Tagged ‘hip replacement’

Hip Pain: Easing Discomfort with Proven Solutions

Hip pain can severely affect your independence, your lifestyle, your job, and more. With pain reaching unbearable levels, a bum hip can level the toughest among us.

It Might Not Be Your Hip

“One of the major things we immediately try to differentiate between is if it’s actually a hip condition—or is the pain coming from the back?” says Dr. Bryan Whitfield, an orthopedic surgeon at Emory Healthcare.

True hip pain culprits include impingement, labral tear, bursitis, pain coming from the gluteal tendon, and osteoarthritis.

Causes & Symptoms of a Hip Condition

Sometimes the shape of the bones leads to impingement—the socket and ball essentially running into each other and tearing cartilage around the rim. A fall can sprain the hip and tear tendons.

“Most people think their hip is on the back and on the side, what we would call the flank,” states Dr. Whitfield. “It turns out, conditions within the ball and socket are usually felt in the groin, more on the front than the back.” Typically, patients experience discomfort going from a seated position to a standing one. Pain can be triggered by certain activities or accompany every step.

Getting a Diagnosis

If there’s nothing else going on with the body, most normal aches and pains should go away within two weeks. If pain is holding on after two to six weeks, it’s time to get it checked out.

“When diagnosing hip issues, we really take into account an entire view: history, physical, imaging, and response to treatment,” explains Dr. Whitfield. “That helps us determine where exactly the pain is coming from and what condition is most relevant.”

Treatment Options

Some patients just want to be reassured nothing major is to blame and will often do nothing more if the pain is not limiting. However, Dr. Whitfield finds injections in the symptomatic location to be quite helpful.

“The other approach I routinely take is physical therapy. Much of the pain individuals experience is from muscle imbalances,” states Dr. Whitfield. “Physical therapy can help to correct that.”

Anti-inflammatory medications and avoiding activities that exacerbate the pain are also options. If significant pain continues over a long period of time, surgery should be considered.

Hip Surgery

When a patient has arthritis, the only reliable answer is to remove the damaged cartilage in the underlying bone and replace it with different material such as metal and plastic, which is hip replacement.

Pain may also be a result of a tear in the labrum from a sprain or bones impinging, or because of a torn tendon. “If there’s no significant arthritis in the hip, I can go in and remove some of the bone that is impinging and repair the labrum,” explains Dr. Whitfield. “Oftentimes, that’s very effective in taking away the pain.”

Benefits of Total Hip Replacement

In terms of risk versus reward, total hip replacement is considered one of the most successful surgeries and is effective in easing the majority of osteoarthritis pain.

“As techniques have advanced, we’ve changed our approach. A direct anterior procedure is minimally invasive and does not require any muscle detachment,” states Dr. Whitfield. “This allows for a quicker recovery.”

How Long Does a New Hip Last?

“I tell people it’s like a car,” says Dr. Whitfield. “If you’re just driving slowly on Sundays, the tires will never wear out. However, if it’s a sports car and you’re going off the line and around corners quickly, those tires are probably not going to last the life of the car. In my opinion, if a new hip doesn’t last a good 15 to 20 years, I’m disappointed. My hope is that it can last up to 30 years or more.”

For more information about hip pain and treatment, please visit emoryhealthcare.org.

About Bryan Whitfield, MD

Dr. Bryan Whitfield has extensive training and experience in treating all individuals who want to maximize their potential to be active, from high performing athletes to individuals who simply want their joints to keep up with their lifestyle. He believes in a patient-centered approach, tailoring his treatments both operatively and non-operatively to the individual patient’s needs. He earned his BS from Duke University in mathematics and economics before obtaining his medical degree from the George Washington School of Medicine and Health Sciences.

 

**To listen to an interview with Dr. Bryan Whitfield, an orthopedic surgeon at Emory Healthcare, follow this link: http://www.emoryhealthcare.org/podcasts/index.html?segitem=37811

Joint Replacement for an Active Life: Q&A with Dr. Maughon

Joints play an essential role in your body’s movements, and joint pain can negatively impact almost every facet of life. The goal of joint replacement surgery is to return patients back to their original level of activity.

From organized sports athletes to weekend warriors, Scott Maughon, MD, an Emory orthopaedic surgeon, enjoys helping athletes of all levels get back to doing what they love.

Below, he answers a few common questions about joint replacement surgery.

What is joint replacement surgery?

Dr. Maughon: Joint replacement surgery replaces the joint, or damaged or diseased parts of the joint, with man-made parts in order to relieve pain and improve mobility. Emory offers the highest in quality joint replacement surgery from our expert team of specialty fellowship-trained physicians.

What joints can be replaced with surgery?

Dr. Maughon: Almost any joint in the human body can be replaced. Some replacements are more common than others – hips, knees, and shoulders, for example. However, advances in technology and medicine have made ankle, finger, wrist and many other joint replacements more common as well.

Who is a candidate for joint replacement?

Dr. Maughon: My goal is to get my patients back to the same level of activity they enjoyed before injury or pain. Anyone who seeks to relieve pain in their joints could be a candidate for joint surgical intervention and/or replacement.

What is the recovery like after joint replacement surgery?

Dr. Maughon: Joint replacement surgery recovery time can range from several weeks to several months, depending on the patient and the joint being replaced. Emory Healthcare physicians work with each patient to develop a recovery plan based on their unique circumstances and needs.

For all joint surgery patients, there are a few general recommendations around activities. As the primary reason patients have joint replacement surgery is pain relief, the recommended post-op activities focus on those that do not put undue pressure or wear on the joint, including:

  • Swimming
  • Cycling
  • Using the Elliptical
  • Playing Doubles Tennis
  • Golf
  • Ice Skating

What inspired you to choose the sports/orthopaedic medicine specialty?

Dr. Maughon: Joint replacement helps athletes – from professional and organized sports players to weekend warriors – relieve pain and lead an active life. An athlete myself, it’s rewarding and exciting to be able to help kids and adults, and athletes of myriad abilities and levels, get back to what they enjoy doing. Moreover, being in sports medicine helps me connect to the community, making sure local youth sports have access to the appropriate medical care for any sports-related injuries.

Have there been any recent advances in joint replacement surgery?

Dr. Maughon: Arthroscopic surgery has made a significant difference in joint replacement and sports medicine. Being able to make a small incision instead of opening up major muscle groups during surgery dramatically improves recovery time for patients.

Watch Dr. Maughon discuss joint replacement in the video below.

Dr. Maughon practices at Emory University Orthopaedics & Spine Hospital in Johns Creek, Ga. To learn more about Emory Orthopaedics & Spine surgeons and treatment options available to you, visit www.emoryhealthcare.org/ortho or call 404-778-3350.

 

About Dr. Scott Maughon


T. Scott Maughon, MD, is an orthopaedic surgeon specializing in joint surgery and sports medicine, including ACL/MCL/PCL reconstruction, knee arthroscopy, rotator cuff tears, shoulder instability and dislocations, injuries in the aging athlete, meniscal/cartilage repair, ligament injuries, tendon injuries, joint preservation, and joint replacement surgery of the knee and shoulder. His research interests include the prevention of youth injuries in baseball for the throwing athlete, as well as proactive training and conditioning of youth and high school athletes to avoid the risk of injury.

Dr. Maughon is a member of the American Academy of Orthopaedic Surgeons and a member of the American Orthopaedic Society for Sports Medicine. He is also Board Certified in Orthopaedic Surgery and Sports Medicine. He received his medical degree from the Medical College of Georgia, completed an internship and residency in orthopaedic surgery at Georgia Baptist Medical Center in Atlanta, Ga., and a sports medicine fellowship with Dr. James R. Andrews at the American Sports Medicine Institute in Birmingham, Alabama.


About Emory Orthopaedics & Spine Hospital

Emory’s Orthopaedics & Spine Hospital has locations across the Atlanta metro area and offers a full range of services to diagnose, treat and repair bones, joints and connective tissue, like muscles and tendons. Emory Healthcare has the only hospital in Georgia that is dedicated to spine and joint surgery as well as non-operative spine and joint surgical interventions for physical therapy. For more information, or to schedule an appointment or an opinion, visit www.emoryhealthcare.org/ortho.

Takeaways from the Live Chat on Hip and Knee Replacement

joint-replacement260x200Are you or someone you know considering hip or knee replacement after living with pain for an extended time? Whether you have just begun exploring treatment options or have decided to undergo hip or knee replacement surgery, we answered some questions that may be helpful about the procedure and recovery time.

Thank you to everyone who participated in our live chat on Tuesday, December 13 at 12 PM EST with orthopedic surgeon Dr. Thomas Bradbury of Emory Orthopaedics & Spine Center where he answered questions about hip and knee replacements, new treatment options, recovery and more. We received a lot of great questions, and below are some of the highlights from this live chat. Read the full chat transcript here.

 

Question: Will I need physical therapy about a knee replacement?

Dr. Bradbury: Yes, physical therapy is much more important after knee replacement than after hip replacement. In general, the physical therapist will first help you achieve range of motion and then work on strengthening. Most people require supervised physical therapy for several weeks after surgery. After that point, they can do many of the exercises on their own.

Question: How soon will I be able to walk after a hip replacement?

Dr. Bradbury: Our goal is to have you walking within 3 hours of surgery. Early mobilization after hip replacement surgery is helpful to avoid complications like blood clots in the leg or in the lung. In general, a physical therapist will help you get out of bed and walk for the first several times. Once you demonstrate safety when walking with the therapist, you will be able to walk on your own. Most people require crutches or a walker for a period of time after surgery. Once you feel confident, you can begin walking without an assistive device.

Question: Are there different types of knee replacements?

Dr. Bradbury: Yes. Just like with cars, there are hundreds of different models. Your surgeon can explain the pros and cons of different types of replacement systems. However, the surgical technique used to implant the device is more important than the device itself.

 

Thank you again too all of our participants! View the full chat transcript and learn more about hip and knee replacements below.

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Hip and Knee Replacement Live Chat: December 13, 2016

joint-replacement260x200Are you or someone you know considering hip or knee replacement after living with pain for an extended time? Whether you have just begun exploring treatment options or have decided to undergo hip or knee replacement surgery, we can help answer your questions about the procedure and recovery time.

Join us on Tuesday, December 13 at 12 PM EST for a live chat with orthopedic surgeon Dr. Thomas Bradbury of Emory Orthopaedics & Spine Center. Learn more about new treatment options and whether total joint replacement surgery is right for you. Register here today.

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About Dr. Bradbury

Thomas Bradbury, MDThomas Bradbury, MD, enjoys hip and knee arthroplasty because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Pediatric & Adult Hip Dysplasia

hip-painHip Dysplasia

The thigh bone’s connected to the hip bone – that’s what the song says. But sometimes that connection doesn’t work so well, which is the result of a hip socket that is too shallow – a condition known as hip dysplasia.

The hip is the largest “ball and socket” joint in the body, held together by ligaments, tendons and a joint capsule. The hip socket is designed to hold the femur tightly to prevent it from coming out of the socket while allowing enough motion to permit a wide variety of activities. Hip dysplasia simply means that the hip is in the wrong shape, most commonly, the hip socket is too shallow and not positioned to fully cover the femoral head.

Most people with hip dysplasia are born with the condition. Many patients never have any symptoms of dysplasia as a child. However, if left untreated, many patients with hip dysplasia will progress to arthritis in their 30’s or 40’s, if not before. Hip arthritis can be a debilitating condition.

Treatment

Treatment for hip dysplasia depends on the age of the affected person and the extent of the hip damage. Infants are usually treated with a soft brace that holds the ball portion of the joint firmly in its socket for several months, helping the socket mold to the shape of the ball.

But some forms of the condition can develop later in life. Older children and adults usually require surgery to correct hip dysplasia. In mild cases, the condition can be treated arthroscopically — using tiny cameras and tools inserted through small incisions. However, if the dysplasia is more severe, the position of the hip socket can also be corrected or cuts can be made in the bone around the socket (an osteotomy) to increase its depth.

In many cases, the condition will lead to tear of the labrum and eventual arthritis because of damage to the cartilage in the socket. Total hip replacement is possible to improve pain and function in this situation.

Our providers have extensive experience in treating patients of all ages with hip dysplasia. The majority of patients with hip dysplasia are treated with surgical procedures including the periacetabular osteotomy (PAO) or “Ganz” osteotomy. This procedure, only performed by a small handful of physicians in Georgia, offers the ability to correct hip dysplasia and potentially avoid the need for a hip replacement. This exciting treatment has offered patients with hip dysplasia a hope for returning to normal activities.

Learn more about Emory’s experienced, board-certified hip specialists who provide the best possible treatment for a wide range of conditions affecting the hip. Pediatric orthopaedic patients should click here to learn more about the variety of pediatric orthopedic conditions we treat.

If you are considering a pediatric orthopaedic procedure at Emory, we encourage you to make an appointment by calling 404-778-3350 or completing our online request form by clicking the banner below.

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About Dr. Bradbury

bradburyThomas Bradbury, MD, enjoys hip and knee arthroplasty because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Hip Replacement Surgery 101

hip replacementThe hip is one of the body’s largest and most important joints. It allows us to walk, run and jump, and bears our body’s weight and the force of the muscles of the hip and leg. If your hip has been severely damaged—by a fracture, arthritis, osteonecrosis or other conditions–common activities such as walking or getting in and out of a chair may be painful and difficult. You may even feel uncomfortable while resting.

If other alternatives such as medications, the use of walking supports, or changes to daily activities do not effectively help your symptoms, hip replacement may be a viable solution and you should consult with your physician to learn more. Generally, hip replacement surgery is a safe and effective procedure that can help you get back to enjoying everyday activities.

Takeaways from Dr. Bradbury’s Hip and Knee Replacements Chat

Thank you for participating in the online chat on Hip and Knee Replacements.  We had a lot of really great questions.  We received a few questions a couple times so we will highlight the answers to those questions here!

What is the longevity of knee replacements?

The lifespan of a knee replacement is related to the body weight and activity level of the individual who receives the replacement.  Individuals who are very active often reduce the longevity of their knee replacement because high activity can put extra stress on the implant leading to loosening of the implants from the bone or “wearing” of the parts used to replace the joint.  Being overweight increases the forces on implant and can also lead to early failure.  In general, 15 year survivorship of modern knee replacement designs used in  good candidate is around 90 percent.

Typically for younger patients,  if x-rays do not show complete loss of cartilage, “bone on bone”, I recommend waiting as long as possible to have the knee replacement surgery.  However, if there is “bone on bone” arthritis, knee replacement is the most effective treatment, but the risks of early failure are increased.

What exercises can I do for a total knee replacement?

Low impact aerobic conditioning 4-5 times per week for 4-6 weeks prior to surgery is best.  Low impact activities include swimming, elliptical, or stationary  bike.

“Prehabilitation” is rehabilitation to get your body ready for the surgery so you can recovery as quickly as possible after surgery.  Instruction during this period should be focused on strengthening the muscles around the joint.  The prehabilitation period should last for several weeks before surgery.

How long is recovery after hip/knee replacement?

It is best to think of how long it takes to reach recovery milestones –

• For hip replacement, pain is typically better than what it was prior to surgery in 2-3 weeks, normal walking typically occurs by 6-8 weeks and full recovery typically occurs within 3-4 months.

• For knee replacement, pain is typically better than what it was prior to surgery by 4-6 weeks, normal walking typically occurs by 8-10 weeks and full recovery typically occurs within 4-5 months.

Thank you again for attending the chat. I hope you found the information useful!  If you have questions or would like to schedule an appointment with an Emory Orthopedic Surgeon about hip or knee replacements please call 404-778-7777.

>>Read the full transcript from the online chat here!<<

About Dr. Bradbury

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory. He specializes in hip and knee arthroplasty. He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Related Links

Learn all about Hip or Knee Replacements

The decision to get a hip or knee replaced is a difficult one for many patients.  Hip and knee replacements are typically advised only when all other options have not worked for you.  If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements.  He will be available to answer questions such as:

• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?

Come prepared to ask your questions and learn more about your options!

CHAT TRANSCRIPT

About Dr. Bradbury

Thomas Bradbury, MD

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory.  He specializes in hip and knee arthroplasty.  He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Related Resources

Minimally Invasive Hip Surgery Gets Patients Active Faster – A Patient Story

Thomas Bradbury, MDWhen I first met Mark Putnam, he had chronic pain in his right groin and lower back caused by osteoarthritis of the hip. At 49, Mark felt twice his age. His local orthopedic surgeon was uncomfortable performing surgery because of the extent of the damage to the joint and instead referred Mark to the Emory Orthpaedics & Spine Center.

Mark needed a total hip replacement, and I knew he would be an excellent candidate for anterior total hip arthroplasty, an Emory-pioneered minimally invasive surgery that involved a new approach to the hip joint. Hip arthroplasty traditionally is performed through the posterior, or back, of the hip. This means the surgeon has to remove muscle and ligaments from the bone in order to reach the affected area. Because it takes a while for the tissues to heal after posterior total hip arthroplasty, the range of motion the hip can have for the first couple of months is restricted to prevent dislocation.

Anterior total hip arthroplasty has changed the way we perform hip replacement surgery at Emory. During the procedure, the orthopedic surgeon enters the front of the hip, as opposed to the back, via a single, very short incision to the patient’s leg. Because the surgeon can expose the hip without removing as much muscle and ligament from the bones around the hip joint, the patient retains a better range of motion in the hip and has greater hip stability following surgery.

While anterior total hip arthroplasty takes longer than traditional posterior surgery, the quick recovery time more than makes up for it. After surgery, Mark was pain free for the first time in years.

“It’s been terrific,” he said. “I was out the other day playing catch with my son, and I got down in a catcher’s squat and it didn’t even affect me.”

I encourage you to read up on the details of Mark’s total hip arthroplasty, and watch a video on Mark’s journey. Have you had anterior total hip arthroplasty? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About Thomas Bradbury, MD

Thomas Bradbury, MD, is an assistant professor of orthopedic surgery. He holds clinic at Emory Orthopaedics & Spine Center at Executive Park and performs surgery at Emory University Orthopaedics & Spine Hospital (EUOSH). Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems. He started practicing at Emory in 2007.

New Biomaterials Mean Fewer Hip and Knee Replacement Reoperations

James Roberson, MDIn Emory Orthopaedics, we perform hundreds of hip and knee replacement operations every year. Most of these operations are highly successful, but occasionally, a reoperation is necessary. In these cases, it’s usually because the materials originally used in the knee or hip have worn down over time.

At Emory, we’ve been testing new and improved biomaterials for use in hip and knee replacements for more than a decade, and we’ve found that a new generation of biomaterials is making a significant difference in the longevity of these replacements. This means fewer patients will need reoperations down the road.

The failure rate in a knee replacement operation is directly related to how fast the knee wears, which is affected by how well the knee was put in, the patient’s activity level, the patient’s weight, and the wear resistant properties of the materials used. Think of the tires on a car. The stronger the tire material, the longer it lasts. What if, instead of getting 30,000 miles on a set of tires, you could get 100,000 miles? In essence, that order of magnitude difference is similar to the improved wear resistance of new biomaterials used in hip and knee replacement.

I’ve been using alternative bearing surface materials in hip replacements for about 12 years, starting with metal on metal, then ceramic on ceramic, and now highly cross-linked polyethylene. All three materials have dramatically improved wear resistance and have worked very well for several thousand patients, with no measurable wear on any patient visible through x-rays. But while metal on metal and ceramic on ceramic are useful in hip replacements, they aren’t an option in knee replacements. Until recently, this was also true of cross-linked polyethylene. However, the more recent second generation techniques for cross-linking now make this a viable option for knee replacement also.

Polyethylene, simply put, is a plastic formed from long molecular chains made of carbon and hydrogen atoms linked together. Prior to cross-linking manufacturing techniques, these molecular chains consisted of carbon atoms linked to other carbon atoms in single long chains with the remainder of the molecular bonding sites filled with hydrogen atoms. On a molecular level, cross-linking simply means that the single chains now are cross bonded together to, in essence, create a woven structure. This results in a material that looks identical but is actually a more wear-resistant form of plastic.

Over the past three to five years, we’ve performed approximately 1,000 knee replacement surgeries using cross-linked polyethylene. While all three materials—metal, ceramic, and polyethylene—appear to perform fairly evenly in hip replacement surgery, cross-linked polyethylene is less expensive than ceramic on ceramic. Although the individual patient does not experience a cost difference, this is a benefit to the industry as a whole. Our goal is to develop improved materials that will result in better outcomes and be cost-effective.

If you’re having knee or hip surgery, you can trust your doctor to choose the most effective material for you. Regardless of whether it’s metal on metal, ceramic on ceramic, or cross-linked polyethylene, with all of these new biomaterials, we are cautiously optimistic that wear may no longer be a problem.

Have you had or are you going to have hip or knee replacement surgery? Have you had experience with any of the new biomaterials? We’d like to hear from you. Please take a moment to give us feedback in the comments section below.

About James R. Roberson, MD:

James R. Roberson, MD, chairman of the Department of Orthopaedics and professor of Orthopaedic Surgery, specializes in treating hip and knee arthritis and has performed more than 10,000 hip and knee replacements over the course of his career. Dr. Roberson has practiced at Emory since 1982.