Paisley Prescriptions - April 2020

Feeling Out of Joint? What You Should Know About Knee & Hip Replacements


April 2020 Issue - Paisley Prescriptions
Feeling Out of Joint? What You Should Know About Knee & Hip Replacements

Sure, most of us look for that parking space closest to the entry of our favorite store or restaurant, even though we can walk perfectly fine and without pain. It’s an interesting behavior, which seems to point to a conclusion that walking is something people want to minimize, that is until their ability to walk is threatened by pain, injury or degeneration. Then we wish we would have walked more when we could and valued our independent, pain-free mobility. The good news is total joint replacement of the hips or knees can give people a second chance for leading an active and possibly pain-free life. According to the American Academy of Orthopaedic Surgeons, total joint replacement is one of the most commonly performed, elective surgical procedures in the United States. This procedure traditionally has been performed on older people, requiring long recovery times, often accompanied by a lot of pain. Now, there are almost 7-million Americans with either knee or hip replacements, and the majority of them now live their lives free again doing things they love to do. Some of them even park far away on purpose so they can walk…just because they can!

PYRx0420 CarterSummit Sports Medicine—Denny A. Carter, M.D.

What usual symptoms are associated
with the following replacement surgeries?

Knee Replacement
Symptoms associated with knee replacement include knee pain that significantly affects quality of life and does not respond to conservative treatment. Additional concerning symptoms include repeated episodes of joint swelling, severe loss of motion, mechanical symptoms such as popping, locking or giving way, and falls or near falls. If these symptoms cannot be managed with conservative treatments, like rehabilitation or medications, knee replacement may be considered.

Shoulder Replacement
Pain, popping, loss of motion and weakness can occur with severe shoulder degeneration.
This process often takes years to develop. Many mild cases can be treated with medications, physical therapy, injections and activity modification. Severe cases that do not respond to conservative treatments may be considered for joint replacement surgery.

Hip Replacement
Hip degenerative disease is often associated with pain, loss of motion and varying degrees of limpness. Lower back and hip disease symptoms can often overlap. Mild cases are often treated with medications, physical therapy, injections or walking aids. If symptoms are severe and do not respond to conservative treatments, hip replacement surgery may be considered.
Denny A. Carter, M.D., is a board-certified orthopaedic surgeon with Summit Sports Medicine & Orthopaedic Surgery, an integral practice in the Southeast Georgia Health System.

PYRx0420 Sasser
Summit Sports Medicine — Beau Sasser, M.D.

Does regular exercise help or hinder your joints?

What can I do to prevent joint replacement?
Exercise always helps joints. However, it also depends on what exercise is being performed. For patients who have a known diagnosis of arthritis, I recommend lower impact exercises. I stress to patients that higher impact exercises can put upwards of five to seven times their body weight across the joints, which can exacerbate arthritis. Lower impact exercises can include walking, biking, rowing and elliptical as a good cardio regimen. Strength training with lower weights and higher reps is always good to incorporate into an exercise program as adequate strength helps to stabilize joints.

Unfortunately, once a patient starts to develop moderate to severe arthritis the final option is usually a joint replacement. The benefits after a joint replacement are decreased pain, which allows for a better quality of life. With patients who have early arthritis, preventing a joint replacement consists of exercising and maintaining an ideal body weight.

What can I do to keep my shoulders from joint injury?

More than anything, proper lifting of heavy objects. Like knees and hips, higher impact activities may increase the force across the shoulder.

What’s new in joint health?

There has been a lot of social buzz about CBD oil and stem cells. I do have patients who swear by both these new treatments. Currently, there are few studies that show true benefit more than just anecdotal evidence. I’m waiting on better data before I recommend these to my patients.

Why are hip injuries so detrimental to the elderly?

A hip fracture in an elderly person can be a catastrophic injury. The reason in most of these patients is they are already limited in their ambulatory status, so having them rehab from a hip fracture can be monumental. Most of the time we try to perform these surgeries within 48 hours of the injury in order to decrease the incidence of other complications such has pneumonia, bed sores and blood clots.

Is age the biggest factor in joint deterioration?

That’s a hard question to answer. I would say yes and no. The human body is basically a mechanical device and unfortunately, over time, parts wear out just like tires on a car. However, I think the biggest factor in joint deterioration is excess weight. Walking alone puts three times our bodyweight across our joints. So, for every 10 pounds gained the resultant force across the joint is 30 pounds. So, every single step carrying extra weight can lead to early deterioration of joints.

Beau Sasser, M.D., is a board-certified orthopaedic surgeon with Summit Sports Medicine & Orthopaedic Surgery, an integral practice of Southeast Georgia Health System.

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