Q
: 1
08/19/2008 |
My 82-year-old mother had her right hip replaced several years ago. In the spring of 2006, it was discovered she had osteolysis of her right hip with medial displacement of her acetabular component. At that time she was told it would take several surgeries to reconstruction and she didn't want to go thru that. However she is unable to walk now without having a great deal of pain and wants the surgery if at all possible. She recently had X-rays showing a protuded acetabular component which is spun into a more horizontal position. It appears the greater trochanter is now coming into contact with the lateral pelvis. The doctor who did her hip replacement says she is beyond his level of expertise due to the complex reconstruction with pelvic dissociation that is necessary. He thinks it is possible with the right surgeon to have what she needs done in one complex surgery. He recommended you to us. Do you think this is possible?
I am happy to see your mom as a patient. I spend most of my time doing repeat/revision hip replacement operations and the pelvic dissociation problem can be a complicated one but in most instances can be addressed in a single operation and repaired.
If you wish to make an appointment for an evaluation and discussion, you may do so by calling 410-448-6400 to schedule.
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Q
: 2
02/18/2008 |
I had a broken hip in 1992 and was repaired with screws and plate and pinned. Recently I have been having severe pain in the femur and plate area and I am unable to bear weight. I was told I would need a total hip replacement down the road. Do the plates and screws wear out or do the screws loosen? And why do I have the pain? I had an X-ray and the diagnosis was contusion. No injury, just severe pain.
Many complications can arise after repair of hip fracture, including nonunion and avascular necrosis as well as simple irritation resulting from the plate. An X-ray would help to differentiate these issues in large part.
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Q
: 3
02/12/2008 |
I am 53-years old and was diagnosed about five years ago with osteoarthritis in my left hip. I do not need any prescription or OTC NSAIDs on a regular basis, but the bone spurs and discomfort is resulting in a limp now. What things should I consider before trying to schedule a hip replacement. Also, what activities are 'allowed' with a replacement hip?
A long conversation, but anti-inflammatory medicines or Tylenol are commonly the first line of treatment. Activity is nearly normal and full with exception of avoidance of impact activities and extreme positions of leg crossing and knee to chest.
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Q
: 4
12/05/2006 |
What is the advantage of a total metal hip as opposed to one with a plastic liner? Is minimally invasive surgery always better?
Less invasive operations can be an improvement for the appropriate patients and the advatage of metal on metal hip replacements is unclear and not established at this time. Concerns about metal particle debris and ions in the bloodstream have been the greatest fear.
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Q
: 5
12/02/2006 |
Does your center use ceramics for hip replacement? Do you do minimally invasive surgery? I just had a great experience with MIS Valve Repair by Dr. James Gammie at the UM Medical Center. I have great confidence in the UM Medical Team.
We do perform less invasive hip replacement. We do not choose to use ceramics for hip replacement materials for a variety of reasons. I would be happy to visit with you and review your case and discuss options.
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Q
: 6
09/17/2006 |
Do you do a new procedure where artificial cartilage is placed in the knee instead of a total knee replacement?
Yes, but it has limited application for small lesions at this point in time and is not available for larger, more completely, arthritic knees.
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Q
: 7
06/12/2006 |
I am 61-year-old person who is very active in playing tennis, hiking, gardening etc. I have been told a knee replacement would be the thing for me as I have osteoarthritis in my knee. I have had the outpatient knee surgery, draining of fluids, cortisone shots and stay continually on anti inflammotory medications. I am in pain constantly and I'm finding it very difficult to walk, shop, run the sweeper, etc. I am very bowed legs. If I have the surgery is it a possibility that the bowed leg can the be straightened?
Yes, typically the bow leg is always straightened out, since the arificial knee replacement lasts longer if the bow is corrected.
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Q
: 8
06/12/2006 |
My husband needs to have his knee replaced. We have been told that a surgeon in Minnesota does a non-invasive surgery that does not cut the muscles and requires very little, if any, physical therapy.
Are you familiar with this procedure? Do you do this procedure?
There is no such thing--a procedure that does not somehow violate the muscles and requires no physical therapy. We do less invasive knee replacement and recently published our experience with a modified surgical approach but there is no approach that does not somehow violate the muscle to get there.
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Q
: 9
06/06/2006 |
How soon should you start physical therapy after having a uniknee replacement? Is it the same as for a total knee?
Usually you would start the day after the operation (same as after total knee replacement) but everyone has some slight variation.
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Q
: 10
05/09/2006 |
Do you use the Trident Ceramic Hip System for joint replacement? Are you able to see patients who have one and are having ongoing problems with it?
I do not use that system but am well familiar with it and have cared for such patients, as well as revised them when necessary.
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Q
: 11
03/14/2006 |
What happens to a badly damaged ligament when a knee replacement is needed?
Usually it has scarred in and is functional. If not, its function is substituted by a different design of knee replacement.
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Q
: 12
02/24/2006 |
I have been examined and been told I need a hip replacement but I'm too heavy. I weight 309 pounds, yet the pain is too bad to lose weight. Exercise is out of the question. I have to lose 70 pounds before my orthopedic surgeon will operate. That could take months and this pain is so bad I don't know how much longer I could exist with it! Any suggestions?
While weight reduction is clearly advantageous before you undertake hip replacement, in some instances it is appropriate to proceed with the understanding that weight loss is essential, but yet to occur. This practice is quite surgeon dependent and there are several thoughtful approaches. We certainly have done hip replacement in patients greater than your weight in select circumstances. another opinion may be of value to you.
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Q
: 13
02/13/2006 |
Can a 92-year-old female with aortic stenosis have hip replacement surgery?
Yes, with the appropriate anesthetic and perioperative care. An in-person assessment is obviously required before a definitive "yes" can be given, but this is done not uncommonly on such patients.
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Q
: 14
02/07/2006 |
Is jogging/running a reasonable expectation following knee replacement? I am 55, in good health and exercise as pain permits.
No. While you "can" do it, you "should not" do it.
It is NOT a reasonable expectation after knee replacement.
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Q
: 15
11/18/2005 |
My mother had her knee replaced about five years ago. She has gotten weaker. It's hard for her to pick up her legs and walk. All the lung and heart tests are negative. She is on Prednisone. Could this be an autoimmune response and how could I get report on problems of autoimmune response in knee replacement patients?
It's an autoimmune issue only if she previously had autoimmune issues, such as rheumatoid disease. It would be quite unusual to have the knee replacement trigger this without a prior history of the same.
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