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Senior Health Week: Joint Replacement
Health News You Can Use •

Latest Joint Replacement News:

Crushed Glass and Radioactive Glass Spheres May Be Used to Mend Joints: The spheres, about one-fifth to one-tenth the diameter of a human hair, would be injected into the joint. Once the radiation is delivered, the spheres react with body fluids, eventually disappearing from the body.


Recent Joint Replacement News:

New Materials Produce Longer Life for Artificial Knees: New Oxinium™ femoral components, made out of an exclusive oxidized zirconium material, have been shown in knee simulator wear last longer.

Computers Take Guesswork Out of Incisions for Joint Replacement: Software creates three-dimensional muscle and bone models of each patient prior to surgery, letting doctors see the size and orientation of the muscles before the first cut.

Testing Set on Instrument to Aid Minimally Invasive Knee Replacement: Howmedica Osteonics Scorpio® Total Knee instrumentation is designed to complement the surgical technique pioneered by Dr. Peter Bonutti and used in a less invasive knee replacement procedure.

Mexican-Americans Far Less Likely to Seek Hip Replacement Surgery: With insurance not the issue, researchers speculate Hispanics who need hip replacement may not know anyone else who has had the surgery.

Joint Replacement Surgery for Ankles Is Becoming More Common: But the procedure has lagged behind joint replacement surgery for hips and knees due to problems with the designs of the artificial ankle joints.

New Option for Patients With Early Stage Knee Arthritis: The UniSpacer, a small, minimally invasive device that fits between natural bone structures of the knee, allows surgeons to preserve the patient's bone by replacing only damaged cartilage.

Court Approves $1 Billion Settlement for Faulty Joint Replacements: Patients who had implants replaced without complications will receive about $200,000 each. The payment will be higher for patients suffering complications..

Canadians in Need Have Limited Access to Joint Replacement Surgery: Researchers report Canadians with a lower income and lower level of education have a higher incidence of osteoarthritis but have a more limited access to joint replacement surgery.

Synthetic Cartilage May Be Option to Total Joint Replacement: A synthetic cartilage now available in Europe for cartilage repair that may be an option for patients requiring a total joint replacement.

Clinical Trials Underway on New Type of Total Knee Replacement: In most knee prostheses, the tibial polyethylene is firmly attached to a metallic tibial base plate. In the new rotating platform design, the tibial polyethylene is free to rotate about a central axis..

2 Surgeons Perform Minimally Invasive Knee Replacement Procedures: The surgeons performed the procedures using Zimmer's NexGen® Legacy ® LPS-Flex Knee, using techniques researchers hope may make knee replacement a much less daunting operation.

FDA Approves Replacement for Middle Joint in Arthritic Fingers: The U.S. Food and Drug Administration has approved a total replacement joint for patients suffering from arthritis of the proximal interphalangeal joint.


Joint Replacement Primer:

When all attempts to alleviate hip or knee pain have been exhausted by your doctor, your next option may be a total joint replacement. Approximately 150,000 total hip replacements and 90,000 total knee replacements are now performed annually.

Hip Replacement. Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery are to improve mobility by relieving pain and improve function of the hip joint.

The most common reason that people have hip replacement surgery is the wearing down of the hip joint that results from osteoarthritis. Other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling), avascular necrosis (loss of bone caused by insufficient blood supply), injury, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.

In the past, hip replacement surgery was an option primarily for people over 60 years of age. Typically, older people are less active and put less strain on the artificial hip than do younger, more active people. In recent years, however, doctors have found that hip replacement surgery can be very successful in younger people as well. New technology has improved the artificial parts, allowing them to withstand more stress and strain. A more important factor than age in determining the success of hip replacement is the overall health and activity level of the patient.

For some people who would otherwise qualify, hip replacement may be problematic. For example, people who suffer from severe muscle weakness or Parkinson’s disease are more likely than healthy people to damage or dislocate an artificial hip. Because people who are at high risk for infections or in poor health are less likely to recover successfully, doctors may not recommend hip replacement surgery for these patients.

The hip joint is located where the upper end of the femur meets the acetabulum. The femur, or thigh bone, looks like a long stem with a ball on the end. The acetabulum is a socket or cup-like structure in the pelvis, or hip bone. This “ball and socket” arrangement allows a wide range of motion, including sitting, standing, walking, and other daily activities.

During hip replacement, the surgeon removes the diseased bone tissue and cartilage from the hip joint. The healthy parts of the hip are left intact. Then the surgeon replaces the head of the femur (the ball) and the acetabulum (the socket) with new, artificial parts. The new hip is made of materials that allow a natural, gliding motion of the joint. Hip replacement surgery usually lasts 2 to 3 hours.

Sometimes the surgeon will use a special glue, or cement, to bond the new parts of the hip joint to the existing, healthy bone. This is referred to as a “cemented” procedure. In an uncemented procedure, the artificial parts are made of porous material that allows the patient’s own bone to grow into the pores and hold the new parts in place. Doctors sometimes use a “hybrid” replacement, which consists of a cemented femur part and an uncemented acetabular part.

Cemented prostheses were developed 40 years ago. Uncemented prostheses were developed about 20 years ago to try to avoid the possibility of loosening parts and the breaking off of cement particles, which sometimes happen in the cemented replacement. Because each person’s condition is unique, the doctor and patient must weigh the advantages and disadvantages to decide which type of prosthesis is better.

For some people, an uncemented prosthesis may last longer than cemented replacements because there is no cement that can break away. And, if the patient needs an additional hip replacement (which is likely in younger people), also known as a revision, the surgery sometimes is easier if the person has an uncemented prosthesis.

The primary disadvantage of an uncemented prosthesis is the extended recovery period. Because it takes a long time for the natural bone to grow and attach to the prosthesis, people with uncemented replacements must limit activities for up to 3 months to protect the hip joint. The process of natural bone growth also can cause thigh pain for several months after the surgery.

Research has proven the effectiveness of cemented prostheses to reduce pain and increase joint mobility. These results usually are noticeable immediately after surgery. Cemented replacements are more frequently used than cementless ones for older, less active people and people with weak bones, such as those who have osteoporosis.

Patients are allowed only limited movement immediately after hip replacement surgery. As early as 1 to 2 days after surgery, a patient may be able to sit on the edge of the bed, stand, and even walk with assistance. Usually, people do not spend more than 10 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3 to 6 months, depending on the type of surgery, the overall health of the patient, and the success of rehabilitation.

Knee Replacement. A knee replacement is an operation to remove a knee joint that has become so damaged that it causes pain and loss of mobility. In its place, an artificial joint is inserted, allowing the knee to become functional and removing the discomfort of the original knee.

Any condition that leads to a damaged knee joint may eventually result in the need for a knee replacement. Hence, people who suffer from osteoarthritis, rheumatoid arthritis and other joint diseases are more likely to need joint replacements. People who have damaged their knees, either in an accident or through continued wear and tear (for example, those working in heavy manual jobs) may also find that their knees deteriorate.

The most common symptoms in the knee that indicate damage to its structure are pain on moving it and standing on it, stiffness in the joint (especially in the morning) and inability to bend or straighten the knee completely. Pain can be felt within the knee joint itself, but also in the hip and thigh above it or in the calf and ankle below.

Once knee ligaments have been damaged, a person's knee becomes very painful and he or she is unable to walk unaided. If medical attention is not sought, damage can be done to other joints. As the individual tries to walk with minimum weight on his or her 'bad' knee, so extra force on the other leg may lead to damage to the 'good' knee or hip.

The knee-replacement operation usually lasts about an hour and a half. During that time, the damaged ends of the bones that form the knee joint are removed and replaced with metal ends covered in a durable plastic coating that will form the new surfaces. The incision is closed with metal clips. Occasionally, a small plastic tube may be left in the wound for 24 hours after surgery to allow fluid to drain from the new knee joint.

Twenty-four hours after the operation, an X-ray is performed to check the position of the joint replacement. If this is satisfactory, a specially planned physiotherapy program begins. Special knee exercising machines gently bend and straighten the knee joint without force for the first day or two after surgery and you are gradually allowed to bear weight on that leg again, at first with a frame or crutches. By the time of discharge from hospital, you should be using a single crutch. After you leave hospital, outpatient physiotherapy often continues until you can walk unaided. The clips are removed about seven days after the operation when the wound has healed.

For the majority of people, the knee replacement allows a return to a good quality of life with full mobility and without pain. Often the opposite knee is also affected by the same condition, such as osteoarthritis. In this case, the second knee may also have to be replaced at a later date.

Background information provided by: The National Institute of Arthritis and Musculoskeletal and Skin Diseases, , National Institutes of Health, Bethesda, MD 20892 and BUPA.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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