The Joint Center at Orthopedic Institute

According to the National Center for Health Statistics, each year about about 650,000 Americans need to have their knees or hips replaced through total joint replacement surgery.

There are a lot of reasons. A frequent reason for performing a total joint replacement is to relieve the pain and disability caused by severe arthritis. Each year, about 32 million Americans visit their physician for having some form of arthritis. That’s about one in 10 Americans suffering from some form of arthritis pain.

Another reason is the excessive weight that a person may put on their knee or hip joints. Sadly, recent statistics show that more than half of Americans are overweight, and one in four are clinically obese. Consequently, knee and hip joints over time simply wear down from having to carry excessive body weight.  The fact is, the human knee and hip joints were never really designed to carry a 300 pound body frame.

Most total joint replacements involve hip and knee joints; however, total joint replacement also can be performed on joints in the ankle, shoulder, fingers, and elbow.

Individuals with a total joint replacement still can lead active lifestyles. Exercise not only is important in the recovery process, but also in the years following the surgery. A proper exercise program can help restore mobility and strength in the joint.

Joint problems require joint specialists

The Joint Center at Orthopedic Institute brings specialists who are board-certified orthopedic surgeons who are fellowship-trained  in joint surgery. This can include non-surgical treatment to relieve joint pain, simple surgery to alleviate joint pain symptoms and restore motion, all the way to complete replacement of the damaged joint with an artificial joint implant.

The specialists at The Joint Center at O.I. are also trained in minimally invasive knee and hip replacement surgery, and make use of the most advanced surgical implants, such as Zimmer, Biomet, Depuy, and J&J.

The goal of the implant is to remove the damaged knee or hip joint and replace it with a mechanical implant that relieves pain symptoms, and enables the person to walk and run on the new joint.

Before even considering knee or hip replacement surgery as an option, generally the joint specialists at O.I. physicians will try to find other ways of relieving pain.

It is important to try other options before knee replacement surgery, however, since an artificial joint has a limited lifespan.  While it can vary, physicians will assume that a mechanical joint may only last for 15 to 20 years.  Additionally, when the old implant needs to be removed and replaced it is more complex surgery than the initial implant procedure. For this reason, physicians are very selective about who qualifies for joint replacement surgery.

Who qualifies for joint replacement?

Total joint replacement is reserved for the patient has not responded to, or will not benefit from, non-surgical treatment options or simple surgical options.

Knee replacement is also often reserved for those who are over 50 years of age who are in good health.

Who is not a candidate?

For some people, joint replacement may not be the right course of treatment.

Patients who are too young, in their thirties and forties, should first consider and exhaust all other types of treatment for knee pain, since after 15 or 20 years, the implant will need replacing.

In a second surgery, for knee replacement, the leg bones is cut shorter, which can affect mobility after the second operation.

Knee Replacement Surgery

Quality of life is never to be underestimated and when a knee problem is so debilitating that it is impossible to enjoy hobbies that are important to you like gardening or playing with your children or grandchildren, than it is crucial to seek medical help.

Fortunately, before even considering knee replacement surgery as an option, generally physicians will try to find other ways of assuaging the pain. For instance, physical therapy, analgesics and walking aids might be the answer to many knee problems including those stemming from arthritis.

However, it is also nice to know that when other treatments prove to be futile, knee replacement surgery is an option. So prevalent is this surgery, in fact, that over 250,000 knee surgeries are performed each year in the United States alone. It is estimated that in 2040, more than 500,000 knee and hip replacement surgeries will be performed due to the influx in aging Baby Boomers. Knee replacement will help renew the ability to participate in several fun, day to day activities such as gardening, going on walks, golfing, and overall mobility. It is important to try other options before knee replacement surgery, however, since they only last for 15 to 20 years and are not easily replaced. For this reason, physicians are very selective about the types of candidates for the surgery.

So, who is a candidate?

Knee replacement is a procedure generally reserved for those who are over 60 years of age who are in relatively good health, aside obviously, from their knee pain. In fact, 72 percent of knee replacements are done on those over the age of 65. Generally, this means, they maintain a healthy weight, they do not suffer from cardiovascular problems, and they are not suffering from a terminal illness.

Active knee replacement candidates will find it comforting to know that they will be able to resume some athletics following surgery such as golf, swimming, and walking. Some knee replacement recipients have even continued to play tennis and snow ski. Unfortunately, a knee prosthesis is not quite as effective as a healthy, natural knee, however it will be a great improvement over the preoperative pain and discomfort.

Who is not a candidate?

To receive knee replacement surgery, you must be a good candidate. If not, surgery could prove counterproductive. For some, knee replacement surgery is not in their best interest. Those who are too young, with the exception of those who suffer from severe rheumatoid arthritis, should consider other types of treatment for knee pain since after 15 or 20 years, the prosthesis will need to be replaced. Unfortunately, the bone will need to be cut short to make room for a new prosthesis and function and mobility is likely to be damaged during the second operation. Those who are overweight are not good candidates as the prosthesis (just as the natural knee) is designed to carry a weight in proportion to the person’s body. Too much weight on the prosthesis can cause it to be damaged and subsequent knee surgeries will be necessary. Those with cardiovascular problems and with terminal illnesses are also not good candidates as the surgery may be too much for the body to handle. Also those with poor skin coverage over the knee are not good candidates as surgery could impair movement of the knee.

[Top]

About Hip Arthroscopy

The hip arthroscopy (or “hip scope”) procedure has been slower to develop in the United States than arthroscopy of the knee and shoulder because the hip is deeper in the body and less accessible. Additionally, because the hip is a “ball and socket” type joint, it is necessary to use traction in order to expose the joint enough to fit the surgical instruments inside the joint without causing further damage to the cartilage and labrum.

A “hip scope” or arthroscopy is a minimally-invasive procedure. The procedure is done using 2-3 small incisions (approximately 1/4-1/2 inch long) rather than a larger incision as used in a typical “open surgery”. The small incisions are used to insert the surgical instruments into the joint.

A fluoroscope, or portable x-ray, aids the surgeon during the surgery to ensure that the instruments and arthroscope are inserted properly.

The long thin camera, also known as arthroscope, allows the surgeon to view the inside of the joint. Tools known as “shavers” allow the surgeon to cut away the frayed cartilage or labrum that is the source of pain. The shaver is also used to shave away the of bone pieces that are responsible for the cartilage or labral damage.

A “hip scope” is normally performed as an “outpatient” surgery, allowing the patient to recover at home. Normally, the patient is under local anesthesia, meaning the patient is numbed only from the waist down and a breathing tube is not required.

Following the procedure, patients are usually given crutches to use for the first 1-2 weeks to minimize pressure on the hip. Sutures are typically removed about a week after surgery. Following this appointment, patients often begin physical therapy that improves strength and flexibility in the hip. Many patients can return to normal activities after six weeks of physical therapy, however it may take 3-6 months for the individual to experience no soreness or pain following physical activity.

So, who is a candidate?

Patients who respond best to hip arthroscopy are active individuals with hip pain, where there exists an opportunity to preserve the amount of cartilage they still have. Studies have indicated that 85-90% of hip arthroscopy patients return to sports and other physical activities at the level they were at before their onset of hip pain.

Who is not a candidate?

Patients who have already suffered significant cartilage loss in the joint may be better suited to have a more extensive operation, such as a hip replacement.

[Top]

Walter O. Carlson, M.D. Evan N. Hermanson, M.D. Peter A. Looby, M.D. Matthew J. McKenzie, M.D. Peter K. Rodman, M.D. Corey P. Rothrock, M.D. Robert C. Suga, M.D. Timothy M. Zoellner, M.D.

Orthopedic Institute Sioux Falls has clinic locations in Brookings, Dell Rapids, Flandreau, Freeman, Huron, Madison, Mitchell, Vermillion, Yankton and Sioux Falls South Dakota. With additional clinic locations in the Iowa cities of Rock Rapids, Rock Valley, Sibley as well as a location in Marshall, Minnesota. Orthopedic Institute is the largest orthopedic specialty group in the region. In addition to general orthopedics, areas of focus include back and neck pain, leg, foot, and ankle, knee or hip pain, as well as shoulder, arm, and hand problems. The group also specializes in knee and hip joint replacement, pediatrics, and offers physical medicine and physical therapy.

NO PHYSICIAN REFERRAL IS NEEDED UNLESS REQUIRED BY YOUR INSURANCE

Quick navigation links:

About Us | Treatment | Conditions | Educational Resources | Contact Us | Site Map

Educational illustrations and content Copyright © 2009 Prizm Development, Inc.
Web design & Copyright 2009 © Prizm Development, Inc.
www.prizmdevelopment.com