Tag Archives: Hip Replacement
Hip replacement
What is a hip replacement?Hip replacement, is an operation to replace a hip joint with an artificial (’ prosthetic’) hip joint. It is a common procedure and effectively relieves pain and restores mobility.Why might a hip joint need to be replaced?The hip is the joint that connects the thigh bone (the femur) to the pelvis. The hip joint is what is known as a ‘ball and socket’ type of joint. The upper end (head) of the femur is rounded and smooth so that it fits into a hollow cup in the pelvis. This arrangement gives the upper leg the very wide range of movement needed to walk, run, climb and jump.The hip is a ’synovial’ joint, meaning that it is enclosed by a ‘capsule’. The space within the capsule is filled with fluid, which allows the two bone surfaces to go smoothly over each other. The bone surfaces are also covered by a smooth substance called ‘cartilage’ to aid this movement. There are many reasons why a hip joint may need to be replaced. But, by far the most common reason for hip replacement is joint hurt due to arthritis. There are two major forms of arthritis, which are fully described in another factsheet. Rheumatoid arthritis is an inflammation of the joints that tends to affect women in early to middle age. Osteoarthritis is ‘wear and tear’ of the joint and most commonly affects the joints of elderly people. Both of these conditions can lead to destruction of the hip joint which results in pain and loss of mobility of the joint.The hip joint may also need to be replaced after injury. In older people particularly, the head of the femur can be broke in an accident and it may not be possible to repair surgically.A less common reason is death of the head of the femur. This may be from a number of causes, including sickle cell disease, trauma, excessive use of steroids and rare genetic conditions.What happens during a hip joint replacement?The replacement joint is an artificial version of the natural ball and socket joint. It has two separate components. The lower part is usually made of metal and is a shaft with the ball part of the joint at the top. The other part of the artificial joint is the socket which fits into the pelvis and this can be made of either metal or a special type of plastic.There are many different types of prosthetic hip joint, made of different materials and in different shapes. Improvements are being made all the time to strengthen and to perfect these artificial joints. The surgeon performing the operation will choose the type of replacement joint he or she feels is most appropriate for your condition and build.During a hip replacement operation, the surgeon first cuts through the skin and parts the muscle to get to the hip joint. The femur is then separated from its cup in the pelvis.The rounded head of the femur is then removed and replaced with the artificial substitute. The natural socket in the pelvis is opened out and the artificial socket inserted. Both parts of the artificial hip joint are strongly bonded to the normal bone using a special glue rather like cement.The ball and socket are then re- united and the muscles and ligaments repaired. Any final repairs to tissues are then made and the incisions closed.What are the preparations for a hip replacement?The hip replacement operation is carried out under general anaesthetic. This means you may be questioned to visit the hospital one to two weeks before the date of your surgery, to have a preoperative interview with a nurse and / or the anaesthetist. They will question you questions about your current and past health, and will need to know about any allergies you may have, medications you are taking (including over the counter products or vitamin supplements), previous surgery, whether you smoke or take street drugs, and how much alcohol you use. You may also be given a physical examination, during which your heart and lungs will be checked to make sure it is safe for you to have an anaesthetic. You may be given routine laboratory tests, such as urinalysis (tests of your urine), chest x- rays, or complete blood cell counts, as well as a hip x- ray. These should reveal potential problems that might complicate the surgery if not detected and treated early. No testing may be necessary if you are in excellent health and younger than age 65, but each clinic may have different requirements.Please answer all questions completely and honestly as they are questioned only for your own wellbeing, so that your surgery can be plotted as carefully as possible. If you are unsure of the names of any medications, bring them with you. You will be told whether or not to stop any medications at this preoperative clinic visit. For example, if you are taking aspirin-containing medicines or anticoagulants, they may need to be temporarily withdrawn or reduced in dose for two weeks before the procedure. If you can, try to stop smoking at least six to eight weeks prior to surgery.What are the possible complications?Hip replacement is usually very successful and can lead to an enormous improvement in quality of life. The operation can relieve constant severe pain and make it possible for people who had become virtually immobile to get about comparatively easily.One potentially serious complication is for the new joint to become infected. For this reason you will be given antibiotics when you have the operation and for a small time afterwards. If an artificial joint does become infected, it may have to be replaced. Surgery on the leg combined with immobility after the operation increases your chances of getting a blood clot in one of the veins in the leg (venous thrombosis). For this reason you will be given injections of heparin, a substance that helps prevent clots.Eventually, the artificial joint may need to be replaced, usually after about 10 years. The weakest point is the glue used to bond the artificial parts to the bone. Sometimes the bond can gradually loosen with time. If the joint becomes loose, surgery to repair it is necessary. But, constant research and development is leading to rapid advances in the design of artificial joints and methods of uniting them to the pelvis and femur.How long will I stay in hospital?The joint remains unstable for 1 or 2 weeks after the operation. The length of time you will stay in hospital will therefore depend very much on your progress and mobilisation in hospital, as well as your age and general health and how you are set up to manage at home. Mobilisation as early as is safely possible after the operation is generally recommended. Your progress should be discussed with your doctors, nurses and physiotherapists.What happens after a hip replacement?The joint and the muscles need time to settle down after the operation as at first the joint can easily become dislocated. You will be advised on how to go about mobilising yourself by your physiotherapist and on how best to sleep so as not to place undue strain on the newly replaced joint. The main point is to take things gently and delight in your new- found freedom of movement.
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Is it Safe to Exercise After My Back Surgery?
Many people want to, but have never been given any specific instructions or guidelines to follow regarding what exercises to do after surgery. Some surgeons believe the surgery itself helps right the problem. Most often than not, the problem was not addressed by the surgery. The surgery only addresses either a sign or symptom caused by the right problem. Most disc injuries and arthritic conditions develop and progress over a long period of time. Typically, if there is a traumatic event, such as a fall, a motor vehicle accident or job related injury, the body will heal itself over an unspecified period of time. On rare occasions, a traumatic back injury will require immediate surgery. There are always additional conditions that impact the health of the spine. Those conditions include the following, but are not exhaustive: * lower extremity muscle imbalances * weak abdominal and lower back muscles* restricted spinal range of motion* leg length discrepancy* gait asymmetry* improper biomechanics that are necessary for a particular job or sport* other physical limitations that effect the hip, knee, ankle, foot, and/or upper backAddressing these physical limitations, especially after surgery, are paramount to the success of the surgery. For example, if you undergo a lumbar fusion in which two vertebrae are fused together, the vertebrae above and below tend to be the targets of future potential injury. If the above conditions are not addressed, you run the risk of further injury and possible surgeries. Simple, simple to perform exercises can help eliminate those factors which can lead to further injury. The success of the surgery, in my opinion, is directly related to what happens after the surgery. More importantly, addressing the physical limitations prior to surgery may even eliminate the need for surgery, and if not, it will provide a excellent foundation for recovery following the surgery. What can I do?The first thing you need to do it question your surgeon, to give you a list of instructions, of the motions that you can and can not do and make sure that they indicate if they are temporally or are they for ever. For example If you have had a Total Hip Replacement there are motions, that you can never do and only your surgeon can tell you what they are based on the type of procedure and the hardware that they used.Where do I Start?Sounds like a simple question but there is are some considerations, Pain level, tolerance to activity, is the surgical site stable…the list of considerations can go on and on so lets imagine we get past all of the physical limitations and now we have to start were we are and how we are.What is the state of your physical being, to start you need to identify imbalances in your physical being, you must first be assessed or assess your self, looking for muscle imbalances and postural dysfunctions and then a well plotted corrective exercise program can be established.Why look for Postural Dysfunction after surgery?Postural dysfunctions, take into account the position of your pelvis and the curvature of your spine. The distress is, if your pelvis is not in the most neutral position you spine will have abnormal curvature and that abnormal curvature is what cause excessive ware and tear on the muscles, joints, ligaments and yes it can also cause the discs to start to bulge.The postural dysfunctions you have are also a factor in your recovery after surgery, please know that just because the bulging or herniation part of the disc was removed that does not mean the forces that cause the disc to herniated in the first place have been eliminated, that is not right.If you do not address your postural dysfunctions those same forces will start working on other discs in your back and the process will start all over again. That is why back surgeries have such a high failure rate after 5 years.The surgery very well many have eliminated the irritation that was on the nerve but it sure did not address the root cause of the problem. Please be sure that all measures are taken that the after the surgery your postsurgical pain is addressed as well as your postural dysfunctions.Is it Safe to do Exercises?Please know that the term “back pain exercise” is a misnomer, let me clarify, you would not want to exercise your back pain would you? NO, of course not, then you must have mean what exercises should you do to strengthen my back, well guess what that may not be what you need to do to get pain either.You see regardless of your condition and with in the limitations of your surgery your main focus need to be on getting your body back to a more neutral, more balanced and more stable state in order to insure that the surgery is a success.The best way to insure that is accomplished is to address your muscle imbalances and only do very specific stretches and exercises that are appropriate for you and your current condition and the only way to know what it is that you need to be doing is to assess your body as a whole looking at your posture What if my Therapist will not Address my Muscle Imbalances?If your therapist will not address your muscle imbalances then you need to do it on your own. The muscle balance therapy™ technique is widely becoming the standard as the best self care system available and should be considered if you have not had your posture assessed…You do not want to end up with yet another failed back surgery, simply because no one took the time to look at your body as a whole and look for the right root cause. Now that you have read this you have no excuse but to address it your self if no one else has helped you do it…
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