Health
Physician experts from the Danbury Hospital Center for Advanced Orthopedic Care project hip and knee replacements beyond 2008
By [unknown placeholder $article.art_field1$]
Nov 19, 2008 - 7:57 AM

When it comes to knee and hip wellness, wear and tear are the biggest concerns that may adversely affect these joints over time. Whether it’s from contact sports, countless miles of running or a progressing case of arthritis, hip and knee replacement surgery has become much easier for patients and doctors alike.

A frequently performed surgery, particularly in athletes, is called a meniscectomy, or the partial removal of the meniscus cartilage found within the knee. This is a minimally invasive arthroscopic surgery that can dramatically help the individual. However, 50 percent of patients who undergo arthroscopic meniscectomy will develop osteoarthritis.

Orthopedic surgeon, Dr. Lawrence Schweitzer spoke of how knee replacement surgery can improve the life of someone with arthritis. “If arthritis is affecting only one part of the knee, why replace the whole thing? Partial knee replacement requires much less surgery and is just as effective for the right patient,” Dr. Schweitzer said.

Because partial knee replacement surgery does not address the entire knee, some restrictions are placed on patients, which may not make them good candidates for the operation. The severity of arthritis must be limited and also focused only on the inner side of the knee, the patient must have a functional anterior cruciate ligament (ACL) and the patient should not suffer from obesity. Under ideal conditions a patient who undergoes partial knee replacement should be able to return to work within a month.

The wear and tear leading to osteoarthritis affects 23 million Americans. By the year 2020, the aging Baby Boomer generation will include 60 million arthritis sufferers. Speaking of the onset of this condition, Dr. Sanjay Gupta, orthopedic surgeon, highlighted the signs and symptoms.

Because cartilage lacks sufficient blood supply, it is very difficult to receive nutrients so cartilage found in the knee greatly benefits from synovial fluid. Every motion made by the joint pushes more nutrients into the area. However some repetitive motions such as running could have a negative effect after a long period of time because of repetitive impact.

Signs of osteoarthritis to monitor are constant aching, grinding or popping, giving out or buckling, stiffness in the morning, difficulty going up and down stairs and transient pain that usually occurs after being sedentary. “When you have tried losing weight, exercise, and over the counter medications and that hasn’t worked and you wake up in the middle of the night because of the pain, then its time to consider surgery,” Dr. Gupta said. “Hip and knee replacement surgery are for patients who can no longer live with the pain.”

Just as surgical procedures evolve, so do anatomical replacement parts. Dr. Robert Deveney, orthopedic surgeon, spoke of the history of total hip and knee replacement as well as some of the benefits to present day surgery.

In the 70’s and 80’s total hip and knee replacement surgery involved cement, bone cutting and at least two weeks bed rest. The ideal candidate could not be above 65 years old and could not weight more than 170 pounds. The individual who underwent this surgery also had many activity limitations as well. The hip and knee replacements done during this time had several problems. Continuous wear was still a factor, the joint would loosen or in some instances even break, and occasionally bone would deteriorate from the site of the surgery, which was later named “Cement Disease”.

Fortunately many steps have been taken to improve the surgery, increase longevity of the replacement, and reduce severe problems that can occur. Total hip and knee replacement in present day includes a three-day recovery in the hospital. The patient is usually able to drive within 2-3 weeks and have almost a full recovery between week three and four. There is much less cement, if any, used in these surgeries and the patient experiences much less pain during recovery. Patients also have a knee survivorship of 95-98 percent at 10-15 years with the potential of a replacement hip or knee lasting upwards of 30 years.

“The past was good, the present is great and the future looks outstanding,” Dr. Deveney said referring to total hip and knee replacement.

Just as much goes into rehabilitating a patient after surgery, the same effort goes into preparing the patient before surgery. Physical Therapist Frank Ripperger elaborated on the rehab process. The main goal of the rehabilitation process is to restore the quality of life the patient had before arthritis. This process also includes a pre-operative joint replacement surgery class that educates the individual on what hey or she can expect from surgery.

Physical therapy begins the day of surgery. In some cases, patients can stand up and walk the very same day. Physical therapy can range from outpatient to VNA home visits and short-term rehabilitation. In each type of therapy, the patient is expected to continue rehab training 3-5 times per week for 1-3 months.

Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with New York Medical College, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. It provides centers of excellence in cardiovascular services, cancer, weight-loss surgery, orthopedics, digestive disorders and radiology, with specialized programs for sleep disorders and asthma management. More than 95 percent of the medical staff are board certified in their specialties.

Danbury Hospital is ranked number one in Connecticut for Cardiac Surgery and in the top 5 percent of hospitals in the country for overall clinical performance by HealthGrades®, an independent healthcare rating organization, for 2005 through 2008. It is the only hospital in Connecticut ranked among the top 5 percent of hospitals nationwide for overall clinical performance four years in a row.

For more information about Danbury Hospital Medical Town Meetings and community health and wellness outreach programs, visit our website at http://www.danburyhospital.org.

© Copyright by StamfordPlus.com





© Copyright by StamfordPlus.com. Some articles and pictures posted on our website, as indicated by their bylines, were submitted as press releases and do not necessarily reflect the position and opinion of StamfordPlus.com, Stamford Plus magazine, Canaiden LLC or any of its associated entities. Articles may have been edited for brevity and grammar.