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The Do's & Don'ts after Hip Replacement

Dr Robert Lock — Tue, 13 Mar 2012 18:00:00 GMT

The following precautions will help to prevent the new hip joint from dislocating and will help to ensure proper healing.

The Don’ts:

Don’t bring your knee up higher than your hip.

Don’t try to pick up something off the floor while sitting.

Don’t turn your feet excessively inward or outward while bending down.

Don’t kneel on the knee of the non-operative leg

Don’t use pain as a guide for what you can do.

The Do’s:

Do keep the the affected leg in front of you as you sit or stand.

Do use ice to reduce pain and swelling, but remember that ice will diminish sensation. Don’t apply ice directly to skin; use an ice pack or wrap it in a damp towel. Do not leave ice packs on for longer than 20 minutes at a time.

Do apply heat prior to exercising to assist with range of motion. Use a heating pad or hot, damp towel for 15 to 20 minutes prior to beginning therapy. Diabetic patients should exercise caution with ice and heat to avoid serious injuries. Always use a timer to ensure that the heat or ice does not stay on for longer than 20 minutes.

Do kneel on the knee on the operated hip side.

Do keep the leg facing forward.

Do cut back on your therapy and exercises if your muscles begin to ache or become sore, but don’t stop doing them altogether. If you feel pain after 2 hours of exercise then back down the therapy or activity by half.

Questions about what you can do and not do? Call the office or ask Dr. Lock at your next appointment.

Knee Arthritis & Replacement

Dr Robert Lock — Tue, 06 Mar 2012 18:27:47 GMT

Arthritis, the leading cause of disability in the US, currently affects more than 46 million

individuals. Recent government research, published in late 2008, indicates that number

will rise to more than 67 million by the year 2030. Of those affected, the study

concluded that 1 in 2 individuals will suffer from knee osteoarthritis due to increasing

sedentary lifestyles and obesity.

Knee osteoarthritis (OA) is a wear and tear disease where cartilage and bone slowly

break down due to genetics, high loading forces or injury. Knee OA leads to pain,

swelling and stiffness. As the disease progresses so do the symptoms. In severe knee

OA individuals may have a difﬁcult time climbing stairs, walking and sleeping due to the

debilitating pain.

Physicians diagnose knee OA with history and examination and X-rays. In late stage

knee OA the health care practitioner may refer to the arthritis as “bone on bone”,

indicating that the protective cartilage surface has been worn completely away. In early

stages of knee OA individuals may be treated with medication, activity modiﬁcation,

exercise and weight loss. Research indicates that losing 10 pounds may signiﬁcantly

improve the symptoms of knee OA. Other treatments for knee OA include injections that

are given to decrease the pain and hopefully prolong any surgical intervention.

If non-surgical treatments are no longer providing adequate pain relief a knee

replacement surgery may be indicated. Each year more than 400,000 individuals

undergo knee replacement, which was ﬁrst performed in 1968. Knee replacement is the

resurfacing of the worn out surfaces of the knee with replacement of those surfaces with

metal and plastic. The goal of knee replacement is to eliminate or signiﬁcantly reduce

pain and to allow the individual to return to a more normal lifestyle.

In the last decade knee replacement surgery has increased by 65%. This increase has

led researchers to develop cutting edge technology in implant design and materials. It

has also led surgeons to develop new surgical techniques that drastically reduce post-

operative pain and shortens rehabilitation time. Modern knee replacements are hoped

to have a survivorship of 15-25 years depending on factors such as placement, loading

forces and use.

The most common risks involved in knee replacement are infection and post-operative

blood clots. Rehabilitation after knee replacement consists of walking and knee

exercises that promote strength and range of motion. Individuals are encouraged to

participate in low impact activities and to maintain a healthy body weight to avoid

excessive wear of the implant.

With current research suggesting a dramatic increase in knee OA in the next 20 years

individuals should be proactive in adopting a healthy lifestyle with exercise, activity

modiﬁcation to protect the knee joint and maintaining a healthy body weight.

When your Joints speak

Dr Robert Lock — Sat, 11 Feb 2012 23:23:24 GMT

Our newest billboard in Kingman and Fort Mohave features the tag line, "Is your knee trying to tell you something?" It's a lighthearted look at a very serious problem for millions of Americans. Knee arthritis affects both men and women and the symptoms typically do not improve over time. If you suffer from knee pain and swelling be sure to speak with your physician or make an appointment to determine the source of pain. There are multiple interventions that are available to help diminish the symptoms. Some things you might try doing on your own:

Lose Weight (Even a few pounds can make a big difference with pain)

Stay Active (Try low impact exercises like swimming and cycling)

Try Ice & Heat (Low cost option that can give good results)

Over the Counter NSAID or Tylenol

Joint Rest (just as important as exercise when the pain is more severe)

To learn more about knee arthritis visit the American Academy of Orthopedic Surgeons website geared toward knee arthritis & surgical options: www.saveyourknees.org

New Years Resolution: Get Moving!

Dr Robert Lock — Fri, 13 Jan 2012 17:30:00 GMT

Recent research from the Centers for Disease Control (CDC) has indicated that Americans are exercising more, however, those with arthritis tend to exercise less due to pain and decreased mobility.

The benefits of exercise for arthritis are well documented. Low impact exercise a few times a week will help to increase function, mobility, and overall mood. Make 2012 the year that you get up and get moving! Here are some suggestions for low impact exercises available right here in the Tri State area:

Yoga
Pilates
Water Aerobics
Walking in the Mall
Cycling
Ballroom, Belly or Line dancing

Try exercising with a group to help you stay motivated. Not sure which activity is right for you? Try them all. Most facilities and programs offer a free class just to try them out. Start out slow and work your way up to feeling better!

Complications after Knee Replacement

Dr Robert Lock — Fri, 30 Dec 2011 21:00:00 GMT

As with all surgical procedures certain risks are involved after knee replacement.

The complication rate following knee replacement surgery is low. Serious complications, such as joint infection, occur in fewer than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. Chronic illnesses, however, may increase the potential for complications. When complications occur they can prolong or limit full recovery.

Blood clots in the leg veins are the most common complication following knee replacement surgery (see picture). The AAOS recommends one or more measures to prevent blood clots from forming in your leg veins or, if they do form, measures to prevent them from becoming symptomatic. These measures will include support hose (TED hose), inflatable leg coverings (SCD’s), ankle pump exercises, early mobility after surgery, and a blood thinner (Aspirin, Coumadin or Lovenox).

After surgery you are at risk for Pneumonia. Your nurse will instruct you on the use of the Incentive Spirometer to help expand your lungs and significantly reduce your risk. You will also be asked to cough and deep breathe. Early mobilization and discharge are also effective ways to limit your risk of pneumonia.

Although implant designs and materials as well as surgical techniques have been optimized, wear of the bearing surfaces or loosening of the components may occur. Additionally, although an average of 120° of motion is generally anticipated after surgery, scarring of the knee can occasionally occur, and motion may be more limited, particularly in patients with limited motion before surgery. Finally, although rare, injury to the nerves or blood vessels around the knee can occur during surgery causing numbness or foot drop.

Activity following Knee Replacement

Dr Robert Lock — Fri, 23 Dec 2011 23:00:00 GMT

The Do’s and Don’ts following Total Knee Replacement:

Avoid repetitive heavy lifting
Avoid excessive stair climbing
Maintain appropriate weight
Stay healthy and active
Avoid "impact loading" sports such as jogging, downhill skiing, baseball, basketball, football, hockey, soccer, power lifting, hang gliding, rock climbing, gymnastics and high impact aerobics
Think before you move
Avoid any physical activities involving quick stop-start motion, twisting or impact stresses
Avoid excessive bending when weight bearing, like climbing steep stairs
Do Not lift or push heavy objects
Avoid kneeling
Avoid low seating surfaces and chairs
Do participate in activities including bowling, croquet, golf, yoga, thai chi, doubles tennis, table tennis, ballroom dancing, walking, swimming, rowing, water aerobics, line dancing, cycling, square dancing, belly dancing or Pilates.
Do cut back on your therapy and exercises if your muscles begin to ache or become sore, but don’t stop doing them altogether. If you feel pain after 2 hours of exercise then back down the therapy or activity by half the time.

How long will it last?

Dr Robert Lock — Fri, 16 Dec 2011 21:37:29 GMT

I often get asked the question, "How long will my new knee or hip last?"

Longevity of joint replacements vary from patient to patient. It depends on many factors, such as a patient’s physical condition, activity level, and weight, as well as the accuracy of implant placement during surgery. It is useful to keep in mind that prosthetic joints are not as strong or durable as a natural, healthy joint, and there is no guarantee that a prosthetic joint will last the rest of a patient’s life.

Today, joint replacement has become a common and predictable procedure. Many patients enjoy relief from pain and improved function, compared to their status before surgery. As a result, some patients may have unrealistic expectations about what the prosthetic knee or hip can do and how much activity it can withstand. As a mechanical joint, the hinge components move against each other. Natural fluid in the joint space, called synovial fluid, helps to lubricate the implant just as it lubricates the bones and cartilage in a natural joint. Still, the prosthetic components do wear as they roll and slide against each other during movement.

As with car tires or brake pads, the rate of wear depends partly on how the knee or hip joint is used. Activities that place a lot of stress on the joint implants, as may be the case with heavier and more active patients, may reduce the service life of the prosthesis. Implant loosening and wear on the plastic portions of the implant can lead to the necessity for revision surgery to replace the worn components, or all of the components.

CAS

Dr Robert Lock — Mon, 24 Jan 2011 03:18:00 GMT

Computer-assisted (CAS) joint replacement surgery uses special trackers that are attached to parts

of the bone. The trackers are detected by an infrared camera that is connected to a computer.

The computer then generates a ʻvirtual model of the extremity in real time.

The computer assists in guiding the placement of the implants and assists with positioning and correct alignment of the joint replacement. One of the most critical aspects of a joint replacement surgery is to ensure proper positioning of the implant. A misaligned implant can lead to early wear, loosening, and persistent pain. Similar to the alignment of the wheels on your car, a poorly aligned joint replacement will cause problems with early wear.

Standard referencing instruments conﬁrm the position of the hip or knee implant, however, the

computer provides an additional state of the art, real-time conﬁrmation.

Currently, I am using the computer with both hip and knee replacements with much success.

Welcome

Dr Robert Lock — Fri, 26 Feb 2010 01:48:03 GMT

Welcome to my blog. Please check back soon for new entries.