Total Shoulder Replacement Surgery: Symptoms and Procedure

People suffering from arthritis can develop pain in shoulder. Total hip replacement and knee replacement is well known among the masses. But a person suffering from severe shoulder arthritis can also undergo total shoulder replacement. It is the best solution to reduce the pain and improve shoulder motion in the person suffering from this situation. When an individual suffers from severe arthritis, movement of shoulder becomes quite painful and can even be restricted. The pain can be reduced by some medications but it is not the long term solution for the patient. So the best solution in such cases is total shoulder replacement surgery.

If a person is suffering from severe arthritis pain, movement is restricted then it is better for the patient to undergo this treatment. Shoulder joint replacement is the best solution for the treatment of severe arthritis of the shoulder joint. By undergoing Total Shoulder replacement surgery, patient can get relief from pain by replacing the damaged bone and cartilage with a plastic and metal implant.

Some of the symptoms of shoulder arthritis are:

• Limited motion of shoulder
• Swelling of the joint
• Pain with activities
• A feeling of grinding or catching within the joint
• Stiffness of the shoulder
• Tenderness around the joint

What is Shoulder Joint Replacement?

Total shoulder joint replacement is the procedure to replace bone and socket of the shoulder with metal and plastic implant to reduce pain and improve the movement in the patient. Orthopedic surgeon performs this surgery under general anesthesia. In this surgery, the surgeon replaces the ends of bones in a damaged joint. This helps to create new joint surfaces. Surgeons replace the ends of the damaged arm bone and the shoulder bone or cap them with artificial surfaces lined with metal or plastic. Cement is used to hold the shoulder joint component or other material that allows new bone to grow into the joint surface for the time being to hold in place of cement.

Orthopedic surgeons normally replace the top of the upper arm bone with a long metal piece that has a round head. If the cup-shaped surface of your shoulder bone that cradles your upper arm bone is damaged then doctors will smooth it and then cap it with a metal or plastic piece.

These days' surgeons use new methods for quick recovery. This method is called a reverse total shoulder replacement which is done on people who have severe painful arthritis in their shoulder. In this procedure damaged bone is removed and smooths the ends, and then the rounded joint piece are attached to the shoulder bone and use the cup-shaped piece to replace the top of the upper arm bone. Then stitches are taken to close this.

The patient recovers within 4 to 6 weeks of time. Shoulder replacement surgery is performed by skilled orthopedic surgeons in hospitals. Success rate of total shoulder replacement surgery is around 90 percent so individuals suffering from severe shoulder arthritis can undergo this surgery.

Lessons Learned From Three Knee Replacement Surgeries!

3 knee replacement surgeries in 3 years on the same knee! They even took the knee joint out and left it out for a month! Did I get your attention? Knee replacement surgery is pretty common today. Knee replacements help a lot of people and are a very successful operation. I am the exception to the rule! I tore the meniscus in my left knee when I was 18 and three years later I had surgery to remove the meniscus on the inside of my left knee.

About 30 years later the knee joint was down to bone on bone and painful. I went to three doctors and they all said the knee joint needed replaced. The surgery was done and after a year my knee was not working well. I was on crutches and in a lot of pain. I had a second surgery. The doctor said my body had made about three quarters of an inch of scar tissue. He said he thought that is why the first knee did not work right.

Two years later and I was back to crutches again. A third replacement was scheduled after lots of test. The doctors and myself devised a plan we thought would work. The knee joint was removed and left out for a month. I was put on intravenous antibiotics. After the month I had surgery and the new joint was put in. Everything seemed to work out good. After about two months it started going downhill. I have inflammation in the tissue around the joint. After more research and more tests we have come to the conclusion I'm allergic to the metal it's made out of.

The point of this whole story is I have never given up on life. As an example last summer we went to Pocono Raceway in Pennsylvania and did a ride along in NASCAR Race Car. That was exciting going over 170 mph. We just got back from a white water raft trip on the South Fork of the Payette River in Idaho. My wife and I both love to ride roller coasters and have been to numerous theme parks in the past few years. I still have fun in life and do a lot of exciting things with my lovely wife.

I am always ask by my friends why I am always so happy and have a positive attitude. What I have to remember is that I do not have to like what is going on in my life, but I do not have to be miserable because of it. The misery is optional! It is your choice. You can choose to be happy or miserable. I choose to be happy! Life is great!

This goes for about anything in my life. In this down economy I have to remember that I do not have to like what is happening in my life, but I do not have to be miserable. What's your choice?

Knee Replacement - Types, Benefits and Risks

If you are experiencing chronic knee pain and restricted knee mobility and you have tried all other treatments such as physiotherapy or steroid injections to get respite from pain and improve your knee mobility but to no avail, knee replacement may be the only option for you.

Knee replacement is a surgical procedure often recommended for patients with severe pain, stiffness and immobilization in their knee joint arising out of degenerative arthritis, osteoarthritis or some form of injury.

For severe cases where painful symptoms do not respond to conservative, non-operative treatments such as weight loss, activity modifications, anti-inflammatory medications or cortisone injections, replacement of the knee may only be helpful.

While performing the replacement surgery, the surgeon replaces the severely affected and destroyed part(s) of the arthritis knee with artificial metal or plastic devices called 'prostheses'.

Types
Depending on the severity of the damaged, worn or diseased knee, the replacement of the knee can either be partial or total.

Total Knee Replacement (TKR) is a highly successful surgical procedure which involves replacement of all three parts of the knee- inside, outside and the front of the knee.

While performing total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with an artificial implant made of metal or plastic that functions similar to a normal knee.

Partial knee replacement (PKR) is a minimally invasive surgery that may be considered if pain is present in only one of the knee's 3 compartments. When you have a PKR, the surgeon replaces only the single affected knee compartment located underneath the kneecap with a metal and plastic implant.

Benefits
Knee replacement can significantly reduce knee pain, improve muscle strength and correct deformities.
Following the surgery, you can return to your daily routine activities with a healthy new knee.
It can significantly improve the quality of your life with improved movement of the knee joint
After getting your knee replaced, you can walk without a stick and can carry out household chores such as dusting and washing up
You get rid of instability, disability and limited mobility of the knee
Your problems like chronic knee stiffness and swelling that prior to the surgery prevented you from bending and straightening your knee are completely alleviated
With less pain and greater mobility, you'll be able to perform low-impact activities including climbing stairs and getting in and out of car without the use of a support.

Risks
As with any surgical procedure, knee replacement also has some potential risks. Although most knee replacement patients do not experience serious complications, there are possible risks associated with the surgery. These complications and risks include:
Blood clots or deep vein thrombosis (DVT) in the veins in lower leg
Pulmonary embolism (a blood clot in your lung) is a possibility
Excessive bleeding and scarring at the site of incision
Damage to nearby blood vessels, bones or nerves, is also possible
Possibility of primary infection as well as a superficial infection
Urinary tract infection is likely
Adverse reactions to anesthesia
Failure/loosening of the knee implant may occur
Fracture in the bone around the replaced joint during or after the surgery

There are several other possible post-surgery complications, so it is vital to educate yourself about the knee replacement surgery before undergoing the procedure. Fortunately, majority of knee replacement surgeries are performed successfully and go without any major complications whatsoever. If performed by a skilled surgeon and if the new knee is cared for properly, it can last for many years.

If I Need a Total Hip Replacement, What Are My Options?

The information provided below is meant to educate the patient about the options available to hip replacement candidates. Your orthopedic surgeon should explain to you which hip replacement is best for you and why.

In a total hip replacement, both the thigh bone (femur) and the socket are replaced with implant materials and prostheses. Specifically, a metal stem is inserted into your thighbone. Attached to the neck of the stem is a hip ball, just over an inch in diameter. The hip ball fits into a liner. Together, the ball and liner create the new joint. The liner is inserted into a metal shell that in turn is anchored to your pelvis. But there are a number of different approaches a surgeon can take, depending on her analysis of your particular case.

Because of the advances in the last thirty years, several different types of implant materials have also been found useful in hip replacement procedures. Each material has its own advantages and disadvantages, but it is ultimately up to your surgeon which materials to use. Beyond the different types of materials, a surgeon must also decide whether to anchor the hip implant to the bone using cement fixation or something called "bone ingrowth."

Fixation

For bone ingrowth, the surface of the prostheses simulates the bone with a special granular surface into which the bone grows, thereby locking the implant into place. Cement fixation holds the implant in the bone by acting as a filler between the bone and the implant. It is made of a substance that is mixed at the operation and hardens into a durable, long lasting polymer.

Modularity

You may also want to consult with your doctor about the design of the implant. Modular systems offer the ability to interface different sizes of femoral heads to fit over the stem; angles, sizes, and lengths of the implant are made to fit your anatomy. The advantage of a modular system is that it gives the patient more flexibility.

Choosing Hip Replacement Implant Material

The main issue that doctors and patients confront when choosing implant material revolves around the wear debris that is released into your body from any of the implant materials. Even the materials with the most wear debris (metal ball and polyethylene liners) show up only after many years (10-15). Nevertheless, it is important to educate yourself about the various options for hip replacement surgery.

Metal-on-Polyethylene

Because of its durability and performance, Metal-on-Polyethylene has been the leading artificial hip component material chosen by surgeons since FDA approval 30 years ago. The metal ball is cobalt chrome molybdenum alloy and the liner is polyethylene.

Metal-on-Polyethylene is the most understood and practiced of all the procedures. Using these materials, a surgeon has a range of options to obtain stability in the body while the operation is underway. This ability to adapt and customize during the surgical procedure is an important attribute of polyethylene. It is also the least expensive bearing.

The disadvantage of Metal-on-Polyethylene is shedding over time. After 10 to 15 years, patients who are extremely active may shed debris that results in joint inflammation and bone loss. However, new wear resistant polyethylene liners have been introduced, called "highly crosslinked polyethylene." If you are a very active individual or a relatively young patient, your surgeon may prescribe an all-ceramic hip joint or all-metal hip joint.

Ceramic-on-Polyethylene

Your next option is a ceramic ball and polyethylene liner. Ceramic heads are harder than metal and are the most scratch resistant implant material. The hard, scratch resistant, ultra-smooth surface can greatly reduce the wear rate on the polyethylene bearing. The wear rate for this type of implant is less than Metal-on-Polyethylene.

One disadvantage found in Ceramic-on-Polyethylene are the incidents of fractures, but newer, stronger ceramics have resulted in fewer of these. Overall, the wear rate for Ceramic-on-Polyethylene is 50% less than that of Metal-on-Polyethylene.

In terms of cost, Ceramic-on-Polyethylene is more expensive than Metal-on-Polyethylene, but less than Ceramic-on-Ceramic.

Metal Ball and Metal Liner

Metal-on-Metal bearings were approved by the FDA in 1999, offering the potential for greatly reduced wear, with less inflammation and less bone loss.

One clear advantage of metal-on-metal implants is the variety of femoral head sizes and neck lengths available (modularity). Metal-on-metal components allow the largest heads throughout the entire range of implant sizes. Large ball heads provide increased range of motion and greater stability, which can significantly reduce the risk of hip dislocation, a crucial factor in the long-term success of an implant.

Although wear is reduced, the wear products (sub-microscopic particulates, soluble metal ions) are distributed throughout the body. This has raised concerns about long-term bio-compatibility. At present these are only concerns, for there have been no definitive clinical findings that these wear products are harmful.

Anatomic Size Metal-on-Metal Ball Heads

Because the human femoral (ball) head is naturally large, it makes sense to implant a large, anatomic replacement. This was not possible in the past because traditional polyethylene liners made smaller femoral heads necessary. However, with the introduction of metal-on-metal implant components, liners may be eliminated, allowing surgeons to use large femoral heads. Use of a larger ball head has been shown to increase the range of motion an individual may experience as well as decrease the possibility of dislocation.

Ceramic Ball and Ceramic Liner

Ceramic is the hardest implant material used in the body, and has the lowest wear rate of all, to almost immeasurable amounts (1000 times less than Metal-on-polyethylene). These implants have been used in Europe for more than 30 years, and since 2003 in the United States.

Consequently, there is usually no inflammation or bone loss, nor systemic distribution of wear products in the body. New ceramics offer improved strength and more versatile sizing options. However, there has been a very few incidents reported of noises from such implants.

Hip-Resurfacing Option

For younger patients, a total hip replacement may not be the best solution for their hip pain because it can mean difficult and numerous revisions later in life. Hip resurfacing, however, leaves more of the bone in place, giving these patients more time before a total hip replacement becomes necessary.

Conclusion

If you are a candidate for hip replacement surgery, fixation, modularity, and implant materials are all topics that factor into making the right decision. Your doctor should explain to you which procedure and materials are best for you.

ACL Knee Surgery May Not Always Be Necessary

If you are suffering from an ACL injury, you must now be wondering what you can do to get back the perfect condition of your knees. This might be crucial for you, especially if you are an athlete. Athletes undoubtedly need healthy knees to perform their best. But where do you have to start if you are looking for the type of ACL knee surgery that you need? Although it is vital that you consult a physician, it is also important that you take part in the decision-making of what can be done to your torn ACL.

The kind of treatment or surgery that will be appropriate for a person with a torn ACL all depends on how severe the damages to the ligament are. For instance, there are people who have had prior surgeries on the areas near the knees, so in their case, they may need some minor operations only, in order not to affect the previous injury. So to make it easier for you to understand your options in the treatment of your ACL injury, it is good to know how different all these treatments are.

First of all, you can choose not to do anything about your injury. The fact is that not only sportsmen can sustain a torn ACL. Even ordinary people doing ordinary daily activities can suffer from it. So if you don't think you need to do any physically stressful activities in the future, you may not necessarily have to have any surgeries. You will basically avoid the pain of the ACL knee surgery, and of course you will not need to spend so much on that. However, the downside of this will be the fact that you are in a very sensitive condition as far as your knees are concerned. You should not do anything that will put so much stress on your knees that can worsen your ACL injury.

On the other hand, choosing to undergo an invasive surgery will definitely relieve you from the pain that you may have to put up with in case you chose not to have it fixed. With the latest technology available today, it is no longer impossible for you to get back to playing within 6 to 9 months. There are also a lot of programs that promote the recuperation of the ligament after a surgery.

Whichever method you choose, you have to keep in mind that it is always better to avoid getting this injury. If you are an athlete, there are certainly a lot of physical training programs that will help strengthen your knees so that they will be less prone to ACL tear. You wouldn't want to have only the ACL knee surgery as your option, would you?

Hip Replacement Exercises - Pre & Post Surgery Hip Exercises

A diagnosis of osteoarthritis of the hip generally progresses to the likelihood of requiring a hip replacement in the near future. As the degenerative condition advances, it causes a decreased range of motion, pain, muscle weakness, gait changes, and tight muscles. Specific exercises designed for hip arthritis can help maintain range of motion at your joint, prevent loss of muscle, stretch muscles that will become tight, and lubricate the joint to decrease stiffness and pain. In addition, performing exercises prior to surgery will speed up your recovery post operation.

Goals of a Hip Arthritis Exercise Program - Pre Operation:

There are two main goals to target with a pre operation hip arthritis exercise program. One is strength of the gluteal muscles and the other is to maintain range of motion by working within your pain free range. There are exercises that work both of these goals simultaneously. The gluteal muscles are extremely important to strengthen pre operation because they comprise the stability of the joint. Ironically, arthritis causes pain, decreased range of motion, and therefore less weight bearing which all contribute to atrophy, or shrinking, of the gluteal muscles. Therefore, it is paramount to actively engage in specific strength exercises that target these muscles. Although strength and range of motion are highlighted as the priorities here, cardiovascular or aerobic conditioning is also extremely important. Usually due to pain and decreased range of motion, both walking and overall activity are reduced drastically which negatively lowers an individual's aerobic capacity. Using stationary bikes or participating in water classes are excellent non weight bearing options to keep your cardiovascular conditioning strong.

Hip Exercises Post Surgery

There are a series of exercises your physiotherapist will guide you through immediately post operation. They will guide you through an exercise program that will be safe with the goal of returning you to full function in daily activities. This program will last up to 6 to 8 weeks post operation. A lot of patients stop the exercises once they are discharged or released from the supervision of their physiotherapy. It is imperative that you continue hip strengthening exercises in a progressive format for at least one year post operation. Patients that have continued with an exercise program consistently for a full year post operation, receive amazing results in functional ability.

Goals of Hip Arthritis Exercise Program - Post Operation:

Follow the exercise program guidelines given to you by your physiotherapist for the first 6 to 8 weeks post operation. The post operation exercise program varies from the pre operation program on three aspects which include the following: range of motion stretches have to be modified to follow restrictions that protect your joint from dislocation, strength exercises will progress to weight bearing, and one leg balance exercises along with gait retraining become a priority. Post surgery, the goal of your exercise program should be to progressively advance your strength exercises, when your body is ready, from isolated muscular endurance exercises to dynamic, functional exercises. Again, the most important muscles to strengthen post operation are your gluteals. Your exercise program should also include quadricep strengthening and core stability exercises. When you are selecting exercises, it is highly advised to select unilateral or one limb exercises in order to make the strength equal across limbs.

The journey your muscles have endured from the pre surgery pain through the operation leaves them tight and contracted in a shortened position. Therefore, stretching is equally important to include in your post operation exercise program. Often the hip flexors, hamstrings, and quadriceps will be tight post operation and need to be stretched. The very exciting aspect of the post operation exercise program is that you are pain free and therefore can gradually increase your cardiovascular training time and intensity to your pre arthritic conditioned level.

When you are disciplined at consistently keeping up with your exercises and gradually progress through incremental stages of exercises, you will notice huge improvements in your cardiovascular, strength, flexibility, balance, gait, and overall functional ability. The importance of engaging in a regular, consistent exercise program both pre and post hip operation will impact your full recovery greatly. A hip exercise program is the best single action you can take to encourage a highly successful return to function post surgery.

Wearing Support Stockings After Knee Replacement Surgery

Knee replacement surgery is an invasive procedure that involves removing the damaged joint and inserting an artificial knee joint in its place. Afterwards, most patients undergoing total knee replacement surgery are told by their doctors to wear compression stockings. Compression garments are meant to improve blood flow in the part of the body where they're worn. When it comes to knee replacement surgery, thigh-high support stockings are worn daily during recovery to assist in improved circulation.

Purpose
After knee replacement surgery, patients must stay off their feet for a few days, although foot, ankle and leg motion exercises are recommended to assist in stimulating blood flow. The compression stockings are used to improve blood circulation and minimize the risks of blood clots. They also help to keep swelling down. The patient's orthopedist or surgeon can recommend the proper size and type of support socks, including how long and how often they should be worn. Incisions may run about six inches to a foot long and will be sutured or stapled shut. The patient wears a dressing over the wound until it heals. The compression stockings can be worn over the wound dressing.

Duration
Recovery from knee replacement surgery lasts several weeks to several months. Within a few days of surgery, patients will learn from a physical therapist how to move their new joint and begin a program for standing and walking. Most patients are released from the hospital once they are able to get in and out of bed and walk with the assistance of crutches. The stockings should be worn for longer periods of time in the beginning, with the patient following the doctor's recommendations on how long to take them off and when to keep them on. After a time, they will only be worn during the daytime, and eventually may not be needed, depending on the individual.

Style
Support Stockings after knee replacement surgery typically pull up to the thigh. There are support knee-highs and waist-high styles also available, but due to the location of the surgical site, the blood flow is not normal at the knee and must be stimulated.

Changes in Time
The early days of compression hosiery began with thick white stockings with bold seams running down the back of the legs. They were often toeless, made of a rubber blend and smelled funny. Today's compression stockings come in white, beige and black. The seams and toes are optional and the material is more likely made of a nylon blend. While some brands still use rubber components, it is more likely a small percentage of silicone rubber in a weave with nylon and other stretchy fabrics. While some patients find their feet smell funny, it is often when they are cooped up in shoes or slippers that don't breathe. Lotion on the feet or powder in the shoes will help to alleviate foot odor.