Birmingham Hip Resurfacing System

Hip replacement surgery has long been used to treat patients whose hips have been damaged by arthritis, fractures, trauma, dysplasia or avascular necrosis. Over the course of past decade, hip resurfacing has been developed as a high-performance surgical alternative to traditional hip replacement surgery used for severe arthritis of the hip joint.

In recent years, Birmingham hip resurfacing has emerged as an exciting new alternative to total hip replacement.

Birmingham Hip Resurfacing System
Birmingham Hip Resurfacing is the first hip resurfacing system approved by the FDA for use in the United States. Approved on May 9, 2006, this innovative system is now widely used in the United Kingdom and 26 other countries.

Its bone-preservation approach, globally proven results and state-of-the-art design together have made this new resurfacing system a huge hit among worldwide patients with end-stage arthritis of the hip. The system has been implanted in 125,000 hip arthritic patients around the world.

Mechanism
Birmingham hip resurfacing is a safe and effective metal on metal resurfacing system, in which an implant is surgically placed to replace an arthritic hip joint. It is a two-part system involving a socket in the shape of a shallow cup that fits into the hip socket (acetabulum), and a cap in the form of a ball head.

In the surgery, the orthopedic surgeon shaves off, instead of cutting of, only the worn surface of the femoral head (ball) and implants a cobalt-chrome metal cap over the resurfaced ball of the femur.

The major difference between resurfacing and a hip replacement is the amount of bone that is preserved or removed during the surgery. The system is designed to conserve more bone than a traditional hip replacement. Essentially, this technologically advanced surgical procedure removes only the diseased surface of the head.

While implanting the resurfacing prosthesis, the surgeon resurfaces just a few centimeters of bone, retaining the healthy bone in the hip joint.

The younger, athletic baby boomers who have worn out their joints too soon can benefit from this system's conservative approach to treatment. What makes the procedure more ideal are the virtual elimination of dislocation and excellent survivorship.

It is not suitable for female, patients of child-bearing age and the adults over 60 who are not so active. However, the elderly who are living non-sedentary lifestyles may also be may be good candidates.

Complications
If not taken care of properly, the resurfaced hip joint can wear, which may result in an increase in metal ions in the patient's blood and urine.

Also, femoral neck fracture can occur. The improper prosthetic seating or misalignment of the device can increase the risk of fracture. Risk of hip fracture is twice as high in women as in men.

Femoral component loosening is another complication that may occur due to inadequate fixation of the prosthesis.

The risk of metal hypersensitivity is common in patients who have undergone arthroplasty.

Femoral neck narrowing and higher-grade heterotopic ossification (HO) are the other complications associated with this surgery.

Precautions
Birmingham hip resurfacing surgery requires special care during the first few months following the operation.

Mentioned below are some precautions you should consider in the first six to 12 months, which are the most vulnerable for the new hip joint.

Avoid heavy lifting.
Do not bend forward to pick up things or reach your feet.
Do not participate in high-impact activities like jogging or jumping.
Do not twist or cross your legs.
Try not to lift your knee higher than your hip.
Avoid extreme movements of the hip.
Keep a pillow between your knees to prevent crossing of the legs while sleeping.
Lastly, strictly follow your surgeon's limitations on activity level for a successful hip resurfacing procedure.

Knee Joint Pain - How to Find Relief For Your Joint Pain

Do you suffer from constant pain the affects your knee joints? If you have a problem with your knee then you are one of millions of Americans who suffer from knee joint pain. Because the knee is used throughout your whole life on a constant basis, it is no surprise that many people are often inflicted with bad knee pain. This is usually a result of the wearing down of the cartilage that is in your knees. Once the cartilage starts to wear down, there is nothing that is protecting your bones from rubbing together.

Suffering from bad pain in your knee is no fun. There is nothing worse than constantly having a bummed out knee, especially if you are normally a very active person. A painful knee can often make people immobile due to the pain that they feel when they are on the go. The important thing to remember if you are experiencing pain is that there are many solutions that are available. You just need to find one that will work to alleviate your pain.

When it comes to knee joint pain, the main cause is usually arthritis. Medical professionals are split on why arthritis occurs in some people and why doesn't in others, however, they mostly agree that certain lifestyles will lead to the occurrence of arthritis more frequently. For example, if you are overweight then there is a good chance that you will put a lot of extra stress on your joints, which may in fact lead to some form of arthritis.

Long Term Effects of General Anesthesia - Just Sharing My Thoughts!

I am writing this article simply to share my experiences with others in hopes that it might give comfort to others that are experiencing similar things that I have had after surgeries. I am the first to admit that I am not an expert on this topic, but I do have first hand experience from surgeries that I have been through. I know that anesthesia is needed for most surgical procedures, but as with any drug that is administered the risk of side effects is always there.

Possible Side Effects of Anesthesia

Most doctors seem to focus on the short term side effects like nausea, vomiting, headache, fatigue, weakness, blurred vision, sore throat, dizziness, mood swings and unusual dreams. What about long term effects? I feel that the long term damage to the brain is a real problem that few doctors care to admit. Makes sense to me that shutting the brain down for a long period of time (say 2-6 hours just for example) cannot be good for overall brain function. I believe that an adverse effect as a result can come in the form of depression, mood swings, loss of memory and overall changes in the ability to think clearly.

The Effects of Anesthesia From Multiple Surgeries

I have worked in construction all of my life, and I have had numerous injuries which have required surgery. The first major one was a knee surgery in 1986 which lasted 6 hours and I had the hick-ups for 3 days after the surgery, (which was called a side effect). I was hospitalized for those 3 days and was given what they said was anti- psychotic medications to relieve this problem! I also had memory lapses and depression issues, which I blamed on the fact that I was out of work for so long to recover.

I have had four other surgeries since then:

1.right elbow repair from an old injury. (3 hour surgery) Oct.1990
2.left arm bicep repair. (2 hour surgery) June 1991
3 Right rotator cuff repair (4 hour surgery) Oct. 2004
4. Left rotator cuff repair (4hour surgery) July 2009

I have had many questions for years about the long term side effects of general anesthesia... which are based on my own experiences. This last surgery has me feeling worse than any of the others. Maybe it is due to the fact that I have been off of work so long, but I don't think that is all of it! I think the long term effects are stacking up from all of the surgeries.

General Anesthesia... the Necessary Medicine?

I know that all of my surgeries did require anesthesia. I know I would not have been to comfortable without the help of anesthesia. I am just hoping to bring to light by sharing some of my own experiences a need to do more research on helping others cope with these after effects. I have thought of myself as just not being strong enough to cope. After reading in forums on this topic I now realize I am not alone. After my surgeries in 1990 and 1991. I sought psychiatric help for this problem, and was prescribed Zoloft to help with the depression I was feeling. The cost for this drug was $100.00 per month at that time, and it made me feel like a zombie! The extra monthly expense was depressing me also... a no win situation! You need a drug to offset the after effect of the previous drug! Craziness in my opinion!

I am Choosing to Take a Different Path this Time!

I will be 57 years old next month. This last surgery in July of 2009 has been a blessing for me. It has opened my mind to all kinds of new ways of thinking. I am learning new computer skills and starting my own online business so that I can quit working construction. I am doing quite well, but my thought processes just aren't as sharp as they need to be when I talk to people. I know what I want to say, but it just won't come out of my mouth correctly! Not a good thing when trying to make a new business contact... people seem to be waiting on me to explain my thoughts! People are to busy to wait for me to talk.

I am battling depression big time, but I don't want to lean on prescription medications to get over that. I just started a vitamin and natural supplement program which I hope will help me to win this battle! I just don't trust the drug companies any more. I think they do more damage than good for people.

I have found some natural supplements that I believe will help me. I've been on them for one month now and it may be the "placebo effect" going on, but I do feel better. My mood swings aren't as severe. My bouts with depression are less frequent. I have never been a person to take vitamins in the past, but this time I just want to feel better. What have I got to lose? I hope now that I will be able to share some positive results with you in the months to come. Thanks for reading my article! I sure hope it helps someone else feel as though they aren't alone or crazy. Blessings to you!

Knee Clicking and Pain - 3 Things You Must Know About the Right Treatment For Your Knee

Have you ever heard that clicking or crunching in your knees when you walk or crouch down? For some of us, it has happened for so long that we have grown used to it and are now able to ignore it and just accept it as normal. For others of us, we have that feeling that something is not right but we're not quite sure what it is. And for still others of us, we experience pain around the front of the knee or just under the knee cap and are simply resigned to the fact that we have bad knees.

One of the main causes of this kind of knee pain is the knee cap. In fact, the knee cap is one of the parts of the body that we generally give very little thought to and many people actually don't know much about. Here we will explore 3 widely unknown secrets about the knee cap and why it gives you pain, discomforting and clicking or crunching noises.

1. Movement - The kneecap slides up and down a groove on the end of the thigh bone as the knee bends. The kneecap is designed to fit in the center of this groove, and slide evenly within the groove. However, in some people, the kneecap is pulled towards the outside of the knee. As this happens, the kneecap does not slide centrally within its groove. This can cause clicking or crunching noises when you walk for a long period or when you bend. Over time, this can lead to the knee cap becoming dislocated. If your kneecap has become dislocated, you will need your doctor or physiotherapist to provide you with treatment.

2. Pain Relief - In my own experience with knee cap problems following knee surgery, I was advised by my physiotherapist to strengthen my inner quad muscle. This would have the effect of pulling my kneecap back into proper alignment to allow it to slide in its groove smoothly again. I was also able to massage the knee cap to loosen it up so that it could move more freely without causing such discomfort. This is done by using a cream such as sorbolene and gently pushing the kneecap from the outer side of the knee in towards the opposite knee while the leg is stretched out straight. In fact, doing this at any time discomfort or tightness of the kneecap is felt can bring some immediate temporary relief. Focusing also on strengthening of the hip abductors and hip flexors offers better control of the kneecap.

3. Taping - One of the most helpful things you can do to reduce, and even eliminate, pain and discomfort due to knee cap mis-alignment is to tape it. This involves using a special type of tape that is used to pull the kneecap across towards the inner part of the knee and hold it there for an extended period of time, such as a full day, while you go about your usual activities. From first hand experience, this has been one of the most amazing ways to relieve knee pain resulting from kneecap problems.

Does Your Dog Need Knee Surgery?

Dear Val,

My little Annie was diagnosed with luxating patella on her back right leg. They have suggested operating. I am not wanting to go that route as she is so hyper that I do not think I can keep her calm etc for 6 weeks. Am going to get her cartilage shots for a month and see if that helps. Wondering what is the best decision? -- Sheila

Dear Sheila,

Thanks for your question and concern about your dear doggie friend, Annie. I've worked with many dogs in similar situations with good results. In fact, your story reminds me of another dog named Zena with this same problem that I wrote an article on.

With problems like this, it's wise to seek a vet's opinion, which you have already done.

The next thing is talk to your Annie. She needs to know what you're thinking. And, you need to know how she's actually feeling.

Many people get in trouble with their animals, even endanger their lives, by not communicating with them directly before making any decision on their behalf.

We need to know many things that only she can tell us. For instance:

Is this really a problem for her?

Does it hurt, and if so, how bad does it hurt and what does it feel like?

Are there other areas of pain or discomfort?

What makes it worse?

Does she want to have the surgery to fix it? Or is this more of a non-issue for her?

Many dogs have similar problems but live good lives without having the surgery done. And, doing surgery on her may in fact cause other problems or make things worse for her in some ways.

One dog I worked with had several vets and specialists insist that he had to have major surgery including hip replacement! It turns out that the real problem wasn't in his hips. The weakness in his hind end was due to a cracked vertebrae in his withers that no one had noticed before! Once that was addressed, his hips were fine. No surgery was needed. Had his owner gone ahead with the surgery she most likely would have had a paralyzed dog. Very scary.

I'm glad you are not entering into this without questioning and considering it very carefully.

Depending on what Annie says, you'll know what decision to make. If she wants to do the surgery, then she needs to understand that she has to be calm afterward and for how long. She needs to know why that's important and what could happen if she doesn't take proper care of herself. She needs to know how it would feel and look to do the surgery, and what to expect.

Also depending on what Annie tells us, you will need to know how to best help her, and what is working for her or not. For instance, we can ask her about the cartilage shots - are they helping or hurting? Does she know what they're for, what they are designed to do for her? And also important, can she tell if they are actually helping?

We also need to know if she feels strong enough to survive the surgery, and if there is anything you need to know before committing her to that course of action. There are other alternatives to surgery that may be equally successful, including many alternative healing therapies.

If Annie was my special friend, I'd want to invite her help in making this kind of decision.

Do you have a question for me? Go to http://www.valheart.com and let me know what's on your mind.

Arthritis and the Prevention of Arthritis

Your bones are exposed in a lot of joints. Knee joints. Hip joints. The joints in your fingers and the joints in your toes.

Wherever bones join, there is also cartilage, a rubbery, shielding layer that ensures your joints bend smoothly and painlessly. Even cartilage cannot fix this tremendous responsibility alone. A delicate covering called the synovium provides fluid to grease the moving parts of the joint. Once the cartilage wears away the synovium becomes inflamed, the end result is normally a case of osteoarthritis or else rheumatoid arthritis.

During osteoarthritis, the cartilage can remain eroded so much that bone rubs on bone creating a friction effect. As a result arthritis develops slowly but surely over a lifetime being a simple end result of the wear and tear placed on your joints over the years. Hardly any individual gets away from a certain degree of osteoarthritis, though the severity varies a significant deal.

Such as a matter of fact, if you are above the age of fifty, you are most likely to experience at least one location affected by osteoarthritis. Osteoarthritis affects men and women the same and is by far the main normal type of arthritis, with almost 16 million people in the world.

In the field of rheumatoid arthritis, destruction to the synovium is the source of trouble. Physicians and researchers aren't definitely certain what causes it, but the majority think that rheumatoid arthritis is a disease in which the immune system in fact attacks particular tissues in the body, together with those that join the joints and the synovium.

Rheumatoid arthritis begins with inflamed, red, stiff, and tender joints, but it might progress until scar tissue forms inside the joint or, in extreme cases, until the bones in fact fuse as one. Almost 75% of the two million individuals with rheumatoid arthritis residing in the United States are women. The disease can strike as young as the teenage years.

Exercising And Prevention To Help Control The Disease Before It Develops.

Investing a small amount of time in increasing a helpful weight-bearing low-impact exercise and stretching activity can add up to splendid results when it comes to starving off arthritis grief. Strong muscles help guard the joints from wear and tear, and the movement keeps joints flexible.

That's why the quest for fitness is at hand, even if you are fifty years and above. However, Americans over fifty are still exactly where they always were sitting back and watching others run or jog by. The majority of them contend that exercising is merely for individuals who have been in good shape all their life, or else a few say doing exercises is for young people and engaging in exercising will do them more damage than good.

Presently there are still several that insist on excusing them selves in working out routines since they don't just have time or they have not as much energy than they use to in the past. These are all lame excuses. Therefore, it is time to start to get rid of those pains and aches. Start an exercising routine now. But, before starting the routine make sure to consult your doctor.

Consequently, preventing or delaying arthritis isn't an exact science, but physicians have uncovered a few ways to decrease your risk. Here is how:

1. Don't weight around start exercising now it will payoff in the long run.

The single largest significant measure someone can take to prevent osteoarthritis of the knee is to lose body weight if they are heavy. Added weight puts additional stress on your knees. If you are 10 pounds overweight, for example, you put sixty pounds per square inch of additional pressure on your knees every time you take a step. That additional pressure can gradually but surely eat away at the cartilage in your knees, leading to arthritis.

A study has unmistakably supported the theory that weight loss weighs in on the boundary of prevention. Taking part in the study, obese women who lost 11 pounds or more over a ten year time decreased their chances of developing osteoarthritis of the knee by 50%.

2. Stretch those muscles by slowly exercising the joints.

Several kinds of stretching is fine as long as you don't bounce, or over do it, which can lead to a muscle sprain or pull. This is according to a few of the professors of clinical medicine in New York City.

Try to sustain a slow, steady stretch for 15 to 20 seconds, after that relax and repeat. It is best to loosen up all the muscles in the body by stretching before any exercise, especially running or walking. But, it is an additionally good idea to stretch each day. Ask your doctor to teach you stretches and exercises that focus on possible arthritis trouble spots, such as the knees, lower back. Hips, and legs and remember the weight loss prevention measures.

3. Stretching, Walking, or a slow jog for about 30 minutes is always the best exercises for arthritis prevention.

Take a good long walk at least three times a week for 30 minutes or take part in a step-aerobics or low-impact exercising routine for maximum results. There is no proof that running is bad for the joints just make sure you buy a good quality running shoe, but remember, it may irritate an injury if you already have one. Definitely remember to check with your doctor before starting a new exercise program of any kind including a stretching or low-impact exercise.

The bottom line is that of all the healthful practices you could do, exercise is the largely important one to keep all sorts of diseases down. This is because people are designed to be very active everyday. Therefore, it is really important for people to keep fit in order to stay healthy and keep those joints free from wear and tear.

Just keep in mind that an un-exercised body, even if it is free from the symptoms of illness and problems like arthritis, is not at its complete potential. Therefore, start exercising right now to fight off, lesson or prevent arthritis!

The Importance of Functional Rehabilitation Following Knee Injury

Injuries affecting the knee joint can cause considerable disability and time off sport. They are common in all sports that require twisting movements and sudden changes in direction. It is important to understand the role of the different ligaments and menisci in the knee joint in order to understand better the mechanisms of injury which will lead to form an appropriate rehabilitation programme. The knee injury of greatest concern to the athlete is the tear of the anterior cruciate ligament (ACL). The ACL is a tough fibrous structure that attaches the shin bone (tibia) to the thigh bone (femur). This ligament helps to stabilise the knee by preventing excessive forward movement of the tibia on the femur.

Clinical Features

Most ACL tears occur when the athlete is landing from a jump or when running, suddenly side-stepping or changing direction by decelerating. Occasionally, a tear will occur as a result of another player falling across the knee. It is often surprising to patients how a relatively simple movement can result in a torn ACL. At the time of the injury, the athlete may report hearing a "pop" and that it feels like the knee was being stretched apart. Most complete tears of the ACL are extremely painful, especially in the first few minutes after injury. Athletes are initially unable to continue their activity. Tear of the ACL is usually accompanied by the development of a haemarthrosis. This may be visible as a large tense swelling of the knee joint within a few hours of the injury. Examination of the knee is also very typical. There is often a loss of full extension of the knee and an inability of the athlete to weight-bear on the injured leg. Manual testing may reveal excessive forward movement of the tibia on the femur. Once the athlete is diagnosed with an ACL injury, they may undergo surgery to reconstruct the torn ligament, or rehabilitate the knee without surgery.

Functional Rehabilitation After ACL Reconstruction

Management principles have changed dramatically in recent years, resulting in greatly accelerated rehabilitation after ACL reconstruction. The traditional principle of complete immobilisation has been replaced with protected immobilization with a resultant dramatic decrease in stiffness and increase in range of motion of the knee joint. This has allowed earlier commencement of a strengthening programme and a rapid progression to functional exercises. Hence, the average time for rehabilitation after ACL reconstruction to return to sport has been reduced from 12 months to six to nine months.

Rehabilitation must commence from the time of injury, not from the time of surgery, which may be days or weeks later. The preoperative management aims to control swelling and restore full range of movement and adequate strength. Walking, swimming and the use of a bike is incorporated during this phase. The progression of the post-operative programme depends on the patient's determination, level of swelling and pain, and the progression of healing of the reconstructed ligament.

The second phase of the rehabilitation phase is to control swelling, regain full knee extension, improve quadriceps strength, hamstring length and increase proprioceptive input. Normal walking pattern can be achieved in this phase.

Phase 3 aims to achieve full range of movement of the knee, strength of the quadriceps and hamstring muscles, a full squat and the athlete may be able to return to straight line jogging and running. Some athletes progress rapidly in the post-operative phase, but full functional rehabilitation of the ACL may not occur until 6-12 months post-operatively. Functional testing should be used to help assess readiness to return to sport. Functional tests include agility tests, the standing vertical jump and the "Heidon" hop. The patient performs the heidon hop by jumping as far as possible using the uninjured leg, landing on the injured leg. Athletes with good function are able to land still. Those with functional disability step further or take another small hop. Another way of testing function is by incorporating sport-specific drills in the rehabilitation programme; for example, running forwards, sideways, backwards, sprinting, jumping, hopping, changing directions and then kicking.

Phase 4 of the rehabilitation programme includes high-level sport-specific strengthening as required and return to sport, progressing from restricted training to unrestricted training, and finally to match play. The therapist must be careful on the progression of the rehabilitation exercises and on the timetable for returning the athlete to their particular sport. An accelerated rehabilitation programme under a controlled environment allows the athlete to return to sport sooner without increasing the risk of complications.