| Frequently Asked Questions |
- What is Orthopaedics?
- The Body’s Frame
- Orthopaedic Disorders
- Vertebra
- What are some of the procedures we perform
as an Orthopaedic Center?
- Questions You Might Have About Heartland Orthopaedics & Sports
Medicine, L.L.C.
- Questions You Might Have About Joint Replacement & Your
Treatment Options
- Questions to discuss with your physician
- Should I have a joint replacement?
- What does an orthopaedic evaluation include?
- What causes my joint pain?
- If I have a joint replacement, how long will
I have to be in the hospital?
- Will I have to go to a physical therapist
after the surgery?
- What are the risks of joint replacement surgery?
- Can I have a joint replacement at my age?
- If I have a blood transfusion, what are my
chances of getting AIDS?
- How much blood would I have to deposit before
joint replacement surgery?
- What things can I do after joint surgery?
- What things can't I do after joint surgery?
- How long will the joint replacement last?
- #21Will my medical insurance pay for joint replacement
surgery?
- What should I do if I have more questions
|
1. What is Orthopaedics?
If you want to know just how complex and sophisticated your
musculoskeletal system is, ask someone who designs robots.
So far, nobody has come up with a “mechanical man” that
can match the human body for durable construction and fluid
movement. Hundreds of components fit together in an ever-changing
structure that gives the body its strength, stability and
mobility. And if you need help with a musculoskeletal problem,
ask a specialist in orthopaedics.
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2. The Body’s Frame
Two hundred and six bones comprise the human skeleton. It provides the frame
that muscles work against to produce movement and also protects internal organs
from injury. Bones get their strength from a hard outer layer composed mainly
of calcium and other minerals. Within the center of most bones, soft tissue
called marrow manufactures the body’s blood cells.
Bones come together in joints, some rigid and some that allow motion. Within
the joints, cartilage covers the ends of the bones to cushion and protect them.
Ligaments surrounding most joints connect the bones together. Posture and movement
come from skeletal muscles that are attached to the bones by tendons. Where any
of these components could rub against each other, fluid-filled sacs called bursas
provide protection.
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3. Orthopaedic Disorders
Movement and exercise, which help to keep the musculoskeletal system healthy,
can also lead to many of the problems treated by orthopaedic surgeons. Pain
and loss of function can come from excessive wear, injury or inflammation.
Some of the most common problems include sports injuries, pulled muscles, strained
ligaments and dislocated joints.
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4. Vertebra
Inflammation can result from tissue irritation or damage, or can be caused by
inflammatory diseases such as rheumatoid arthritis. The more common osteoarthritis
involves degeneration of the joints. Bones and joints can become infected,
causing serious debilitation if not properly treated. Non-cancerous tumors
in the bones are relatively common while cancerous bone tumors are rare. However,
bone cancer can spread to other tissues and organs.
The spinal column, made up of sections of bone called vertebrae, can require
specialized care for injuries, tumors and degenerative diseases. Scoliosis, which
is abnormal curvature of the spine, can begin in childhood and if severe can
result in permanent deformity.
Often, treatment for an orthopaedic condition involves relieving discomfort and
prescribing rest to allow the problem to heal. Hot or cold compresses, splints
and bandages can help this self-healing. Medications may be used to combat inflammation
or infection. More serious injuries or degeneration of joints may require surgery.
Successful replacement of severely damaged joints with artificial ones has become
commonplace. Various types of therapy help patients overcome the limitations
of orthopaedic disorders.
Our orthopaedic surgeons provide comprehensive care for people of all ages with
musculoskeletal injuries and diseases. Specialized areas of expertise include
treatment of spinal conditions and deformities in both children and adults, repair
of injured or impaired shoulders, treatment or reconstruction of damaged knees
and hips, and repair of hand or arm disorders and birth defects.
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5. What are some of the procedures we
perform as an Orthopaedic Center?
• |
Bone fracture repair |
• |
Bone graft |
• |
Bone-marrow transplant |
• |
Bunion removal |
• |
Carpal tunnel repair |
• |
Club foot repair |
• |
Hip joint replacement |
• |
Knee arthroscopy |
• |
Knee joint replacement |
• |
Lumbar spinal surgery |
• |
Replantation of digits |
• |
Shoulder separation |
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6. Questions You Might Have About Heartland
Orthopaedics & Sports Medicine, L.L.C.
• |
What type of procedures are offered in
this practice? |
• |
What hospital do you use? |
• |
Are procedures done in the office? |
• |
Do residents assist with surgery? |
• |
Do I need a referral? |
• |
Would you recommend the glucosamine and chondroitin
sulfate arthritis treatment? |
• |
What is injection therapy and is it right for me? |
• |
What is Synvisc? |
• |
What is Osteoporosis? |
• |
Where do I find information about my particular disease
or condition? |
• |
Do I need to take antibiotics if I have a joint replacement
prior to dental procedures or other surgery? |
• |
What can I expect pre- and post-operatively for arthroscopy
of the knee at your hospital? |
• |
How do I know if joint replacement is right for me? |
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7. Questions You Might Have About Joint
Replacement
& Your Treatment Options:
• |
How
do I know if joint replacement is right for me? |
• |
What
does an orthopaedic evaluation include? |
• |
What
causes my joint pain? |
• |
Should
I have a joint replacement? |
• |
Can
I have a joint replacement at my age? |
• |
If
I have a joint replacement, how long will I have to
be in the hospital? |
• |
Will
I have to go to a physical therapist after the surgery? |
• |
What
are the risks of joint replacement surgery? |
• |
If
I have a blood transfusion, what are my chances of
getting AIDS? |
• |
How
much blood would I have to deposit before joint
replacement surgery? |
• |
What
things can I do after joint surgery? |
• |
What
things will I be unable to do after joint surgery? |
• |
How
long will the joint replacement last? |
• |
Will
my medical insurance pay for joint replacement surgery? |
• |
What
should I do if I have more questions? |
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8.
Questions to discuss with your physician:
Our orthopaedic
surgeons can evaluate your condition and tell you if joint
replacement would be right for you. Before your appointment
with your orthopaedic surgeon, it can be very helpful to
write down the answers to these questions:
• |
Where
do I have pain? |
• |
When
do I have pain? |
• |
How
long have I had this pain? |
• |
Do
I have any redness or swelling? |
• |
What
daily tasks are hard to do now? |
• |
Did
I ever injure the joint? |
• |
Does
anyone in my family have similar problems? |
Thinking about
the answers to these questions before your appointment
and having your answers ready at the time of the appointment
can help your orthopaedic surgeon with your evaluation.
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9. Should I have a joint replacement?
When joint pain is severe and interferes with daily activities and work, joint
replacement may be an option.
The pain from arthritis and joint degeneration can:
• |
Be constant or it can come and go |
• |
Occur when an individual is moving or motionless for some
time |
• |
Be located in one spot or in many parts of your body. The
pain and the stiffness of joint degeneration may be worse during certain
times of the day, or after certain activities such as: |
| |
• Walking |
| |
• Climbing stairs |
| |
• Getting in and out of a chair
Individuals with arthritis may even feel uncomfortable or have pain while
resting or sitting in a chair or lying down. They may be uncomfortable
at night, and the pain may wake them up. |
| The pain of joint degeneration can limit many
everyday activities, such as: |
| |
• Walking |
| |
• Bending |
| |
• Going up and down stairs |
| |
• Getting in and out of a car |
| |
• Getting dressed |
| |
• Sexual activities |
Joint degeneration can eventually make it extremely difficult for individuals
to work and enjoy themselves. It also can make it difficult for individuals to
care for themselves.
If medications, changing everyday activities, and the use of walking aids such
as a cane are not helpful, joint replacement may be a treatment option.
More than 125,000 hip replacements and more than 140,000 knee replacements are
performed each year in the United States.
| In order to make informed
treatment decisions, you will need to know |
• |
What treatment options exist |
• |
Which of these options may be right for
you |
• |
What do these options really mean to you
today |
• |
What will these options mean to you in
the future |
| The decision to have joint
replacement surgery should involve: |
• |
You |
• |
Your primary-care physician |
• |
Your orthopaedic surgeon |
Once the orthopaedic surgeon determines that joint replacement surgery is a medical
option for you, it is still up to you to make the final decision, based on your
own assessment of pain and dysfunction.
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10. What
does an orthopaedic evaluation include?
Every orthopaedic evaluation is different. For example, there
are many tests an orthopaedic surgeon may consider when evaluating
a patient's condition. Some of these tests are listed below.
If you have questions during your evaluation, you should
talk to your orthopaedic surgeon or nurse.
The
orthopaedic evaluation usually consists of:
• |
A
medical history |
• |
A
physical examination |
• |
X-rays |
Occasionally,
additional tests may be needed to confirm that a patient's
pain is from the joint degeneration alone. During
the medical history, the orthopaedic surgeon or nurse
will ask questions about your general health, about the
pain you have and how it affects your ability to perform
daily activities.
The information gathered during the medical history usually
suggests several different possible causes.
What
the orthopaedic surgeon sees during the physical examination helps
confirm (or rule out) the possible diagnosis. Gait analysis (watching
how you walk) is very important. The orthopaedic surgeon will observe
you:
• |
Standing |
• |
Walking |
• |
Sitting Down |
• |
Laying Down |
During the physical examination, the orthopaedic surgeon evaluates
many aspects of your hips and legs including:
• |
Size and length |
• |
Strength |
• |
Range of motion |
• |
Swelling |
• |
Reflexes |
• |
Skin condition Your back may be examined because hip pain
may actually be the result of problems in the lower back |
The
X-rays help show how much damage or deformity exits. Abnormal
X-ray change may include:
• |
Narrowing
of the joint space |
• |
Cysts
in the bone |
• |
Spurs
on the edge of the bone |
• |
Areas
of bony thickening called sclerosis |
• |
Deformity
or incorrect alignment |
Usually your medical history, physical examination, and the
X-rays are enough for the orthopaedic surgeon to decide if
surgery is an option and if so what type of surgery may be
done. Occasionally, additional tests may be needed to confirm
the diagnosis or rule out other diseases that can cause similar
symptoms.
Laboratory
testing of your blood, urine, or joint fluid can be helpful
in determining the type of arthritis you have and in ruling
out other diseases.
Specialized
X-rays of the black can help confirm that hip pain isn't actually
coming from a back problem.
Magnetic
Resonance Imaging (MRI) or a bone scan may be needed to determine
the condition of the bone and soft tissues of your joint.
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11. What causes my joint pain?
Normally, all of the parts of the knee or hip joint work together
and the joint moves easily and without pain. However, diseases
or injury can disturb the normal functioning of the joint resulting
in:
• |
Pain |
• |
Muscle
weakness |
• |
Limited
movement |
Arthritis is one of the most common causes of hip and knee
disorders .Thirty-eight million people in the United States
suffer from arthritis. The most common types of arthritis are:
• |
Osteoarthritis |
• |
Rheumatoid
Arthritis |
• |
Post-traumatic
Arthritis |
• |
Paget's
Disease |
• |
Avascular
Necrosis |
For individuals with these types of arthritis, joint replacement
may be a beneficial therapy option.
Osteoarthritis is probably the most common joint disorder
in the world, affecting approximately 16 million people.
This type of arthritis usually occurs after 50 years of age
and frequently in an individual with a family history of
arthritis. Each year more than 5% of individuals who retire
from the work force retire because of osteoarthritis.
• |
Cartilage,
which normally acts like a cushion between the
bones, wears away |
• |
Bones
rub up against each other |
• |
Pain
and stiffness result |
Rheumatoid Arthritis is a disease that affects approximately
7 million individuals; women are affected about
three times more often than men. In addition to
affecting the joints, rheumatoid arthritis may
affect other organs of the body including the skin
and the heart.
• |
The synovial
membrane (the membrane that surrounds the
joint) becomes thickened
and inflamed |
• |
Too much
synovial fluid (the fluid that lubricates
the joint) is produced within
the joint space |
• |
Chronic inflammation damages
the cartilage and cartilage loss, pain, and stiffness
result. |
Post-traumatic Arthritis may develop after an
injury to the joint. The bone and cartilage do
not heal perfectly. The joint is no longer smooth
and these irregularities lead to more wear on the
joint Avascular Necrosis can result when bone is
deprived of its blood supply:
• |
The bone is no longer receiving
nutrition from the blood |
• |
The bone's structure weakens |
• |
The bone may collapse and
damage the cartilage |
Paget's Disease is a bone disease in which bone
formation is speeded up:
• |
The density and the shape of
the bone changes |
• |
Paget's Disease commonly affects
the hip |
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12.
If I have a joint replacement, how long will I have
to be in the hospital?
Every individual is different and every treatment plan is different.
The length of hospital stay after joint replacement varies
and depends on many factors including age and physical ability.
Usually patients are encouraged to stand and walk (with help)
a few days after surgery.
As the days progress, the patients usually becomes more independent
using two crutches or a walker. Physical therapists and nurses
give the patient instructions on:
• |
How
to get out of bed |
• |
How
to use the bathroom |
• |
How
to get dressed |
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13.
Will I have to go to a physical therapist after the surgery?
Your orthopaedic surgeon works closely with nurses, physical
therapists, and other health care professionals to ensure the
success of the surgery and rehabilitation. Following joint
replacement, the physical therapist begins an exercise program
to be performed in bed and in the therapy department.
The
physical therapist or another member of the staff works with
the indivdual to help the patient:
• |
Regain
muscle strength |
• |
Increase
range of motion |
Discharge
from the hospital depends, to some extent, on when the
patient "graduates"
from physical therapy. The physical therapist will
often give the patient a list of activities, exercises, and "do's
and don'ts"
when he or she leaves the hospital. In addition to the physical
therapist, an occupational therapist or nurse may work with
the patient to assist with special needs.
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14. What are the risks of joint replacement
surgery?
The complication rate following joint replacement surgery is
very low. Serious complications such as joint infection occur
in less than 2% of patients.
Blood clots are the most common complication. To prevent blood
clots following surgery, your orthopaedic surgeon may prescribe
measures such as:
• |
Special
support hose |
• |
Medications
to thin your blood |
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15. Can I have a joint replacement at
my age?
After the age of 80, some individuals may feel they are too old for joint replacement
surgery. However, these individuals should base their decisions on the quality
of their present life.
As long as an individual has reasonably good potential for walking after surgery,
then joint replacement may be appropriate, regardless of age.
Joint replacement was once limited almost entirely to individuals over 60 years
of age because these individuals usually subjected their new joints to less stress
than younger individuals.
Due to improved implants and techniques, increasing numbers of younger individuals
are receiving joint replacements. Currently, about one-third of hip replacements
are in adults less than 65 years of age.
Joint replacement is a highly effective and successful procedure. Close to 3%
of all individuals over 65 years of age have at least one artificial joint.
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16. If I have a blood transfusion, what
are my chances of getting AIDS?
Patients often are concerned
about the risk of infectious diseases from blood transfusions, and
the risk of AIDS is usually the primary concern. The risk of developing
AIDS from a unit of banked blood is approximately 1 in 40,000.
Although the risk of AIDS and other infectious diseases is very low, it is possible
to reduce this risk to nearly zero by depositing your own blood for use during
your surgery.
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17. How much blood would I have to deposit before
joint replacement surgery?
One to two units
of blood is the usual amount suggested for pre-deposit prior
to joint replacement. (Please check with your physician). This
blood can be deposited up to 42 days before surgery, but is
needed at least 14 days before surgery. After pre-depositing
blood, the patient is usually given an iron supplement and
a healthy diet is encouraged to ensure an appropriate blood
count before surgery.
Some patients may not be allowed to pre-deposit blood if they have conditions
such as heart failure, cancer, or anemia.
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18. What things can I do after joint surgery?
The vast majority of individuals who have joint replacement surgery experience
a dramatic reduction in joint pain and a significant improvement in their ability
to participate in the activities of daily living. However, joint replacement
surgery will not allow you to do more than you could before you developed your
joint problems.
You not be able to drive for a period of time, we will let you know when you
can resume driving your car.
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19. What things can't I do after joint surgery?
For approximately 12 weeks after surgery certain limitations are placed on your
activities. You will give you instructions about these limitations.
Remember:
It is very important to follow these instructions!
When fully recovered, most patients can return to work. However, some types of
work may not be advisable for individuals with a joint replacement.
These types of work include:
• |
Construction
work |
• |
Certain
types of carpentry |
• |
Occupations
that involve repeated high climbing |
Athletic activities that place excessive stress on the joint replacement will
need to be avoided. Examples of these activities include:
• |
Skiing
(snow or water) |
• |
Basketball |
• |
Baseball |
• |
Contact
sports |
• |
Distance
running |
• |
Frequent
jumping |
After joint replacement, acceptable physical activities should:
• |
Not
cause pain - including pain felt later |
• |
Not
jar the joint - running and jumping should be avoided |
• |
Not
place the joint in the extremes of its range of motion |
Joint wear and loosening increases with weight increase.
In addition, individuals with joint replacements may need to take antibiotics
before dental work (including dental cleaning) and any surgical procedure that
could allow bacteria to enter the bloodstream.
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20. How long will the joint replacement last?
The success of your joint
replacement surgery will depend on how well you follow your orthopaedic surgeon's
instructions during the first several weeks after surgery. It is impossible to
predict in individual cases how long a joint replacement will last. Many factors
determine the outcome including:
| • |
Age |
| • |
Weight |
| • |
Activity
level |
| • |
Bone
strength |
Loosening is the most common cause of failure with standard cemented joint
replacements. A small amount of loosening and bone loss is expected, but
if it reaches a certain degree then repeat surgery may be required.
Follow-up X-rays are very important because in cemented joints loosening
can occur without symptoms. In the early stages, this does not present a
problem, but if loosening is allowed to continue repair may be more difficult
with greater potential for complications.
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21. Will my medical insurance pay for joint replacement surgery?
Joint replacement surgery is usually covered by medical insurance, including
Medicare. You should check with your insurance company.
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22. What
should I do if I have more questions?
It is very helpful to take some time to write down all of your
questions before you speak with your health care provider. If you
have an appointment with your health care provider, remember to
take your list of questions with you. When speaking with your health
care provider, you may want to make a note of the answers to your
questions. We often forget exactly what we heard!
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