HIP AND KNEE

 It is a degenerative condition, a “wear-and-tear” disease, in which the cartilage in the knee joint gradually wears away, enabling the bones to rub together. The common symptoms are pain, stiffness, a grating or creaking sensation, and swelling.

There is no cure for osteoarthritis. But treatment can help you deal with pain and stiffness, improving your quality of life. Initial treatment of knee osteoarthritis is nonsurgical. The goal is to improve the way you move and decrease your pain.

• Reduce the amount of weight on the knee by: 
  • maintaining a healthy weight. (You might need to lose weight.) 
  • using a cane, crutches, or a walker. 
• Changes in your daily life can help you manage your knee osteoarthritis: 
  • wearing a knee brace.
  • limit the activities that aggravate the condition, such as squatting or climbing stairs. 
  • sitting to do activities instead of standing.
  • switching from activities with high impact on the knees like running to lower impact activities like swimming and other water sports.
• Physical Therapy: 
  • your physiotherapist will help you with exercises to strengthen your thigh and leg muscles.
  • exercises to maintain the range of motion and flexibility are encouraged.
  • if you have balance and coordination issues, these will be addressed by the physiotherapist.
• Take medicine, it might help. But talk to your doctor before you start taking anything new. Some of the kinds of medicine used to treat knee OA include: 
  • acetaminophen, such as Tylenol Arthritis Formula. 
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as over-the-counter ibuprofen (Advil) or prescription-required Celecoxib (Celebrex).

Remember that these drugs may only be used for short periods of time.

• Injections: 
  • corticosteroid injections provide pain relief but are limited to three to four per year due to possible side effects.
  • hyaluronic acid injections provide extra lubrication and usually improve the pain for a few months.

Surgery may be suggested if you have pain that limits your daily activities and other treatments have not helped.

The type of surgery will primarily depend on your age and how damaged the knee joint is. Your surgeon might suggest:

• Osteotomy – is usually done for younger patients with only one side of the knee joint damaged. Most patients will need a Knee Replacement in the future.
• Knee Replacement- your surgeon removes damaged bone and cartilage at the end of the femur (thigh-bone) and top of the tibia (shin-bone) and replaces them with prosthetic components made of metal and plastic. The goals are to relieve the pain and improve knee function.

The recovery period is different for each individual, but in general, patients resume daily activities within 3-4 months. And most patients can safely drive after 6 weeks. However, it may take 6-12 months to fully recover. Your surgeon and physiotherapists will guide your return to activity.

Total knee replacement, also called Total knee arthroplasty, is a surgical procedure in which damaged articular cartilage and adjacent bone are removed and replaced with artificial parts made of metal and plastic.

The most common reason for surgery is to reduce patients’ pain. It is also performed to help patients with limited knee function which usually leads to improvement in activities such as walking or climbing stairs.

In summary, during knee replacement surgery, the surgeon makes an incision, removes damaged bone and cartilage from the femur and tibia, and replaces them with prosthetic components (implants) made of metal and plastic. These implants are placed, and an x-ray is taken to ensure the correct position. The incision is closed, and a bandage is applied.

Patients are encouraged to begin ambulation right after surgery, with the aid of an assistive device. But they will need help with everyday activities for the first 3-4 months. Physiotherapy starts after the first postoperative visit and lasts 6-10 weeks for most people. It takes something around 6-12 months to fully recover.

After proper rehabilitation, low-impact activities such as swimming, walking, cycling, water aerobics, dancing and golfing are recommended. However, patients should avoid jogging/running, contact sports, heavy lifting and sports that require twisting/pivoting.

Osteoarthritis (OA) is a degenerative joint disease that causes gradual damage to the joint. The deterioration of the cartilage of the hip joint makes bones rub together and over time joint damage increases. Common symptoms are a pain in or near the hip joint, limited range of motion, and joint stiffness.

There is no known cure for OA, but treatments can reduce pain and help you move better. Your doctor will recommend non-surgical treatment as a first option.

• Changes in your daily life can help you manage your hip OA: 
  • limit the activities that aggravate the condition, such as squatting or climbing stairs. 
  • sitting to do activities instead of standing.
  • switching from activities with high impact on the hips like running to lower impact activities like swimming/cycling and other water activities.
  • Weight loss, if needed, may reduce pain, and improve your mobility.
• Supportive devices:
  • cane, crutches, or a walker provide extra stability. 
• Physical Therapy: 
  • your physiotherapist will help you with exercises to strengthen your thigh and hip muscles.
  • exercises to maintain the range of motion and flexibility are encouraged.
  • if you have balance and coordination issues, these will be addressed by the physiotherapist.
• Take medicine, it might help. But talk to your doctor before you start taking anything new. Some of the kinds of medicine used to treat hip OA include: 
  • acetaminophen, such as Tylenol Arthritis Formula. 
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as over-the-counter ibuprofen (Advil) or prescription-required Celecoxib (Celebrex).

Remember that these drugs may only be used for short periods of time.

Surgery may be suggested if you have hip pain that limits your daily activities and other treatments have not helped.

Your orthopedic surgeon will recommend a surgery called a hip replacement (or hip arthroplasty). This is an established procedure with well-known results.

Hip replacement – your doctor will remove the damaged acetabulum cartilage and femoral head and replace them with prosthetic components made of a combination of metal, plastic, and ceramic. It’s an effective procedure that can relieve your pain and improve your quality of life. 

The recovery period is different for each individual, but on average, patients resume daily activities within 3 months. And most patients can safely drive after 6 weeks if it was the right hip. However, it may take 6-12 months to fully recover. Your return to activity will be guided by your surgeon and physiotherapists.

Hip replacement, also called hip arthroplasty, is a surgical procedure in which damaged parts of your hip are removed and replaced with artificial implants (prostheses) made of metal and plastic.

Surgery might be an option if you have pain and limited hip function that interfere with daily activities and nonsurgical treatments are no longer effective. The most common reason for having a hip replacement is joint damage by osteoarthritis.

During hip arthroplasty surgery, the doctor will make an incision to access your hip in order to remove damaged articular cartilage and bone. After that, the surgeon will place the artificial implants. The correct position is checked through an x-ray and the incision is closed. Dressings are applied.

You will be encouraged to walk with an assistive device soon after surgery and will be expected to use it for about 4-8 weeks. For most patients’ physiotherapy can begin after the first postoperative visit and it can last about 2 or 3 months. Usually, daily activities are resumed within 3 months.

In general, low-impact activities such as golfing, dancing, biking, swimming, and walking are recommended after rehabilitation. On the other hand, running, jogging, heavy lifting and sports that involve twisting/pivoting should be avoided.