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How should I prepare
for surgery?
Once you and your surgeon have decided that you need orthopedic
surgery, it is important to check with your family doctor
to evaluate your overall health and medications, and to see
if any blood tests or an EKG (electrocardiogram) are needed.
This is important to ensure that the surgery and anesthesia
you receive will not cause any new medical problems for you,
and that it is ‘safe’ for you to go through the
surgery, so that your recovery process will go as smoothly
and safely as possible.
It is also important to find out from your
surgeon’s office what appointments are required before
and after surgery (in the hospital and surgeon’s office),
if any physical therapy will be required after surgery, and
if you will need to plan on using a walker, crutches or cane
during your recovery. It is also very important that you tell
your surgeon about all of your medications (including all
prescription medications, over the counter medications, and
vitamins/supplements) and medication allergies/unwanted side
effects. This is important because some medications can interfere
with anesthesia or medications prescribed after surgery. Your
surgeon also needs to know your complete medical history since
childhood (including any heart conditions you have been treated
for, any history of blood clots, pneumonia, or infections
or illnesses that required medical treatment), and all previous
surgeries in your lifetime, and any problems you have had
with anesthesia or with your surgery recoveries. The more
your surgeon and his team know about your health history,
the better they can take care of you.
Most surgeons prefer to know if you have
a family member or significant other/friend who will be able
to help you when you get home; this is an important part of
making a safe plan for your recovery after you leave the hospital.
Lastly, please make a list of your questions, and anything
about your surgery that you are concerned or worried about,
and make sure to discuss these things with your surgeon—this
will reduce your stress so that you can put your energy into
having a smooth recovery.
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How long do hip/knee
replacements last?
Most hip and knee implants currently being used will last
at least 10-15 years on average; 95% will last 10 years, and
85% will last 15 years. The long term outcome or life of hip
and knee implants actually depends on several factors, including
the design and materials of the implants, and the actual alignment
of the implants, which is dependent on the surgeon. These
figures are based on current research findings. Patient age,
weight, health conditions and activity level are also factors
that can affect how long hip and knee replacements last.
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What are the risks
of hip/knee replacement surgery, and how can I prevent them?
All surgeries carry risks—some can be prevented, and
others can’t. Many are short-term conditions that will
resolve in the long term. There are several risks of joint
replacement surgery. The main risks include fracture during
the procedure, nerve injury in the joint and leg, change in
length of the operated leg, infection, blood clots in the
legs which can travel to the lungs, anesthesia complications,
wound healing problems, strokes and other flare-ups of new
or pre-existing medical conditions. The most important things
you can do to help prevent complications are to follow all
of your surgeon’s instructions before and after surgery,
have a thorough medical check-up by your family doctor before
surgery, tell your surgeon your complete medical history (don’t
assume that anything is ‘not important’-let your
surgeon make that decision), and communicate any health change
or symptom to your surgeon and his health care team after
surgery—don’t ignore any new or flared-up health
symptom.
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What hip/knee replacement
complications should I watch for after I get home from the
hospital?
Your surgeon needs you to report any unwanted medication side
effects, and any ‘new’ health problems that can
flare-up during the first three months after surgery. It is
very common to lose your appetite and your energy, have short-term
constipation, and disrupted or poor sleep in the first month
after surgery—these things are normal (and not considered
‘complications’) for most people. The most common
complications that can occur in the first few weeks at home
are infection or blood clots. Infections usually have symptoms
in or around your incision: any clear or cloudy drainage,
or redness of the incision that is not getting better, or
areas in the incision that are not growing closed. Blood clot
symptoms can include a feeling of tightness, soreness or discomfort
in the back of the calf or in the thigh muscles, or if a blood
clot travels to your lungs, you can have sudden anxiety, chest
pain and difficulty breathing. In knee replacement surgery,
stiffness can set in the knee due to fast-growing scar tissue
that does not improve with exercise or physical therapy. In
hip replacement surgery, excessive hip bending can cause dislocation
(in which case you would not be able to stand or walk on the
hip). It is best to err on the side of safety by calling your
surgeon with any concerns about unexplained changes in your
health or surgery site.
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When can I drive after
surgery?
The concern about not having you drive for a few weeks after
surgery is related to making sure that your physical reaction
time returns to normal, and making sure that you are not driving
while relying on narcotics for pain relief—which can
make you drowsier than normal. According to research studies,
it generally takes about 6-8 weeks for your physical reaction
time to return to normal after major hip or knee surgery.
Because each person is different in how they recover from
surgery, it is important to discuss this with your surgeon.
On average, patients can return to driving around 6 weeks
after surgery.
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When can I return
to work after surgery?
This depends on the type of surgery you had, and the type
of work you do (sedentary/desk job, versus physically demanding
active work). So it is very important to discuss this with
your surgeon before surgery. Often patients who have hip or
knee replacement surgery will return to work somewhere between
4-6 weeks after surgery, depending on the physical demands
of their job. It is common to return to work part-time or
on light duty at 4-6 weeks, and then work back into full work
activities between 6-12 weeks. This is an individual situation
that is important to fully discuss with your surgeon, as most
employers require a written work release note from the surgeon.
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Are hip and knee replacement
surgeries only done on people 65 and older?
Nowadays, hip and knee replacement surgeries can be safely
done on people of almost any age, from age 12 up (as in those
with juvenile rheumatoid arthritis or very serious injuries)
to adults in their nineties if one’s overall health
is stable. Hip and knee replacements have been performed in
the U.S. for almost 40 years now, and the quality, selection
and types of implants (design and materials) are better now
than ever before. Through several decades of orthopedic research,
surgeons now know how to tailor implant selection and procedures
to patients’ age, activity level and health status,
and how to care for patients with joint replacements for the
remainder of their lives, which includes any additional revision
surgeries if all or part of the implants loosen or wear out.
Thus, joint replacements can dramatically improve the quality
of life of people of all ages who are living with serious
and disabling joint pain.
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I’m very active
in sports (golf, tennis, jogging), but I need a hip/knee replacement.
When can I resume all my sports activities after my surgery?
This is an important question to discuss with your surgeon.
What activities that can be resumed, and when it is safe to
resume them will depend on the procedure your surgeon uses,
and your recovery. Generally, high impact activities should
be avoided, or resumed very carefully with specific guidance
from your surgeon, based on your individual health and surgery.
High impact activities, such as singles tennis and jogging,
can put too much wear and strain on joint replacements, whereas
low impact activities, such as golf, generally do not affect
the wear of joint replacements. Your surgeon’s goal
is to help your joint replacement last as long as possible—so
this includes guiding you on what types of activities are
‘safe’ for you to do.
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I had surgery a couple
of years ago for a hip fracture, and now my hip is starting
to bother me almost every day, especially when I’m getting
out of bed or a chair. Should I go have it checked out at
all?
Yes, it is important to have your joint x-rayed and examined
by your orthopedic surgeon. There are many different types
of hip fractures and hip fracture surgeries, and some of these
surgeries can occasionally lead to arthritis or other hip
problems, such as irritation around the implant used to repair
your fracture. By doing new x-rays and an exam of your hip,
and learning about your current symptoms, your surgeon can
determine what is causing your pain, and work with you to
resolve this so that you can be active without pain.
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What is a Doctor of Osteopathic Medicine (D.O.)?
If you're like most people, you've been going to a physician ever since you were born and perhaps were not aware whether you were seeing a D.O. (osteopathic physician) or an M.D. (allopathic physician). You may not even be aware that there are two types of complete physicians in the United States.
The fact is that both D.O.s and M.D.s are fully qualified physicians licensed to prescribe medication and perform surgery. Is there any difference between these two kinds of physicians? Yes. And no.
D.O.s and M.D.s are alike in many ways:
- Applicants to both D.O. and M.D. medical colleges typically have four-year undergraduate degrees with an emphasis on scientific courses.
- Both D.O.s and M.D.s complete four years of basic medical education.
- After medical school, both D.O.s and M.D.s obtain graduate medical education through such programs as internships and residencies. This training typically lasts three to six years and prepares D.O.s and M.D.s to practice a specialty.
- Both D.O.s and M.D.s can choose to practice in any specialty area of medicine-such as pediatrics, family practice, psychiatry, surgery or obstetrics.
- D.O.s and M.D.s must pass comparable examinations to obtain state licenses.
- D.O.s and M.D.s both practice in fully accredited and licensed health care facilities.
- Together, D.O.s and M.D.s enhance the state of health care available in America.
D.O.s, however, belong to a separate yet equal branch of American medical care. It is the ways that D.O.s and M.D.s are different that can bring an extra dimension to your family's health care. more...
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