By Dr. Dwight Engdahl

You and your doctor tried everything, but the pain in your knee, hip or shoulder won’t go away. You can’t sleep through the night and you can no longer do the things you love to do.

It may be time to consider one last option – a joint replacement.

Joint replacement surgery is always a last resort, but it’s an option that can give relief to those who suffer continual pain and loss of motion despite more traditional therapies. The need for joint replacement becomes necessary when, because of injury, arthritis or other diseases, the cartilage that cushions the meeting point between two bones wears away. The result is bone against bone – and pain.

The decision to undergo a joint replacement should be made only after getting all the facts from your doctor. Your age, activity level and medical condition will all be considered.

If you do opt for a joint replacement, here are a few things to know:

• First, the goal of surgery is to relieve pain. This is done by replacing the damaged cartilage with artificial surfaces like metal or plastic. The replacement cushions the ends of the bones and allows greater movement without pain.

• After surgery, your doctor will prescribe physical therapy to make sure your new joint functions as intended. Recovery time varies from person to person and according to the type of surgery, but expect it to last several weeks.

• Depending on the joint replaced, your doctor will advise you against certain activities, at least at first. A hip or knee replacement may require the temporary use of a walker and safety features in high risk areas, like showers. If you’ve had a shoulder replacement, you probably will need to wear a sling for a few weeks. All recoveries will require you to make adjustments in your daily life. Friends and family members can be especially helpful during this time.

While it will take hard work to make the most of your new joint, the effort will be worth it. Eventually, you will more than likely be able to return to your regular activities  — and a pain-free, better quality of life.

Two previous posts were on the History of Sports Medicine and the History of Physical Therapy and we would like to continue to provide you with information on the history of surgeries, technology and other common injuries we see here at OAZ. Today we would like to give our readers 10 facts about total hip replacement:

1.     According to the American Academy of Orthopaedic Surgeons (AAOS), the first total hip replacement was performed in 1960 (only 51 years ago!) and is considered one of the most important surgical advances of the last century.

2.     Improvements in surgical techniques and technology, like arthroscopy, have greatly increased the effectiveness.

3.     According to the AAOS, more than 193,000 hip replacement surgeries are performed each year in the U.S.

4.     Early designs had the potential to loosen from their attachment to the bones, becoming painful after 10-12 years.

5.     Initial hip designs were made of a one-piece femoral component and a one-piece acetabular component.

6.     Modern acetabular components are made up of two parts – a metal shell and a separate liner.

7.     Once an uncommon surgery for frail patients, total hip replacement is common among aging athletes.

8.     Hips are one of the body’s largest weight-bearing joints.

9.      In most cases, modern hip replacement surgery allows patients to walk almost immediately post-op.

10.    Various approaches to the hip can be done for replacement, including posterior, lateral, and anterior. Each approach is available at Orthopaedic Associates of Zanesville and your physician will be glad to discuss the options with you.

Anterior approach to Hip Replacement Surgery – Animation

Here at the Orthopaedic Associates of Zanesville, many of our patients have tendinitis. Tendinitis is a common injury associated with weight lifting.

Tendinitis

Tendinitis can be found in the biceps, triceps, Achilles, shoulder and patella, just to name a few places. It’s an irritation or inflammation of the tendon, the thick band that attaches bone to muscle. Anyone can get tendinitis but it is most common in adults over the age of 40. Tendons age and as a result they

• Tolerate less stress
• Become less elastic
• Tear more easily

To avoid tendinitis, try the following:

• Start slow when starting a new activity and gradually build your level
• Use limited force and limited repetitions
• Stop if unusual pain occurs

Home remedies for treating include:

• Avoiding activities that aggravate the problem area
• Rest
• Ice
• Taking anti-inflammatory drugs

As always, the physicians here at OAZ suggest seeing a doctor if the pain persists because if you ignore the problem for too long, it can cause an even greater one.

The Centers for Disease Control (CDC) established September as Fruits and Veggies – More Matters Month. Bone and joint health is more than adding exercise or rehabilitation from an injury into your daily routine. We recently talked about the importance of bone health in a blog post, but now we want to talk about the role of your diet and bone health.

The physicians here at OAZ are all advocates of exercise and healthy living. When we include more fruits and veggies into our diet, we provide our body with vitamins and minerals, both important to our bones and muscles.

The following vitamins and minerals are found in fruits and veggies:

• Calcium: It’s essential for healthy bones and teeth and assists with normal functioning of muscles, nerves and some glands.
• Fiber: Diets rich in fiber have shown to decrease risk of coronary heart disease.
• Folate: May reduce women’s risk of having a child with a brain or spinal cord defect.
• Iron: We need iron for healthy blood and normal functioning of all cells.
• Magnesium: Necessary for healthy bones and is involved with more than 300 enzymes in your body. Inadequate amounts may result in muscle cramps.
• Potassium: Diets rich in potassium may help maintain healthy blood pressure.
• Sodium: Needed for normal cell function. Too much sodium can lead to high blood pressure.
• Vitamin A: Keeps skin and eyes healthy. Helps protect against infections.
• Vitamin C: Keeps teeth and gums healthy. Helps heal cuts and wounds.

Remember when you’re filling your plate at home or at a restaurant, the more colorful and the more texture the food has, the better!

Happy eating and for more information on Fruits and Veggies – More Matters Month check out the website here.

If you like what you’re reading, follow us on Twitter: @OrthoZane

Last week we began a discussion of fall sports injuries and injury prevention. We continue that discussion here with a look at football and golf.

Football injuries and prevention

No matter how well protected athletes appear to be, football lends itself to injury so injury prevention is important to address more than once.

• Sprains and strains are the most common football injuries. These injuries can be treated by using R.I.C.E. (rest, ice, compression, elevation).
• Fractures are a common football injury as well and often include finger, wrist and leg fractures.
• Achilles tendinitis is an injury that, if left untreated, can result in a more serious injury like a ruptured tendon.
• An ACL tear is another common football injury. It can result from rough play, collisions and falls. The knee can swell and cause pain. Consult a physician if you think you have an ACL tear.
• Concussions are caused from tackles and other blows to the head. They can cause brain injury, so it is important to be aware of symptoms: confusion, short-term memory loss, and loss of consciousness.
• Spine injuries are rare but can occur from playing football and, clearly, need to be addressed by a physician immediately.

To prevent football injuries, the physicians at Orthopaedic Associates of Zanesville stress the importance of stretching out properly, incorporating cross-training into the program and seeking professional help if an injury does not improve.

Golf Injuries and Prevention

Although golf does not require the speed or endurance of soccer or cross-country running, golf injuries still occur. Here are some typical golf injuries:

• Back pain – Swinging the club puts a great amount of stress on a player’s back. Injuries vary from the mechanical to disc-related, arthritis-related, or stress fracture-related.
• Tennis/golf elbow – Inflammation, soreness or pain is caused in and around the elbow or upper arm.
• Shoulder pain – Golfers can experience shoulder pain from rotator cuff tendinitis, a tear in the rotator cuff, A-C joint arthritis or instability in the joint.
• Carpal Tunnel Syndrome – CTS is caused from repetitive hand motion.
• Knee pain – As in other sports, knee pain can occur from a torn meniscus, knee arthritis, or a kneecap injury.
• Trigger finger – Trigger finger occurs when a finger or multiple fingers lock up or when the flexor tendon sheath, connecting the fingers, is inhibited.
• Wrist impaction syndrome – This injury happens when the bones of the wrist knock into one another because of excessive or repetitive movements.

As with other sports, take time to stretch muscles before playing golf. Since back injuries are common, incorporate back strengthening exercises, like lateral pull-downs, reverse flies or rowing, into your exercise routine. To strengthen the wrist muscles, squeeze a tennis ball, do wrist curls and reverse wrist curls. For more information on the strengthening exercises, see our website.