Posts

“Dual Mobility” Hip Replacement Does Double Duty: Relieves Pain and Reduces Risk of Dislocation

Image
Hip replacement to relieve arthritis pain is considered one of the most effective surgeries in the United States. Over the past decade, improvements in surgical technique, implant design, anesthesia and pain control after surgery have contributed to its success, says Geoffrey Westrich, MD, an orthopedic surgeon at Hospital for Special Surgery (HSS).  More than 450,000 total hip replacements are performed each year in the United States, according to the Agency for Healthcare Research and Quality. One of the most noteworthy advances is what’s known as a “dual mobility” hip replacement, according to Dr. Westrich, who has conducted several studies on the implant. He and colleagues have found that the dual mobility prosthesis reduces the risk of dislocation, one of the most common complications after hip replacement surgery. While the incidence is less than 2% at Hospital for Special Surgery and other major joint replacement centers, it is significantly higher at some other locations.   “Du

Cementless Knee Replacement Could Last Longer

Image
Knee replacement surgery is one of the most effective and predictable orthopedic procedures.  Hundreds of thousands of patients have a knee replacement each year so they can enjoy life pain-free and get back to activities they’ve given up.   Over the past couple of years, I’ve seen good outcomes with a newer type of “cementless” or uncemented knee replacement. There is reason to believe that this type of implant could last longer than traditional implants that require the use of bone cement.  The traditional implant used in knee replacement generally lasts a long time—15 to 20 years—but it doesn’t last indefinitely. When the implant wears out or loosens, patients generally need a second knee replacement, known as a revision surgery. The cementless knee replacement could change that.  In a standard knee replacement, the components of the implant are secured in the joint using bone cement. The technique has worked well for decades. But eventually, over time, the cement starts to loosen f

Is Outpatient Joint Replacement Surgery Right for Me?

Image
Having a hip or knee replacement and going home from the hospital the same day is becoming more common. The surgery is generally performed early in the morning, and the patient goes home at the end of the day. Five years ago, outpatient joint replacement was almost unthinkable. But advances in technology, surgical technique and pain management over the past few years have made same-day hip or knee replacement a viable option for patients who meet certain criteria. During the pandemic, many people find this appealing since they leave the hospital more quickly and can spend their first night after surgery in the comfort of their own home. These days, much smaller incisions and robotic-assisted joint replacement, which allows for ultraprecise positioning of the implant, benefit patients who wish to go home the day of surgery. A study in the Bone & Joint Journal in 2018 by researchers in the United Kingdom found that robotic-assisted total knee replacement was associated with decrease

Robotics Transforms Knee Replacement Surgery: Technology Allows for Ultraprecise, Customized Procedure

Image
Over the past two decades, I have seen many advances in joint replacement surgery that have benefited patients. I believe robotic-assisted knee replacement, which allows for an ultra-precise procedure, is one of the most exciting.  I recently reached a milestone when I performed my 500 th robotic-assisted knee replacement. I use the MAKO robotic system, which is FDA-approved for both total and partial knee replacements. Joint replacement is highly successful in relieving arthritis pain and improving quality of life, and robotic system allows us to really customize the procedure for each patient. The MAKO system allows for optimal alignment and positioning of the knee implant, as well as optimal ligament balancing, all critically important for the best outcome and long-term success of the surgery. Such precision could potentially lead to a longer-lasting knee replacement. Over the past few years, I've seen more patients in their 40s and 50s with arthritis. The main concern for

Joint Replacement During Pandemic? Long Island Dad Says "Yes" So He Can Dance at Daughter's Wedding

Image
John Schieck wanted to dance at his daughter’s wedding, and he wasn’t going to let the pandemic stop him. But his severely arthritic hip was another matter.  So, when the Long Island resident learned he could schedule a hip replacement when elective surgeries resumed at Hospital for Special Surgery (HSS), he didn’t hesitate. Before the pandemic, he had a knee replacement at HSS. In May of this year, he came to see me for a regular follow-up exam. Mr. Schieck’s knee was fine, but his hip pain and gotten much worse.  He had trouble sleeping at night and found himself limping at work. Mr. Schieck, who is 65, went ahead with hip replacement surgery at HSS in June, and two months later, he attended his daughter’s wedding. “My hip pain was gone. I danced with my daughter, my wife, my friends. I was a ‘dancing machine’,” he recalled. For others suffering from arthritis pain who are reluctant to schedule surgery, HSS has instituted extensive precautions to ensure that patients, visitors and st

When the Weather and Walkways are Treacherous, Slow and Steady are the Way to Go

Image
Snow storms and freezing temperatures can turn streets into obstacle courses, and hazardous conditions  can lead to a fall if  people aren't careful. It's something people don't always think about when they are  focused on shoveling snow or in a hurry to get somewhere. Even after much of the snow and ice are removed, there are always some slippery surfaces to watch out for. Here are some safety tips when out in bad weather or on slippery streets after a snow storm: * Wear shoes or boots that provide traction on snow and ice, such as those with rubber and neoprene composite soles. Avoid plastic and leather soles, smooth-soled shoes and, of course, high heels. * Walk at a safe pace. Give yourself enough time to get to your destination without rushing. * When given no choice but to walk on ice, take short steps or shuffle for stability. * Look where you're going. Watch for icy patches, especially on the north side, that remain even if the sidewalk or parking lot has been c

A Steroid Injection for Bone-on-Bone Arthritis? Not So Fast

Image
When elective surgeries resumed in New York City in June, it was a relief for patients with severe hip or knee arthritis who had made up their minds to have joint replacement surgery. Many people needed to wait when the procedures, considered elective, were put on hold due to the pandemic. Some patients were in so much pain, they wanted to have the procedure as soon as possible. But a number of them were surprised to learn they would have to wait, in some cases up to three months, because they had received an injection of a steroid or hyaluronic acid in their joint at another doctor’s office. There are two issues for patients. First, the injections do nothing to relieve pain when someone has bone-on-bone arthritis and is a candidate for joint replacement, or if they provide any pain relief at all, it is very short lived. The other problem is that anyone who has received a steroid or hyaluronic acid injection must then wait approximately three months from the date of their l