Arthroplasty Notes

Hip & Knee devices, next to femur model. Titanium, Oxinium and polyethylene.

Iaman reports:

Hi, I'm scheduled for my Hip Arthroplasty (the surgical reconstruction or replacement of a joint) [this November], by surgical scheduler Narcy. I cannot drive for 2 weeks.

Notes from Orthopedic Surgeon Consultation.

• "Yep, your hip was bad a year ago". No range of motion right leg, limited on left.
• I've exhausted my cortisol shot effectiveness limit of 2 shots.
• No bilateral replacements in same operation, have to wait at least 6 weeks.
• Doc has done 10,000 + hip arthroplasties then he stopped counting.
• He does about 6 operations a day 2 days a week, Mondays & Tuesdays.
• He stopped Birmingham Hip Resurfacing (BHR) after doing 500, a smaller device, yet more invasive.....but worse were certain patients, but not all, with gout interacting with the synovial fluid would have enough metal on metal erosion to warrant a revision(go in again & fix, in this case with a conventional device). An unexpected bad outcome, after thousands had been installed.
• Doc has used the Smith & Nephew hip device for years a primary feature is their patented Oxinium ball that has significantly less wear. Oxinium is Zirconium alloy (used to clad nuclear reactors). S&N not part of the Warsaw Cartel.
• Doc really doesn't like ceramic, "just try to clean out the glass when one shatters", from athletic hits,falls, or car crashes.
• Doc uses the standard proven posterior approach, "imagine a line between your jeans front & back top of the pockets." This allows good access to the head of the femur for pounding the device into the femur with a 3 pound hammer. If anything happens, bone breaking etc., there is full access. Versus the touted new minimal anterior approach where a special table and a assistant is needed to contort the body to access the femur head, at an angle. If something goes wrong the posterior approach is needed to fix anything.
• None of the docs provide quality stats, though google says this is a essential part of the vetting process.
• Bones density varies per person from Balsa softness to Ebony like hardness.
• The standard angle between the head and femur is 135 dgrees, though it varies per person by +- 7 degrees, causing knock-knee or bow-legs.
• Doesn't glue device into femur, the glue acts as a barrier to bone adhesion, pressure fit of titanium which bone will attach to within 6 weeks.
• Though he uses computer alignment on knees, doesn't use on the "universal ball joint" of the hip. The placement of the marker screws is more painful that the results warrant.
• High protein diet 2 weeks before operation significantly improves healing.
• No recliner-chairs post-op for 6 weeks, stresses hip joint.
• Post-op antibiotics for all dental work, curiously mouth bacteria have a affinity to metal joints.
• I like this Docs private practice better than the big bone factories. Direct telephone to live person. Staff is personable, not so fatigued. Small quiet reception area versus crowded airport terminal like setting. Zoey, a Bichon , roams the office unobtrusively.
• Learned new word Kinematics, which describes the motion of objects without consideration of the causes of motion.
• Bones are innervated, they have nerves in them.