I AM AVIDLY AGAINST BILATERAL KNEE OR HIP REPLACEMENTS. AS AN ORTHOPEDIC SURGEON AND THROUGHOUT MY TRAINING THE MAIN COMPLICATIONS IN JOINTS I HAVE SEEN HAS BEEN BECAUSE OF BILATERAL SURGERY. YOU TRIPLE YOUR COMPLICATION RISK OF BLOOD CLOT , INFECTION DUE TO LONGER SURGERY TIME AND MORBIDITIES. NOT TO MENTION THE PAIN AND THE PHYSIO. ALTHOUGH CONVENIENCE IS THE BIGGEST REASON IF THAT COMPLICATION HAPPENS TO YOU THEN YOU WILL THINK BACK.
We all should hope for the best. The lumbar spine issue may be improved in the fact that you can walk better and are not loading your back more. Fibromyalgia is a tough one. If you are bone on bone, you need surgery done for sure, but the fibromyalgia won't improve. This and the stenosis will interfere to a degree, but not to the point you should hold off. Your doctors should be cognizant of such with pain meds as well.
This is common and is called HETEROTOPIC OSSIFICATION. Essentially the surrounding tissues in their desire to heal form calicification. This calcification usually leads to stiffness once this calcium matures to bone. Some people have a genetic predisposition to form this. In our training we were always told that debris in the tissue can incite this. For this keep following up with your surgeon and keep active. Worse case scenarios the calcium will have to be removed surgically .So definately followup with your surgeon to get serial xrays to moniter the progress of this bone formation. This will not affect your implant negatively..View Thread
In today's competitive markets, many companies and surgeons are advocating and pushing their own prosthesis, when it comes to hip replacements. You may even go to a surgeon where the hospital dictates what is being used, based on price. It is so important to be educated and involved in the process of decided what implant is best for you, and why. In a day where there are recalls and aggressive advertising, all of this information can be overwhelming.
First, make sure your surgeon is board certified. Being board certified means that you surgeon has surpassed the highest qualifications to practice as a surgeon. There are many non-certified surgeons practicing today. Second, do some research on your surgeon to make sure that their patients have been happy with the work they have done. Remember that any negativity travels fasters than positivity. Make sure you and your surgeon can freely communicate and there is a positive working environment. When you are in a waiting room, talk to some of your surgeon's patients.
With implants, there are options and it is overwhelming. The general rule of thumb is to ask questions and realize that not all implants are a fit for all people. With respect to approaches, you will have surgeons going anteriorly, posteriorly, or lateral. The simple basic rule is both anterior and posterior are great in someone who does them often. The advantage of these two approaches are they are muscle sparing, and can prevent limping.
On bearing surfaces you can use metal, polyethylene and ceramic. The best of these three is a tough answer. There have been issues with ceramic on ceramic cracking, metal on metal causing increased ions. The safest in my opinion, is ceramic on polyethylene. As surgeons, we aim for the biggest heads to enhance stability and prevent dislocation.
** Ask your surgeon if there is a risk of leg length discrepancy, due to any anatomic issues.
Nowadays, we aim for press fit to allow immediate weight bearing. Immediate weight bearing is very important, as it prevents issues with bedsores, infection, pneumonia, and blood clots. So, ask your surgeon when you will be able to walk and when you will be at full weight bearing.View Thread
Frequently hip pain is mistaken for another diagnosis and vice versa. In my practice, I have seen people have hip replacements from various other doctors and their issue ended up being spine related, and not related to their hip. Not all diagnosis' are concrete. It is good for a patient to know that typically hip pain is not in the buttocks area. Hip pain from arthritis is usually in the groin, which radiates down the inner aspect of the leg to the knee. This pain is usually in conjunction to weight bearing. Hip pain is also associated with stiffness in the morning, due to being immobilized throughout the night. It is very important for your doctor to establish a correct diagnosis. Many entities such as disc herniations, hernias, abdominal or pelvis issues can mimic hip pain.
Sometimes even when the diagnosis looks simple on a XRAY, your doctor still needs to look and confirm that your pains are in fact, due to your hip. Personally, is I have even a small percentage of doubt, I will perform a hip injection under XRAY guidance. Within this injection is lidocaine and steroids. If my patient's pain goes away with the numbing agent right away, this confirms hip pathology 100% - as the cause of pain. So, as a patient, before you undergo a procedure such as a hip replacement, if you sense any doubt of the diagnosis make sure that your doctor has cleared all other options that the pains could be from.View Thread