When it comes to hip replacement surgery, not all surgeries are created equal

The options you need to know before deciding to have hip replacement surgery

Author: Dr. James Loging, MD, MBA, FAAOS

   You have always enjoyed an active lifestyle until that one day when you start to notice an unusual pain in your hip. You tried to manage the pain hoping it would get better, only to find that over time it has progressively gotten worse. As the pain worsens you find yourself avoiding activities you once enjoyed.  After realizing that the pain will not get better on its own, you decide to see your doctor to see what may be going on.  It’s then that you find out that the pain your experiencing is related to severe arthritis in your hip and that you need a hip replacement to resolve your pain.  This can be a scary and very stressful situation.  But it doesn’t have to be if you know that there are options available to help you recover faster and experience less pain after surgery.

   Most people don’t realize that there are multiple ways that the hip can be replaced by an orthopedic surgeon.  Unfortunately, not all orthopedic surgeons are trained on all the different options available and tend to only offer one approach to patients. They also usually don’t even discuss the approach they will perform with the patient.  The reason for this is because of the type of training the doctor received typically only involves one approach, which is why the orthopedic surgeon only performs that one option for patients.  However, not all the different approaches are created equal and certain ones have significant benefits over others.  The approach that has the most benefits is called the Anterior Approach.

   Anterior Hip Replacement surgery means that the surgeon replaces a patient’s hip by coming from the front (anterior) of the hip. The benefit of coming from the front is that the doctor doesn’t have to cut muscles to replace the hip which makes for a significantly faster recovery compared to all the other methods of replacing a hip. All other approaches, which include posterior, lateral, and anterolateral all must cut muscles and disrupt vital tissues to replace the hip. Other benefits of anterior approach and not cutting muscles include less pain, less blood loss, less risk for dislocation, and more equal restoration of leg lengths. But the biggest thing most patients care about is the faster recovery which allows you to get back to living life without the pain and not having a prolonged recovery process.  Anterior hip replacement is also so less invasive that lots of patients are candidates to have their surgery done outpatient and able to recover in the comfort of their own home with out the need for a costly hospital stay.

Some physicians may recommend a hip resurfacing surgery instead of a hip replacement. A hip resurfacing is essentially a hip replacement but instead of replacing the ball, a cap is placed over the patients existing ball and the hip socket is still replaced as in a hip replacement. Be cautious when considering this as hip resurfacings has lots of potential downfalls. First, for most surgeons to resurface a hip, a posterior approach is performed which cuts most all muscles away from the hip and leads to permanent damage to the muscle that can have detrimental consequences in the future. Second, hip resurfacings are all metal on metal components which have significant well known complications including implant failure, local hip tissue and muscle damage, and absorption of metal fragments that are generated from the metal components rubbing together into the blood stream and traveling throughout the body. This absorption of metal ions has been suggested to lead to numerus health problems including cancer. Hip resurfacings all have a very short and limited lifespan and will all eventually have to be revised to a full hip replacement. For these serious concerns mentioned, hip replacement performed by anterior approach is much preferred to hip resurfacing. Patients also experience a faster and easier recovery compared to hip resurfacing.

   When it comes to anterior hip replacement, experience also matters. If your surgeon hasn’t been performing anterior hip replacement for very long or doesn’t perform it regularly, then you should consider looking for a surgeon who has more experience in the surgery. Surgeons with limited experience have a much higher complication rate and can lead to decreased success of the surgery. Thus, experience matters. Palmetto Bone and Joint has the most experienced surgeon in anterior hip replacement and has been performing this procedure longer and performed more anterior hip replacements than any surgeon in South Carolina.

So, if your contemplating hip replacement surgery, know that you have options and don’t settle for an approach that will affect your recovery and outcome. Call Palmetto Bone and Joint to discuss these options and what’s best for you.

Hip Replacement Facts You May Not Know

Hip replacement is one of the most successful surgeries in all of medicine. Fact or fiction? According to the American Academy of Orthopaedic Surgeons, it’s true. And doctors perform the surgery on more than 300,000 Americans every year. That’s a lot of people who find relief from hip pain and return to their active lives. If this surgery might be in your future, here are some hip replacement facts you should know. 

1. Hip replacement isn’t just for ‘old people.’

Hip replacement surgery relieves pain and improves mobility in people with diseased or damaged hip joints. Arthritis and hip joint injuries are common causes of these hip problems. And these conditions aren’t limited to older adults. In fact, the rate of total hip replacement in middle-aged adults—45 to 54 years—more than doubled between 2000 and 2010. This age group also accounts for an increasing percentage of total hip replacements. What’s more, adults in this age group had a shorter average hospital stay compared to older adults.

2. Hip replacement takes preparation.

Hip replacement surgery will require some preparation. If you’re overweight, you should try to shed some extra pounds before surgery. It will reduce stress on your new joint. Regardless of your weight, you can improve your safety and comfort during your recovery by preparing your home as well. Remove tripping hazards, such as cords and rugs. Make things convenient by getting a reacher, dressing stick, and long-handled bathing sponge. Your doctor can give you other ideas. Check with your insurance company too, to arrange coverage of a walker or toilet seat ahead of surgery.

3. Hip replacement can be minimally invasive.

New techniques allow doctors to perform hip replacement using minimally invasive surgery. This means you will have a smaller incision instead of one large one. It also means you may recover quicker and with less pain than traditional surgery. In general, ideal candidates are thin, young and healthy although you can still be a candidate for hip replacement regardless of weight or age. You also need to be committed to a thorough rehab program. Dr. James Loging, MD at Palmetto Bone and Joint was the first surgeon in South Carolina to perform Anterior Hip Replacement and is the most skilled and trusted surgeon in South Carolina when it comes to this minimally invasive hip replacement surgery. Dr. Loging believes all patients deserve the benefit of anterior hip replacement and patients come from all over to have him replace their hip. 

4. Hip replacement recovery used to be lengthy, but it doesn’t have to be anymore. 

In the past, it would take numerous weeks to return to normal activities, including work. You would need a lot of assistance during this time. You wouldn’t be able to drive. Daily activities would be challenging, especially during the first six weeks. Some people would have benefited from staying in a rehabilitation center before returning home. However, now with Anterior Hip Replacement surgery, you will be able to perform more daily activities quicker and have a much faster recovery compared to traditional posterior approach hip replacements and even faster compared to hip resurfacings. Hip replacements are now even done outpatient and you’re able to recover in the comfort of your own home with a personal nurse and therapist coming to your house to work with you. 

5. You’ll be walking within a few hours of surgery.

Walking will be a high priority during recovery, even right after surgery. In the hospital, your nurse will get you up and moving within a day of surgery. However, you won’t be walking on your own. You will use a walker or other support for a few weeks. Gradually, you will be able walk longer, farther, and with more stability. Walking helps prevent blood clots and strengthens your hip as you heal. Walking and rehab exercises will be a daily part of your recovery and your team will give you goals. Meeting those goals will speed your recovery.

6. Health insurance usually covers hip replacement.

Many people wonder about hip replacement cost. Check with your insurance company to find out about your coverage. Most plans will cover a medically necessary hip replacement. This includes Medicare and Medicaid. Palmetto Bone and Joint will work with you to provide any necessary paperwork before surgery. Your insurance provider will have information about your out-of-pocket costs. This may include copays, deductibles and co-insurance (your portion of the expense after your copay and meeting your deductible).

7. Life will be different after a hip replacement.

A hip replacement can greatly improve your quality of life. Most people return to an active lifestyle with little or no pain and stiffness. But life can be different in other ways as well. High-impact activities are not good for your new hip. If you are a runner or play basketball, you may need to find alternatives however this can be discussed with our doctors. You may also find that your walking gait is different or you have a limp. Physical therapy rehab exercises can help correct this. Being diligent about your exercises will strengthen the supporting muscles and improve your flexibility. Eventually, your gait will feel normal again.

8. Hip replacements can last for decades.

Hip implants are mechanical devices, so they can and do wear out. But the implants used by our surgeons have been reported to last up to 30 years. And you can take steps to prolong the life of your hip implant. Maintaining a healthy weight will keep extra stress off the implant. Avoiding high-impact and contact sports will protect the implant from damage. Staying active and exercising will strengthen your hip muscles and stabilize the implant. It’s also important to see your orthopedic surgeon regularly to monitor the health of the implant.

Make an appointment

If you’ve been suffering from hip pain and are curious if hip replacement including minimally invasive anterior hip replacement is right for you, contact us to make an appointment with Dr, James Loging to discuss what options are best for you. 803-321-6254 or 803-941-8095

Hip Replacement Testimonal

Causes Of Hip Pain And What To Do About It

As the largest ball-and-socket joint in the body, the hip enables you to stand, sit, walk and run. But when inflammation or injury strikes, the ensuing hip pain can inhibit mobility and decrease your quality of life. Hip pain can be caused by injury, such as a broken hip, inflammatory conditions like arthritis, or many other conditions. If your hip pain becomes chronic or causes you to reduce your activity level, it may be time to visit an orthopedic doctor to get a diagnosis and learn about treatment options.

Common Causes of Hip Pain

Hip pain usually arises due to injury or inflammation in or around the joint. The most common causes of hip pain include:

  • Bursitis, which occurs when one of the two lubricating sacs of the hip joint becomes inflamed
  • Arthritis including osteoarthritis due to overuse or normal aging, rheumatoid arthritis or psoriatic arthritis 
  • Dislocated hip
  • Hip fracture
  • Sciatica, which is caused by compression of the sciatic nerve
  • Structural damage to any surrounding soft tissues, such as a hip labral tear, blunt trauma, tendinitis, or an inguinal hernia

The location of your hip pain often can tell your doctor a great deal about what is causing it. For example, hip pain when climbing stairs may indicate sacroiliac joint dysfunction. Hip pain after sitting might be caused by trochanteric bursitis—inflammation of a bursa located on the outer point (the outer ridge near the top of the femur) of the hip.

Hip Pain Treatment at Home

When hip pain is mild, or if it comes and goes, you might be able to treat it at home and find relief. Try these home remedies for hip pain:

  • Applying heat with a heating pad (take care to use the low setting and to place a barrier, such as a towel, between the pad and your skin to avoid a burn)
  • Applying ice, alternating between 20 minutes with the ice pack on followed by 20 minutes with the pack off
  • Hydrotherapy including either taking a hot shower or soaking in a hot tub or whirlpool. At home, you can add Epsom salts to a warm bath for added benefit.
  • Nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin or naproxen sodium (Aleve)
  • Resting the hip including avoiding activities that make the pain worse. Avoid sleeping on your side. If you routinely sleep on your side, use a firm pillow between your knees to help align your hips.
  • Stretching exercises for the lower back and hip area

If hip pain comes on suddenly and severely, or if home remedies don’t alleviate the pain within a week, you should seek medical attention.

When to See a Doctor for Hip Pain

In certain situations, you should seek immediate medical attention for hip pain. Call 911 if:

  • You cannot bear weight on the hip joint
  • The joint appears deformed
  • You cannot move the affected leg
  • Your toes begin to turn blue or feel numb
  • You experience sudden, severe swelling in the hip or associated leg
  • You have a fever higher than 101 degrees Fahrenheit along with the hip pain
  • The pain is severe

For milder cases of hip pain that linger over the course of weeks, you should consult your primary care provider or an orthopedic physician to receive a diagnosis and obtain treatment options. Professional medical care for even mild conditions can keep the problem from worsening and help prevent complications.

Who to See for Hip Pain

If your hip pain does not respond to home remedies, you should consider consulting an orthopedic specialist for an evaluation. As part of your treatment, you may work with a physical therapist to strengthen the muscles that support your hip and lower back.

Left untreated, hip pain can progress from annoying to debilitating. Avoiding activity because of pain can lead to additional problems. By seeing a doctor early in the process for an accurate diagnosis, you may be able to use conservative treatments to relieve the discomfort and avoid any lasting damage to the joint and surrounding muscles.

The doctors at Palmetto Bone and Joint specialize in the most cutting-edge and minimally invasive treatments to alleviate your hip pain. If you’re suffering from hip pain, contact one of our three convenient office locations to schedule an appointment to discuss what treatment options are best for you.

What You Need to Know About Back Problems

Back pain doesn’t only occur because of improper heavy lifting or sleeping on a non-supportive mattress. There are a myriad of potential causes – and not all of them even originate in the back. If you’re experiencing back pain, either suddenly or for a prolonged period of time, it’s important to see a medical professional, such as one of the doctors at Palmetto Bone & Joint, for an accurate diagnosis.

Back Injuries

Acute back pain often is associated with injuries – such as from a fall, stress or strain, sports injury or a car accident. Sprains, strains and spasms are common. But it’s important to have your symptoms evaluated to check for more serious injuries such as a herniated, or “slipped” disc, or a fracture, especially if your pain is severe.

Less serious back injuries may heal on their own in a matter of days or weeks. But that doesn’t mean you should suffer during that time. A doctor can evaluate your situation and offer guidance and, if needed, medication or other measures to help you feel more comfortable while the injury heals. More serious injuries may require more serious interventions.

Spinal Conditions

Sometimes back problems can be exacerbated or caused by conditions of the spine. You may have a congenital condition, meaning you were born with it, that you may not even be aware of. Examples include scoliosis or spina bifida. Or you may have a degenerative disease, such as arthritis or osteoporosis, that has developed and worsened over time.

There are also a number of conditions that affect the nerves and tissues around the spinal cord that can cause discomfort in your back. Sciatica is one example. It affects the sciatic nerve, which travels down through the back of the leg. Sciatica can cause severe back pain that continues through the buttocks and down the leg. Another example is spinal stenosis, in which the spinal column narrows, putting pressure on the spinal cord and nerves – and which can lead to sciatica.

Non-Spinal Causes of Back Pain

Because the back is such a central structure of the body, there are situations in which you may feel discomfort in your back that originates elsewhere in the body. Some examples include:

  • Kidney stones or infection – You may feel sharp pain in your lower back, especially on one side.
  • Endometriosis – This is a condition of the uterus.
  • Fibromyalgia – This chronic condition causes widespread muscle pain and fatigue throughout the body.
  • Tumors – Tumorous growths can put pressure on the spine. It’s crucial to have these evaluated to screen for cancer.
  • Pregnancy – Back pain is common later in pregnancy and generally resolves after birth. A doctor can help expectant mothers manage discomfort while it persists.

Innovative Treatments

Diagnosing the cause of your back pain is just the first step toward helping you feel better. At Palmetto Bone & Joint, our spinal experts have years of experience in developing effective treatment plans that help patients get their lives back.

Our spine surgeon, Dr. Samuel Davis, received his training at Duke and Emory universities and has been at the leading edge of spine research.  He specializes in less invasive advanced procedures of the cervical, thoracic and lumbar vertebrae. Depending on your situation, treatment may include medication, rehabilitation, or surgery.  

Drs. Jaqueline Van Dam, Alaric Van Dam, and Giridhar Gundu provide a range of non-surgical treatment of patients such regenerative medicine including stem cell therapy, nerve conduction studies, injections, employing technology such as dynamic ultrasound to for precision diagnosis and treatment.



6 Things to Know About a Torn Meniscus

Your meniscus protects your knee joint.

Certain knee injuries can cause a meniscus tear. The meniscus is cartilage in the knee joint. You have two in each knee. They provide protection and cushioning that keeps the bones in the joint from rubbing together. Here’s what happens when you have a torn meniscus, what it feels like, and what to do about it.

1. A meniscus tear is an equal-opportunity injury.

Anyone can tear a meniscus. However, people who play sports are more at risk. That’s because sports often involve quick movements and contact. Twisting the knee the wrong way can result in a meniscal tear. This sometimes happens to older people with normal day-to-day activities because cartilage in the knee can weaken as you age. About 70 to 80% of people who tear their meniscus are male. Most tears occur in the right knee.

2. Pain and swelling are common symptoms of a torn meniscus.

You’ll most likely know if you have a torn meniscus. People usually feel pain, but can still walk. Sometimes swelling also occurs and it may get worse over time. You also might feel your knee getting stiffer. Some people feel like their knee is weak or gives way easily at times. See your doctor as soon as possible if you have any of these knee symptoms.

3. Doctors sometimes make a “snap” diagnosis.

Your doctor has many ways to tell if you have a torn meniscus. One of the best ways is the McMurray test. You will lie on your back and your doctor will bend and straighten your knee. With a torn meniscus, this will cause a snapping sound or pain. You might also have X-rays to rule out other possible causes of knee pain. Sometimes doctors order an MRI to get a good look at the inside of your knee.

4. Surgery isn’t always necessary for a torn meniscus.

A torn meniscus might not require surgery. The outer part of the meniscus sometimes heals itself. This is most likely to happen if the tear in this outer area is small. If this is the case, your doctor may want you to rest and elevate the knee. Also, over-the-counter pain medicine like ibuprofen (Advil, Motrin) can help while the knee heals.

5. Sometimes, a meniscus tear requires surgery.

Sometimes doctors recommend repairing or removing the torn cartilage. Today, doctors usually use arthroscopic surgery to stitch the cartilage back together. This type of surgery uses small incisions, a camera, and special equipment. If the tear cannot be repaired, your doctor might remove just the damaged tissue or remove the entire meniscus. The name for that surgery is meniscectomy. Your doctor can do this operation arthroscopically, too.

6. Rehab is necessary.

No matter what treatment you have, you will need to rehabilitate and strengthen your knee afterwards. If you had surgery, you might need to wear a brace for a while. This keeps the knee stable. Your doctor also might want you to do exercises to strengthen the muscles around your knee. Examples include leg raises, walking in a pool and riding a stationary bike. Some people work with a physical therapist during rehab. Recovery time varies, but people who have a meniscectomy tend to heal faster than those who have the tear repaired.

If you’re experiencing knee pain or suspect you have a meniscus tear, make an appointment to see one of our many specialist at Palmetto Bone and Joint to find out what can be done to fix your pain and get you back to an active lifestyle quicker!

Chapin – 803-941-8095

Newberry – 803-321-6254

Clinton – 864-833-3046

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Runner’s Knee: How Much Do You Know?

Runner’s knee, the common term for patellofemoral pain syndrome, is a knee problem that affects many people. It happens when your kneecap (patella) is either misaligned because of a defect, or your knee is stressed, causing it to be out of alignment. Although it is painful, runner’s knee is usually not a serious knee injury, although it can have a significant impact on your life by limiting your activity. How much do you know about runner’s knee? Here are some facts about the condition that might surprise you.

1. You don’t need to be a runner to get runner’s knee.

Patellofemoral pain syndrome is called runner’s knee because it affects a lot of runners. However, many people who never run anywhere also develop runner’s knee. It’s like people who don’t golf can get golfer’s elbow, or those who don’t play tennis can get tennis elbow. Anyone who participates in an activity that bends the knee and puts a lot of strain on it is at risk of developing runner’s knee. This includes cycling, walking, jumping or climbing up and down stairs.

2. Repetitive movements can irritate your knee.

Do you have a job that requires you to bend and squat a lot? When you squat repeatedly, your knee makes the same movement and carries your body’s weight in the same places over and over again. You could be squatting to lift boxes, pick items off the floor, or reach lower shelves. Even parents of young children who have to pick them or their playthings off the floor are at risk of irritating their knees to the point of developing runner’s knee.

3. Your hamstring could be causing runner’s knee.

Your hamstrings are really three muscles in the back of your thigh. They help you extend and retract your leg. You may feel your hamstrings pull if you bend at your waist without bending your knees or you straighten your legs in front of you while sitting on the floor. When your hamstrings are too tight, they cause extra stress on your knees and could cause runner’s knee. Exercises and stretches to loosen the hamstrings can help reduce knee pain and keep it from coming back.

4. Your glutes can also cause runner’s knee.

Like your hamstrings, your gluteus medius, a muscle in your buttocks, may also be the culprit behind your runner’s knee. Instead of being too tight, like the hamstrings, if your gluteus medius, or glutes, are not tight enough, the rest of your leg tries to compensate. This puts stress on your knee. The gluteus medius is responsible for helping to pull your leg away from your body and rotate it externally. This is called hip abduction. If the muscle isn’t strong enough, the other muscles respond by trying to pull the leg inward instead.

5. Flat feet can equal knee pain.

Your feet play a vital role in your knees’ health. If you have flat feet, a low arch, or no arch at all, this puts your feet in an unnatural position when you step forward, particularly when you run. The impact of walking or running without arch support can cause extra tension on the muscles in your legs and pull on the knee, causing misalignment and stress. Wearing appropriate shoes and orthotics in your shoes can help fix how your foot lands when you take a step, taking stress off your legs and knees.

6. Where you exercise could cause runner’s knee.

Concrete and asphalt are unforgiving surfaces. If you’re running or playing sports on these hard surfaces, the stress on your legs and knees could cause runner’s knee. The solution is to run or play on more forgiving surfaces, like synthetic tracks, grass or dirt. This is also where good shoes appropriate for the activity are beneficial. They can help absorb some of the shock of running and jumping, taking away some of the stress on your knees.

7. Women are more prone to developing runner’s knee.

Doctors aren’t entirely sure why more women than men develop runner’s knee, but overall women do develop more knee problems. A woman’s pelvis is wider than a man’s. This wider pelvis affects how a woman stands and places a different type of pressure and strain on the knee. As well, women tend to have looser ligaments, the tough fibrous tissue that connects bones. Women also land on their feet differently when they run or jump, adding to the difference in knee stress.

8. Runner’s knee can be easy to treat.

Once you know what is causing your runner’s knee, it can be fairly easy to treat. If it is caused by improper foot support, good shoes or orthotics will help. If it’s caused by too tight ligaments or muscles, physical therapy and exercise can ease the pain and reduce the risk of it returning. Muscles too weak? Strengthening them at home or in a gym will help. Running on a hard surface? Switch locations for a gentler landing when you run or jump. The key is working at it and staying consistent.

9. Surgery is rarely necessary for runner’s knee.

Doctors only consider surgery for runner’s knee if you have tried non-surgical treatment for 24 months and you still have pain. It’s rarely necessary. If you have runner’s knee and you have faithfully tried all the exercises and changes recommended by your doctor or physical therapist, an orthopaedic surgeon will assess you to see if surgery will help.

If you are experiencing knee pain, call and make an appointment with one of our orthopaedic specialists today at Palmetto Bone and Joint.

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Knee friendly exercises to help you lose weight.

Losing weight can be difficult when pain and stiffness from arthritic knees keep you from being active and makes it tough to burn calories. Studies suggest carrying a few extra pounds can create added pressure on joints causing further stress to your knees which may hamper your exercise level even more. So what exercises can you do to lose weight without irritating your knees? Let’s explore a few.

1. Strength Training

Studies show as you get older, the amount of muscle in your body tends to decrease. Fat accounts for more of your weight which slows down your body’s ability to burn calories. But muscles reportedly burn more calories than fat, so by building up muscle through strength training, you can boost your body’s ability to burn more calories. Developing muscles also increases your body’s ability to absorb shock to your joints, something that can benefit an arthritic knee. Strengthening exercises include lifting weights, using weight machines at the gym, and resistance band training.

2. Water Aerobics

Water aerobics can make a splash when it comes to weight loss and strengthening muscles especially when you have pain in your knees. Fitness experts say water helps un-weight your joints allowing you to move more freely without feeling the impact of hard ground surfaces that stress an inflamed knee joint. There are water weights and assistive equipment to help. And try walking in the pool for an extra workout. Water has much greater resistance than air, which means walking in water requires more effort, thus burns more calories.

3. Biking

Riding a stationary bike is a good way to burn calories and is a nice alternative to running which can irritate your knees.  Experts suggest doing at least 30 minutes of aerobic activity 5 times a week to see the beneficial effects. A bike also addresses the range of motion in your knees, hips, and ankles which is often affected by arthritis. Keep the resistance mild to moderate and vary your speed. Be sure your knees don’t roll in or roll out while pedaling to avoid straining them.

4. Walking

Looking for a low impact exercise that burns calories? Walking typically puts less pressure on your joints compared to running. Be sure to wear cushioned supportive sneakers. Also, avoid walking with your toes facing out to the sides. This puts more pressure on the inner portion of your knee joints. Walking on grassy surfaces will also soften the blow on your knees as you walk. Experts suggest exercising at a moderate pace 30 minutes a day, 5 days a week to help burn fat.

5. High Intensity Interval Training

Depending on your fitness level, try High Intensity Interval Training (HIIT) to shed abdominal fat. HIIT involves performing short bursts of exercise at a high intensity level followed by a longer lower intensity level. You can do these cycles on a stationary bike or an elliptical machine to avoid hurting your knees while exercising outside on pavement.

6. Yoga

Yoga not only burns calories it has added benefits that may help you lose weight and alleviate inflammation in your knee joints. Fitness experts say yoga has been shown to lower cortisol–a stress chemical that some studies link to weight gain. Another study revealed women who practiced yoga showed lower levels of interleukin-6 in their blood, a protein that causes inflammation. Inflammation plays a central role in the painful swelling and stiffness in arthritic joints. Yoga also addresses muscle strength and flexibility which can help keep you moving with other activities.

7. Tai Chi

A recent study found that tai chi can specifically reduce the pain and physical impairment of people with severe knee osteoarthritis.Tai chi offers a way to burn some calories and incorporates range of motion, strengthening, flexibility and balance motions–all of which can be affected by arthritic knees.

8. Swimming

Swimming is a great way to get aerobic exercise with the added benefit of using the water’s buoyancy to help reduce impact on your joints. It also addresses the range of motion of your arms and legs. Swimming strengthens leg muscles which protect your knees throughout the day. Fins and kickboards are available to enhance your swimming routine. If the pool is heated, it can help soothe stiff joints.

Call for an Appointment 

Palmetto Bone and Joint has numerous specialist to take care of your arthritis or any bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations.

 803-941-8095, 803-321-6254, or 864-833-3046.

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5 Facts Palmetto Bone and Joint Wants You to Know About Arthritis

Osteoarthritis is the most common type of arthritis, affecting nearly 27 million Americans ages 25 and older. Each day, many people suffering from osteoarthritis will visit our offices, and many of them are confused about what they’ve heard about the disease.

Here are some facts about arthritis that we discuss daily with our patients. 

Fact #1: If one of your parents has osteoarthritis, you won’t definitely get it

You are more likely to get osteoarthritis if one of your parents has it, particularly if they have it in the knees. Women are more likely to inherit it than men. However, genes aren’t a perfect predictor. There’s a lot you can do to lower your risk of developing osteoarthritis, even if it runs in your family. If you live a healthy lifestyle, exercise regularly, and maintain a healthy weight, you can reduce your risk. 

Fact #2: Diet and exercise have a LOT to do with osteoarthritis

Actually, diet and exercise have a LOT to do with preventing osteoarthritis and lessening the pain it causes. With every pound you gain, you add four pounds of pressure to your knees. Being overweight increases your risk of developing osteoarthritis and speeds the rate at which the condition will develop. It’s very important to maintain a healthy weight. In fact, two out of three people who are obese will develop osteoarthritis. People with osteoarthritis can stay active and lessen their pain with low-impact exercises like walking, swimming, cycling, and yoga. These exercises help keep the muscles around your joint strong, and they involve stretching, so you’re able to maintain a full range of motion. 

Fact #3: A doctor can still help me with knee pain if I don’t want surgery

It’s true that there is no cure for osteoarthritis, but surgery isn’t the only option. In fact, about 40 percent of seniors have osteoarthritis of the hip or knee, but only about 5 percent will undergo replacement surgery. You can manage osteoarthritis symptoms through a combination of exercise, weight loss, pain management techniques, alternative therapies, and nonprescription and prescription medications. Some improvement in pain and function is possible in almost everyone with osteoarthritis. 

Fact #4: Osteoarthritis doesn’t happen to everyone when they age

Osteoarthritis is not a normal part of the aging process, but the risk of developing it does increase with age. There are plenty of elderly people who don’t have osteoarthritis, and there’s a lot you can do to prevent it from developing. You can lower your risk by maintaining a healthy weight, exercising regularly, and resting any exercise-induced injuries. 

Fact #5: Osteoarthritis and rheumatoid arthritis are not the same thing

Osteoarthritis and rheumatoid arthritis are two types of arthritis. Osteoarthritis is the most common type. It’s also known as degenerative joint disease or “wear-and-tear” arthritis, because it’s caused by the breakdown of joint cartilage. Osteoarthritis is mostly a consequence of aging, because as we age, the water content of our cartilage increases while the protein composition of our cartilage degenerates. Osteoarthritis can also be caused by the overuse of joints, and by obesity, among other contributors. 

Rheumatoid arthritis, on the other hand, is a chronic, inflammatory type of arthritis. It’s an autoimmune disease that involves multiple joints. Researchers are still working to determine the cause of the abnormal autoimmune response. Common theories point to a genetic predisposition and a triggering event. 

Osteoarthritis is a difficult problem to deal with, but with education and encouragement, patients can feel empowered to improve their daily lives. 

Call for an Appointment 

Palmetto Bone and Joint has numerous specialist to take care of your arthritis or any bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.

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10 Things Palmetto Bone and Joint Wants You to Know About Fractures

About 6 million people break bones in the United States every year. The most frequently broken bone is the clavicle, or collarbone. Other common bone fractures include those in the arms, wrists and ankles. If you’re over 65, you’re more likely to break your hip than any other bone. You can break bones due to injury or diseases like osteoporosis, which weakens bones. Orthopedic surgeons specialize in treating broken bones in all scenarios. Here’s what three board-certified orthopedists want you to know about bone fractures, risk factors associated with them, and tips for helping them heal properly.

1. “A fracture and a break are the same thing.”

Patients frequently think bone fractures and bone breaks are different, says Dr. James Loging, MD. “I hear this all the time,” Dr. Loging says. Sometimes people think “fracture” means a crack while “break” means a clearly separated bone, but this is not true, he says. “Fracture” is simply the term doctors use to refer to any break or crack in a bone.

2. “If you smoke, your fracture might not heal as fast.”

If you ingest nicotine—whether through cigarettes, cigars, chew tobacco, or even the nicotine patch—you may find that your fracture takes longer to heal than for a non-smoker, says , Dr. Phillip Milner, DO. This is due to the effect of nicotine on the healing process. If you quit smoking, it will take three months before your body responds to bone breaks like a non-smoker’s would, Dr. Milner says.

3. “Try RICE for non-emergency injuries.”

If you have a broken bone cutting through your skin or your bones are looking crooked and weird (what doctors call a deformity), you need emergency medical care, says Dr. Mark Wilson, MD. But if you only have pain and swelling, and aren’t sure if it’s a break, he says, you could try treating your injury at home for a day or two with “RICE”: rest, ice, compression (wrapping with an ace-type bandage) and elevation. “If that doesn’t work, then you should be seen by a doctor,” Dr. Wilson says.

4. “Don’t wait too long to be seen.”

If you wait too long to bring your possible bone fracture to your doctor’s attention, your bone could start healing on its own—and possibly in a crooked way. That makes fixing the problem more difficult than if you’d come in earlier, says Dr. William Owens, MD. Or you could have underlying damage to the surface of the joint or other problems that are harder to treat the longer you wait, says Dr. Owens. Waiting can also make it more likely you’ll need surgery. For non-emergency fractures, Dr. Owens recommends patients be seen within a couple of days. If you require an operation, he says, this gives you time to get it scheduled before bones start knitting back together (which usually happens within a few weeks).

5. “Even little fingers and toes need to be checked out.”

You crack your little toe against a table leg. Should you bother getting it checked for a fracture? “It depends how bad you feel,” says Dr. Samuel Davis, MD, noting that in similar situations, he might wait a couple days and, if still in pain, see a doctor to have it X-rayed. But in general, he says, it’s better to err on the side of caution and see your doctor. After all, broken toes that heal crookedly can cause your shoes not to fit right, resulting in pain, warns Dr. Davis. Similarly, ignoring finger fractures can cause “significant disability” and lead to longer surgeries once patients finally come in, he says.

6. “Moving it doesn’t mean it is not broken.”

Dr. Loging often has patients say they didn’t think their bone was broken because they could still move the affected body part. But, he says, this is a fallacy. “There’s only one way to know if it’s broken and that’s with an X-ray,” he says. Dr. Loging says “The idea that if I can move it, therefore it can’t be broken is not true. You can almost always move it,” even if it is broken. Signs that it could be a bone fracture include significant swelling, tenderness around the site, bruising, and an inability to bear weight on it even after a couple of days’ rest, says Dr. Loging.

7. “I don’t always operate.”

“People think orthopedic surgeons do surgery 99% of the time,” says Dr. Milner. This can cause some patients to avoid seeing him, he says, because they think they’ll wind up in the operating room. It’s perhaps an understandable misconception, given that “surgeon” is part of his title. But, Dr. Milner says, “Most of what we do isn’t surgery.” Instead, he says, orthopedists do the least invasive procedures possible first to promote bone fracture healing, only moving up to surgery if more conservative measures don’t work.

8. “When we tell you to elevate it, take us seriously.”

“We’ll have folks come in a couple of days after a broken ankle, for example, and they may have been laying around on the couch but not with the ankle truly elevated—which is above the level of your heart,” says Dr. Wilson. If you’re lying down, you can put two or three pillows under your leg to achieve proper elevation, she says, but if you’re sitting, you’re going to have to use more than that to get your leg high enough. Elevation is key to preventing swelling, which also could delay surgery, if that’s needed, Dr. Wilson says.

9. “Splints are not second-class citizens.”

Casts are non-removable and go all around your broken bone, while splints go only halfway around and can be taken off and on. Both casts and splints are used to immobilize your broken bone and both can be written on and decorated. Yet some patients think casts are best and get disappointed if they get a splint instead, says Dr. Davis. “A lot of times patients don’t give the splint a lot of respect.” Doctors use splints for several reasons, says Dr. Davis, including when a cast is difficult to place due to the location of the break or when doctors want to leave room for swelling.

10. “Forget the ‘6-week rule’ of bone healing.”

Dr. Owens says he often has patients tell him they know fractures are cured in six weeks, which he says is “an incredible piece of misinformation; no adult is going to heal in six weeks.” Most bone fractures take anywhere from 2 to 6 months to heal, depending on many factors, he says. “There’s not just one rule for every broken bone,” says Dr. Owens. “It’s important to understand there is specificity and details matter,” such as where a bone is broken, what bone it is, what the fracture pattern looks like, and so on. “It’s difficult to generalize.”

Call for an Appointment

Palmetto Bone and Joint has numerous specialist to take care of any fracture or bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.

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Are Knee Injections Right for Me?

The fluid in your knee joints have a natural lubricant between the bones called hyaluronic acid. The lubricant acts as a shock absorber. In many people, this lubricant wears away with time, causing knee pain. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to provide relief. But if over-the-counter or prescription strength NSAIDs don’t provide relief, your doctor may recommend injections. Your options include synthetic hyaluronic acid and corticosteroids. Each acts in a different way.

Viscosupplementation Injections

Viscosupplementation injections infuse your problem joint with synthetic hyaluronic acid. Depending on the product your doctor uses, he or she may give you an injection once a week for three to five weeks. As part of the procedure, your doctor will likely remove a small amount of your own joint fluid to make room for the synthetic version. According to the American Academy of Orthopaedic Surgeons (AAOS), you are not likely to experience pain relief immediately. You may even have some swelling, pain, and a feeling of warmth at the site of your injection. Applying an ice pack will help, and your symptoms should go away quickly. For the first 48 hours, you should stay off your leg as much as possible and avoid heavy lifting. 

You should find that your pain lessens as you receive more injections. Hyaluronic acid is not an anti-inflammatory, but it may stimulate your body to make more of its own hyaluronic acid. It seems most helpful for those with early, mild-to-moderate knee conditions. Viscosupplementation is not recommended for people who have had osteoarthritis for a long time. 

Corticosteroid Injections

Sometimes doctors will inject corticosteroids into your knee joint to relieve pain. Cortisone is a specific kind of steroid that your adrenal glands make naturally. These glands are located above each kidney. Cortisone decreases inflammation and, in turn, reduces pain. 

People with moderate-to-severe knee pain are likely candidates for corticosteroids. According to the AAOS, corticosteroid injections are most helpful if you have a lot of swelling. They are not as useful if your osteoarthritis affects your joint mechanics—your ability to move. Your doctor has a choice of corticosteroids to use. 

As with viscosupplementation, the site of your injection can become inflamed immediately after the injection. Icing and avoiding strenuous activity can help with cortisone injections as well. 

Manufacturers say that corticosteriods can provide relief from pain and inflammation, anywhere from a few days to more than six months. However, studies find the benefit is short-lived, from one to four weeks. 

While cortisone injections don’t have the same side effects as oral steroids, they still have risks. If you get too many injections, your cartilage can break down, causing more joint damage. For this reason, your doctor is likely to limit the number of injections.

Viscosupplementation Versus Cortisone Injections

Both approaches have mixed reviews. A 2009 analysis of studies on both types of injections revealed that people had better initial benefits from the cortisone injections than from viscosupplementation. After four weeks, the results were about the same. At the three- and six-month marks, however, relief was better from the hyaluronic acid (viscosupplementation).

Another analysis in 2012 offers a different viewpoint. It found that injections of hyaluronic acid have little effect on pain, and when they do, results start to fade after eight weeks. The study also suggested that the injections had side effects, including gastrointestinal and cardiovascular events. Doctors still don’t know the long-term effects of hyaluronic acid injections, and more research needs to be done in this area.

The bottom line is that there is uncertainty surrounding both types of knee injections.  

Talk to your doctor to make the right decision for you. 

Key Takeaways

  • If you’re not getting the relief you need from oral medications for knee pain, your doctor may recommend injections into your joint.

  • There are two main kinds of injections, viscosupplementation and corticosteroids.

  • Viscosupplementation is suggested for people with mild-to-moderate osteoarthritis. Corticosteroids are suggested for people with moderate-to-severe pain.

  • Both injections have side effects, and the benefits may be short-lived. Talk to your doctor to help make the right decision for you.

Call for an Appointment

Palmetto Bone and Joint has numerous specialist to take care of any fracture or bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.

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