Arthritis of the Hip and Knee : The Active Person's Guide to Taking Charge

by Allen, Ronald J.

• ISBN13: 9781561451494
• ISBN10: 1561451495
• Edition: 1st
• Format: Paperback
• Copyright: 1998-05-01
• Publisher: PEACHTREE PUBLICATIONS

Summary

This book highlights the recent substantial advances made in the treatment of osteoarthritis of the hip and knee. It encourages patients to take charge of their situation: to actively participate in the decision-making about their treatment and to become and stay physically active. The book is the collaborative effort of three people--a patient, an orthopedic surgeon, and a physiatrist--each contributing valuable insight into the treatment of osteoarthritis and the rehabilitation process.

Table of Contents

Chapter 1 Introduction	1	(10)
What You Need to Know	2	(2)
A Patient's Experience	4	(4)
Considerations for Treatment	4	(1)
Surgical Considerations	5	(1)
Physical Therapy Considerations	6	(2)
Lessons Learned	8	(1)
Conclusion	9	(2)
Chapter 2 Arthritis: The Disease	11	(16)
What Is Osteoarthritis?	12	(5)
Other Forms of Arthritis	17	(1)
How Is Osteoarthritis Diagnosed?	18	(5)
Signs and Symptoms	18	(1)
Mild Arthritis	18	(1)
Progression of the Disease	19	(1)
Other Causes of Pain	19	(1)
Physical Changes of the Hip	19	(1)
Physical Changes of the Knee	20	(3)
A Patient's Perspective: Ron	23	(3)
What Caused His Arthritis?	23	(1)
What Took Him So Long to Seek Medical Care?	23	(2)
What Advice Does He Give for Seeking Care?	25	(1)
Conclusion	26	(1)
Chapter 3 Living with Arthritis	27	(34)
Take Control of Your Life	28	(1)
Overcome the Physical Issues of Arthritis	28	(3)
Exercise, Exercise, Exercise	29	(1)
Don't Stop Doing What You Love	30	(1)
Periodically Loosen Up	30	(1)
A Patient's Perspective: Ron	31	(1)
Make Your Daily Activities Easier	31	(8)
Personal Hygiene	31	(2)
Dressing	33	(4)
A Patient's Perspective: Ron	35	(2)
Common Activities in the Home and Workplace	37	(2)
Get Enough Rest	39	(5)
A Patient's Perspective: Ron	39	(1)
Sleeping	40	(4)
A Patient's Perspective: Ron	43	(1)
Arthritis Drug Therapy	44	(7)
Applying Heat and Cold	44	(1)
Topical Medications	45	(1)
Anti-Inflammatory Drugs	45	(2)
Analgesics	47	(1)
Steroid Injections	48	(1)
Hyaluronic Acid Injections	48	(1)
The Cost of Drugs	49	(1)
A Patient's Perspective: Ron	49	(2)
Alternative Treatments and Medicines	51	(2)
Meditation, Massage, and Biofeedback	51	(1)
Acupuncture	51	(1)
Chiropractic Manipulation	52	(1)
Unproven Medications	52	(1)
Diet and Nutrition	53	(1)
Overcome the Emotional Issues of Arthritis	54	(5)
Sexual Relationships	54	(3)
A Patient's Perspective: Ron	56	(1)
Depression	57	(2)
A Patient's Perspective: Ron	56	(1)
Conclusion	59	(2)
Chapter 4 Building to the Decision to Operate	61	(44)
Your Responsibility as Patient	62	(1)
Non-Surgical Ways to Control Pain and Loss of Function	63	(2)
Exercise	63	(1)
Medications	64	(1)
Weight Control	64	(1)
Concerns of Older Patients	65	(1)
Less Invasive Surgical Methods	66	(6)
Arthroscopy (Primarily for Knees)	66	(2)
Osteotomy (For Knees or Hips)	68	(4)
Arthrodesis (For Knees or Hips)	72	(1)
Factors in Considering Joint Replacement Surgery	72	(8)
Risks and Benefits	73	(1)
Expected Physical and Functional Outcomes after Surgery	73	(1)
Post-Operative Disability and Recovery	74	(1)
Expected Longevity of an Implant	74	(1)
A Patient's Perspective: Ron	75	(5)
Selecting a Surgeon	80	(10)
Sources for Referral	81	(2)
The Surgeon's Experience	83	(1)
Interviewing Surgeons	84	(5)
Seeking a Second, or Even a Third, Opinion	89	(1)
A Patient's Perspective: Ron	90	(1)
Selecting the Implant	90	(8)
Joint Implant Issues	91	(2)
Possible Conflicts of Interest in Implant Selection	93	(1)
Issues of Fixation	94	(3)
Durability	97	(1)
Selecting an Inpatient Rehabilitation Unit	98	(2)
The Costs of Joint Replacement and Your Insurance Coverage	100	(1)
Costs	100	(1)
Determining Actual Coverage	100	(1)
Legal Liability and the Potential for Conflicts of Interest	101	(2)
Negligence and Malpractice	101	(1)
Possible Divergence of Interests between You and Your Doctor	102	(1)
Conclusion	103	(2)
Chapter 5 Preparing for Surgery	105	(10)
Pre-Operative Medical Evaluation	106	(2)
Discontinuing Medication before Surgery	106	(2)
The Anti-Clotting Effects of Specific Kinds of Medications	107	(1)
Interim Pain Medications	107	(1)
Precautions against Infection	108	(1)
Donating Blood for Possible Transfusion	108	(1)
The Importance of Good Nutrition	109	(1)
Physical Conditioning before Surgery	110	(1)
Planning for the Initial Weeks after Surgery	110	(2)
The Rehabilitation Facility	111	(1)
In-Home Care	111	(1)
Daily Chores and Errands	111	(1)
Assessing Your Health Insurance Coverage	112	(2)
Authorization for the Length of Stay at the Hospital	112	(1)
Coverage of Post-Discharge Care	113	(1)
Conclusion	114	(1)
Chapter 6 Surgery	115	(16)
An Overview of the Surgical Procedure	115	(2)
The Morning of Surgery	117	(2)
A Patient's Perspective: Ron	118	(1)
Anesthesia for Total Joint Surgery	119	(3)
General Anesthesia	119	(1)
Regional Anesthesia	119	(1)
Combined Anesthesia	120	(1)
A Patient's Perspective: Ron	121	(1)
The Goal of Joint Replacement Surgery	122	(1)
The Total Hip Replacement Procedure	123	(4)
Making the Incision	123	(1)
Inserting the Prosthetic Components	124	(1)
Securing the Prosthetic Components	125	(2)
Closing the Incision	127	(1)
The Total Knee Replacement Procedure	127	(2)
Instruments	128	(1)
The Three-Part Procedure	128	(1)
The Bone Cuts	129	(1)
Balancing the Soft Tissues	129	(1)
Securing the Implants	129	(1)
Conclusion	129	(2)
Chapter 7 Post-Surgery	131	(40)
Recovering from Total Hip and Knee Replacement Surgery	132	(19)
Care Protocols	132	(11)
Management of Pain	143	(2)
A Patient's Perspective: Ron	143	(2)
Sleep	145	(1)
Immediate Physical and Occupational Therapy	145	(6)
A Patient's Perspective: Ron	150	(1)
Preparing for Hospital Discharge	151	(1)
Complications from Surgery	151	(15)
Infection	151	(3)
Urinary Retention	154	(1)
Constipation	154	(1)
Thromboembolic Disease (Blood Clots)	155	(2)
A Patient's Perspective: Ron	157	(1)
Dislocation of the Hip	157	(1)
Nerve Injuries	158	(1)
Heterotopic Ossification	158	(5)
Leg Length Discrepancies (in the Hips)	163	(3)
First Post-Operative Visit to the Surgeon	166	(3)
How Much Can You Do?	167	(1)
What Can't You Do?	167	(1)
Why Are You Still Experiencing Pain?	167	(1)
Will You Become Dependent on the Pain Medications?	168	(1)
Other Follow-Up Visits with Your Surgeon	169	(1)
Conclusion	169	(2)
Chapter 8 Rehabilitation: The Significance of Physical Conditioning	171	(26)
Positive Effects of Exercise	171	(1)
Reducing the Effects of Arthritis	172	(1)
Controlling Pain	172	(1)
The Importance of Physical Therapy	172	(5)
Dedication and Determination	174	(1)
Effect of Sports on Arthritic and Artificial Joints	175	(1)
A Patient's Perspective: Ron	176	(1)
A Note of Caution	177	(1)
How to Exercise	177	(17)
Warm-Ups	179	(1)
Stretching Program	179	(4)
Strengthening Exercise Program	183	(7)
Aerobic Exercise Program	190	(1)
Cool-Down	190	(1)
A Patient's Perspective: Ron	190	(4)
Sport-Specific Training	194	(1)
Conclusion	195	(2)
Chapter 9 Living with an Implant	197	(20)
What It Feels Like	198	(1)
A Patient's Perspective: Ron	198	(1)
Problems That Can Cause Pain	199	(3)
A Patient's Perspective: Ron	200	(1)
Alerting the Orthopedist to Your Discomfort	200	(1)
Inadequate Rehabilitation	201	(1)
Re-Injury	202	(4)
A Patient's Perspective: Ron	202	(1)
What Is the Likelihood of Fracture or Dislocation?	203	(1)
Does a Fracture around an Implant Require Surgery?	204	(1)
Will the Implant Need to Be Replaced?	204	(1)
After Re-Injury, Will the Joint Be Pain-Free Again?	205	(1)
Revision (Replacement) Surgery	206	(6)
Common Causes	206	(4)
An Overview of Revision Surgery	210	(2)
Rehabilitation Care after Revision Surgery	212	(1)
Conclusion: A Patient's Perspective: Ron	212	(5)
Psychological Impact of Undergoing Revision Surgery	213	(1)
A Sense of Well-Being and Acceptance	213	(1)
Some Final Thoughts	214	(3)
Chapter 10 The Future of Care for Arthritis of the Hip and Knee	217	(13)
Increased Accessibility of Information	217	(3)
How to Obtain Information	218	(1)
A Cautionary Note	219	(1)
Telemedicine for Physicians	220	(1)
Ongoing Research into Causes of Osteoarthritis	220	(1)
Medications	221	(1)
Exercise Programs	222	(1)
New Surgical Techniques and Implants	223	(3)
Increased Implant Durability	223	(2)
Making Total Joint Implantation Safer	225	(1)
Inserting Joint Replacements More Accurately	226	(1)
Less Invasive Procedures	226	(2)
Arthroscopic Surgery	227	(1)
Transplanted Cartilage	227	(1)
The Impact of Medical Costs on Future Hip and Knee Care	228	(1)
A Bright Future Ahead	229	(1)
Index	230