Questions & Answers

Does my weight impact my joints and ability to move?

Being overweight can hurt. Carrying extra pounds puts added stress on your joints and that can cause your bone-cushioning cartilage to wear down, your ligaments to become strained and, as a result, you find yourself in constant pain. If you’ve struggled with finding and maintaining the motivation to stick with a weight loss plan in the past—it can be challenging—focus on the greater ease of movement and decreased discomfort that can come when you improve your joint health through weight loss.

What impact does my weight have on my knees?

It’s estimated that your knees regularly absorb a force of three to six times your body weight with each step you take. Packing on the pounds’ increases that exponentially, which can cause painful inflammation, pressure and wear-and-tear. Knee pain is one of the most common joint pain complaints, ailing almost 18 percent of Americans, according to the Centers for Disease and Control. One study found that the association between weight gain and knee pain was strongest in obese people, who experienced a 59-point increase in pain when they put on weight compared to just 6.4 points in non-obese people.

How many calories do I need to burn to lose a pound of weight?

You need to burn off 3,500 calories more than you take in to lose 1 pound. This translates into a reduction of 500 calories per day to lose 1 pound in a week, or 1000 calories per day to lose 2 pounds in a week. (1-2 pounds per week is generally considered to be a safe rate of weight loss.) This can be achieved by eating fewer calories or using up more through physical activity. A combination of both is best.

What Is a Knee or Hip Replacement?

Knee or Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of the replacement surgery include increasing mobility, improving the function of the joint, and relieving pain.

Why Do People Have Replacement Surgery?

For the majority of people who have hip or knee replacement surgery, the procedure results in:

  • a decrease in pain
  • increased mobility
  • improvements in activities of daily living
  • improved quality of life

What Are Alternatives to a Replacement?

Before considering a total knee or hip replacement, the doctor may try other methods of treatment, such as exercise, walking aids, and medication. Exercise may strengthen the muscles around the joint. Walking aids such as canes and walkers may alleviate some of the stress from painful, damaged hips and help you to avoid or delay surgery.

There has been a lot of news lately about some kinds of artificial hips. Why do these devices go bad?

Total hip and knee replacements are excellent operations with predictable, superb results. They have evolved in design over the last 50 years to the point where survivorship of the prosthesis and good function at 20 years’ averages 85 percent to 90 percent. Nevertheless, various investigators have attempted to improve on these results by developing slightly different designs. Unfortunately, many of these design- and surgical-technique changes are insufficiently tested prior to release by the FDA and general marketing.

If I’m a patient with severe arthritis who needs a joint replacement, how do I choose a surgeon?

There are near 2,000 orthopedic surgeons in the United States who do primarily joint replacement surgery. You will want to work with a surgeon whose practice focus is joint replacement. You also want to obtain an appropriate referral from your family doctor to a surgeon they know who achieves consistently good results. Next check out the reputation and the experience of the identified surgeon.

If I have arthritis in my hip or knee, what can I do to prevent or delay the need for a joint replacement?

Stay physically fit. Lose weight. Avoid impact loading of the joint (e.g., jogging or jumping from heights). Osteoarthritis, once it has started, will usually progress at its own rate, which varies from patient to patient. Medical treatment and minor surgical procedures, like arthroscopy, can mitigate one’s symptoms, but unfortunately, don’t slow down the progression of the disease.

What questions should I ask my Orthopeadic Surgeon before surgery?

The goal of orthopaedic treatment is to relieve pain and restore function. In planning your treatment, your doctor will consider many things, including your age, activity level, and general health. If nonsurgical treatment methods, such as medication and physical therapy, do not relieve your symptoms, your doctor may recommend surgery.

  • Why is this procedure being recommended? Are there alternatives?
  • What are the benefits of this procedure in terms of pain relief, functioning/mobility? How long will the benefit last?
  • What are the risks involved?
  • What is the success rate for this procedure?
  • What is the procedure called? How is it done?
  • Will this surgery solve the problem? Will any more surgery be required in the future?
  • How many of these procedures are annually performed at this hospital?
  • What percentage of patients improve following the procedure?
  • What will happen if I don't have the surgery now?
  • If I want a second opinion, whom can I consult?
  • Will I need any tests or medical evaluations prior to the surgery?
  • What kind of anesthesia will be used? Are there possible after effects or risks? Will I meet with the anesthesiologist in advance? Will her or she know my needs/allergies?
  • What kind of implant or prosthesis will be used? What are the outcomes using this device? How long will it last?
  • Will I have pain following the procedure? What pain relief or pain control measures will I be given?
  • How long will the recovery take? What are my limitations during recovery? Will I need assistance at home afterwards? For how long? What will discharge instructions be?
  • Will I have any disability following surgery? Will I need physical therapy?
  • When can I return to work? When can I drive my car? When can I have sexual activity?
  • Are there any materials about this surgery that I can review?

As the patient, you should request and/or confirm that the surgeon will preoperatively confirm and mark the surgical site.

 I’ve been having back and leg pain for a long time and my medication is not helping very much. My neighbor has the exact same symptoms and he’s taking a different medication which helps him a lot. Why isn’t my doctor giving me the same medication?

Even if your symptoms sound exactly like your neighbor’s, it is most likely that the two of you are still having different problems. Doctors treat the problem not just the symptoms. Different problems oftentimes cause similar symptoms, but because they are different problems each person needs to be treated individually.

 I have chronic back and leg pain. What can a Pain Management specialist do to help me? What is a Pain Management specialist?

Anyone who has a pain problem which has not been eased with the help of your primary care doctor and the usual medications should be evaluated by a doctor who is specially trained to treat various pain problems. As with any type of physician, you should seek a doctor who has completed a fellowship program and is Board Certified in Orthopedics or Pain Management. The doctor will devise a plan to ease the pain and improve your ability to enjoy activities which the pain may have been preventing. This plan is very individualized and may consist of medications, special pain relief injections or specific exercises to ease the pain.

Can pain be relieved without taking pills or medications?

Oftentimes, pain can be alleviated or stopped by using specific exercises and stretches. Physical therapy offers a variety of non- medicinal treatments which are effective in reducing pain. This helps people to get back to a previous level of activity following an injury and also decreases the chances of a repeat injury. Weight loss, smoking cessation and proper posture/ lifting techniques can especially help back, knee, hip and neck problems.

“Why do I feel better when I use ice?”

Ice is a natural pain reliever because it slows nerve conduction and numbs the tissues. In this way, it prevents the pain information from reaching the brain. Ice also slows the inflammatory response to injury by decreasing swelling. Ice tends to be more helpful for acute injuries and pain although it can also help with chronic pain.

“Why do I feel better when I use heat?”

Heat can be very helpful for chronic pain for two major reasons. One, it causes increased blood flow to tissues. This allows more oxygen to reach the tissues and also flushes out toxins. Two, it allows muscles and ligaments to stretch more easily which will help alleviate painful spasms.