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Archive for the ‘Hip’ Category:

For an elderly patient with known heart blockage, is a stress-test necessary for a micro-invasive hip replacement (SuperPATH)?

The decision to have a stress test is left to the discretion of your cardiologist. Like any procedure, a thorough pre-operative workup is required for your safety. This includes general medical clearance, as well as any specialty clearance that is deemed necessary (depending on any pre-existing conditions). This would likely involve some sort of cardiac […]

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My 73 yo mother had an unsuccessful hip replacement which has left her with not one day free of pain. I am going to bring her to you for evaluation. What do you do if the bone chips or cracks during the operation?

If the bone cracks during the operation, then I fix it at that time. There are many ways to do so, and they have a wide range of applications depending on the type and location of the crack. I always have a few backup plans on hold if this occurs. The main issue is to […]

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What do you think about doing simultaneous bilateral Total Hip Replacement (THR) vs. 2-stage bilateral THR? Would I need a urinary catheter for one THR or simultaneous THR?

I prefer to do bilateral (both) hips as a staged procedure, one THR then the other 6 wks later. I have on occasion done simultaneous bilateral THRs, but only on my healthiest patients, since it can be more dangerous in terms of blood clot, blood loss & cardiac risk. I almost never use a catheter, […]

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Am I a SuperPATH candidate if I have had previous hip surgery?

Q: I had a right hip fracture repaired with screws and then the screws started coming out and would catch the tendon on the side of my leg, so the surgeon removed them. When I was finally released by the surgeon, I was told I had arthritis in that hip and I should consider a […]

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Are your procedures covered by Medicare and AARP Medicare Supplement?

Q: Considering your hip and knee surgeries: Are the procedures now covered by Medicare and AARP Medicare Supplement? One article on your website from 2009 said they are not covered by Medicare. A: Yes, all of my procedures are now covered by Medicare & all insurances in the same fashion as any standard procedure. The […]

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How do you feel about “rocker bottom” (ie- MBT, Sketcher’s Shape Up, etc) shoes for people with hip or knee issues?

It really depends on how your body reacts to wearing them. Walking mechanics can vary greatly from person-to-person. On average, your natural foot position is in a few degrees of “plantar-flexion”, meaning that a slightly raised heel in a shoe’s foot-bed would be the most supportive and natural for walking. Most walking/comfort shoes are designed […]

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You said that your anesthesia protocol involved “local & regional anesthesia”. Is this the same as the “twilight-sleep” I got during my colonoscopy?

You will be completely asleep, and you will have no knowledge or recollection of the surgery. This is far more sedation than your described colonoscopy, but not so much that you would require a machine to “breath” for you.

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What is the best bearing-material for my total hip replacement?

This is a topic of much debate right now among surgeons. Probably the best answer is this: There is no perfect bearing surface. That is why there are so many options currently available. I try to carefully select a bearing surface that best utilizes the potential benefits against the potential shortcomings. Here are some common […]

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In total hip replacement, I have heard a larger ball (femoral head) is “better” for post-operative motion limits, etc. Can you set me straight here, please?

I use a very wide variety of head sizes in my practice. There a few main issues to consider here: 1) larger head sizes can increase stability with certain approaches, 2) certain head sizes work better with certain bearing surfaces in terms of long-term wear & 3) head sizes may be limited to size of […]

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How long is the recovery from your joint replacement surgeries?

A very general guide for all joint replacement is:- You will continue to improve for an entire year, even if you feel 100% within weeks after surgery. The following is highly variable, and represents a reasonable baseline. The recovery can be longer depending on the severity of the disease. Most of my patients stop their […]

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