When you think about your hip or knee, you most likely don’t consider how much these joints support and stabilize your body or the range of motion they allow. Because they bear the full weight of your body every day, these joints are susceptible to injury due to aging, deterioration, strain, trauma, and repetitive injuries.
At Pinnacle Surgical Orthopedics, Dr. Rory Sandberg specializes in the treatment of hip and knee issues related to the aging process, as well as inflammatory arthritis, necrosis of the hip or knee, post-traumatic arthritis, degenerative hip labral tears, degenerative meniscal tears, and problems with previously performed total hip or knee replacements. He received fellowship training at the prestigious Indiana University-Saxony Hospital, which has been shown to have some of the best joint replacement outcomes in the country.
If you have joint pain in your hip or knee that no longer responds to conservative treatments such as medication, cortisone injections, viscosupplementation injections, or physical therapy, then you may be a candidate for joint replacement.
Dr. Sandberg will conduct a comprehensive examination and advise you of options. He performs several different joint replacement procedures, including:
- Revision hip and knee replacement (including infections)
Chronic Hip and Knee Pain
Your hips and knees are especially vulnerable to wear and tear and diseases such as osteoarthritis (also known as wear-and-tear arthritis), as well as other related conditions. These complex joints bear your entire body load as you sit, stand, walk, or run.
Cartilage in these joints works likes a shock absorber. Articular cartilage in the knee, for example, cushions and reduces stress on the bones of your upper and lower leg. Likewise, the two C-shaped menisci, another type of knee cartilage, help to stabilize the knee and allow the bones to glide easily during motion.
The bones of the hip joint are also covered with articular cartilage, and a ring of cartilage called the labrum lines the outside rim of the hip socket. The labrum provides cushioning and support for the hip joint.
As you age, cartilage begins to undergo certain degenerative changes. It becomes thinner and more prone to tearing. Without cartilage to protect the bones in the joint, the bones start rubbing together during movement, causing swelling, stiffness, and pain.
Common symptoms of chronic hip pain from arthritis can include:
- Pain that worsens throughout the day
- Difficulty putting on socks and shoes
- Trouble getting in and out of a car or chair
- Difficulty going up or down stairs
- Pain that is worse with activity and improves with rest
- Pain localized to the groin, front of thigh, or buttock
Common symptoms of chronic knee pain from arthritis can include:
- Pain that worsens throughout the day
- Knee instability (feeling that the knee is giving way)
- Pain that gets worse with activity and improves with rest
- Pain localized to the knee area
- Difficulty going up or down stairs
- Trouble sitting down or standing
Once a hip or knee has developed these hallmarks of arthritis, it needs to receive unique treatment as a whole, rather than trying to treat one component (such as a labral tear in the hip or meniscal tear in the knee) in isolation. Rather than immediately seeking a repair or replacement, the goal of treatment becomes symptom management to help maintain an acceptable quality of life. Many non-operative treatments have been shown to be successful in the treatment of hip or knee arthritis, such as:
- Activity modification
- Use of an ambulatory aid
- Viscosupplementation injections (knee only)
- Cortisone injections
- Strengthening exercises, which can be done at home or with the assistance of a physical therapist
- Oral medications such as Tylenol and anti-inflammatories
- Maintaining a healthy weight
- Sleeves
- Braces
- Topical agents
If non-operative measures fail, or patients wish to have a more permanent fix, then joint replacement is an option.
During total hip replacement, the painful surfaces inside the hip joint are removed and replaced with new bearing surfaces, most commonly a ceramic ball and a highly cross-linked polyethylene hip socket.
During total knee replacement, the painful surfaces inside the knee are resurfaced in all three compartments of the knee. This resurfacing removes approximately one centimeter of painful bone and degraded cartilage from the ends of the bone, which are then capped with metal and plastic implants held to the bone with cement.
Partial knee replacement involves a similar process but is performed in only one compartment of the knee.
Arthroscopy for hip or knee arthritis has not been shown to be an acceptable treatment, and in many cases may worsen the disease process.
If you’re considering hip or knee replacement surgery, you should seek treatment by a specialist – one who performs these procedures on a regular basis and at a dedicated joint replacement center, which has been shown to produce superior outcomes.
As seen on NewsChannel 5 Medical Mondays: Adult Hip and Knee Reconstruction
If you or a loved one is seeking comprehensive, lasting care for hips or knees, then look no further than Pinnacle Surgical Orthopedics. Call (615) 885-2778 today for an appointment with Dr. Rory Sandberg, or request an appointment using our convenient online form.
