January 2018

by Nancy Alexander, PT, CSCS

So, you’re thinking about getting a hip replaced. You’ve had enough of the pain and limitations. Here are some considerations and questions to ask as you research this more. The answers can help you understand the pros and cons of different kinds of procedures and help you know what to expect after surgery.

There are different approaches to this – literally. The more traditional surgery is called a posterior approach. As it sounds, the incision is more towards your backside. More recently, some physicians are using an anterior approach to total hip replacement surgery. This incision is more towards the front of you and often a little to the side. One is different from the other but not necessarily better. The actual replacement of the joint does not change (see picture below). Your surgeon can help you understand the differences.

This picture shows a hip with arthritis on the left, and a replaced joint on the right.

If you have a certain surgeon in mind, then make sure that the physician has done his preferred approach many times. I like my surgeon to have had a lot of experience using a certain method. Leads me to have a certain confidence in the outcome. In recent years, we are seeing more physicians use the anterior approach. It is considered less invasive and some argue their recovery is quicker. With the anterior approach, typically (but not always) there are no “precautions” like that with the posterior approach. This can be very helpful right after surgery. The three hip precautions for the posterior approach are:

1) Don’t flex your hip past 90 degrees

2) Don’t cross your legs

3) Don’t turn the operated leg in toward your other leg

Here are the 7 questions to ask your surgeon:

1) What approach do you use? Will I need to follow hip precautions after surgery? If yes, what are they? And, how long do I need to follow them?

2) How soon can I progress from a walker to a cane?

3) Do you use staples or any specialized dressing? There are some new dressings physicians are using that are left on for a week or so, then removed. They are using these for improved infection control measures.

4) How long do you expect me to be in the hospital? There are some hospitals in my area discharging on day 2… one is trialing same day discharge. It is good to know what to expect both for you and for your family/friends/support system. Ask if you should expect a short rehab stay after surgery before you go home, especially if you live alone.

5) How do you manage anti-coagulation needs (blood thinners)? Prescription meds vs aspirin. Will I need to have blood work done regularly to check levels? Do I need to wear compression stockings? If yes, how long?

6) How soon can I shower after surgery?

7) Lastly, my favorite question for everything… Is there anything else I should know?

Arthritis is the most popular reason people opt for a total joint replacement. When the increased pain and decreased function impact your life, that is when most people seek out a surgeon to perform the procedure. Do your homework and ask lots of questions. Then you will have the faith to do it and be closer to doing the things you enjoy again.

http://www.agingwellnow.com/about/

By Nancy Alexander, PT, CSCS

Never mind driving… just walking in our current winter conditions can be challenging. It’s been a tough winter here in the northeast and yesterday a foot of the white stuff landed in my yard, on my driveway and on my walkway. Even if you’re able-bodied, it’s tough to get around. But what about the many adults who require a walker to get from point A to point B. Four wheeled walkers typically have larger wheels and can negotiate these conditions a little better than a front wheeled walker. Front wheeled walkers provide more support and some people simply must use them for safe ambulation. However, they are not designed for New York winters.

Enter the “Off Road Walker Kit.”

“I see folks trying to walk outside with these walkers and it’s next to impossible,” said Paul Nothnagle of Victor NY. “I went looking around on the internet and found this walker kit. I bought it and it really helps.” Paul has been using it for about a month now and he said he feels more stable when walking on sidewalks with snow and slush on them. The rock salt can also make smaller wheels less reliable. “The larger wheels handle it all much better,” said Paul.

In addition, they will come in handy during the warmer months when walking on grass, dirt and gravel surfaces. “They can be used year-round,” Paul added. He noted that this walker does not go inside his home so no messy clean-up is needed. He has another front wheeled walker that waits for him right inside the door for the hand-off. The off road walker stays in the garage or folds when placed in the car.

I did a search myself and typed in “off road walker wheels” and a host of options appeared. One of the kits with 8-inch tires (like Paul’s) and skis for the back legs of the walker sells for about $36.00 on Amazon. There are plenty of options with different tire sizes. Be sure to read the fine print. Consult your physician or movement specialist for recommendations on what options are right for you.

Our winters are long. You can’t stay inside forever. Be safe out there.

http://www.agingwellnow.com/about/

Archives for January 2018

Top 7 Questions to Ask Your Surgeon When Considering Hip Replacement Surgery

This picture shows a hip with arthritis on the left, and a replaced joint on the right.

Winter Walker Travel Advisory