The Limited Research Available Suggests Spinal Pathology Predicts And Warns Of Less Pain Relief And Worse Outcomes After Total Hip Replacement
These same unfortunate results had been previously reported earlier in 2017 by doctors at the Department of Orthopaedic Surgery, the University of California, San Francisco in The Journal of Arthroplasty:
- The coexistence of degenerative hip disease and spinal pathology is not uncommon for the number of surgical treatments performed for each condition increasing annually.
- The limited research available suggests spinal pathology predicts and warns of less pain relief and worse outcomes after total hip replacement.
The UCSF researchers concluded their study with:
- Patients with preexisting lumbar spinal fusion experience worse early outcomes after primary total hip replacement including higher rates of complications and reoperation.
- The complex interplay between the lumbar spine and hip warrants attention and further investigation.
Stomach Problems After Hip Replacement
You might feel a little stomach ache after the surgery, moreover, gradually with time, the pain will get away.
Apart from that, its not more of a big deal though, & a small stomach pain cant be the reason behind not going for the surgery.
However, you might feel headache, nausea, abdominal bloating after the surgerybut its sure that your severe hip pain will get away.
The Low Back Pain In Patients With Hip Osteoarthritis: Current Knowledge On The Diagnosis Mechanism And Treatment Outcome
Weijun Wang, Minghui Sun, Zhihong Xu, Yong Qiu, Wenjie Weng
Department of Joint Surgery The Affiliated Drum Tower Hospital of Nanjing University Medical School , , China
Contributions: Conception and design: W Wang, Y Qiu, W Weng Administrative support: Y Qiu, W Weng Provision of study materials or patients: W Wang Collection and assembly of data: W Wang, M Sun, Z Xu Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Abstract: The low back pain might be the most common comorbidity of hip osteoarthritis , with reported incidence of 21.2% to 100%. Its critical to identify the LBP secondary to the HOA for treatment protocol making. A throughout history, physical examination, differential diagnosis test, and understanding on the pathogenesis of LBP are needed to different the sources of LBP. The LBP secondary to HOA could be relieved by the treatment of HOA, such as total hip arthroplasty.
Keywords: Low back pain hip-spine syndrome sagittal alignment range of motion arthroplasty
Received: 20 May 2016 Accepted: 03 June 2016 Published: 28 June 2016.
doi: 10.21037/aoj.2016.06.03
Figure 1
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Tests Reveal Advanced Arthritis Or Significant Joint Damage
Your hip is a ball-and-socket joint. Cartilage and synovial fluid reduce the friction caused where the socket in the pelvic bone and the ball of the femoral head move together. Significant joint damage caused by arthritis or other joint conditions can create inflammation, causing the cartilage to wear away. Without cartilage, theres no cushion between the bones rubbing together, and they begin to wear down. Advanced cases of joint damage may make surgery necessary.
Hss Is A Top Choice For Hip Replacement
At HSS, our hip replacement surgeons are among the most skilled surgeons in the world. In addition to their deep expertise and extensive training, they have a singular focus on joint replacement surgery. This experience allows them to achieve very high success rates, avoid complications and help effectively relieve our patients pain.
Another advantage is that the hip replacement surgeons at HSS embrace the multidisciplinary aspects of orthopedic care. They work closely with anesthesiologists, rehabilitation specialists, nurses and many others to keep our patients safe and healthy so they can get back to what they love to do.
Posted: 4/9/2021
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Can You Get Both Hips Replaced At The Same Time
Both left and right hips can be replaced during a single surgery. A double hip replacement is also called a bilateral hip replacement. If you are having issues with both hips, your doctor might recommend a double hip replacement if you are in good health and can tolerate a longer surgery and a more challenging recovery.
Conservative Treatments Do Not Adequately Relieve Hip Pain
Many people with conditions affecting the hip joint, such as arthritis, do not need hip replacement surgery immediately. Your doctor will probably attempt conservative treatment options initially, including:
- Physical therapy: Strengthens and stabilizes muscles surrounding the hip joint and can also preserve the hips range of motion
- Steroid injections: Reduces swelling and blocks pain sensations
- Anti-inflammatory medications: Reduces inflammation in the hip joint, which can relieve pain
These treatments do not cure hip conditions. However, they can improve function and make hip pain more tolerable. Unfortunately, there may reach a point when these conservative measures become less effective and fail to provide relief. When that happens, your doctor may suggest hip replacement surgery.
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Anatomy Of The Hip Joint
The hip is an important load-bearing joint. Thats why a hip joint that isnt working correctly can cause so much pain and discomfort. The hip joint is where the top of the thigh bone meets a socket inside the pelvis . Ligaments connect the femoral head to the acetabulum. The joint is lined with synovium, a membrane that produces fluid to lubricate the joint and keep it moving smoothly. The joint is cushioned by fluid-filled sacs, or bursae, designed to remove friction between the surrounding muscles, tendons, and bones.
Find Out If Youre A Candidate For Hip Replacement At Orthobethesda
If you struggle with severe hip pain or disability, you may be a candidate for hip replacement surgery. To find out if thats an appropriate treatment option for you, contact the team at OrthoBethesda. Our highly skilled orthopedic specialists serve the community in and around Bethesda, MD, with compassionate care and can help you decide on the best treatment option for your hip pain. Call us today at .
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Is Hip Replacement Surgery For You
Hip pain can be hard to deal with. Not only can it cause soreness, stiffness, and inflammation, but it can interfere with critical day-to-day activities like walking and moving.
If youve suffered from hip pain for a long time, you may be considering surgery. But how do you know if hip replacement surgery is a good choice for you?
No Relief From Other Treatments
Most hip problems can be resolved without a full hip replacement. There is a range of treatments available, including physiotherapy, medication and hip resurfacing that may better address your symptoms.
If your hip pain is not severely limiting your daily life, or you have found ongoing relief from these less invasive treatments, then it indicates a hip replacement is likely not the right option for you yet.
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Patients May Still Be Undergoing Knee Arthroplasty For Degenerative Lumbar Spine And Hip Osteoarthritis
Here is study from surgeons in the United Kingdom. Published in the medical journal International Orthopaedics, the surgical team of this study wanted to answer the question as to why up to 20% of total knee replacement patients complain of persisting pain after the knee replacement. Here was there answer:
- The investigators examined 45 consecutive patients with pain after total knee replacement. Of the 45 patients, one-third, 15 patients had degenerative hip and lumbar spine disease. Nine patients had unexplained pain.
- The study concluded: Patients may still be undergoing knee arthroplasty for degenerative lumbar spine and hip osteoarthritis. We suggest heightened awareness at pre- and post-operative assessment and thorough history and examination with the use of diagnostic injections to identify the cause of pain if there is doubt.
How Hip Replacement Surgery Is Performed
A hip replacement can be done under a general anaesthetic or under a spinal anaesthetic .
Sometimes you may have an epidural, which is similar to a spinal anaesthetic.
The surgeon makes a cut into the hip, removes the damaged hip joint and replaces it with an artificial joint or implant.
The surgery usually takes around 1 to 2 hours to complete.
Find out more about how a hip replacement is done.
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You Know Your Hip Is Causing Your Pain
Sometimes pain around your hip is actually caused by pain in your back or knee. In these cases, hip replacement surgery wont help. To see where your pain is coming from, your doctor can numb your hip. If you still have pain in your hip afterwards, then your pain is probably coming from your back or knee.
What Are We Seeing In This Image Pelvic Pain In A Spinal Fusion Patient
In this x-ray image of a pelvis, we see a previous surgical fusion in a patient. This patient developed severe bilateral sacroiliac pain following the surgery. We can see the close proximity between the fusion instrumentation and the sacroiliac joints.
A July 2020 study in The American Journal of Sports Medicine noted: Medical research suggests that lumbar spine disease is an independent risk factor for poorer outcomes following total hip replacement however, the effect of lumbar spine disease on hip replacement outcomes has not been fully investigated. At present, there is little in the research investigating the effect of coexisting hip and lumbar spine disease on outcomes after hip replacement.
Note: Above we started this article with a study from 2012 suggesting that hip-spine pain is an under-investigated phenomenon. This is still so in July 2020. In this study, it was found that Patients with known lumbar spine disease who underwent hip replacement had a significantly greater percentage improvement at 24-month follow-up compared with those without a history of lumbar spine disease, and outcomes were ultimately not significantly different. No increased risk of reoperation was noted in patients with concomitant lumbar spine disease. Hip replacement helped these peoples back pain without the ultimate need for spinal surgery as well.
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Do You Have Questions Ask Dr Darrow
A leading provider of stem cell therapy, platelet rich plasma and prolotherapy11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025
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The Mechanism Of Lbp Caused By Hoa
The reduced range of motion in hip joint was also found be involved in the mechanism of LBP. Several studies have reported reduced internal rotation of the hip in athletes or general population suffering LBP . In addition, the limited hip flexion , reduced hip abduction , total rotation and asymmetric hip rotation were also identified in patients with LBP. Hence it has been proposed by previous studies that reduced ROM of the hip might contribute to the pathogenesis of LBP, by leading to a greater lumbopelvic rotation in compensation, subsequently inducing increased mechanical stress in the lumbopelvic region. In patients with HOA, the hip function accessed by the Western Ontario and McMaster Universities Arthritis Index was found to correlate significantly with LBP , and limitation of flexion has been identified as an independent risk factor for LBP . Hence further study should be carried out to explore the role of reduced hip ROM on the LBP in patients with HOA.
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Revision Hip Replacement Surgery
Your hip implant may wear out or loosen over time. It might also become damaged if you have an injury or dislocation. You may need a revision surgery to replace the damaged parts of the prosthesis. Most hip prostheses last 20 years or longer. You might be able to extend the life of your implant by doing regular low impact exercise, avoiding high impact exercise and taking precautions to avoid falls.
A rare risk of hip replacement is infection, which can happen if bacteria circulating in the bloodstream get caught in the prosthetic pieces. An infection may require a revision surgery to remove the infected tissues, and a course of antibiotics to kill the bacteria. When the infection is gone, a new prosthetic can be put back in.
If you had a partial hip replacement , you may need a revision down the road to replace the socket as well.
What Are The Risks Of Hip Replacement Surgery
Most patients do well with hip replacement. As with any surgical procedure, there are some risks during and after a hip replacement:
- Bleeding
- Blood clots in the legs or lungs
- Leg length discrepancy
- Loosening or wearing out of the prosthesis
- Unrelieved joint pain
In very, very rare cases of bone surgery, particularly procedures using cement, an embolism can occur if fat from the bone marrow enters the bloodstream. A fat embolism can raise the risk of a heart attack or stroke.
There may be other risks depending on your medical condition. Be sure to discuss any concerns with your doctor before the procedure and ask which risks are highest for you.
After the surgery, notify your doctor if you notice any of the following:
- Fever
- Redness, swelling, or bleeding or other drainage from the incision site that doesnt stop after a few days
- Increased pain around the incision site
- Pain in the lower leg that is unrelated to the incision
- New or increased swelling of the lower leg
- Chest pain
- Shortness of breath
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Is It Really The Glutes
When this patient comes into our clinic, we talk with them about the difficulties in isolating one part of the pelvic-hip-spine complex as the main culprit of their problem. This we find especially true in treating a patient with problems of Gluteus Medius tendinopathy. We are not the only ones to understand this challenge.
A February 2020 study in the Journal of Physical Therapy Science offered this:
Gluteus medius syndrome is one of the major causes of back pain or leg pain and is similar to greater trochanteric pain syndrome, which also presents with back pain or leg pain. Greater trochanteric pain syndrome is associated with lumbar degenerative disease and hip osteoarthritis. Gluteus medius syndrome is also related to lumbar degenerative disease, hip osteoarthritis, knee osteoarthritis, and failed back surgery syndrome. Accurate diagnosis of gluteus medius syndrome and appropriate treatment could possibly improve lumbar degenerative disease and osteoarthritis of the hip and knee, as well as hip-spine syndrome and failed back surgery syndrome.
Reasons Not To Wait To Get Your Hip Replacement
May 14, 2017
Surgery is often considered a last resort treatment, right?
If you can manage a condition with medication, or struggle through the pain, or make some significant lifestyle changes, you might cope with a health problem without having to go under the knife.
Thats true of certain health issues, but a significantly damaged hip joint isnt one of them.
When it comes to arthritis of the hip, waiting too long can make things worse in the long run. Here are our orthopaedic surgeons top reasons NOT to wait to get your hip replacement surgery.
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Sciatica Symptoms In Hip Is It Sciatica Or Something Else
Sciatica symptoms in the hip is a very common feature of sciatica but it can also be a sign of a completely different issue entirely. Use this handy guide below to find clues as to whether your pain is a sign of sciatica symptoms in the hip or a different problem.
Before we dive in, please be aware that we are part of the Amazon Affiliate programme. This page may contain Amazon affiliate links, so if you choose to purchase a product for your sciatica that we recommend through a link on this page, we will receive a small commission at no extra cost to you. This helps us keep Overcome Sciatica alive! Thank you for your support. Please be assured that we only ever recommend products that we truly believe can help.
So How Could My Hip Mri Be So Wrong Here Is A March 2019 Study
In March 2019, in the surgeons journal Clinics in Orthopedic Surgery, surgeons and radiologists at the Chung-Ang University College of Medicine in Seoul, Korea shared these findings with the international medical community.
We are going to go back to talking about sensitivity and specificity .
In this research, the doctors and radiologists investigated sensitivity, specificity, and accuracy of magnetic resonance imaging and computed tomography arthrography , on the basis of arthroscopic findings, to diagnose acetabular labral tears and chondral lesions.
- They reviewed the results of MRI and subsequent CTA in 36 hips that underwent arthroscopic surgery
- All patients had positive impingement test results and groin pain.
The sensitivity, specificity, and accuracy of computed tomography arthrography for detection of acetabular labral tears by two observers were 60%, 80%, and 64%, respectively, and 65%, 70%, and 69%, respectively.
- In other words, 64% of the time or 69% of the time, the computed tomography arthrography and its interpretation correctly identified acetabular labral tears. How was this verified? By observation during arthroscopic surgery.
- So it is possible that 31-36% of people had arthroscopic surgery to DISPROVE what the computed tomography arthrography suggested.
If you think that is bad. Here is the comparison to MRIs
What could the researchers conclude other than:
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