knee replacement surgery

5 Signs It May Be Time for Knee Replacement Surgery

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knee replacement surgeryIn most cases, the choice to have knee replacement surgery is not made on a whim. Usually, a gradual worsening of knee pain and stiffness has already occurred over the course of several months or even years. If your knee discomfort has become intolerable, here are five signs that it may be time to consider knee surgery.

5 Reasons to Consider a Knee Replacement

You Have Severe Arthritis

If your knee joint is deteriorating from severe arthritis, you might want to consider knee replacement surgery. There are several types of arthritis, such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, traumatic arthritis (injury-related), and avascular necrosis, which happens when the knee does not get an adequate supply of blood.

Your Knees Are Constantly in Pain

Debilitating knee pain may indicate that the strain on the knee joint is becoming worse. Avoid ignoring knee discomfort that worsens over time or occurs often, particularly if it lasts more than a few weeks, prevents you from sleeping, or does not react to prescription medications.

You Are Struggling to Keep Up With Daily Activities

You should consider seeking long-term knee treatment or surgery if your pain is enough to keep you from completing regular tasks or taking care of yourself. Pay particular attention whenever you’re sitting, standing, or climbing stairs—medical intervention may be necessary if you are unable to complete these activities without discomfort, stiffness, or needing assistance.

Your Knees Are Keeping You From Doing the Things You Love

Your knees should not be so bad that they keep you from spending time with the people you care about or enjoying simple hobbies, such as taking walks in nature. Whatever your interests or passions may be, whether it’s cooking or hiking, knee discomfort should not be a reason for you to give up a life worth living.

Nonsurgical Treatments No Longer Work

Non-steroidal anti-inflammatory drugs, intra-articular steroid injections, and viscosupplementation are all examples of conservative treatments that may alleviate pain and restore function in the early stages of knee disease.

However, if the arthritic process worsens over time, patients will have worsening pain and diminished function that cannot be treated with conservative methods alone. A complete knee replacement should be carefully considered at this stage.

Schedule a Consultation for Knee Replacement Surgery in Pinehurst, NC

For more information about knee replacement surgery in Pinehurst, NC, or to see if you’re a good candidate for this procedure, schedule an appointment with Dr. Moore at the Pinehurst Surgical Orthopaedic & Joint Replacement Center today by calling (910) 295-0224.

young man sleeping on bed

Sleep Problems after Knee or Hip Replacement

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One of the common problems we hear from our Pinehurst Surgical patients after their knee or hip replacement is sleep. They’ve been through the stress of the surgery, but now find a good night’s sleep to be as out of reach as running a 100-meter sprint.

This is an unfortunate common phenomenon after knee and hip replacement. It’s unfortunate not only because everyone hates tossing and turning throughout the night, but that your body needs the sleep time to do its magical nighttime repair work on the tissues around your new knee or hip.

Here’s some more on insomnia after replacement surgery.

You need the sleep

We all need a good night’s sleep; there’s plenty of research out there on the benefits. This is even more true when you’re recovering after knee or hip replacement with Dr. Moore. Here’s why you really need sleep at this time:

  • Sleep helps you physically heal — When we sleep our body can focus on healing, as it doesn’t have anything else to do. It’s an opportunity for our systems to decrease inflammation, clear bruising, decrease swelling, and rebuild affected tissues. When we’re sleeping, our brain triggers the release of hormones that encourage tissue growth.
  • Sleep helps reduce stress and anxiety — Recovery from replacement surgery isn’t a walk in the park. We can feel stressed and anxious about our long-term results. Sleep helps us combat mental fatigue, reduces blood pressure, and helps to mental recharge which is important for setbacks that can occur during recovery.
  • Sleep gives you the energy for rehabilitation — You need energy to work through the physical therapy ahead of you. You want to be able to push as much as necessary to aid your recovery, and you need restful sleep to do so.
  • Sleep boosts overall health — Sleeping 7-8 hours a night is linked to better overall health in all sorts of areas, everything from lower obesity rates to lower blood sugar levels.

Three reasons you’re not sleeping

There are different reasons you may not be sleeping during your initial recovery from knee replacement. These are the three most common:

  • Pain and discomfort — The pain will last for several weeks. After you hit the 2–3-week mark in recovery, your narcotic pain medication is cut back or eliminated. And you’ve increased your activity level to meet the demands of your rehabilitation. This can make pain spike during bedtime.
  • Narcotic pain medication — Pain killers combat pain, of course, but the medication itself can also cause insomnia. Some prescribed pain meds affect your natural REM cycle and disrupt sleep patterns.
  • Depression and anxiety — It’s not uncommon for someone who’s had joint replacement to have some feelings of depression. You can fret about your ongoing recovery time. You can be anxious about your future ability to return to various activities. You can feel isolated because you can’t participate in some of the things you formerly did while you’re recovering.

So, now you know that sleep problems are a common side effect after having knee or hip replacement. The good news? At about the six-week mark you should be experiencing much less pain, be off pain medications, and likely able to sleep in more comfortable positions. That should get you back to your normal sleep patterns.

Do you have chronic hip or knee pain? Give Dr. Moore a call at Pinehurst Surgical, (910) 295-0224, to set up a consultation.

a man touching his knee at pain point

Common Reasons Your Knee Hurts All the Time

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Everyone can have occasional knee pain. Maybe you slipped on some wet leaves this past fall and tweaked your knee. Maybe you were playing an awkward lie over at Pinehurst #2 and after you nearly shanked your shot, your knee told you it wasn’t a fan.

Those instances of knee pain are fleeting, maybe lasting a day or two.

Chronic knee pain is a different story. Estimates place from 15-20 percent of men and about 20 percent of women suffering from chronic knee pain. Chronic knee pain trails only chronic back pain in its prevalence in the U.S. population.

If your knee pain begins to preclude you from doing the things you want to do in your life, it’s time to consider treatment. Down that line, the final option is knee replacement with Dr. Moore at Pinehurst Surgical.

In this first blog of a New Year, let’s get into some of the conditions behind that aching knee of yours.

What are some causes of chronic knee pain?

Unlike temporary knee pain that improves, chronic knee pain rarely goes away without treatment. It can’t always be pinned on one cause or incident, but can result from several of these causes or conditions:

  • Osteoarthritis — This “wear and tear” arthritis typically occurs in patients 50 and over. As the cartilage begins to wear away, the cushioning in the joint decreases and pain follows.
  • Tendinitis — Pain in the front of the knee that is made worse when taking stairs or walking up an incline.
  • Bursitis —Inflammation of the knee bursae, usually due to overuse or poor technique when doing things such as running.
  • Chondromalacia patella — This is damage to the cartilage under the kneecap.
  • Rheumatoid arthritis — Your body’s immune system mistakenly attacks your joints, causing swelling and joint degradation.
  • Post-traumatic arthritis — This is another common form of osteoarthritis caused by a previous injury to the knee or another form of trauma.
  • Dislocation — Dislocation of the kneecap. This usually leads to future arthritis.
  • Meniscus tear — A tear in the cartilage that cushions the knee. A torn meniscus does not heal.
  • Torn ligament — Four ligaments help keep the knee in its proper position. The most commonly torn of the four is the anterior cruciate ligament (ACL).

If you’re suffering from chronic knee pain strong enough it is impinging upon your life, it’s time to give Dr. Moore a call at Pinehurst Surgical. Call us at (910) 295-0224 to schedule a consultation.

Knee Anatomy 101

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Knee replacement has become a relatively commonplace procedure — last year in the U.S. over 700,000 people had knee replacement. Those numbers are expected to continue to grow as more and more baby boomers move into their mid to upper 60s and above. Estimates place knee replacements in the U.S. at 3.5 million by 2030. 

That’s a whole lotta titanium and Teflon replacing bone and cartilage. 

Dr. Moore is a board-certified orthopaedic surgeon who has been serving our patients at Pinehurst Surgical for over two decades, and he has helped many people overcome their chronic knee pain caused by osteoarthritis through outpatient and inpatient knee replacement. 

But what do we all really know about our knees anyway? We know they allow us to make all sorts of complex movements, from running in a softball game to springing up to grab a rebound on a basketball court. But what makes up our knees? Let’s get into that in this autumnal blog for Pinehurst Surgical Orthopaedic & Joint Replacement. 

Let’s call it Knee 101. 

The largest joint in the body 

Working like a hinge, our knee is the largest joint in the human body. It’s the junction of the bones of the upper and lower legs. The knee consists of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (the kneecap). 

The ends of the bones are covered with a layer of cartilage, a slick, elastic material that absorbs shock and allows the bones to glide easily against one another as they move. Between the tibia and femur bones are two crescent-shaped pads of cartilage that reduce friction and disperse the weight of the body across the joint. They are the lateral meniscus (situated at the outside of the knee) and the medial meniscus (situated on the inside of the knee). 

The bones of the knee are held together in a joint capsule, which consists of two distinct layers — an outer layer of dense connective tissue and an inner membrane, called the synovium, which secretes a fluid to lubricate the joint. 

The outer layer of the capsule is attached to the ends of the bones and is supported by these ligaments and tendons: 

  •     Quadriceps tendon, which attaches the quadriceps to the patella
  •     Medial collateral ligament (MCL), which gives stability to the inner part of the knee
  •     Lateral collateral ligament (LCL), which stabilizes the outer part of the knee
  •     Anterior cruciate ligament (ACL), which is located in the center of the knee and prevents excessive forward movement of the tibia
  •     Posterior cruciate ligament (PCL), which is located in the center of the knee and prevents excessive backward shifting of the knee

Two groups of muscles support the knee: the hamstrings on the back of the thigh, which run from the hip to just below the knee and work to bend the knee; and the quadriceps, four muscles on the front of the thigh that run from the hip to the knee and straighten the knee from a bent position. 

Now you’re a knee expert. There’ll be a pop quiz later! So how does your knee feel? If it’s causing you chronic pain, it’s time to give us a call at Pinehurst Surgical, (910) 295-0224, and let’s see how Dr. Moore and our entire team can help.

What expectations can I have with total knee replacement?

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Last month we talked about how the prevalence of joint replacement is increasing in the U.S. population. Last year in the U.S. alone, over 700,000 people received new artificial knees.

But when patients meet with Dr. Moore talking about their chronic pain and what they hope to gain with knee replacement, they often don’t know what they can expect from the procedure. What will they be able to do moving forward, for instance?

Let’s get into that in April.

Expectations for your surgery and your new knee

As a patient moves forward toward having knee replacement, Dr. Moore wants his patients to have realistic expectations for these replacements. The human knee is a miracle machine of both function and durability. While today’s artificial replacements are excellent, they still have some limitations.

Over 90 percent of people who have total knee replacement report a dramatic decrease in pain and a significant increase in the ability to perform common activities such as walking. But your artificial knee won’t make your knee superhuman.

With normal use and activity, every knee replacement implant begins to wear in the plastic spacer. Not respecting your new knee speeds up this wear. Placing too much impact or gaining lots of weight can cause the knee replacement to loosen and become painful. That’s why the high-impact sports and activities need to be replaced by low-impact or no impact exercises and activities.

But when patients follow their rehabilitation guidelines and do the necessary work on their part the vast majority of our Pinehurst Surgical Orthopaedic knee replacement patients are quite happy with their new knee.

What kinds of activities can I do after I have a knee replacement?

Our knee replacement patients from across the Carolinas are excited by the feeling of freedom after having this surgery. That’s because their knee pain was causing them to have to miss out on more and more activities such as hiking or even walking around the block.

You’ll be walking at just 1 to 3 weeks, but you’ll use a walker. From there you’ll move to crutches, and then a cane. In 4-8 weeks, you should be walking without support.

Many Carolinians equate “activities” with sports. Here are some dos and don’ts moving forward. Again, Dr. Moore stresses these guidelines toward the goal of the longest duration for your new knee.

  • Swimming, cycling, and golf can resume after the surgical wound is healed.
  • Jogging, basketball, and volleyball are likely out, as they put pressure on your new knee and will cause it to wear out more quickly.
  • Tennis should probably change to doubles only, and at a relaxed pace. Or consider switching to pickleball.
  • Downhill skiing, skating, and sports where there is a risk of falling can be resumed, but the patient should have been proficient prior to their surgery, and you need to understand the risks.

Do you have chronic knee pain that’s impeding your life? Call Dr. Moore at Pinehurst Surgical Orthopaedic & Joint Replacement, (910) 295-0224, to schedule a consultation.

close up back and white picture of man holding knee with both hands

Alternatives to Knee Replacement Surgery in NC

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Whether you’re trying to put off your knee replacement surgery until you meet your deductible, or you simply can’t take the time off, are there alternatives to knee replacement surgery? While the damage to your knee may something you can live with for some time, eventually, knee replacement surgery will become necessary to prevent you from losing too much mobility in your leg. Until then, we can help you manage the pain and discomfort until you are ready for surgery.

Preventing Aggravation to Your Knee

One of the best ways to minimize your knee pain is to stay off your knee as much as possible. You’ll need to avoid the activities that stress your knee the most, whether it’s racquetball or biking. You can replace your activity with something more congenial to your knee joints, like swimming, because it is still going to be important that you exercise and maintain your health.

Options for Managing Knee Pain

We can help you manage your pain in a variety of ways. Icing and heating the knee can help reduce swelling and stiffness. NSAIDs like ibuprofen can also help to keep your pain and swelling to a minimum to reduce the level of discomfort you experience. If those therapies don’t work, we can give you a steroid injection. You may also benefit from visco-supplementation (a series of injections to the knee joint). Between treating the pain and preventing aggravation to your knee that further exacerbates the old damage, we can extend the time you have left before you are forced to have knee replacement surgery.

Patient Testimonial

(Google review)

“They were so quick with my appointment without me feeling like I was being rushed out. I only waited a few minutes before being called in, my nurse and doctor were so nice and listened fully to any and all of my concerns or questions. I found this to be such a great experience, and am very happy with my choice to go here for my care!”  -Christina P.

When Is It Time for Knee Replacement Surgery?

For many of our patients, the final determinant of when to have knee replacement surgery is a decision based on how much pain you are in and how much you can tolerate. It also depends on your mobility. When your quality of life is more impacted by not having surgery, it’s time to have the surgery.

For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

How to Avoid Knee Replacement Surgery

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The knee is a joint that takes a lot of brutal punishment over the course of a person’s life. It doesn’t matter what activity you’re doing – walking, running, biking, tennis, football, soccer, weightlifting – they all depend on your knees. So how do you avoid damaging your knees enough that you require knee replacement surgery?

What Is Total Knee Replacement Surgery?

Knee replacement surgery is a surgical procedure performed to relieve the knee pain caused by injury, age, or arthritis in the knee.  Here at our Pinehurst, NC surgical center, Dr. John Moore uses a metal-on-plastic artificial knee joint to replace the hinged joint of the knee. While you may not be able to prevent age-related deterioration of the cartilage or arthritis, you may be able to prevent knee replacement surgery from athletic injury and prolong the life of your knee joints through practicing good joint health.

The Key to Healthy Joints Is Exercise

It may seem counterintuitive, but the more you move, the better it is for your joints. Exercise not only keeps you flexible and keeps the tendons and muscles that support your joints in shape, but it helps to keep your weight at a healthy level. Carrying extra pounds makes your knee joints work that much harder.

Protect Your Joints with the Right Gear

Knee pads and knee braces should be worn when needed, whether they’re part of your sports gear or just a precaution. Biking, inline skating, and other activities may not require the gear, but a single accident can injure your knee sufficiently to require knee replacement surgery.

Stretch and Strengthen

Stretching is important, but if you do it at the wrong time, you put your joints at risk. Warm up first and loosen up your muscles with a walk or a 10-minute jog – then stretch. Work on strengthening your core, your leg muscles, and increasing your range of motion.

You may not be able to prevent the need for knee replacement surgery, but you can give your knees their best chance by incorporating these healthy joint habits. For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

How to Prepare for Knee Replacement Surgery

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Knee replacement surgery is a common joint replacement surgery that can increase your ability to remain active and improve your quality of life. If you’ve been living with knee pain or have needed knee replacement surgery but have been nervous to proceed, you can stop living in pain. Orthopaedic surgeon Dr. John R. Moore and his staff offer relief from the pain with total knee replacement surgery at their surgical center in Pinehurst, NC.

How Is Knee Replacement Surgery Performed?

During your knee replacement surgery, Dr. John Moore will replace the hinged joint of the knee with an artificial knee joint. The surgery will only last about an hour. Recovery time, including physical therapy to build up strength in the leg and range of motion, usually takes about three months.

Before Your Surgery

Before your surgery, you will need to see your primary care physical to review your medical state and ensure you are healthy enough to undergo anesthesia. You may be asked to stop taking medications and supplements up to a week before the surgery, especially supplements like fish oil, vitamins, iron tablets, and calcium supplements as well as anti-inflammatory medications and NSAIDs. You will be asked to attend a patient information class a few days before your surgery to help you prepare.

The Day of Your Knee Replacement Surgery

Most knee replacement surgeries are outpatient procedures, so you will go home after you are sufficiently recovered. This means you do need someone to come with you for the surgical procedure who can drive you home. While the surgery itself only lasts about an hour, you will be in the operating room, pre-op, and recovery room for several hours. Your doctor will work with you to develop a pain management plan that limits or avoids the use of opioids.

After Surgery

In the days after your total knee replacement surgery, you will see a physical therapist the day of your surgery or the next morning in order to develop a therapy plan to regain your mobility and flexibility as quickly as possible. Complying with the therapists recommended exercises is vital. It won’t be long until you are up and moving again and back to your regular activities.

For More information about Knee Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

Knee Surgery Pinehurst, NC

How to Avoid A Ski Injury This Winter

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Tis the season for all things snow. If you are a big snow enthusiast then you may have more than a few ski trips planned. However if you have had a prior knee injury, then you know just how scary skiing and other snow sports can be. To help you avoid getting an injury while you’re on the slopes, Dr. John Moore has created a list of things for you to do.

Wrap It

One of the easiest ways to get an injury while you’re skiing is to lose stability. To help you keep your knee protected, try wrapping it before you head out on the slopes. This extra added support will help keep your knee in place while you’re downhill skiing.

Ice Afterwards

If you notice that your knee is feeling a little bit sore and tender after you spend the day skiing, try to ice it as soon as you get home. Ice is one of the easiest ways for you to get rid of swelling without having to take any medication. To ice your knees, put some soft ice packs over your knees and then bandage them over the top so that they don’t move.

Wear the Right Size of Ski Boots

Whether you are planning on using old ski boots or if you are renting ski boots, make sure that they fit your feet well. Boots that are either too large or to small may cause you to trip and get either a foot, ankle, or knee injury.

If you have recently had knee surgery and you are getting ready to go skiing, make sure that you use these tips so that you avoid getting an injury. To learn more about other ways for you to protect yourself and your joints, contact our Pinehurst office today at 910.295.0224.

Osteoarthritis Pinehurst, NC

Pain in the Knee: What May Be Causing Your Knee Pain

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When it comes to joint pain, nothing is quite as common as patients who feel it most in their knees. Even though your knee pain may have felt like it came out of nowhere, there are three common culprits that may be causing it. Let’s take a closer look at them to see if you fit into one of these categories.

Osteoarthritis of the Knee

If you are over the age of 50 and are experiencing knee pain, then it may be due to a condition called osteoarthritis of the knee. Because osteoarthritis is slow developing, you may have had it for years without ever knowing about it. This degenerative form of arthritis usually occurs when the knee cartilage wears away at the joint space between the bones of the knee. In extreme instances, it may result in bone on bone joint pain.

Avascular Necrosis

This condition is usually caused after some sort of trauma or accident in which the bone loses blood supply. Because bones are living tissues, if their blood supply is interrupted, the bone will begin to die and collapse if left untreated. As you can imagine, this process will lead to some knee pain.

Post-Traumatic Arthritis

We see this form of arthritis in joints all across the body including knees, shoulder, elbows, and hips, but it can also occur in your knees. Post-traumatic arthritis is a form of osteoarthritis but rather than it being caused by age, it’s usually caused by injury or another form of trauma.

These are just three of the common culprits of knee pain, but it can be caused by many different factors as well. If you suffer from knee pain, let Dr. John Moore help you find some relief. Schedule your consultation at our Pinehurst office today and call us at 910.295.0224.