What expectations can I have with total knee replacement?

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.

Joint Replacement Becomes More Mainstream

One consequence of a population whose average lifespan has increased 10 to 15 years over the past quarter century is the question if the machinery, particularly the joints, can take the extra decade or two of work. That explains the continuing increase in joint replacement as the U.S. population ages; our joints need a little help keeping up.

At Pinehurst Surgical, Dr. Moore is a board-certified orthopedic surgeon, so you couldn’t be in any better hands for your total hip and total knee replacement surgeries. Of course, replacement surgery is always the last treatment option, but it is a treatment that is becoming more and more common.

Here’s some information on joint replacement trends.

More frequent

Joint replacement has become a common surgery and it comes with low complication rates. In most cases, pain relief and functional improvement are nothing short of night and day. More and more of these surgeries are being performed as outpatient procedures, such as Dr. Moore performs at our Surgery Center. Twenty years ago, many of today’s surgery options didn’t even exist, and if they did recovery was measured in weeks, not days.

Last year in the U.S. roughly 700,000 knee replacement procedures were performed. Add to that another 400,000 total hip replacements. That combination is projected to swell to 3.5 million annual procedures by 2030 as the population ages.

The trend is to move these surgeries and their initial recovery out of the hospital setting and to outpatient centers, such as The Surgery Center of Pinehurst. Pain management protocols must be followed, but almost all patients would rather be in their own bed rather than the hospital. Home health (following our instructions for movement and the like) and physical therapy are both crucial to facilitate successful outcomes.

Joint procedures performed

At Pinehurst Surgical, Dr. Moore specializes in total knee and total hip replacement. They are the two most popular joint replacement procedures. These are the other common joint replacements:

  • Total shoulder replacement
  • Reverse total shoulder replacement
  • Total elbow replacement

If you have continuing joint pain, call us at Pinehurst Surgical Orthopaedic & Joint Replacement Center, (910) 295-0224.

How Osteoarthritis and Rheumatoid Arthritis Affects the Joints

Arthritis is simply the clinical term for joint inflammation. Various types of arthritis are common, and they lead to pain and stiffness in the joints. Two of the most common forms of arthritis are osteoarthritis and rheumatoid arthritis, yet they affect the joints in different ways.

Since we’re all about your joints here at Pinehurst Surgical, let’s spend this blog noting how these forms of arthritis affect your joints.

A joint

A joint is simply the place where two bones meet. The muscles surrounding a joint move the bones. Muscles are joined to the bones with tendons. At the ends of the bones are layers of cartilage that provide cushion and shock absorption between the bones and prevents them from rubbing against each other. The joint is surrounded by a membrane, called the synovium, which produces a thick fluid that lubricates the joint. The synovium is enclosed by the capsule, which holds the joint together with fibrous bands called ligaments.

Osteoarthritis and your joints

Osteoarthritis affects the entire joint, all of the above pieces. This “wear and tear” arthritis breaks down the cartilage, making it flaky and rough. Pieces may come loose and float about in the synovial fluid. This deterioration in the cartilage leaves the bones unprotected.

As the cartilage thins, the bones around it thicken and may develop bone spurs on the ends. Microfractures may occur in the ends of the bones. The joint capsule and ligaments stretch and may thicken in an attempt to stabilize the changing joint. This can cause inflammation throughout the joint to all the soft tissues.

Osteoarthritis commonly affects these joints: knees, hips, neck, lower back, and the hands.

Rheumatoid arthritis and your joints

Whereas osteoarthritis is due to age and wear and tear, rheumatoid arthritis is an autoimmune disease, where your immune system attacks the tissues in the joints, causing inflammation. Rheumatoid arthritis particularly affects the synovial membrane. This creates an overproduction of synovial fluid, which causes the joints to swell and the capsule to stretch. This causes pain and affects mobility in the joint.

This inflammation causes damage to the cartilage and even the bone ends. The inflammation, if left unaddressed, can result in destruction of the joint. Adjoining tendons can also become inflamed and wear down.

Rheumatoid arthritis commonly affects these joints: wrists, hands, fingers, ankles, toes, shoulders, and the knees.

If you have joint pain, you may have one of these forms of arthritis. This isn’t something to “soldier” through. Call Dr. Moore and our team at Pinehurst Surgical, (910) 295-0224, to make your appointment.

Problems with Your Hips

Because the hips feature large bones, many people don’t think of them when it comes to orthopedics. The knees, shoulders, and even the ankles can seem more destined for overuse and damage.

Ah, but your hips will let you know when they’re not happy. At Pinehurst Surgical, Dr. Moore diagnoses the root causes of our patients’ hip pain, and he employs different options for treatment.

What makes up the hips?

The hip is a ball-and-socket joint that joins the ball of the thigh bone (femur) to the socket of your pelvis. Inside the hip joint is a cartilage lining that cushions impacts between the femur and the hip socket. But those impacts can be pretty intense in the hips, and they can be very repetitive. That’s why dancers, gymnasts, and other athletes that participate in sports with impact often have damage to their hip cartilage, not to mention strains, bursitis, and the effects of osteoarthritis.

Common hip conditions

These are some common hip problems that we treat at Pinehurst Surgical:

  • Bursitis of the hip — Bursitis is the painful swelling of the bursae, the fluid-filled sacs that cushion areas where tendons and muscles slide across bone. When a patient has hip bursitis, the bursa at the top of the femur is affected. Because it is involved in so many movements, when this bursa is inflamed it can be very painful.
  • Arthritis in the hip — Osteoarthritis in the hip is gradual loss of cartilage due to daily wear and tear. As the cartilage wears down, or tears, it leads to chronic inflammation that can make it difficult to sleep, let alone perform certain normal activities. Usually, arthritis in the hip is in the form of osteoarthritis, but it can also develop after a traumatic injury.
  • Osteoporosis in the hip — When a person develops osteoporosis, their bone density drops. This leads to the bones weakening and breaking much more easily than is normal. A precursor of osteoporosis is known as osteopenia.
  • Avascular necrosis of the hip — If you’re old enough to know about Bo Jackson (if not, watch the ESPN 30-for-30 show or check out highlights on YouTube), this is the injury that sent him into retirement. A seemingly simple tackle led to dislocation of his hip. This led to avascular necrosis, where the bone tissue begins to die because it isn’t receiving enough blood. This eventually led Mr. Jackson to full hip replacement.

Having pain in your hips? Maybe it’s time to see Dr. Moore and our team at Pinehurst Surgical Orthopaedic & Joint Replacement Center. Give us a call at (910) 295-0224 to schedule an appointment.

How Corticosteroids Help with Inflammation and Pain

At Pinehurst Surgical, Dr. Moore sees patients with joint pain every day. While his expertise and training as a board-certified orthopaedic surgeon make a difference for his patients when they need knee or hip replacement, surgery is typically only pursued after conservative treatments have been exhausted. One of these treatments is the injection of corticosteroids. Often this is the next step when the patient has not responded to other treatments such as physical therapy or oral anti-inflammatory medications.

Here’s some more information about corticosteroids.

What are corticosteroids?

Although often confused with the steroids we hear about from professional athletes or bodybuilders, corticosteroids are different. The steroids for bulking up are anabolic steroids, not corticosteroids. Corticosteroids are synthetic drugs that closely resemble cortisol, a hormone produced by the body. Triamcinolone, cortisone, prednisone, and methylprednisolone are all examples of corticosteroids.

What do corticosteroids do?

For our patients at Pinehurst Surgical, we typically use corticosteroid injections to reduce inflammation. They can also be used to reduce the activity of the immune system, which can cause inflammation as the body is working against its own tissues, such as in rheumatoid arthritis.

Dr. Moore uses corticosteroids to provide relief from pain and stiffness. For instance, we inject them directly into joints and into inflamed bursa. We also inject them around tendons that have been strained due to repetitive movements, such as in patients with tennis elbow.

Why are corticosteroids injected?

Taking steroids orally can produce numerous side effects — everything from high blood pressure to insomnia to muscle weakness. Plus, corticosteroids taken by mouth or through an IV aren’t assured of reaching the problem area. Injections, on the other hand, guarantee the inflamed joint or area is directly targeted.

How are these injections used in treatment?

For our patients who are otherwise healthy, but maybe have joint pain from early osteoarthritis, we may use only corticosteroids for treatment. This may be sufficient to calm the inflammation and end the pain.

In other patients with more involved conditions, we may use corticosteroid injections as part of an overall treatment regimen that includes physical therapy, possible occupational therapy, supportive devices such as braces, and possible other anti-inflammatory pain medications. This, obviously, depends on the unique situation of the patient.

If you have joint pain, call us at Pinehurst Surgical Orthopaedic & Joint Replacement Center, (910) 295-0224, and let’s see how we can help.

Protect Your Joints through the Holidays

The holiday season is fast approaching and while it will look different this year depending on where you are and how serious the pandemic is, there are steps you can take to make sure that your holiday habits don’t impact your joint health.

Holiday Eating

We all indulge a bit over the holidays, and that’s not a problem, as long as you strive for balance. If you just have to have the gravy, be sure to add in an extra walk that week. If you choose to splurge on Grandma’s homemade pumpkin pie (and you should), try to have a smaller slice or increase your strength training. And instead of a nap after your turkey dinner, enlist your family in a game of basketball or touch football and get moving. The biggest risk to your joint health is sodium intake, because that causes you to retain water, puts extra pressure on your joints, and can increase the amount of pain you are experiencing.

Keep Moving

Our routines tend to get disrupted over the holidays, but if there is any way to maintain your exercise routine – even if you’re doing different activities – it can be good for your joints. Alternatively, if you’re supposed to be staying off your feet as part of your therapy, don’t let holidays be the excuse you use to not take care of yourself. All it may take is one more wrong twist and knee replacement surgery will be how you greet the New Year.

Keep Arthritis Pain at Bay

Being mindful about what you eat, striving for balance, and getting some exercise can all be good for managing your arthritis pain, too. In addition, be sure to stay hydrated and don’t go overboard on the alcohol. You can enjoy the holidays and have a little fun without overdoing it to such an extent that you suffer more.

If your arthritis or joint pain is no longer responding to traditional therapies, you should make an appointment to see Dr. Moore. For More information about, contact our Pinehurst, NC office, call us at (910) 295-0224, or check out our orthopaedic surgery blog.

Alternatives to Knee Replacement Surgery

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.

Managing 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.

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

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.

Benefits of Outpatient Joint Replacement Surgery

There are many benefits to choosing outpatient joint replacement surgery at our facility over traditional outpatient surgery at the hospital. Not only do you get to recover primarily from your own home, but there are a number of additional benefits to choosing our outpatient surgery center instead of a hospital.

Patient Experience

You’ll spend one night in our outpatient facility after your joint replacement surgery. That night you will be cared for by our skilled nursing team with a concierge setting. We provide a 2:1 ratio of nurses to patients, so you are more closely monitored and cared for than the standard 1:8 ratio in the hospital.

Reduced Infection Rate

Because you’re not exposed to a hospital setting, you reduce your risk of exposure to everything from staph to COVID-19. Our facility only takes in healthy patients having outpatient surgery and nothing else. Dr. Moore has successfully completed over 100 outpatient joint replacements in the past four years with ZERO hospital re-admissions after outpatient surgery. The Surgery Center at Pinehurst has six operating rooms, two pain management rooms, and provides outpatient surgeries for joint replacement, plastic surgery, ENT, gynecology, and more.

Improved Recovery Times

Because outpatient joint replacement surgeries performed in the centers like the one at Pinehurst require smaller incisions, the risk of infection is reduced, and recovery time is accelerated. Accompanied by our more intimate, concierge-like post-surgical care, detailed communication, and support for both the patient and the family the overall experience and satisfaction of patients is higher, too.

Who Qualifies for Outpatient Joint Replacement Surgery?

Most private insurances will cover the cost of outpatient joint replacement surgery. The facility is limited to healthy, privately insured patients. Unfortunately, Medicare will not cover the outpatient center for this reason.

The Surgery Center of Pinehurst is located across the street from our practice and provides easy access to the facility for patients and their families. Dr. Moore’s team has created a structured guideline and protocol for impeccable preoperative and post-operative care to all of our patients. For more information about Outpatient Joint Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at (910) 295-0224.

Avoid Injury This Summer

With the warmer weather and we all start spending a little more time outside, it’s a good time to be mindful of the injuries we can sustain after a long, inactive winter. To avoid injury as you resume summer activities, sports, and exercise, heed this advice.

Ease Back into Your Training

Whether you’re an athlete getting ready for a new season of baseball, track, or soccer or a jogger ready to get off the treadmill and back out in the fresh air, there are precautions you should take to avoid an injury that would keep you inactive for weeks or longer.  Be sure to warm up and stretch your muscles before your activity. Listen to your body – if you feel pain or discomfort, moderate the activity or stop.

Wear the Right Shoes

One of the most important ways to prevent injury is to wear the right gear. While that means wearing the proper equipment for your chosen sport (including proper visibility), nothing is more important than the shoes you wear – the right size, the right type of shoe, and the right support structure.

Don’t Overexert Your Body

Unless you’ve been conditioning in preparation for resuming your activities, it’s important to ease into the activity slowly and build up your stamina and strengthen the muscles that support your joints. Early season injuries can be serious – serious enough to require significant downtime or even knee or hip replacement surgery.

Don’t Just Get Physical – Get a Physical

Summer is a great time of year to schedule an annual physical, so that you can clear up any medical issues and make sure you’re in good shape to handle the uptick in exercise you’re planning.

There’s no reason you can’t spend your summer doing things that you love in the outdoors. Just be sure you’re taking steps to take care of your joints along the way so that you don’t get injured. If you are suffering from a knee or hip injury, contact us at our Pinehurst office today or call us at 910-295-0224.