Category Archives: Hip

Can Activity Trackers Assist with Recovery After Knee or Hip Arthroplasty?

activitytrackerCommercial wrist-worn activity monitors, like those by Fitbit or Garmin, have the potential to accurately assess activity levels and have been gaining popularity in the last few years. In a 2018 study published in The Journal of Arthroplasty, researchers set out to determine if feedback from activity monitors can improve activity levels after total hip arthroplasty or total knee arthroplasty.

To conduct this study, 163 people undergoing primary total knee arthroplasty or total hip arthroplasty were randomized into two groups. Subjects in the study received an activity tracker with the step display obscured two weeks before surgery and completed patient-reported outcome measures. On the day after surgery, participants were randomized into either the “feedback group” or the “no feedback group”. The feedback group was able to view their daily step count and was given a daily step goal. Those in the no feedback group wore the device with the display obscured for two weeks after surgery and did not receive a formal step goal, but were also able to see their daily step count after those two weeks were up.

Average steps taken by both groups were monitored at one, two, and six weeks, and again at six months. At six months after surgery, subjects repeated their patient-reported outcome measures.

It turns out that the feedback group subjects had a significantly higher average daily step count by 43% in week one, 33% in week two, 21% in week six, and 17% at six months, compared to the no feedback group. Additionally, the feedback group subjects were 1.7 times more likely to achieve an average of 7,000 steps per day than the no feedback group subjects at six weeks after surgery. Six weeks after surgery, the feedback group participants were back to their pre-op activity levels (100%) and at six months, they were actually stepping more (137%). While 83% of the no feedback group participants reported they were satisfied with the results of the surgery, 90% of the feedback groups reported the same.

With mobility and physical activity being imperative to healthy aging and very helpful for recovery after total hip arthroplasty or total knee arthroplasty, incorporating an activity monitor into your after-surgery-care checklist is a great idea.

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in total knee arthroplasty, total hip arthroplasty, exercise and health, and more. Contact Dr. Stickney to return to your healthy, pain-free lifestyle.

Can Patients Who Live Alone Be Sent Home Safely After Joint Replacement?

homerecoveryAccording to a recent study published by The Journal of Bone & Joint Surgery in partnership with Wolters Kluwer, most patients who live alone can safely be discharged home from the hospital to recover after knee or hip replacement surgery.

This encouraging finding questions the firmly held belief that patients who live on their own should first be sent to an inpatient rehabilitation facility after undergoing joint replacement surgery. “Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” write Andrew N. Fleischman, MD, and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia.

The study focused on 769 patients of a similar age demographic who were sent directly home after one-sided total hip or knee replacement; 138 of these patients were living alone for the first two weeks after surgery. The researchers compared complication rates and other important outcomes for patients who lived alone versus those who lived with others.

The researchers did find that patients who lived alone were more likely to spend more than one night in the hospital, had higher rates of in-home nursing care and physical therapy. But otherwise, the outcomes were very similar for patients living alone compared to those who lived with others. In both groups, the post-discharge complication rate was around eight percent. The two groups also had similar rates of “unplanned clinical events,” such as emergency department or urgent care visits. Pain relief and satisfaction scores during recovery were very alike as well.

Perhaps some of the most exciting results: up to six months after surgery, there were no significant differences in scores for joint functioning and quality of life and nearly 90 percent of patients living alone said they would choose to be discharged home directly after surgery again.

Although some patients who live alone can benefit from home health services or even an extra day in the hospital, discharge directly home may be a much more economical and comfortable choice than routinely sending them for inpatient rehabilitation – while also avoiding the believed associated risks.

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in exercise and healthjoint replacement surgerysports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

The Link Between Distance Running and Arthritis

marathonAlthough distance running is often associated with numerous health benefits, the impact on hip and knee joint health has been inconclusive up to this point. Long-distance running has been linked with an increased prevalence of arthritis in some studies, but others have shown an inverse association or no association at all.

In a recent study published by Journal of Bone & Joint Surgery, authors Ponzio et al. investigate hip and knee health in active marathon runners, including the prevalence of pain, arthritis and arthroplasty and associated risk factors.

To conduct their research, Ponzio et al. distributed a hip and knee health survey internationally to marathon runners from 18-79 years old, divided into subgroups by age, sex BMI and physical activity level. The survey questions assessed pain, personal and family history of arthritis, surgical history, running volume, personal record time, risk factors and current running status. The results were then compared with National Center for Health Statistics’ information for a matched group of the US population who were not marathon runners.

What the authors of the study found is that while age, family history and surgical history independently predicted an increased risk for hip and knee arthritis in active marathoners, there was no correlation with running history. In the researcher’s cohort study, the arthritis rate of active marathoners was below that of the general US population.

While the authors conclude that longitudinal follow-up is needed to determine the effects of marathon running on developing future knee and hip arthritis, it’s a hopeful and encouraging finding for long-distance runners.

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in joint replacement surgerysports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

Is Your Job Putting You at Risk for Hip Osteoarthritis?

constructionOsteoarthritis of the hip, which causes the cartilage that cushions your joints to be lost, can be extremely painful and negatively affect one’s quality of life. Could your job be putting you at risk for hip osteoarthritis (HOA) and if so, what can you do about it? A new study takes a closer look.

In the last decade, there has been an influx of studies searching for an association between occupational strain and the risk of developing hip osteoarthritis. The published studies conclude that there is a basic link between occupations involving physically demanding work and the development of HOA. A new study, published by Deutsches Aerzteblatt International, explores a new systematic survey of the previous literature. The goal? To identify ways of preventing occupational HOA if the link between physically demanding work and HOA was indeed present.

The study takes a look at five cohort studies along with 18 case-control studies that were found suitable for inclusion. The researchers found that years of physically demanding work consisting of activities such as dealing with heavy loads, heavy manual work or prolonged walking and standing increases the risk of HOA (and eventually total hip replacement) by 150% in men and 40% in women. The new study found that even though the evidence base for risk assessment in women is currently inadequate (most previous studies didn’t explore occupations where women predominate, such as nursing), the greater the exposure to physically demanding work, the greater the risk for HOA.

The study explored recommendations for preventive measures and further research that should be conducted in the future:

  1. Loads of 45lbs or more should NOT be lifted without mechanical assistance.
  2. With the goal of detecting signs of HOA as early as possible, preventive occupational medicine should include examination of the hip after no more than 15-20 years in a relevant occupation.
  3. Since the limited available data do not show any meaningful effect of training and exercise on the progression of HOA in the occupational content, any measure taken should aim at reducing the amount of strain.
  4. Workers who need to change their job should take advantage of the occupational rehabilitation programs offered by health insurance providers and pension insurance funds.

Questions about HOA or joint replacement surgeryDr. Stickney, a Kirkland orthopedic surgeon, is an expert in hip replacement surgery, sports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

First nationwide prevalence study of hip and knee arthroplasty

The orthopedic community and public are well aware that hip and knee replacement operations are among the most commonly performed operations in the U.S. Figures show around 1 million of these procedures are performed each year. But how many people actually are living with a hip or knee replacement in the United States?

This important measure of the impact of joint arthroplasty on public health, known as prevalence, has been missing until the recent release of the Mayo Clinic orthopedics study.