Category Archives: Hip

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 (joint replacement) 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!

Tips for Running After Hip Replacement

Runners rely on mobility when hitting the track or trail on any given day. Running is a high-impact activity that relies not only on your legs to move, but also your hips; and according to the American College of Sports Medicine, about 500,000 hip replacement surgeries occur yearly in the United States.  Running after Hip Replacement article 3-26-15

According to Dr. Stickney, “The decision on whether to have hip replacement should be a cooperative decision between you, your family and your orthopedic surgeon. After review of your symptoms, x-rays, and your personal expectations, recommendation for surgery is based primarily on the extent of pain and disability, and not on age or necessarily x-ray findings.”

The hip is one of the body’s normal weight-bearing joints made up of a ball and socket frame covered by articular cartilage, lined with synovial membrane that produces the lubricating fluid for movement. Over time, wear and tear of the ball and socket causes the pain and can lead to osteoarthritis and traumatic arthritis.

Running after hip replacement requires hip postoperative rehabilitation, physical therapy and a graduated activity program to avoid stiffness as well as build stamina and strength. Below are some tips on how to build up to your normal running pace:

  • According to the American Academy of Orthopedics (AAOS), start with a slow walking regimen with the aid of a walker, crutches or event trekking poles. These tools will help increase your energy as you continue to heal. Once your surgeon feels that you are ready to put more weight into your step, then and only then, should you increase your walking pace.
  • It is also important to rebuild the muscle strength in your legs by participating in a mild swim exercise with the help of swim fins. Fluid movement in the water minimizes weight-bearing stress to your hip while you are still recovering.
  • A low-impact activity like riding a stationary bike is also a great way to build the muscles in your leg and hip, prevent stiffness and keep it flexible.
  • Lastly, after your walk or run, don’t forget to ice the hip to reduce or prevent inflammation and rest the affected hip.

Dr. Stickney specializes in hip, knee and shoulder surgery in his Kirkland and Redmond locations. If you are a runner considering a hip replacement, contact Dr. Stickney at (425) 823-4000 to schedule an appointment or email him at ProOrthoAppointment@proliancesurgeons.com.   Watch Dr. Stickney’s video and learn more about hip replacement surgery.

 

Hip Replacement – Performing the Anterior Approach

Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA that performs this procedure.

How does the anterior approach to total hip replacement differ from the traditional hip replacement surgery? For one, the anterior approach is a tissue-sparing alternative. The approach to the hip from the front does not involve cutting any major structures to get to the hip. Instead, the interval between two muscles is separated, leading to the hip capsule. I work between your muscles and tissues without detaching them from either the pelvis or thighbones – sparing the tissue from trauma. The traditional posterior approach from the back requires dividing the gluteus maximus (butt) muscle and splitting part of the ilio-tibial band on the side of the hip and then cutting several small tendons off the back of the hip.

Many surgeons are hesitant to perform the anterior approach because it is new since their training. The special equipment necessary to perform this anterior hip approach has only been popularizer in the past 5 years. This approach is through a much smaller incision and is technically demanding. The anterior approach uses a special table called a Hana table that allows me to position the leg in a very specific way to place the hip components. All of the operating room staff and my assistants are used to doing this hip replacement approach.

Benefits to the anterior approach for hip replacement include:

  • Faster postoperative rehabilitation, recovery time and improved mobility – The muscle tissues are spared during the surgical procedure
  • Less pain – No hip precautions when at home like having to put a pillow between the legs when at rest
  • Limping is eliminated on average 16 days after anterior hip approach vs. 24 days after a posterior approach. Pain relief is faster, 98% of patients are off narcotics 2 weeks after an anterior approach, vs. 70% off narcotics after a posterior approach.
  • Agility – There are no restrictions on hip flexion after an anterior approach.

If you are considering hip replacement and would like more information, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.