Knees and Hips

Does it matter where I do my rehabilitation therapy after hip replacement surgery?

DEAR DOCTOR K: I'm having hip replacement surgery next month. I know I'll need rehabilitation afterward, but does it matter where I do it?

DEAR READER: It's been routine after hip replacement surgery to have extensive physical therapy. This rehabilitation therapy, or "rehab," usually consists of a series of outpatient appointments with a physical therapist, as well as exercises to do at home. The goal of rehab is to improve the strength, stamina and balance of walking.

Do I need surgery for a torn meniscus?

DEAR DOCTOR K: My knees hurt a lot, more on the left. At 76 years young, I guess I should expect that. An MRI scan shows I have a "torn meniscus" in my right knee, and arthritis in both knees. Is there anything to be done?

DEAR READER: Before I can answer your interesting question, I need to provide some basic information. The meniscus is a crescent-shaped disk of fibrous tissue and cartilage. Each knee has two menisci located between the thighbone (femur) and the lower leg bone (tibia).

What types of joints are available for a knee replacement?

DEAR DOCTOR K: I am going to have my knee replaced. What types of artificial knee joints are available?

DEAR READER: The knee is a joint formed by the bottom end of the thigh bone and the top ends of two bones of the lower leg. When the ends of the bones that form the joint become damaged, they can be removed and replaced. That's total knee replacement, and it is major surgery.

Should I have arthroscopic knee surgery?

DEAR DOCTOR K: I'm a lifelong runner with severe knee pain. I hate the thought of surgery, but hear it's not such a big deal these days, using arthroscopy. How do I know if I'm a good candidate for it?

DEAR READER: Arthroscopy is a technique used to diagnose problems in the knees and other joints. If a problem requiring surgery is identified, arthroscopic surgery can be performed. To appreciate how valuable arthroscopic surgery is, you have to understand what things were like back in the "old days" -- like when I was in medical school.

When is the right time for a knee replacement?

DEAR DOCTOR K: I have osteoarthritis that's gotten worse over the past few years. My doctor has explained the pros and cons of knee replacement, but it seems like the timing is up to me. How will I know when the time is right to replace my joint?

DEAR READER: If your experience with a knee replacement is like that of most of my patients, you'll know when the time is right only after the time has passed. I've rarely met a person who had a knee or a hip replacement who did not say, after the surgery, "I should have had the surgery long before I finally did." That surely was my experience with hip replacement due to osteoarthritis. Looking back, I should have had the surgery at least two years before I did.

Should I be worried about complications from a hip replacement?

DEAR DOCTOR K: My doctor says I need hip replacement surgery. She says it will help my pain. But I'm worried about complications. Should I be?

DEAR READER: I get a lot of questions about hip replacement surgery, and I'm in a good position to answer them: I had a hip replacement about a decade ago. Before I give a more detailed answer, let me cut to the chase: The benefits of hip replacement surgery greatly outweigh the risks.

I’m having knee pain, can you describe the anatomy of the knee so I can understand more?

DEAR DOCTOR K: I've been having a lot of knee pain. Would you describe the anatomy of my knee so that I can understand more when I see my doctor about it?

DEAR READER: Joints are places where two or more bones meet, to allow a part of your body to move. And the knee joint is a remarkable structure. It is a complicated network of bones, cartilage, muscles, tendons and ligaments. These structures, working together, allow us to walk, kick, squat, stand back up and do the Twist. (I know that's a dated reference!)

How serious is Osgood-Schlatter disease?

DEAR DOCTOR K: My 12-year-old daughter has been doing gymnastics for years. Lately she's complained about pain in her knee. Her doctor says it's Osgood-Schlatter disease. How serious is this?

DEAR READER: This is a case where the name makes the condition sound worse than it is. Osgood-Schlatter disease is a common, temporary condition. It causes knee pain in older children and teenagers, especially those who play sports. About 20 percent of kids who play sports develop this condition. It starts when a kid's growth spurt starts, and major symptoms typically go away at the end of a teenager's growth spurt.

How can I recover quickly from a knee replacement?

DEAR DOCTOR K: I'm having knee replacement surgery next month. What can I do to speed my recovery and get back on my feet as quickly as possible?

DEAR READER: I'm glad you asked, because you are very important in making the outcome of your surgery completely successful. A knee replacement is major surgery. During the procedure, the surgeon removes damaged sections of your shin bone and thigh bone. He or she cuts the bone to precisely fit the shape of the replacement implant, then attaches the artificial joint at the knee.