Sinusitis

Sinusitis is one of the most common chronic (ongoing) conditions in the United States effecting fifty million Americans, 20% of the nation’s population.

Sinusitis is often a chronic (ongoing) disease that includes the symptoms of nasal obstruction (difficulty breathing through the nose), nasal drainage, decreased sense of smell, facial pressure, and frequent sinus infections. Allergies and related respiratory problems such as asthma can also be associated with chronic sinusitis.

It can sometimes be difficult for patients to decipher if they are suffering from allergies, an upper respiratory tract infection, or a sinus condition. Symptoms and signs for each condition differ, and each diagnosis requires a unique treatment regimen. The Oregon Sinus Center team can help make an informed choice as to the best management strategy for a patient with any of these conditions.

After getting the correct diagnosis, a number of medical treatments can be started. These medications may include anti-inflammatory nasal sprays, decongestants, oral inflammatory inhibitors, and systemic steroid medications. It is important that the physician and patient recognize that medications are often required on a long-term basis.

In some cases, surgery is required using a telescope (endoscope) which is placed through the nostril. This type of surgery is often referred to as Endoscopic Sinus Surgery, which is minimally invasive and does not require any external incisions. It is our goal that after surgery, patients will not require any further surgery on the nose and sinuses.

In some cases, however, sinusitis can return. Our surgeons have a particular interest in patients whose sinusitis has failed traditional surgery and require advanced techniques to control the underlying inflammation. The Oregon Sinus Center actively conducts ongoing research into better treatments for sinusitis.

Sinuses Anatomy

Nasal & Sinus Polyps

Nasal polyps are associated with sinusitis and occur when the lining of the sinuses swell. Polyps may block the nasal airway, creating difficulty in breathing. Polyps may also block the natural drainage of the sinus cavities leading to infections. Polyps are generally thought to occur as a result of an ongoing inflammatory process within the nose and sinuses.

After getting the correct diagnosis, our team of can help patients decide on the most appropriate treatment plan. Most commonly, medications are tried as first line therapy. Different combinations can be tailored for individual patients. In some cases, a patient’s disease cannot be fully controlled with medication and surgery may be recommended. This surgery is done with telescopes (endoscopes) through the nose in a minimally invasive fashion.

Following this type of surgery, it is very important to maintain medical treatment. Additionally, the nose and sinus cavities must be watched carefully to prevent the return of the polyps. It is our goal that after surgery, patients will not require any further surgery on the nose and sinuses to remove polyps.

In some cases, however, polyps may return. Our surgeons have a particular interest in patients who have experienced the return of polyps following previous nasal and sinus surgeries. We are experts in the more advanced techniques that may be required to control polyp formation. The Oregon Sinus Center actively conducts ongoing research into better treatments for sinus polyps.

Smell and Taste Disorders

Disorders of smell and taste can have a large impact on quality of life. Currently about 2 million adults in the United States are evaluated for smell and taste disorders every year, but it is believed many more cases go unreported. It is estimated that up to 80% of taste is a result of olfactory (or smell) input. As a result, loss of smell is frequently interpreted as a loss of taste.

Problems with smell and taste can be due to a variety of causes. Examples of these include chronic rhinosinusitis, polyps, allergic rhinitis, upper respiratory infection, trauma, tumors or other neurological disorders.

Evaluations of these disorders include a thorough history and physical exam with an endoscope, objective smell testing, and may also include imaging. Treatment of these problems depends on the problem and the severity of the loss. Our team works with each patient to best understand the cause of their smell and taste problems. From there, a therapeutic plan can be initiated.

Disclaimer : This article has been sourced from https://www.ohsu.edu/ as it is. Click here to read original article.

What is a kidney transplant?

A kidney transplant is a surgical procedure that’s done to treat kidney failure. The kidneys filter waste from the blood and remove it from the body through your urine. They also help maintain your body’s fluid and electrolyte balance. If your kidneys stop working, waste builds up in your body and can make you very sick.

People whose kidneys have failed usually undergo a treatment called dialysis. This treatment mechanically filters waste that builds up in the bloodstream when the kidneys stop working.

Some people whose kidneys have failed may qualify for a kidney transplant. In this procedure, one or both kidneys are replaced with donor kidneys from a live or deceased person.

There are pros and cons to both dialysis and kidney transplants.

Undergoing dialysis takes time and is labor-intensive. Dialysis often requires making frequent trips to a dialysis center to receive treatment. At the dialysis center, your blood is cleansed using a dialysis machine.

If you’re a candidate to have dialysis in your home, you’ll need to purchase dialysis supplies and learn how to use them.

A kidney transplant can free you from a long-term dependence on a dialysis machine and the strict schedule that goes with it. This can allow you to live a more active life. However, kidney transplants aren’t suitable for everyone. This includes people with active infections and those who are severely overweight.

During a kidney transplant, your surgeon will take a donated kidney and place it in your body. Even though you’re born with two kidneys, you can lead a healthy life with only one functioning kidney. After the transplant, you’ll have to take immune-suppressing medications to keep your immune system from attacking the new organ.

Who might need a kidney transplant?

A kidney transplant may be an option if your kidneys have stopped working entirely. This condition is called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). If you reach this point, your doctor is likely to recommend dialysis.

In addition to putting you on dialysis, your doctor will tell you if they think you’re a good candidate for a kidney transplant.

You’ll need to be healthy enough to have major surgery and tolerate a strict, lifelong medication regimen after surgery to be a good candidate for a transplant. You must also be willing and able to follow all instructions from your doctor and take your medications regularly.

If you have a serious underlying medical condition, a kidney transplant might be dangerous or unlikely to be successful. These serious conditions include:

Your doctor may also recommend that you don’t have a transplant if you:

If your doctor thinks you’re a good candidate for a transplant and you’re interested in the procedure, you’ll need to be evaluated at a transplant center.

This evaluation usually involves several visits to assess your physical, psychological, and familial condition. The center’s doctors will run tests on your blood and urine. They’ll also give you a complete physical exam to ensure you’re healthy enough for surgery.

A psychologist and a social worker will also meet with you to make sure you’re able to understand and follow a complicated treatment regimen. The social worker will make sure you can afford the procedure and that you have adequate support after you’re released from the hospital.

If you’re approved for a transplant, either a family member can donate a kidney or you’ll be placed on a waiting list with the Organ Procurement and Transplantation Network (OPTN). The typical wait for a deceased donor organ is over five years.

Who donates the kidney?

Kidney donors may be either living or deceased.

Living donors

Because the body can function perfectly well with just one healthy kidney, a family member with two healthy kidneys may choose to donate one of them to you.

If your family member’s blood and tissues match your blood and tissues, you can schedule a planned donation.

Receiving a kidney from a family member is a good option. It reduces the risk that your body will reject the kidney, and it enables you to bypass the multiyear waiting list for a deceased donor.

Deceased donors

Deceased donors are also called cadaver donors. These are people who have died, usually as the result of an accident rather than a disease. Either the donor or their family has chosen to donate their organs and tissues.

Your body is more likely to reject a kidney from an unrelated donor. However, a cadaver organ is a good alternative if you don’t have a family member or friend who’s willing or able to donate a kidney.

The matching process

During your evaluation for a transplant, you’ll have blood tests to determine your blood type (A, B, AB, or O) and your human leukocyte antigen (HLA). HLA is a group of antigens located on the surface of your white blood cells. Antigens are responsible for your body’s immune response.

If your HLA type matches the donor’s HLA type, it’s more likely that your body won’t reject the kidney. Each person has six antigens, three from each biological parent. The more antigens you have that match those of the donor, the greater the chance of a successful transplant.

Once a potential donor is identified, you’ll need another test to make sure that your antibodies won’t attack the donor’s organ. This is done by mixing a small amount of your blood with the donor’s blood.

The transplant can’t be done if your blood forms antibodies in response to the donor’s blood.

If your blood shows no antibody reaction, you have what’s called a “negative crossmatch.” This means that the transplant can proceed.

What is kidney transplant procedure?

Your doctor can schedule the transplant in advance if you’re receiving a kidney from a living donor.

However, if you’re waiting for a deceased donor who’s a close match for your tissue type, you’ll have to be available to rush to the hospital at a moment’s notice when a donor is identified. Many transplant hospitals give their people pagers or cell phones so that they can be reached quickly.

Once you arrive at the transplant center, you’ll need to give a sample of your blood for the antibody test. You’ll be cleared for surgery if the result is a negative crossmatch.

A kidney transplant is done under general anesthesia. This involves giving you a medication that puts you to sleep during the surgery. The anesthetic will be injected into your body through an intravenous (IV) line in your hand or arm.

Once you’re asleep, your doctor makes an incision in your abdomen and places the donor kidney inside. They then connect the arteries and veins from the kidney to your arteries and veins. This will cause blood to start flowing through the new kidney.

Your doctor will also attach the new kidney’s ureter to your bladder so that you’re able to urinate normally. The ureter is the tube that connects your kidney to your bladder.

Your doctor will leave your original kidneys in your body unless they’re causing problems, such as high blood pressure or infection.

Kidney Transplant Procedure Aftercare

You’ll wake up in a recovery room. Hospital staff will monitor your vital signs until they’re sure you’re awake and stable. Then, they’ll transfer you to a hospital room.

Even if you feel great after your transplant (many people do), you’ll likely need to stay in the hospital for up to a week after surgery.

Your new kidney may start to clear waste from the body immediately, or it may take up to a few weeks before it starts functioning. Kidneys donated by family members usually start working more quickly than those from unrelated or deceased donors.

You can expect a good deal of pain and soreness near the incision site while you’re first healing. While you’re in the hospital, your doctors will monitor you for complications. They’ll also put you on a strict schedule of immunosuppressant drugs to stop your body from rejecting the new kidney. You’ll need to take these drugs every day to prevent your body from rejecting the donor kidney.

Before you leave the hospital, your transplant team will give you specific instructions on how and when to take your medications. Make sure that you understand these instructions, and ask as many questions as needed. Your doctors will also create a checkup schedule for you to follow after surgery.

Once you’re discharged, you’ll need to keep regular appointments with your kidney transplant procedure team so that they can evaluate how well your new kidney is functioning.

You’ll need to take your immunosuppressant drugs as directed. Your doctor will also prescribe additional drugs to reduce the risk of infection. Finally, you’ll need to monitor yourself for warning signs that your body has rejected the kidney. These include pain, swelling, and flu-like symptoms.

You’ll need to follow up regularly with your doctor for the first one to two months after surgery. Your recovery may take about six months.

If you want to know what is kidney transplant, then when your kidneys fail, treatment is needed to replace the work your own kidneys can no longer do. There are two types of treatment for kidney failure — dialysis or transplant. Many people feel that a kidney transplant offers more freedom and a better quality of life than dialysis. In making a decision about whether this is the best treatment for you, you may find it helpful to talk to people who already have a kidney transplant. You also need to speak to your doctor, nurse and family members.

Kidney transplant & COVID-19

Find answers about transplant during the COVID-19 outbreak here.

What is a kidney transplant?

When you get a kidney transplant, a healthy kidney is placed inside your body to do the work your own kidneys can no longer do.
On the plus side, there are fewer limits on what you can eat and drink, but you should follow a heart-healthy diet. Your health and energy should improve. In fact, a successful kidney transplant may allow you to live the kind of life you were living before you got kidney disease. Studies show that people with kidney transplants live longer than those who remain on dialysis.
On the minus side, there are the risks of surgery. You will also need to take anti-rejection medicines for as long as your new kidney is working, which can have side effects. You will have a higher risk for infections and certain types of cancer.
Although most transplants are successful and last for many years, how long they last can vary from one person to the next. Many people will need more than one kidney transplant during a lifetime.

What is a “preemptive” or “early” transplant?

Getting a transplant before you need to start dialysis is called a preemptive transplant. It allows you to avoid dialysis altogether. Getting a transplant not long after kidneys fail (but with some time on dialysis) is referred to as an early transplant. Both have benefits. Some research shows that a pre-emptive or early transplant, with little or no time spent on dialysis, can lead to better long-term health. It may also allow you to keep working, save time and money, and have a better quality of life.

Who can get a kidney transplant?

Kidney patients of all ages—from children to seniors—can get a transplant.
You must be healthy enough to have the operation. You must also be free from cancer and infection. Every person being considered for transplant will get a full medical and psychosocial evaluation to make sure they are a good candidate for transplant. The evaluation helps find any problems, so they can be corrected before transplant. For most people, getting a transplant can be a good treatment choice.

What if I’m older or have other health problems?

In many cases, people who are older or have other health conditions like diabetes can still have successful kidney transplants. Careful evaluation is needed to understand and deal with any special risks. You may be asked to do some things that can lessen certain risks and improve the chances of a successful transplant. For example, you may be asked to lose weight or quit smoking.
If you have diabetes, you may also be able to have a pancreas transplant. Ask your healthcare professional about getting a pancreas transplant along with a kidney transplant.

How will I pay for a transplant?

Medicare covers about 80% of the costs associated with an evaluation, transplant operation, follow-up care, and anti-rejection medicines. Private insurers and state programs may cover some costs as well. However, your post-transplant expenses may only be covered for a limited number of years. It’s important to discuss coverage with your social worker, who can answer your questions or direct you to others who can help. Click here to learn more about insurance and transplant.

Getting a Transplant

How do I start the process of getting a kidney transplant?

Ask your healthcare provider to refer you to a transplant center for an evaluation, or contact a transplant center in your area. Any kidney patient can ask for an evaluation.

How does the evaluation process work?

Medical professionals will give you a complete physical exam, review your health records, and order a series of tests and X-rays to learn about your overall health. Everything that can affect how well you can handle treatment will be checked. The evaluation process for a transplant is very thorough. Your healthcare team will need to know a lot about you to help them—and you—decide if a transplant is right for you. One thing you can do to speed the process is to get all the testing done as quickly as possible and stay in close contact with the transplant team. If you’re told you might not be right for a transplant, don’t be afraid to ask why—or if you might be eligible at some future time or at another center. Remember, being active in your own care is one of the best ways to stay healthy.
If someone you know would like to donate a kidney to you, that person will also need to go through a screening to find out if he or she is a match and healthy enough to donate.
If it’s your child who has kidney disease, you’ll want to give serious thought to getting a transplant evaluation for him or her. Because transplantation allows children and young adults to develop in as normal a way as possible in their formative years, it can be the best treatment for them.
If the evaluation process shows that a transplant is right for you or your child, the next step is getting a suitable kidney. (See “Finding a Kidney” below.)

What does the operation involve?

You may be surprised to learn that your own kidneys generally aren’t taken out when you get a transplant. The surgeon leaves them where they are unless there is a medical reason to remove them. The donated kidney is placed into your lower abdomen (belly), where it’s easiest to connect it to your important blood vessels and bladder. Putting the new kidney in your abdomen also makes it easier to take care of any problems that might come up.
The operation takes about four hours. You’ll be sore at first, but you should be out of bed in a day or so, and home within a week. If the kidney came from a living donor, it should start to work very quickly. A kidney from a deceased donor can take longer to start working—two to four weeks or more. If that happens, you may need dialysis until the kidney begins to work.
After surgery, you’ll be taught about the medicines you’ll have to take and their side effects. You’ll also learn about diet. If you’ve been on dialysis, you’ll find that there are fewer restrictions on what you can eat and drink, which is one of the benefits of a transplant.

What are anti-rejection medicines?

Normally, your body fights off anything that isn’t part of itself, like germs and viruses. That system of protection is called your immune system. To stop your body from attacking or rejecting the donated kidney, you will have to take medicines to keep your immune system less active (called anti-rejection medicines or immunosuppressant medicines). You’ll need to take them as long as your new kidney is working. Without them, your immune system would see the donated kidney as “foreign,” and would attack and destroy it.
Anti-rejection medicines can have some side effects. It is important to talk to your healthcare provider about them, so that you know what to expect. Fortunately, for most people, side effects are usually manageable. Changing the dose or type of medicine can often ease some of the side effects.
Besides the immunosuppressive medicines, you will take other medicines as well. You will take medicines to protect you from infection, too. Most people find taking medicines a small trade for the freedom and quality of life that a successful transplant can provide.

After Your Transplant

What happens after I go home?

Once you are home from the hospital, the most important work begins—the follow-up. For your transplant to be successful, you will have regular checkups, especially during the first year. At first, you may need blood tests several times a week. After that, you’ll need fewer checkups, but enough to make sure that your kidney is working well and that you have the right amount of anti-rejection medication in your body.

What if my body tries to reject the new kidney?

One thing that you and your healthcare team will watch for is acute rejection, which means that your body is suddenly trying to reject the transplanted kidney. A rejection episode may not have any clear signs or symptoms. That is why it is so important to have regular blood tests to check how well your kidney is working. Things you might notice that can let you know you are having rejection are fevers, decreased urine output, swelling, weight gain, and pain over your kidney.
The chances of having a rejection episode are highest right after your surgery. The longer you have the kidney, the lower the chance that this will happen. Unfortunately, sometimes a rejection episode happens even if you’re doing everything you’re supposed to do. Sometimes the body just doesn’t accept the transplanted kidney. But even if a rejection episode happens, there are many ways to treat it so you do not lose your transplant. Letting your transplant team know right away that you think you have symptoms of rejection is very important.

How often do rejection episodes happen?

Rejections happen much less often nowadays. That’s because there have been many improvements in immunosuppressive medicines. However, the risk of rejection is different for every person. For most people, rejection can be stopped with special anti-rejection medicines. It’s very important to have regular checkups to see how well your kidney is working, and make sure you are not having rejection.

When can I return to work?

How soon you can return to work depends on your recovery, the kind of work you do, and your other medical conditions. Many people can return to work eight weeks or more after their transplant. Your transplant team will help you decide when you can go back to work.

Will my sex life be affected?

People who have not had satisfactory sexual relations due to kidney disease may notice an improvement as they begin to feel better. In addition, fertility (the ability to conceive children) tends to increase. Men who have had a kidney transplant have fathered healthy children, and women with kidney transplants have had successful pregnancies. It’s best to talk to your healthcare practitioner when considering having a child.
Women should avoid becoming pregnant too soon after a transplant. Most centers want women to wait a year or more. All pregnancies must be planned. Certain medications that can harm a developing baby must be stopped six weeks before trying to get pregnant. Birth control counseling may be helpful. It’s important to protect yourself against sexually transmitted diseases (STDs). Be sure to use protection during sexual activity.

Will I need to follow a special diet?

In general, transplant recipients should eat a heart-healthy diet (low fat, low salt) and drink plenty of fluids. If you have diabetes or other health problems, you may still have some dietary restrictions. A dietitian can help you plan meals that are right for you.

Finding a Kidney

Where do donated kidneys come from?

A donated kidney may come from someone who died and donated a healthy kidney. A person who has died and donated a kidney is called a deceased donor.
Donated kidneys also can come from a living donor. This person may be a blood relative (like a brother or sister) or non-blood relative (like a husband or wife). They can also come from a friend or even a stranger.
When a kidney is donated by a living person, the operations are done on the same day and can be scheduled at a convenient time for both the patient and the donor. A healthy person who donates a kidney can live a normal life with the one kidney that is left. But the operation is major surgery for the donor, as well as the recipient. As in any operation, there are some risks that you will need to consider.

Is it better to get a kidney from a living donor?

Kidneys from living or deceased donors both work well, but getting a kidney from a living donor can work faster and be better. A kidney from a living donor may last longer than one from a deceased donor.
To get a deceased donor kidney, you will be placed on a waiting list once you have been cleared for a transplant. It can take many years for a good donor kidney to be offered to you. From the time you go on the list until a kidney is found, you may have to be on some form of dialysis. While you’re waiting, you’ll need regular blood tests to make sure you are ready when a kidney is found. If you’re on dialysis, your center will make the arrangements for these tests. Your transplant center should know how to reach you at all times. Once a kidney become available, the surgery must be done as soon as possible.

Are there disadvantages to living donation?

A disadvantage of living donation is that a healthy person must undergo surgery to remove a healthy kidney. The donor will need some recovery time before returning to work and other activities. However, recent advances in surgery (often called minimally invasive or laparoroscopic surgery) allow for very small incisions. This means shorter hospital stays and recovery time, less pain, and a quicker return to usual activities. Living donors often experience positive feelings about their courageous gift.

What are the financial costs to the living donor?

The surgery and evaluation is covered by Medicare or the recipient’s insurance. The living donor will not pay for anything related to the surgery. However, neither Medicare nor insurance covers time off from work, travel expenses, lodging, or other incidentals. The National Living Donor Assistance Program (www.livingdonorassistance.org) or other programs may help cover travel and lodging costs.
Donors may be eligible for sick leave, state disability, and benefits under the federal Family Medical Leave Act. In addition, federal employees, some state employees, and certain other workers may be eligible for 30 days paid leave.
Disclaimer : This article has been sourced from https://www.kidney.org/ as it is. Click here to read original article.

Laparoscopy, also known as diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen. It’s a low-risk, minimally invasive procedure that requires only small incisions.

Laparoscopy uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.

Laparoscopy allows your doctor to see inside your body in real time, without open surgery. Your doctor also can obtain biopsy samples during this procedure.

Why is laparoscopy performed?

Laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It’s usually performed when noninvasive methods are unable to help with diagnosis.

In many cases, abdominal problems can also be diagnosed with imaging techniques such as:

Laparoscopy is performed when these tests don’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.

Your doctor may recommend laparoscopy to examine the following organs:

By observing these areas with a laparoscope, your doctor can detect:

As well, your doctor may be able to perform an intervention to treat your condition immediately after diagnosis.

What are the risks of laparoscopy?

The most common risks associated with laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, these are rare occurrences.

After your procedure, it’s important to watch for any signs of infection. Contact your doctor if you experience:

There is a small risk of damage to the organs being examined during laparoscopy. Blood and other fluids may leak out into your body if an organ is punctured. In this case, you’ll need other surgery to repair the damage.

Less common risks include:

In some circumstances, your surgeon may believe the risk of diagnostic laparoscopy is too high to warrant the benefits of using a minimally invasive technique. This situation often occurs for those who’ve had prior abdominal surgeries, which increases the risk of forming adhesions between structures in the abdomen. Performing laparoscopy in the presence of adhesions will take much longer and increases the risk of injuring organs.

Shoulder replacement surgery involves removing damaged areas of your shoulder and replacing them with artificial parts. The procedure is performed to relieve pain and improve mobility.

You might need a shoulder replacement if you have severe arthritis or a fracture in your shoulder joint. About 53,000 people in the United States have shoulder replacement surgery each year.

Read on to learn more about how this surgery is performed and what your recovery will be like.

Who’s a good candidate for this procedure? | Candidates

Shoulder replacement surgery is usually recommended for people who have severe pain in their shoulder and have found little or no relief from more conservative treatments.

Some conditions that may require a shoulder replacement include:

  • Osteoarthritis. This type of arthritis is common in older people. It occurs when the cartilage that pads bones wears away.
  • Rheumatoid arthritis (RA). With RA, your immune system mistakenly attacks your joints, causing pain and inflammation.
  • Avascular necrosis. This condition happens when loss of blood to a bone occurs. It can cause damage and pain in the shoulder joint.
  • A broken shoulder. If you badly break your shoulder bone, you might need a shoulder replacement to repair it.

Your doctor can help you decide if shoulder replacement surgery is the best option for you.

People who have good results with shoulder surgery commonly have:

  • weakness or loss of motion in the shoulder
  • severe pain in the shoulder that interferes with everyday life
  • pain while resting or during sleep
  • little or no improvement after trying more conservative therapies, such as medications, injections, or physical therapy

This type of surgery is less successful in people with:

How to prepare for surgery

Several weeks before your procedure, your doctor may suggest that you have a complete physical exam to determine if you’re healthy enough for surgery.

You might need to stop taking certain medications a couple of weeks before the shoulder replacement. Some medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and arthritis therapies, can cause too much bleeding. Your physician will also tell you to stop taking blood thinners.

On the day of your procedure, it’s a good idea to wear loose-fitting clothing and a button-up shirt.

You’ll probably stay in the hospital for 2 or 3 days after surgery. Since driving is only recommended after you’ve regained normal motion and strength in your shoulder, you should arrange for someone to take you home from the hospital.

Most people require some assistance for about six weeks after surgery.

What happens during the procedure?

Shoulder replacement surgery typically takes about two hours. You might receive general anesthesia, which means you’ll be unconscious during the procedure, or regional anesthesia, which means you’ll be awake but sedated.

During the surgery, doctors replace the damaged joint “ball,” known as the humeral head, of the shoulder with a metal ball. They also place a plastic surface on the “socket” of the shoulder, known as the glenoid.

Sometimes, a partial shoulder replacement can be performed. This involves replacing only the ball of the joint.

After your procedure, you’ll be taken to a recovery room for several hours. When you wake up, you’ll be moved to a hospital room.

Hip replacement is highly successful surgery in which portions of the hip joint are replaced with prostheses (implants). HSS performs more hip replacements than any other US hospital. Hospital for Special Surgery is ranked the #1 hospital for orthopedics in the United States by U.S. News and World Report.

What is hip replacement surgery?

Hip replacement is the removal and replacement of portions of the pelvis and femur (thighbone) that form your hip joint. It is performed primarily to relieve hip pain and stiffness caused by hip arthritis.

This procedure is also sometimes used to treat injuries such as a broken or improperly growing hip, and for other conditions.

How do you know if you need a hip replacement?

If you have these arthritis symptoms, you should consider a hip replacement:

To learn more, read Here’s What to Know if You Think You Need a Hip Replacement.

Hip anatomy

The hip is a ball-and-socket joint. The ball, at the top of your femur (thighbone) is called the femoral head. The socket, called the acetabulum, is a part of your pelvis. The ball moves in the socket, allowing your leg to rotate and move forward, backward and sideways.

In a healthy hip, soft-tissue called cartilage covers the ball and the socket to help them glide together smoothly. If this cartilage gets worn down or damaged, the bones scrape together and become rough. This condition, osteoarthritis, causes pain and restricts motion. An arthritic hip can make it painful to walk or even to get in or out of a chair. If you have been diagnosed with hip arthritis, you may not need surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) and/or physical therapy may provide relief. But, if these efforts do not relieve symptoms, you should consult an orthopedic surgeon.

Illustration: anatomy of the hip joint showing the pelvis and femur, with the femoral head (ball) and acetabulum (socket) labeled

What are the different types of hip replacement surgery?

The three major types of hip replacement are:

The most common type of hip replacement surgery is called a total hip replacement (also called total hip arthroplasty). In this surgery, worn-out or damaged sections of your hip are replaced with artificial implants. The socket is replaced with a durable plastic cup, which may or may not also include a titanium metal shell. Your femoral head will be removed and replaced with a ball made from ceramic or a metal alloy. The new ball is attached to a metal stem that is inserted into the top of your femur. (Learn more about types of hip implants.)

Graphic showing elements of a healthy hip, arthritic hip and total hip replacement.

Two other types of hip replacement surgeries are each generally appropriate for patients of specific age groups and activity levels:

X-ray of a total hip replacement showing the ball, socket and stem implants.
X-ray of a total hip replacement showing the ball, socket and stem implants

Hip replacement surgical methods

There are two major surgical approach methods for performing a total hip replacement:

To begin the operation, the hip replacement surgeon will make incisions on either the back (posterior) or front (anterior) of the hip. Both approaches offer pain relief and improvement in walking and movement within weeks of surgery.

Total hip replacement animation: Posterior approach

Animation: Hip Replacement

How should I prepare for hip replacement surgery?

There are certain steps patients can take both before and after surgery to improve recovery time and results. It is important to follow the instructions and guidance provided by your orthopedic surgeon, medical team and rehabilitation therapist. Visit Preparing for Your Surgery to get information on preoperative hip replacement classes and patient education materials about joint replacement surgery.

Can hip replacement be done as an outpatient?

Most patients will stay in the hospital one or two nights after surgery. Some patients may be able have same-day hip replacement and return home after an outpatient procedure.

Learn more about same-day hip replacement by reading Outpatient Hip Replacement Surgery: Frequently Asked Questions.

How long does hip replacement surgery take?

Total hip replacement surgery takes about one and a half hours. Most patients also stay in the hospital for one or two days after the procedure.

What is hip replacement surgery recovery like?

Your rehabilitation will begin within 24 hours after surgery. Most hip replacement patients progress to walking with a cane, walker or crutches within day or two after surgery. As the days progress, you will increase the distance and frequency of walking.

If you have THR surgery at HSS:

Can I have both hips replaced at the same time?

Yes, healthy patients younger than 75 years old who have no history of cardiopulmonary disease may be able to have both hips replaced at once. In some cases, however, it may be better to stage the surgeries.

What are the risks of hip replacement surgery?

The surgery is very safe, but every surgery has risks, and infection is the most serious. You should ask your surgeon what the surgical infection rate is for hip replacements at the hospital or facility where you will have your surgery.

HSS has one of the lowest rates of infection for hip replacement surgery, as well as a significantly lower rate of readmission compared to the national average. In 2015, The New York State Department of Health reported that out of more than 160 hospitals in New York that did hip replacements in 2014, only Hospital for Special Surgery had a hip replacement surgery site infection (SSI) rate that was “significantly lower than the state average” for that year, and that those infection rates at HSS had been significantly lower than the state average in each of the seven years between 2008-2014.

Other risks include blood clots in the leg or pelvis, and accidental hip dislocation during or after recovery. Hospital for Special Surgery performs better than the national average in preventing blood clots after surgery.

What are hip implants made of?

There are three separate implants: the stem, the ball and the socket.

  1. The stem, made out of metal (usually titanium or cobalt-chrome) is inserted into your natural thighbone.
  2. The ball is usually made out of polished metal or ceramic, and fits on top of the stem.
  3. The socket is usually a combination of a plastic liner and a cobalt-chrome or titanium backing.

Learn more about joint replacement prostheses by reading Understanding Implants in hip and Hip Replacement.

Will my new hip set off the metal detector at the airport?

Today’s sensitive screening machines will detect the implant but can also effectively identify it. The machine operator will know that it is an implant rather than an unauthorized metal object contained outside the body.

It is still helpful to tell airport security that you have had a hip replacement before entering the screening machine. You may also ask your doctor’s office if they can provide a card that identifies that you have received a hip implant that contains metal.

How long do hip implants last?

Generally speaking, a hip replacement prosthesis should remain effective for between 10 and 20 years, and some can last even longer.

Results vary according to the type of implant and the age of the patient. In a 2008 study of more than 50,000 patients who had THR surgery at age 55 or older, between 71% and 94% still had well-working implants after 15 years.

When a hip implant does need to be replaced because it has loosened or worn out over time, this requires what is called hip revision surgery.

How soon after surgery can I resume driving?

Most patients can resume driving by six weeks after surgery.

What should I look for in a hip replacement surgeon?

When looking for an orthopedic surgeon to perform your hip replacement surgeon, it’s important to do your research and check the surgeon’s credentials, experience and reputation. It is also important to research the hospital or facility where you will have your operation, as well as its supporting staff, such as the anesthesiologists.

The success rate for hip replacement surgery at HSS is very high. In a study, HSS interviewed patients to learn about their progress. Two years after their surgeries, 99.4% of patients said they had relief from pain, 98.8% said their ability to move was improved, and 97.8% said their quality of life was better because of their surgery.

 

Disclaimer : This article has been sourced from https://www.hss.edu/ as it is. Click here to read original article.