Conditions We Treat at Warwickshire Hip & Knee Clinc

A joint is where two or more bones meet. The joint allows the bones to move freely but within controlled limits. To facilitate this movement, the ends of the bones are coated with a layer of tough, slippery tissue called cartilage. This cartilage acts a bit like a shock absorber to spread the load more evenly across your joint.

 

When an individual develops osteoarthritis, formerly known as wear and tear or degenerative joint disease, the cartilage lining the joints becomes damaged so the joint doesn’t move as smoothly as it should.

 

Many factors can work alone or in combination contributing to the development of osteoarthritis. These include age, gender, obesity, previous joint injury, joint abnormalities, genetic factors and other types of joint disease such as rheumatoid arthritis or gout.

 

Although osteoarthritis can develop in any joint, hips and knees are among the most affected.

 

The most common symptoms of osteoarthritis are pain, stiffness, crepitus, swelling and not being able to use the joint normally. Crepitus is described as a grating or grinding sensation on moving the joint.

 

In the case of hip or knee osteoarthritis, these symptoms tend to have a significant impact on the patient’s ability to walk.

 

In the early stages measures such as activity modification, losing weight, using a cane, taking painkillers and anti-inflammatories, physiotherapy and the sensible administration of steroid joint or visco-supplementation injections can help to keep the symptoms under control.

 

When the pain fails to respond to the above measures, affects the ability to perform the normal activities of daily living and regularly interferes with night sleep the time for a joint replacement, and in some special circumstances a hip resurfacing, has come.

 

According to the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, every year over 100.000 hip replacements and an even greater number of knee replacements are being performed in these nations and dependency.

 

I am a high-volume hip and knee replacement surgeon year on year performing between 3 and 4 times the number of hip and knee replacements than the average UK based surgeon. Read More Here

The most common complications leading to the revision of a failing hip replacement, knee replacement, or a hip resurfacing, are the following

• Mechanical (or aseptic) loosening. Usually caused by wear of the joint replacement components after many years of use resulting in them becoming loose and painful.


• Dislocation. Usually applies to a hip replacement, and rarely to hip resurfacing. In this rather common complication, the ball repeatedly comes out of the socket with activities of daily living and very often the patient lives in fear of it happening again losing confidence in the new hip.


• Infection. When a joint replacement gets infected, it usually becomes inflamed, tender, and painful. With the passage of time the components may also become loose, and if the infection is left untreated there is a risk of sepsis. A periprosthetic joint infection is a serious complication which might result in the loss of limb or life.


• Peri-prosthetic Fracture. A fall or a blow can cause a fracture of the bone near the hip or knee replacement. In some cases, the prosthesis components were already loose, and the trauma required to cause the bone to fracture is minimal. If the joint replacement components were not loose before the fracture, they can become loose because of it.


• Adverse reactions to metal debris in patients that carry a hip resurfacing, or a hip replacement with large metal on metal bearings, or a modular neck. These types of prostheses were broadly used until a decade ago. Many of the patients that carry these kinds of implants are found to have elevated metal ion levels in blood and serum, the significance of which is poorly understood. At local level, the metal particles released from either the bearings or the interfaces between the different components can cause an adverse reaction in the tissues that surround the prosthesis that can involve bone and/ or muscles. This latter complication can cause pain swelling, loosening of the implants, and fracture. In 2012, the MHRA (Medicine and Healthcare products Regulatory Agency) published a guideline recommending that the patients carrying these types of prostheses must be followed up at regular intervals in order to identify those likely to fail in the early stages so that they can be counselled and treated promptly.

Patients should be informed by their consultant of warning signs that there may be a problem with the replaced or resurfaced joint. Anyone with a joint replacement experiencing any of the following symptoms: pain, instability, swelling, inflammation, or a purulent discharge from either the surgical scar or a nearby area should see their doctor immediately.

A revision joint replacement tends to be more complex than the initial operation and many surgeons that feel comfortable performing primary joint replacements will refer their patients to an expert in revision surgery.

I am a high-volume revision surgeon that year on year performs between 3 and 4 times the number of revision hip and knee replacements than the average UK based surgeon. Read More Here