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Orthopedics
Bursitis
Bursitis is an inflammation of the bursa, a fluid
filled sack that cushions the junction of two bones.
Both sides contain lubricating fluid which normally
eliminates friction in the area while maintaining
smooth muscle movement over the bone. Sudden extreme
pressure or continuous strain can cause inflammation.
Pain from bursitis can be very disabling and any joint
in the body can be affected by bursitis. However,
shoulders, knees and elbows are most commonly
effected. Acute bursitis may heal with time if the
joint is immobilized. Patients may consider using
crutches or slings. Or, complete bed rest may help
relieve the pressure on the affected area. In severe
cases, your doctor may recommend surgery.
Bursitis is probably the most common hip joint
condition. When it does not respond to traditional
simple measures such as a modification of activities
or a trail of anti-inflammatory medicines, then many
times it is appropriate to consider referral to an
orthopedic surgeon for better delineation of the
problem. The suffix "itis" in medicine refers to an
inflammation or irritation. A "bursa" is a fibrous
covering overlying a bone. Hence, bursitis is an
irritative condition overlying the bones in the hip --
typically the part of the femur known as the Great
Trochanter. Frequently, an injection with a cortisone
type preparation will be tried to see if the symptoms
are alleviated. Many times, however, the focus of
attention may be to determine if some other condition
exists.
Avascular Necrosis
Avascular Necrosis or Aseptic Necrosis of the hip
represents a condition where the hip has at least
temporarily lost the critical blood supply to the ball
part of the hip. This can cause a condition where the
bone begins to collapse at this weakened site and then
arthritis can begin. This is the condition many people
identify with Bo Jackson who eventually underwent hip
replacement surgery for the treatment of this
disorder. There are several factors which have been
statistically identified with this condition, but for
the vast majority of patients, there is no know cause.
Arthritis of the Hip
Arthritis is a gradual wearing down of the smooth
gliding surfaces of the hip joint. When this occurs,
raw bone becomes exposes within the hip joint which
becomes painful with activity. This may have occurred
due to a variety of reasons but frequently the end
result is the same -- increasingly persistent pain and
decreasing activity level. First line treatments
include modification of activity and use of an
anti-inflammatory medicine or perhaps Tylenol type
products. Sensitivity of the stomach and intestines
many times makes prolonged use of the
anti-inflammatory medicines difficult. When the
condition becomes particularly severe, then surgery is
indicated. The most common procedure is Total Hip
Replacement which aims at resurfacing both the cup and
the ball surfaces. A frequent misconception of
patients is that they are too old for this type of
surgery since it is extensive. However, the vast
majority of patients undergoing hip replacement
surgery are easily within the retirement age group and
usually do excellent.
Tendonitis
The tendon is the tissue connecting the tissue to
the bone. A slight injury can make the tendon inflamed
and torn. This condition is known as tendonitis. This
is a painful condition, and takes quite a while to
heal since the muscle is in constant use. When the
torn area does not heal, it leaves a reminder -- a
scar in the tendon which can cause pain. The pain
usually disappears in a few weeks, but with older
people, the pain can remain and even get worse over
time. The injury can occur any place a tendon joins a
muscle to the bone.
Arthritis
Arthritis is an inflammation of a joint usually
accompanied by pain and frequently changes in
structure. Contrary to popular belief, arthritis is
not inherited. Arthritis is not caused by bad weather
or stress, although these conditions may cause the
symptoms to worsen. While there is no specific therapy
-- rest, passive exercise and anti-inflammatory drugs
are usually prescribed. If the condition is severe
enough, bed rest may be recommended. The use of
exercise and physical therapy is important in
maintaining range of motion of the affected joints.
The drug most often prescribed for relieving the pain
of arthritis is still aspirin. However, Naprosyn and
Ibuprofen are also used in treatment. Surgical
replacement of the joint has been effective in very
severe forms of arthritis.
Rheumatoid Arthritis
Although arthritis most commonly occurs in person
over the age of 50, rheumatoid arthritis can strike at
any age. The symptoms include aching of the joints,
swelling, stiffness, fever and fatigue. This type of
arthritis sometimes goes into remission when the
symptoms disappear. However, when the symptoms
reoccur, it can be more severe. Your physician may
prescribe anti-inflammatory drugs to relieve pain. A
low impact exercise program interspersed with rest
periods may help reduce stiffness. In extreme cases,
rheumatoid arthritis can affect the heart, lungs and
the nerves.
Knee Problems
In a normal knee, the space between the thigh and
shin bone is filled with fluid and cartilage. This
serves as a cushion and shock absorber. In an
arthritic knee, the cartilage deteriorates, causing
the bones to rub against each other. This results in
pain and stiffness. Since the knees are major
weight-bearing joints, they are often severely
affected by arthritis. Losing excess body weight is
often recommended as a first step in relieving some of
the pain. Light to moderate exercise can also help.
Short walks and swimming are often recommended to help
keep joints limber and reduce the stiffness. In
addition, ice or heat packs on the affected joint may
provide relief. Your doctor may also prescribe
anti-inflammatory medication. When the arthritis
becomes so severe that is intolerable, surgery may be
advised. Depending on the diagnosis, a partial or
total knee replacement may be recommended. Results of
these procedures have been excellent, and most
patients are able to return to a more comfortable and
active lifestyle. |