Advances in Knee Replacements

This new design allows surgeons to preserve the important central ligaments of the knee called the anterior and posterior cruciate ligaments. This design should allow a knee replacement to move, respond, and feel more like a normal knee.

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The Anterior Hip

Patients are being told by both surgeons and orthopedic implant companies that Anterior Hip Replacement approach offers something unique and different compared to other approaches. This is a flatly untrue, unscientifically supported myth...

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Outpatient Joint Replacement

With Outpatient Joint Replacement Surgery, patients are able to return home the same day as the procedure. Patients also begin physical therapy within hours of surgery.

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Viscosupplementation Injections for Hip Degenerative Joint Disease

Degenerative joint disease, or osteoarthritis, of the hips causes damage to the joint cartilage, resulting in pain, stiffness, and swelling. Osteoarthritis also causes a loss of synovial fluid, which lubricates the joint and absorbs shock.

Synovial fluid naturally contains an important component called hyaluronic acid. Viscosupplementation is the process of injecting hyaluronic acid into the affected joint to help restore the lubrication lost from degenerative joint disease. Viscosupplementation is more commonly used to treat osteoarthritis of the knee, but has shown promising results in the treatment of hip osteoarthritis as well, although it is not FDA approved for use in the hips at this time. Therefore, insurance will not cover this procedure.

Procedure and Recovery

Viscosupplementation works best for those who are in the early stages of osteoarthritis. Hyaluronic acid, a thick fluid, is injected into the diseased joint to help replace some of the lubrication lost from arthritis. Your doctor may choose to use ultrasound guidance to help him administer the injection. Ultrasound guidance can help to ensure proper placement of the injection. Improper placement of hyaluronic acid can result in increased swelling and discomfort in the joint, so accuracy is very important. If there is any swelling in the joint, your doctor may also aspirate, or remove, any excess fluid before administering the injection.

Immediately following the procedure, you may experience pain, warmth, or swelling in the injection area. If you experience any of these aftereffects, you can apply an ice pack to the area. You should avoid putting excessive weight on the hip, such as standing for long periods of time, for at least the first 48 hours after receiving the shot. It is important to remember that viscosupplementation injections will not relieve your hip pain immediately. In fact, it may take several weeks to feel the full effect of the treatment. This treatment also cannot reverse any damage to the cartilage from arthritis, but may help to slow or prevent further damage. Generally, the treatment can be repeated about six months after the injection, if needed.

Benefits of Viscosupplementation

Although viscosupplementation is a relatively new treatment for hip degenerative joint disease, it has shown positive results for some patients, particularly those with early-stage osteoarthritis. Patients have experienced a decrease in pain, with long-term effectiveness lasting for several months. Viscosupplementation generally involves a low complication rate, with fewer side effects compared to other injected treatments like corticosteroids. This may be due to the fact that hyaluronic acid occurs naturally in synovial fluid. Additionally, ultrasound guidance helps to further lower the complication rate by helping your doctor check the accuracy of the injection, which is why many doctors opt to use this technology.

Viscosupplementation may also be a good option for those who cannot have surgery or cannot take NSAID pain medications like ibuprofen, Motrin, or Advil. Clinical studies have shown that hyaluronic acid injections can be as effective as NSAID medications in relieving pain, without the stomach and gastrointestinal risks associated with NSAIDs. Some patients have had more success with viscosupplementation than with steroid injections. Hyaluronic acid may also have anti-inflammatory properties, and could stimulate the body to produce hyaluronic acid on its own, according to some studies.

Hip degenerative joint disease can severely interfere with your everyday life. If other nonsurgical treatments have not helped to relieve your hip pain, viscosupplementation may be a good option for you.

Viscosupplementation in Portland, OR

Dr. James Ballard is committed to providing the best orthopaedic care possible, and will use nonsurgical treatment methods whenever possible. If you would like more information about viscosupplementation, or would like to schedule an appointment, please feel free to contact his offices in Oregon City or Tualatin.