A single dose of zoledronic acid helps prevent migration of a total hip replacement, according to a report in the February issue of the Journal of Bone & Joint Surgery.
Gerald Friedl, M.D., and colleagues from the Medical University of Graz in Austria randomly assigned 50 patients who had undergone cementless total hip arthroplasty with osteonecrosis of the femoral head to a single infusion of 4 mg of zoledronic acid or a saline solution.
During a median follow-up of 2.8 years, the researchers found that a single dose of zoledronic acid minimized migration of the acetabular component (the cups) in both the transverse and vertical directions but did not significantly reduce subsidence of the stem. Although both groups had rapid increases in the Harris hip-rating score with time, the increase was more pronounced in the zoledronic acid group, the authors note.
via Single Drug Dose Prevents Migration of Hip Replacement – Zoledronic acid helps improve fixation of a cementless implant – ModernMedicine.
ONE consequence of the high cost of medical care in the United States has been the rise of medical tourism. Every year, thousands of Americans undergo surgery in other countries because the allure of good care at half the price is too good to pass up.
Average total fees at well-regarded hospitals like Apollo and Wockhardt in India are 60 percent to 90 percent lower than those of the average American hospital, according to a 2007 study by the consulting group Mercer Health and Benefits (where Dr. Milstein is affiliated). Even compared with low-cost American hospitals, the offshore fees are 20 percent to 50 percent lower.
via Op-Ed Contributors – Overseas, Under the Knife – NYTimes.com.
Hip replacement is one of the most successful operations in all of medicine, which prompts many orthopedic surgeons to think, as one leader in the field put it, “Why change something that doesn’t need fixing?”
But that leader, Dr. Robert Berghoff; his colleagues at Arizona Orthopedic Associates in Phoenix; and other orthopedic surgeons around the country believed that improvements were possible, especially with regard to reducing complications and speeding recovery.
The technique these surgeons use is called anterior hip replacement, one of several minimally invasive operations that are associated with a shorter hospital stay, smaller incision, less trauma to muscles, less pain and blood loss, reduced risk of dislocation after surgery, faster healing and a quicker return to normal activities.
via Personal Health – Less-Invasive Hip Surgery That Speeds Recovery – NYTimes.com.
Concerns Over ‘Metal on Metal’ Hip Implants (March 4, 2010)
But in the last two years, broader concerns have emerged amid research reports that the metal debris can ignite severe inflammatory reactions that can damage or destroy muscles, tendons and other soft tissue.
via Studies Raise Concerns About Metal-on-Metal Hip Implants – NYTimes.com.
Understanding how your hip works
Your hip is one of the largest weight-bearing joints in your body. When it’s working properly, it lets you walk, sit, bend, and turn without pain. To keep it moving smoothly, a complex network of bones, cartilage, muscles, ligaments, and tendons must all work in harmony. The hip is a very stable ball-and-socket joint: A ball (femoral head) at the top of the thighbone (femur) fits into a rounded socket or cup-like cavity (acetabulum) in your pelvis. Bands of tissues called ligaments form a capsule connecting the ball to the socket and holding the bones in place.
via What Is Causing My Hip Pain?.
In another controversy involving all-metal hips, an influential group has found that there is insufficient evidence to show that an alternative technique known as hip resurfacing is as safe and effective as a traditional replacement.
via Hip Resurfacing Operation Loses Important Endorsement – NYTimes.com.