LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

hip replacement

Having Orthopedic Surgery? You NEED to Know this Scary Risk

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orthopredic surgery and troponin
lenetsnikolai / Dollar Photo Club

Everyone knows that there are risks associated with any surgery. But the risks that you know about are the obvious ones.

Problems with the anesthesia such as aspiration pneumonitis or respiratory failure.  Problems with the surgery itself such as excessive blood loss, damaging the spinal cord or spinal nerves, infection or blood clots.

But what if there was something more insidious that can occur?  Something that won’t kill you today or tomorrow, but waits in the shadows until years later?

Before I tell you what this scary thing is, I do need to point out that there is a time and a place for orthopedic surgery.  But this should only be considered as an absolute last option.  All too often we THINK something is a last option.

But time and time again research proves that this is just not true.  Some examples:

This list is much longer, but you get the idea.  There are an uncountable number of orthopedic surgeries done every year that were unnecessary.  Which would be fine if there weren’t dangerous risks associated with orthopedic surgery and the chance that you will be no better after the surgery, or worse, in more pain after the surgery.

Side note–these comments do not apply to trauma-induced orthopedic surgeries–in these cases there are usually no options for avoiding an emergency surgery after trauma.

All of this brings me to this particular study.  In it, researchers looked at a scary side effect of orthopedic surgery called myocardial necrosis.  As you may be able to tell from the name, this is a condition were the heart muscle dies as a result of the stress on the heart from the surgery.  This bad effect from surgery is well known and characterized for short term mortality after orthopedic surgery.

What is not as well-known is what happens in the long term.  To get a better idea of how often this happens, researchers looked at levels of troponin (a protein found in the heart; elevated troponin levels are a sign that damage to the heart has occurred) immediately after orthopedic surgery and whether this related to long term death in hip, knee, and spine surgery 3 years later.  Here’s the details:

  • There were 3,050 surgeries with an average age of 60.8 years.
  • Myocardial necrosis occurred in 179 cases (5.9%) and heart attacks in 20 (0.7%).
  • In those patient who experienced myocardial necrosis, 16.8% of them did not survive in the long term (3 years).
  • In those who had normal troponin levels around the time of surgery only 5.8% did not survive.
  • To put it clearer, those orthopedic surgery patients who had higher levels of troponin were 233% more likely to die in the long term evaluation, while those who had a heart attack after the surgerys were 351% more likely to die.

Now certainly, if you had a heart attack just after your orthopedic surgery you’d know about it.  But myocardial necrosis may not have been fully explained to you if it had been identified.  Either way, if you DO end up having orthopedic surgery, it may makes sense to push your surgeon to run troponin levels along with everything else to get an idea about whether or not you’re going to be around in the next 3 years.

Seems simple enough.

 

Time a New Hip? News Your Ortho Doesn’t Want you to Know

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hip replacement and exercise
philhol/DollarPhotoClub

Arthritis in any joint is a bad thing and sucks your quality of life. At a time when should be enjoying life more, you find you can’t move because of hip pain.

When you were younger, nothing slowed you down but now, even a short trip to the mall sucks.  And forget exercise—it’s way too painful.

I see this scenario all too often in my practice.  And certainly not just the hip, but also the knee and spine.  Arthritis in any of these areas can be painful enough to put a dent in your quality of life.

The best way to deal with arthritis is to prevent it in the first place by staying active, maintaining an ideal body weight and living an anti-diabetic, anti-inflammatory lifestyle.  All of these things will go a long way towards keeping arthritis at bay for a lifetime.

If you read my recent blog post on the links between arthritis and heart disease (which can be read by clicking here), then you already know that joints need motion to get nutrition in and waste products out.  And this applies to a perfectly healthy joint or a joint riddled with arthritis.  Movement is key.

That is one of the reasons why we are able to help most of the arthritis sufferers that come into our office.  The combination of advanced soft tissue techniques (like Graston, ART, NMR and Fascial Manipulation) with stretching and chiropractic adjusting goes a long way towards keeping joints moving and lubricated.

However, if the patient that comes into our office decides to leave our office and sit his or her butt back on the couch, the outcome is not going to be nearly as good.  As I mentioned, exercise is a key component to the management of arthritis, both treatment and prevention.

For clarification, I am not talking about “exercises” that you would get from a therapist or from an orthopedic surgeon.  I have always explained to patients that, when combined with treatment in our office, life is rehab enough.  Hiking, yoga, tai-chi, tennis, racquetball—these are the types of activities that will keep your joints lubricated and moving.  Not spending 20 minutes every morning doing hip-specific stretching and exercises.

But just how powerful can exercise be if you already have arthritis of the hip?  Even worse, if you have been told your only answer is a hip replacement?

For that answer, I bring you this particular study.  In it, researchers asked just this same question in a group of 109 patients who had painful arthritis of the hip confirmed by X-ray.  They were given either exercise therapy and patient education or patient education only and followed for 6 years to seen what effect the exercises had on saving the hip and preventing the hip replacement.

The results may surprise you:

  • 22 patients (59%) in the combo group ended up having a hip replacement while 31 (75%) patients in the education-only group had a total hip replacement.
  • To put this another way, 41% in the combo group save their hips, but only 25% in the exercise-alone group avoided the hip replacement.
  • Overall, this meant that those who did the exercises had a 44% lower risk of having the hip replaced.
  • Even better, in those that did end up with a hip replacement, the exercise group delayed the surgery for 5.4 years while the education-alone group had the replacement done at 3.5 years, almost a full 2 years earlier.

This is not too shabby for a treatment that has no cost, no side effects and is going to have lots of additional benefits.

Contrast this with the use of anti-inflammatories to control the pain of hip arthritis.  NSAIDs will destroy your intestinal tract, destroy your brain, give you a heart attack or stroke and, paradoxically, lead to the destruction of the joint that you are trying to protect.

Quite a difference.