Primary Total Hip Replacement Surgery is generally a successful procedure, allowing people to restore their active and painless lifestyle. It involves the replacement of a hip joint with a prosthesis or an implant made of different materials. But, over a period of time, this procedure might fail for a number of reasons. When such a failure happens, revision surgery is employed. The Revision Total Hip Replacement Surgery is hence the second operation that removes parts of the first prosthesis to replace them with a new set.

The ultimate goal of both the procedures, namely Total Hip Replacement Surgery and Revision Total Hip Replacement Surgery is the same that is to improve the quality of life by bettering the functionality and relieving pain. However, these two surgeries are different in their procedure and complexity. Revision Total Hip Replacement Surgery is more complex and takes much longer time. It requires good planning and use of specialized tools and implants for achieving good results. Use of specialized implants compensates for the damage to soft tissue and bone that makes it difficult for the surgeon to use standard Primary Hip Implants.

Revision Total Hip Replacement Surgery can manifest itself into two forms:

There might be the need to remove the entire prosthesis and its replacement. It might also involve rebuilding the bone around the hips with augments or bone graft.

In another case, there is a possibility that only some parts or components of the prosthesis need to be removed and replaced.

When to go for Revision Total Hip Replacement Surgery:

When there is wearing and loosening of Implant, it does not function properly. For proper functioning, the implants can be cemented into place or press- fit allowing the bone to grow onto them. If this does not happen, the components get loose leading to pain. Loosening of implants might be caused by excessive body weight, rigorous physical activity, and wearing of the plastic liner inserted between metal cup and ball. Also, younger patients might also have to go through a Revision Surgery when the implant completes its life expectancy.

If there is a bacterial infection in the Total Hip Replacement, Revision Surgery is employed. This is so because antibiotics cannot alone eliminate bacteria from joints. In such cases, two stages of the operations are required. But sometimes, a single stage operation is also employed. However, it has limited application.

When there is a recurrent hip location in the ball and socket joint, Revision Surgery is opted to properly align the joint and to insert the implant.

In case of a periprosthetic fracture (when bone around the implant breaks), Revision Surgery is required.

When metal used in implant breaks or degrades, it may cause damage to soft surrounding tissue and bone. This would require a corrective Revision Surgery.

Preparation for the Surgery:

The patient undergoes a thorough physical examination. It is to ensure that undergoing surgery would not be harmful in any possible way. X-Rays, MRIs, and CT scans are employed to fully understand the structure of the joint. Laboratory tests are conducted to ascertain the fitness of the patient to undergo the procedure. It should be noted that post- surgery, the patient is not able to function at all and requires help even to perform petty tasks for himself. Thus, suitable arrangements should be made accordingly in advance for the same.

Post-Operative Care:

Post-operative care involves pain management, preventing infection, physical therapy, wound care, and prevention of blood clot. It ensures a healthy recovery.

Primary & Revision Total Hip Replacement Surgeries!

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

As you age, your body and bones start to grow weaker. You may experience a number of health disorders that you did not suffer from before. These are known as degenerative diseases. Such conditions also affect the spinal region of a person. The degenerative diseases that affect the spine are termed as lumbar spondylosis.

What causes spondylosis?

Here are some known causes and risk factors for spondylosis-

  The bone, ligaments and other connective tissues in the spine wear down with age. Additionally, the intervertebral discs also undergo degeneration. This can lead to bulging discs and even herniation.
  Apart from your age, your genes also play a role in spondylosis. People who have a family history of the condition are more likely to suffer from the disorder.
  Lastly, if you have suffered from an injury to the spine, spondylosis is much more likely. It does not develop as soon as the spine is injured, but may gradually appear over a period of years.

Common symptoms of spondylosis:

Symptoms differ from one patient to the next and some people may not experience any effect of the disease. However, symptoms are present if the herniation or slipped disc leads to excessive pressure on the nerves.

  The most common symptoms of lumbar spondylosis are back and neck pain
  In case the spondylosis results in a pinched nerve, the pain may radiate into the legs and arms
  Other minor symptoms of spondylosis include tingling, weakness and numbness

Treatments for spondylosis:

Spondylosis cannot be cured. However, symptoms can be managed using medications and therapies.

  Pain medications - Non-steroidal anti-inflammatory drugs are prescribed to deal with the pain and discomfort from the degenerative disorder.

  Antidepressants - Some antidepressants are useful in treating the pain associated with spondylosis. However, these medications have side effects. This is why it is wise to consult a doctor before consuming them.

  Topical medication - In some cases, topical medication applied directly at the site of the pain is more effective than oral pain medications.

  Physical therapy - Your doctor may recommend physical therapy for you as well if the spondylosis is severe and is interfering with daily life.

Acupuncture and chiropractic practices can also help deal with the discomfort to some extent. Furthermore, exercise relieves some pressure on pinched nerves, reducing the pain.

Lumbar Spondylosis - Common Symptoms & Treatment Of It!

After a tough workout session or a strenuous day at the office, your muscles may feel floppy and exhausted until you have given them a chance to rest. However, persistent muscle weakness with no apparent cause or explanation can be a sign of an underlying medical problem.

What causes muscle weakness?
Voluntary muscle contractions and movement are generated when the brain sends a signal through your spinal cord and nerves to the particular muscle. If there are any hindrances in the connections between them, it can result in muscle weakness. However hard you try, the muscle is such cases becomes abnormal.

Here are some common causes of muscle weakness:

Lack of Use: One of the most common causes of muscle weakness, lack of muscle fitness may occur as a result of a sedentary lifestyle. If the muscles are not used, then the fibers are partially replaced with fat.
Ageing: As we age, our muscles tend to get weaker and lose strength. Muscles become bulky and recovery times during injury are greater. However, with physical activity, it is still possible to increase the muscle power. So stay active and instill strength in your muscles.
Infections: Infections and inflammation can cause temporary muscle fatigue. Even though recovery is quick, if the infection is severe the weakness can last for some time. Without proper care, it can lead to permanent damage.
Pregnancy: During and just after pregnancy, high levels of steroid in the blood and low levels of iron can cause muscle tiredness. Lower back pain is common during pregnancy and all your muscles may feel floppy.
Chronic Diseases: With conditions of diabetes, heart disease, kidney disease and anemia, it can lead to muscle weakness by thwarting the essential blood or nutrient supply to the muscles. Also, chronic pain related ailments cause weakness.
Injuries: Injury or trauma such as sporting injuries, pulls and sprains can deter the muscles. Along with localized pain, it can also lead to muscle weakness if not taken care of properly.
Sleep Disorders: With disturbed or reduced sleep there is a general sense of tiredness that leads to fatigue in the muscles. Insomnia, anxiety, depression and other mental disorders also affect the muscles a great deal.
Conditions affecting Nerves: Conditions like Myasthenia gravis or motor neuron disease affects the nerves and thereby fail to relay signals to the muscles, leading to weakness.
Genetic disorder affecting muscles: There are also certain inherited diseases which can affect the muscles like muscular dystrophy.
Spine-related disorders: Conditions like slip disc and other disorders affect the muscles served by the irritated or compressed nerves of the spinal cord.

Muscle Weakness - 10 Common Reasons Behind It!

A sprain refers to a break or a tear in any of the ligaments of your body. A ligament is a band consisting of tissues that connect the bones at any given joint in our body.

A strain on the other hand refers to a tear or a break in the entire muscle itself or a tendon (the band of tissues that connect the muscle to the bones).

Occurrence
Sprains usually take place due to unforeseen incidents like falls, accidents, and such other things that forces the body part to go out of its normal position. The most common types of sprains that people suffer from are ankle sprains which affect about 25,000 people every day on a worldwide basis.

Strains usually happen when you twist a whole muscle or a tendon. This condition most commonly occurs in cases of sportspersons who are engaged in contact sports like hockey, football, rugby, and such others.

Symptoms
The identification signs of sprains and strains are mostly very similar, which are listed below:
1. Pain and discomfort in the joints
2. Visible swelling or inflammation seen on the joints
3. Bruising of the affected area
4. Tenderness and softness of the affected joint

The overall intensity of the above mentioned symptoms might differ basis on the severity of the condition that is directly proportional to the nature of injury that you have faced. Some pains are so light that it may not affect your daily routine at all, whereas some pains are so intense, that you might not be able to move your affected joint at all.

Treatment
Some of the common methods to cure a sprain or a strain are listed below:
1. Rest the area which is affected
2. Apply ice bags or cold compress to soothe the pain
3. Compress the affected joint using a compression tape
4. Place the affected joint on an elevated area to speed up the healing process

Sprain Versus Strain

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