Total Hip Replacement Surgery

The goals of total hip replacement (arthroplasty) are to provide relief of pain and discomfort, improve function and enhance stability in patients suffering from arthritis or any disabling orthopedic hip problem. This goal was originally met in the late 1960's and has been improved over the past several decades.

In India Total hip replacement is a common surgical procedure with a high success rate. In an arthritic hip, the damaged ball (the upper end of the femur) is replaced by a metal or ceramic ball attached to a metal stem fitted into the femur (with or without cement), and a plastic or ceramic socket (fitted into a metal socket) that is implanted into the pelvis, replacing the damaged socket.
Using a combination of metal and plastic, the joint implant surgeon creates a new ball and socket joint, which will glide smoothly and painlessly. During the past two decades, multiple advances in hip arthroplasty have been accomplished and many types of prosthesis are available and currently used. The metals used are chrome cobalt alloy and/or titanium alloy. These are super metals initially developed for the aerospace industry and now adapted for the orthopedic industry. The plastic is a high-density plastic polymer called polyethylene. In younger patients a ceramic ball is used with a polyethylene or ceramic socket.

Methods of total hip replacement surgery:

Modern Total Hiip replacement surgery is divided in two different methods. With elderly people it is often more reasonable to put in and fix the total hip in a softer bone by using bone cement. The advantage of this method is that the prosthesis holds from the very first day and will not loosen itself in the relatively soft bone of an elderly person. This represents a very stable and reasonable construction. Today, a stainless steel prosthesis is inserted into the bone of the upper leg by using a little amount of bone cement and is immediately stable.

The inverse of the hip bone will be shaped and a piece of synthetic material will be fixed with bone cement. The connection is immediately stable. This method has been approved worldwide for over 40 years and is still recommended. The life expectancy of a prosthesis of this kind is a minimum of 10 years, normally 15 years and very often 20 years.

A well established second method is a system of joint replacement without bone cement. In this case titanium trunks are fitted into the upper leg bone (femur) and are fixed by exact insertion into the femur. This method of the cementless prosthesis normally takes a couple of weeks until it is fixed to the upper leg bone. We recommend the use of crutches for 6-8 weeks.
In Rheinfelden a titanic cup which is screwed into the bone and also not fixed by bone cement has proved true. In this type of titanic cup either plastic or ceramic inlay is fitted in exactely.
The slide bearing (so called ,,Gleitpaarung") means that materials for bonehead and inlay of the cup can be different. In most cases the slide bearing plastic and metal has proved to be good. The stay in the clinic in case of a hip replacement usually is 2 weeks.

Alternatives to Total Hip Replacement Surgery.

Conservative treatment

One alternative is not to have an operation. If your pain can be controlled with medication (pain killers: such as paracetamol, or non steroidal anti-inflammatory drugs; or disease management medication: like glucosamine-sulfate), physiotherapy, and adapting your physical activities, so that you are sufficiently comfortable and you are content with your present activity level and motion in your hip, then you may decide to wait (AKA watchful waiting).
Femoral/acetabular osteotomy

For patients with developmental dysplasia of the hip (DDH), cutting the thigh bone (femoral astronomy) or pelvis (Ganz, Berne or Bernice osteotomy) in order to realign the hip may be indicated if the hip weight-bearing area can be broadened or made more congruent. This is often useful in young patients. Recovery following osteotomy may be longer than with joint replacement, implicating no weight bearing for 6 weeks up to 3 months!

Arthrodesis

Arthrodesis is rarely performed, but is an especially effective procedure for younger patients, particularly those who are of short stature and who are otherwise healthy. "Arthrodesis" relieves pain by fusing the femoral head to the acetabulum. It has none of the limitations that a joint replacement or other procedure has in terms of restrictions in activity level. If the patient's back is mobile and without symptoms, it is a very worthwhile procedure. The procedure generally requires internal fixation with plate and screws and occasionally cast immobilization while healing takes place. An arthrodesis can be converted to a total hip replacement at a later date, usually 15 years on average after the operation.

Why go to India for total hip replacement surgery?

Orthopedic surgery in Western countries cost 5 to 6 times as much as in India. Over the years, India has become a global centre of excellence in orthopedics surgery including the total hip replacement surgery by promoting the notion that medical services in India can be bought off the shelf from the lowest priced provider anywhere in the globe, care. The concept has broad appeal, as Indian private facilities offer advanced technology and high-quality procedures on par with hospitals in the major industrialized countries at a fraction of the cost It is a deepening of the whole notion of health care that is being pushed today which emphasizes on technology and private enterprise. More and more western patients seeking surgery are looking towards eastern destinations such as India, for their medical needs, including orthopedic procedures like the hip replacement surgery. Once in India you can be rest assured about your proper diagnosis and medication. Furthermore, if situation demands, surgery packages are also within your reach. Medical Treatment in India is amid the best in the world, facilitated by the most skilled doctors and up to the minute super sphere hospitals of India.

Costs for Bilateral Hip replacement surgery:

The total cost of the Hip Replacement Surgery in India is very less as compared to USA or UK. The patient can go back to his country by the 12th day in case of single hip joint replacement and by 20th day after a bilateral hip replacement. The stay is shorter after double hip replacement surgery as the intervening period between sequential knee replacements is avoided.

Total Knee Replacement - Get Walking Faster

A total knee replacement will help your mobility in the long term, but short term you are going to spend a lot of time on your back. You want to minimize that time as much as possible. Four things are essential to get you up and around as soon as possible, and you can't afford to neglect any of them. They are, in order of importance:

o Exercise for strength

o Exercise for flexibility

o Therapy to reduce swelling

o Nutrients to promote healing

I want to talk about the first three items in this article. I have covered nutrients in another.
Exercising for strength is really about helping your leg regain the strength it had before the knee surgery. Several things happen during a knee replacement. A large incision cuts through a lot of muscle fiber, and this then induces a lot of swelling. Both of these make movement difficult.

What we know now, that they didn't know 35 years ago, when I first had knee surgery, is that you don't have to wait for the incision to heal before you start physiotherapy. The physio will promote the healing, as well as maintain functionality that would have been lost if the leg was immobilized for 5 weeks before working it. They will start physio in the hospital, but it is imperative that you continue it at home. Even skipping one day will have a negative effect. Now, when you are a bit more able to get around, and start to do some walking or climbing of stairs with your cane, you can use your judgment about the strengthening exercises. You don't want to over use your joint and cause swelling. But you must do the flexibility exercise every day to make progress.

Ideally you started exercising before the knee replacement, trying to increase strength in your leg before surgery. If not, you just have to start wherever you are when you get home and work hard to get stronger every day. The three ways you get stronger are increase your repetitions, increase your resistance, or slow down the speed you do the exercises at.

Increasing repetitions is easy, but of limited use. Don't bother going beyond 15 reps. Adding resistance is actually easy as well, if you use a little imagination. If you are doing your leg lifts in slippers, try doing them in a shoe, or a heavy boot, or with a towel hanging across your foot, or against a resistance band. You don't need any special weight lifting equipment. Once you can do your repetitions with some resistance, slow down so that it takes 5 seconds to extend your leg. Do ten repetitions like that and see what kind of a workout you get. Progressive resistance is the best way to increase strength, not just increasing your repetitions continuously.

Increasing flexibility is critical for full recovery. Every day you should strive for a slightly greater bend. You should definitely see measurable improvement every four days. If not you may need to get into a physiotherapists office for active hands on work. Try going for a nice warm bath, once your staples are out. Let your leg soak in the warm water for fifteen minutes or longer, then dry off and try your flexibility exercises. Don't push too hard, but expect improvement.

Swelling can be reduced several ways. Initially you need to spend time lying down, with your leg elevated above your heart for an hour each session at least. I'm talking three or four pillows high of elevation. I hope you like reading or listening to the radio, or even watching TV for an hour at a time.

It is best to do this after your exercise sessions, when you may tend to suffer from some inflammation. You can help control any tendency towards additional swelling by wrapping a bag of frozen peas or beans (or baby carrots if you prefer) in a towel and placing the cold pack over your knee for 15 minutes. Then switch it to under your knee for another 10. Try to get a second session in at night before you go to bed. After all, as the days go by, you will be working your leg more and more. The end of the day is a good time to try and have gravity suck the fluids out of the joint.

Exercising for strength, exercising for flexibility, and doing the correct therapy to reduce swelling are all critical elements in your recovery. Follow the advice of your doctor and therapists, and get a little better every day.

What's New for Osteoarthritis Treatment?

The American College of Rheumatology meeting, held in Atlanta, Georgia, from November 7 through November 11, 2010 provided some new modest advances in the understanding of osteoarthritis.

Osteoarthritis is characterized by the gradual wearing away of articular cartilage the gristle that caps the ends of long bones. Osteoarthritis primarily affected weight-bearing regions such as the neck, low back, hips, and knees.

Osteoarthritis is the most common form of arthritis and affects more than 20 million Americans and is expected to increase in frequency as Baby Boomers continue to age.

The aim of treatment in osteoarthritis is to provide pain relief and improve function. However, the ultimate goal has always been to restore articular cartilage.

Some important highlights from this year's meetings were:

1. The demonstration that genetic markers called "SNPs" may provide clues as to why some people develop osteoarthritis more readily than others. So, in addition to trauma to the cartilage, which is a known risk factor for the development of osteoarthritis, there also appears to be a genetic predilection for the disease. Perhaps, in the future, patients who are at higher risk for contracting osteoarthritis might be identified and treated more aggressively.

2. Cymbalta (duloxetine), a drug already approved by the FDA for treatment of major depressive disorder, fibromyalgia, and diabetic peripheral neuropathy, was approved by the FDA for treatment of chronic musculoskeletal pain, including pain resulting from osteoarthritis and chronic lower back pain. The efficacy of Cymbalta for chronic lower back pain and osteoarthritis were assessed in four double-blind, placebo-controlled, randomized clinical trials. Patients taking Cymbalta in these trials experienced significantly greater pain reduction compared with placebo.

3. Data on Naproxcinod, a unique non-steroidal anti-inflammatory drug was presented. Naproxinod is the first cyclooxygenase inhibiting nitric oxide donator (CINOD) in development for the treatment of osteoarthritis. It was found to be comparable to naproxen in its ability to relieve the pain of hip osteoarthritis, while causing fewer adverse effects on blood pressure.

4. The popular "new kid on the block", vitamin D, suffered a blow to its reputation. Supplementation with vitamin D was unsuccessful in helping patients with osteoarthritis of the knee overcome pain in one study presented from Tufts University.

5. The use of ultrasound to guide knee injections for osteoarthritis treatment led to a 42 percent reduction in pain, a doubled response rate to therapy and a 15 percent reduction in cost to patients, compared with conventional injections guided by "feel."

6. Pennsaid, a relatively new topical agent which combines the anti-inflammatory effects of diclofenac with the penetrating power of DMSO presented some encouraging data on pain relief for osteoarthritis of the knee.

7. Another study showed that Lidoderm patches provide another possible options for knee osteoarthritis pain relief and were superior to placebo.

8. Researchers from Rush Medical School in Chicago recently studied the gaits of 16 adults who, through x-rays and reported symptoms, were diagnosed with osteoarthritis of the knees. The researchers found that special shoes can ease knee pain and slow the progression of knee pain and arthritis.

9. A study from the Netherlands showed that distraction of the knee ( using pins to open the knee joint) actually led to cartilage growth and improvement of symptoms as well as avoidance of the need for knee replacement.

10. Two presentations on mesenchymal stem cells provided hope that in the near future, the ability to regenerate cartilage to treat osteoarthritis is a possibility. The first was a talk given by Dr. Nathan Wei, from the Arthritis Treatment Center in Maryland, who presented data on 22 patients treated with mesenchymal stem cells for osteoarthritis of the knee. At six months and at one year following treatment with autologous stem cells (a patient's own stem cells), patients showed improvements in both subjective measures as well as objective measures of cartilage growth. The second talk given by Dr. Rocky Tuan from the University of Pittsburgh, demonstrated that transformation of adult mesenchymal stem cells into human articular cartilage was not only possible but relatively easy.

How To Generate Non-Stop Leads In Multi-Level Marketing

So, are you also engaged in the multi level marketing business? That's great, because right now, multi level marketing is one of the easiest yet most rewarding businesses that you can engage into right now - but for what reasons? Personally, for someone who does multi level marketing while raising a family and being active in socio-civic volunteer work, multi level marketing is just very convenient because it allows me to earn money without actually having to go regularly to work. Plus, I get to share the stuff with my fellow volunteers and friends. The perks associated with multi level marketers are great, too, especially if they're health products or cosmetic products. You get freebies, which include free products and services. One time, my teenage daughter was able to earn 1,000 freebie points in her own cosmetic business line. She used these points to garner free facial from the company. So you see, it does not bring benefits to grown up's, it can even teach your kids to be responsible about money, too.

However, the glitch with multi level marketing comes forth if you don't know how to do sales talk. Add to that the fact that there are just some multi level marketing companies that, though they have great products for sale, do not offer ample training for their employees. Now if you're naturally shy, you'll definitely get into problems making the programs work for you as you might not be able to come up with sales leads at all.

Adwords: The Key To Non-Stop Leads

Do you know what? Not all leads are really smart enough leads. And as someone who has long since first ventured into the multi level marketing business, I know that if your lead isn't smart enough, you definitely won't be able to sell.

That's why I suggest that each one who wants to go into the multi level marketing business have a hand first on adwords. AdWords are basically those promotional things you say or write down that are sure to click into the hearts of your target buyers. Here is how you use AdWords to rev up your leads:

o Make up a script that will show people how using the product or service you peddle will be of an advantage to them. For example, this medicine will help hasten healing of cancer, heart diseases, etc.

o Show your prospective buyers what you yourself can do for them. Show them that you're not just there to sell them wares, but you're also there to really help them. That's why you're showing them your products. (That's why for me, it's easier to sell to friends. I can kid them easier)

o Lastly, come up with a header that's really going to knock knees out. What I mean is, come up with a really clever cliché that will make people curious as to what you have in store for them. Your header or cliché should also make people want to, of course, purchase your product or avail of your services. One word of caution though: please try not to make promises in fine print or that are false. Not only are they irking to customers or to the law, they also affect your credibility as a businessperson.

Some Facts on Medical Tourism

Owing to the fact that there are many health problems that people of different races want to get solved at a comparatively low risk as well as low cost, there has been an increasing migration of diseased individuals from their home countries to other parts of the world.

This practice has been popularly termed "medical tourism," otherwise known as health tourism or medical travel or global healthcare.

Health-Care Services Common to Medical Tourism

For one reason or the other, individuals travel across international borders to access health services that are available in their destination countries. Similarly, medical tourism could also be referred to as the practice whereby some physicians, doctors or health-care providers are itinerant travelers to different parts of the world to deliver health-care services to potential patients.

It is worthy of note that the health services that medical tourists commonly seek to have include dental surgery, joint (hip or knee) replacement surgeries, cosmetic surgeries, cardiac surgery, psychiatry, alternative treatments, in-vitro fertilization and freezing embryos for retro-production, and surrogate pregnancy.

Countries Associated with Medical Tourism

It is worth stating again that one of the major causes of medical tourism is the relative cost of undergoing a certain medical procedure. For instance, carrying out a liver transplant surgery costs about $250,000 in United States compared to that of Taiwan which costs about $90,000 USD. Another major reason is the lack of adequate health care facilities and services.

As a result, more of medical tourists come from places like Europe, the US, Canada, Japan and the Middle East. Health service providers from such countries stand the chances of losing billions of dollars revenue.

In the same vein, the countries where medical tourists usually consider for medical procedures include India, Jordan, Malaysia, South Africa, Thailand, South Korea, Tunisia, Argentina, Israel, Ukraine, and New Zealand.

Potential Risk of Medical Tourism

It is quite vital for medical tourists to be well aware of the risks involved in seeking health care in some other countries. This will help to determine what could be done so as to minimize or eliminate the risk factors of medical tourism.

1. Low level of expertise of some health-care service providers. There have been cases where some even practice outside of their field. This is highly risky.
2. Low health-care standards. Some countries other than First World have low standards in the health sector.
3. Lack of proper Health Insurance Scheme in some Medical Procedures.
4. The possible risk of post-operation complications after tourists' return to home countries.
5. Lack of physical contact with the physician after medical care for essential medical check-up.

Factors Responsible for Medical tourism

1. High cost of health-care service. In fact, one of the major reason why medical tourist travel from First World countries to other places is as result of the high cost of health-care services.

2. Convenience and speed. In countries like US and UK unlike in some other countries, many health care services require long waiting times before the medical procedures are embarked on.

3. There is advanced medical technology in many countries today. Many countries are taking advantage of medical tourism by providing high standards of health care services.

4. Lack of local health-care services on certain medical problems. For instance, a medical tourist may seek help for in-vitro reproduction in a foreign country if it is not available in his own country.

From the foregoing, the views held by individuals about medical tourism are not the same at all. Some people from First World countries see it as a risky medical alternative. However, since many countries are now taking to advanced medical technology, some still consider that it is worth doing.

3 Secrets to Knee Harder and Faster

The knee is one of the most powerful weapon in your body. A simple knee to the head can knock a guy out quickly and simply. It can also break bones and stop any kicks quickly in its tracks. It is one of the most offensive and defensive weapons that we have on our body. All martial arts have knees, and the most effective martial arts know how to use the knees better than anyone else. Here are 3 secrets how to get lightening fast and hard knees like no other!

1. Squats

To get the most strongest knee that you can ever have is to squats as many times as possible and quickly! The power of the knee in martial arts mainly come from the hip flexor muscles of your body. So to strengthen them quickly and easily, you have to do squats as much as you can which work on your hip flexor muscles. Squats also make you jump higher and faster because you need to bend down and then push up from your feet to straighten up!

2. Kneeing your chest

If you knee your chest as fast and quickly as possible, you help strengthen your knees and also flexibility. To have fast knee speeds, you have to have good flexibility. Also kneeing yourself helps you to build toughening and resistance to pain.

3. Running

To have fast and strong knees, you have to run as much as you can. At least 5 miles a day is the minimum to get knees as strong as a bull. This will help build up endurance and strength of your knees.

If You Want to Grow Taller, What Are the Options?

Most people would agree that being tall is a valuable attribute in our society. If you aren't sure about this, let me tell you some interesting statistics:

• If two people who are equally qualified, go for a interview for the same job. The taller person will get the job in 72% of cases. That means the taller person has a three times better chance of getting the job than the short person.


• In all but 3 of the Presidential elections in the last 110 years, the taller man has won. 


• Women will tend to rank shorter man as less desirable than taller men. Even if (using objective measures) the taller man is uglier than the shorter man.


• Shorter men are much less likely to get married (probably as a result of the above point)


• On first impressions, people tend to attribute positive characteristics to tall people and negative characteristics to short people.

So, it's pretty clear that shortness is a liability. Which leads the logical person to look at how they can deal with this situation? What are the options available to the person that wants to do something about their height (And remember you don't have to be short to benefit from a few extra inches in height.).

In this article I want to talk about the three main methods available to people who want to increase their height.

1. Growth Hormone supplements. 

Growth hormone is sometimes given to children with short stature and can result in reasonable increases in height. Although there is some controversy about this, it is carried out and obviously does have some benefits. 

The issue lies with giving growth hormone to adults to increase height. Growth hormone has recently been touted as an elixir that can reverse aging. It attracts big price tags and is offered at exclusive clinics to customers eager to slow their aging. Whether it truly has "fountain of youth" properties is not clear. We are still waiting for the proof. What is most clear is that giving growth hormone for increasing height is not advisable. Here is why:

When a child is growing, their bones grow at points called growth plates. Giving growth hormone can result in increased bone growth at those growth plates found in the long bones (e.g. in the legs). However, after the growth plates have closed (around the late teens/ early twenties) then growth hormone has no effects on these bones. Therefore you could give lots and lots of growth hormone to someone in their thirties and it would have no effect.

So, growth hormone is useless after a certain age. But it does have other effects. The most obvious one is on your wallet. Growth hormone courses can cost up to $20,000. The other issue is that taking excess quantities of growth hormone can have serious side effects, including bloating, major organ damage, heart failure and even premature death.

So basically, taking growth hormone for height is not only ineffective, it is also expensive and potentially lethal.

2. Height Surgery

Height Surgery is a very effective way of increasing height. Originally it was performed to help people with limbs of different length, but more recently to give height to people with short stature. It originated in Russia, but is now being performed around the world.

The basis of the procedure is to break the long bones and then allow them to heal over a period of several months. By careful mechanics, the new bone that heals is made to be longer than it was before the bones were broken. There can be gains of 3-4 inches with this surgery.

The main issues with this type of surgery are the risks associated with any procedure that requires the patient to be put to sleep. But these risks are very small. There are also risks of infection. The cost of the procedure is very high, around $100,000. The other issue is that the procedure requires long periods in bed (up to 8 months) while the external fixation devices are adjusted and tightened. The procedure can be very painful, but pain relief is given.

So, limb lengthening surgery works very well, but is very expensive, time consuming and as well as pain has some other risks involved like infection and anaesthesia.

3. Natural Methods for Height Increase

Which leaves us with how to grow taller naturally. Natural methods focus on things you can do to help with height increase that don't involve drugs or surgery. Natural methods use a combination of exercises, diet and cosmetic strategies to bring about increases in height. 

Some people appear shorter than they are due to postural problems like slouching, knock-knees, tilted pelvis etc. These postural problems can be improved by doing certain exercises. In addition compression of the inter-vertebral discs can result in height decrease. Exercise to improve the strength of muscles and ligaments supporting the spine can prevent this compression.

In other cases, poor nutrition can contribute to poor bone health which affects stature. There is also a possibility of improving "perceived" stature by sartorial (dressing) techniques.

Using natural methods requires effort and responsibility to be taken by the individual. You will need to apply the system in your life. People who expect things to happen without effort will be disappointed.

So, natural methods are cheaper and safer than other methods, but they require effort and application to make them work. Some people may find this taking responsibility for their height increase difficult to do. Of course it all comes down to how much you want to increase your height.

I hope that has given you a clear overview of the options available for height increase. Increased height can be a real advantage in our society and if you have the motivation to do something about it, then there are definite options available. Good luck!