Complex Joint Replacement

knee-joint-replacementDespite significant improvements in surgical techniques and implant development, joint replacements often require surgical revision for a variety of reasons. Because of bone loss, scarring, and soft tissue compromise, revisions are more complicated and challenging than the original joint replacement. As a procedure, joint revision is similar to the methodology used for joint tumors. For that reason, Dr. Daniel C. Allison and his team are often called upon to treat joint replacement failures.

Dr. Allison has extensive experience in the treatment of musculoskeletal structures, which makes him exceptionally qualified in treating complex fractures and degenerative joints of the hip, knee, and shoulder. He provides exceptional care through advanced reconstructive joint surgery and arthroscopic procedures supported by a multi-disciplinary team of orthopedic experts. Schedule an appointment with Dr. Allison today by calling (310) 730-8008 or filling out the online contact form.

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Symptoms and Diagnosis

Though joint destruction may result in stiffness or instability, the main problem associated with arthritis is pain. Therefore, arthritis treatments are directed towards stopping the symptoms of pain from degenerative joints, not replacement.

Hip and knee replacement is usually a salvage treatment for severe, destructive disorders of these joints. Conditions which often cause joint destruction are:

  • Trauma
  • Synovial tumors
  • Degeneration (“wear and tear”)
  • Inflammatory arthritis (rheumatoid arthritis, lupus)

Arthritis will cause a narrowing of joint space and cartilage degeneration with the bones rubbing together. A diagnosis is obtained initially with a careful history, physical examination, and diagnostic tests, such as a simple weight-bearing radiograph (x-rays). The condition is confirmed when x-rays show a narrowing of joint space, hardening of the bone under the cartilage, and the presence of bone spurs.

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Conservative Treatment First

Joint replacement is always a procedure of last resort. All conservative modalities should be exhausted before even considering replacement. Conservative treatments could include weight loss, activity adjustment (decrease high impact activity), physical therapy, and anti-inflammatory medication, such as acetaminophen or non-steroidal anti-inflammatory (NSAID) medication, and corticosteroid injection.

A highly effective minimally invasive treatment for qualified patients is arthroscopy. Dr. Allison recommends this procedure in cases where there is extensive cartilage and soft tissue damage. When these conservative measures fail, and the pain interferes with work and activities of daily living, then joint replacement may be an option.

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For a hip replacement and depending on the patient, Dr. Allison often performs arthroplasty, a surgical procedure replacing a diseased or damaged hip joint with an artificial device. Degenerative conditions such as osteoarthritis, bone tumors, fractures or rheumatoid arthritis are very common hip joint conditions. Additionally, Dr. Allison’s expertise as an orthopedic oncologist often has him treating patients whose cancer has metastasized and damaged the hip joint.

Total joint replacement involves resection of the entire cartilage surfaces and their replacement with metal and plastic. These pieces can be secured through cementation with medical bone cement or through immediate press-fit followed by delayed bone ingrowth.

For hip replacements, Dr. Allison is one of a handful of surgeons who performs the direct anterior method. The result is less damage and trauma to the soft issues around the hip, quicker recovery time, and better support to the hip structure overall.

Contact the Orthopedic Trauma Specialist

Dr. Daniel C. Allison has the specialized expertise of an orthopedic oncologist and uniquely qualified to treat cancer and the musculoskeletal structures it affects. Dr. Allison is renowned for leading multi-disciplinary oncology teams to coordinate the type of integrated medical plan sarcomas require. Call today to schedule a personal consultation at (310) 730-8008.

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