Times Staff Writer
Dr. Phil Ireland, of the St. Vincent Center for Joint Replacement, gave a presentation on hip and knee pain and treatments Friday at Traditions. The program was hosted by the St. Vincent Clay Hospital.
The Indianapolis physician is a Brazil native who answered all questions from the crowd of more than a hundred local residents who attended the seminar.
Ireland explained that arthritis is the leading cause of hip and knee pain. Non-surgical treatment includes low impact aerobic exercises, muscle strengthening, losing weight if overweight, modifying lifestyle and walking aids.
Medications like non-steroidal anti-inflammatory drugs and steroid injections into the joints were discussed. Also mentioned as viable alternatives were supplements such as glucosamine and chrondroitin sulfate, accupuncture and magnets.
Surgical intervention was recommended for people with advanced deterioration of the joints or when pain and discomfort altered their daily living and severely limited their activities.
"People who can walk just five blocks or less without having to stop because of the pain would be surgical candidates," Ireland said.
With knee replacement surgery, the weight bearing part of the knee is metal on plastic rather than bone on bone. Replacements are expected to last from 15 to 20 years.
There are different materials used for hip replacement. Ceramic is one of the newest. The choice of the bearing material is based on the age of the patient and their activity level.
When asked if St. Vincent Center for Joint Replacement would do surgery here at St. Vincent Clay Hospital, Ireland said no. The set up, staff and equipment, can't be duplicated here due to the low volume.
Ireland responded to other questions. If equally bad, it's recommended that both knees be done at the same time unless the patient has significant heart disease. He also said he has no lifting restrictions after recovery unless the patient works daily on an assembly line lifting excessive weight.
Overweight people do really well with knee replacement up to a certain weight. Ireland said that people who are two times their ideal body weight don't do well. But under that point, most heavy patients do as well as thin people except on climbing stairs and getting out of chairs.
Ireland also advised that over weight people needing knee replacement have the surgery first then try to lose the weight. He said that trying to lose significant weight before surgery, without being able to exercise due to joint pain, was extremely difficult if not impossible.
Diet and exercise may prevent joint problems but Ireland said he thinks 90 percent of cases are affected mainly by genetics.
Carolyn Boyd asked if a person can get on their knees for gardening after knee replacement surgery. Ireland responded yes.
"It may be painful for the person but it will not damage the knee. Most gardeners just use a padded support to kneel on and continue to enjoy their gardening."