Total Knee Replacement Saves Money, Improves Sex Life

Orthopaedic Surgeons Joel Buchalter and Doug Fauser Respond to New Research,

Offer Tips to Optimize Recovery

Carmel, NY, October 2013 - Recent studies on total knee replacement (TKR) surgery indicate the procedure pays off in important ways in both the wallet and the bedroom. The research highlights why seeking TKR can be a valuable decision for those with diseased and damaged knee joints that cause chronic pain and dysfunction, according to Joel S. Buchalter, MD, FAAOS and Douglas J. Fauser, MD, FAAOS, founding partners of Somers Orthopaedic Surgery & Sports Medicine Group.

New research published in the Journal of Bone and Joint Surgery found that knee replacement surgery saves between $10,000 and $30,000 per patient over their lifetime in increased earnings and fewer missed workdays. Meanwhile, a study presented in March 2013 at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that the sexual functioning of those who had TKR or hip replacement surgery improved by 90 percent.

"More than 27 million Americans live with osteoarthritis, the most common reason for knee joint replacement surgery," says Dr. Buchalter, a board-certified orthopaedic surgeon. "These studies clearly demonstrate that the benefits of this surgery extend much farther than eliminating pain - a top reason for seeking the procedure - and also enhance patients' productivity and quality of life."

The desire to stay active is fueling the growth in joint replacement surgeries nationwide, along with an aging population. TKR surgery is expected to be performed on 3 million patients annually by the year 2030, up from 600,000 in 2009, according to the Agency for Healthcare Research and Quality. During the procedure, also known as knee arthroplasty, a surgeon excises damaged bone and cartilage in the knee area, replacing it with an artificial joint made of metal alloys, high-grade plastics and polymers.   

Studies quantify professional, personal value of TKR

The Journal of Bone and Joint Surgery study showed that the societal benefits for knee replacement patients of working age greatly outweigh the combined cost of the surgery and rehabilitation compared to non-surgical treatments for osteoarthritis. More than 90 percent of those who undergo TKR experience a dramatic reduction of knee pain and significant improvements in the ability to perform common daily activities, according to the AAOS.

"Almost half of TKR patients are now under age 65, with most still in the workforce," says Dr. Fauser, also a board-certified orthopaedic surgeon, "so these cost benefits can obviously add up quickly."

The sexual functioning study presented at the AAOS meeting, which included 174 men and women (average age 58), found that 49 percent had suffered from reduced libido prior to knee or hip replacement and 53 percent felt their arthritis had hurt their sexual self-image. After surgery, 81 percent of those whose sexual activity was previously affected had noticed an improvement in the frequency of sexual activity.

"Few people think about the effect knee replacement surgery might have on their sex lives," explains Dr. Fauser, "but this research clearly shows that eliminating their pain can markedly improve their enjoyment."

How to optimize surgical outcomes

As with any surgery, patients' attitudes and efforts toward recovery can optimize the process when literally getting back on their feet after TKR, Drs. Buchalter and Fauser agree. They offer these tips for patients to boost their recovery:

• Watch for signs of infection, such as fever, chills, surgical site drainage or increasing knee swelling or tenderness.
• Create a living space on one floor of your home for several weeks after surgery to avoid stairs.
• Install safety bars or handrails in your bathroom and on stairways.
• Remove all loose carpets and cords around your home.
• Keep "enthusiastic" pets away until you have healed.
• Continue physical therapy as recommended and slowly resume normal household activities.
• Avoid high-impact activities such as jogging, skiing, tennis and sports that involve contact or jumping until your doctor approves.

"There is much that patients can do to take the lead in their own recovery after TKR surgery," says Dr. Buchalter: "The combination of proactive healing and favorable research results makes TKR a great choice to improve patients' lives."      

Note that both Drs. Fauser and Buchalter are concerned for the growing Medicare population as reimbursements to surgeons who perform these operations on a routine basis may no longer be able to offer these services to Medicare patients if the reimbursements from the government drop any lower. Medicare pays them less than $1200 per surgery which includes 3 months of aftercare with increasing bureaucratic demands. This is little thanks for such a successful and valuable procedure.

Somers Orthopaedic Surgery &Sports Medicine Group, PLLC, founded in 1988, is one of the most comprehensive and specialized practices in the region with offices in Carmel, Hopewell Junction, Mt. Kisco and Newburgh. www.somersortho.com

Joel S. Buchalter, MD, FAAOS and Douglas J. Fauser, MD, FAAOS,are board-certified orthopaedic surgeons and founding partners of Somers Orthopaedic Surgery & Sports Medicine Group, PLLC .

Press release courtesy of Melissa Chefec of mcprpublications.com

Big Toe Joint Pain Causes Misery, Disability

Podiatry specialist Dr. Alan Berman offers tips for seniors with big toe joint pain

Carmel, NY, October 2013

Never underestimate the power of a little joint to cause big problems. But that's what can happen to senior citizens suffering from big toe joint pain - often as a result of arthritis - which can not only sour the mood and lessen quality of life, but raises the risk of falling and in many cases proves disabling, according to Alan Berman, DPM, of Somers Orthopaedic Surgery & Sports Medicine Group, PLLC.

Most people associate arthritis with the "big" joints such as the knees and hips. But arthritis, which afflicts an estimated 46 million adults in the United States and 50 percent of those over age 65, comes in many forms, two of which are specific to the big toe joint and are hardly rare. In a 2009 study in the Journal of Foot and Ankle Research, about 16 percent of people reporting symptoms of disabling foot pain identified the big or "great" toe as the source of their woes.

"It's truly remarkable how much misery can result from big toe joint pain," explains Dr. Berman, who specializes in podiatry and also performs podiatric surgery. "Many patients don't like to complain and think they can outwait the problem, but seeking professional advice and treatment is the right approach. There's simply no need to suffer in silence."  

Big toe joint targeted by 2 types of arthritis

No matter what type of arthritis you have, the condition generally includes ongoing joint pain, swelling, stiffness, tenderness, and problems using the joint. But two types of arthritis specifically affect the big toe: gout and hallux rigidus, or rigid big toe.

Gout is an inflammatory form of arthritis, typically affecting older men and resulting from the deposition of uric acid crystals in the joints (but usually targeting the big toe). Acute gout typically shows up as an intensely hot, red and swollen big toe causing excruciating pain. Risk factors for developing gout include:

• Drinking alcohol (beer and liquor more than wine)
• Eating a diet rich in meat and seafood
• Being overweight or obese
• Having high blood pressure

Hallux rigidus, or rigid big toe, results from "normal" osteoarthritis - or joint wear-and-tear - affecting the base of the big toe and is the most common site of arthritis in the foot. Symptoms specific to hallux rigidus include:

• Pain in the joint when you're active, especially when pushing off on toes as you walk
• Swelling around the joint
• A bump (caused by bone spurs) that develops on the top of the foot
• Stiffness in the big toe and the inability to bend it up or down
• An inclination to walk on the outside of your foot to avoid bending the big toe

Most people suffering from gout are in such distress that they're compelled to seek medical help. But Dr. Berman says that hallux rigidus, which may provoke a less-insistent response, is just as important to treat quickly since the bone spurs that eventually form are evidence of advanced disease and are tougher to eradicate.

"If you wait until you see a bony bump on the top of your foot, x-rays will be required to show the location and size of those spurs, which may require surgery to remove," he says.

Many treatment options

For gout, the drug colchicine is typically prescribed, both to treat flares and prevent future ones. Diet and lifestyle measures such as weight loss, avoiding alcohol, and eating less meat and seafood are also helpful. For hallux rigidus, surgery is sometimes recommended to remove bone spurs, fuse bones together in the big toe joint or even replace the joint.

But both gout and hallux rigidus share some common home treatments that can be effective for each. They include:

• Taking anti-inflammatory medications such as ibuprofen
• Using ice packs
• Using contrast baths, which alternates immersion of the affected foot in cold water for 30 seconds with equal time in hot water for a total of 5 minutes, three times per day
• Wearing shoes with a large toe box to avoid pressure on the big toe
• Avoiding high-heeled shoes

"Never think, 'Oh, it's just my toe,'" Dr. Berman says. "When pain in your big toe joint starts becoming a real nuisance, it's time to take action. Speak up and start living your life without pain again."  

Somers Orthopaedic Surgery & Sports Medicine Group, PLLC, wasfounded in 1988 and is one of the most comprehensive and specialized practices in the region.  www.somersortho.com

Alan Berman, DPM, is a board-certified podiatrist with Somers Orthopaedic Surgery & Sports Medicine Group. 

Press Release courtesy of Melissa Chefec of  www.mcprpublicrelations.com

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