A study carried out by Heart Research UK found that people that received certain hip replacements in the 2000’s, could now be at risk of heart disease. This follows a deeper analysis of the heart health of those patients who received the metal-on-metal replacements, which revealed some disturbing findings.

Although concerning news for those patients affected, this has brought into focus the cardiovascular health risk for anyone undergoing hip surgery. Following this research, more advanced testing measures are being developed that will only lead to better outcomes for patients.

The Heart Research Study

Metal-on-metal implants made from a cobalt and chromium alloy were once believed to be a more durable alternative to the ceramic or polyethylene implant materials. This was a good option for the young and active. But, in fact, the lifespan was significantly shorter.

Although some loose debris is expected after any replacement, metal debris is more toxic. Over time, implant loosening caused metal ions to contaminate the blood. This caused tissue damage and inflammation around the joint, leading to pain, muscle as well as organ damage.

Research carried out at the University of Strathclyde looked at blood samples of 30 patients that had received metal-on-metal implants. It found varying levels of cobalt present in the blood, and further ultrasound analysis revealed abnormal contractile function in their hearts.

The researchers believe that cobalt interferes with calcium levels in heart cells, reducing their ability to contract. This could potentially lead to heart dysfunction in some patients.

Modern Hip Replacement Implants

Unsurprisingly, metal-on-metal bearings are no longer used for hip replacements and are exclusively used for hip resurfacing procedures these days.

Mr Punwar typically uses a combination of metals, ceramics and plastic materials for hip replacements. When using a metal head, a plastic liner will be used, or a ceramic head with a plastic liner for younger patients. All of his materials are 10* rating, and proven to have excellent long-term results on the National Joint Registry (NJR).

It is important to understand there are always risks associated with a major surgery such as a hip replacement. All aspects of the surgery, including risks and your suitability, will be discussed with you before you decide whether you want to go ahead. Mr Punwar and his team will provide a comprehensive aftercare programme and you will have regular check-ups following your surgery.

To discuss whether total hip replacement surgery is the appropriate option for you, call 0808 163 1268 or email Punwar.admin@lips.org.uk to arrange a consultation with Mr Shah Punwar.

Long-distance runners are often cautioned about the potential wear and tear on their joints. However, a recent study has revealed that running distance, frequency, and speed are not linked to a higher risk of osteoarthritis.

In this blog, we explore the findings of this latest research and look at the factors that do increase the risk of knee arthritis.

What did the latest study find?

The latest research was presented at the American Academy of Orthopaedic Surgeons (AAOS) 2023 Annual Meeting.

In the study, investigators collected data from 3,804 runners who took part in either the 2019 or 2021 Chicago Marathon. The participants provided information on their running history, weekly average mileage, and typical running speed. Also, any known osteoarthritis risk factors such as BMI, family arthritis history, and prior hip and knee injuries that affected their ability to run.

On average, the runners were around 44 years old and covered 27.9 miles per week. Most respondents (37.3%) had completed two to five marathons, approximately 21% had finished six to 10 marathons, and 17% were participating in their first marathon.

With an average of 15 years of running experience, 1,892 participants reported previous hip or knee injuries, and 413 had undergone knee or hip surgery. In total, 36.4% mentioned experiencing hip or knee pain in the past year, while 7.3% had been diagnosed with arthritis.

The general belief has been that running might elevate the risk of osteoarthritis due to the increased stress on joints compared to walking or standing. However, the study’s findings revealed no connection between osteoarthritis risk and factors such as weekly mileage, duration of running experience, the number of marathons completed, or running speed.

What factors increase the risk of knee arthritis?

While the study didn’t find any correlation between long-distance running and increased arthritis risk, it did reveal some risk factors. Runners with a history of knee or hip surgery, or past hip or knee injuries, had the highest likelihood of developing arthritis.

Other factors that contribute to the development of osteoarthritis include increasing age, which is the strongest risk factor. Also, being female, as hip osteoarthritis is nearly twice as common in women compared to men. Obesity also plays a role by increasing the load on weight-bearing joints, making knee arthritis over three times more likely and speeding up disease progression.

Both high bone density and low bone density can impact the risk of osteoarthritis. The former increases the likelihood of developing the condition, and the latter raises the chances of rapid progression.

Protecting the knees in long distance runners

Even though marathon running and arthritis are not inextricably linked, safeguarding your knees during long-distance runs remains crucial. Key practices to adopt include proper warm-up routines, selecting appropriate running shoes, and progressively increasing the distance.

If you encounter knee discomfort after running, don’t hesitate to schedule a consultation with Mr. Shah Punwar.

Knee replacement surgery can be a life-changing treatment for those suffering from severe knee pain and limited mobility. This common procedure is carried out on thousands of patients each year, helping them to regain a better quality of life.

Prior to undergoing a knee replacement, it helps to know what to expect. In this blog, you’ll discover the answers to the most asked questions about the surgery. This includes what to expect before, during, and after the procedure.

Before knee replacement surgery

Prior to having knee surgery, you should try to keep yourself as fit and healthy as possible. This means maintaining a healthy weight and exercising regularly. Avoid shaving or waxing the area where the incision will be made, and if you smoke, make sure you quit a few weeks before the surgery.

These recommendations will help to reduce the risk of complications, as well as aid in the recovery process. Mr Punwar will be able to give you specific pre-op care advice you can follow to prepare for the procedure. His expert team are always on hand to answer your questions.

During the procedure

During a total knee replacement procedure, also known as knee arthroplasty, the damaged or worn out knee joint will be replaced with an artificial implant made of metal and plastic components.

The surgery is typically performed under general anaesthetic and will take around 90 minutes to complete. Your surgeon will make an incision on the front of the knee, before removing the damaged cartilage and bone.

The ends of the thigh and shin bone are then prepared to fit the new artificial joint. Mr Punwar only uses modern implants that have an excellent track record.

The implant is positioned and secured in place before the incision is closed with stitches or clips. Then, a surgical dressing is applied to keep the wound clean and to minimise infection. You will be given antibiotics before your surgery and several doses following the procedure to give you the best coverage.

Recovery after knee replacement surgery

The recovery process after a knee replacement surgery can vary depending on the individual and the specific type of surgery performed. In general, it typically takes up to six weeks to fully recover and to return to normal activities.

Immediately following the surgery, you will need to stay and be monitored in the hospital for a few days to manage pain and begin physical therapy. Pain and swelling can be eased with medication, ice, and elevation. After a couple of weeks you will be booked in for a wound check to ensure the skin incision has healed properly.

After being discharged from the hospital, patients typically attend physical therapy sessions 2-3 times a week for a total of 4-6 weeks. You will also be given exercises to do at home. It may take a few weeks, but you may be able to start putting weight onto the knee in as little as a few days.

It is also important to note that knee replacement surgery does not necessarily restore the knee to its normal function. This means you may have some limitations when carrying out certain activities. Mr Shah Punwar will give you plenty of after-care advice. He will let you know what kind of activities you should avoid and what kind of activities you can do.

If you have more questions about what to expect from total knee replacement surgery, book a consultation with Mr Shah Punwar now. He has carried out hundreds of knee replacement surgeries and can answer any questions you have.

Knee pain affects millions of people every day, leading to a lower quality of life and issues with mobility. Treatments for knee pain largely depend upon the root cause of the problem. For those suffering with pain due to bone marrow lesions, one option that is proven to work is subchondroplasty.

So, what is subchondroplasty for the treatment of knee pain? Learn everything you need to know below…

What is subchondroplasty?

Subchondroplasty is a minimally invasive procedure that aims to fill in subchondral bone defects. It is a fluoroscopically assisted procedure that uses AccuFill®Bone substitute material (BSM) to fill in the gaps.

The procedure tends to be carried out alongside an arthroscopy. This helps to both visualise and treat the problems discovered in the joint. The Accufill BSM hardens and creates new bone as the body heals.

Those who undergo a subchondroplasty report a reduction in pain and an improvement in quality of life. Having the procedure also doesn’t impact your ability to have further surgery if it is needed.

What types of knee pain will subchondroplasty help?

Subchondroplasty can treat subchondral bone defects which may occur due to osteoarthritis for example. Over time, conditions such as osteoarthritis can wear down the cartilage and bone. Not only is this extremely painful, but it can also lead to a loss of mobility.

A previous study has shown that subchondroplasty can also be highly effective at treating bone marrow lesions. The study also showed that the procedure could reduce pain and prevent the need for a total arthroplasty at the follow up stage.

Whenever the pain is caused by the bones, and not the tissue of the joint, subchondroplasty can help. As it is an outpatient procedure, patients can usually leave on the same day. It is provided via an injection into the bone, making it a minimally invasive procedure.

Seeking a diagnosis for knee pain

If you are experiencing any type of knee pain, it’s important to get to the root cause of it. If left untreated, knee pain can worsen, and you may start to lose function in the joint. This can limit your quality of life, preventing you from moving around and putting you at greater risk of other health problems.

To find out what might be causing your knee pain, contact Mr Shah Punwar today. Mr Punwar is a specialist in knee pain and he can determine the cause of your discomfort and the right treatment for you.

Soon, Mr Shah Punwar will be offering subchondroplasty treatment (Zimmer Biomet method), but he can discuss all of your treatment options that would give you the best results. It may be that a knee replacement is the best way to treat your knee pain permanently.

Hip arthritis can be a very painful condition that makes life difficult for many people. Normally, following symptoms of prolonged pain or tenderness in the hip joint, it is formally diagnosed after a clinical assessment by a GP and an X-ray.

However, sometimes the pain of hip arthritis can be misleading. This is because the distribution of pain can be more widespread. It can even be felt in the knee, and mistaken for other conditions.

Here, we will look at why patients often experience knee pain when they have hip arthritis, and the best ways to manage it.

Why does hip arthritis cause knee pain?

The reason you may seek a diagnosis for hip arthritis is experiencing pain in and around the hip joint that lasts more than a few days. But, pain relating to hip arthritis can be felt in one or more parts of the body including in the groin, the front of the hip, lower back and even in the knee.

The main symptoms of hip arthritis include:

• Pain and tenderness in the hip joint
• Joint stiffness after sitting or lying down for a long period of time
• Difficulty in performing daily activities
• A feeling of bone rubbing against bone

When you have hip arthritis, inflammation of the tissues and nerves can occur. This causes pain initially in the hip, but can refer to the knee. This usually follows the distribution of the saphenous nerve, which branches from the femoral nerve. However, the obturator nerve which passes from the hip to the inside of the knee can also cause referred pain.

Get your knee pain checked

If you have knee pain without any symptoms of hip arthritis such as stiffness, then it is very unlikely that you have hip arthritis. But, you could have knee arthritis – another very painful condition that affects the knee joint, caused by inflammation that develops over time due to cartilage damage. It can also lead to other problems including swelling and muscle weakness in the legs, when left untreated and can cause mobility issues, usually later in life.

When you have knee pain, it is best to get a confirmed diagnosis of the cause so that you can look at the best treatment options. You can request X-Ray imaging from your GP, that should confirm a diagnosis of arthritis. Imaging can also help you understand the nature and extent of damage, and your doctor can check your joint movement and function.

Treating your knee or hip arthritis

When you have a diagnosis of arthritis, the next best step is to organise a consultation with experienced knee and hip surgeon, Mr Punwar. You can discuss treatment options, including lifestyle changes, medications, physiotherapy and whether joint replacement surgery would be the best option for you.

If you are experiencing knee pain, hip pain, or a combination of symptoms, consult Mr Shah Punwar today.