“Domestic Violence Awareness Month (DVAM) is a national campaign dedicated to raising awareness about domestic violence. Every October, organizations and individuals unite across the country for a national effort to uplift the needs, voices, and experiences of survivors. Congress declared the month of October to be Domestic Violence Awareness Month in 1989.”
Domestic Violence Awareness Project (https://www.dvawareness.org/HealHoldCenter)
“During hip replacement, a surgeon removes the damaged sections of the hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.
Also called total hip arthroplasty, hip replacement surgery might be an option if hip pain interferes with daily activities and nonsurgical treatments haven’t helped or are no longer effective. Arthritis damage is the most common reason to need hip replacement.”
MAYO CLINIC (https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042)
To understand hip replacement, you need to understand the structure of the hip joint, a ball-and-socket joint. The ball, at the top of the femur (thighbone) is called the femoral head. The socket, called the acetabulum, is a part of the pelvis. The ball rotates in the socket, allowing the leg to move forward, backward, and sideways.
Regarding the surgery its repairing the hip to do fixation like it use to without pain. Fixation is simply the action of making something firm or stable. Hopkins Medicine states in a hip surgical procedure ORIF (open reduction internal fixation), for example, is a surgery used to treat a broken thigh bone. … In a “broken hip,” it is actually part of your femur that breaks, and not part of the hipbone itself. … Most people do very well after ORIF for their femur fracture
In a healthy hip, soft tissue called cartilage covers the ball and the socket to help them glide together smoothly. If this cartilage wears down or gets damaged, the bones scrape together and become rough. This causes pain and can make it difficult to walk. Think of a car, our brake pads allow our car not to walk but drive, the pads (like cartilage) when thinning down to the point hitting metal (not bone) will scrape on the rotors and don’t repair like the cartilage gone hitting bone to bone the damage to the car will scrape on the rotors till they break and new rotors with brake pads needed. Where in patient hitting bone to bone, pain results, limitation of the movement takes place at that area (example Hip) and become immobile. Repair it with surgery and mobilization reoccurs so you can move around like you use to and do regular of activities you previously did.
The most common type of hip replacement surgery is called a total hip replacement (THR). In this surgery, worn-out or damaged sections of the hip are replaced with artificial implants. The socket is replaced with durable plastic or polyethylene cup with or without a metal titanium shell. The femoral head is removed and replaced with a ball made from ceramic or a metal alloy. The new ball is attached to a metal stem that is inserted into the top of the femur.
Information hip replacements is more easily available than ever before. But direct-to-consumer advertising, online articles and other reports in the media may make it more difficult for people considering these surgeries to understand their options. Becoming familiar with the key considerations that go into selection of the implant that is used to replace the injured or damaged joint can make the process easier.
Total hip replacement surgery – in which the damaged joint is replaced with an implant – is associated with a high degree of successful and predictable outcomes.
Orthopedic surgeons may approach the surgery in one of three different ways:
The majority of people who undergo hip replacement receive a traditional hip arthroplasty in which the surgeon uses a stemmed device and prosthetic head to replace the upper part of the femur (the head and neck of the bone) and a hemispherical shaped cup to replace the acetabulum. [Figure A, below]
However, some patients may be candidates for hip resurfacing in which the head and neck of the femur are not removed. In this procedure, the surgeon resurfaces or sculpts the femoral head to accept a metal cap with a short stem. Hip resurfacing is usually most successful in male patients under the age of 55, who are larger in stature There is little data to support functional benefit of one type of hip replacement over the other, although if revision surgery is needed, this may be easier after hip resurfacing.
Figure A: Illustrations and X-ray images of a traditional hip replacement versus a hip resurfacing implant (Hip resurfacing images courtesy of Smith and Nephew)
It should be noted that while the procedure has vastly improved the ability to treat certain hip disorders with minimal surgical trauma, it is not always an appropriate replacement for other larger operations. If the hip has severe degeneration, total hip replacement may be the only procedure that will provide long-term pain relief. Conversely, in younger patients with skeletal deformities ( i.e. dysplasia, impingement) hip arthroscopy will usually provide relief. But the relief may be short-lived because the underlying pathologic condition has not been corrected.
Total Hip Replacement – Total hip replacement is extremely effective at relieving pain and restoring function as well as range of motion. But, it is an artificial joint and should be performed only if other “joint saving” procedures are not appropriate.
Osteotomy – Osteotomy (cutting the bone) is a technique were the anatomy of the femur or socket is altered to relieve pain and prolong survival of the joint by reducing the abnormal loads on the cartilage.
Fusion – Fusion (arthrodesis) makes the hip permanently stiff by obliterated the joint via bone bridging across the joint. This procedure was performed much more frequently in the past and is still appropriate in certain conditions, such as severe arthritis of one hip in a young person.
Arthrotomy – Arthrotomy (opening the joint) is a procedure where the joint is opened to clean out bone spurs, loose bodies, tumors, or to repair fractures.
Dr Padgett is a M.D. from 1987 a resident in orthopedic surgery at Hospital for Special Surgery (HSS) to chief of the Hip Service, and in 2008 to the present chief of the Adult Reconstruction and Joint Replacement Service at HSS. Learn much more about him in tomorrow’s topic with an excellent hospital to go to if you need this in N.Y.C. If not you can also find out where to go for help in finding excellent hospitals in hip surgery out on NY to California.
Knowing your components is very helpful. Hip implants come in two primary types: the traditional single-piece implants and modular models, in which the stem and head of the implant portion that is placed in the femur can be matched independently. Although the single piece implants provide a good fit for many patients, “modular devices were developed to improve the fit of the implant to the patient’s specific anatomy,” explains Dr. Padgett. However, he adds, some modular implants have recently been found to be associated with problems related to the linkage between the various parts.
Some degree of corrosion and fretting has been seen with these metal on metal components, a process that can result in the creation of metallic debris that is destructive to the soft tissue surrounding the joint. As a result, some of these implants have been recalled.
Implants may be made of a variety of materials including metal (usually titanium), ceramic or polyethylene (a type of hard plastic). Ongoing research and enabling technology will determine new directions in materials used in hip replacement surgery. At present, bearing surfaces – where the femoral component of the implant meets the acetabulum – may combine in three different ways:
Placement of the hip implant components involves an additional consideration: how the implants are bonded to the bones. This can be accomplished either through the use of acrylic cement or with uncemented fixation, in which the surface of the implant is composed of a porous, honeycomb-like surface that allows for the in-growth of new bone tissue to help hold the component in place.
“On the cup portion of the implant, uncemented fixation is clearly superior,” Dr. Padgett a orthopedic M.D. and from 2008 says. “However, cemented fixation may be preferable in older patients or others with compromised bone quality.” With regard to fixation of the stem, Dr. Padgett notes, available data shows no advantage of one type of fixation over the other, and the decision to use one over the other is left to the surgeon’s discretion.
With a history of excellent surgical technique and outcomes, the focus of new development in this area is on the use of enabling technology to improve preparation and component positioning in hip and knee replacement surgery. These tools include navigation devices that provide three-dimensional spatial orientation and robotics which can also provide tactile feedback during surgery. “The role of these emerging technologies is still evolving,” Dr. Padgett notes.
Much of the important early work in the development of successful hip implants took place in the late 1960s and early 1970s, including that of British surgeon John Charnley, MD and introduced at HSS by Philip D. Wilson, Jr. MD.
“October was first designated as National Down Syndrome Awareness Month in the 1980s and has been recognized every October since. It is a time to celebrate people with Down syndrome and make others aware of their abilities and accomplishments.
People with Down syndrome are just like everyone else. They have similar dreams and goals, and they want to have successful careers and families. They can drive, go to work, go to college, go on dates, get married, and contribute to society.”
Special Oympics (ttps://www.specialolympics.org/stories/news/national-down-syndrome-awareness-month#:~:text=October was first designated as,are just like everyone else.)
“October was first declared as National Bullying Prevention Month in 2006. Since then, October has been a time to acknowledge that bullying has devastating effects on children and families such as school avoidance, loss of self-esteem, increased anxiety, and depression. Bullying can occur in multiple ways. It can be verbal, physical, through social exclusion, or via digital sources like email, texts, or social media. Unlike mutual teasing or fighting, bullying occurs when one person or a group of people is perceived as being more powerful than another and takes advantage of that power through repeated physical assaults, threats of harm, intimidation, or by purposefully excluding a person from a valued social group. Being bullied can severely affect the person’s self-image, social interactions, and school performance and can lead to mental health problems such as depression, anxiety, and substance use, and even suicidal thoughts and behaviors.”
The National Child Traumatic Stress Network – NCTSN (https://www.nctsn.org/resources/public-awareness/national-bullying-prevention-month)
“A risk factor is anything that increases your chances of getting a disease, such as breast cancer. But having a risk factor, or even many, does not mean that you are sure to get the disease.
Some risk factors for breast cancer are things you cannot change, such as getting older (Menopause) or inheriting certain gene changes. These make your risk of breast cancer higher.Women who have had more menstrual cycles because they went through menopause later (typically after age 55) have a slightly higher risk of breast cancer. The increase in risk may be because they have a longer lifetime exposure to the hormones estrogen and progesterone.
Women who were treated with radiation therapy to the chest for another cancer (such as Hodgkin or non-Hodgkin lymphoma) when they were younger have a significantly higher risk for breast cancer. This risk depends on their age when they got radiation. The risk is highest for women who had radiation as a teen or young adult, when the breasts were still developing. Radiation treatment in older women (after about age 40 to 45) does not seem to increase breast cancer risk.From the 1940s through the early 1970s some pregnant women were given an estrogen-like drug called DES because it was thought to lower their chances of losing the baby (miscarriage). These women have a slightly increased risk of developing breast cancer. Women whose mothers took DES while they were pregnant with them may also have a slightly higher risk of breast cancer.From the 1940s through the early 1970s some pregnant women were given an estrogen-like drug called DES because it was thought to lower their chances of losing the baby (miscarriage). These women have a slightly increased risk of developing breast cancer. Women whose mothers took DES while they were pregnant with them may also have a slightly higher risk of breast cancer.
From the 1940s through the early 1970s some pregnant women were given an estrogen-like drug called DES because it was thought to lower their chances of losing the baby (miscarriage). These women have a slightly increased risk of developing breast cancer. Women whose mothers took DES while they were pregnant with them may also have a slightly higher risk of breast cancer.”
American Cancer Society (https://www.cancer.org/cancer/types/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html)
“1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. In 2024, an estimated 310,720 women and 2,800 men will be diagnosed with invasive breast cancer. Chances are, you know at least one person who has been personally affected by breast cancer.
But there is hope. When caught in its earliest, localized stages, the 5-year relative survival rate is 99%. Advances in early detection and treatment methods have significantly increased breast cancer survival rates in recent years, and there are currently over 4 million breast cancer survivors in the United States.”
National Breast Cancer Foundation Inc (https://www.nationalbreastcancer.org/breast-cancer-facts/)
“A risk factor is anything that increases your chances of getting a disease, such as cancer. But having a risk factor, or even many, does not mean that you are sure to get the disease. While you can’t change some breast cancer risk factors—family history, sex, race and aging, for example—there are some risk factors that you can control like exercise, diet, and weight. Studies have shown that risk for breast cancer is due to a combination of factors. The main factors that influence risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older. ”
Centers for Disease Control and Prevention CDC (https://www.cdc.gov/breast-cancer/risk-factors/index.html)
“Breast cancer caused 670 000 deaths globally in 2022.
Roughly half of all breast cancers occur in women with no specific risk factors other than sex and age.
Breast cancer was the most common cancer in women in 157 countries out of 185 in 2022.
Breast cancer occurs in every country in the world.”
World Health Organization (https://www.who.int/news-room/fact-sheets/detail/breast-cancer)
“Reye’s syndrome is a serious condition that causes swelling in the liver and brain. It can occur at any age but usually affects children and teenagers after a viral infection, most commonly the flu or chickenpox. Reye’s syndrome is rare. The condition also is known as Reye syndrome.
Symptoms such as confusion, seizures and loss of consciousness need emergency treatment. Early diagnosis and treatment of Reye’s syndrome can save a child’s life.”
MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/reyes-syndrome/symptoms-causes/syc-20377255)