R. David Heekin

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R. David Heekin
Dr.
M.D.
Jacksonville
Orthopedic Surgery
Heekin Orthopedic Specialists
10475 Centurion Parkway Ste. 220
Jacksonville
FL
32256

My knee creaks whenever I bend it. It sounds as though it is grinding inside, but there is no pain. Does this mean I’ll have trouble down the road?

A “grinding” sensation in the knee is not normal.  If it’s not painful, it’s likely the thickened lining of the joint (called “synovium”) getting caught between the moving parts of the knee (usually the patella or knee cap) and may be the precursor of arthritis in the years ahead.  If the grinding is painful, it likely represents the end stage of arthritis where the cartilage has worn off the ends of the bones.  In either case, it would be helpful to see a health care provider for a physical exam and to get appropriate x-rays to help diagnose the cause of the grinding and direct appropriate treatment.    
How many knee replacements should a doctor perform a year to be considered an expert at this procedure?

There is no set number of procedures per year which qualifies a surgeon as an expert in total knee replacement surgery.  On the other hand, every study which has evaluated the effect of surgical volume (number of knee replacements a surgeon performs each year) on quality and outcomes demonstrates that in general the more knee replacements a surgeon performs each year patients can expect better outcomes and fewer complications.  This was confirmed in the latest Consensus Statement on Total Knee Replacement by the National Institutes of Health.    

Are hip replacements more difficult, recovery wise, than knee replacements?

Both hip and knee replacements are major surgery and the recovery process for both depends largely on the physical condition, strength and endurance of the patient before surgery.  A course of physical therapy or program of conditioning exercises before surgery always helps makes the recovery process easier and faster.  Since hips require less bending than knees during everyday activities, and typically don’t involve stretching the surgical incision to achieve the required range of motion, hip replacements typically are a little easier and quicker to reach full recovery than knee replacements.  Recent advances in anesthesia, surgical technique and physical therapy after knee replacements have made the difference less noticeable.   

R. David Heekin
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