How To Avoid A Hip Replacement Naturally

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Hip Replacement Surgery in a Throwaway Society

In 2023, Forbes reported on the rampant overuse of “unnecessary” and “inappropriate” surgeries in the U.S., worriedly discussing im­plications related to health care costs as well as patient outcomes.¹ Policy analysts define health care overuse as “the delivery of tests and proce­dures that provide little or no clinical benefit” or that “risk patient harm in excess of potential benefits.”² Ironically, the events engineered in the spring of 2020 catapulted many procedures into the “unnecessary” category—including the majority of hip and knee replacement surgeries.³ Now, however, business is once again booming, and the temporarily discretionary surgeries are “back and bigger than ever.”¹

The technical name for joint replacement surgery is arthroplasty, with the goal being “substitution of the joint with an implant able to recreate the articulation functionality.”⁴ The volume of total hip and total knee arthroplas­ties (THA and TKA) was already surging well before the temporary slowdown imposed by the putative “pandemic,” with some experts dubbing hip arthroplasty “the operation of the century.”⁵ According to the Centers for Medi­care and Medicaid Services (CMS), between 2000 and 2019, the annual volume of THA in the Medicare population rose by 177 percent, with hip replacements representing over a third (35 percent) of all joint arthroplasties performed.⁶ With the post-2020 uptick in these procedures, CMS projects further 176 percent and 139 per­cent increases in THA and TKA, respectively, by 2040.⁶ Shoulder replacements also began accelerating about a decade ago,⁷ and growth rate projections for shoulder arthroplasty now outpace projections for THA and TKA.⁸

The remainder of this article focuses pri­marily on hip replacement surgery; however, many of the issues discussed also pertain to arthroplasty of the knee and other joints.

CREAKY JOINTS

In the human body, a joint is any place where two bones meet. The main functional joints—also the most common type of joint in the body—are called the synovial joints and are the target of arthroplasty. The synovial joints include “hinge” joints like the knees, ankles and elbows; condyloid joints like the wrists; and “ball-and-socket” joints like the hips and shoul­ders.⁹ In the case of the hip joint, the femoral head—the “ball” found at the top of the thigh bone that allows for hip motion¹⁰—fits into a rounded socket called the acetabulum.

The joint inflammation or pain known as arthritis—including osteoarthritis, rheumatoid arthritis and osteonecrosis (bone death caused by poor blood supply)—is the primary impetus for surgeons to recommend and patients to request arthroplasty. Around the world, osteo­arthritis prevalence is rising.¹¹ In the U.S., data from seven cycles of the National Health and Nutrition Examination Survey (NHANES) for the years 2005–2018 show that self-reported os­teoarthritis (adjusted for age) increased linearly throughout the period.¹² According to recent Centers for Disease Control and Prevention (CDC) data for U.S. adults (with type of arthri­tis not specified), more than one in five women (21.5 percent) has arthritis, as does one in six men (16.1 percent).¹³ When broken down by age group, arthritis affects 4 percent of young adults into their mid-thirties but rises to 11 percent (about one in ten) of thirty-five to forty-nine year-olds, 29 percent (three in ten) of fifty to sixty-four year-olds, 44 percent of seniors be­tween ages sixty-five and seventy-four, and over half (54 percent) of the elderly aged seventy-five or older.¹³ Osteoarthritis is, in the U.S., “the most common cause of walking-related dis­ability among older adults.”¹⁴ Researchers have estimated the prevalence of hip osteoarthritis in North America to be around 8 percent.¹⁵

Given the correlation of arthritis with age, it is not surprising that use of hip and knee ar­throplasty increases with age. Referencing the “baby boomer” generation, a 2015 assessment of THA and TKA prevalence noted that “living with a total joint replacement is a remarkably common condition” in the U.S.; however, the researchers also called attention to the younger demographic, in whom joint replacements are increasing.¹⁶ Remarking on factors that have sent hip and knee replacements “trending younger”—such as rising rates of obesity (which puts “extra stress” on the joints) and changes in attitudes and expectations—one health care system blithely observes, “Joint replacement surgery isn’t just for the elderly anymore.”¹⁷

NEW JOINTS FOR HIP VICTIMS

Hip replacement surgery has a colorful if sometimes disturbing history, marked by continual tinkering with materials and tech­niques—and unrestrained experimentation. As one set of authors mildly puts it, until the advent of modern informed consent, patients did not always know what they were in for when they went under the knife; early generations of practitioners attempting these novel surgeries were prone to making “authoritative decisions that most times were not discussed with the patient.”¹⁸

Medical historians note how the first stir­rings of interest in hip surgery arose in the eigh­teenth and early nineteenth centuries, a violent age that predisposed surgeons to look favorably on “amputations and limb disarticulations.”⁵ According to one account, amputation in the pre-anesthesia era had the compelling virtue of being “expeditious” and could be carried out by the less technically adept.¹⁸ At the same time, however, some surgeons recognized the fact that in certain situations, amputation might be overly drastic. Consequently, a subset of daring practitioners began attempting to excise (cut out) joints.

Finding that excision “ameliorated pain and preserved mobility, but at the expense of stability,”¹⁸ surgeons continued to experiment with various hip operations throughout the 1800s, with mixed results. When one surgeon, “a great promoter of hip resection,” tried out his operation on fifty-nine patients in the 1850s, a third of them died.⁵ Often, the patients—one as young as nine years old—were said to have “hip tuberculosis.”⁵ To digress for a moment on the topic of TB, the conventional medical literature claims that although TB most often affects the lungs, it can also “infect the joints” and, in some instances, cause “septic hip arthritis.”¹⁹ The Weston A. Price Foundation and Sally Fallon Morell have disputed the conceptualization of TB as the result of an infectious microbe, sug­gesting that it may actually be a form of iron poisoning.^20,21 From this standpoint, it is interest­ing to note that a 2021 paper discusses a likely role of iron in the development of osteoarthritis “under conditions of iron overload.”²²

Key requirements for the materials used in surgical hip interventions include biocompat­ibility, the ability to resist heavy stress, and low friction and wear rates,⁴ but as we shall see, up through the present day it has been difficult to satisfy these criteria. In fact, concerning the biocompatibility criterion, doctors already knew in the late 1800s that the human body “could not accept large quantities of external material.”⁴ Nevertheless, from the 1860s through the 1890s, surgeons became intrigued by the possibility of “treating the joint surfaces, by using different types of materials of biologic interposition tissues.”⁵ This placement of some type of membrane over an arthritic joint surface became known as “interposition arthroplasty,”²³ a procedure that still remains in the orthopedic surgeon’s toolkit as “a useful nonprosthetic alternative.”²⁴ A Czech surgeon working in the late 1890s experimented with a wide range of interposition materials, including “muscle, cel­luloid, silver plates, rubber struts, magnesium, zinc, glass, pyres, decalcified bones and wax.”⁵

It was in Germany in 1891 that a surgeon performed the first documented full-on hip replacement surgery.²⁵ Again seeking to help patients with hip joints “destroyed by tubercu­losis,” the prominent surgeon, whose father had been the personal physician of King Charles I of Romania, replaced the femoral head with ivo­ry,²⁵ fastening it to the bone with nickel-plated screws and using “plaster of Paris and powdered pumice with resin to provide fixation.”⁵

Apparently, ivory did not provide the looked-for results, so the search for other hip replacement materials and techniques continued apace. By 1918, Johns Hopkins Hospital had es­tablished the practice of pig bladder arthroplas­ty, with doctors reportedly finding pig bladder to be “sufficiently strong to withstand the stresses of weight bearing and intra-articular pressure.”¹⁸ In the 1920s and early 1930s, glass molds made a brief appearance, placed between the head of the femur and the acetabulum.¹⁸ Glass had the significant advantage of being biocompatible but suffered from one major drawback: it “failed to withstand the great forces going through the hip joint and shattered.”²⁵ Acrylic prostheses met with a similarly short-lived fate; when trialed in the late 1940s, they “turned out to be exception­ally susceptible to wear, and failed even before the general acclaim had ceased.”¹⁸

In the 1950s, metal-on-metal prostheses came into vogue,⁴ and in the 1960s, a British surgeon—now credited with being “the father of the modern THA”—refined an approach called “low friction arthroplasty” that combined metal, polyethylene, and acrylic bone cement.²⁵ Although metal proved more durable than glass, when doctors began seeing prosthetic failures and complications due to the “side effect” of “metallosis,” it became evident that the materi­als were far from biocompatible. As Drugwatch explains:

“Metallosis is a type of metal poisoning that can occur as a side effect of joint replace­ment devices with metal components, such as metal-on-metal hip replacements or other metal implants. These devices are made from a blend of several metals, including chromium, cobalt, nickel, titanium and molybdenum. When the metal parts rub against each other, they release microscopic metal particles into the blood and surround­ing tissues. . . . Metallosis develops as these metal ions build up in the bone, muscle and other tissue around the implant.”²⁶

In a study published in 2021 that elaborated on the mechanisms of metallosis, University of Connecticut researchers explained that “[b]odily fluids are electrochemically active and react with biochemical implants.”²⁷ When implants release metallic particles, “[t]he body’s normal defense mechanism becomes activated, which can elicit a cascade of events, leading to inflam­mation of the immediate surrounding tissues and eventually implant failure.”

Due to the problem of metallosis—which resulted in recalls, lawsuits and thousands of people being injured—the Food and Drug Ad­ministration (FDA) no longer allows metal-on-metal THA, but many individuals still harbor the all-metal implants. Strangely, FDA does allow metal-on-metal “hip resurfacing.”²⁸ (The difference in the two procedures is that whereas THA removes both the femoral head and the socket, hip resurfacing leaves the femoral head in place but covers it with a metal cap.²⁹) Accord­ing to a 2012 review article cited by Drugwatch, hip resurfacing patients are equally prone to metallosis, with patients experiencing potential symptoms ranging from “a feeling of instabil­ity, an increase in audible sounds from the hip, and pain that was not present immediately after surgery” to bone loss and tissue necrosis.³⁰

In the 1970s, dissatisfaction with metal-on-metal prompted a further shift toward metal-on-polyethylene prosthetics, now considered by many to be the THA “gold standard.”²⁵ However, case reports indicate that this has not eliminated the threat of metallosis. According to a 2022 study, the release of metal ions and nanoparticles from metal-on-polyethylene constructions can produce “[a]dverse local tissue reactions,” in­cluding “periprosthetic solid and cystic masses known as pseudotumors”; the pseudotumors, in turn, “can result in pain, swelling, extensive destruction to surrounding hip soft-tissues, and compression syndromes on neurovascular, gastrointestinal, and genitourinary structures.”³¹

In the 1980s, ceramic-on-ceramic and ceramic-on-polyethylene implants entered the picture, offering the advantages of hardness and apparently inert debris alongside the disadvan­tages of being expensive and requiring superla­tive surgical technique.⁴ Another variable that affected the ever-changing surgical picture in the ‘80s was the shift toward noncemented rath­er than cemented fixation.³² The non-cemented approach rapidly gained ground and is now used in over 90 percent of hip replacements, but it, too, is being called into renewed question, with some surgeons suggesting that cemented tech­niques still produce superior outcomes.

Nowadays, orthopedic surgeons use various combinations of metals, ceramics and plastic materials, but the profession also is excited by what it perceives as hip arthroplasty’s “high-tech future.”⁵ In early 2024, Henry Ford Health (one of the nation’s leading academic medical centers) bragged about technological advances that are improving joint replacement surgery, enthusiastically citing developments such as robotic placement of implants, “personalized” 3D-printed implants and Bluetooth-enabled “smart sensors” that allow surgeons to track patients’ steps and range of motion as well as “how frequently they’re getting up and moving around.”³³ And if patients are not doing what they are supposed to be doing, the Big Brother sensors pave the way to harass them and get them “back on track.”

FROM BAD TO WORSE

Hip replacement surgery comes with other risks in addition to the problem of internally migrating metallic particles. The conservative Mayo Clinic lists seven major risks, several of which may lead to further surgical interven­tion.³⁴ In addition to the anesthesia risks that come with any form of surgery (in the case of THA, it is either general anesthesia or a spinal block), risks include:

1. The danger of blood clots, addressed with blood-thinning medications that have their own set of risks and “side effects”
2. Trauma at the incision site or tissue (called “infection”), leading to the prescribing of heavy-duty antibiotics or a recommendation for more surgery
3. Fracture of healthy parts of the hip joint during surgery, which, if large, “might need to be stabilized with wires, screws, and possibly a metal plate or bone grafts”
4. Hip dislocation within a few months of surgery, potentially requiring a brace or more surgery
5. Nerve damage (meaning numbness, weakness, or pain) at the area of implant insertion³⁵
6. Loosening, causing pain that, again, possibly points to more surgery
7. Changes in leg length

Unfortunately, both TRA and hip resur­facing can fail outright—and the health care system’s only answer to failure is “revision surgery”—meaning another round of hip replacement surgery.³⁶ Some authors refer to revision surgery as a “salvage procedure,”³⁷ with outcomes that “are often worse than after primary surgery.”³⁸ Given that THA is one of the “top five most common and fastest-growing procedures” in the U.S., it stands to reason that the frequency of revision surgery will also continue to rise—and research bears this out.

A study that looked at national inpatient data from 2006 through 2014 identified a 28.5 percent increase in revision surgery over that period, with a postoperative complication rate of nearly 40 percent.³⁷ More than one in four first-go-round THA recipients—27 percent— also experienced complications. The younger someone is when they undergo THA, the higher their risk of revision (a pattern that is even more pronounced for knee replacements), prompting some researchers to propose delaying primary surgery by five years in those younger than age seventy-five.³⁸

A final risk—relevant to far more than just arthroplasty—concerns the aggressive incur­sions of private equity into the health care space over the past decade.³⁹ Over that period, private equity has spent one trillion dollars to finance health care acquisitions, translating into a six­fold jump in private equity buyouts of physician practices, and private equity ownership of 30 percent of the nation’s for-profit hospitals.⁴⁰ One of the key features of this ownership pattern has to do with the fact that private equity firms have very short-term goals that often focus on gener­ating a generous return by quickly “flip[ping] the asset.” To achieve that kind of return re­quires immediately jacking up profits, which means “rapidly cutting costs, raising prices, or increasing the number of services provided.”³⁹

In that context, it is interesting to note the findings of a study published in JAMA Health Forum in early 2022. The researchers found that health care “overuse” (which, as discussed at the outset of this article, often means provision of “low-value” or unnecessary services that can be “physically, psychologically, and financially harmful to patients”) was significantly higher in investor-owned facilities and systems.⁴¹ Stated another way, it would appear that facili­ties owned by private equity may be hawking unneeded care to boost profits. Hip replacement surgery earns health facilities more in the U.S. (over forty thousand dollars per operation) than in any other country in the world (in Poland, the surgery costs around five thousand dollars).⁴²

Disturbingly, another JAMA study published in December 2023 looked at how private equity ownership affects hospital quality of care— and the results were hardly reassuring.⁴³ According to that study, “Pri­vate equity acquisition was associated with increased hospital-acquired adverse events, including falls and central line-associated bloodstream infections” as well as more surgical site infections. Although there is a growing trend to provide joint replacements on an outpatient rather than inpatient basis,⁴⁴ individuals contemplating these surgeries in either type of setting would do well to do their due diligence and look at who owns the facility or system where they plan to receive care.

ADDRESSING ROOT CAUSES

The topic that few doctors seem interested in pursuing is what people can do to prevent arthritis and preserve joint health in the first place, thereby obviating any future perceived need for arthroplasty. The obesity rate in the U.S. is twice the average of other countries belonging to the Organisation for Economic Co-operation and Development (OECD),⁴⁵ so if it is true that obesity is “the greatest modifiable risk factor” for osteo­arthritis,⁴⁶ then eating the kind of diet that ensures a healthy weight—a Wise Traditions diet—seems like a sensible place to start. A practicing sports medicine doctor shared an anecdote illustrating the merits of this approach in a 2011 letter to the Weston A. Price Foundation; therein, she described her delighted discovery that a “WAPF-style protocol” helped patients with pain and joint problems and made a “huge difference” in their recovery.⁴⁷

In a 2014 Wise Traditions article titled “Nutrition: The Anti-Aging Factor,”⁴⁸ author Sylvia Onusic unabashedly stated that “probably the most important factor in aging and living long with a good quality of life is nutrition.” An interesting section of the article also describes how fluoride “hastens aging,” notably causing “breakdown and irregular formation of collagen in the skin, along with weakened tendons, ligaments, muscles, cartilage and bones, causing cases of irreversible arthritis.” A number of studies have confirmed that elevated fluoride levels increase arthritis risks.⁴⁹ The fact that the United States fluoridates more than 70 percent of its water supplies could have something to do with the outsized preva­lence of arthritis in the U.S. population. As the Fluoride Action Network observes, “Americans ingest daily doses of fluoride that overlap doses that cause joint pain.”⁵⁰

In the human hip, the “smooth and spherical head of the femur fits perfectly into the natural seat of the acetabulum” and the entire joint “is wrapped in very resistant ligaments that make the joint stable.”⁴ To date, it does not appear that medical science has come up with anything close to this level of perfection. Although modern medicine touts hip replace­ment surgery as (surprise, surprise) “safe and effective,” one group of clinicians notes that “because there are many hip replacement component types and many techniques for surgical installation of these products, there is concern that medical research on the long-term effectiveness of the varying techniques is inconclusive.”⁵¹ Specifically, there are indications that both doctors and patients may be underreporting adverse events and that some surgeons may be representing patient outcomes “as being much better than they actually [are] to support the use of a specific implant or specific technique.”⁵¹

In all fairness, the majority of patients report being pleased with the results of hip arthroplasty—from 70 to 93 percent, depending on the study.^52-54 Achieving pain relief is a key variable influencing patient sat­isfaction.⁵⁵ For individuals in the throes of painful arthritis who are less inclined toward surgery, there are alternatives that may be worth explor­ing. As one website about hip replacement surgery comments, “Surgery is permanent—there is no going back once you undergo an operation.”⁵¹ Alternative modalities that may provide relief include traditional Chinese medicine,⁵⁶ homeopathy,⁵⁷ yoga⁵⁸ and DMSO.⁵⁹

Clinicians who recognize that hip replacement can be “a very effec­tive procedure for many people” point out that people do not just “wake up one morning with advancing bone-on-bone hip osteoarthritis”—os­teoarthritis is generally the end result of a much lengthier process.⁵⁵ If that is the case, why not celebrate the perfect hips that we were born with and do what we can to nurture and protect them?

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SIDEBARS

WHAT CAN BIOFILMS TELL US?

Biofilms—“highly organized” communities of microorganisms—“represent a predominant form of microbial life that is ubiquitous in natural ecosystems.”⁶⁰ A biofilm can consist of “a mixture of bacteria, fungi, archaea, protozoa, and yeasts.”⁶¹ Scientists view biofilm formation as “an ancient and fundamental part of the life cycles of many microorgan­isms,” and important for the growth and survival of bacteria in “diverse environments.”⁶²

In the context of medical devices, however, modern medicine views biofilm formation as something more akin to a hostile takeover due to microorganisms’ ability to “adhere to and grow on device surfaces,” creating a “biofilm structure” that may eventually reach a stage of “irreversible attachment.”⁶¹ Conventional medicine warns: “When the biofilm on the surface of implanted medical devices reaches a critical level, it can induce an inflammatory response in the host and may even cause implant failure.”⁶¹ With hip and knee replacements, a common postoperative complication is infection,⁶³ “on top of which the formation of a combined bacterial biofilm may lead to osteomyelitis” (bone infection).⁶¹ Flummoxed by “the notorious difficulty [of] eradicating” biofilms,⁶⁴ medicine is, as is its wont, eagerly exploring aggressive methods of biofilm inhibition or attack, with future directions pointing toward “novel coatings for prostheses” that contain “surface-tethered antibiotics and metal oxide nanoparticles.”⁶³

From a “new biology”⁶⁵ or terrain theory perspective, might there be a different way to interpret the formation of biofilms on hip and other joint replacement devices? In terrain theory, “the body is always in an active pursuit of returning to, or maintaining, a state of equilibrium” wherein disease and symptoms “are not the problem, but an adaptive answer to the problem.”⁶⁶ The well-documented sophistication⁶⁷ of biofilms suggests that biofilm formation following joint re­placement surgery may be part of the body’s response to the trauma of invasive surgery and the insertion of high-tech agglomerations of foreign materials. It is a question worth exploring.

BORON FOR ARTHRITIS

In addition to protecting your joints with a Wise Traditions diet—including plenty of gelatin-rich bone broth and fat-soluble vitamins, especially vitamin K₂—boron works well for eliminating joint pain and the cost is mere pennies.

Here’s the recipe: dissolve one teaspoon boron powder or laundry borax in one quart of water. Every morning put one teaspoon of this solution in a small glass and add a little water. Then, down the hatch.

Your editor can attest to the magical power of boron solution, having eliminated debilitating knee pain in just two weeks with this remedy taken daily. Don’t take more than this recommended dose, as too much boron can be toxic.

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REFERENCES

1. Licholai G. Combating the growing rate of unnecessary surgeries. Forbes, Aug. 2, 2023 (updated Aug. 13, 2023).
2. Chalmers K, Smith P, Garber J, et al. Assessment of overuse of medical tests and treatments at US hospitals using Medicare claims. JAMA Netw Open. 2021 Apr 1;4(4):e218075. Erratum in: JAMA Netw Open. 2021 Jun 1;4(6):e2117001.
3. Bedard NA, Elkins JM, Brown TS. Effect of COVID-19 on hip and knee arthroplasty surgical volume in the United States. J Arthroplasty. 2020 Jul;35(7S):S45-S48.
4. Merola M, Affatato S. Materials for hip prostheses: a review of wear and loading considerations. Materials (Basel). 2019 Feb 5;12(3):495.
5. Bota NC, Nistor DV, Caterev S, et al. Historical overview of hip arthroplasty: from humble beginnings to a high-tech future. Orthop Rev (Pavia). 2021 Mar 30;13(1):8773.
6. Shichman I, Roof M, Askew N, et al. Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040-2060. JB JS Open Access. 2023 Feb 28;8(1):e22.00112.
7. Farley KX, Wilson JM, Kumar A, et al. Prevalence of shoulder arthroplasty in the United States and the increasing burden of revision shoulder arthro­plasty. JB JS Open Access. 2021 Jul 14;6(3):e20.00156.
8. Wagner ER, Farley KX, Higgins I, et al. The incidence of shoulder arthro­plasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg. 2020 Dec;29(12):2601-2609.
9. Joints. Cleveland Clinic, last reviewed Jul. 18, 2023. https://my.clevelandclinic.org/health/body/25137-joints
10. Lo D, Talkad A, Sharma S. Anatomy, bony pelvis and lower limb, fovea capitis femoris. 2023 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
11. The Lancet: New study reveals the most com­mon form of arthritis, osteoarthritis, affects 15% of the global population over the age of 30. Institute for Health Metrics and Evalua­tion, Aug. 21, 2023. https://www.healthdata.org/news-events/newsroom/news-releases/lancet-new-study-reveals-most-common-form-arthritis
12. Xu Y, Wu Q. Trends and disparities in osteoar­thritis prevalence among US adults, 2005-2018. Sci Rep. 2021 Nov 8;11(1):21845.
13. Elgaddal N, Kramarow EA, Weeks JD, et al. Arthritis in adults age 18 and older: United States, 2022. Centers for Disease Control and Prevention, NCHS Data Brief No. 497, February 2024.
14. Suri P, Morgenroth DC, Hunter DJ. Epidemiol­ogy of osteoarthritis and associated comorbidi­ties. PM R. 2012 May;4(5 Suppl):S10-9.
15. Fan Z, Yan L, Liu H, et al. The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Res Ther. 2023 Mar 29;25(1):51.
16. Maradit Kremers H, Larson DR, Crowson CS, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015 Sep 2;97(17):1386-1397.
17. Walton C. Why knee and hip-replacement patients getting younger? Novant Health, n.d. https://www.novanthealth.org/healthy-headlines/why-are-knee-and-hip-replacement-patients-getting-younger
18. Gomez PF, Morcuende JA. Early attempts at hip arthroplasty—1700s to 1950s. Iowa Orthop J. 2005;25:25-29.
19. Al-Tikrity MA, Mohamed A, Yasin AKA, et al. A subacute presentation of isolated tuber­culous septic hip arthritis. Cureus. 2023 Aug 14;15(8):e43493.
20. Time for a new look at TB: infectious bacillus or iron poisoning? Weston A. Price Founda­tion press release, Mar. 24, 2024. https://www.westonaprice.org/time-for-a-new-look-at-tb-infectious-bacillus-or-iron-poisoning/
21. Morell SF. Solving the mystery of TB: the iron factor. Wise Traditions. Spring 2022;23(1):25-31.
22. Cai C, Hu W, Chu T. Interplay between iron overload and osteoarthritis: clinical significance and cellular mechanisms. Front Cell Dev Biol. 2022 Jan 14;9:817104.
23. Morrey M, Dutta A, Whitney I, et al. Interposi­tion arthroplasty: current indications, technique and expectations. J Clin Orthop Trauma. 2021 May 19;19:175-182. Erratum in: J Clin Orthop Trauma. 2021 Jul 30;20:101540.
24. Blaine TA, Wiseman SP, Morrey BF. Interposi­tion arthoplasty for posttraumatic ulnohumeral arthritis. J Shoulder Elb Arthroplast. 2019;3.
25. Knight SR, Aujla R, Biswas SP. Total hip ar­throplasty—over 100 years of operative history. Orthop Rev (Pavia). 2011 Sep 6;3(2):e16.
26. Turner T. Metallosis & metal poisoning. Drug­watch, last modified Jan. 29, 2024. https://www.drugwatch.com/hip-replacement/metallosis/
27. Ude CC, Esdaille CJ, Ogueri KS, et al. The mechanism of metallosis after total hip ar­throplasty. Regen Eng Transl Med. 2021 Sep;7(3):247-261.
28. Metal-on-metal hip implants. U.S. Food & Drug Administration, content current as of Sep. 30, 2019. https://www.fda.gov/medical-devices/implants-and-prosthetics/metal-metal-hip-implants
29. Sheth NP, Foran JRH. Hip resurfacing. Or­thoInfo, last reviewed February 2023. https://or­thoinfo.aaos.org/en/treatment/hip-resurfacing/
30. Pritchett JW. Adverse reaction to metal debris metallosis of the resurfaced hip. Curr Orthop Pract. 2012 Jan/Feb;23(1):50-58.
31. Mastel M, Boisvert A, Moore R, et al. Metallosis following hip arthroplasty: two case reports. J Med Case Rep. 2022 Mar 23;16(1):115.
32. Matthias J, Bostrom MP, Lane JM. A compari­son of risks and benefits regarding hip arthro­plasty fixation. J Am Acad Orthop Surg Glob Res Rev. 2021 Nov 1;5(11):e21.00014.
33. Swanson E. Advances in technology that are improving joint replacement surgery. Henry Ford Health, Jan. 10, 2024.
34. Hip replacement. Mayo Clinic, Apr. 22, 2022. https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042
35. Goh GS, Parvizi J. Nerve injuries following total hip arthroplasty: the influence of surgi­cal approach. Orthop Clin North Am. 2022 Apr;53(2):129-137.
36. Revision hip surgery. Cedars-Sinai, n.d. https://www.cedars-sinai.org/health-library/diseases-and-conditions/r/revision-hip-surgery.html
37. Patel I, Nham F, Zalikha AK, et al. Epidemiol­ogy of total hip arthroplasty: demographics, comorbidities and outcomes. Arthroplasty. 2023 Jan 3;5(1):2.
38. Gademan MGJ, Van Steenbergen LN, Can­negieter SC, et al. Population-based 10-year cumulative revision risks after hip and knee arthroplasty for osteoarthritis to inform patients in clinical practice: a competing risk analysis from the Dutch Arthroplasty Register. Acta Orthop. 2021 Jun;92(3):280-284.
39. Blumenthal D. Private equity’s role in health care. The Commonwealth Fund, Nov. 17, 2023.
40. Garber J. The rising danger of private equity in healthcare. Lown Institute, Jan. 23, 2024.
41. Segal JB, Sen AP, Glanzberg-Krainin E, et al. Factors associated with overuse of health care within US health systems: a cross-sectional analy­sis of Medicare beneficiaries from 2016 to 2018. JAMA Health Forum. 2022 Jan 14;3(1):e214543. Erratum in: JAMA Health Forum. 2022 Feb 25;3(2):e220132.
42. Hip replacement cost by country 2024. World Population Review, 2024. https://worldpopulationreview.com/country-rankings/hip-replacement-cost-by-country
43. Kannan S, Bruch JD, Song Z. Changes in hospital adverse events and patient outcomes associated with private equity acquisition. JAMA. 2023 Dec 26;330(24):2365-2375.
44. Outpatient total joint replacement. OrthoInfo, last reviewed September 2022. https://orthoinfo.aaos.org/en/treatment/outpatient-joint-replacement-surgery/
45. Gunja MZ, Gumas ED, Williams II RD. U.S. health care from a global perspective, 2022: accelerating spending, worsening outcomes. The Com­monwealth Fund, Jan. 31, 2023.
46. King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185-193.
47. Wolfer LR. Letters, Spring 2011: A physician discovers WAPF. Weston A. Price Foundation, Mar. 31, 2011. https://www.westonaprice.org/letters-spring-2011/
48. Onusic S. Nutrition: the anti-aging factor. Wise Traditions. Summer 2014;15(2):20-31.
49. Singh VK, Rathore KS, Khan G, et al. Clinical and radiological study of serum fluoride in relation to knee osteoarthritis. Malays Orthop J. 2020 Nov;14(3):151-154.
50. Sanders J. Fluoride & arthritis. Fluoride Action Network, Jun. 4, 2012. https://fluoridealert.org/studies/arthritis01/
51. Hauser R, Matias D. Alternatives to hip replacement: the evidence for non-surgical treatments for hip osteoarthritis. Caring Medical Florida, n.d. https://caringmedical.com/prolotherapy-news/hip-replacement-surgery-alternatives/
52. Okafor L, Chen AF. Patient satisfaction and total hip arthroplasty: a review. Arthroplasty. 2019 Sep 2;1(1):6.
53. Palazzo C, Jourdan C, Descamps S, et al. Determinants of satisfaction 1 year after total hip arthroplasty: the role of expectations fulfilment. BMC Musculoskelet Disord. 2014 Feb 24;15:53.
54. Miravete-Galvez A, Serrano-Ardila AM, Camacho-Galindo J. Correlation between functionality and satisfaction index after total hip or knee replace­ment. J Musculoskelet Surg Res. 2020;4:213-217.
55. Hamilton DF, Lane JV, Gaston P, et al. What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement. BMJ Open. 2013 Apr 9;3(4):e002525.
56. Li W, Yu L, Li W, et al. Prevention and treatment of inflammatory arthritis with traditional Chinese medicine: underlying mechanisms based on cell and molecular targets. Ageing Res Rev. 2023 Aug;89:101981.
57. https://www.peacehealth.org/medical-topics/id/hn-2246008
58. Haaz S, Bartlett SJ. Yoga for arthritis: a scoping review. Rheum Dis Clin North Am. 2011 Feb;37(1):33-46.
59. Storey L. DMSO: The most suppressed natural remedy & best-kept secret in the world? W/ Amandha Vollmer. The Life Stylist, episode 480, Jun. 20, 2023. https://www.lukestorey.com/lifestylistpodcast/dmso-the-most-suppressed-natural-remedy-best-kept-secret-in-the-world-w-amandha-vollmer-480
60. https://www.sciencedirect.com/topics/materials-science/biofilms
61. Zhao A, Sun J, Liu Y. Understanding bacterial biofilms: From definition to treatment strategies. Front Cell Infect Microbiol. 2023 Apr 6;13:1137947.
62. Hall-Stoodley L, Costerton JW, Stoodley P. Bacterial biofilms: from the natural environment to infectious diseases. Nat Rev Microbiol. 2004 Feb;2(2):95-108.
63. McConoughey SJ, Howlin R, Granger JF, et al. Biofilms in periprosthetic orthopedic infections. Future Microbiol. 2014;9(8):987-1007.
64. Gbejuade HO, Lovering AM, Webb JC. The role of microbial biofilms in prosthetic joint infections. Acta Orthop. 2015 Apr;86(2):147-158.
65. Cowan T. The new biology initiative. New Biology Clinic, n.d. https://newbiologyclinic.com/the-new-biology-initiative/
66. Roytas D. Can You Catch a Cold? Untold History & Human Experiments. Daniel Roytas, 2024, p. 59.
67. Sharma S, Mohler J, Mahajan SD, et al. Microbial biofilm: a review on formation, infection, antibiotic resistance, control measures, and innovative treatment. Microorganisms. 2023 Jun 19;11(6):1614.

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2024

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