Orthopedic Services
Arthritis
What is arthritis?
Arthritis occurs when the cartilage lining the joint thins. The coating of the joint (knee, hip, wrist) is made of smooth cartilage that allows painless movement. Injuries to the joints can cause early arthritis. Over time from wear and tear most patient develop arthritis as they age. Arthritis can cause stiffness, pain, limping, and limitations in activity and sports.
Sports Medicine
What is Sports Medicine?
Sports Medicine is the treatment of sports related injuries. Many non-sports related soft tissue injuries can be treated in the same manner. Sports medicine involves the practice or both surgical and non-surgical treatments. The goal of treatment is to return the patient to an active lifestyle.
What is arthroscopy?
Gaining widespread use in the 1980’s to 1990’s, an arthroscope is a surgical instrument that has a video camera attached to a light cord that is inserted into the surgical site. It is the size of a #2 pencil, and can be inserted through a very small 8-10 mm incision. Using small windows into the joint or surgical area, we can treat injuries that previously required large incisions to access. The surgeon does surgery while looking at a TV monitor from the arthroscope.
Which doctors are sports medicine doctors?
Some primary care doctors specialize in Sports Medicine. These doctors DO NOT perform surgery. Orthopedic surgeons provide both non-surgical care and surgery. The highest level of training for an Orthopedic Surgeon is to be Board Certified in Orthopedic Surgery AND Sports Medicine, AND to have completed a Sports Medicine Fellowship as I have.
Fractures
What is fracture? Is it the same as a broken bone?
A fracture is a broken bone. Fractures typically occur from injuries in which the force applied overcomes the strength of the bone (fall, car accident). Fractures typically hurt enough to seek immediate treatment, but many patients incorrectly assume they have a sprain or “jammed their finger.” Any patient with an injury causing pain or limp should seek medical care. X-rays allow accurate diagnosis of fractures.
I was seen in the ER and splinted, how soon should I see an Orthopedic Surgeon?
Typically seeing an Orthopedic surgeon within a week of injury is appropriate. It is helpful to bring any reports or X-rays you may have to the visit.
When do fracture require surgery?
Nearly all fractures are temporarily immobilized by use of a splint. Fractures that have not displaced (moved in position from the norm) may be able to be treated with casting or fracture bracing. Immobilization allows the fracture to heal. In fractures that involve the lower extremity long bone, fractures that are displaced, and many fractures that extend in the joints (area of movement where two bones meet) may require surgery. Surgery can include use of plates, screws, nails, or joint replacement surgery. Surgery allows restoration of the normal shape of the bone and may even stabilize the fracture enough to move or to bear weight.
Joint Replacement
What is a joint replacement?
Arthroplasty, or joint replacement, is a surgical procedure in which the arthritis is removed and replaced with a metal and plastic joint. We are able to resurface the joint to create pain relief and return to activities. Commonly replaced joints include the hip, knee, and shoulder- all of which I perform.
What is the implant made out of?
The metal is made of titanium and cobalt chrome alloys. These implants can contain nickel, and any nickel allergy should be reported to your surgeon.
What non-surgical treatments are available?
Joint replacement surgery is only considered typically after failing non-operative treatment. These treatments include: Anti-inflammatory medications, injections, activity modification, physical therapy, and occasionally pain medications. Injections are very effective treatment options for short term relief. Steroid injections typically give immediate pain relief. Gel injections (viscosupplementation) can give slower onset but up to 6 months of pain relief. Platelet Rich Plasma or PRP injections are relatively newly studied and can also provide pain relief. None of these treatment eliminates the arthritis, and simply treats the pain.
When should I consider having a joint replacement?
You should consider joint replacement when non-operative care is not giving adequate pain relief and your X-rays show advanced arthritis.
Am I too old to have surgery?
Nobody should be forced to live in joint pain, regardless of age. So long as your medical doctor feels you are healthy enough to undergo surgery, it is a viable option. There is no age cut off for surgery.
How long do joint replacements last?
The literature suggests that many joint replacement surgeries can last 15-20 years.
What happens if my joint replacement wears out or fails?
The joint replacement can be done again if it fails over time: This is called a revision surgery and serve to re-build the joint and removed the worn out components. Patients can still have good outcomes with revision surgery, but the complication rates are higher than the first surgery.