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Natural Healing with Regenerative Medicine Treatments

Regenerative Medicine involves repairing and regenerating the damage in the body. These new treatments utilize the body’s natural healing powers to relieve a wide range of physical problems related to tendon, ligament, muscle, and bone damage.

Leading orthopedic and sports medicine practices, such as OSPI in Arizona, offer various regenerative medicine treatments –

  • Bone Marrow Derived Stem Cell Therapy (Your Own Bone Marrow)
  • Amniotic Fluid Stem Cell Therapy
  • Platelet Rich Plasma Therapy (PRP Therapy)

Stem cell and PRP therapy have been utilized in treating various areas of the body, including knees, hips, backs, and shoulders, that people have injured or that are affected by degenerative conditions such as rheumatoid arthritis.

OSPI has teamed up with R3 Stem Cell, the nation’s leading regenerative medicine company offering cutting edge technologies and research, to provide OSPI patients with state of the art options.

Stem Cell Therapy

Stem cell therapy involves harvesting stem cells from a human source, either the amniotic fluid or the person’s own bone marrow. Amniotic stem cells are either extracted from a willing donor’s amniotic fluid.

Once either of these fluids is harvested, the stem cells are isolated and injected into the affected area. This encourages the creation and strengthening of the affected tissue and also helps to reduce inflammation and pain.

PRP Therapy

PRP therapy involves deriving platelet rich plasma (PRP) from the person’s own blood. The PRP contains several growth and healing factors that aid healing in the damaged tissues.

Many orthopedic doctors are now utilizing stem cell and PRP therapy instead of highly invasive and risky joint replacement surgeries. Regenerative medicine treatments are relatively non-invasive, pose fewer risks and are less expensive, quick and efficient.

If you are looking for the best regenerative and sports medicine doctor in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

Are you an Athlete and injured?

Sports or athletic injuries occur during play or practice for a sports event. Such injuries may vary in their extent and severity but require timely treatment if you want to recover fully.

If you are an athlete or if you maintain an active lifestyle, read on to learn the about the common sports injuries. It will help you recognize if you have been injured.

Sprains

Sprains are the result of a ligament being stretched beyond its capacity. Wrist and ankle sprains are more common than others.

Concussions

Concussions occur due to a violent blow to the head. These are common among athletes who participate in contact sports. AT the same time, concussions can also occur as a result of a fall. Some concussions may prove serious if they are left untreated and the player continues to play.

Shin Splints

Acute pain in the shin or lower leg after prolonged running can be the result of shin splints.

Runner’s Knee

Runner’s knee, as the name indicates, is caused due to years of running and the pain in the knee due to that. It is an overuse condition in which the tendons and the cartilage, around the knee cap, are worn out.

Achilles Tendinitis

Achilles Tendonitis shows up as heel pain. It occurs when overuse causes the tendon, just above the heel, to become swollen or irritated.

What should I do if I am injured?

Since most athletes try to ensure pain and push through injury, their injuries usually become worse.

The best course of action is to seek immediate treatment if you suspect injury and experience pain. This will reduce your healing time, chance of reoccurrence, pain, and will get you back in the game quickly. Modern regenerative medicine treatments, such as PRP therapy, help to avoid surgery and allow you to recover naturally.

To learn more about PRP therapy or to consult a sports medicine doctor in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

Suffering from an ACL Tear?

The ACL or the Anterior Cruciate Ligament in the knee can be injured in several ways:

  • Sudden stopping or change of direction
  • Abruptly slowing down while running
  • Landing from a jump incorrectly
  • Direct collision

ACL tear

The ACL is one of the four important knee ligaments. These ligaments hold the knee together.  It connects the thigh bone to the shin bone.

The ACL is a tough band of tissue that runs diagonally through the inside of the knee and gives the knee joint stability. An ACL tear is often a result of excessive stress due to one of the reasons explained above.

ACL Injury Symptoms

ACL injuries are often accompanies by a “popping” noise and/or the knee may feel giving out from under you. Other symptoms include:

  • Swelling and pain
  • Limited range of motion
  • Tenderness along the joint
  • Discomfort while walking

You may observe swelling within a day of the injury. In some cases, the swelling and the pain may subside on its own but if you attempt to return to activity, the knee is likely to remain unstable. This can result in further damage to the meniscus or the cartilage that cushions your your knee.

To learn more about ACL tear and treatment options or to consult an experienced knee doctor in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333. OSPI offers modern, cutting edge treatments including minimally invasive orthopedic surgery as well as regenerative medicine, such as PRP Therapy in Gilbert, AZ.

Ever too old for Knee Replacement?

If you are wondering whether you are too old for knee replacement surgery, you should know that more than 500,000 people undergo total knee replacement in the United States alone. Generally, people with chronic joint pain and debilitating arthritis are considered candidates for total knee replacement.

Total knee replacement can help these people regain lost confidence and independence. A knee replacement can go a long way in restoring your ability to lead a normal life.

Read on to know more about knee replacement surgery and get answers to the most commonly asked questions.

Arthritis and Knee Pain

The knee joint has a layer of smooth cartilage on the ends of thigh bone, shinbone and the kneecap. This cartilage cushions the gliding surface facilitating smooth knee motion. Arthritis involves wear and tear of this cartilage. This leads to bones rubbing against each other, causing pain, inflammation, swelling and stiffness.

Total Knee Replacement

Total knee replacement involves cartilage replacement with an artificial surface, using metal and plastic implants. This creates a new smooth cushion and a functioning joint that does not hurt.

Success Rates

More than 90% patients achieve good to excellent results with pain and symptom relief and improved activity and mobility.

Candidates for Total Knee Replacement

Based on your history, physical examination, X-rays and conservative treatment results, your orthopedic surgeon will discuss with you if you are a candidate for total knee replacement surgery.

In general, you may not be a good candidate if you –

 

  • have poorly-controlled diabetes
  • are an active smoker
  • are morbidly obese
  • have experienced infections in the affected arthritic joint in the past

Can a person be too old for knee replacement?

Age is not a big issue if you have good overall health and wish to continue living an active life. There are cases of patients in their 90’s who get knee replacements and do well. Your orthopedic may ask you to consult your personal physician about your readiness for surgery.

To learn more or to consult an the best knee replacement doctors in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

4 Top Reasons you can’t straighten your Knee

Knee injuries are often a result of a twisting or a direct impact injury to your leg. The severity of the injury can vary but loss of bending in the knee is common after an injury. An inability to straighten and bend your knee is a sign you have been injured badly.

Here is a look at the top reasons why you are unable to straighten your knee after an injury.

Swelling

Swelling is common after injuries that cause bleeding, inflammation and pain, making it too painful to straighten the knee.

Tendon Injuries

Injuries to the quadriceps or patella tendon do not allow you to straighten the knee and also cause significant weakness. Such injuries are more common in professional sports.

Meniscus Tear

A tear in which the torn piece of meniscus flips into the center of the knee joint, can lock your knee and prevent it from straightening.

ACL Tear

ACL tear do not cause the knee to be locked but it hurts too much to straighten it. Within a few days, the swelling will reduce and you may be able to straighten your knee. But sometimes ACL tear is accompanied by a meniscus tear. In such cases, it will be hard to straighten the knee and you should see an orthopedic surgeon.

If you have suffered an injury to your knee and are not able to straighten or bend your knee, it could be due to a severe knee injury. Consult an orthopedic surgeon to find out the root cause and begin treatment.

To learn more or to consult the best orthopedic surgeons in Mesa, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

Rehab Exercises after Total Knee Replacement

Once you return home after a total knee replacement (TKR), you will need to perform certain exercises to prevent complications, improve motion of the knee, and build strength. Most people have weak leg muscles before surgery because they were not used much due to knee problems. Now that surgery has corrected this knee problem, you will need to have a regular exercise regimen.

Exercise Program

A regular exercise program is used to strengthen weak leg muscles. Your success with rehabilitation relies on your willingness to follow the exercise program developed by your physical therapist. You should perform these exercises 2-3 times each day after surgery. Each exercise must be done 10 times, starting out, and you gradually increase the repetitions by 5 times each week until you reach 20 repetitions. Your schedule will be:

  • Week 1 – 10 repetitions
  • Week 2 – 15 repetitions
  • Week 3 – 20 repetitionsheel-slides

Ankle Pumps and Circles

  • Bend both ankles up, pulling toes toward you.
  • Bend both ankles down, pointing toes away from you.
  • Rotate each foot clockwise and then counterclockwise while keeping toes pointed to the ceiling.

Heel Slides (Knee and Hip Flexion)

  • Bend the hip and knee by sliding the heel up toward buttocks while keeping the heel on the bed.
  • Slide heel back down again while keeping kneecap pointed at the ceiling.
  • Repeat with opposite leg.

Thigh Squeezes (Quadriceps Sets)

  • Tighten muscles at the front of the thigh by pushing the back of your knee down on the bed.
  • Hold for 5 seconds, then relax.
  • Repeat with opposite leg.

Leg Slides (Abduction/Adduction)

  • Slide leg out to the side while keeping kneecap pointed toward ceiling.
  • Slide leg back to the starting position.
  • Repeat with opposite leg.

Lying Kicks (Short Arc Quadriceps)

  • Lie on back with a rolled blanket under your knee.
  • Straighten knee and hold for 5 seconds.
  • Lower leg down slowly and relax.
  • Keep back of knee in contact with blanket.
  • Repeat with opposite leg.

Straight Leg Raises

  • b7a636bc5a5da7a0eafbb497fb8cac4eBend leg with foot flat on the bed.
  • Raise opposite leg up 12 inches with knee straight.
  • Hold for 5 seconds.
  • Slowly lower leg and relax.
  • Repeat with other leg.

Knee Bending (Sitting Knee Flexion)

  • Sit on a chair.
  • Bend knee back as much as you can and hold for 10 seconds.
  • Return to starting position and relax.
  • Repeat with other leg.

Sitting Kicks (Long Arc Quads)

  • Sit on a chair.
  • Lift foot and straighten knee as much as possible.
  • Keep knee level as if you are holding a tray on your lap.
  • Hold for 5 seconds.
  • Lower leg down slowly and relax.
  • Repeat with other leg.

Prolonged Knee Stretch

  • Sit on a chair.
  • Bend knee back as much as possible.
  • Scoot your body forward to increase the stretch.
  • Hold for 30-60 seconds.

Knee Straightening Stretch

  • Sit on a chair with your heel up on a footstool or chair in front of you.
  • Hold this for 30-60 seconds.
  • Repeat with other leg.

Knee Dangling/Swinging

  • Sit on a high chair or bed so that feet don’t touch floor.IMG_5017
  • Bend knees and swing surgical leg back and forth.
  • Do this for 2-3 minutes.

Heel Digs (Hamstring Sets)

  • Bend surgical knee.
  • Tighten muscle at back of thigh by digging heel into the bed.
  • Hold for 5 seconds.
  • Repeat with other leg.

Buttock Squeezes (Gluteal Sets)

  • Tighten buttock muscles by squeezing.
  • Hold for 5 seconds and relax.

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Rehab After a Total Knee Replacement

Total Knee Replacement Rehabilitation

Having a total knee replacement surgery is usually the best option for patients with severe knee arthritis. At present, more than 4.5 million people in the U.S. are living with at least one total knee replacement, and around 1.5 million people with a replaced knee are 50-70 years of age. During the last couple of decades, total knee replacement increased by 84% in the U.S. population, with the current rate 22 per 10,000 persons. The most important part the knee replacement process is rehabilitation.

The greatest demand for total knee replacement is not coming from the elderly demographics. Rather, it is younger people who have weight issues. There is a strong relationship between knee osteoarthritis and having a high body mass index. More people ages 18 to 64 years are having severe knee pain and loss of mobility related to being overweight.

General Considerations

  • Patients are weight-bearing as tolerated with a walker, crutches, or cane until they can walk without assistance.
  • Early emphasis is on developing full extension equal to the opposite leg soon as possible.
  • No active or passive flexion motion greater than 90 degrees until stitches are removed.
  • Early exercise will focus on recruitment of proper quadriceps set.
  • Keep incision site clean and dry.b7a636bc5a5da7a0eafbb497fb8cac4e
  • Avoid submerging in a pool, tub, or sauna until wounds are healed.
  • Avoid jumping, twisting, pivoting, or rigorous activities.

Week 1

  • You will return to see the Arizona orthopedic surgeon to change the dressing and review health status.
  • Icing, leg elevation, and swelling control are implemented. Swelling control can be achieved using a compression wrap and circumferential massage.
  • Soft tissue treatments and gentle mobilization are implemented by physical therapist.
  • Exercises include gluteal sets, gait training, and balance/proprioception maneuvers. Straight leg raise exercises with quad sets are began, and passive/active range of motion exercises are started.
  • Goals of therapy are to increase range of motion < 90 degrees, and to decrease swelling and pain.

Weeks 2-4

  • You will return to the Gilbert orthopedic surgeon’s office to have staples/stitches removed and for a check-up.canstockphoto7424057
  • The therapist will continue with soft tissue treatments and gentle mobilization, avoiding flexion or patella contracture.
  • Exercises are continued, including progress flexion range of motion, functional exercises, gait training, and balance/proprioception maneuvers.
  • Aerobic exercise is began as tolerated (cycling, swimming).
  • Goals include decreasing swelling and edema and range of motion < 10 degrees extension to 100 degrees.

Weeks 4-6

  • You will follow-up with the orthopedic surgeon.
  • Gentle mobilization and soft tissue treatments continue.
  • Exercises continue, such as functional exercises (weight machines and walking outside), balance/proprioception maneuvers, and swimming after incisions are closed.
  • Goals include walking without a limp and range of motion < 5 degrees extension to 110 degrees.

Weeks 6-8

  • Continue soft tissue treatments, joint mobilizations, and patellar glides to increase range of motion.
  • Add lateral training exercises, and incorporate single leg exercises as tolerated.
  • Goals include patient walking without limp, and range of motion 0-115 degrees.

Weeks 8-12

  • Continue joint mobilizations, soft tissue treatments, and patellar glides to increase range of motion.
  • Begin activity specific training, such as gardening, sports, and household chores.
  • Low impact activities after week 11.
  • Patients are weaned into a home and gym program with emphasis on their particular sport/activities.
  • Goals include return to functional activities and range of motion within functional limits.

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Resources

Health Research Funding (2016). 23 Amazing Total Knee Replacement Statistics. Retrieved from: http://healthresearchfunding.org/23-amazing-total-knee-replacement-statistics/

Intermediate and Long-Term Quality of Life after Knee Replacement

Osteoarthritis (OA) is one of the main causes of functional disability and chronic pain in older people. OA is related to environmental factors, aging, lifestyle changes, and genetic predisposition. When the knee is affected canstockphoto10845760by arthritis, many people undergo knee replacement procedures.

The goal of total knee replacement is to improve overall quality of life and return patients to a higher level of functioning than before surgery. Most people will heal well without problems if they follow their rehabilitation program. Some activities are permitted and others are not:

  • Permitted: Swimming, golf, dancing, water aerobics, cross-country skiing, cycling, hiking, light labor (involves standing and walking), and sedentary occupations.
  • Not permitted: Jogging, running, impact exercises, contact sports, sports that require pivoting and twisting, and heavy labor.

Post-Operative Exercise

golf swingPost-operative exercise may be detrimental to the success in recovery after a total knee arthroplasty (TKA). You will begin to receive physical therapy in the hospital, and will continue at home, outpatient, or in a skilled nursing facility. A home exercise program is provided before hospital discharge.

Weeks 1-2: Anticipate discharge from the hospital after 3-5 days. Continue using walker with instructions from the therapist. At this time, you will start walking 300 feet, begin to straighten the knee, dress independently, and perform simple homemaking tasks. Home exercises will be advanced with your therapist.

Weeks 2-4: During this time, you will gradually increase independence. The home exercise program involves progressive ambulation using the cane, resuming driving if you had a left knee replacement, independent showering, and walking around ¼ mile.

Weeks 4-6: During this time, your physical therapist will have you bending the knee to 90 degrees, using a cane as needed, walking up stairs, and straightening the knee completely.

Weeks 6-12: You will continue home exercises. During this time, you will progress to walking one mile, climb stairs, and resume usual activities, such as swimming and bowling.

Clinical Studies

Many clinical studies regarding total knee replacement have studied quality of life after surgery. Considered a highly successful operation, technical outcomes from total knee replacement are excellent. In a recent study evaluating intermediate and long-term quality of life following surgery, researchers conducted a large review of studies. They found that both intermediate and long-term post-operative quality of life were superior to the pre-Hiking2operative level in analyses.

In the review of clinical reports, researchers found that most patients were satisfied with the knee replacement surgery and reported substantial improvement in daily functional activities. In addition, the benefits were related to health-related quality of life as well as disease-specific quality of life. Four validated measurement tools were used to assess quality of life: the Western Ontario and McMaster’s Universities Osteoarthritis Index, the Knee Society Score, the Center for Epidemiological Studies Depression Scale, and the visual analogue scale for pain.

Another study evaluated self-reported outcomes in the first year after total knee replacement and attempted to determine which factors influenced patient quality of life. The results showed that after 6 weeks, all patients reported significant improvement for all measured parameters in relation to quality of life.

To examine health-related quality of life after total knee arthroplasty, researchers in a Singapore hospital interviewed patients. Data were collected from almost 5,000 patients. The patients who had total knee replacement all had improved pain scores. In addition, two years after surgery, the majority of patients showed improved physical functioning scores.

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Resources

Ko Y, Narayanasamy S, Wee HL, et al. (2011). Health-related quality of life after total knee replacement or unicompartmental knee arthroplasty in an urban asian population. Value Health, 14(2), 322-328.

Papakostidou I, Dailiana ZH, Papalychroniou T, et al. (2012). Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskel Dis, 13, 116.

Shan L, Shan B, Suzuki A, et al. (2015). Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am, 97(2), 156-168.

Managing Pain after Total Hip Replacement

People who undergo a hip replacement surgery often have problems with post-operative pain. For many, pain management is a matter of managing your expectations. Surgery on a hip requires a significant period of rest in order for the body to fully recover and regain strength. Post-operative pain after hip replacement is shorter for a hip replacement than for a knee replacement surgery.

Rest

In the first week of recovery, the patient should rest often and be active only in short spurts. The more rest the  body gets during this crucial time, the better for your recovery. Usually, after 10 days, hip joint pain has gone away and soft tissue pain lessens. Some people may use a cane for up to 4 weeks post-surgery. After 4-6 weeks, most patients can return to usual activities without pain.

Ice

Ice is used to provide pain relief and reduce swelling. For hip replacement patients, use gel packs and keep them in the freezer. During recovery, you will need to change these packs frequently. Remember that gel packs can burn the skin, so wrap them in a soft, thin cloth. Also, elevate your leg and rest during icing.

Medications

Patients are typically sent home with strong narcotic analgesics at first. The orthopedic surgeon will have you scheduled for a follow-up to remove staples/sutures and refill pain medicines as needed. Take the medication as needed, and follow post-operative instructions. If the medication is not effective for your pain, talk with your doctor about increasing the dosage or changing your medication.

Elevate Legs

Elevating your legs will help reduce pain and swelling. Put your feet higher than your hips to offset some of the physical discomfort in the legs. In bed, prop your legs up on pillows at the end of the bed. Regularly elevating the legs several times each day, along with icing and medication, will help manage post-operative pain.

Regional Pain Medication

Regional anesthesia is associated with fewer complications than general anesthesia. The regional method avoids central nervous depression, and has a different spectrum of effects on the heart and lungs. Regional anesthesia provides excellent pain relief, allows for painless weight-bearing and range of motion exercises, and enhances overall patient satisfaction.

Epidural Analgesia

Epidural analgesia can consist of an opioid, an anesthetic, or a combination of both. This method of administering pain medication allows the patient to have a continuous low-dose infusion that is effective for controlling post-operative pain. The continuous infusion allows the analgesia to be more precisely titrated to a level of pain Exercise-senior-couple-199x300stimulus, and to rapidly terminate should problems occur.

Oral and Injectable Agents

After a total hip replacement, some medications used include:

  • Oral or IV Toradol
  • Oral anti-inflammatory drugs (ibuprofen, naproxen, and ketoprofen)
  • COX-2 inhibitors – Mobic Celebrex
  • Oral and IV opioids (oxycodone, morphine)

Post-Operative Rehabilitation

Patients are mobilized out of bed on the day after surgery. The patient works with a physical therapist to learn how to get up and down from bed, how to use the walking device (walker, crutches, or cane), and performs exercises for strengthening and flexibility. The therapist teaches thee patient how to avoid pain with the new hip, and what activities to avoid.

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Resources

Maheshwari AV, Blum YC, Shekhar L, et al. (2009). Multimodal Pain Management after Total Hip and Knee Arthroplasty at the Ranawat Orthopaedic Center. Clin Orthop Relat Res, 467(6), 1418-1423.

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