Tag Archive: orthopedic surgeon

Physical Therapy After Total Hip Replacement

One of the most commonly performed orthopedic surgeries is a total hip replacement (THR). The surgical techniques and prosthesis used for a THR have improved over the years, allowing the patient to now achieve optimal recovery and less pain. Physical therapy is an important aspect in a successful, full recovery after hip replacement.

In the Hospital

Right after your total hip replacement, a physical therapist begins working with you to restore joint motion and strength. Initially, therapy begins in physical therapy1the hospital the day after surgery. A therapist shows you how to get in and out of bed, ways to get into the shower and car, and how to walk using a walker or crutches. In addition, the therapist has you perform simple exercises in bed to prevent blood clots, such as gluteal squeezes and tightening the thighs.

After a hip replacement, some patients received additional physical therapy in a rehabilitation facility before going home. This will depend on the age of the patient, what the home environment is like, and functioning when discharged from the hospital. The physical therapist works with the patient using exercise equipment for strengthening and mobility. Balance exercises are used to decrease risk of falling. In addition, the physical therapist uses heat to warm up tight muscles and ice to reduce soreness and swelling.

Avoiding Dislocation

After a total hip replacement, there are some considerations the physical therapist follows to help you decrease risk of dislocating the new hip. With the posterior approach hip replacement, you cannot bend the hip past 90 degrees, must avoid crossing your legs, and cannot rotate the hip inward. Maneuvers to assist with avoiding these activities include use of a raised toilet seat and shower chair, use of a pillow between the knees, and using an orthopedic device to put on shoes and socks.

Home Physical Therapy

Once you go home, the physical therapist will visit you 3-4 times each week to improve hip strength, mobility, and flexibility. Common therapy exercises include:

  • Buttock contractions – Tighten muscles and hold to a count of 5.
  • Abduction exercise – Slide leg out to the side as far as possible and then back.
  • Quadriceps set – Tighten thigh muscles and try to straighten knee. Hold for 5-10 seconds.
  • Straight leg raises – Tighten thigh muscles with knee straight. As muscles tighten, lift leg sever inches from bed and hold for 5-10 seconds.
  • Standing exercises – These include standing knee raises, hip abduction, and hip extensions.
  • Walking and full weight-bearing – These exercises are used to help you perform light everyday activities.

physical_therapy

Recovery at Home

Don’t be surprised if you feel fatigued right after surgery. This will improve over the next few weeks, however. You should arrange to have someone help you out for 1-2 weeks after your total hip replacement. The exercises given to you by your physical therapist are an essential part of recovery.

You should be able to stop using crutches or a walker, and resume normal leisure activities within 6 weeks of the surgery. However, it could take up to 12 weeks for pain to completely resolve. Your new hip is continuing to recover for up to 2 years after the operation, which involves scar tissue healing and restoration of muscles.

Orthopedic and Sports Performance Institute in Gilbert AZ offers top surgeons specializing in joint replacement (hip and knee), along with sports medicine too. Most insurance is accepted with patients being seen from all over the Valley including Mesa, Chandler, Queen Creek and Scottsdale too! Call us today.

Do I need a Total Hip Replacement?

A total hip replacement is one of the most successful surgeries of modern medicine. This procedure is very effective for improving range of motion and relieving pain. The orthopedic surgeon in Chandler AZ follows certain guidelines to determine of you are ready for a total hip replacement.

The main goals of hip replacement are to stabilized the hip and offer pain relief. Leg-length equality is a Hip painpriority after the first two goals are established. Hip replacement parts in the U.S. are most often press-fit into the bone. To limit small cracks in the bone, the surgeon uses special implants and techniques.

Conservative Treatment Measures

Patients with hip arthritis or injury are often managed with conservative treatments. The orthopedic specialist will not perform a total hip replacement unless you have failed with these measures:

  • Physical therapy – Used to strengthen weak hip muscles and improve hip function, physical therapy involves strategic exercises. Many patients with hip arthritis often respond to physical therapy.
  • Corticosteroid injections – The doctor can injection the hip joint with an anti-inflammatory corticosteroid solution. These injections are usually given in a series of 3, which are spaced 3-4 months apart.
  • Anti-inflammatory drugs – Acetaminophen is the gold standard drug for arthritis. Anti-inflammatory drugs, such as ibuprofen and naproxen, can help alleviate the pain associated with inflammation.

Candidates for Total Hip Replacement

The Arizona orthopedic surgeon will decide if or not you are ready for a total hip replacement. Candidacy is based on:

  • Groin, hip, buttock, and knee pain – Patients with serious hip arthritis often have pain deep down in the groin region. This pain is relieved with a hip replacement. In addition, knee pain can occur because nerves that supply the knees run by each hip. When affected by inflammation, the nerves canstockphoto13092914can cause knee pain. Buttock and hip pain also can occur.
  • Bone-on-bone arthritis – The orthopedic surgeon will take some x-rays to see if the bone ends of the hip are touching. Pain occurs when the femur ball (thigh bone) does not fit properly in the socket.
  • Marked interference with daily activities – Surgery is considered when you have marked interference with daily activities. Patients will have trouble climbing stairs, putting on socks and shoes, and may need a cane for walking.
  • Trouble sleeping – Hip pain can affect ability to sleep, despite the use of pain medications.
  • Ability to participate in recovery – The patient having a total hip replacement must be able to participate in the rehabilitation program. Recovery takes around 3-6 weeks, and involves intense exercises and strengthening maneuvers. The doctor will consider a person’s ability to participate in the recovery process.

Total Hip Replacement Candidates

In years past, orthopedic surgeons in AZ reserve hip replacement surgery for persons age 60 years and older. This was because older people are less active and will not put stress on the artificial hip as a younger person would. In recent years, doctors have found that total hip replacement is useful for younger persons as well. New technology has improved surgical techniques and prosthetic components, allowing the new hip to withstand more strain and stress.

Hip replacement surgery involves a new hip that can last for as long as 20 years. A person’s overall health status and activity level are important in predicting the success of total hip replacement. A recent study shows that people who choose to have this surgery before advanced joint deterioration occurs tend to have an easier time with recovery.

The top orthopedic surgeons in Arizona at OSPI offer hip and knee replacements which are top notch. Often they are outpatient, allowing for rapid recovery getting people back to work and recreational activities fast! Call us today.

Resources

National Institute of Arthritis and Musculoskeletal Diseases (2016). Questions and answers about hip replacement. Retrieved from: http://www.niams.nih.gov/health_info/hip_replacement/

 

Treatment Options for a Rotator Cuff Tear in Arizona

Rotator Cuff info from OSPI in Gilbert Arizona

 

A rotator cuff tear is a common cause of disability and pain. A torn rotator cuff can weaken your shoulder, causing problems performing simple daily activities, such as getting dressed or brushing your teeth.

How common are rotator cuff tears?

According to a study in 2008, around 2 million people visit their doctors due to a rotator cuff problem. In cadaver studies, researchers found that 39% of deceased individuals older than Rotator Cuff Tear60 years had full-thickness rotator cuff tears. The incidence in the general population is around 20% for partial and full tears.

What structures are affected by a rotator cuff tear?

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). The shoulder forms a ball-and-socket joint, with the ball being the head of the humerus and the socket being a groove in the scapula.

The arm bone is held in the socket by the rotator cuff, which is a network of four muscles and several tendons that form a covering around the humeral head. This cuff attaches the arm bone to the shoulder blade, and it helps elevate and rotate the arm. The lubricating sac of the joint is called the bursa, and it lies between the acromion bone (at the top of the shoulder) and the rotator cuff

How does a rotator cuff tear occur?

If one of the rotator cuff tendons tears, the tendon can no longer attach to the humerus head. Most tearing occurs in the tendon or the supraspinatus muscle. A partial tear involves only soft tissue, and it is not completely severed into two pieces. A full-thickness tear involves splitting into two pieces of soft tissue. The causes of a rotator cuff tear are:

  • Injury – Includes a fall onto an outstretched arm, or from lifting something heavy in a jerking motion. This often occurs along with a dislocated shoulder or broken collarbone.
  • Degeneration – Most rotator cuff tears occur from wearing down of the tendon that occurs gradually over time. Degeneration is related to aging. The factors that contribute to degeneration include repetitive stress, lack of blood supply, and bone spurs.

What are the risk factors for rotator cuff tears?

Certain people have a greater chance of suffering a rotator cuff tear. Risk factors include:

  • Aging – Normal wear-and-tear occurs with aging, so people age 40 and older are at greater risk.
  • Certain activities – People who do overhead activities and repetitive lifting are at risk, including carpenters, painters, and laborers. In addition, athletes who use their arms/shoulders (tennis players and baseball pitchers) are also at risk.

What symptoms are associated with rotator cuff tears?

The most common symptoms are pain at rest, particularly at night with lying on affected shoulder, pain with lifting and lowering the arm, weakness when rotating the arm, and crackling sensations (crepitus) when moving the shoulder through certain positions.rotator cuff

How is a rotator cuff tear diagnosed?

The doctor will ask you questions about your activities, inquire about your symptoms, take a medical history, and conduct a physical examination. The doctor checks for deformities, tenderness, and range of motion. In addition, the doctor checks arm and muscle strength. Tests used to make the diagnosis include:

  • X-rays – Do not show soft tissues of the shoulder but show bony deformities and fractures.
  • Magnetic resonance imaging (MRI) scans – Used to show rotator cuff tears, and shows if the tear is old or new. Also, it can dhow the quality of the rotator cuff muscles.

How are rotator cuff tears treated?

The goal of treatment is to restore arm and shoulder function, as well as to relieve pain. In planning your therapy, the doctor will consider your activity level, general health, age, and grade of tear you have. Treatment options include:

  • Medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen will reduce swelling and pain. Narcotic analgesics can be prescribed short-term for severe pain.

 

  • Physical therapy – Special exercises are used to strengthen the shoulder and restore movement. The exercise program involves stretches that improve range of motion and flexibility, and strengthening exercises that enhance strength of muscles that support the shoulder to prevent further injury.

 

  • Corticosteroid injection – The doctor can inject the shoulder with a corticosteroid, with or without an anesthetic. This anti-inflammatory drug relieves irritation and swelling. In a review of several clinical trials comparing steroid injection to placebo injection, studies found significant benefit of steroid injections.

 

  • Suprascapular nerve block – This involves injecting a long-acting anesthetic agent near the affected nerve. The doctor will use x-ray guidance (fluoroscopy) to assure correct needle placement. In a large clinical study, patients receiving this block were followed for 12 weeks. Statistically significant improvements in disability and pain scores were observed, along with improved range of motion scores.

 

  • Surgery – If pain continues and does not improve with nonsurgical efforts, surgery may be required. Surgery is a good option if your symptoms have persisted for 6-12 months, you have a large tear, your tear was caused by a recent, acute injury, and/or you have significant loss of shoulder function. The tendon is reattached to the humeral head if possible. If the tear is severe, a graft may be used to replace the tendon.

Orthopedic and Sports Performance Institute offers comprehensive treatments for all types of shoulder conditions including arthritis, rotator cuff tears, labral tears and more. OSPI offers pain management, physical therapy and orthopedic surgeons in Gilbert AZ as well! Call us today.

The Diagnosis and Treatment of Arthritis in Gilbert and Chandler AZ

Arthritis; Its Treatment and Diagnosis

There are many nonoperative treatment options for arthritis; such as alternative therapies, occupational therapy, and medications. Here is a short list of potential those treatments:

  • Anti-inflammatory Medications
  • Topical Prescription Pain Medication[ File # csp11032144, License # 2179054 ] Licensed through http://www.canstockphoto.com in accordance with the End User License Agreement (http://www.canstockphoto.com/legal.php) (c) Can Stock Photo Inc. / pixologic
  • Bracing
  • Physical Therapy
  • Exercise program such as CrossFit
  • Cane
  • Injections with Hyaluronic Acid, Steroid, PRP Therapy, Stem Cell Therapy
  • TENS Unit

Arthritis Patients Opting For Joint Replacements

As a last resort, an orthopedic surgeon in  Mesa AZ may perform a joint replacement. For the hip and knee, these have been incredibly successful. But they should only be performed as an elective procedure after considerable conservative options have been tried. One of the most common forms of surgery when it comes to arthritis patients is joint replacement surgery, with hip and knee replacements being particularly popular among older patients.

Over 500,000 hip and knee replacements are performed annually in the US and it rises every year. Considered to be far more successful than any other surgery, joint replacements can last up to 20-30 years after which a revision surgery may be required.

[ File # csp9997688, License # 2179057 ] Licensed through http://www.canstockphoto.com in accordance with the End User License Agreement (http://www.canstockphoto.com/legal.php) (c) Can Stock Photo Inc. / Andreus

The Procedure

Total hip and knee replacement procedures take approximately two hours, and involve removal of the arthritic joint spaces. In their place, the orthopedic joint replacement doctor will implant a combination of plastic and metal for the new joint surfaces. Modern joint replacement procedures allow patients the ability to start walking the day after surgery with physical therapy assistance. Recovery takes approximately three months in total.

Outcomes

Overall, joint replacements have some of the best outcomes imaginable at 90% good to excellent. It is crucial for patients to participate in their post-surgical physical therapy regimen, as that is “half the battle.”

The Board Certified providers at OSPI offer expert joint replacement procedures for the hip and knee. Some can even be done as an outpatient depending on the patient’s baseline health. Most insurance is accepted at the practice, with physical therapy being offered at the office as well.

For the top hip and knee replacement doctors in Gilbert, Chandler and Mesa AZ, call OSPI today!

 

Are Orthopedic Knee Braces Helpful In Preventing Or Treating Injuries?

This has been a controversial topic for a very long time. On one hand, knee braces can be used and are suggested by most orthopedic surgeons to help in a variety of conditions and problems, but there’s still the question of “Do they really help?”; which needs to be answered.

There are two types of basic knee braces that your orthopedic surgeon might suggest depending on the situation; Functional and Prophylactic knee braces.knee brace

Functional Knee Braces

Patients who are already suffering from a ligament injury are the ones concerned about the effectiveness of knee braces. In such cases, they are usually interested in the functional knee brace type, because they are specially designed to support a torn knee ligament. This means the knee braces can prove beneficial if the patient’s already suffering from a ligament injury, as further confirmed by a number of studies done on the subject.

In summary; functional knee braces are fully able to provide at least some protection to the knee, particularly when force is applied. The studies done, further examined that the knee with the brace is more stable as compared to without it.

Prophylactic Knee Braces

Specifically designed to prevent knee injuries from happening in healthy athletes, these knee braces were first made available and highly popularized in the late 1970s when they were tried and tested by NFL players. Since then, use of prophylactic knee braces has only increased with the positive results shown by several studies, regarding the injury rate of athletes wearing the braces as compared those who don’t.

Although the difference isn’t questionably large, they do show that athletes of certain sports such as football; have a much lower rate of contraKnee Bracecting an MCL injury, when wearing the brace. Some important factors however, should be taken into account as well when determining the likelihood of injury, such as;

  • The sport played
  • The position of the player
  • The conditioning of the player
  • The size and weight of the player

At first; there was a huge concern with regard to usage of prophylactic knee braces. It was said that they could potentially alter the force on the knee which could very well become problematic. This isn’t the case at all, because when fitted and worn properly, they have shown to decrease the rate of ankle injuries.

OSPI offers bracing for clients for both types. This includes braces that are either custom made or potentially “off the shelf”. Insurance often covers them. Call OSPI today at (480) 899-4333.

When to Meet with a Gilbert Orthopedic Surgeon

Many people sustain a variety of injuries through regular wear and tear or through sports or even just through repetitive motions associated with hard work. In many cases regular inflammation and pain might just be circumstantial, something which results from regular use of your body. In other cases these small indicators might represent a much more serious condition, something which must be treated immediately.

Many people wonder when they should meet with an orthopedic surgeon. Meeting with a Hip Replacement PhoenixGilbert orthopedic surgeon should be something reserved for injuries which you have already diagnosed with your primary care physician and what you have already attempted to treat using nonsurgical methods. An orthopedic surgeon is a great person with whom to meet after you have exhausted all nonoperative methods of repair and treatment.

An orthopedic surgeon in Gilbert and Chandler is somebody who can help complete minor and major surgical procedures on your joints. If you have already exhausted all nonsurgical methods of treatment you can ask your primary care physician for a referral and meet with an orthopedic surgeon to discuss your situation and evaluate what options you now have it your disposal.

If you have torn your cartilage, your tendon, or suffer from other serious joint conditions it may be in your best interest to meet with an orthopedic surgeon. An orthopedic surgeon can resurface your joint or repair your joint using minor surgery such as arthroscopic surgeries. This type of surgical procedure involves a small incision in the affected area through which a tube is inserted. This tube has connected to a small camera which sends a live feed directly to the monitors in the operating room.

The Arizona orthopedic surgeon can use this to locate the damaged area and repair it immediately. In cases where you are referred to an orthopedic surgeon but the extent of the damage cannot be known at the time, an arthroscopic procedure can be used to first locate the site of the damage, the type of the damage, and the size of the damage, after which the surgeon can immediately repair the problem through a secondary incision.ospi_small

Prior to undergoing any surgical treatment for joint injuries you will of course have a consultation with the orthopedic surgeon so that you can review your current medical conditions and your medical history to determine if you qualify for certain procedures. The consultation is an excellent time to review which options you have your disposal given your particular situation and to discuss any potential problems you may encounter during your surgical processes.

OSPI is the top orthopedic practice in the East Valley, including Gilbert, Chandler, Mesa, Queen Creek and surrounding areas. Most insurance is accepted, call 480-899-4333 today!

Understanding Rotator Cuff Tendinitis – Info from OSPI

The rotator cuff is a grouping of four muscles and tendons attached to the inside of your shoulder joint. Together these muscles and tendons allow your shoulder to remain stable and to move inside of the shoulder joint.

So what is rotator cuff tendinitis?

Rotator cuff tendinitis is something that happens when the tendons inside of your rotator cuff become irritated. This irritation causes the lining of rotator cuff bursitisthe tendon to become inflamed. Normally this lining is very smooth and if it becomes inflamed it can lead to a significant torn tendon or muscle. When your tendon has been used too much or it becomes injured it can increase the chances of a torn tendon.

What usually happens is the soft tissues start to rub up against the bone of the shoulder. This leads to significant inflammation, swelling and pain.

What causes rotator cuff tendinitis?

Your shoulder joint is a ball and socket joint. This means that you have a socket and a ball inside of which your bones sit. The top part of the arm bone joins together with the shoulder blade. And the rotator cuff is what holds the top of your arm bone inside of your shoulder blade and is responsible for controlling your movement.

Tendinitis happens when the tendons inside of this area move underneath the bone while they are still attached to the top part of your arm. This can take place if your tendon becomes inflamed and it can also happen when they regularly move and fray over the bone. Each time this happens it causes significantly more fraying to the shoulder. If this happens enough you can lead to a bone spur developing inside of the small area. Regular bone spurs can lead to rotator cuff tendinitis.

Most often rotator cuff tendinitis is caused by playing sports where you have to move your arm regularly over your head. This can include movements such as pitching during baseball or tennis. But it can also because by work, if you have to regularly move your arms over your head for your job. Painting and carpentry or to such examples of jobs where this can take place. Even gardening can lead to tendinitis.

The common symptoms of rotator cuff tendinitis include mild pain when the arm is lifted above the head. When you try to reach for something over your head or you ospi_smallbrush your hair you might experience mild pain at the front part of your shoulder which travels to the side of your arm. This pain should stop before it reaches your elbow. But if the mild pain does not go away it can be an indication of something much more serious.

It is in cases like this that you should meet with our Gilbert orthopedic surgeon and discuss your options. In some cases you will have to work with a licensed physical therapist to help strengthen and naturally improve the muscles around your shoulder.

 

OSPI accepts most insurance plans, and offers several Board Certified sports medicine doctors who are experts in the treatment of rotator cuff tendinitis and tears. Call 480-899-4333 for more information and scheduling today with orthopedic surgeons Gilbert and Chandler trust!

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