Urgent Orthopedic Injuries

While some orthopedic injuries can heal on their own, others require urgent treatment. Such injuries and problems include:

  • Cuts and lacerations
  • Fractures
  • Ligament tears
  • Painful, swollen joints
  • Pediatric injuries
  • Sports injuries
  • Sprains, strains, and discolorations

Orthopedic Injuries that should be urgently treated by an orthopedic doctor or surgeon –

Any injury or condition that can prove serious or life-threatening should be treated at a hospital ER, such as –

  • arm or leg is severely fractured and/or out of alignment
  • bone is fractured and exposed through the skin
  • significant blood loss has occurred
  • other injuries from falls or accidents are present
  • severely injured children

Children who require urgent orthopedic care include:

  • children with a fractured bone, are experiencing pain and/or are irritable, despite treatment and medication. Any pain, swelling, redness, tenderness at a site or injury that has been treated may also require urgent medical attention.
  • children who have no obvious symptoms of an injury but is crying, restless, feverish, and unable to walk. This could indicate a serious hip joint infection.
  • children with large, deep cuts or wounds
  • children with positional deformities of the limbs

To learn more about orthopedic injuries and treatments, call the top orthopedic surgeon in Gilbert, AZ, call OSPI Arizona at 480-899-4333. OSPI’s Board Certified orthopedic surgeons offer complete care and treatment for individuals in all stages of life, participating in all levels of activity. This includes orthopedic, physical therapy, chiropractic, medical weight loss, hormone replacement, performance training, pain management, podiatry, regenerative medicine, stem cell therapy and family practice.

Do Vestibular Disorders Go Away With Manual Lymphatic Drainage?

The vestibular sensory organs in our inner ear, the cochlea, and the semicircular canals are responsible for our balance and proprioception/position. When these organs are damaged with disease or injury, it can lead to dizziness, vertigo, balance problems, and other symptoms. These can be transient as people are able to recover after a few weeks of normal activity due to vestibular compensation. Conversely, the symptoms can be lasting, affecting a person’s ability to maintain posture and balance.

 

A person with a vestibular disorder may have difficulty in maintaining balance and may adopt an exaggerated hip sway, swivel the entire body while keeping the head still when turning to look at something, or always look down to avoid a confusing swirl of activity. Ironically, these mannerisms can worsen the vestibular symptoms and often cause headaches, muscle tension, and fatigue.
Meniere’s disease is the most common vestibular disorder this procedure is considered for

Endolymphatic sac decompression is a procedure that involves draining of the excessive endolymph from its sac in order to decompress it. It is sometimes indicated for Ménière’s disease or secondary endolymphatic hydrops to relieve endolymphatic pressure in the cochlea and vestibular system. Meniere’s disease is the most common vestibular disorder this procedure is considered for. It is characterized by vertigo, tinnitus, hearing loss, imbalance and a feeling of pressure deep inside the ear. While there are several treatment options for it, including betahistine, cyclizine, steroid injections, and gentamicin injections, but endolymphatic sac decompression is considered for refractory cases.

 

There are multiple ways to perform this procedure. One method involves removing the mastoid bone surrounding the endolymphatic sac and allowing the sac to decompress. Alternatively, a shunt may be placed into the endolymphatic sac so that the excess fluid can drain out into the mastoid cavity.

Endolymphatic sac decompression is performed as an outpatient procedure. During the procedure, an incision is made behind the ear and the mastoid bone is exposed. The bone is fragmented to reveal the endolymphatic sac and a hole is cut into the outer layer of the sac using a laser. A shunt is then inserted into the sac and the incision is closed. The procedure takes approximately 90 minutes and is performed under general anesthesia. If there are no adverse events, the patient is discharged an hour later. Most patients return to work the day after surgery. The patient’s hearing gradually improves in the ensuing few weeks and then returns to normal.

Endolymphatic sac decompression has proven to be an effective treatment for patients with Meniere’s disease with vertigo and light-to-moderate hearing loss. In a recent study published in JAMA, endolymphatic sac surgery provided an improvement in major spells of vertigo in 77% of patients at 24 months after surgery. Furthermore, revision surgery provided an improvement in 65% of cases, especially those with recurrent symptoms more than 24 months after their original procedure.

Symptoms of an ACL Injury

The ACL or Anterior Cruciate Ligament connects the bottom of the thigh bone or femur to the top of the shin bone or tibia. It is one of the four knee ligaments that keep the knee stable and prevent rotational stress. ACL is the weakest of these four ligaments and can get torn when subject to excessive stress.

ACL injuries are common among athletes and active individuals, especially during sports that involve sudden halts and changes in direction, such as basketball and soccer.

Symptoms of an ACL injury

  • “Popping” or a “clicking” sensation in the knee
  • Severe pain
  • Inability to continue activity
  • Swelling within a few hours
  • Loss of range of motion
  • Feeling of instability

Treatment for ACL Injury

To avoid more damage, such as meniscus tears and degenerative joint disease, reconstructive ACL surgery is done. Such surgery also provides stability and function in the knee. Your surgeon may use the repair tissue from your own hamstring (autograft) or from a cadaver (allograft).

Prevention of ACL Injuries

You can reduce the chances of an ACL injury with adequate warm up before activity, training drills to improve power and agility and by improving balance.

Sports medicine doctors now offer regenerative medicine options such as PRP therapy and stem cell treatments to treat conditions involving the shoulder, elbow, hip and knee.

To learn more about regenerative medicine treatments, such as PRP therapy, call the best orthopedic and knee replacement doctors in Gilbert, AZ, call OSPI Arizona at 480-899-4333. OSPI’s Board Certified orthopedic surgeons have extensive experience and expertise in sports medicine, general orthopedics and joint replacement surgery.

Grade I Hamstring Strain

Hamstrings are the three muscles at the back of the thigh. They traverse between the hip and the knee and are named semimembranosus, semitendinosus and biceps femoris. They are involved in bending the knee., tipping the pelvis back when you lean backwards, and twisting the knee when the knee is bent.

 

A hamstring injury ranges from a strain to a muscle tear.
There are three grades of hamstring injury:

  • Grade I: a mild muscle strain
  • Grade II: a partial muscle tear.
  • Grade III: a complete muscle tear or tear of an attachment.

 

Grade I injury may take a few days to heal but a grade III injury can take months. We’ll focus on grade I hamstring injury in this article.

The best way to avoid hamstring injury is to spend time working on your hamstring strength

Grade I Hamstring injuries are very common in sports, especially those that involve sprinting, suddenly stopping and changing direction, and jumping. These include football, rugby, baseball and track running. They typically happen at the end of the swing phase of running, just before the outstretched leg touches the ground, as it is at this point that the hamstring muscles have to suddenly contract to bend the knee.

 

There are multiple predisposing factors for hamstring injury, such as:

 

  • Weak hamstrings – if they are not toned up and strong enough to handle the stress, they are more likely to get injured.
  • Lack of warm-up before exertion – Hamstring muscles are less likely to be injured when they are warmed up through brief stretching/contracting exercises. Keeping the legs warm with suitable clothing while warming up also helps a lot.
  • Tiredness – if the muscle is fatigued, it is more likely to get injured. Having good fitness overall helps.
  • Previous hamstring injury – You are much more likely to have a hamstring injury if you have had a previous one.
  • Older age – you are more likely to have a hamstring injury as you get older.

 

Interestingly, being overweight is not thought to be a risk factor for a hamstring injury.

The best way to avoid hamstring injury is to spend time working on your hamstring strength. A highly trained sportsperson will tend to do this as part of their training but anybody looking to do any activities that involve these muscles is probe to grade I hamstring injury and needs to warm up as well.

There are various approaches to hamstring rehabilitation, with varying times of immobilization to the type of exercise. The goal of any hamstring rehabilitation (especially so in cases of sportspersons) is to return to the previous level of performance while attempting to minimize the rate of injury recurrence. It has been shown that Grade I (and even II) hamstring strains can be aggressively treated with brief immobilization followed by early initiation of running and isokinetic exercises. This is likely to lead to early recovery of function and a relatively low reinjury rate.

Microfracture of the Knee – Recovery & Outcomes

Microfracture is a simple but cost-effective procedure performed to treat smaller cartilage injuries. It is not used to address defects with damage to the underlying bone. It also cannot be used to treat widespread arthritis in a joint. But it is an excellent choice as an initial treatment of smaller articular cartilage injuries.

 

Recovery process

After the microfracture repair of the knee, the post-operative recovery period is fairly complication-free. After the procedure has been performed in the patella and the trochlear groove, there will likely be mild transient pain or “gritty” sensation. The pain resolves sooner but the gritty sensation typically resolves with a few weeks. Patients may notice “catching” as the ridge of the patella rides over this area during joint motion. This may be apparent during continuous passive motion machine (CPM). If it is also painful, it is best to limit weight bearing; it should resolve within 3 months. Any residual swelling and joint effusion disappears within 8 weeks after microfracture. Sometimes, there is a recurrent effusion between 6 to 8 weeks after surgery but it is usually painless and typically resolves within several weeks.

 

Rehabilitation

The rehabilitation process is vital to the long-term success and functional outcome of these patients. Postoperative rehabilitation programs for microfracture procedures vary greatly based on lesion size, depth, location, quality of tissue, patient age, BMI, general health, and surgical details. Thus, the appropriate rehabilitation program must be highly individualized to ensure successful outcomes. The goal of rehabilitation is to restore full function in the shortest time possible without overloading the healing articular cartilage. It is imperative to create a healing environment while avoiding deleterious forces that may overload the healing tissue.

The pain resolves sooner but the gritty sensation typically resolves with a few weeks

Paste grafting

In order for microfracture to work consistently, the healing tissue must be stimulated to form cartilage rapidly and durably. The progenitor/stem cells and bone paste can be added to a super microfracture of the lesion in a technique called Paste grafting. The healing process can be augmented by injections of growth factors and hyaluronic acid lubrication injections during the healing period.

 

Outcomes

The studies are showing mid-term and long-term success for microfracture in the knee. Multisite microfracture was seen to have poorer outcomes. This is likely because multiple cartilage injuries are indicative of a more advanced disease process. It has been found that patients younger than 45 years had significantly improved outcomes after microfracture as compared with those older than 45 years. Patient age and BMI have been found to be significant predictors of postoperative improvement after microfracture.

 

Overall, presence of a single cartilage lesion, lower BMI, or being a male has been found to result in greater functional improvement after microfracture. Moreover, larger defects (>3.6 sq.cm) and prior surgery were both independent predictors for future surgery after microfracture.

5 Effective Ways to Prevent Knee Replacement Surgery

The knee is the largest and one of the most complex joints in the body. However, it also endures the most stress and damage.

Fortunately, there are several ways to avoid knee surgery and prevent knee joint damage.

Weight Loss and Exercise

Losing extra weight can relieve the excess pressure on your knees. Weight loss can also reduce inflammation and boost the immune system. Regular exercise provides a variety of health benefits, including strong and flexible muscles.

Physical Therapy

Physical therapy can prevent degeneration or manage your existing knee condition. It can improve mobility and joint function, reduce pain and prevent more damage.

Arthroscopic Surgery

Arthroscopic surgery is a minimally invasive procedure in which a small camera is used to look inside the damaged knee joint, make small incisions and repair the knee. Arthroscopic surgery is less painful with a shorter recovery time.

Knee Osteotomy

A knee osteotomy refers to surgery involving removal or addition of a piece of bone to the thigh or shin bone. This can be done to re-distribute the weight such that pressure is shifted off the knee.

Platelet-rich Plasma (PRP) Injection

PRP refers to Platelet Rich Plasma. The PRP therapy is a regenerative medicine treatment that uses platelets from the patient’s own blood to allow the damaged joint to heal and increase mobility. It is a non-invasive procedure with brief recovery time and barely any risk of infection or rejection.

Consult your knee doctor before exploring any alternatives to total knee replacement surgery. To learn more about the best knee replacement doctors and PRP therapy specialists, call OSPI Arizona at 480-899-4333. OSPI’s Board Certified orthopedic surgeons have extensive experience and expertise in sports medicine, general orthopedics and joint replacement surgery.

Stem Cell Therapy for Dementia

Stem cells are undifferentiated cells of a multicellular organism that is capable of giving rise to indefinitely more cells of the same type, and from which certain other kinds of cell arise by differentiation. There are a number of diseases were harvested stem cells can be used therapeutically to repair damaged or lost cells. They have been used for joint repair and wound healing.

 

Signs and symptoms of dementia vary from patient to patient and there is a wide spectrum of clinical severity and associated conditions. Cognitive changes include memory loss, confusion, difficulties with language, communication, finding the right words, reasoning, solving problems, dealing with complicated tasks, organizing, and planning, etc. Furthermore, it can cause depression, personality changes, anxiety, paranoia, hallucinations etc.

Dementia is the next frontier for stem cell therapy. The medical community is now turning to stem cell therapy how it can treat dementia and Alzheimer’s. Dementia may be defined as a loss of cognitive or intellectual function. The most common type of dementia is Alzheimer’s disease. At present, there is no cure for it.

 

In the 90’s, it was discovered that stem cells exist in certain areas of the brain and that they constantly divide, producing new cells. This led to the research that focused on differentiating these from ordinary brain cells and studying how stem cells in the brain are regulated so that they can be stimulated to become the kind of nerve cells needed in the brain.

 

Patients with Alzheimer’s disease lack the stem cells as compared to those with healthy brains, but stem cells nevertheless do exist inside their brains as well. The reduction of stem cells is believed to be due to plaque formation in the brain and the cells.  There are now experimental drugs that stimulate stem cells to produce more nerve cells in animal models with Alzheimer’s. This causes stem cells to create nerve cells when introduced into the diseased brain. This result was shown to cause improvement in behaviors and memory testing in the animals. This is an exciting development as it can translate into successful therapies in humans as well.

 

Majority of so-called “regenerative medicine clinics” in the world aren’t dispensing safe and effective stem cell therapies. It is very important to differentiate between them and state-of-the-art treatment centers that base their therapeutic services on the latest research and use safe means of delivering these treatments. We have the most advanced stem cell procedures available today. We have highly trained and experienced, board-certified doctors and staff who are experienced and professionally trained in performing stem cell procedures. Moreover, we use only the most potent resources of viable stem cells that are harvested on the same day for procedures. We provide excellent post-procedural rehabilitation, diet and supplement protocols to improve the likelihood of success.

What are the Alternatives to Knee Surgery?

Chronic knee pain doesn’t always equal knee replacement surgery. Modern medicine offers several new, non-invasive and minimally invasive treatment options to manage knee pain and improve quality of life for patients with knee injuries and degenerative knee conditions.

Read on to learn more about alternatives to knee surgery.

Pain Management
Whether your knee pain is the result of a simple injury or a chronic degenerative condition, minimally invasive pain management options can help you achieve long term pain relief. The treatment options include steroid injections, hyaluronic injections, anti-inflammatory medications and more.

Regenerative Medicine

Regenerative treatments focus on stimulating natural healing in tissues such that it can regenerate and eliminate pain caused by damage to those tissues. For instance, stem cell and PRP treatments can relieve a wide range of problems and pain related to tendon, ligament, muscle, and bone damage.

Physical Therapy

Physical therapy can reduce pain and stiffness, as well as improve functional ability and endurance. Physical therapy is usually included in a comprehensive treatment program your doctor would design for your specific condition.

Bracing

Orthopedic knee bracing is prescribed to reduce pain and enhance movement. However, bracing in an ACL injury would be different from the one for an MCL injury. Only an experienced knee doctor would ensure that you receive the right brace for your specific knee problem, level of activity, and prescribed treatment.

You do not have to fear a knee replacement surgery, if you have been experiencing knee pain. There are many cutting edge, non-invasive treatments that can eliminate pain and improve your quality of life.
To learn more or to consult the best knee and shoulder doctor in Gilbert, AZ, call OSPI at 480-899-4333 Now!

How can PRP Therapy Heal my Orthopedic Injury?

PRP or Platelet Rich Plasma is simply blood plasma, rich in platelets. Human blood consists of plasma, red blood cells, white blood cells, and platelets. The role of platelets is to aid blood clotting in the event of an injury. However, platelets also contain hundreds of granules of growth factors and cytokines that help in healing. Many growth factors contained in these granules aid building new connective tissue, creating new blood vessels, other calling other cells that help healing, and reducing inflammation.

PRP is created by centrifuging or spinning a sample of your own blood to get concentrated platelets (3-5 times that present in blood) in a small volume. This concentrated plasma or PRP is a powerful healing product with multiple growth factors and cytokines.

PRP has been used to help healing of various orthopedic injuries, especially –

  • chronic tendon injuries, for example, tennis elbow
  • acute soft tissue injuries, for example hamstring tears
  • arthritis
  • surgical augmentation

Benefits of PRP Therapy

3 biggest benefits of PRP therapy are –

  • PRP comes from your own body and uses your body’s own natural healing ability for healing and pain relief
  • PRP can be administered with an injection under ultrasound or fluoroscopic guidance
  • PRP has the potential to return you to activity in a short time without surgery. This is beneficial in terms of not only shortened recovery, but also in terms of avoiding the high costs of surgery and missed time off work.

To learn more about regenerative medicine treatments, such as PRP therapy in Gilbert, AZ, call OSPI Arizona at 480-899-4333. OSPI’s Board Certified orthopedic surgeons have extensive experience and expertise in sports medicine, general orthopedics and joint replacement surgery.

Factors and Different Treatments for the Dreaded Scoliosis

Scoliosis is a condition that causes the spine to curve forming a “C” or “S” shape. The curved spine can irritate and stretch nerves, strain joints comprised of two bones, affect the posture, and make muscles fatigued. It causes pressure on the disks between the spinal vertebrae making them inefficient shock absorbers and causes strain with pressure on facet joints of the spine. The cause is unknown and there is no cure. Managing symptoms associated with the condition is the main course of treatment.

 

The single worst symptom is pain. The condition impacts quality of life and is a long-term disability. The curve is not usually painful but when changes cause it to become painful, it is debilitating. For some patients, over-the-counter medication helps them cope with the pain and discomfort, while others require stronger pain relievers that are taken several times a day. Pain is individualized and each person perceives it differently. Pain medications are not a long-term solution because they have no impact on the source of the pain.

 

There are several factors that affect how well the nerves work to decrease pain. These factors are:

  • Genes
  • Environment
  • Medication
  • Personal beliefs or perception

Surgical intervention is generally recommended when the curve is greater than 40-degrees

The most common pain is due to muscle strain as the individual tries to compensate for the curve while completing activities of daily living. (getting dressed, taking a bath, cleaning…)

The basic treatments for muscle strain include over-the-counter pain relievers, hot packs, cold compresses for inflammation, and rest. Often a brace is worn but can be uncomfortable and burdensome. Surgical intervention depends on the progression of the condition.

 

Finding appropriate treatment(s) begin with:

  • Talking to your healthcare provider
  • Participating in alternative therapies
  • Wearing a brace for support, if able to tolerate
  • Possible surgical intervention

 

Physical Therapy can help with pain management by incorporating exercises to improve back strength and flexibility. Stretching often is recommended. If an activity causes increased pain, stop doing it and rest. Other recommended therapies and programs include Pilates and Yoga to promote balance, develop deep and superficial muscles, and relax the mind.

 

Other treatments and therapies that can help alleviate pain and improve coping skills include:

  • Chiropractics
  • Massage Therapy
  • Acupuncture
  • Hydrotherapy
  • Steroid or Anesthetic Injections
  • Counseling
  • Surgical spinal fusion

Counseling can include Cognitive Behavioral Therapy (CBT). Cognitive Behavioral Therapy allows a counselor and patient to identify ways to manage and cope with pain and limitations. It can help the individual to overcome beliefs or behaviors that aggravate or cause more spinal damage and leads to the identifying techniques, like meditation, that help with mental ability to deal with pain (coping skills).

 

Surgical intervention is generally recommended when the curve is greater than 40-degrees. It is done to ensure the curving stops. Without surgery, the spinal curve would continue to increase by 1-2 degrees annually. But surgery has risks, so alternative therapies are recommended first.

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