The Experience of Knee Surgery

Sports medicine is a discipline where numbers count: how long does a shoulder procedure take? How many years does a patient have left on that ailing knee? But numbers alone cannot account for the whole experience of surgery, which is why I field a lot of questions about what orthopedic surgery feels like – before, during, and after the procedure.

This article offers a quick look at some of the experiences you can expect following orthopedic knee surgery. It includes common issues such as swelling and pain, and throws in some numbers about how long you should expect to be laid up. But the real meat of the piece is its emphasis on recovery as an active process:

We will initially focus on regaining your range of motion (ROM) and then strengthening you through your available ROM. Especially after a total knee replacement, you will want to gain full extension. Do not stay in bed all day, and more importantly do not lay with a pillow under your knees!

Many people want to rest after surgery, and there’s no question that sleep is an essential component of recovery. But to truly regain function and reclaim an active life, you will also need to get up frequently and work at your healing process.

To learn more about orthopedic knee surgery in San Diego, please contact our orthopedic surgeons today.

Orthopedic Hand and Wrist Surgery: Radial Nerve Injury

Hand and wrist injuries can be caused by trauma or repetitive stress. One of the most common wrist injuries, known as radial nerve injury, can arise from either or both origins, which is why you’ll need to speak with an experienced orthopedic surgeon to get a proper diagnosis and plan.

No matter what the culprit may be, the symptoms tend to be similar: wrist pain, tingling, numbness, and a sense of slackness or muscle fatigue in the fingers and hand. Although some of these complaints can be resolved with medicine or therapy, persistent discomfort may require wrist surgery. As this article explains, the process is straightforward:

This type of surgery will repair any damage to the nerve. After surgery, a brace or splint is necessary to allow the injury to heal. Your doctor will then refer you to a physical therapist for rehabilitation to restore range of motion and strength.

Planning and executing this kind of surgery requires many years of training and a deep understanding of the various biomechanics involved in the human wrist – including bone, nerve and muscle. To learn more and speak with an expert San Diego orthopedic surgeon today, contact AOSM.

Shoulder Surgery and the Elite Prognosis

This fall has brought news of local legend Kobe Bryant’s now-certain return to professional basketball. Those of you following closely may be aware that Kobe has been slumping for some time now, and that whispers of retirement have grown louder in recent years. Add to this a mounting series of sports injuries both major and minor, and there was legitimate reason to question whether he would ever play again.

We can put those to bed. Kobe is back and planning to play all season. One interesting wrinkle for me as an orthopedic surgeon: Kobe has made a fast and, by all accounts, complete recovery following shoulder surgery earlier this year:

Kobe Bryant missed most of last season after undergoing surgery to repair his torn rotator cuff. This surgery forced Bryant to refrain from any basketball activities for nine months.

Progressing right on schedule, the Los Angeles Lakers star recently returned to the court to work on his shooting for the first time since his shoulder surgery.

It’s always encouraging to see the fruits of orthopedic surgery writ large in one of the major sports stories of our time, and especially gratifying to watch elite athletes show the world that steady dedication and rehabilitation can restore full motion and comfort to an injured rotator cuff within a few short months.

If you are experiencing shoulder pain, shoulder discomfort or limited shoulder mobility, it may be time to visit your local orthopedic surgeon. Call the shoulder surgery experts today.

The Facts on Tennis Elbow Surgery

Tennis elbow: it’s not just for tennis anymore. Many people who visit my San Diego orthopedic surgery practice with this diagnosis express some confusion over the name, especially if they don’t spend any time volleying balls on the court.

In fact the name “tennis elbow” can refer to a variety of ailments related to repetitive arm movements. Chopping, swinging, even certain musical instrument motions may result in the soreness and inflammation which define the disorder.

So what can be done for tennis elbow? This NIH page describes the more common approach:

If you have open surgery, your surgeon will make one cut (incision) over your injured tendon. The unhealthy part of the tendon is scraped away. The surgeon may repair the tendon using something called a suture anchor. Or, it may be stitched to other tendons. When the surgery is over, the cut is closed with stitches.

But many orthopedic specialists offer arthroscopic surgery as well:

The surgeon makes 1 or 2 small cuts, and inserts the scope. The scope is attached to a video monitor. This helps your surgeon see inside the elbow area. The surgeon scrapes away the unhealthy part of the tendon.

No matter what the cause and which procedure you require, my San Diego elbow surgery practice ensures you get the standard in diagnostic and surgical care. To learn more, feel free to call us here.

Shoulder Pain 101

Shoulder pain is common, but that doesn’t mean that it is welcome or harmless. Many active people experience some pain in the shoulder following hard lifting, vigorous exercise, or injury. Typically this pain will resolve on its own, but some deeper injuries come with persistent pain that never seems to improve.

This article lays out a nice tiered primer on shoulder pain, including when it can be ignored, when it must be treated, and when shoulder surgery is the most viable option. This passage gets to the heart of diagnosing chronic pain:

Pain at night or pain not improving with therapy after 4 weeks are red flags. Pain radiating down the arm or up to the neck or to the back are also worrisome for injuries not just in the shoulder but sometimes of the neck. These injuries need to be worked up with careful physical exams, x-rays and MRIs. A full tear of the rotator cuff often will present with night pain, since when you roll over you push the arm up into the socket through the rotator cuff tear. Pain radiating down the arm or up to the neck can sometimes be from the discs in the neck or the nerves at the front of the shoulder called the brachial plexus [12]. Instability of the shoulder, with the shoulder popping in or out of the joint is another area that is best treated with early repair of the torn ligaments.

As a San Diego orthopedic surgeon who specializes in shoulder pain, I offer a wide suite of surgical options for patients who can no longer tolerate the agony of restricted motion and shoulder discomfort at play and at rest.

If you’d like to schedule your own sports medicine exam today, contact the shoulder pain experts at AOSM.

Shoulder Surgery and Olympic Dreams

Few American Olympic athletes are more decorated or better known than Kerri Walsh Jennings, one half of a beach volleyball duo that has consistently bested the world’s stars over many years.

Although Ms. Walsh Jennings is a superlative athlete, constant impacts with hard sand and the slow stress of daily conditioning have left their mark: she has undergone shoulder surgery several times to repair cartilage and tendons strained from overuse.

Now the Los Angeles Times has announced that she is set for one more procedure:

The three-time Olympic gold medalist will have surgery Thursday to repair a torn labrum and torn capsule in her right shoulder, she told the Los Angeles Times.

Walsh Jennings will miss the remainder of beach volleyball tour events domestically and abroad in 2015, and is aiming to make it back to competition in mid-March.

Volleyball is a sport where strain falls upon the shoulder almost exclusively; beach volleyball is especially notorious for its hard landings. It is a testament to the effectiveness of modern shoulder surgery that Walsh Jennings continues to compete on the world’s biggest stage, and that she plans to return to that stage once again in the spring.

I treat world class athletes on a regular basis in my offices, and applaud the extraordinary dedication of Olympians like Kerri Walsh Jennings. If you’re looking for the standard in San Diego Shoulder surgery, please contact the AOSM offices today.

Better Imaging for Pediatric Elbow Pain

Elbow pain is a common complaints among young athletes , especially those who get involved in rigorous sports. Although many of these complaints arise from chronic overuse, some elbow pain originate with an injury on the field, the court, or in the gym.

In my field of orthopedic surgery, imaging remains the key to successful intervention. Properly visualizing and diagnosing elbow pain is essential element of orthopedic care, and the only way to ensure your surgeon can work effectively to relieve the pain.

This recent article looked at the rapidly evolving landscape for imaging and understanding elbow pain, covering everything from radiography to sonography, CT and MRI. Issues under review include tennis elbow, pitcher’s elbow, golf elbow and cubital tunnel.

The conclusion comes with a solid guide:

Imaging plays an important role in the evaluation of athletes with elbow soft tissue and/or osseous trauma. Tendinosis and tendon tears of the common extensor tendon origin occurring in tennis players are far more common than injuries involving the common flexor-pronator tendon origin of golfers and pitchers. Concomitant lateral and medial collateral ligament injuries should be sought with MR imaging or sonography in patients with recalcitrant elbow pain in order to address underlying sources of instability.

If you’ve been having chronic elbow pain in San Diego and want to speak with an expert orthopedic surgeon today, please contact my offices for a full diagnostic visit.

Labral Tears and Shoulder Pain

At AOSM, we assist patients with a wide variety of shoulder injuries and shoulder pain. Typically when we write about these injuries, we list the most common culprits and assure you that they can be resolved surgically if necessary. But sometimes I like to drill down and take a closer look at a single shoulder injury, offering a guide to how it happens and how it may improve.

Labral tears are some of the most frequent injuries in sports. When someone falls on an arm and overextends a shoulder, or catches herself in a sudden overhead reaching motion, a tear may result in the tissue surrounding the shoulder socket. This page includes some basic symptoms you’ll want to watch out for, including:

  • Pain, usually with overhead activities
  • Catching, locking, popping, or grinding
  • Occasional night pain or pain with daily activities
  • A sense of instability in the shoulder
  • Decreased range of motion
  • Loss of strength

Labral tears are revealed through CT or MRI scans, and may require surgery if the trauma is too great to recover on its own. Arthroscopic shoulder surgery is the preferred means of correcting the tear, typically through removing the torn flap and repairing any tendons which have grown unstable.

It is a familiar procedure which comes with a high success rate: many patients are able to return to their normal lives within a few months. My San Diego orthopedic surgery practice specializes in labral tear surgery and a variety of cutting edge interventions for chronic shoulder pain. To learn more, please call or write us today.

Knee Surgery Continues to Advance

The field of orthopedic knee surgery covers everything from minimally invasive arthroscopic techniques to total knee replacements. Although the majority of procedures we see at my San Diego orthopedic practice fall into the less invasive category, some edge cases will always require more involved interventions.

That’s why we are always monitoring the latest techniques and advances in knee surgery. Although the most common procedures are by now well known and considered safe, innovations continue to develop to cut down on recovery and rehabilitation. Case in point: a new artificial knee that has some patients back to work the very same day.

Of course there are always caveats, and not every candidate will respond in precisely the same way:

Professor Wilkinson adds that the success of a knee replacement also depends on many other factors, including age, weight, how active a person is and their attitude to post- rehabilitation therapy.

We are experienced in total knee replacement procedures, and proud to help many athletes, adults and children regain mobility after a serious injury. If you’re suffering with knee pain and want to learn about the vanguard in orthopedic knee surgery, contact my San Diego practice here today.

Unseen Risks for Knee Surgery?

Some of our patients have expressed concern in recent days over this study, which found a correlation between orthopedic knee surgery and in increased risk of heart attack down the line.

Although the scare headlines may sound alarming, the truth is more mundane: the study is an observational one, meaning that it was completed without controls or placebos. Although scientists may yield some valuable insights from studies like these, in general they tend to be considerably less reliable than randomized studies.

In this case the observed correlation between knee surgery and later health issues could be due to factors that simply lie beyond the study’s scope, including that many people who require knee replacements already exhibit a higher risk for health issues across the board.

Of course we cannot ignore correlations even if they aren’t directly causal, and this one rightly points toward the value of asiduous follow up care and rehabilitation. Knee surgery is no trivial thing, and the risk of clots and venous thromboemboli are typically higher after any kind of surgery.

To learn more about knee surgery and how we can help you restore a more normal life, contact the San Diego knee surgery professionals at AOSM.