Orthopedic Knee Surgery: How Much is Too Much?

Knee replacement surgery is one of the more involved procedures in any orthopedic surgeon’s schedule. It is neither minimally invasive nor easily recoverable, and is typically reserved for cases when wear or damage proves insurmountable.

But as intense as the procedure is, some proponents have begun calling for double knee replacements on occasion, a procedure known as simultaneous bilateral knee replacement. It is the subject of much disagreement:

A study in May in the Journal of Arthroplasty compared cases matched for risks in simultaneous bilateral and unilateral knee surgeries in a database of nearly 44,000 patients. It found no significant difference in the rate of complications including infection, hospital re-admission, or death. But bilateral procedures were associated with increased overall complications and risk of subsequent surgery within 30 days.

Each side has a point, of course. If a patient is likely to replace the second knee anyway and endure many months of rehab, there is no question that it’s more efficient to combine both procedures into a single hospital stay. On the other hand, a second, separate surgery doubles all the risks we associate with orthopedic surgery, inducing the chance of infection, blood clots, and other complications.

The only sure way to determine which approach is right for you is to speak with the best orthopedic surgeons in San Diego. Contact my offices to set up your appointment today.

Diagnosing Elbow Pain and Shoulder Pain in San Diego

One of my jobs as an expert in orthopedic surgery is to work with athletes to understand the source of their pain. Pain is a natural byproduct of playing hard, of course, and most people expect a little soreness after a particularly rigorous day on the field, court or pitch.

But how can you tell when typical soreness has graduated to something that may require a medical or surgical intervention?

This article address this fundamental question, exploring the sources of each pain type to help patients better assess when they may have a significant problem on their hands. Money quote:

Pain that does not go away with rest is not normal. Pain that begins to affect your function outside of sports, such as walking or sleeping, is not normal. Pain that is constant or increasing over time and does not go away is not normal. Pain that does not improve with treatment may be something to be concerned about. Pain that requires increasing amounts of pain medication over time is not normal, and you should consider seeing a physician. Pain that begins to wake you from your sleep is also a concern, especially if it increases over time.

The good news is that every pain has a cause, and every cause can be addressed through a combination of medical care and surgical intervention. My San Diego orthopedic surgery practice offers excellent care for elbow pain, shoulder pain, and knee pain, as well as holistic care for your entire active lifestyle.

To learn more or set up an appointment, reach out to the pain experts today.

Never Too Late for Shoulder Surgery: An NBA Case Study

Pro basketball players face an unlikely combination of struggles: their exceptional height means they have longer limbs which experience greater torsional forces, and they spend half their athletic lives leaping and extending those limbs as far as they can go.

The result is often undue wear and tear on the back and shoulders.

So it is perhaps no surprise that Chicago Bulls legend Scottie Pippen recently posted this photo, alerting fans and friends that he has succumbed to the pain at long last, and begun taking active steps to restore comfort and mobility in his shoulder:

As the accompanying squib says, “It’s no surprise that the wear and tear of 1,386 games is beginning to take effect.”

Professional athletes aren’t the only people who report increasing shoulder pain as they age. At my orthopedic surgery practice here in San Diego, I see many hundreds of people who struggle with shoulder pain each year. When rest and rehab no longer do the trick, it may be time for orthopedic shoulder surgery.

Exercising Through the Pain: An Orthopedic Surgeon’s Perspective

The old advice about resting up after an injury has largely been discarded by now, replaced by a more robust set of guidelines designed to maintain flexibility and bone mass. No longer do athletes spend a few months convalescing after a knee or shoulder injury; in many cases they are back to rehab and exercise within a matter of days.

But every injury has its own origins, and sometimes the worst mistake you can make is to go too fast too soon. Comprehensive advice is needed for active people who want to stay strong without injuring themselves. This article provides a nice start.

Along with some good exercise recommendations for the knee, back and wrist, it includes this sane paragraph on what to do when you are experiencing chronic shoulder pain:

“Concentrate on upper back and scapula exercises,” says Edmond Cleeman, a surgeon at Manhattan Orthopedic & Sports Medicine Group who specializes in knees and shoulders. “Most concentrate on just chest and arms. Upper back muscles are critical as they control the scapula—which is part of the shoulder! So: Do machine rows, single arm dumbbell rows, reverse flys, TRX, and avoid pull-ups—they can aggravate the shoulder.”

And if you want an even more complete treatment and recovery plan for shoulder pain in San Diego? Contact my offices here.