Month: March 2016

How Long Does It Take to Recover from Pediatric Orthopedic Surgery?

A lot has been written about what adults can expect from orthopedic surgery procedures in the way of recovery and mobility. Most 60-year-olds headed in for hip surgery or knee surgery become capable autodidacts, scanning the Web for information about prognosis and aftercare.

Not so for younger patients, whose parents are often left in a state of confusion about the most common surgical procedures, and how these procedures may impact young lives.

Which is why this web page is long overdue; released by the American Academy of Orthopaedic Surgeons, it details the average recovery times for some of the most frequent procedures in pediatric orthopedics:

1. Supracondylar fracture pinning: Six days
2. ACL reconstruction: Six days
3. Arthroscopic partial meniscectomy: Six days
4. Spinal fusion for adolescent idiopathic scoliosis: 42 days
5. Both-Bone forearm fracture fixation: Four days
6. Arthroscopic shoulder surgery: Six days
7. Hip arthroscopy for hip impingement: 10 days
8. Limb length discrepancy correction: Nine days
9. Slipped capital femoral epiphysis: 9.5 days
10. Femur fracture fixation: 13 days

Clip and save this list, but do not assume its figures are gospel. Every patient is different, and each child heals differently from major orthopedic surgery. The best way to learn your options and foretell the future is by speaking with an expert San Diego orthopedist in person.

Orthopedic Surgery: An Evolving Field

There are fewer female orthopedists than there are male orthopedists in the U.S. Some in our field believe the reasons run deeper than the simple structural issues which affect the med school pipeline. One oft-cited explanation, for instance, is that practicing orthopedic surgery takes considerable strength:

“If you think about orthopedics, you think about hip and knee replacements, spine surgery, trauma, and some of those are bigger cases,“ says Kristy Weber, chief of Orthopaedic Oncology at the Perelman School of Medicine (PSOM). . . “Some of my work is physically significant, tiring I suppose, but I’ve never had a case where I felt that I wasn’t strong enough—and I’m not even that strong.”

Indeed, strength alone cannot possibly explain a 6:1 disparity, nor can it explain the great number of male orthopedists who are too old, weak, or injured to brace their full body weight against a stubborn hip flexor, yet somehow maintain a thriving practice.

The issue is almost certainly related to professional inertia, which is both good and bad. Good because inertia can be overcome with time, but bad because it suggests a deeply embedded issue:

The dearth of female residents correlates, of course, with the dearth of female orthopedic surgeons: Studies have shown the opportunity for same-sex role models to be a critical factor in women’s decisions about where to train and work, so if female medical students don’t see women in a specialty, they are less likely to pursue it themselves. Given that the threshold of visibility is 30 percent, the 5 percent of orthopedic surgeons who are women are not collectively visible enough to attract a critical mass of female residents.

As we move toward equity in our field as in medicine as a whole, I am encouraged to imagine of the emergence of true meritocracy, where the best orthopedic surgeons in San Diego rise to the top because of talent and experience alone.

Can a Synthetic Meniscus Help Me?

One of the wonderful things about working as a sports medicine specialist is the sheer speed of progress in our field. As surgical procedures for knee pain have grown steadily less invasive and more effective, more patients have benefited from these advances.

But when developments such as this one come along, they inevitably upend the order once again.

Chronic knee pain is a common issue in adults as well as young athletes. In many cases the pain can be traced to wear and tear on the meniscus, a disc-like structure which cushions the bones within your knee. Replacing this cushion has always been a fraught procedure, with wildly varying results. But now a new technology aims to address some of the more common complications by using a synthetic material. It is…

…a new meniscus implant made of a special medical grade plastic. Studies in Europe have been promising. “We put this implant in which is relatively stable and the patient gets up and puts full weight on it right away,” says Dr. McKeon. “And if it doesn’t work, I don’t burn bridges. I can take it out,” he adds.

Innovations such as this are the lifeblood of American orthopedic and sports medicine, and they are welcome additions to any San Diego orthopedist’s arsenal. To learn more and schedule your own consultation for knee pain, contact my offices today.

Understanding Knee Pain from the Inside

This recent video highlights a common complaint: knee pain that is so severe that simply climbing a single stair step can be agony:

The name of the enemy here is osteoarthritis, a disorder which can graduate from a dull ache to searing pain quite quickly without treatment. Some sufferers call the knee pain of osteoarthritis the most intense they can possibly imagine.

Prescribed treatments are plentiful, and may include exercise, therapy, corticosteroids or surgery. One thing to watch out for, as the video rightly attests, is engaging too vigorously in unhelpful activity:

Overdoing it during exercise can lead to overuse injuries, but low-impact exercise such as swimming, biking, or walking is not something you should stop doing when experiencing knee problems. “If you do have arthritis, some level of exercise and activity is actually going to be beneficial,” Moore said.

As an expert in knee pain in San Diego, I have long written and spoken on the best advances in this evolving field. If you’re looking for holistic and effective results for osteoarthritis, bursitis, or any other issue, please don’t hesitate to contact my San Diego orthopedic offices today.

San Diego Orthopedic Surgeon

Using the Web to zero in on any medical specialist can be fraught and confusing, especially if you are looking for a San Diego orthopedic surgeon. The medical Web is a poorly organized mix of research and reviews, and too many people rely on cold information friend without surveying all their options first.

There is a better way, beyond reviews and recommendations, to locate an expert orthopedic surgeon: check the transcript. More specifically, look at each candidate’s bona fides – education, fellowships and faculty positions – to get a good overview of the most qualified and respected individuals in each field.

For instance:

Dr. Holland is a Fellow of the American Academy of Orthopaedic Surgeons, and a Diplomat of the American Board of Orthopaedic Surgery. He is a member of the California Medical Society as well as the San Diego County Medical Society, and has performed research in the fields of sports medicine and pediatric orthopaedics, and presented papers at a number of national and international meetings.

As an orthopedic expert, I focus on ailments including knee pain, elbow pain, shoulder pain, and a variety of pediatric orthopedic symptoms – all specialties born out my many years of training.

If you’d like to work with one of the best regarded orthopedic surgeons in Southern California, and the credentials suit what you’re looking for, please don’t hesitate to contact my offices today.

Choosing an Orthopedist: Checklist

Choosing an orthopedist for help with pain, immobility, or orthopedic issues requires more than just a gut feeling. As numerous articles have pointed out, making a smart selection requires looking at several criteria, from credentials to areas of specialty.

This page offers some sound advice without getting too technical, pointing patients toward a thumbnail list of questions you might want to ask before committing. I am especially strongly in favor of anything that prizes communication as an essential component to a solid relationship, to wit:

Do I like and trust this doctor? Do I feel good about this doctor’s expertise? Do we communicate well?

Other good questions include this couplet, which covers some important decision-making considerations:

What procedures do you recommend for my case? Why? Why not others?
How many times have you performed this procedure in the past year?

This page touches on an essential final question, which covers the issue of insurance and whether or not your preferred orthopedist is in-network or out-of-network:

Your insurance coverage is a practical matter. To receive the most insurance benefits and pay the least out-of-pocket for your care, you may need to choose an orthopedic surgeon who participates in your plan. You should still consider credentials, experience, outcomes, and hospital quality as you select an orthopedic surgeon from your plan.

Ultimately the only way to choose an orthopedist is to do your homework and reach out with questions as they arise. Stick with a San Diego orthopedist who shows patience and care when addressing your concerns, and look for strong experience in your area of pain. You’re likely to have a better experience throughout.

Making Sense of Orthopedic Pain and Surgery in San Diego

This site was designed to be a comprehensive resource for patients in San Diego looking for the vanguard in orthopedic care. Although as a sports medicine expert I see patients of every kind – including pediatric patients – this site’s layout represents my specialties, which is why they are highlighted in its content and structure:

Click any of those links and you can read more about my holistic approach to working with pain and aiding in rehabilitation. And if you want to know where my training originated or the various positions I am grateful to hold, you can click here.

Still have questions about orthopedic pain and orthopedic surgery in San Diego? Please don’t hesitate to contact my offices here: we always take the time to answer your questions and address all of our patients’ understandable concerns.

Is Gait Speed a Proxy for Overall Knee Health?

Most patients have not ever considered the rate at which they walk – known in medicine as gait speed – as an indicator of something more serious. After all, some people just walk more slowly than others, especially as their age advances, right?

In fact, diminished gait speed can be a harbinger of ailing health overall, as one recent study reiterated:

[Gait speed] is an important indicator of health, well-being, and mean life span in older adults and is a strong predictor of future disability and mortality.

When that speed declines, especially if it is associated with progressive knee pain or obesity, it can be a pretty clear signal that further trouble is brewing. As this study found:

Frequent [knee pain] alone, obesity alone, and the combination of frequent [knee pain] and obesity were all associated with decreased [gait speed] in older adults. These associations did not change in any of the groups longitudinally; as such, the slopes corresponding to the data remained unchanged.

Although the researchers could not separate which factor led most directly and causally to the issue, the correlation remains strong and worthy of further study. What this means for you is that slowing down with age should be considered something less than inevitable, especially if knee pain is involved.

To get lasting relief of knee pain and learn more about expert knee surgery in San Diego, contact the offices of Dr. William Holland today.