When To Use Cortisone For Joint Pain

Cortisone is a miraculous medication, one which can diminish chronic pain and restore a freer range of motion within minutes. But as chronic elbow pain sufferers will tell you, that relief may be short-lived, and can exact its own price over time.

Cortisone is a steroid, which means it can activate some of the body’s most powerful signaling mechanisms for healing. These can be especially effective for joint pain, including elbow pain, shoulder pain, knee pain, and wrist pain, as well as specific diagnoses including bursitis and arthritis.

But cortisone’s power cuts both ways, and may eventually deteriorate the treated joint, by diminishing bone density and thinning soft tissues. Consequently many orthopedic surgeons such as myself use the shots sparingly, and always in concert with a more holistic rehabilitation effort which includes exercise, stretching, and restful recovery.

Bottom line: cortisone is a perfect example of short-term benefit, long-term harm. If you’re looking for a lasting solution to joint pain which won’t hamper your chances for a more lasting recovery, it’s wise to consider lifestyle changes and orthopedic surgery instead.

Knee Surgery? Not For Everyone

Demographic data can be a double-edged sword in the world of medicine. In the wrong hands, it may be treated as evidence of an underlying health liability, or poor lifestyle choices. In the right hands, it can guide us toward more responsible medical decisions predicated on the idea that not every patient population is precisely the same.

Consider this recent study of total knee replacement (TKR) surgeries, which resulted in a startling set of findings, including:

In comparison to the white population, minorities had lower rates of TKR utilization.
Minorities were less likely to undergo TKR in high-volume hospitals.
The risk for in-hospital mortality, and the complication rate following TKR, were significantly higher for blacks, Native Americans and mixed-race individuals.

In other words, minorities underwent fewer knee replacement procedures, but experienced a higher rate of complications and mortality for them.

Does this mean that knee replacement is inappropriate or ill-advised for nonwhites? Not necessarily; this is an observational study, not a controlled or randomized study, which means it is entirely possible that other socioethnic factors may be pushing the figures in one direction or another, independent of the medical facts.

Still it is a worthy reminder that medicine must take into account the whole patient, and that surgery is not always the first or best answer for knee pain.

How Much Does Knee Surgery Cost?

We live in a world where the actual costs of many medical procedures get hidden behind insurance copays and complex accounting. But many patients rightly want to know what their orthopedic surgery procedures actually cost – both for the system, and for their own pocketbooks.

There is little consistency in the fees charged for comparable orthopedic surgeries as you travel from place to place. This damning article includes some eye-opening discrepancies that cannot be explained through property values or practice size alone:

At my San Diego orthopedic practice, we make every effort to keep our prices reasonable and to serve our patients well within their means, for knee surgery, shoulder surgery, elbow surgery, and pediatric orthopedic care. To schedule your own rational diagnosis with the best orthopedic surgeon in San Diego, start here.

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.

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.

Knee Surgery and the NFL

Ravens quarterback Joe Flacco is a superstar whose inconsistent performance has bedeviled Ravens fans for many years. Often compared to Eli Manning, Flacco has a tendency to show flashes of brilliance – he has the Super Bowl ring to prove it – punctuated by entire seasons of struggle.

Recently, a new obstacle reared its head: knee injury. Flacco suffered a torn ACL and MCL after a recent hit, and is out for the season. The good news is that orthopedic surgery outcomes for ACL and MCL tears have improved greatly over the last few decades, and today the prognosis for a full recovery is stronger than ever. Flacco is currently expected back by training camp next season.

You don’t need to be a star athlete to recover quickly from knee surgery. If you’re searching for a holistic and effective approach to knee repair and recovery, please don’t hesitate to contact the offices of Dr. William Holland right here in San Diego.

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.

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.

Welcome to the San Diego Orthopedic Surgeon Blog

Welcome to the San Diego orthopedic surgeon blog! This is a place where you can find answers to your questions and concerns, and get all the latest news about events and advances in the field of orthopedic surgery.

As a San Diego orthopedic surgeon who spent many years treating soldiers, athletes, and active patients of all ages, I have spent the better part of my lifetime refining an approach to holistic orthopedic care. When patients come to me with complaints, I look for ways to treat without surgery first. If interventions such as physical therapy and medications can’t do the trick, then we begin to plan a minimally invasive procedure together, placing a premium on good communication.

My practice covers a wide range of sports injuries and other orthopedic issues, but I specialize in a few key areas:

Shoulder Pain
Shoulder Surgery
Knee Pain
Knee Surgery
Elbow, Hand and Wrist Pain
Elbow, hand and Wrist Surgery

To learn more about any of these subjects, please click the links above. And if you’d like to keep up with all the most current information on orthopedic surgery in San Diego, just bookmark this link and check back often. Welcome aboard!