The most common joints we talk about in terms of arthritis are hips and knees, but in some people, other joint can be just as painful.
Elbow arthritis can occur as a result of rheumatoid arthritis, the result of an old injury, or wear-and-tear osteoarthritis. While many people can manage the symptoms of arthritis in the elbow joint with simple treatments (including medications, activity modifications, and often a cortisone shot), there are also surgical treatment options.
The two most common surgical procedures are arthroscopic elbow surgery to clean up damage including loose cartilage and bone spurs, and an elbow replacement surgery. Learn about these procedures and other treatments for elbow arthritis...
ACL surgery is often a recommended treatment for athletes who injure the anterior cruciate ligament. ACL surgery can have complications with serious implications.
The possible risks of surgery include:
- Re-tear of the ACL
- Persistent knee pain
Learn about the possible complications of surgery and what you can do to avoid these problems.
A report in the Washington Post is raising questions about the medical necessity of many spinal fusion surgeries. The report highlights a single neurosurgeon, who had his spine fusion surgeries audited. While internal audits from the hospital found no problems with the rationale for surgery, an external review found that only 1 of the 10 was a necessary surgical procedure.
Spinal fusion surgery is a major surgical procedure with significant risks for the patient to consider. National studies have estimated that up to half of spine fusion surgeries are probably not necessary. Have you had a spine fusion? Were you told it was mandatory by your surgeon? Leave your comments below...
Doctors have identified a new ligament in the knee joint. While this structure had been previously described (as long ago as the 1800s), it is only now that the ligament has been clearly defined. Does it matter?
The doctors who describe the ligament think it does, and they have a good point. When people injure their knee ligaments, the injuries are much more complex than we often appreciate. Having a torn ACL often means much more than just injury to one ligament. For example, we know people who tear their ACL often damage cartilage, injure the meniscus, tear other ligaments, sustain bone bruises, and other injuries. Most surgeons agree that the diagnosis of an isolated ACL tear is a dramatic simplification of a very complex injury. People have an easier time understanding when a single ligament is discussed, but this is a much more complicated problem when examined closely.
One reason some people don't fully recover after ACL injury, is that this other damage in the knee was not recognized and treated. For example, posterolateral rotatory instability of the knee joint is one common reason that people don't fully recover from ACL surgery. It could be the case that damage to this "new" knee ligament may be another reason for persistent knee instability after ACL surgery.
The recently identified ligament is called the anterolateral ligament, or ALL, and is closely related to the lateral collateral ligament. The doctors are theorizing the ALL contributes to rotational stability of the knee, and may be one of the primary restraints to the pivot shift test, a common test for stability of the knee joint.
Sources: Paddock C. "Surgeons describe new knee ligament" Medical News Today. 8 November 2013.
As I am completing my time here in Tanzania working along with the Orthopedic team at a local hospital, one of the most common injuries they are confronted with are severe bone fractures. These injuries are seem all over the world, in developed and developing nations alike, and they all require the same treatments:
- Open fractures should be surgically cleaned
- Fractures should be stabilized
- Doctors need to be aware of concerns of compartment syndrome
These severe injuries can have life-threatening implications, and prompt treatment is necessary, no matter what part of the world you live in.
Do you know everything about osteoporosis? What about these commonly held beliefs that may not be completely true? He are 10 osteoporosis myths--see if everything you thought you knew was right!
Knowing about osteoporosis, what this condition means, and what can be done to prevent it, can help ensure you life a strong, healthy life. Learn about osteoporosis, and what you can do to help prevent this condition.
I am going to take a small break from my usual blog updates of orthopedic conditions and advancements in treatments to share my current project in orthopedics.
I am in Moshi, Tanzania, an area in East Africa not far from the Serengeti National Park. Moshi is a beautiful setting, the starting point for those wishing to summit Mt. Kilimanjaro. I am working at the Kilimanjaro Christian Medical Centre, a facility with about 450 hospital beds proving broad medical services to both local and regional Tanzanians.
Orthopedics in Moshi is different. In some ways worse, in the sense that technology is limited, facilities are poorly funded, and problems often overwhelm the providers. But there is a bright side: a tremendously dedicated staff of orthopedic doctors and trainees learning the art of quality medicine.
The differences are easy to see at first look, but as you take a step back, the problems they face here are no different than those in Western countries, including the United States. These include difficulty with funding of medical services, especially for the poor. They face challenges in coordination of care, particularly in the prevention of illness and social support after acute hospitalization. Providers are frustrated with paperwork and documentation, and often these efforts fail to improve the care of patients. I could go on, but the point is, the problems, in concept, are no different.
They say medical professionals answer to a calling. I think this is true, and my calling is to help providers here in Moshi with the same struggles we face back home. It is important that we not presume that any medical system is perfect; we can all learn ways to improve. Improvement comes with experience, and I am here to learn just as much as I hope the providers here can learn from me.
Hip replacement surgery is a treatment for severe arthritis of the hip joint. Patients who commit to hip replacement surgery must understand that there are some changes they will have to adapt to for the rest of their life. The trade-off for the patients is that they will likely have a significant decrease in hip pain and disability. Learn about the important hip precautions after hip replacement surgery.
Image © Medical Multimedia Group
ACL surgery is never a mandatory treatment, but it may be a good option, especially for those who want to continue to participate is sports that require a functioning ACL.
Learn about the process of making a decision for ACL surgery, and if this is the best option for you...
Many studies have been performed to evaluated the use of PRP (platelet rich plasma) injections, but most of these have been done with injections administered in a doctor's office.
Another way some doctors use PRP is to try to stimulate healing at the time of surgery. A recent study found some encouraging results when PRP was used after the surgical repair of rotator cuff tears. The effect was most notable in patients with massive rotator cuff tears.
Interestingly, the study did not find these patients felt better or had better shoulder function--they were simply found to have a stronger repair. That likely matters, but it is important that these patients continue to be followed to find out if they actually have less pain or better functional results--the reason to have surgery in the first place!