Surgical Solutions

Ask The Doctors: December 2019

Q: Sometimes my knee locks up and I cant bend or straighten it. Eventually, I can move it, but its sore. Whats wrong with my knee?A: There are several possibilities, but the most likely one is a torn meniscus. The meniscus is a piece of cartilage in the knee joint. There are two types of cartilage in the knee. Articular cartilage covers the ends of the upper leg bone (femur) and the bone at the front of the lower leg (tibia).

When to Treat Dupuytrens

While engaged in a woodworking project you plane a board, and then you run your hand over it to make sure its nice and smooth. But your hand wont lay flat against the board. Or, you are washing windows and you find that when you press the cloth against the window pane, your hand doesnt lay flat.

In The News: December 2019

Blood Sugar Often Not Tested Before Joint Replacement SurgeryMany people with osteoarthritis also have type 2 diabetes. Having high blood sugar levels, which is characteristic of diabetes, can increase risk for complications from surgery. Addressing risk factors and lowering blood sugar levels can reduce complications. However, testing blood sugar levels before joint replacement surgery for hip or knee osteoarthritis is not done often enough, according to a study published in JAMA Network Open (September 2019).

Anesthesia: Less Is More

When you have a joint replaced, your anesthesiologists job is to keep you comfortable and safe during your surgery and as pain-free as possible after the procedure. In the past, that often meant going under general anesthesia and getting strong narcotics to dull the pain. Not anymore. Today, when it comes to anesthesia, less is more.

Knee Pain: Front and Center

Do you have pain in the front of your knee and feel a grinding sensation when you bend your knee? If so, you may have chondromalacia patella. This is the breakdown of articular cartilage on the underside of the kneecap (patella). Articular cartilage is a tough, elastic tissue that covers the ends of bones in the most mobile joints in the body, including the knees. It allows for smooth, pain-free movement.

Knee Replacement: One at a Time or Both Together

Total knee replacement surgery is always the last resort. It is an option only after all other measures have failed to provide adequate relief. These include physical therapy, pain medications, corticosteroid injections, bracing and others. The goal of knee replacement surgery is to eliminate the chronic disability from pain. Youre not going to get the knee you had when you were 19, says Nageotte. But you can get pain relief and improved function.

Home after Joint Replacement Surgery

If you are having joint replacement surgery, its likely that youll be going home soon after the surgery, possibly even the next day. Fewer and fewer people go to a rehabilitation facility, and thats for the best. Studies are showing that people who undergo joint replacement recover just as well at home.

Understanding Degenerative Disk Disease

Theres no doubt that our bodies, including the complex array of structures in and around the spine, change with age. For example, the cylindrical disks tucked between each bone (vertebra) of the spine are subject to some deterioration. This may or may not lead to pain or other symptoms.

Wrist Surgery & Lyme Disease

Rheumatoid arthritis commonly affects the hands and wrists. Medications and nondrug measures, such as physical therapy and joint protection strategies, are the primary treatments. If pain and dysfunction become severe and seriously limit movement, surgery can be considered. There are many possible causes of the symptoms you describe, and you may have more than one problem. For example, you may have arthritis plus the flu. But there are other reasons for joint pain besides arthritis. The fact that you spend a lot of time outdoors raises suspicion that you may have Lyme disease.

Medication Management during Hip and Knee Replacement

Total hip or knee replacement surgery can be life-changing for many people with severe arthritis, allowing them to return to a high level of function free of pain. But for people with rheumatoid arthritis or another form of inflammatory arthritis (rather than osteoarthritis), there are some added concerns.

In The News: May 2017

Some bone loss occurs in everyone with age. For women at menopause, this process speeds up. A study published in the Journal of Bone and Mineral Research (February 2017) found that women who ate what is considered an anti-inflammatory diet (high in vegetables, fruits, fish and whole grains and low in sugar and processed foods) had less bone loss. The researchers analyzed data from the large Womens Health Initiative study to look for an association between inflammatory elements in the diet and bone density and fractures.

Osteoporotic Spine Fractures

For people with the bone-thinning disease osteoporosis, the greatest concern is a broken bone. Once the bones of the spine (vertebrae) become fragile from osteoporosis they can fracture even without a traumatic injury, like a fall. This is called a vertebral compression fracture.