Friday, September 20, 2013

Rotator Cuff Repair Surgery

There you are, winding up to throw the winning pitch to win the softball tournament, and you find yourself tripping over your own feet. You put out an arm to break the fall, but hear a snap when you land. A hurried – and painful – ride to the Emergency Room results in an orthopedic diagnosis. You have a torn rotator cuff.

No more softball for you as rotator cuff repair surgery is the recommended treatment. What does all of this mean and when can you expect to be back out on the pitcher’s mound?

What is a rotator cuff?
The rotator cuff is made up of four tendons and muscles that work as a team to stabilize and move the shoulder.

What causes a tear in the rotator cuff?
There are a number of reasons why a rotator cuff injury can occur. Typically, wear and tear – especially for patients reaching their 40s and 50s – is the most common culprit.

An over-the-head action that is repeated over and over can cause inflammation and a shoulder tear. This is common for avid swimmers, tennis players, and yes, baseball or softball pitchers. Even some tradesmen such as carpenters and painters experience damage to the shoulder’s rotator cuff.

Other causes include an improper lift or pull and a fall that is broken with the arm.

Are certain patients more likely to experience a tear than others?
Studies show that patients who repeatedly smoke or rely on steroid injections for shoulder pain are more likely to have rotator cuff difficulties. The integrity of the rotator cuff is often compromised and partial or complete tears of the tendons or muscles are likely.

Can a patient live with a torn rotator cuff?
Tendons do not heal like other parts of the body. Only orthopedic rotator cuff repair surgery will correct the shoulder condition.  However, patients can live with rotator cuff tears for a limited amount of time.

Bear in mind that the rotator cuff injury will worsen, causing additional damage and certainly more shoulder pain and weakness. The rate at which this happens depends solely on the patient and the nature of the injury.

Many patients can no longer maintain a normal activity schedule. Secondary side effects include difficulty sleeping and a noticeable catch or grinding sound when shoulder movement is attempted.

Mild pain-relieving medications will temporarily help the discomfort. And while steroid injections may seem like a viable option, they will weaken the quality and quantity of the tendon.

For these reasons, orthopedic surgeons recommend rotator cuff repair surgery to be performed within 2-3 weeks of the injury for best results. Although more challenging, the rotator cuff can also be repaired after chronic injury to the tendons.

What can patients expect after a rotator cuff repair surgery?
The overall success of the procedure depends entirely on the patient’s health and motivation.

Naturally, the shoulder will be weak for several months, and the range of motion may be limited. However, an orthopedic surgeon will recommend gentle rehabilitation exercises in order to prevent scar tissue and speed up recovery.

If the recommended post-surgery steps are followed, patients will be able to jump back into their daily activities within a few months. Although the tendon will be repaired, it will never regain its original state. Patients can rest assured, though, that they will experience an improvement in shoulder mobility and comfort.

If you have a torn rotator cuff and are in need of orthopedic surgery, contact MedToGo today. We can help you get the treatment you need and the care you deserve. 

Tuesday, August 27, 2013

Osteoarthritis and Knee Replacement Surgery

If you suffer from chronic knee pain, then rest assured. Orthopedic knee replacement surgery may just be the thing to getting you back leading a full and active life.

According to the American Academy of Orthopaedic Surgeons (AAOS), “Total knee replacements are one of the most successful procedures in all of medicine.” In fact, joint replacement surgery is quite common and is performed on more than 600,000 people in the United States each year. About 90% of those patients no longer have pain and can enjoy an increase in mobility.

Osteoarthritis – the “wear and tear” of bone cartilage that cushions the bones within the joint – is the most common cause for knee replacement. Osteoarthritis leads to bones rubbing against one another resulting in chronic knee pain, swelling and stiffness. Rheumatoid arthritis (the inflammation and thickening of the synovial membrane surrounding the joint) and post-traumatic arthritis (due to a serious knee injury) can be contributing factors.

It may be time to talk with your orthopedic surgeon about knee replacement surgery options if you are experiencing any of the following long-term symptoms (6 months or more):  

  • ·       Chronic pain despite anti-inflammatory medication
  • ·       Difficulty sleeping
  • ·       Decreased mobility
  • ·       Excruciating pain when weight is placed on knee joint
  • ·       Decreased range of motion
  • ·       Trouble getting in and out of sitting positions
  • ·       Swollen or stiff knee joints which last up to 30 minutes
  • ·       Pain and discomfort during rainy weather
  • ·       Relying on canes and walkers for mobility

Keep in mind that the primary goal of treatment is to get you back to leading a full life as quickly as possible. Orthopedic surgeons first aim for more conservative treatment plans which can include weight loss strategies, pain killers, cortisone or Hyaluronic Acid injections, braces and routine physical therapy. However, if these treatments prove ineffective at eliminating the pain and discomfort, then joint replacement surgery will be recommended.

Together, you and your orthopedic surgeon can discuss knee surgery options. Of course, the risk of infection, substantial bone loss or decreased bone strength will be taken into consideration before orthopedic surgery option is presented.  

Total knee replacement surgery is a great solution for patients who have tried – without success – other noninvasive treatments. The AAOS notes that a majority of patients who experience total knee replacement are between the ages of 50 to 80. However, knee replacements have been performed successfully on patients of all ages.

Total knee replacement surgery removes the cartilage and bone on the ends of the femur and tibia. Usually a metal prosthesis is implanted in the knee joint. Depending on the condition of the kneecap cartilage, the surface may be replaced.

Most likely, your surgeon will discharge you at least two days after your orthopedic surgery. You will be able to stand and walk, with assistance, the day after surgery.  Keep in mind that experiencing a complete range of motion is unusual and largely depends on the range of motion you had prior to surgery. However, most post-surgery patients are able to climb stairs, garden and get in and out of a vehicle within weeks of their total knee replacement surgery.

In total knee replacement surgery, your orthopedic surgeon will give you at-home instructions to prevent blood clots, infection and falls. These include post-operative care for your stitches/staples as well as dietary guidelines and physiotherapy exercises. You can expect to get back to your normal activities within 3 to 6 weeks after surgery. Some discomfort is to be expected within a few weeks after surgery, but you can assume to get a new lease on a pain-free life within a month after the knee replacement surgery.

Say “goodbye” to chronic knee pain and say “hello” to increased mobility with safe and affordable orthopedic surgery options from MedToGo International. Contact us today.


Wednesday, August 14, 2013

Should You Consider Hip Replacement Surgery?

If chronic joint pain and hip discomfort keep you from living a full life, then maybe it’s time to consider orthopedic hip replacement surgery.

As a ball-and-socket joint, the hip is designed to offer a full range of motion. However, if it is damaged or diseased, chronic joint pain can be devastating and often debilitating to your everyday activities.

Orthopedic hip replacement surgery is the solution for men and women of all ages. The goal of orthopedic surgery is to remove the source of the pain and increase mobility. The injured hip joint and cartilage is replaced with a plastic or metal implant, allowing you to “jump” back into a rich, active lifestyle. 

With a 90% success rate, orthopedic hip replacement surgery is one of the most successful types of orthopedic surgery performed worldwide.

Hip replacement surgeries are most beneficial for patients who are dealing with the following conditions:

  • Osteoarthritis (the most common cause)
  • Osteonecrosis (an inadequate blood supply to the ball portion of the hip joint)
  • Rheumatoid arthritis
  •  Bone tumor
  •  Chronic joint pain in the hip despite medication and limited activity
  •  Old age without full range of motion
  •  Traumatic injury to the hip joint such as a broken bone

This is good news for thousands of patients. However, it’s bad news for those who need hip replacement surgeries but can’t afford the hefty price tag.

According to the American Academy of Orthopedic Surgeons, over 285,000 hip replacement surgeries are performed in the United States each year. However, too many American patients are left to suffer because of little or no insurance coverage. Plus, they are too young to qualify for Medicare. These hip replacement candidates are faced with two options: deal with the chronic pain or pay out-of-pocket.

Canadian patients have to wait years before getting immediate treatment thanks to socialized medicine. They are more than willing to pay out-of-pocket to get fast relief and a speedy recovery.

In both cases, worried patients are looking beyond their borders for orthopedic hip replacement surgery solutions. They are traveling internationally to receive exceptional care from highly trained medical professionals and cutting edge hospitals and clinics – for a fraction of the cost of what it would cost in the U.S.

The surgical procedure is the same no matter if you are in Alberta, Washington D.C. or Puerto Vallarta, Mexico. Medical tourism patients are given top quality treatments – and often, better patient care – as well as detailed short- and long-term post-surgery instructions.

After hip replacement surgery, you can expect to wear either compression stockings or inflatable air sleeves. Both will prevent blood from pooling in your legs, reducing your risk of blot clots. You will also need to take a prescription blood thinner for several weeks after your surgery. This will be prescribed by your surgeon.

Physical activity is mandatory for joint and muscular recovery. A physical therapist will give you strengthening and mobility exercises that can be performed during your hospital stay and once you are home. You will have the use of a walker, crutches or a cane for added balance. By following your exercise regimen, you can add more weight to your legs and move about freely.

By following the recommendations of your surgeon and physical therapist, you will be able to “get back in the swing of life” within three weeks. Depending on your body, it may take anywhere from 6 to 8 weeks after surgery to regain your full range of motion.

Keep in mind that there may be a few activities that you will want to skip. These include basketball and running. However, with a little time and faithfulness to your recovery routine, you will be walking, dancing, swimming, golfing or bicycling before you know it. 

Countless people suffer from hip pain every day, but you don’t have to. Orthopedic hip replacement surgery can give you the relief you deserve. Contact us today to increase your mobility and quality of life. 

Thursday, August 4, 2011

RSD after hip replacement surgery and what are other complications?

The risks of total hip replacement include blood clots in the lower extremities that can travel to the lungs (pulmonary embolism). Severe cases of pulmonary embolism are rare but can cause respiratory failure and shock. Other problems include difficulty with urination, local skin or joint infection, fracture of the bone during and after surgery, scarring and limitation of motion of the hip, and loosening of the prosthesis which eventually leads to prosthesis failure. Because total hip joint replacement requires anesthesia, the usual risks of anesthesia apply and include heart arrhythmias, liver toxicity, and pneumonia.

Reflex Sympathetic Dystrophy
Reflex sympathetic dystrophy is an abnormal pain reflex that can occur after surgery on the upper or lower extremities.  It is more common after total knee replacement than after total hip.  This process can result in a significantly protracted pain in the knee.  It is also commonly accompanied by significant stiffness in the knee.  The skin will change to a very thin frail appearing skin that can be of varying colors; from purple to reddish to pink.  In addition, it is frequently noted that there will be no hair growth in the area affected by a reflex sympathetic dystrophy.  The skin will be exquisitely sensitive and painful to even light touch.  There may be some remaining warmth within the leg. 
The diagnosis of this condition can be extremely difficult.  It is most commonly a diagnosis of exclusion.  A patient must be evaluated for the possibility of loosening of the components, infection, or other mechanical problem with the replacement prior to being diagnosed with reflex sympathetic dystrophy.  Occasionally, a three phase bone scan can be helpful in determining the diagnosis of a reflex sympathetic dystrophy. 
When a patient is diagnosed with a reflex sympathetic dystrophy it is important to note that additional surgery on the leg will most commonly result in worsening of the condition.  Occasionally, the condition can be benefited from a sympathetic blockade which is usually carried out by an interventional neuroradiologist.  In this procedure, a long-acting local anesthetic or nerve blocking agent is placed near the lower lumbar spine where the sympathetic nerves originate.  These nerves control the pain reflex and control blood flow through the skin of the lower extremities.  The injection may result in a blush of color in the area involved with the reflex sympathetic dystrophy, and frequently can result in significant relief of the pain of a reflex sympathetic dystrophy.  If the injection is successful, a more permanent blockage may be necessary to maintain long term relief for the patient.

Risks of Shoulder Surgery

The risks of shoulder replacement surgery include:
     Blood clots. People can develop a blood clot in a leg vein after shoulder joint replacement surgery but usually only if they are inactive.
        Infection in the surgical wound or in the joint. Infection is rare in people who are otherwise healthy. People who have other health problems, such as diabetes, rheumatoid arthritis, or chronic liver disease, or those who are taking corticosteroids are at higher risk of infection after any surgery.
          Nerve injury. In rare cases, a nerve may be injured around the site of the surgery. It is more common (but still unusual) if the surgeon is also correcting deformities in the joint. 
         Problems with wound healing. Wound healing problems are more common in people who take corticosteroids or who have diseases that affect the immune system, such as rheumatoid arthritis and diabetes.
        Lack of good range of motion. How far you can move your shoulder after surgery depends a lot on how far you could move your shoulder before surgery. Some people are not able to move their shoulder far enough to allow them to do their regular daily activities, even after several weeks of recovery.
          Dislocation of the upper arm bone (humerus). This usually only happens if the soft tissues around the shoulder are stretched too soon after surgery. To help prevent dislocation, do not allow your elbow to move past your body toward your back.
         Fracture of the upper arm bone. This is an unusual complication, but it may happen either during or after surgery.
          Instability in the joint. This can be the result of either the soft tissues being stretched too soon after surgery, or the new joint pieces loosening.

The usual risks of general anesthesia . Risks of any surgery are higher in people who have had a recent heart attack and those who have long-term (chronic) lung, liver, kidney, or heart disease.

Wednesday, June 22, 2011

Total Hip Replacement Contraindications

You are not be a candidate for total hip replacement if your doctor determines that you have any of the following conditions: Infection, sepsis and osteomyelitis. You may not be a candidate for total hip replacement if your doctor determines that you exhibit any of the following: 1) uncooperative patient or patient with neurologic disorders who are incapable of following directions, 2) osteoporosis, 3) metabolic disorders which may impair bone formation, 4) osteomalacia, 5) distant foci of infections which may spread to the implant site, 6) rapid joint destruction, marked bone loss or bone resorption apparent on roentgenogram, 7) vascular insufficiency, muscular atrophy, or neuromuscular disease.

In addition to contraindications the following conditions tend to adversely affect hip implants: excessive patient weight, high levels of patient activity, likelihood of falls, poor bone stock, metabolic disorders, and disabilities of other joints.