Shoulder Joint Replacement Surgery

Shoulder Joint Replacement Surgery
Although shoulder joint replacement is less common than knee or hip replacement, it is just as successful in relieving joint pain.

If nonsurgical or minimally invasive treatments are no longer helpful for relieving pain, you may want to talk with an orthopedic surgeon about shoulder joint replacement surgery.

Shoulder Anatomy
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The shoulder is a ball-and-socket joint. The ball, or head, of your upper arm bone fits into a shallow socket in your shoulder blade. This socket is called the glenoid.

The surfaces of the bones where they touch are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily. A thin, smooth tissue called synovial membrane covers all remaining surfaces inside the shoulder joint. In a healthy shoulder, this membrane releases a small amount of fluid that lubricates the cartilage and eliminates almost any friction in your shoulder.

The muscles and tendons that surround the shoulder provide stability and support.

All of these structures allow the shoulder to rotate through a greater range of motion than any other joint in the body.

Shoulder Joint Replacement
In shoulder joint replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).

Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery.

Osteoarthritis (Degenerative Joint Disease)
This age-related “wear and tear” type of arthritis usually occurs in people over age 50 years, but occasionally in younger individuals. The cartilage that cushions the bones of the shoulder softens and wears away. The bones then rub against one another. Over time, the shoulder joint slowly becomes stiff and painful.

Rheumatoid Arthritis
This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation eventually causes cartilage loss, pain, and stiffness.

Post-traumatic Arthritis
This can follow a serious shoulder injury. Fractures of the bones that make up the shoulder or tears of the shoulder tendons or ligaments may damage the articular cartilage over time, causing shoulder pain and limiting shoulder function.

Rotator Cuff Tear Arthropathy
A patient with a very large, long-standing rotator cuff tear may develop cuff tear arthropathy. In this condition, the changes in the shoulder joint due to the rotator cuff tear may lead to arthritis and destruction of the joint cartilage.

Avascular Necrosis (Osteonecrosis)
Avascular necrosis is a painful condition that occurs when the blood supply to the bone is disrupted. Because bone cells die without a blood supply, osteonecrosis can ultimately cause destruction of the shoulder joint and lead to arthritis. Chronic steroid use, deep sea diving, severe fracture of the shoulder, sickle cell disease, and heavy alcohol use are risk factors for avascular necrosis.

Severe Fractures
A severe fracture of the shoulder is a common reason people have shoulder replacements. When the head of the upper arm bone is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. In this case, an orthopedic surgeon may recommend a shoulder replacement. Failed Previous Shoulder Replacement Surgery
Although uncommon, some shoulder replacements fail, most often because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary.

People who benefit from surgery often have:
• Severe shoulder pain that interferes with everyday activities.
• Moderate to severe pain that prevents a good night’s sleep.
• Loss of motion and/or weakness in the shoulder.
• Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, minimally invasive surgery or physical therapy.

Orthopaedic Evaluation
An evaluation with an orthopedic surgeon consists of several components, including:
• A medical history.
• A physical examination.
• Blood tests.
• X-rays.
• Magnetic Resonance Imaging (MRI)

Your orthopedic surgeon will review the results of your evaluation with you and discuss whether shoulder joint replacement is the best method to relieve your pain and improve your function. Other treatment options — including medications, injections, physical therapy or minimally invasive surgery— will also be discussed and considered.

There are different types of shoulder replacements. Your orthopedic surgeon will evaluate your situation carefully and discuss with you which type of replacement would best meet your health needs. Do not hesitate to ask what type of implant will be used in your situation, and why that choice is right for you.

Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function.

Knee Microfracture Surgery

Knee Microfracture Surgery
Microfracture surgery of the knee is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot.

Microfracture surgery has gained popularity in sports in recent years; numerous professional athletes including members of the NBA (most notably Andrew Bogut, Anfernee Hardaway, Jason Kidd, Greg Oden, Allan Houston, Kenyon Martin, Tracy McGrady, Chris Webber and Amar’e Stoudemire, MLB (Jeff Clement), Matt Kemp, Derek Holland, NFL and NHL players have undergone the procedure.

The microfracture procedure uses the body’s own healing abilities and provides an enriched environment for tissue regeneration of chondral defects, which are damaged areas of articular cartilage of the knee. The surgery is quick – typically lasting between 30–90 minutes – minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement).

The Surgical Procedure: Microfracture
The microfracture procedure is done arthroscopically. An orthopedic surgeon visually assesses the defect and performs the procedure using special instruments that are inserted through three small incisions on the knee.

After assessing the cartilage damage, any unstable cartilage is removed from the exposed bone. The surrounding rim of remaining articular cartilage is also checked for loose or marginally attached cartilage. This loose cartilage is also removed so that there is a stable edge of cartilage surrounding the defect. This process of thoroughly cleaning and preparing the defect results in optimum surgical outcomes.

Multiple holes, or microfractures, are then made in the exposed bone about 3 to 4mm apart. Bone marrow cells and blood from the holes combine to form a “super clot” that completely covers the damaged area. This marrow-rich clot is the basis for the new tissue formation.

The microfracture technique produces a rough bone surface that the clot adheres to more easily. This clot eventually matures into firm repair tissue that becomes smooth and durable. Since this maturing process is gradual, it usually takes two to six months after the procedure for the patient to experience improvement in the pain and function of the knee. Improvement is likely to continue for about 2 to 3 years.

Following rehabilitation and physical therapy, which begin immediately after the microfracture procedure, most patients return to normal activities after 6 to 8 weeks. Athletes can resume sports that involve pivoting, cutting, and jumping approximately 4 to 6 months after a microfracture procedure.

What are the signs and symptoms of an articular cartilage injury that may be treated with the microfracture technique?

  • Intermittent swelling – Loose fragments floating in the knee can cause swelling to occur.
  • Pain – Pain with prolonged walking or climbing stairs.
  • Giving way – The knee may occasionally buckle or give way when weight is placed upon it.
  • Locking or catching – Loose, floating pieces of cartilage may catch in the joint as it bends, causing the knee to lock or have limited motion.
  • Noise – The knee may make noise (called crepitus) during motion, especially if the cartilage on the back of the kneecap is damaged. This noise is often described as “snap, crackle, and pop”.

Knee Injuries and Treatments

The knee is the body’s largest joint. Its complexity makes it vulnerable to a variety of injuries.

The knee is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shinbone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur.

The knee contains large ligaments which connect bones and brace the joint against abnormal types of motion. The meniscus is a wedge of soft cartilage between the femur and tibia that cushions the knee and helps it absorb shocks.

Torn ligaments and cartilage are common knee injuries. Runners, cyclists, swimmers, step aerobics devotees, and football, basketball and volleyball players commonly fall victim to other knee injuries, including a variety of aches and pains related to the kneecap.

Orthopaedic surgeons use a variety of methods to treat the knee. Most treatment begins with R.I.C.E. – rest, ice, compression, and elevation.

Seek attention from an orthopedic surgeon if pain continues, especially if you:
• Hear a popping noise and feel your knee give out at the time of injury
• Have severe pain
• Cannot move the knee
• Begin limping
• Have swelling at the injury site

Many knee injuries can be successfully treated without surgery, while others require surgery to correct.

Knee Arthroscopy
When necessary, an orthopedist will perform arthroscopy, a type of surgery that takes a direct look at the inside of your knee joint.

The orthopedist makes a small opening in the knee and inserts an arthroscope, a tiny tube-like tool, into the joint. The arthroscope contains a lighted video camera at one end and is wired to a monitor that the surgeon watches while moving the scope to pinpoint the injury, often repairing the injury during the same procedure.

When used to treat ligament and meniscal tears and other types of serious knee injuries, arthroscopy decreases postoperative pain, risk of complications and recovery time.

Knee Replacement Surgery
You and your doctor may consider knee replacement surgery if you have a stiff, painful knee that makes it difficult to perform even the simplest of activities and other treatments are no longer working.

Minimally invasive surgery has revolutionized knee replacement surgery, requiring a much smaller incision, just 3 to 5 inches, versus the standard approach and incision. This less invasive approaches results in less pain, decreased recovery time and better motion due to less scar tissue formation.

The vast majority of people who undergo knee joint replacement surgery enjoy dramatic improvement. Once muscle strength is restored through physical therapy, knee joint replacement patients can often return to many activities that were previously restricted due to pain and decreased range of motion.

Knee surgical procedures have undergone a dramatic evolution in the last decade. Always seek an experienced orthopedic surgeon and together, determine the best treatment for your knee injuries and chronic conditions.

Think Spring, Think Injury Avoidance

At this time of year, many individual can’t wait to leap into spring, getting back to the gym to drop some winter weight, or onto the golf course or other playing field. Proceed with caution! Sports injuries can be caused by poor training practices, improper gear and not warming up or stretching enough. People often get hurt because they are not in shape and take on too much, too soon.

The most common sports injuries are:

  • Achilles tendon injuries
  • ACL tears
  • Dislocations
  • Fractures
  • Knee injuries
  • Pain along the shin bone
  • Rotator cuff injuries
  • Sprains and strains
  • Stress fractures
  • Swollen muscles
  • Tennis elbow

If you do get injured, stop. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery.

It’s important to know when to look further than your medicine cabinet to treat sports injuries. An orthopedic surgeon is a medical doctor or doctor of osteopathy with extensive training in keeping your bones, joints, ligaments, muscles, tendons, cartilage and spine in good working order. Together, all of these parts of our bodies make up our musculoskeletal system.

Orthopaedic surgeons have the greatest knowledge of and experience with the wide range of conditions and treatment options available in musculoskeletal care, many of which do not involve surgery. However, if surgery is the best option for recovery, an orthopedic surgeon is the best trained to provide that surgical treatment.

Orthopaedic surgeons use the most effective and efficient diagnostic tools and our experience in musculoskeletal treatment to determine the best care for our patients.

Initial treatment of an injury following the basic RICE formula may be all you need, but if your injury does not heal on its own and continues to be painful, swollen or stiff, you may need surgery.

Depending upon the type of injury, your age and other factors, your orthopedic surgeon may recommend minimally invasive surgery such as arthroscopy following by physical therapy to help you resume your normal activities. In other cases, more traditional surgical repair may be recommended by your orthopedic surgeon.

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. Working out regularly will help you to enjoy your sports activities safely and you’ll garner extra health benefits as well. If you feel your sports injury isn’t healing on its own, consult an experienced orthopedic surgeon to help you get well and back into the game as soon as possible.

Understanding ACL Reconstruction

In ACL reconstruction or repair, an orthopedic surgeon restores the function of the normal anterior cruciate (KROO-she-ate) ligament of the knee. This ligament is important in stabilizing the knee in athletics and day-to-day activities. The term ACL is an acronym for the anterior cruciate ligament, and easier to pronounce.

In ACL reconstruction or repair, an orthopedic surgeon restores the function of the normal anterior cruciate (KROO-she-ate) ligament of the knee. This ligament is important in stabilizing the knee in athletics and day-to-day activities. The term ACL is an acronym for the anterior cruciate ligament, and easier to pronounce.

Anterior (front) view of arthritic adult knee from below hip to lower leg showing the bones of leg ghosted within the skin including the femur, patella, tibia and fibula. Osteophytes (bumps) and torn articular surfaces and indicative of osteoarthritis of the knee.

Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects the thighbone (femur) to the shinbone (tibia) and helps stabilize the knee joint.

ACL injury most commonly occurs during sports that involve sudden stops and changes in direction — such as basketball, soccer, football and volleyball. ACL injuries typically occur in non-contact events on the sporting field. They can also be the result of workplace injuries and traumas such as motor vehicle accidents.

In the past, a torn ACL would mean the end of high level athletic activity for a prolonged period of time and possibly permanently. Today’s minimally invasive arthroscopic reconstruction followed by aggressive rehabilitation can restore the knee’s stability and function.

Not everyone who tears an ACL requires reconstruction. Sedentary people who forgo sports that involve a lot of quick stops and changes in direction usually recover well with conservative treatments and physical therapy. Bracing is also an option.

An orthopedic surgeon may recommend ACL reconstruction if:

  • You are an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
  • More than one ligament or the cartilage in your knee is injured
  • You are young and active
  • The injury is causing instability in your knee during activities of daily life, such as stair climbing

What to Expect During ACL Surgery

ACL reconstruction is performed on an outpatient basis under anesthesia. The ACL is replaced with a piece of tendon from another part of the leg or from a tissue bank.

Orthopedic surgeons use an arthroscope, a small fiber-optic viewing instrument made up of a tiny lens, a light source and video camera, to perform ACL repair.

The orthopedic surgeon creates a tiny 5mm puncture in the joint space of the knee – about 1/4 of an inch – called a portal. Additional small punctures are made for the insertion of surgical instruments. These punctures result in tiny scars, which become unnoticeable, providing direct access to most areas of the knee joint.

The orthopedic surgeon views the procedure on a large screen monitor as the graft is positioned and then secured with screws or other fixation devices.

In an acute injury, surgery is usually delayed until muscle strength and knee mobility has been improved with physical therapy. People who go into surgery with a stiff, swollen knee often have problems regaining full range of motion after surgery.

What to Expect After ACL Repair

The patient returns home on the day of surgery and immediately begins the rehab process. Before going home, patients practice walking with crutches. To reduce swelling and pain in the days immediately following surgery, the R.I.C.E. model of self-care is followed at home:

  • Rest. Use crutches to avoid weight bearing on the knee.
  • Ice. Applying ice for 20 minutes every two hours when awake will help reduce swelling and ease pain.
  • Compression. An elastic bandage or compression wrap keeps the knee immobile and supported.
  • Elevate. Elevating the leg to heart level reduces swelling and pain.

The orthopedic surgeon will also prescribe medication to help manage pain. Physical therapy strengthens the muscles around the knee and improves flexibility. Most patients can expect a return to full function within 6 to 9 months. Athletes can often return to their sports after 6 to 12 months.

Choosing an Orthopedic Surgeon for ACL Repair

To ensure the best possible outcome, it is important to choose a surgeon experienced performing minimally invasive ACL repair.

Good communications between patient and surgeon is critical. You should be comfortable asking your doctor questions, sharing your concerns, and feel that your surgeon takes the time to respond fully and completely. Together, you and your orthopedic surgeon can create the best plan of care to help return you to normal activities as soon as possible following ACL repair.

Arthroscopy Revolutionizes the Treatment of Hip and Other Joint Injuries

Arthroscopy is an outpatient procedure usually performed under regional or general anesthesia in a surgical center. The most common use of arthroscopy is for repair of tears of cartilage, ligaments, and defects in the surfaces of the knee, shoulder, ankle, wrist and hip. Arthroscopy is also used for diagnosis, reconstruction and restoration of damaged tissue in the joint, and in the treatment of arthritis.

Orthopedic surgeons use an arthroscope, a small fiber-optic viewing instrument made up of a tiny lens, a light source and video camera, to perform arthroscopy. An orthopedic surgeon inserts the arthroscope into the joint through a tiny 5mm puncture – about 1/4 of an inch – called a portal. Two or three very small punctures may be made for the insertion of surgical instruments. These punctures result in very small scars, which in most cases become unnoticeable, providing direct access to most areas of the joint, which the surgeon can view on a large screen monitor during the procedure.

As an orthopedic surgeon who has performed over 2,000 arthroscopic procedures, I have personally seen how arthroscopy has evolved and revolutionized the treatment of joint injuries. Arthroscopy enables skilled orthopedic surgeons to examine, diagnose and treat even complex joint injuries and conditions and quickly return patients to their normal routines.

In the past, treatment may have involved extensive surgery, including large incisions, a hospital stay, a prolonged recovery and risk of post-surgical infection and complications. With today’s high-technology arthroscopic surgery, patients experience less pain and quicker recovery, returning home on the same day as their procedure. Risk of infection and complications are minimal.

Hip Arthroscopy
Hip arthroscopy has emerged as a specialty in the last five or six years as an alternative to more invasive hip replacement surgeries. Hip arthroscopy is much less common than knee or shoulder arthroscopy and can help to relieve the pain that results from injury or chronic conditions of the soft tissue surrounding the hip joint.

While less invasive than conventional surgeries, outpatient hip arthroscopy is still technically challenging. As one of the few orthopedic surgeons in Monmouth County who regularly performs hip arthroscopy, this procedure offers pain relief to patients who would have required more extensive procedures in the past. Hip arthroscopy has been a part of my practice for the past five years.

All patients should choose an orthopedic surgeon who takes the time to get to know them and fully answers all questions. Initial patient contact should include an orthopedic evaluation consisting of a medical history; a physical examination to assess range of motion, stability, strength and alignment; X-rays to determine the extent of damage and occasionally blood tests, and an MRI or bone scan as needed.

After evaluation and diagnosis, treatment options are discussed. Your orthopedic surgeon should take the time to explain each treatment option so you can make an informed decision.

Arthroscopic Surgery – Solution for All Ages

As you go along the age spectrum, a younger active person may have a soft tissue or ligament injury repaired arthroscopically, and an older person may receive hip arthroscopy. Either way, both patients can be back to their normal routines very quickly. Thanks to arthroscopic procedures and a supportive care environment, most joint injuries and conditions are not the setbacks they once might have been.

It gives me personal and professional satisfaction to have returned thousands of patients to active lifestyles thanks to high quality, personalized care and innovative treatment.

Ask The Expert

Dr. Marshall Allegra has a private practice in Hazlet and has affiliations with Riverview Medical Center, Bayshore  Community Hospital, Shrewsbury Surgical Center, and Metropolitan Surgical Institute. Dr.Allegra has been in  continuous private practice in Monmouth County since 1988. His education and training includes Undergraduate  Education at Bucknell University, Medical UAG/RWJ at Jersey Shore Medical Center and Surgical and Orthopaedic training at UMDNJ Newark.Dr.Allegra is a Fellow,American Academy of Orthopaedic Surgeons and a Diplomate on the American Board of Orthopaedic Surgeons.

Dr. Allegra, being in practice for over 20 years youmay have seen many cases where a patient is a candidate for either arthroscopic or joint replacement surgery. Can you tell our readers what criteria dictate one or the other?

Surgical treatment of arthritic joints has evolved over the 23 years I have practiced in Monmouth County. The emergence of arthroscopy in the late 1970s offered hope for less invasive care of joint pain. Orthopedic surgeons later realized that arthroscopy had limited use in the treatment of severe arthritis, and with the improvement of joint replacements, arthroscopy was relegated to a secondary role in these cases. Arthroscopy is best suited for younger, active patients with limited arthritic involvement of joints. The goal in arthroscopy in these patients is to delay eventual joint replacement surgery. Total joint replacements are best suited for those patients over 60 years of age who are not obese. These are not intended for extremely active patients, like runners, as such activity will increase the rate of wear of the implants. While these guidelines are not absolute criteria, we have witnessed an increase in patients that are heavier, younger, and more active that require joint replacements. Older patients have become more active as well, and life expectancy has been extended. Newer techniques, including minimally invasive replacements, limited joint replacement (less than total joint replacements) and arthroscopy-assisted joint replacements are emerging. These techniques are used with greater frequency today.

On a similar note, when is a partial joint replacement (minimally invasive) procedure appropriate?

In general, partial joint replacement refers mainly to the knee, which is divided into three compartments. Patients will often present with one or two of the three compartments affected. The procedure replaces only the diseased areas of the joint, leaving the healthy joint spaces and ligaments intact. The advantage is that recovery is quicker and usually more activity is allowed for the patient. Typically, it is offered to the younger (less than 65), more active patient with limited arthritis. It can also be performed in an outpatient setting, utilizing regional anesthesia, and allowing for a same day return to home.

Can you also comment on the differing surgery’s recovery period and what a potential candidate would need to be aware of for the respective surgeries?

Total Joint replacements of the hip and knee typically require a hospital stay of 2 to 4 days, with most patients spending some time in a rehabilitation facility, usually 3 to 7 days after discharge from the hospital. Partial knee replacement and total shoulder joint replacement are typically performed in an outpatient surgical center setting or as an overnight stay in a hospital. Total joint replacement patients require longer periods of recovery before returning to work, usually (but not always) 2 to 3months,whereas partial joint replacement patients recover in about one half that time.

For the procedures that you personally specialize in, can you comment on the mobility after and the length of time these surgeries can provide a normal lifestyle?

In general, the total joint replacement offers predictable, lasting relief of painful, arthritic joints. The typical patient treated this way can expect pain relief and the ability to walk without a cane or crutches within the first 3 to 4weeks, and will experience continued improvement up to 12 to 18 months post operatively. Patients often report that the joint has a more natural feel 1 to 2 years post operatively. Good to excellent outcomes are in the 95% range. The typical modern hip and knee replacement can be expected to last 20 to 25 years within a 95% probability. These are best suited for an older population, but at times the indication for surgery is extended to much younger patients. Mobility is usually excellent, but this should not lead people to believe they can place unreasonable demands on the implants, such as distance running. Partial joint replacement offers less invasive surgery, more rapid recovery and generally more mobility. These procedures should be viewed as a stop-gap measure in many younger, more active patients who will eventually require revision to total joint replacements when they are older. The use of smaller incisions in hip and knee replacement surgery has resulted in less blood loss and faster recovery. The typical hip replacement in my practice can be performed through a 4 to 5 inch incision. Partial replacements of the knee use even smaller incisions.

Highlights and News

Getting Back to Your Best with Minimally Invasive Surgery.

 Today we are living longer and fully expect to enjoy a long and active life. Minimally invasive orthopedic surgery is helping to keep us in the game of life, restoring function and range of motion in older athletes, relieving pain for individuals with arthritis or work-related conditions such as carpal tunnel syndrome, and helping anyone recovering from a traumatic accident or injury get back on their feet.

“Orthopedic technology advances in minimally invasive techniques, specialized tools and advanced imaging are helping to reduce and eliminate pain and restore functionality and range of motion to key areas of the body such as hips, knees, hands and shoulder joints,” says Dr. Marshall P. Allegra, M.D., an orthopedic specialist in Hazlet, New Jersey.

In an arthroscopic examination, an orthopedic surgeon makes a small incision in the patient’s skin and then inserts a pencil-sized instrument that contains a small lens and lighting system to magnify and illuminate the structures inside the joint. This enables the surgeon to visualize, diagnose and treat problems inside the joint.

“Partial join replacement has become a refined procedure, with sameday surgery, immediate rehab and quick recovery,” says Dr. Allegra. “Hip arthroscopy has emerged as a specialty in the last five or six years, as well as the ability to resolve soft tissue problems, bone spurs, ACL and other ligament repairs – treatments are now available for these conditions in same day surgical settings.”

Excellent outcomes are being achieved thanks to a full continuum of care supporting same day surgery patients. “Patients may receive a continuous pain block that lasts for two or three days after surgery, home care is available for patients who require it, and physical therapy begins almost immediately,” says Dr. Allegra.

“As you go along the age spectrum, a younger active person may have a soft tissue or ligament injury repaired arthroscopically, and an older person may have partial joint replacement. Either way, they can both be back to their normal routines very quickly,” says. Dr. Allegra. “Thanks to minimally invasive procedures and a supportive care environment, these injuries are not the setbacks they once might have been.”

The benefits of minimally invasive procedures include less blood loss, less post-operative pain, lower risk of infection, less damage to musculature and tissue, and earlier return to normal function, work and recreation. “The
techniques of minimally invasive surgery are ‘technically’ more demanding,” adds Dr. Allegra, “so it’s important to seek out surgeons with exceptional training and experience.”

Dr. Marshall P. Allegra, M.D.

Practice Overview

Dr. Marshall P. Allegra is a board-certified orthopedic surgeon in private practice in Monmouth County for over 23 years. Specializing in minimally invasive arthroscopic surgery, full and partial joint reconstruction, hand, foot and ankle surgery, fracture care, and non-surgical treatment options. Dr. Allegra is dedicated to providing one-on-one personalized care to every patient.

Dr. Allegra is the only physician you will see when you visit the practice, and he will supervise each phase of your diagnosis, treatment and recovery.

An experienced diagnostician, Dr. Allegra can expertly determine the causes of chronic and acute pain in his patients due to hip, knee, hand, shoulder and sports-induced injuries, and then determine the best treatment options to return patients back to work, to the playing field, restoring functionality and range of motion as quickly as possible.

Dr. Allegra has performed more than 500 hip and knee replacements on patients from Monmouth County and surrounding areas. Thousands of Dr. Allegra’s patients have returned to active lifestyles thanks to his quality, personalized care and innovative treatment options.