Take a Walk: Spring into Better Health

Walking is a great way to improve or maintain your overall health. Just 30 minutes every day can increase cardiovascular fitness, strengthen bones, reduce excess body fat, and boost muscle power and endurance. It can reduce your risk of developing conditions like heart disease, type 2 diabetes, osteoporosis and some cancers. Unlike some other forms of exercise, walking is free and doesn’t require any special equipment or training.

Physical activity does not have to be vigorous or done for long periods in order to improve your health. Even a low level of exercise – around 75 minutes per week – improves fitness levels significantly, when compared to a non-exercising group.

Walking is low impact, requires minimal equipment, can be done at any time of day and can be performed at your own pace. You can get out and walk without worrying about the risks associated with some more vigorous forms of exercise. It’s also a great form of physical activity for people who are overweight, elderly, or who haven’t exercised in a long time.

Health benefits of walking

You carry your own body weight when you walk. This is known as weight-bearing exercise. Some of the benefits include:

  • Increased cardiovascular and pulmonary (heart and lung) fitness
  • Reduced risk of heart disease and stroke
  • Improved management of conditions such as hypertension (high blood pressure), high cholesterol, joint and muscular pain or stiffness, and diabetes
  • Stronger bones and improved balance
  • Increased muscle strength and endurance
  • Reduced body fat

Walking for 30 minutes a day

To get the health benefits, try to walk for at least 30 minutes as briskly as you can on most days of the week. ‘Brisk’ means that you can still talk but not sing, and you may be puffing slightly. Moderate activities such as walking pose little health risk but, if you have a medical condition, check with your doctor before starting any new exercise program of physical activity.

Building physical activity into your life

If it’s too difficult to walk for 30 minutes at one time, do regular small bouts (10 minutes) three times per day and gradually build up to longer sessions. However, if your goal is to lose weight, you will need to do physical activity for longer than 30 minutes each day. You can still achieve this by starting with smaller bouts of activity throughout the day and increasing these as your fitness improves.

Physical activity built into a daily lifestyle plan is also one of the most effective ways to assist with weight loss and keep weight off once it’s lost.

Some suggestions to build walking into your daily routine include:

  • Take the stairs instead of the elevator (for at least part of the way)
  • Get off the bus one stop earlier and walk to work or home
  • Do housework, like vacuuming
  • Walk (don’t drive) to local stores
  • Walk the dog (or your neighbor’s dog)

Wearing a pedometer while walking

A pedometer measures the number of steps you take. You can use it to measure your movement throughout a day and compare it to other days or to recommended amounts. This may motivate you to move more. The recommended number of steps accumulated per day to achieve health benefits is 10,000 steps or more.

Warming up and cooling down after walking

The best way to warm up is to walk slowly. Start off each walk at a leisurely pace to give your muscles time to warm up, and then pick up the speed. Afterwards, gently stretch your leg muscles – particularly your calves and front and back thighs. Stretches should be held for about 20 seconds. If you feel any pain, ease off the stretch. Don’t bounce or jolt, or you could overstretch muscle tissue and cause microscopic tears, which lead to muscle stiffness and tenderness.

It’s best to dress lightly when you do physical activity. Dressing too warmly can increase sweating and build up body temperature, which can make you uncomfortable during a walk or possibly cause skin irritations. A gradual cool-down will also prevent muscular stiffness and injury.

Footwear for walking

Walking is a low-cost and effective form of exercise. However, the wrong type of shoe or walking action can cause foot or shin pain, blisters and injuries to soft tissue. Make sure your shoes are comfortable, with appropriate heel and arch supports. Take light, easy steps and make sure your heel touches down before your toes. Whenever possible, walk on grass rather than concrete to help absorb the impact.

Safety suggestions while walking

Walking is generally a safe way to exercise, but look out for unexpected hazards. Suggestions include:

  • See your doctor for a medical check-up before starting a new fitness program, particularly if you are aged over 40 years, are overweight, or haven’t exercised in a long time.
  • Pre-exercise screening can identify medical conditions that may put you at a higher risk of experiencing a health problem during physical activity. It is a filter or safety net to help decide if the potential benefits of exercise outweigh the risks for you.
  • Visit an orthopedic physician if you develop any pain that doesn’t go away in just a few days.
  • Choose walks that suit your age and fitness level. Warm up and cool down with a slow, gentle walk to ease in and out of your exercise session.
  • Wear loose, comfortable clothing, and appropriate footwear to avoid blisters and shin splints.
  • Wear sunglasses, sunscreen, long sleeves and a hat to avoid sunburn.
  • Take waterproof clothing to avoid getting wet if it rains.
  • Drink plenty of fluids before and after your walk. If you are taking a long walk, take water with you.

Dealing with Stress Fractures

A stress fracture is a small crack in a bone caused by overuse and high impact.

A stress fracture results from repetitive use injuries that exceed the ability of the bone to repair itself. Impact forces are transferred to the bones, causing microfractures that consolidate into stress fractures. Stress fractures occur in weight-bearing areas, commonly the lower leg, or tibia, and foot, or metatarsals.

Most stress fractures result from a rapid increase in the amount or intensity of exercise. Sports involving running or jumping place individuals at highest risk. Such sports include track and field, basketball, tennis, ballet, and gymnastics. Upper extremity stress fractures, though much less common than lower extremity stress fractures, can be caused by repetitive use of the arms in sports such as basketball or tennis.

Women are more likely than men to develop stress fractures. Women with irregular or absent periods – especially young female athletes – are at particularly high risk. About 60% of persons with a stress fracture have had a previous stress fracture.

Could It Be A Stress Fracture?

Dull, localized bone pain not associated with trauma that worsens with weight bearing or repetitive use. Localized swelling may occur at the pain site, which hurts to touch.

Orthopedic surgeons commonly utilize X-rays to determine stress fracture. Sometimes, the stress fracture cannot be seen on regular x-rays or will not show up for several weeks after the pain starts. Occasionally, a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary.

How Are Stress Fractures Treated?

Stress fractures heal with time and rest. Athletes are advised to rest from any activity that caused the stress fracture for the 6 to 14 weeks that the fractures take to heal, or until pain-free for 2 to 3 weeks. Your orthopedic surgeon can give you the best idea of how long it will take for your stress fracture to heal. If activity is resumed too quickly, a larger stress fracture may develop, the original stress fracture may never heal, and athletes are at risk for re-injury. Activities of daily living and limited walking are permitted.

Ice and nonsteroidal anti-inflammatory drugs can decrease pain and swelling. Calcium and vitamin D supplements may also be helpful. Substitution of a non-weight-bearing exercise, such as swimming, can prevent cardiovascular deconditioning.

Air splinting may help to speed recovery and reduce pain in severe or non-healing lower leg fractures. Other types of fractures occasionally require special shoes, casting or surgery. Ask your orthopedic surgeons which therapies are right for you.

If you have recurrent stress fractures, your orthopedic surgeon may advise an imaging test that assesses bone density.

How Can I Prevent Stress Fractures?

High-impact exercises should be increased gradually (not more than 10% per week). Athletes should stretch and warm-up appropriately before exercise. Using well-cushioned shoes in good condition can help prevent fractures. Ask your orthopedic surgeon if arch supports or orthotics are appropriate for your foot structure. Runners benefit from running on smooth, level surfaces.

Maintain adequate intake of calcium, a mineral found in bones, to have strong, healthy bones.

If you notice any pain or swelling during physical activity, refrain from that activity for a few days. Consult an orthopedic surgeon if the pain does not lessen.

Here Are Some Tips Developed By The American Academy Of Orthopaedic Surgeons To Help Prevent Stress Fractures:

  1. When participating in any new sports activity, set incremental goals. Do not immediately set out to run five miles a day; instead, gradually build up your mileage on a weekly basis.
  2. Cross-training — alternating activities that accomplish the same fitness goals — can help to prevent injuries like stress fractures. Instead of running every day to meet cardiovascular goals, run on even days and bike on odd days. Add some strength training and flexibility exercises to the mix for the most benefit.
  3. Maintain a healthy diet. Make sure you incorporate calcium and Vitamin D-rich foods into your meals.
  4. Use the proper equipment. Do not wear old or worn running shoes.
  5. If pain or swelling occurs, immediately stop the activity and rest for a few days. If continued pain persists, see an orthopedic surgeon.
  6. It is important to remember that if you recognize the symptoms early and treat them appropriately, you can return to sports at your normal playing level.

Fracture Prevention: 6 Tips to Fight Fractures, Falls, and Slips

If you have osteoporosis, treating the condition directly with medicines or calcium supplements is important. But it’s also crucial to do everything you can to avoid the most serious risk of osteoporosis: broken bones. Practicing fracture prevention is a vital part of your osteoporosis treatment.

According to the National Institutes of Health, osteoporosis causes 1.5 million bone fractures every year. And these broken bones can be a lot more than painful and inconvenient. Fractures can have a devastating and sometimes permanent impact on your health.

So what can you do to avoid broken bones and painful rehab? Here’s a list of six tips for fracture prevention that every person with osteoporosis should know. By asking your orthopedic physician the right questions — and making a few changes to your habits — you can greatly reduce your risks.

The Importance of Fracture Prevention

In people with osteoporosis, fractures can happen anywhere, but wrist fractures, hip fractures, and spinal fractures are the most common. The effects can be serious. 700,000 people with osteoporosis fracture their vertebrae every year, and many are left with chronic pain. Of the 300,000 people with osteoporosis who have a hip fracture this year, half will never be able to walk again without assistance. And a staggering 20% of people over age 50 who break a hip will die within a year from complications.

If you’re older and have osteoporosis, not only are falls much more dangerous, but they’re more likely too. As you age, your body’s muscle tone decreases. Your vision worsens. You’re more likely to need medications, which can affect your balance. Even seemingly trivial things, like needing to go to the bathroom more in the night, can up your odds of falling. Essentially, a number of minor risks associated with aging coalesce at the same time, greatly increasing the possibility of a fall and fractured bone.

The good news is that with some simple changes to your lifestyle, you can seriously lower these risks. Here’s a rundown of what you can do.

  1. Exercise to Improve Balance and Strength

Many people with osteoporosis worry about the risks of exercise. The fact is that exercising reduces your risk of falls. Keeping physically active helps your reflexes stay sharp and your muscles stay strong. That can help with coordination and lower your risk of falling. Aside from improving your balance and strength, exercise also has a direct impact on the strength of your bones. Bone is a living tissue. Like muscle, it weakens if you don’t exercise it. By staying fit, you can make your bones stronger and less likely to break during a fall. Experts generally recommend a combination of weight-bearing exercise (like walking), resistance exercise (like lifting weights), and flexibility and balance exercises (like yoga or tai chi).

  1. Tread Carefully

If you have osteoporosis, you need to consider more than fashion when choosing your shoes. Wearing the wrong sort of footwear can really increase your risk of a fall.

But happily, you don’t have to be stuck with “sensible shoes” either. Just look for low-heeled shoes that offer good support and have rubber soles rather than leather ones. While sneakers are fine, avoid ones with deep treads that can trip you up.

Start wearing shoes inside the house too: walking around in socks and slippers can increase your risk of slipping.

When you’re walking outside, play it safe. Walk on the grass when it’s been raining or snowing, since you’re more likely to slip on concrete. Always put down salt or kitty litter on icy patches around your home.

If you have difficulty walking due to a medical condition such as arthritis or another problem, make sure to use the assistive device recommended by your orthopedic physician, such as a cane or walker.

  1. Know How Medicines Might Affect You

Unfortunately, as you get older, you’re more likely to need daily medications. Some medications have side effects which can increase your risk of having a fall. Medications that can cause dizziness or lack of coordination are:

  • Sedatives or sleeping pills
  • Drugs that lower high blood pressure, which can sometimes cause hypotension, or blood pressure that is too low
  • Antidepressants
  • Anticonvulsants, which are used to treat epilepsy and some psychological conditions
  • Muscle relaxants
  • Some medicines for heart conditions

Other drugs, like some corticosteroids, are also associated with a higher risk of osteoporosis and fractures. Just the number of medicines you take can increase the danger. Studies have linked taking four or more prescription medicines with a higher rate of falls, regardless of what the drugs are.

But given that you need these medicines for other health reasons and can’t just stop taking them, what should you do? Go over all the drugs you take with your doctor. Bring in a list or the bottles themselves. Keep in mind that one doctor — like your primary care provider — might not know what other doctors — like your cardiologist, or rheumatologist — have prescribed.

If any of the medicines you take are increasing your risk of falls, ask your doctor for advice. It’s possible that your doctor can change your dosage or change medicines altogether so that you’re less likely to fall.

  1. Lighten Up

As you age, you may notice that your vision isn’t quite as sharp as it once was. Sometimes this is due to a treatable health condition, like cataracts. But it’s also natural to lose some of the contrast sensitivity in our vision as we age, making it harder to discern objects, especially in low light. So you need to brighten up your home. Here are some tips:

  • Install overhead lights in all rooms, so you don’t have to stumble around in the dark to find the lamp.
  • Use nightlights in your bedroom, bathroom, and any hallways that connect them.
  • Make sure all stairways, both inside and outside, are well lit.
  • Keep a flashlight by your bed.
  1. “Fall-Proof” Your Home

A key part of fracture prevention is to make your home safer. Here are some tips:

  • Keep rooms free of clutter — get rid of those piles of clothes and boxes of papers.
  • Put down carpet or plastic runners on polished — and potentially slippery — floors.
  • Get throw rugs, electric cords, and phone lines off the floor.
  • Make sure to have handrails on all stairs.
  • Install railings in the bathroom around the toilet and the shower.
  • Put a rubber mat on the floor of your bath or shower.
  1. Treat Health Conditions

Many chronic diseases and health conditions become more common as you get older. Some can affect your strength or physical functioning and increase the risk of a fall. Arthritis can make it hard to move around. Vision problems directly increase your risk of tripping.

If you have any other health conditions, ask your doctor if they might increase your risk of a fall. If they do, seek out treatments that might help. One difficulty is that some of these problems may come on so gradually that you might not even notice. For instance, you might not realize that your vision is slowly getting worse, or if your gait has become a little less steady. That’s why it’s important to get regular check-ups: not only with your primary physician, but your eye doctor and any other specialists you need.

Bone Fractures Aren’t Inevitable

Even with precautions, some types of bone fractures are tough to avoid. Just a mild bump can be enough to break a bone in people with severe osteoporosis. Only 10-15 percent of vertebral fractures are caused by falls. Many fractures in people with severe osteoporosis are caused by physical stress, even by something as simple as bending over or even coughing.

While some fractures can’t be prevented, you can work on the fracture risks you can control. While bone fractures may be more likely as you get older, they aren’t inevitable.

Avoiding Leaf Raking Injuries

It is that time of year again. The kids enjoy jumping in the leaf piles but you are faced with the daunting task of raking all of those leaves.

Because raking requires different body positions and utilizes several muscle groups, the potential for injury is high. Orthopedic surgeons estimate that over 76,000 people seek care for injuries related to non-powered garden tools (including rakes) every year.

By following a few simple recommendations, hopefully you will avoid becoming a statistic.

  • Warm-up and stretch for a few minutes before beginning to rake. Example stretches include:
    • Trunk rotation stretch
    • Shoulder stretches
    • Wrist stretches
  • Make sure the yard is clear of debris to avoid trip hazards
  • Use a rake that is sized appropriately to your height and strength.
  • Avoid blisters by wearing gloves.
  • Wear skid-resistant shoes to minimize risks for slipping or falling. • Avoid twisting your body. Move your legs to shift your weight. Do not throw leaves over your shoulder or to the side; rake the leaves towards you. This will help to avoid excessive strain on your back muscles.
  • Do not bend over to pick up leaves or bags. Keep your back straight and bend at the knees to pick things up. Make sure the leaf bag is not too heavy to be able to pick up comfortably.
  • Raking is considered an aerobic activity. Pace yourself, take frequent breaks, and stay hydrated. If you experience chest pain or shortness of breath, call 911.
  • Cool down and stretch afterwards to relieve tension.

By following these simple recommendations, your raking experience can be a pain free, if not enjoyable one.

Sport Safety for Young Athletes

For young athletes, sports activities are more than just play.

Participation can improve physical fitness, coordination, and self-discipline, and help children learn teamwork.

However, children’s bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. Growth plates are the areas of developing cartilage at the ends of long bones where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete.

There are also significant differences in coordination, strength, and stamina from child to child and between children and adults. Young athletes of the same age can differ greatly in size and physical maturity. Grade school students are less likely to experience severe injuries during athletic activities because they are smaller and slower than older athletes. High school athletes, however, are bigger, faster, stronger, and capable of delivering tremendous forces in contact sports.

Acute sports injuries are caused by a sudden trauma, such as a twist, fall, or collision. Common acute injuries include broken bones, sprains (ligament injuries), strains (muscle and tendon injuries), and cuts or bruises.

Most acute injuries should be evaluated by an orthopedic physician. Prompt first aid treatment should be provided by coaches and parents when the injury occurs. This usually consists of the RICE method: rest, applying ice, wrapping with elastic bandages (compression), and elevating the injured arm, hand, leg, or foot. This usually limits discomfort and reduces healing time. Proper first aid will minimize swelling and help the doctor establish an accurate diagnosis.

Follow these tips to play it safe:
• Always be in proper physical condition to play a sport
• Know and abide by the rules of a sport
• Wear appropriate protective gear
• Know how to correctly use athletic equipment
• Always warm up before playing
• Stay hydrated
• Avoid playing when very tired or in pain

Following a regular conditioning program with exercises designed specifically for their chosen sport can help young athletes avoid injuries.

Coaches and parents are responsible for creating an atmosphere that promotes teamwork and sportsmanship. A young athlete striving to meet the unrealistic expectations of others may ignore warning signs of injury and continue to play with pain. The “win at all costs” attitude of many parents, coaches, professional athletes and peers can lead to injuries. Above all else, youth sports should always be fun.

Common Foot and Ankle Conditions

Our feet and ankles support our bodies and enable us to move about. While walking, the pressure on your feet can exceed your body weight. When you’re running, it can be three or four times your body weight.

The average person takes 8,000 to 10,000 steps a day – the equivalent of walking several miles. Those steps add up to about 115,000 miles in an average lifetime. That’s like walking around the world four times.

The 26 bones in your feet make up a quarter of all the bones in your body. Each foot also contains 33 joints. More than 100 muscles, tendons and ligaments hold this intricate structure together and allow it to move in a variety of ways.

These numerous small bones are vulnerable to fracture. Some of the most common fractures include ankle fractures, heel bone fractures, midfoot fractures, pilon fractures, shinbone fractures, stress fractures of the foot and ankle, and toe fractures.

The foot and ankle are often the site of injury during sports activities. And whether active in a sport or not, twisting the ankle is an extremely common injury for adults and children alike. About 60 percent of all foot and ankle injuries reported by the U.S. population older than 17 years are sprains and strains of the ankle.

Whether caused by rheumatoid arthritis, post-traumatic arthritis or osteoarthritis, the ankle is an especially vulnerable to the debilitating degenerative joint condition of arthritis.
Other common causes of foot and ankle pain include bunions, plantar fasciitis, heel spurs, hammer toe, and Achilles tendonitis and rupture.

An orthopedic physician can provide both surgical and non-surgical treatments to patients suffering from foot and ankle conditions, including proper shoe recommendations, oral anti-inflammatory medication, anti-inflammatory injection therapy, and surgical correction for severe cases.

Treat ankle sprains by following RICE (rest, ice, compression, elevation). If pain is severe and you cannot bear weight on the sprained ankle, you should see an orthopedic doctor for an exam and X-rays to determine the extent of the injuries.

Your feet mirror your general health. Underlying conditions such as diabetes and nerve and circulatory disorders can show their initial symptoms in the feet. Foot ailments may be your first sign of more serious medical problems.

Whether caused by these underlying conditions, or because of common injuries or ill-fitting footwear, foot and ankle pain is a leading cause of visits to an orthopedic specialist.

Partial Joint Reconstruction Is an Option for Knee, Hip and Shoulder Pain

Joints refer to the areas on our body where two or more bones meet. While we have different kinds of joints, the ones more commonly used and more easily damaged are the weight-bearing joints, such as the hips and knees. Less commonly, non-weight bearing joints, such as the shoulder, are damaged. Through overuse and aging, these joints may become weak and painful. Joint disorders such as arthritis cause pain and limit our daily activities.

Reconstructive partial joint replacement, or hemi-arthroplasty, offers relief for many people through safe and minimally invasive procedures when performed by a skilled orthopedic surgeon. Many people who have ongoing pain or loss of function in a joint may be a candidate for partial joint replacement surgery.

Hips and knees, the largest joints on the human body, bear a tremendous toll over the years from wear and tear, chronic disease such as arthritis, and traumatic injury. When joints are damaged, the resulting pain can disrupt sleep, reduce mobility, and affect all aspects of daily life.

If you suffer from hip or knee pain, rest assured you are far from being alone. Each year six million Americans seek medical help for painful knees. This translates into 2.5 percent of the U.S. population seeking orthopedic specialists for relief of knee pain. It’s estimated that about 32 million Americans visit their physician for some form of arthritis. Non-surgical intervention is the first line of treatment, with medications, therapy and injections. Surgery is reserved for those patients who do not respond to more conservative measures.

Thankfully, partial knee reconstruction and partial hip reconstruction have become very reliable procedures as orthopedic surgeons continue to revise and improve upon these minimally-invasive techniques. And, most of today’s artificial joints can be expected to last at least 15 years, and some longer than 20 years.

Partial knee reconstruction may be possible for patients with damage to one part of the joint. The knee has three distinct compartments, which can be treated separately. Doctors refer to this limited reconstruction as a unicompartmental knee replacement. In a partial or unicompartmental knee replacement, only the diseased parts of the knee are removed and replaced; the healthy portions are left untouched. Successful partial knee replacements can delay or eliminate the need for a total knee replacement. They also allow a greater range of movement than standard total knee replacements, and they are often performed as an outpatient procedure returning the patient home on the same day.

Partial hip reconstruction is an alternative to total hip replacement, and is usually reserved for the elderly patient with a particular type of hip fracture.

Although partial shoulder joint reconstruction is less common than partial knee or partial hip replacement, it is successful in relieving joint pain and is usually used to treat osteoarthritis, and is commonly performed on an outpatient basis.

The benefits of partial joint reconstruction surgery include smaller incisions, a shorter hospital stay, less bleeding, reduced risk of infection and other complications, and faster recovery and rehabilitation.

When searching for the right orthopedic surgeon, ask friends and family for referrals and always consult an orthopedic surgeon with extensive experience performing the reconstruction your condition requires.

Partial Knee Replacement Can Help Relieve Arthritis Pain

Over the course of their lifetimes, approximately one in five Americans will develop knee arthritis. Fortunately, a wide range of nonsurgical and surgical techniques are available to address the discomfort and disability that can accompany this condition.

Partial knee replacement is a reconstructive surgical treatment option that replaces (or resurfaces) only the damaged portion of the knee, while conserving knee ligaments and unaffected cartilage. Over the past 15 years, improvements in minimally-invasive surgical techniques and instrumentation have made partial knee replacement a viable option for a growing number of patients.

Patients with unicompartmental knee arthritis have cartilage degeneration in only one section or compartment of the knee. In cases where nonsurgical techniques do not provide sufficient symptom relief, surgeons can remove damaged cartilage and bone in the diseased area only, while preserving the ligaments that help support the knee joint.

A prosthesis—which may also be called an implant—takes the place of the damaged area of the knee, leaving the other compartments intact.

During partial knee replacement, the orthopedic surgeon makes a small incision to gain access to the affected compartment of the knee and then gently moves supporting structures of the knee out of the way. Damaged cartilage and bone tissue are removed from the surfaces of the tibia and the femur in the arthritic area. The surgeon then prepares these surfaces for insertion of the prosthesis components which are specifically sized to the patient’s joint. Cement is used to secure these components. All surrounding structures and tissues are restored to their anatomic position and the incision is closed.

Partial knee replacement is usually performed as an outpatient procedure in a surgical center with no overnight stay. Most patients are able to walk with assistance, or independently, on the same day as their surgery. Typically, the patient is given a cane within a week of surgery to allow for increased independence and begins outpatient rehabilitation. Medication helps manage post-surgical pain.

Partial knee replacement usually involves minimal blood loss and a low rate of complications. Most patients can expect to be back to their daily activities within three to six weeks. Many patients find that after undergoing physical rehabilitation, they are able to return to sports such as golf or bike riding within six to ten weeks.

There are no age restrictions for partial knee replacement, but in general, partial knee replacements are typically appropriate for patients over 40 years old and less than 60 but each case is evaluated according to the needs and activity of the patient. Partial knee replacement is generally restricted to patients who are not morbidly obese. Patients with rheumatoid arthritis are not candidates for partial knee solutions since inflammatory-type arthritis typically involves the entire joint. Also patient age is typically over forty and less than 60 but each case is evaluated according to the needs and activity of the patient.

Your orthopedic surgeon will perform diagnostic tests and determine with you whether partial knee replacement is your best treatment option.

Partial knee reconstruction is widely recognized as a technically demanding surgery. Choosing an orthopedic surgeon with extensive experience with this procedure will help to ensure the best possible outcome.

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 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.