How to prepare for ankle surgery

There are several steps to take in order to prepare yourself for ankle surgery. And taking them will make surgery and post-op recovery much smoother. Be sure to talk with your physician about any medicines you’re taking, including over-the-counter meds. Some meds like aspirin should be discontinued, as it thins the blood and may cause more bleeding during surgery. Tell your physician about any allergies you may have, including latex. If you have an infection prior to surgery, such as a bladder infection or a sore throat, call your physician and advise them. It’s possible the surgery may need to be rescheduled until the infection is gone. If you smoke, stop. Your body needs oxygen during surgery, and tobacco products decrease the amount of oxygen to your tissues.

Things to keep in mind before the surgery

Be sure to eat healthy prior to surgery. If you’ve had any problems with constipation, let your physician know. Prior to surgery, tests will be ordered to ensure your readiness for surgery. Likely, you’ll have to have some blood tests and an ECG. These procedures may be done in your physician’s office or in the pre-admission unit at the hospital. Don’t eat or drink anything after midnight the night prior to your surgery, as this will increase the chances of vomiting and nausea both during and after the surgical procedure.

What to consider after ankle surgery

Likely, you’ll need some assistive devices after surgery. If you’ve obtained crutches or a walker before surgery, be sure to label them with your name and bring them with you to the hospital. Plus, you’ll need to make arrangements for someone to take you home from the hospital. You won’t be allowed to drive home on your own after the surgery.

If you’re wondering how to prepare for ankle surgery, it’s not rocket science. Take these simple steps, and you’ll be good to go.

Orthopedic Surgeons near me

Many people seeking the best orthopedic surgeons near me in Monmouth County find Dr. Marshall P. Allegra. Dr. Marshall P. Allegra is a board-certified orthopedic surgeon in medical practice in Monmouth County for over two decades. He is a member of the American Academy of Orthopedic Surgeons and a Diplomate of the American Board of Orthopedic Surgeons.

Finding an Orthopedic Surgeon near me

Dr. Marshall P. Allegra specializes in full and partial joint reconstruction, arthroscopic surgery, hand, foot and ankle surgery and offers non-surgical care for fractures. When you visit his practice, he’s the only doctor you’ll see. He is patient-focused and an excellent diagnostician. He will determine the root cause of your pain and determine the best treatment options. Dr. Allegra has helped more than 500 patients with knee and hip replacements from Monmouth County and other surrounding areas.

About Orthopedic Surgeon Dr. Marshall P. Allegra

Turn to Dr. Marshall P. Allegra for all of your hand, wrist, foot and ankle surgeries. He is trained and experienced in the reconstruction of bones, muscles and tendons in the hands, feet and ankles. Using the latest in medical technology, he has successfully treated athletic injuries, tumors, carpal tunnel syndrome and more. His goal is to restore you to a pain-free active life. We use our hands and feet for everyday tasks and activities. It’s not uncommon to incur an injury due to accident or overuse. Contact Dr. Marshall P. Allegra for a one-on-one consultation. He’ll let you know what your treatments are, so you can get back to enjoying your life.


What are the most common orthopedic surgeries?

Orthopedic surgery is a surgical procedure performed on the musculoskeletal system for the correction of injury or other conditions. The musculoskeletal system is made up of bones, joints, and soft tissues such as muscles, ligaments, and tendons. Any part of the musculoskeletal system can become impaired through injury/accident or caused by other degenerative conditions.


Orthopedic surgery can performed through traditional open surgery, or arthroscopically. Arthroscopy is a surgical procedure on a joint that is minimally invasive as treatment is provided using an arthroscope inserted into the joint through a small incision.

Most orthopedic surgeries are performed on the ankle, knee, hip, wrist, elbow, shoulder or spine. The most common procedures include:

  1. Soft tissue repair, for torn ligaments and tendons.
  2. Joint replacement, in which a damaged joint is replaced with a prosthesis.
  3. Revision joint surgery, in which a preexistent implant is changed with a new one.
  4. Bone fracture repair
  5. Debridement, during which damaged soft tissues or bones are removed.
  6. Fusion of bones, in which bones are fused with grafts.
  7. Spine fusion, during which the spinal bones (vertebrae) are joined together.
  8. Osteotomy, aimed at correcting bone deformities.


Dr. Marshall P. Allegra is a board-certified orthopedic surgeon with over 23 years experience treating patients in Monmouth County. Depending on the type of condition or injury, Dr. Allegra may recommend fixing a fracture with rods, plates, and screws that will hold the fracture together during healing. Contact the offices today for answers to any questions you may have or to schedule an appointment.

Arthroscopic Surgery in Hazlet NJ

Joint problems are common simply due to the amount of pressure we put on our bodies. Our joints are constantly flexing and bending as we go about our daily life which can cause major wear and tear to our bodies over time. Arthroscopic surgery uses a camera to look at the damage to your joints to determine what (if anything) needs to be done. An arthroscope can technically be used anywhere in the body but is generally needed for the knees, ankles, wrists, hips, and shoulders.

The Basics of Arthroscopy

Arthroscopy is used to either diagnose or help treat general inflammation or trauma. It’s generally an outpatient procedure, but you will be given some type of anesthetic. Depending on the severity of the injury and the location of the damaged joint, it may be either general or local anesthesia. The doctor will make a tiny cut in your skin before inserting an instrument into your body (about the size of a standard pencil.) The doctor will fill the joint with fluid to make it easier to fit the tiny camera inside.

Next Steps

The arthroscope is used to let the doctor look inside the joint to see if you need arthroscopic surgery. Should you need the surgery, your doctor will need to manipulate your bones to fix the joints. This can be done without making large incisions, but rather using precise instruments to shave or cut the bone. You may not even need stitches! If for any reason you do need traditional surgery, this can be done in the same procedure as the arthroscopic surgery. Dr. Allegra at Allegra Orthopedics serves the people of Hazlet, NJ and understands the ins and outs of joints. He’s here to help you increase your flexibility and range of motion while simultaneously decreasing any discomfort!

What Is a Hairline Fracture?

We often hear the term hairline fracture, but do you know what the term means?

Orthopedic physicians describe hairline or stress fractures as tiny cracks that develop on bones in the foot or lower leg. A common injury in runners, gymnasts, and dancers, anyone can develop a hairline fracture through repetitive jumping or running. Individuals with osteoporosis also are at risk for hairline fractures.

The bones of the foot and leg absorb a lot of stress during running and jumping. Common sites for hairline fracture include the metatarsal bones – the five long and narrow bones connecting the mid-foot to the toes – as well as the heel, ankle bones, and the navicular, the bone on the top of the mid-foot.

What are the symptoms of a hairline fracture?

The most common symptom is pain that gradually worsens over time, especially if you don’t stop weight-bearing activity. Other symptoms include swelling, tenderness, and bruising.

What causes a hairline fracture?

An overuse or repetitive activity, or an increase in either the duration or frequency of activity, can result in a hairline fracture. Even regular runners who suddenly increase either their distance, such as someone training for a marathon, or the number of times per week they run, can cause a hairline fracture.

Another cause of a hairline fracture is changing the type of exercise normally performed.

Bones adapt to increased forces through various activities, where new bones form to replace old bone. This process is called remodeling. When the breakdown of bone happens more rapidly than new bone can form, the likelihood of developing a hairline fracture increases.

Who’s most at risk for developing a hairline fracture?

There are several risk factors that increase the chances of developing a hairline fracture:

  • Certain sports: Participants in high-impact sports such as track and field, basketball, tennis, dance, ballet, long-distance runners, and gymnastics, increase their chances of getting a hairline fracture.
  • Gender: Post-menopausal women have an increased risk of hairline fractures. Female athletes may be at a greater risk because of a condition called the “female athlete triad.” This is where extreme dieting and exercise may result in eating disorders, menstrual dysfunction, and premature osteoporosis.
  • Foot problems: Poor footwear can cause injuries, so can high arches, rigid arches, or flat feet.
  • Weakened bones: People with osteoporosis, or anyone taking medications that affect bone density and strength, can develop hairline fractures even when performing normal activities.
  • Previous hairline fractures: Having one hairline fracture increases your chances of having another.
  • Lack of nutrients:Lack of vitamin D or calcium can make bones more susceptible to fracture. People with eating disorders are at risk for this reason. There can be a greater risk of hairline fractures during the winter months when diminished sunlight decreases the body’s absorption of vitamin D, compounded by an increased risk of slips and trips on icy surfaces.
  • Improper technique: Blisters, bunions, and tendonitis can affect how you run, altering which bones are impacted by certain activities.
  • Changes in surface: Changes in playing surfaces can cause undue stress to the bones of the feet and legs. For example, tennis player who move from a grass court to a hard court may develop injuries.

How is a hairline fracture diagnosed?

If you believe you have a hairline fracture, it’s important to seek treatment from an orthopedic physician as soon as possible.

Your doctor will perform a physical exam and review your medical history and general health, including diet, medications, and other risk factors. Diagnostic tools may include an MRI, X-ray, or bone scan.

How are hairline fractures treated?

If you suspect you have a hairline fracture, follow the RICE method: rest, ice, compression and elevation. An over-the-counter, non-steroidal drug can help with pain and swelling.

It’s important to seek further treatment if the pain becomes severe or doesn’t get better with rest. The treatment your orthopedic physician recommends will depend on both the severity and location of your injury.

Can other conditions develop if hairline fractures aren’t treated?

Ignoring the pain caused by a hairline fracture can result in the bone breaking completely. Complete breaks will take longer to heal and involve more complicated treatments. It’s important to seek advice from an orthopedic physician and treat a hairline fracture as soon as possible.

Medical treatments

Your doctor may recommend that you use crutches to keep weight off an injured foot or leg. You can also wear protective footwear or a cast.

Because it usually takes up to six to eight weeks to completely heal from a hairline fracture, it’s important to modify your activities during that time. Cycling and swimming are great alternatives to more high-impact exercises.

In some cases, a hairline fracture may require surgery. The addition of pins or screws can help hold bones together during the healing process.

What’s the outlook for someone with a hairline fracture?

It’s important to avoid high-impact activities during the healing process. Returning to high-impact activities — especially the activity that caused the injury in the first place — will delay healing and increase the risk of a complete fracture in the bone.

Even after the hairline fracture is healed, it’s important to gradually return to exercise.

In rare instances, hairline fractures don’t heal properly. This result is chronic, long-term pain. Talk with a board-certified orthopedic physician soon after the injury occurs to prevent pain and worsening damage to the bone.

Know Your Knee Pain

The knee is a complicated joint. It enables us to bend and straighten our legs so we can sit, squat, jump and run.

Our knees carry us through life and are exposed to injury as well as normal “wear and tear” throughout our lifetimes, from the scrapes and bruises of childhood to arthritis pain and other degenerative conditions common in older age.

The knee joint has three parts. The thighbone (femur) meets the large shin bone (tibia) to form the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third joint, called the patellofemoral joint. The ends of the femur and tibia, and the back of the patella, are cushioned with cartilage, helping ligaments slide easily over the bones and protecting the bones from impact.

Knee pain is one of the most common complaints heard by orthopedic physicians. When one or more parts of the knee are injured, you may feel different types of knee pain.

Self-Care for Knee Pain

Knee pain that occurs from a relatively minor injury can often be safely observed for a day or two to see if self-care measures will be helpful. Self-care options include:

  • Rest Avoid more strenuous or painful activities, but keep active. Try alternate activities that cause less discomfort – swimming instead of jogging, bicycling instead of tennis
  • Ice Put ice on your knee for 15 to 20 minutes a few times each day. Use ice cubes or a bag of frozen vegetable wrapped with a towel
  • Compression Wrap an elastic bandage around your knee to help control swelling. Make the bandage fit snugly around your knee, but not tight enough to cause pain or leg swelling
  • Elevation Lying down with your knee propped up on pillows may help control pain and swelling
  • NSAIDS Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) may help relieve pain, swelling and inflammation

When to Schedule an Orthopedic Visit

Knee injuries commonly send people to the orthopedic physician. Make an appointment with an orthopedic physician if your knee pain was caused by a particularly forceful impact or if it is accompanied by:

  • Significant swelling
  • Significant pain
  • Redness
  • Tenderness and warmth around the joint
  • Fever

When to Seek Immediate Medical Attention

Call 911 or ask someone to drive you to the Emergency Department if your knee pain is caused by an injury and is accompanied by:

  • A joint that appears deformed
  • A popping noise at the time your knee was injured
  • Inability to bear weight
  • Intense pain
  • Sudden swelling

Top Ten Common Knee Injuries

Treatment will vary based on the cause of your knee pain and the specifics of the injury. Treatment may involve managing pain and inflammation, and rest. Trauma-induced injuries, such as fractures, dislocations and tears, may require bracing, popping the knee back into place, or surgery, which in many cases today, is minimally invasive so patients heal quickly and return to normal activities. Physical therapy may be needed to help regain movement and strength in the knee and leg.

Below are ten of the most common injuries of the knee:

  • Fractures
  • Anterior cruciate ligament (ACL) injuries
  • Dislocations
  • Meniscal tears
  • Bursitis
  • Tendonitis
  • Tendon tears
  • Collateral ligament injuries
  • Iliotibial band syndrome
  • Posterior cruciate ligament injuries

Arthritis of the Knee

Osteoarthritis of the knee is the most common form of arthritis in the knee. It is a degenerative “wear and tear” type of arthritis that occurs most often in people age 50 and older, but may occur in younger people, too. In osteoarthritis, the cartilage of the knee joint gradually wears away.

Long-term knee pain from arthritis can often be helped by weight loss and exercises to strengthen the muscles around the joint.

Seek medical attention immediately for serious knee injuries. Early diagnosis and treatment for chronic, or long term, knee pain or arthritis can make a world of difference in your quality of life.  Know your knees and recognize when it’s time to schedule an appointment with an orthopedic physician.


If your New Year’s resolution is to commit to a triathlon in 2017, you’re probably in the early weeks of training for a spring or summer event. Training for a triathlon is tough but that’s part of the challenge – and the fun.

Before you get too far into your training, consider this; Four out of five amateur triathletes are injured while training, and three of those four are injured badly enough to be sidelined from their daily activities as well as their tri training.

The complexity of the sport and the broad range of knowledge needed to train and compete safely are contributing factors. The triathlete must learn about appropriate equipment, proper body mechanics, nutrition and hydration, injury prevention and overall training programs that prepare the body for the stresses of a triathlon.


Cross training for three events – running, biking and swimming – also increases the risk of certain overuse injuries, and an untreated injury in one part of the body can lead to problems elsewhere. For example, a knee injury from running can cause extra stress on the back, leading to lower back pain when cycling; and the cumulative effect of swimming and cycling can fatigue calf muscles, making legs more susceptible to injury during a run. Improper training can be a vicious cycle, resulting in injury and, ultimately, derailing your resolution to compete in a triathlon.

The good news is, most non-traumatic injuries are related to training errors that can be corrected – and an orthopedic physician with specialized knowledge in sports medicine and injury prevention can help.

Train Smart

The best way to avoid traumatic injury is to undertake a training program that balances strength, flexibility and endurance through weight lifting, stretching and cross training. But training techniques are not one size fits all. Each individual has a unique combination of anatomy, strength, endurance and flexibility, so what works well for one athlete isn’t always the best route for another.

Understanding the relationships between musculoskeletal groups related to swimming, cycling and running is key to triathlon training. An orthopedic surgeon can evaluate your physical conditioning, analyze your training techniques and correct errors that can lead to potential injuries, as well as provide important input into a training program optimized for your needs.

Heal Smart

The best training program can’t prevent all injuries. When injuries do occur, there are three things you need to know:

  • How to evaluate the severity of the injury
  • How to treat an overuse injury
  • When to seek professional help

Congratulations for taking on a triathlon challenge. Whether you’re a first-time athlete or a seasoned tri gal or tri guy, training for and participating in the sport of triathlon involves a huge, months-long commitment. Unfortunately, sometimes things don’t go as planned and injury can overturn even the most dedicated competitor with the most detailed training plan.

When the unforeseen occurs, it is always best to seek medical evaluation from an experienced orthopedic physician. Often, if these issues are addressed early on, they can be treated without significant time loss from training and without surgery. An experienced orthopedic physician understands the sports medicine needs of patients and can be an important part of your team, helping you return to sport as soon as possible.

Preparing For A Triathlon

Make a plan:

  • Select a competition that’s right for you
  • Start your training gradually, begin with short distances and work up to longer distance, faster times and greater intensity
  • Consider recruiting a training buddy to help keep you on track with your goals
  • Check out websites such as USA Triathlon to locate training groups or routes in your area

Eat Properly

  • Consume foods rich in nutritional content and high in complex carbs
  • Increase your intake closer to race time, and supplement with energy gels and sports drinks as needed

Choose Proper Equipment

  • Research water temps to see if you need a wetsuit
  • Make sure your bike chains and pedals are working properly, and don’t forget your helmet
  • Wear comfortable training shoes and avoid sporting a new pair that may lead to blisters
  • If you experience severe or persistent pain while training, seek advice from an orthopedic physician before a more serious injury can occur

Minimally Invasive Orthopedic Surgery Helps Baby Boomers Stay Active

Orthopedics is in great demand, specifically from an aging baby boomer generation. Some of the more common surgeries are total knee and hip replacements, which topped 906,000 in the US in 2009, according to the American Academy of Orthopedic Surgeons. The majority of people that are getting these surgeries are baby boomers, those born between 1946 and 1964.

A study released by Drexel University forecasts that this age group will account for a 17-fold increase in knee replacements alone, surmounting 994,000 procedures annually, by 2030. Baby boomers are unlike older generations in that as their joints are wearing thin, but they want to maintain a high level of activity. Their activeness may be a reason why they need replacements as over exertion accelerates osteoarthritis, the main reason cartilage fades away from joints.

The orthopedic surgical trend is moving towards minimally invasive surgery. Total knee replacement (also called knee arthroplasty) is a common orthopedic procedure that is used to replace the damaged or worn surfaces of the knee. Replacing these surfaces with an implant or “prosthesis” will relieve pain and increase mobility, allowing patients to return to normal, everyday activities.

Minimally invasive knee replacement differs from traditional knee replacement in that it uses an incision that is approximately half as long, and fewer muscles are cut and detached.

Minimally invasive total knee replacement is a variation of the traditional approach. The surgeon uses a shorter incision and a different, less-invasive technique to expose the joint—with the goal of reducing postoperative pain, risk of infection, and speeding recovery.

During any knee replacement, the damaged cartilage and bone from the surface of the knee is removed, along with some soft tissues. The goal of knee replacement surgery is to provide the patient with a pain-free knee that allows for the return to daily activities and lasts for a long time.

Minimally invasive knee replacement is performed through a shorter incision—4 to 6 inches versus 8 to 10 inches for traditional knee replacement. A smaller incision allows for less tissue disturbance.

In addition to a shorter incision, the technique used to open the knee is less invasive. In general, techniques used in minimally invasive knee replacement are “quadriceps sparing,” meaning they avoid trauma to the quadriceps tendon and muscles in the front of the thigh. Other minimally invasive techniques, called “midvastus” and “subvastus,” make small incisions in the muscle but are also less invasive than traditional knee replacement. Because the techniques used to expose the joint involve less disruption to the muscle, it can lead to less postoperative pain and reduced recovery time.

The hospital stay after minimally invasive surgery is similar in length to the stay after traditional knee replacement surgery–ranging from 1 to 4 days. Physical rehabilitation is a critical component of recovery. Your orthopedic surgeon or a physical therapist will provide you with specific exercises to help increase your range of motion, restore your strength, and get you back to your normal routine as quickly as possible.