Patient Info

When one has arthritis, which is the loss of the cartilage coating of the joint, the symptoms can progress to the point of having pain, swelling, stiffness and loss of motion. This can result in an inability to perform not only activities for pleasure such as running and dancing, but can also result in difficulty performing activities of daily living.

Nonsurgical treatment measures initially consist of alternating ice and heat, anti-inflammatories, cortisone shots and activity modification. When these treatment methods are no longer providing adequate relief of one’ symptoms, we then begin to have discussions about surgical intervention. If the arthritis is widespread enough in the knee, the discussion will usually entail performing a total knee replacement. If the symptoms are limited to only one area of the knee, we would consider a partial knee replacement.

In these procedures, basically the ends of the bone that are arthritic are shaved off and the surface of the bone is replaced with a metal cap at the bottom of the shinbone and the top of the thighbone.

This is extremely reproducible operation with excellent long-term outcomes, but is still a rather large undertaking and involves a significant commitment on the patient’s part for rehabilitation and physical therapy.

For further information, please refer to the patient education section.

Arthroscopic surgery has been utilized by the orthopedic surgery community for the past four decades. This was truly the first minimally invasive surgery to be performed.

These operations involve making approximately three 1/4-inch incisions around the joint introducing a fiberoptic camera into the joint and then through the other incision sites introducing instrumentation that allows the surgeon to perform various procedures.

The shoulder and the knee are the joints that most commonly undergo arthroscopic procedures and of these two by far the knee is most prevalent.

These procedures can typically involve treating cartilage injuries whether it be the cartilage coating of the knee or the meniscus cartilage of the knee. However, ligament reconstruction, procedure that addresses cartilage injury, tendon reconstruction, and even cartilage stimulation procedures are all performed in an arthroscopic manner.

The benefits of these procedures being done in such a minimally invasive manner are a much shorter rehabilitation time and a much quicker return to one’s desired activity level.

This is a rapidly evolving area of orthopedic surgery and new techniques are constantly evolving.

For further information regarding arthroscopy, please refer to the patient education section.

Pediatric orthopaedics is the area of orthopaedics that deals with children. In almost all subspecialties of medicine, it is important to think of a child is not just a small version of an adult. Children have very specific conditions that either only occur during childhood or when they do occur in childhood present and are treated very differently then those in an adult.

One of the most significant examples of this is the fact that children have open growth plates. The growth plate is the portion of the bone, which contains a specific type of cell that results in bone growth. There are specific injuries that occur to the growth plate that obviously cannot occur in an adult whose growth plates have fused and are no longer growing. These can range from strains to the growth plate up to fractures of the growth plate. It sometimes takes a very skilled eye to discern the difference between these and also requires a great deal of expertise to determine whether an x-ray is revealing only normal anatomy or a fracture through a growth plate.

Other examples of specific pediatric orthopaedic conditions are scoliosis, angular deformities of the lower extremities such as bowlegs or being bowlegged or knock-kneed.

In my practice, a large percentage of my care is devoted to pediatric conditions and I strive to present a very child friendly atmosphere in the office even having a treasure chest full of toys for the little ones to pick from on each of their visits.

In my mind an important aspect of caring for a child is to speak directly to the child and not talk about them to the parents as if they were not even in the room. I find that this goes a long way to put the child at ease and if they are at ease, it can only result in better care for them.

For further information regarding pediatric orthopedic condition, please refer to the patient education section.

A fracture is a break in ones bone. There are many terms that are used to describe a fracture, all of which are synonymous. These include a fracture, a break, a crack and even stress fractures.

Typically these are the result of a traumatic event, which can be either high energy or low energy. It never seizes to amaze me how some fractures occur with an injury that one would not necessarily think would result in a broken bone. However, there is something called a stress fracture that is not necessarily the result of one traumatic event. This can be the result of a small amount of stress applied to the bone on a repetitive basis.

Fortunately, the overwhelming majority of fractures that present to my office do well with nonsurgical treatment. It is only when one’s outcome will be compromised with nonsurgical treatment that I entertain surgical intervention. Even in these cases, I still strive to achieve an excellent outcome with a minimally invasive technique.

Our ability to provide total fracture care within the office entails our ability to do on-site x-rays in a digital manner, exposing the patient to less radiation, casting and splinting and cast removal right in the office. When appropriate some fractures can even be set or “reduced” right in the office.

One thing I have learned over the years is that even when one is able to move the joint or walk on the leg, this does not rule out the presence of a fracture. I have had patients literally walking to the office, who had a hip fracture that needed to be admitted to the hospital and have a surgical procedure. Even the presence or absence of swelling is not an indication of whether the fracture is present or not.

If you have any concerns whatsoever, always call my office. We make every effort to see these types of injury the same day.

For more information regarding fractures, please refer to patient education section.

Scoliosis is a condition, which affects the bony elements of the spine. The result is a curvature of the spine. Most commonly this is an S-shaped curved in the spine when we are looking at the spine while standing behind someone.

For the most part, we do not know why scoliosis occurs. The most common form of scoliosis we call idiopathic scoliosis meaning that there is no specific cause for the scoliosis. There are times, however, where vertebrae do not form properly are wedge-shaped or fused to another vertebra and this will result in a curvature of the spine.

A majority of times a patient has scoliosis they present in the pediatric-age range. Fortunately, the majority of these patients only need simple observation to monitor the curve and whether it progresses over time. It is very infrequent that they progress to a point where the curvature needs a brace and even less so progresses to a point where it needs surgical intervention.

A recent addition to my practice is the utilization of a genetic test to determine the likelihood the scoliosis will progress to the point of needing a brace or surgery. There are specific patient criteria for needing the genetic requirements, but this is a simple saliva test that is done here in the office.

For further information regarding scoliosis, please refer to the patient education section.