Related Posts

• America Needs Orthopedic Surgeons: Five Things You Didn't Know About the Demand For Orthopedic Medicine

  If you're suffering from a foot, ankle, or knee problem, you're not alone. Orthopedic issues are far more common than you'd think. Here are just a few facts you may not have known.

  There's an Incredibly High Demand For Orthopedic Surgeons. 

  There's actually an incredibly high demand for orthopedic surgeons. In fact, the American Academy of Orthopaedic Surgery reports that there are about 25,500 orthopedic surgeons currently practicing within the United States. Most of these orthopedic surgeons practice privately, as private practices make up about 73.5% of all orthopedic practices. The remaining practices are split between academic institutions, hospital and medical center practices, academic private practices, military practices, pre-paid plans and HMO practices, public institutions, other settings, and locum tenens.

  Women Have a Higher Need For Orthopedic Medicine Than Men. 

  About 75% of Americans experience foot problems to some degree of severity at one point in their lives, and about 60% of all foot and ankle injuries are sprains and strains. However, women have about four times as many foot issues as men do. The reason -- high heels.

  An Average of 32 Orthopedic Procedures Are Performed Each Month. 

  Believe it or not, orthopedic surgeons actually perform a jaw dropping average of 32 orthopedic procedures each month, according to the Orthopaedic Practice in the U.S. 2008 report.

  Knee Surgery Is the Most Common Orthopedic Surgery.

  Adult orthopedic knee surgery is the most popular sub-specialty in orthopedics, as over 35% of orthopedic surgeons practicing in this area. The next most common sub-specialties include arthroscopy (34.4%), sports medicine (34.3%), and total joint (33.4%).

  Most Orthopedic Surgeons Live in California. 

  California has the most orthopedic specialists, with 2,180 practicing there, with New York, Texas, Florida, Pennsylvania, Illinois, Ohio, New Jersey, North Carolina, and Massachusetts following respectively. In other words, if you live in one of these states, and need to have orthopedic surgery, you won't have to look very far, very hard, or for very long to find the doctor you need.

  Who would have thought that there were so many orthopedic specialists out there, or that they performed so many surgeries a month? If you have any questions about orthopedic surgery, feel free to share in the comments.

• Three Essential Questions About Orthopedic Surgery, Answered

  You've probably heard the phrase "orthopedic surgery" thrown around quite a bit, and for good reason: in the U.S. alone, experts estimate that around 51.2 million Americans have been diagnosed with medical conditions like arthritis, gout, and fibromyalgia; many people suffering from these conditions seek help from orthopedic surgeons and therapists.
  
  But if you're like the majority of Americans today, you're probably still not too sure what orthopedic surgery is; maybe you even suffer from one of the conditions listed above, and you're looking for ways to alleviate your pain effectively and safely -- and you happened to end up here.
  
  Luckily, there are plenty of people, just like you, who are looking for answers. So, with that in mind, here are some of the most common questions that people ask about orthopedics:

  What is an orthopedic surgeon? 
  This is a doctor who has received years of training -- usually for at least a decade or longer -- and focuses on medical problems that impact the musculoskeletal system (which includes bones, joints, muscles, ligaments, tendons, and cartilage). These medical experts focus on everything from prevention of injuries to treating and monitoring the rehabilitation of broken bones or inflamed joints.
  
  How do you know when to consult an orthopedist?
   Typically, patients are referred to an orthopedic surgeon by their primary care physician, and this usually happens after other non-invasive treatments have been tried. However, patients who suffer from chronic pain conditions or inflammatory conditions -- and about 1.5 billion people across the world do, in fact -- these patients may already know the symptoms of a flare-up and know when to contact a doctor.
  
  Is surgery always required?
   No, but in many cases, these are the best options for treating injuries involving bones, joints, or muscle damage. Orthopedic knee surgery and orthopedic shoulder surgery are some of the most common procedures performed by orthopedic surgeons, but you've probably also heard many people talking about needing a hip replacement, or are even looking for treatment after tearing an Achilles' tendon. Regardless of the exact issue at hand, orthopedic surgery today uses incredibly advanced techniques that make the surgery safe and affordable.

  The fact is, you don't have to be scared to visit an orthopedic surgeon, and you should never feel like you're alone throughout the treatment process. About 75% of Americans develop foot problems at some point in their lives, 25% of Americans develop severe hip pain from arthritis, and as many as 31 million Americans are currently dealing with lower back pain. You're far from alone, and any questions you have about orthopedic surgery or rehabilitation are valuable -- so we'd love to hear from you and answer any questions you still have.
  

• What our orthopedic specialists would love for Valentine's Day

  

  By: Dr. Burke

  
  

  Love is in the air with Valentine’s Day. I understand, it’s a Hallmark holiday for many people, but there’s no question, our orthopedic specialists have love on their radar this year. No, it’s not romantic love, but it’s the love we have for our patients. Here are a few things our orthopedic specialists would love for Valentine’s Day this year:

  • We would love for everyone to do the right types and amounts of stretches before and after exercising. Asking your muscles to do any type of strenuous exercise without warming up is like doing a math test right after your alarm clock goes off. You probably won’t do your best and your muscles don’t do their best without waking up first. Show your muscles some love and give them a good stretch before and after exercising.

  • We would love for you to use an exercise partner at the gym, especially if you will be lifting heavy weights. Know your limitations and ask a trusted friend to ‘spot’ you when in a vulnerable position with a heavy weight load. It’s better to be safe and healthy than sitting in our waiting room with a bad injury and a bruised ego.

  • We would love to see you complete all your physical therapy exercises as recommended. Your future health and quality of life will be better if you complete all your exercises in the time frame and way your physical therapist teaches them to you. We understand physical therapy can be painful, but the only thing worse than a broken heart is a broken body. Love your body enough to take care of it.

  • We love seeing patients as soon as possible following an injury. The quicker we can diagnose and begin treatment, the more likely you are to make a full recovery. It may not be convenient to take time off work for a doctor’s appointment, but we care about your long-term health. If scheduling seems like a hassle, just click here to schedule an appointment time that works for you.

  • We also love it when patients are smart about their recovery time. All of our board-certified physicians have years of medical school training and field experience for a reason: we know what we’re talking about when we tell you to “take it easy.” For instance, if we tell you not to do weight-bearing exercises for two weeks, please love yourself enough to do what’s right.

  We also love being St. Louis’ leader in orthopedic treatment care for patients of all ages. If you are in need of orthopedic care, the first step is starting a conversation. Schedule your next appointment with Orthopedic Associates.

  
  

• Everything you ever wanted to know about a small rotator cuff tear but were too afraid to ask.

  
  

  Let's just say your MRI scan returned showing a small to moderate sized rotator cuff tear in your shoulder. In addition to this, you have some arthritis in the joint between the collar bone and the shoulder blade, known as the acromioclavicular or AC joint. What now? What does this all mean?
  
  First, you probably want to know what a rotator cuff is:

  The rotator cuff is a group of four muscles that attach to the top of your arm bone and allow you to lift your arm overhead. 
  
  So, what is a tear?
  
  Rotator cuff tears can be the result of a specific injury or the can present as progressively worsening arm and shoulder pain over the course of a few months. Pain with overhead activity, weakness, and difficulty sleeping on the affected shoulder are all common complaints of patients with rotator cuff tears.

  Unfortunately tears of the tendons of the rotator cuff do not heal. Current data suggests that these tears do extend, get larger with age, and eventually, even if they become asymptomatic; become symptomatic again in the future. The nature of the surgery is a combined arthroscopic and mini-open type approach in which bone spurs are removed. The arthritis is removed from either side of the joint, removing a part of the collar bone and part of the shoulder blade. The rotator cuff tendon is then repaired. 
  
  What does rotator cuff surgery look like?

  The overall setup time from the time patients leave the holding area until the surgery is completed and the patient is awake and alert in the recovery room, is about 2 ½ hours. In general, patients have the surgery performed as an outpatient and follow up within the next few days. You will be given exercises to begin to perform after surgery on your own in addition to a formal physical therapy program based on the surgery that was performed and the extent of the tear that was repaired.
  
  How do I heal after surgery?

  Each individual is unique and their postoperative course varies. The following are some general guidelines in regards to activities of daily living after surgery. It is important to remember that these are averages and that you, as an individual, could be on either end of the spectrum of the average.

  1. A sling is worn for four to six weeks, though at least three times a day the sling is removed for gentle range of motion exercises. The Sling is to be worn at all times including sleep. The sling can be worn on the outside of the clothing.
  2. Patients can generally operate a motor vehicle with an automatic transmission in five to seven days, though there are patients who, if they can get off the pain medication early, can drive sooner, and those who have less confidence in driving with one arm may have to delay driving for a longer period of time.
  3. Patients are able to return to work, depending on their job requirements, as soon as they feel up to it. Patients who use keyboards and computers can put their keyboard in their lap and frequently do their job relatively soon, although perhaps not for as long a period of time. My general philosophy is that as soon as patients feel like they can do their job, I recommend returning to work and to all normal activities as rapidly as possible.
  4. In general, patients’ pain after surgery depends to a certain extent on how much pain they have had before surgery and what kind of medications they have had to take prior to surgery. If the pain has been so bad prior to surgery that oral narcotic medication has been required, patients may require more oral narcotic medication in the early postoperative period, as they have gotten used to the medication. The worst pain after surgery is usually over by about 72 hours postoperatively. We will refill narcotic pain medications for patients up to three weeks after surgery. There are individuals who have been on narcotics previously or who, by their nature, have difficulty getting off narcotics and require longer periods of time of prescription narcotic medications. Patients who require narcotic medications past the three week postoperative mark will be automatically referred to chronic pain specialists. These are anesthesiologist or psychiatrists who are skilled in the management of chronic pain and are better equipped to withdrawing patients off medication should the need arise.
  5. Because of the unique nature of the shoulder and the fact that when you lie down flat your shoulder is lower than the heart, most patients cannot sleep flat in the bed for several weeks after surgery. The use of a recliner or stacking of pillows is recommended as a way to stay comfortable at night. Ice is utilized for 24 hours in the hospital and for perhaps 24 hours at home, and then after that, heat on a regular basis and a heating pad on a low setting at night frequently improves comfort and brings in a new blood supply.
  6. The exercises that you will be shown are generally recommended to be done three times a day. Specific guidelines for you as an individual will be given in the hospital and when you are discharged you should have an instruction sheet from my office specifically outlining your postoperative care.
  7. The average time for full recovery to all activities including unrestricted lifting is approximately six months. The key word here is average. There are some patients who you will hear from who do play golf and do all of their activities at six or eight weeks after this type of surgery. For the most part these are rare individuals. The arm can be used for many activities at 6-8 weeks postoperative, but care is required for lifting for quite some time, as this particular tendon (the rotator cuff) is slow to heal.

  
  What if I don't want surgery?

  The risks of living with the problem without surgery include extension of the tear and altered biomechanics of the shoulder, eventually leading to a form of arthritis that is difficult to treat, referred to as rotator cuff tear arthropathy. The risks of surgery are infection, stiffness, failure of the reconstruction to relieve all pain, injury to blood vessels and nerves, and arthritis. All of these complications occur with a rate of less than 1%. Complications such as infection and stiffness are increased in patients with diabetes, theoretically, but in my practice do not seem to have been very common at all. Injury to blood vessels and nerves are extremely rare. 
  
  What if surgery doesn't go well?

  The biggest problem with rotator cuff repair is failure of the tendon to heal. We minimize this by using strong surgical techniques and going slow in the rehab program. Many patients, however, even if their rotator cuff does not heal fully, have excellent pain relief and much improved function by the removal of the bone spurs and healing of at least a portion of the rotator cuff tendon.

  The results from this type of surgery are quite satisfactory with 95+% of patients satisfied with repair of small to moderate tears in the rotator cuff with the treatment as outlined. 
  
  If you are interested in learning more about this surgery, please contact Christy Berman at 314-569-0612.

  Advice straight from the desk of:
  

  Micah C. Hobbs, DO

  
  

• What to know before getting a Cortisone Shot

  

  By: Dr. Michael Nogalski

  Picture yourself in your doctor’s office with the same shoulder pain that’s cramped your work for the past three years. There’s swelling around the rotator cuff and you feel your shoulder locking up at different points throughout the day. Your doctor recommends you get a Cortisone injection… but what does that even mean? What is a cortisone shot? What are the side effects of a cortisone injection? And, will it even work for you?

  A cortisone shot usually involves two elements: a local anesthetic, and a corticosteroid medication to reduce inflammation and alleviate pain. Many cortisone injections can be administered in your doctor’s office, but there is a limit to how many cortisone shots you can receive in a period of time because of possible side effects. Injections should be limited to at least four to six weeks between administrations and no more than four injections in the same location in a calendar year. (Arthritis-Health.com)

  Cortisone injections come with a variety of possible side effects and risks, such as the following and more:

  • Weakening of the soft tissue and cartilage around the injection site

  • Nerve damage

  • Joint infection

  • Osteoporosis

  If you are taking any blood thinners, you may want to withhold medication for at least three days leading up to your cortisone injection. This will help decrease any risk of bleeding or bruising around the injection site. Your physician will clean the injection area and may apply a topical anesthesia to numb the area surrounding the injection target. The local anesthesia is designed to reduce pain immediately with the corticosteroid providing longer-lasting pain and inflammation relief.

  Protect your targeted area for this first three days after receiving a cortisone injection. Keep the injected area clean and free from infection. Avoid heavy lifting or exercises that may place unnecessary strain or pressure on your injection site or joint. This will allow your body to receive the full benefit of the cortisone injection.

  It’s important to know the cortisone injections may eliminate the problem or further treatment may be necessary. Long-term treatment for your injury may require surgery or physical therapy to rehabilitate the injured area for optimal health in the future. We highly recommend having a plan of strategic treatment to begin after the cortisone shot. Our goal is helping you live, work, and play better.

  If you’re in need of a cortisone shot, we recommend meeting with a board-certified physician at Orthopedic Associates to start a conversation about your recovery. Click here to schedule your next appointment.
  

• How to Choose an Orthopedic Care Provider

  How to choose an orthopedic care provider

  Finding the right orthopedic surgeon can seem like a daunting task, especially if you’ve recently experienced a traumatic injury. How does your medical plan fit into the picture? Can you take your time finding the right doctor for you?

  There are several important factors to consider when it comes to choosing an orthopedic care provider.

  Network of insurance coverage for orthopedic care

  The first step is determining which orthopedic providers are included in your medical plan’s network. If you do have an out-of-network orthopedic surgeon in mind, you will want to calculate the projected cost of their services. Your primary care physician usually has a list of orthopedic surgeons they recommend to patients. Review the list with your doctor and ask why they recommend a specific surgeon. 

  Reputation of the orthopedic physician 

  Once you have a list of your in-network orthopedic surgeon, you will want to review those orthopedic specialists. No doctor is perfect, but the more you can gain trust in their expertise through reading about a previous patient’s satisfied experience, the better peace of mind you will have. If you have a co-worker, family member, or friend who recently underwent the same treatment you need, you might want to ask about their experience.

  Specialty experience of orthopedic surgeon 

  Being the nicest doctor in the world doesn’t guarantee exceptional skill in surgery. You want to know your orthopedic surgeon has the track record of doing the exact procedure you require.

  Why you should choose Orthopedic Associates

  For the past sixty years, Orthopedic Associates has been one of St. Louis’ premier orthopedic care providers for both adults and children. We specialize in a variety of traditional and non-traditional orthopedic treatment solutions, including surgical and non-invasive practices. Our orthopedic care team provides the latest in patient care through personalized treatment plans to help your body recover its fullest, healthiest life possible.

  When it comes to choosing an orthopedic surgeon or care provider, we’d love to serve you. Call Orthopedic Associates to speak with a member of our team, ask any questions you may have, and schedule your in-person consultation. We look forward to serving you!