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Overview of Traditional and Reverse Shoulder Replacement

Total Shoulder Replacement (Traditional and Reverse)

Total shoulder replacement is a surgery for those who have a severe cuff care. This replacement can result in pain and limited motion but for some patients may be the only solution. total shoulder replacements is a process which utilizes a plastic cup fit into your shoulder socket joint and a metal ball to represent the ball, in the ball and socket joint. These two items replace your existing ball and socket joint to provide better functionality and movement.

Who qualifies for a total shoulder replacement?

Total shoulder replacement is only recommended if you have endstage shoulder arthritis that cannot be repaired through any other means. It can also be recommended for people who have a cuff tear arthropathy, or those who have had a previous shoulder replacement surgery that was unsuccessful. People who experienced severe shoulder pain and have tried all other nonsurgical treatments but found no relief may also be candidates for the surgical procedure.

What happens during surgery?

This procedure replaces your ball and socket joint with the artificial ball and socket joint. It takes about two hours to complete. During the procedure your surgeon will make an incision on the front of your shoulder or the top of your shoulder. Through this incision they will remove the damaged phone and position your new components inside in order to restore function to your shoulder.

Surgical complications

This is a highly technical procedure and your surgeon will evaluate your situation carefully before you are approved. There can be a loosening or dislocation of the replacement components as well. If this occurs, the new shoulder joint may need to be re-operated.

Recovery

After your surgical procedure your medical team will give you antibiotics in order to prevent an infection as well as pain medication. Many patients can get out of bed today after their surgery and eat solid food. Typically you will be discharged from the hospital and able to go home on the third day. When you leave you will have to keep your arm in a sling and follow the instructions of your surgeon diligently.

You will also have to craft a formal physical therapy program with your surgeon in order to improve the flexibility and strength in your new shoulder. You may need somebody with you for the first few weeks following your surgery, but after two weeks you should be able to eat on your own and dress on your own. You may also be asked to return to your surgeon’s office for x-rays in order to monitor the success rate of your new shoulder.

What can I do after surgery and what can’t I do?

You have to follow the exercise program prescribed by your Los Angeles shoulder surgeon. You should avoid any extreme arm positions for at least six weeks. You should not lift anything heavier than 5 pounds for the first six weeks. You should not push yourself out of a chair or out of bed. And you should not participate in any repetitive heavy lifting movements after this surgery.

References:

http://orthoinfo.aaos.org/topic.cfm?topic=A00094

http://www.hss.edu/conditions_Shoulder-Replacement-Surgery-Diagnosis-Treatment-Recovery.asp#.VNxzCPnF9QA

April 20th, 2015|Shoulder Surgery|Comments Off on Overview of Traditional and Reverse Shoulder Replacement

Overview of Rotator Cuff Repair from a Los Angeles Orthopedic Surgeon

Rotator Cuff Repair

The shoulder has four muscles that comprise the rotator cuff.  These are the supraspinatus, infraspinatus, teres minor and the subscapularis. A rotator cuff tear is the injury that results when one or more of the tendons of the muscles forming the cuff are damaged. It may be partial or complete. The tears are common among athletes whose sport require overhead activity such as baseball and cricket players resulting in a great deal of headache for the players. The disease is also common with advancShoulder paining age but can also occur after trauma.

Affected individuals complain of night pain and difficulty sleeping on the affected side. The shoulder pain worsens with activity and there may be tenderness over the affected region. The patient may also complain of weakness and loss of motion especially when performing overhead activities. However, the condition may be asymptomatic. Unfortunately, rotator cuff tears do not have the ability to heal themselves and intervention is mandatory.

The diagnosis is made through history and physical exam coupled with appropriate investigations. A plain radiograph, an MRI and an arthrogram are common investigations that are ordered.

Traditionally, rotator cuff tears can be managed conservatively or through surgery. In partial tears, the treatment is non operative. The patient goes through six weeks of physical therapy and receives 2 steroid injections into the affected joint. Surgery is only an option once rigorous conservative management has failed. Surgery is the only treatment option for acute and complete tears occurring in healthy individuals. If comorbidities preclude a patient from surgery, the tears are managed conservatively.

The surgery can either be an open rotator cuff surgery, a mini open repair or an arthroscopic rotator cuff repair. General anesthesia or local anesthesia is given before the surgery.

Rotator cuff tear can be repaired using the three techniques:

Shoulder ArthroscopyOpen repair: Usually done in patients who have complex or large tears a large surgical incision is made to remove a large muscle and then the surgery is performed.

Arthroscopy: A small incision is made to insert an arthroscope that is connected on one end to a video monitor. The surgeon is able to see the inside of the shoulder and do the surgery.

Mini-open repair: An arthroscope is used to remove or repair any bone spur or damaged tissue and then a small incision is made and the rotator cuff is repaired.

The mini open repair technique utilizes an incision of two inches compared to five inches used in the open repair technique. Arthroscopy utilizes incisions of up to 0.5 inches. It has the best cosmetic outcome but is more difficult because of the limited view of the operating field and is not suitable for repair of all types of rotator cuff tears. Recent studies have demonstrated that arthroscopic repair are associated with a lower occurrences of post operative stiffness and patients exhibited a quicker return of overall function. Early repair of a tear is also a major determinant of the overall outcome. When left alone, a tear can progress and get to a point where it is irreparable, which is quite an expensive price to pay for the delay.

Incisions are put at the end of the procedure and a dressing is placed on the wound.

Risks of rotator cuff repair surgery

There are the usual risk of anesthesia including difficulty in breathing and allergy to the medicines. The other risks of rotator cuff repair surgery are infection of the wound, bleeding and injury to a nerve of blood vessel during the procedure.

The top shoulder specialist in Los Angeles and Beverly Hills is Dr. Raj at Beverly Hills Orthopedic Institute. Receive treatment from the best orthopedic doctor in Los Angeles, call today.

April 17th, 2015|Shoulder Surgery|Comments Off on Overview of Rotator Cuff Repair from a Los Angeles Orthopedic Surgeon

All About Hip Arthritis from a Beverly Hills Orthopedic

Hip arthritis is when the joints and your hips become inflamed. This causes pain and swelling in your joints. There are many types of arthritis, but osteoarthritis is one of the most common. Hip Surgeon Beverly Hills

This is referred to as age-related arthritis for degenerative joint disease. That being said people who are older are much more likely to develop this.

What is hip arthritis?

Hip arthritis takes place when the cartilage around your hip breaks down and becomes inflamed. This can cause pain, swelling, as well as a deformity. The cartilage is the rubbery material which covers the end of your bones inside of your joints.

It is generally made up of water and proteins. The function of the cartilage is to absorb shock inside of your joints. The quality with which the cartilage absorbs shock comes from its ability to naturally change its shape. But in order to do this it must have significant water content. And if damage this cartilage may not repair itself or grow new cartilage. And with time the flexibility and shock observing nature of the Cartilage decreases which leads to injury and inflammation in the joint.

How does arthritis affect the hip?

Patients who have hip arthritis can have difficulty walking. At first it can be very difficult to diagnose this because the pain will appear in different locations such as the knee, the groin, the thigh, and the buttocks. The pain might be a dull ache or it can be a stabbing and sharp pain.

What causes hip arthritis?

Orthopedic Surgeon Beverly HillsThe causes are not known. But there are factors which can contribute to it including being overweight, getting older and joint injuries. If your joints have not properly formed it can cause hip arthritis.

You could have a genetic defect in your cartilage which can also lead to a high risk of hip arthritis. If you put extra stress on your joints by being overweight or by taking part in activities which involve the hip that can also cause arthritis.

What are the symptoms of hip arthritis?

Joint stiffness will start to take place whenever you get out of bed or when you sit for an extended period of time. You might start to experience pain, tenderness, or swelling in your hip joint. You might feel an actual crunch or hear a crunch which is your bone rubbing against the other bone. If you are unable to move your hip while you perform regular daily activities like putting socks on your feet, this could also be a sign.

How is hip arthritis diagnosed?

There is no single diagnosis but an abnormal x-ray can showcase the features of a narrowing joint in the hip. If this happens to your doctor will check how your hip is functioning and may monitor any loss of motion.

How is arthritis treated?

The goal of treating hip arthritis is to improve your mobility and your lifestyle. Part of these goals includes regaining function of your hip and controlling your pain. The treatment you receive might include rest care, the use of the cane to relieve the weight on your affected hip, exercise, losing weight, non-drug pain control techniques, and medications that are anti-inflammatory such as ibuprofen.

Stem cell therapy procedures are often able to provide exceptional pain relief along with restoration of some of the damaged soft tissues and cartilage. In the worst case, you may need hip replacement surgery with an orthopedic surgeon Beverly Hills trusts if your ball and socket joint is incredibly damaged.

http://orthoinfo.aaos.org/topic.cfm?topic=a00213

http://www.arthritisresearchuk.org/arthritis-information/conditions/hip-pain.aspx

March 28th, 2015|Dr Raj : Hip Surgery in Los Angeles & Beverly Hills, CA|Comments Off on All About Hip Arthritis from a Beverly Hills Orthopedic

The Amazing Knee – Info from the Top Beverly Hills Orthopedic Surgeon

The Amazing Knee

The knee joint is one of the most amazing joints in the body; it is also the most abused.  The knee is subjected to a great deal of stress and weight every time you put your foot on the ground. The more you weigh and the more vigorous your activity, the more stress you place on the joint. Understanding how the knee works can help you protect it from injury.Orthopedic Surgeon Beverly Hills

The knee joint is composed of four bones:

  • the thigh bone (femur)
  • shin bone (tibia)
  • smaller shin bone (fibula)
  • knee cap (patella)

These four bones are connected by muscles, ligaments, and tendons, and together these structures allow you to move and keep your knee joint stable, aligned, and healthy.

Another integral part of the knee structure is cartilage. This gel-like, elastic tissue is a security and shock-absorber system rolled into one: it prevents the ends of the knee bones from banging and grinding against each other whenever your knee moves, and it absorbs the shock that impacts your knee every time you walk, run, jog, squat, climb stairs, or even stand.

If you are an athlete, you may be familiar with the term torn cartilage. This refers to damage to a layer of thick cartilage called the meniscus. The meniscus cushions the meeting point of the tibia and femur and absorbs the impact from movement while also helping to stabilize the knee joint. The knee joint also contains articular cartilage, a smooth tissue that covers the underside of the patella and lines the area of the femur so these bones can move effortlessly whenever you bend and straighten your knee.

Because of the stress put on this large joint, knee pain and injuries are common. The most common knee problems include:

  • ArthritisKnee Injury Pain
  • Ligament injuries
  • Cartilage injuries
  • Tendonitis
  • Fractures
  • Dislocations

Each case is unique, but treatments for these conditions range from ice and rest to physical therapy, or in some cases surgery is required.

If you are experiencing knee pain or problems, schedule a consultation with Dr. Raj. He can help you get back to doing the things you love.

Read more about the knee online at: http://www.nlm.nih.gov/medlineplus/kneeinjuriesanddisorders.html

March 24th, 2015|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on The Amazing Knee – Info from the Top Beverly Hills Orthopedic Surgeon

The Benefits of Arthroscopy with a Beverly Hills Orthopedic Surgeon

benefits-of-minimally-invasive-spine-procedures

The practice of medicine saw amazing developments in the 20th century, and orthopedic surgery was no different. Arguably, joint replacement surgery and arthroscopic surgery were the two most important innovations in orthopedic surgery in the last 100 years.

Arthroscopy, a minimally invasive alternative to standard open surgical techniques and now the most commonly performed orthopedic surgical procedure, was once used as a diagnostic tool. It has evolved into a therapeutic tool capable of treating a wide range of injuries and disorders. The benefits of orthopedic arthroscopic surgery make it the best option in most cases.

The benefits of minimally invasive surgeries include:knee arthroscopy

  • Less postoperative swelling than open techniques
  • Reduced pain
  • Reduced risk of complications
  • Quicker recovery times
  • Less scarring
  • Little to no time spent in a hospital

Many injuries, particularly those that at one time would have been career ending for athletes, can now be addressed with arthroscopy allowing a quicker return to full function. In addition, almost all arthroscopic procedures can be performed in an outpatient setting, allowing patients to recover comfortably at home. It is not unusual for patients to go back to work or school or resume daily activities within a few days.

Athletes and others who are in good physical condition may in some cases return to athletic activities within a few weeks. However, keep in mind that people who have arthroscopy can have many different diagnoses and preexisting conditions, so each patient’s arthroscopic surgery is unique to that person. Recovery time will reflect that individuality.

At Beverly Hills Orthopedic Institute, minimally invasive procedures are used whenever possible. While arthroscopy is generally less risky than open surgical procedures, the procedure is still invasive and requires some type of anesthesia. Some procedures and surgeries may not be suitable for every patient. Dr. Raj will discuss your personal options before any surgery.

Read more about this online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3117522/

March 12th, 2015|Dr Raj : Sports Medicine Doctor Los Angeles & Beverly Hills|Comments Off on The Benefits of Arthroscopy with a Beverly Hills Orthopedic Surgeon

ACL Reconstruction – Should I have it Done?

The anterior cruciate ligament (ACL) is a commonly injured knee structure. Around 200,000 people injury the ACL each year, and Top Orthopedic Surgeon Los Angeleshalf of these cases require ACL reconstruction surgery. The risk of ACL injury is greater for people who participate in high-impact sports, such as football, basketball, soccer, and skiing. About half of ACL injuries occur along with a meniscus tear, articular cartilage injury, or trauma to another ligament of the knee.

The mechanism of ACL injury is often associated with slowing down (deceleration) coupled with pivoting, cutting, side-step maneuvers, out of control play, and awkward landings. Only 30% of ACL injuries are the result of a direct blow or contact with another player. Female athletes are more at risk for ACL tears.

So, if you have suffered an ACL injury, you may be wondering, “Should I have ACL reconstruction or not?” It is a natural reaction to question the need for surgery. There are some things to consider before surgery, and a visit with a Los Angeles sports medicine surgeon is recommended. Find out if you are a candidate for ACL reconstruction surgery by answering these questions.

  • Are you involved in sports? Active athletes who play a sport that requires turning, pivoting, and/or cutting are encouraged to have surgical ACL reconstruction.

 

  • Are you an active adult? Adults who do heavy manual work or jobs that require turning and cutting should consider surgical repair of an ACL injury.

 

  • Do you have functional instability? Any patient with a torn ACL who has an unstable knee has the risk of developing secondary knee damage. Therefore, he/she should have the ACL reconstruction procedure.

 

  • Do you have other ligament or tendon damage? The “unhappy triad” that is often seen in football players and sACL tearkiers involves injuries o the ACL, the medial cruciate ligament (MCL), and the medial meniscus. In cases where there are combined injuries, such as the unhappy triad, surgical repair is warranted for the best outcome.

 

  • Is the ACL only partially torn? The prognosis is better for a partially torn ligament compared to a completely torn one. In addition, the rehabilitation/recover period is shorter, with some patients using the knee within three months. Complete ACL ruptures do not have as high of success rate following surgery.

 

  • Is the patient a child, teen, or elderly person? The surgical reconstruction of the ACL is not indicated for children or teens whose growth plates are still open, people who live sedentary lifestyles, those who have complete tears who are planning to stop playing high-demanding sports, and people with no instability symptoms.

 

ACL Reconstruction Surgery with a Beverly Hills Orthopedic Surgeon

ACL reconstruction surgery is often done using the arthroscopic technique. The surgeon uses an arthroscope (flexible tube with a camera) that is inserted through small incisions made around the knee. Also, the doctor uses small instruments to make repairs through these same incisions. A graft is used to replace the torn ACL, which can come from the patient (autograft) or a cadaver (allograft). Common tendons include the hamstring, patellar, or quadriceps.

The meniscus and cartilage injuries are shaved and repaired, and the torn ACL stump is removed. The surgeon drills bone tunnels into the upper and lower leg bones so the graft can be positioned. The graft is held in place using screws, posts, washers, and/or staples. Variations of this surgery are done, depending on the preference of the surgeon or when special circumstances present. The incisions are sutured closed, dressings are applied, and a postoperative brace is positioned on the knee.

Rehabilitation and RecoveryACL repair

During the first couple of weeks, the surgical wounds are kept clean and dry. Physical therapy begins immediately after the ACL reconstruction, as stronger graft fixation allows for accelerated rehabilitation. The surgeon may order use of the postoperative brace, as well as a range of motion machine. The goals of rehabilitation are to:

  • Reduce knee swelling
  • Regain full range of motion of the knee joint
  • Maintain mobility of the kneecap
  • Prevent pain
  • Strengthen the hamstring and quadriceps muscles
January 5th, 2015|Dr Raj : Sports Medicine Doctor Los Angeles & Beverly Hills|Comments Off on ACL Reconstruction – Should I have it Done?

FAQs about Stem Cell Injections from a Los Angeles Orthopedic

 What are stem cells?

The basic components of our human body are the stem cells. Their most amazing characteristic is they capacity to transform in any stem cellstype of cell, from skin to muscle or bone cells. Although medicine has documented the use of stem cells for quite some time now, regenerative medicine is just picking up in popularity, and extensive research in the field is pushing the boundaries of imagination and human perception related to the possibilities that stem cells have to offer. Some even go as far as calling stem cells the holy grail of regenerative medicine.

Stem cells are collected from your body and they are often adult stem cells (Mesenchymal), collected from the patient’s bone marrow (aspirated from the hipbone) or via liposuction from adipose (fat) tissue located on the abdomen. There are often stem cells obtained from amniotic fluid. These come from women undergoing a scheduled C-section where the amniotic fluid is normally discarded afterwards.

The treatment varies from case to case. Stem cells harvested from the bone marrow have better ability to repair and differentiate into bone, cartilage or ligaments while adipose stem cells have increased regenerative properties to create new blood vessels, which ultimately helps the tissue by delivering essential nutrients and oxygen. There are no ethical issues revolving around adult stem cells therapy.

What are stem cell injections?

If you suffer from any degenerative disease such as arthritis or osteoarthritis, join pain, tissue damage in rotator cuff tears, tennis elbow, meniscal tears or ligament tears, then you should know that stem cells injection have the ability to repair and regenerate the injured tissues, thus relieving the pain, increasing mobility and improving performance.

Stem cell therapy is a non-surgical method of treatment, the procedure is conducted by a specialized physician, takes up to one hour and in most cases patients need only one session, although in severe cases, patient’s are recommended to have up to three sessions, with a 3 to 6 month interval.

Dr. Raj is a top orthopedic in Beverly Hills and offers all types of stem cell therapy for degenerative arthritis, tendonitis or ligament injury.

Stem Cells Beverly HillsAm I a candidate?

If you are considering stem cell injection therapy, you should contact Beverly Hills Orthopedic Institute and prepare to have your medical records reviewed and some X-rays or MRI scans done. It’s a fact that stem cell injections are not suitable for patients who use high doses of Coumadin, or who suffer from lymphoma or leukemia, infections, blood diseases, or multiple medical issues.

What is Platelet Rich Plasma (PRP)?

Platelet Rich Plasma results after spinning at high speed, with the help of a centrifuge, the patient’s own blood, in order to obtain the essential elements for the natural healing process to occur. These elements are called platelets and growth factors and since the plasma is not tampered, there are no risks of allergies associated with PRP therapy. Once the plasma is ready, under ultrasound guidance, the physician identifies the injured area of the tendon or ligament, and then injects the platelet rich plasma which activates itself once it reaches the damaged collagen fibers. Moreover, the platelet rich plasma has a magnetic effect, because it attracts other important healing factors to the injured tissue, and this ultimately helps speed up the healing and regenerative process.

What are the risks?

There are little to no risks associated with stem cell injections because what is being injected comes from the patient’s own body or the amniotic fluid offered is processed at an FDA regulated lab. Aside from some mild tenderness at the site of injection, which is easily remedied with an over-the-counter pain reliever or even some ice, there are no pains or side effects expected with stem cell injections.

January 2nd, 2015|Dr Raj : Stem Cell Therapy in Los Angeles & Beverly Hills CA|Comments Off on FAQs about Stem Cell Injections from a Los Angeles Orthopedic

FAQs on Platelet Rich Plasma Therapy from a Beverly Hills Orthopedic

What is Platelet Rich Plasma?

prpPlatelet Rich Plasma, also commonly referred to as PRP, is actually blood-rich plasma with a concentrated form of platelets that contains a large amounts of proteins and growth factors that are needed for the initiation and acceleration of the tissue healing process in our bodies. This healing process mainly refers to the repair and regeneration of ligaments, bones and tendons, the development of blood vessels, and the overall stimulation of the body’s capacity to heal a wound or injury.

How does the Platelet Rich Plasma Therapy work?

Before the therapy, doctors will extract a blood sample from the patient and will process the blood with the help of a centrifuge. Spun at high speeds, the centrifuge will automatically turn the blood sample into platelet rich plasma. The whole process doesn’t take longer than 15 minutes, but the interesting fact is that the resulting plasma has 500% more platelets and growth factors than the initial sample.

Once this new plasma is ready, it will be injected into the injured ligament or tendon, stimulating a mild inflammation that will eventually trigger the healing process. The result is noticed when the new collagen shrinks and tightens the ligaments or tendons in the problem area. The results usually vary, but overall, patients can improve their condition by significantly decreasing the pain and improving their motor functions without having to go through a painful surgery and long term recovery.

What Can Be Treated with PRP therapy?

Platelet rich plasma injections are suitable for any type of tendon, ligament or cartilage problems. The most popular condprp buffy coatitions treated with PRP are sports injuries in the shoulder, knee, hip, lower back, degenerative disc disease, arthritic joints, shin splits, rotator cuff tears, tennis elbow, plantar fasciitis or the carpal tunnel syndrome.

Since each person’s body is different the treatment frequency varies, but most patients require anywhere between 1-3 PRP therapies, with a minimum of 3-4 weeks between each procedure. There is no maximum on the number of treatments because PRP therapy only uses plasma derived from your own body (blood).

Do I qualify for PRP therapy?

If you suffer from injuries to a ligament or tendon, or you have an arthritic joint condition that so far hasn’t been remedied by traditional treatments, then you can consider the PRP therapy. Along with qualifying for PRP therapy in the health sense, it is also advisable to consider whether or not you qualify financially. The cost of PRP therapy is not covered by Medicare, though it may be partially covered by your personal or employer insurance plan. Speaking to someone at the clinic as well as your insurance provider regarding your financial options and coverage is a good idea prior to arranging treatment to avoid any problems.

Is there anything else I need to know about PRP therapy?

One week before and two weeks after the platelet rich plasma injections, it is recommended that you stop using non-steroidal inflammatory medications (NSAIDs). Also, you should know that after the therapy you might feel some discomfort at the injection site, though this is short-lived and easily treatment with Tylenol. While recovering, you should avoid any overly-strenuous physical activity that may cause injury to your healing ligaments and tendons.

 

 

December 30th, 2014|Dr Raj : Stem Cell Therapy in Los Angeles & Beverly Hills CA|Comments Off on FAQs on Platelet Rich Plasma Therapy from a Beverly Hills Orthopedic

High Tibial Osteotomy Procedure for Knee Arthritis

High Tibial Osteotomy

If you have arthritis in your knee, your surgeon may suggest a high tibial osteotomy procedure. This surgery is done to realign the angle at the knee joint between the tibia and femur, which is called an osteotomy.

xraynorm-arthritisThe advantage of this procedure is that it preserves the natural knee joint as opposed to replacing the structure with a prosthesis (device made of metal and plastic). This surgery is used for active, young patients who develop osteoarthritis of the knee that only affects one joint compartment.

Knee Anatomy and Arthritis

Knee arthritis occurs when there is loss of cartilage of the knee. The knee joint has three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap). These three bones form knee compartments. The femur meets the tibia to form the joint, and the patella lies at the front of the patella. These three bones are covered with cartilage, which is a white polished material that allows for smooth gliding of the bones.

When osteoarthritis occurs, the knee joint is stiff and painful. Basically, bone rides against bone. The Beverly Hills orthopedic surgeon corrects this by realigning the angle made between the bones of the leg, so the patient can shift his or her body weight, allowing the healthy side to assume the majority of stress. Realigning the knee joint angle between the tibia and femur is called an osteotomy.

Benefits of High Tibial Osteotomy

F1.largeThe high tibial osteotomy is helpful for patients with underlying pain and loss of range of motion from arthritis that affects one compartment of the knee. Once the load is decreased on the affected side of the knee, there is a delay in the need for a total joint replacement procedure. By reducing the heavy load, the pain and stiffness is also alleviated. In order to be a candidate for a high tibial osteotomy, you must have:

  • Some ligament function around the knee
  • Minimal arthritis in other compartments of the knee
  • An adequate range of motion

If your orthopedic surgeon thinks you are a suitable candidate for this surgery, a high tibial osteotomy will reduce pain and improve overall knee function. The chance of the procedure offering pain relief five years following the procedure is around 80 percent. That percentage drops to 70 percent after 10 years and down to 50 percent after 15 years.

Before the Procedure

a08fig03Prior to undergoing a high tibial osteotomy, you will have x-rays and an MRI of the knee to assess and gage the degree of arthritis and structure damage. The x-rays show the doctor how the compartment is functioning, so he or she can predict where you are carrying the majority of your weight and how to properly realign the leg to achieve the best outcome. The MRI assesses the cartilage throughout all regions of the knee joint, as well as the knee ligaments and meniscus.

You are admitted to the hospital the day of surgery, and an anesthesiologist or anesthetist will discuss available options for anesthesia with you. You also are given prophylactic antibiotics to decreased risk of infection. When you are in the operating room, the anesthesia is given, and the surgical staff prepares your knee for the operation.

Two Methods of High Tibial Osteotomy

Closing wedge osteotomy – This procedure involves removing a piece of bone below the joint of the upper tibia. When arthritis has affected the medial knee compartment (as with varus knees), the bone wedge is taken from the outer region of the tibia. Once the bone segment is removed, the two bone ends are fixed together using a metal plate and pins.

Opening wedge osteotomy – In the wedge procedure, the orthopedic specialist cuts through the tibia on the inner side to open a wedge. This is often done by adding a segment of bone graft from the pelvic bone to hold the region open. The stabilize this, the surgeon inserts a plate and pins. This knee surgeryoperation is most often done to the upper aspect of the tibia, right below the knee joint.

During the Procedure

During the high tibial osteotomy procedure, care is taken by the Los Angeles orthopedic surgeon to protect the blood vessels and nerves that are behind and around the knee joint. A small part of the fibula bone is used to in the closing wedge osteotomy, which is performed through the same incision.

Usually, a drain is inserted to allow the surgical wound to drain, and it will remain there for 24 hours. The incisions are closed and the leg is wrapped in a dry, sterile dressing. Many times, a brace will be required for a short time following the surgery.

After the Procedure

The patient is transported to a recovery room, where he or she is closely monitored following the high tibial osteotomy. An x-ray is taken of the knee to assess for alignment.

Once stable, the patient is taken to a hospital room and a physical therapist provides passive range of motion exercises. The day after surgery, you are taught to use crutches for up to three months. Most patients are able to go home three days after the procedure. Therapy continues once you are released to home, to help you improve mobility and regain muscular strength of the knee joint.

During the first week after the procedure, your leg will be swollen and the knee will feel stiff. Most orthopedic specialists prescribe regular pain medication during this time frame. It is vital for you to perform the exercises while at home to optimize recovery and rehabilitation. It may take up to six months to full recover from a high tibial osteotomy. Therefore, the most important aspect of rehabilitation is to strengthen the knee and allow it to heal.

Success Rate of a High Tibial Osteotomy

Around 70 percent of patients who have a high tibial osteotomy are satisfied with the results, and around 75 percent are able to return to sports and/or work activities. When the procedure fails, the orthopedic surgeon may suggest a total knee replacement. However, most patients who undergo this procedure have functioning knees at five to ten years following the surgery.

Risks of a High Tibial Osteotomy

All surgeries carry some risks and complications. The high tibial osteotomy is a safe procedure, but complications include:

  • Bleeding
  • InfectionBest Los Angeles Orthopedic Surgeons
  • Blood clots of the legs
  • Knee stiffness
  • Damage to surrounding blood vessels and/or nerves
  • Failure of the cut bone to heal
  • Discomfort from metal-ware and subsequent removal
  • Unexpected fractures
November 24th, 2014|Dr Raj Best Knee Surgeon Los Angeles & Beverly Hills | Knee Surgery|Comments Off on High Tibial Osteotomy Procedure for Knee Arthritis

PRP Therapy for Tennis Elbow in Los Angeles

Tennis elbow is caused by inflammation within the tendon that is located in the elbow region. When this condition occurs, it can be very difficult to use the arm without experiencing pain.

The condition of tennis elbow occurs due to excessive use of the elbow painarm, which causes the small tears to develop over time and allows the areas of the arm that are kept together by the elbow to break away from the support. Without treatment, it can lead to further tearing, and the tendon can actually rip completely.

While the use of surgery to repair the tendon was one a common method of treatment, platelet-rich plasma (PRP) therapy is now being used as a successful treatment for the condition, which allows the area to be free from pain, and also encourages healing of the tendon.

How PRP Therapy Works

PRP therapy is commonly referred to as platelet-rich plasma therapy, and it is used for tennis elbow, along with many other conditions that occur due to tennis elbowdamage in the tendons, ligaments, and small tissues of the body.

When you have an injury occur to one of these areas, it is your body’s natural response to send out platelets to where the damage has occurred, which helps to encourage healing in the area. While this process is completely naturally by the body, it can take a long time for the tendon within the elbow to heal, and supportive gear should be used in order to support the elbow and keep the area from becoming even more damaged, which will often eliminate healing all together.

The use of PRP therapy involves taking a sample of your own blood, and then placing it inside of a machine, which works to split the different pieces of your blood apart and allows the platelets to be collected.

The platelets are collected, put into a syringe, and when they are in their Stem Cells Beverly Hillscompressed form, they are injected into the tendon within the elbow area and the surrounding tissue. By providing the arm with the highly concentrated amounts, the area will heal rapidly, and pain relief can be experienced right away.

PRP Duration and Effectiveness

When you use PRP for tennis elbow, it will provide you with pain relief within the first 48 hours, but many patients say that they experience pain relief immediately or within one or two hours. However, the length of time it takes to actually heal the area will vary, which is dependent upon the amount of damage that is present in the area, as well as how often the area is rested while in the healing process.

While many people can go back to their regular activities after having PRP PRP-2therapy, it is essential that the arm does get the proper amount of rest in order for it to heal. Other than resting the arm, other forms of therapy may be used in order to help speed up the recovery process.

Physical therapy is a common form of treatment used along with PRP for tennis elbow, because it allows you to learn the stretches that are needed to strengthen the area within the elbow, which will promote healing and make the therapy as effective as possible.

Final Thoughts

Prior to having PRP therapy done, your Beverly Hills orthopedic doctor will be able to answer any questions you may have regarding the therapy process. Generally, the therapy takes less than an hour to complete, and there is no recovery time needed after the therapy, which allows you to go back to your normal everyday activities right away.

November 21st, 2014|Dr Raj : Sports Medicine Doctor Los Angeles & Beverly Hills|Comments Off on PRP Therapy for Tennis Elbow in Los Angeles