Thursday, 17 of January of 2019

Category » Revision Surgery

What is Knee Arthroscopy Surgery?

The trend in surgery today is toward a minimally invasive approach that is less traumatic to the body. This is especially true for knee surgery, where it’s possible to repair damage to ligaments, tendons, cartilage and bone without the need for large, open incisions, an overnight hospital stay and a very lengthy recovery period.

Minimally invasive procedures are possible thanks to improvements in technology, such as the development of tiny fiber-optic scopes that can be inserted into the body through incisions or “portals” only three to four millimeters in diameter.

While the incision is small, the surgeon’s ability to perform the procedure isn’t compromised by a tiny view. Instead, a small lens, light source and video camera on the end of the scope sends images of the knee joint to a large monitor in the operating room, which gives the surgeon a “big picture” and a clear view of the operating field.

Additional incisions are made to allow the surgeon to insert small surgical instruments into the knee joint. These tiny instruments are used to repair damage to the knee caused by an accident, sports or other situations or to reduce pain and disability caused by degenerative conditions like osteoarthritis.

The American Academy of Orthopedic Surgeons reports five common reasons why patients undergoing knee arthroscopy:

1. Remove or repair a torn meniscus
2. Reconstruct a torn ACL, anterior cruciate ligament
3. Trim torn pieces of articular cartilage
4. Remove loose fragments of bone or cartilage
5. Remove inflamed synovial tissue

For more information about the kinds of conditions that benefit from arthroscopic knee surgery, go to

What Does Minimally Invasive Surgery Mean?

Minimally invasive surgery is a newer technique that orthopedic surgeons use to diagnose and treat a wide variety of orthopedic-related conditions that can affect the knees, hips, shoulder, ankles and elbows.

Also called arthroscopic surgery and sometimes “keyhole” surgery, minimally invasive surgery has become the preferred choice and standard of care whenever possible due to the many benefits it offers to both the surgeon and the patient, including:

• Small incision size
• Less damage to the tissue
• Less blood loss
• Reduced post-operative pain
• Faster recovery
• Smaller scars
• The potential to go home the same day as the surgery

In contrast with traditional surgery, in which a large incision is used to open the body, with minimally invasive techniques, only tiny incisions – often described as “keyhole” size are required. This shift toward less invasive methods of diagnosing and treating injury and illness represents a major improvement in patient care.

What are some of the orthopedic-related procedures that can be performed with minimally invasive techniques? Removal of bone chips and spurs, damaged cartilage, and inflamed synovial fluid. Repairing ligament tears, bone fractures and tears to the meniscus and ACL. Treatment of shoulder dislocation, instability and rotator cuff tears. Even joint replacement surgery is often performed using minimally invasive techniques.

If you would like to learn more about minimally invasive orthopedic surgery, go to or call 239-936-6778.

ACL Reconstruction

How many times have you read a national news report about a superstar athlete tearing his or her ACL and being sidelined for weeks during recovery? But it’s not just football, soccer or baseball stars who can sustain this type of extremely painful injury. According to the American Academy of Orthopedic Surgeons, the ACL or anterior cruciate ligament, is one of the most commonly injured ligaments of the knee.

Ligaments are bands of fibrous tissue that connect two bones together or the bones to the cartilage. The ACL’s primary function is to keep the tibia (shinbone) and femur (thighbone) in alignment and to stabilize the knee joint to perform all those functions we demand of it.

Forceful contact, such as from a football tackle, landing incorrectly from a jump or fall with the knee extended — a common problem in tennis, basketball, gymnastics and volleyball – can cause the ACL to tear.

But so can twisting your knee from something simple as stepping onto uneven pavement or falling off a curb when you’re out for a run or walking the dog. Even a car or work-related accident can do damage to the ACL if you injure your knee.

Serious ACL injuries require surgery – usually an arthroscopic outpatient procedure. But rather than sew the torn ligament together, the orthopedic surgeon will replace the damaged ACL with a new ligament or “graft.”

The graft is usually a tendon taken from the patient’s own tissue, typically a hamstring, patellar or quadriceps tendon. Your doctor will discuss which type of graft is right for you. Fortunately for everyone who has ever torn their ACL, this type of surgery has an excellent success rate of 82 to 95 percent. Surgery, followed by rehab, will help both athletes and non-athletes to get back on their feet faster with less potential for long-term impairment.

For more information about the latest treatments for knee injuries, go to

Treating Hip Fractures

Hip fractures are a serious concern for older Americans, especially if poor eyesight, medications, osteoporosis or loss of balance places them at risk for tripping and falling. But hip fractures can occur at any age due to a serious car, bicycle or motorcycle accident, a sports-related injury, or an illness like cancer that causes the bones to be weak.

A hip fracture is a painful and potentially disabling break of the upper part of the thighbone, known medically as the femur. Almost always, surgery will be required to mend the bone, promote healing and stabilize the area.

The type of surgery will depend on the area of the hip that is broken, the severity of the fracture, the person’s age and level of activity. The surgeon may use a combination of surgical “hardware” to repair the fracture and “pin” the hip, or joint replacement surgery may be recommended.

If there is already existing damage to the cartilage and the ends of the bone, especially from arthritis, or the bones are not properly aligned after the fracture, the surgeon may be concerned that the blood supply to the hip joint will not be sufficient. In this situation, the surgeon may recommend replacing part or all of the hip joint with a metal replacement prosthesis.

When joint replacement is not needed, the surgeon may use surgical screws to repair the break. Sometimes the screw is attached to a metal plate that is positioned inside the body next to the bone. Or, the surgeon may place a metal rod, known as a surgical nail, inside the thighbone. The rod is attached to the ball of the hip joint with a screw.

Rehabilitation is an important part of recovery from hip fractures. Physical and occupational therapy in the hospital and at home will accelerate healing and return patients to normal activities faster.

For more information about treating hip fractures or other orthopedic-related conditions, visit

Metal-on-metal hip implants: What patients need to know

While surgery is not always the first or best option for every patient, hip replacement surgery to replace the diseased hip joint with an artificial joint may be advised to help relieve pain, increase motion, and get you back to enjoying many normal, everyday activities.

For patients contemplating hip replacement, there are several options for implants. Replacement joints are made of many different materials including plastic, ceramic and metal. Sometimes the ball and socket are made with the same materials and other times, the two are made of different materials. When I determine that hip replacement surgery is the next best step for my patients, I will select an implant based on the patient’s body structure, medical history, and lifestyle.

Recent recalls of metal-on-metal hip implants have prompted more discussions and concerns between surgeons and patients about the types of products available and materials used. About a year ago, the U.S. Food and Drug Administration (FDA) issued a public health communication about hip replacement components that have both a metal ball and a metal socket (metal-on-metal hip devices), due to the number of patients who required a second hip replacement procedure, called a revision surgery.

Symptoms of implant failure may include hip/groin pain, local swelling, numbness or changes in your ability to walk. However, there are many reasons a patient with a metal-on-metal hip implant may experience such symptoms and it does not mean your implant must be replaced but it is important that you contact your surgeon to help determine the cause.

There have also been cases where metal particles from the implant caused a reaction around the joint, leading to deterioration of the tissue surrounding it, loosening of the implant, and failure of the device. In addition, some metal ions from the implant may enter into the blood stream. There have been a few recent case reports of patients with metal-on-metal hip implants developing a reaction to these ions and experiencing medical problems that might have been related to their implants, including effects on the nervous system, heart, and thyroid gland.

Most recently, the FDA issued orders to hip manufacturers requiring post-market surveillance studies to monitor adverse events after a device has been approved by the FDA. Information for patients on the recall and a list of frequently asked questions can be found on the FDA website.

If you are uncertain about which type of implant you have or if you experience pain or other medical concerns following joint replacement surgery, you should contact the orthopaedic surgeon who performed your procedure.

When discussing your options for hip surgery with your surgeon, some questions you should ask include:

  • What are the risks and benefits of each type of hip implant system (metal-on-metal, metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic devices)?
  • What is the surgeon’s personal experience and outcomes with metal-on-metal hip systems?

If you are not satisfied with the surgeon’s responses or have concerns about the surgery, consider seeking a second opinion. Ultimately, it is the “joint” decision of the surgeon and patient on which course of treatment and type of implant is best.

If I can be of assistance, please call my office at 239-936-6778 or visit

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