4 Tips For Senior Citizens Recovering From Knee Surgery

4 Tips For Senior Citizens Recovering From Knee Surgery

BY JOAN TIMPSON | Article Featured on Sunrise Care

As senior citizens age, their bodies become increasingly vulnerable to conditions that decrease mobility and cause chronic pain. One of the most commonly experienced diseases that impacts the joints and muscles of older adults is osteoarthritis, which affects approximately 8.75 million people, according to Arthritis Research UK. As a result of osteoarthritis and other forms of arthritis, many senior citizens turn to knee replacements for relief from pain and to regain mobility.

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What is Knee Arthroscopy? Benefits, Preparation, and Recovery

What is Knee Arthroscopy? Benefits, Preparation, and Recovery

By Jon Johnson | Featured on Medical News Today

Knee arthroscopy is a procedure that involves a surgeon investigating and correcting problems with a small tool called an arthroscope. It is a less invasive method of surgery used to both diagnose and treat issues in the joints. The arthroscope has a camera attached, and this allows doctors to inspect the joint for damage. The procedure requires very small cuts in the skin, which gives arthroscopy some advantages over more invasive surgeries.

Knee arthroscopy surgery has risen to popularity because it usually requires shorter recovery times. The procedure typically takes less than 1 hour, and serious complications are uncommon.

In this article, learn more about what to expect from knee arthroscopy.

Uses and benefits

Knee arthroscopy is less invasive than open forms of surgery. A surgeon can diagnose issues and operate using a very small tool, an arthroscope, which they pass through an incision in the skin.

Knee arthroscopy surgery may be helpful in diagnosing a range of problems, including:

  • persistent joint pain and stiffness
  • damaged cartilage
  • floating fragments of bone or cartilage
  • a buildup of fluid, which must be drained

In most of these cases, arthroscopy is all that is needed. People may choose it instead of other surgical procedures because arthroscopy often involves:

  • less tissue damage
  • a faster healing time
  • fewer stitches
  • less pain after the procedure
  • a lower risk of infection, because smaller incisions are made

However, arthroscopy may not be for everyone. There is little evidence that people with degenerative diseases or osteoarthritis can benefit from knee arthroscopy.

How to prepare

Many doctors will recommend a tailored preparation plan, which may include gentle exercises.

It is important for a person taking any prescription or over-the-counter (OTC) medications to discuss them with the doctor. An individual may need to stop taking some medications ahead of the surgery. This may even include common OTC medications, such as ibuprofen (Advil).

A person may need to stop eating up to 12 hours before the procedure, especially if they will be general anesthesia. A doctor should provide plenty of information about what a person is allowed to eat or drink. Some doctors prescribe pain medication in advance. A person should fill this prescription before the surgery so that they will be prepared for recovery.

Procedure

The type of anesthetic used to numb pain will depend on the extent of the arthroscopy. A doctor may inject a local anesthetic to numb the affected knee only. If both knees are affected, the doctor may use a regional anesthetic to numb the person from the waist down.

In some cases, doctors will use a general anesthetic. In this case, the person will be completely asleep during the procedure. If the person is awake, they may be allowed to watch the procedure on a monitor. This is entirely optional, and some people may not be comfortable viewing this.

The procedure starts with a few small cuts in the knee. Surgeons use a pump to push saline solution into the area. This will expand the knee, making it easier for the doctors to see their work. After the knee is expanded, the surgeons insert the arthroscope. The attached camera allows the surgeons to explore the area and identify any problems. They may confirm earlier diagnoses, and they may take pictures.

If the problem can be fixed with arthroscopy, the surgeons will insert small tools through the arthroscope and use them to correct the issue. After the problem is fixed, the surgeons will remove the tools, use the pump to drain the saline from the knee, and stitch up the incisions. In many cases, the procedure takes less than 1 hour.

Questions to Ask Before You Have Anesthesia

Questions to Ask Before You Have Anesthesia

Article Featured on US News

HAVING A MAJOR SURGICAL procedure can be a scary proposition. First, there’s the fear connected to the issue itself that prompted the surgery. Then, you may also have some concerns about how the procedure will go. Part of this fear often revolves around how you’ll react to anesthesia – powerful medications that block pain.

Dr. Karen Sibert, director of communications and associate clinical professor in the department of Anesthesiology & Perioperative Medicine at UCLA Health in Los Angeles, says that “anesthesia is what enables you to tolerate surgery. Modern surgery really couldn’t develop until anesthesia developed. Before the onset of anesthesia, surgical procedures were short and done as fast as possible for humanitarian reasons.” In the mid-1800s, a gas called ether was first used to anesthetize a patient during surgery. Since then, other drugs have been developed that also work to block pain and desensitize patients to nerve signaling in the body to enable procedures that otherwise would be far too painful to conduct.

Dr. Mary Dale Peterson, president-elect of the American Society of Anesthesiologists and executive vice president and chief operating officer of Driscoll Health System in Corpus Christi, Texas, says the word “anesthesia” comes from the Greek word meaning “without sensation. Anesthesia is either a loss of feeling or awareness,” such as you’d want to have if a surgeon were about to cut into your body to conduct a needed medical procedure.

Here are questions to ask if you’re about to have anesthesia:

  1. What type of anesthesia will be used?
  2. What are the risks of anesthesia?
  3. How can I best prepare for this procedure?
  4. What should I expect after the procedure?

1. What Type of Anesthesia Will Be Used?

Anesthesia can be divided into three major types:

  • Local. This type of anesthetic numbs a specific area of the body, such as what you’d receive when having a cavity filled by a dentist. Peterson says it leaves the patient wide awake and aware of what’s going on, or only mildly sedated.
  • Regional. These anesthetics block pain in an area of the body, such as an arm or leg. Epidurals – injections of pain-blocking medication directly into the spinal column that block pain from the waist down – are commonly used to alleviate labor pains without putting the mother completely to sleep. That way, she can participate in the birth of her child without feeling the pain that typically comes with that experience. Regional anesthetics may also be used for a variety of orthopedic surgeries on the lower extremities, such as reconstructing ligaments in the knee and sometimes in brain surgery, where the patient needs to be awake to respond to cues from the surgeon to help guide where incisions should be made.
  • General. General anesthesia is what most people probably think of when they hear the word “anesthesia.” These drugs make you unconscious and are usually delivered as a gas through a face mask. The National Institutes of Health reports that when given this type of anesthetic, “you do not feel any pain, and you do not remember the procedure afterwards.” It’s commonly used for larger or more complex procedures such as organ transplants or lung or heart surgery.

The type of anesthetic used will depend on the location of the surgery and the type of procedure.

2. What Are the Risks of Anesthesia?

Being sedated or made unconscious is not a risk-free enterprise, and anesthesiologists are highly-trained specialist physicians who know how to react in the dynamic environment of the operating room to keep you safe. “Every patient is a little bit different in how they react to or metabolize drugs,” Peterson says, a situation that can also be influenced by other medications the patient may be taking and disease states or other health issues. “All of these can change how those (anesthetic) drugs work on the body.”

With general anesthesia, “there’s a loss of consciousness and there’s a loss of ability for the patient to maintain their airway or breathe on their own,” which can be a challenge depending on the patient and the particular situation. “For a lot of major operations, a breathing tube will be fit in, and we’ll put the patient on a breathing machine to assist with that.” In addition, some anesthetic medications depress the heart or blood pressure, which means the anesthesiologist will have to counteract those effects with other medications to support the patient.

“In addition, you’ve got the insult of surgery and blood loss” that the anesthesiologist works to counteract with blood transfusions and other techniques and medications to stabilize the patent and allow the surgery to continue, Peterson says, adding that one reason why she loves the field is because “you’re bridging two different worlds. You’re bridging the surgical world and the internal medicine world. You’ve got to know about all those diseases and how they impact the patient, but you also have to know about the surgery, even though you’re not the person performing it.”

During a procedure, Sibert says the anesthesiologist is tasked with taking “care of the heart, the lungs, the brain, the circulation, the kidney function, you name it. We’re the internal medicine physician or pediatric physician for everything else that’s going on with that patient during the procedure.” Being able to do this all safely “requires a great deal of general medical knowledge in addition to what drugs to use to sedate or anesthetize someone and wake them up in the end. We’re also responsible for intraoperative fluid management, transfusions, ventilator management – all kinds of things that people never really think about,” Sibert says.

To make all this happen, the anesthesiologist has sophisticated equipment that monitors the patient’s status. “It’s sort of like a cockpit. We have a ventilator and infusion pumps and machines that deliver the anesthesia gasses. All the vital sign monitors are right there,” Sibert says.

Peterson also uses a flight analogy when describing what anesthesiologists do. “There’s a lot that anesthesiologists and pilots have in common. We have our take-offs – that’s what we call induction or getting the patient to sleep. That’s a very critical time. And we have landings, or waking them up, which is another really critical time. In between, it depends on the surgery and how everything is going.” Some surgeries are turbulence-free while others make for a bumpier ride where the anesthesiologist has to make a lot of adjustments on the fly. “It’s kind of like an airplane pilot – sometimes they’re on auto-pilot and other times they have to have all that experience and training to get the plane through.”

While having anesthesia may confer some risks to the patient, Peterson says anesthesiologists have “led medicine in that we have made anesthesia much safer and we’re operating on much sicker and younger patients” now than they once were able to because of how precisely they can regulate most people’s response to anesthesia. She says pediatric anesthesiologists can now safely anesthetize infants weighing less than a pound. At the other end of the spectrum, more elderly adults aged 90 and older are able to safely undergo surgery because of advances in anesthesiology the past few decades.

3. How Can I Best Prepare for This Procedure?

“Patients do need to take some ownership of their own health,” Sibert says, and “if they are in rough shape to begin with, they’re going to have a tough time getting through surgery.” This means that you may need to take some time prior to a surgical procedure to improve your health. Optimizing blood pressure, addressing anemia (low iron levels), reducing obesity or getting your diabetes under control before a procedure may result in a safer experience. “There isn’t always time to do that, but those things really help. The better shape patients are when they go into surgery, the better shape they’ll be in coming out of surgery.” Eating right, exercising and getting good sleep prior to surgery are also important to improving your outcome.

If you’re a smoker, you should try to lay off the habit for a period of time prior to surgery. “We know that patients do better not only from the anesthesia, but also healing from surgery, if they stop smoking. Even if it’s just for a few days before surgery, it can still make a difference in their recovery and risk,” Peterson says. No doubt, this is a tall order, but smoking cessation efforts prior to surgery have been shown to help.

Generally speaking, you shouldn’t have any food in your stomach when you head into a procedure that involves anesthesia, as that can make you sick. Your doctor will also outline any other specific requirements you need to follow prior to surgery. Follow these directions to the letter; there are many medications that can negatively interact with anesthetic medications or alter the effects of these powerful drugs. Because of this, Peterson says “all patients should be very open and honest with the anesthesiologist and give them a good health history, including things that are sensitive topics,” such as illicit drug use and pregnancy. “Even herbal supplements can affect how some of the drugs work,” Peterson says. Anesthesiologists aren’t there to judge you or your lifestyle choices, they just want to keep you safe.

In addition, “patients need to be really honest with us about what they’ve had done in the past,” Sibert says, including things like plastic surgeries that might not seem related to the current procedure. “Sometimes people who’ve had plastic surgery, their eyes don’t close completely and that puts them at risk for eye damage.” Alternatively, patients who’ve had chin implants pose a specific challenge. “It’s difficult to put breathing tubes into patients with very receding chins,” and a cosmetic augmentation of the chin might hide that aspect of a patient’s physiology. Therefore, “we really need to know anything you’ve ever had in terms of surgery, what health problems you’ve had, what medications you’re taking. And just because you have a health problem that seems to be under control doesn’t mean we don’t need to know about it.” The bottom line is, don’t lie to your surgeon or anesthesiologist about anything you may be taking and other procedures you’ve had. That information is critical to ensuring a safe outcome of the procedure you’re about to have.

Prior to your procedure, you should also ask lots of questions and make sure you understand what’s going to happen and what to expect. “If you don’t understand, you need to ask questions,” Peterson says. She says it’s always helpful to bring a friend or family member to support you, as “you might not be thinking clearly right after anesthesia, and if you’re having day surgery, you need someone to drive you home,” as the drugs can have a lingering sedative effect that makes driving a car dangerous.

In addition, “I also think that patients deserve to know who’s going to be taking care of them in the operating room,” so for that reason, she recommends asking for a meeting with the anesthesiologist. “I think it’s a perfectly legitimate thing to ask, ‘are you a physician anesthesiologist? Is there anyone else on the team who’s going to be taking care of me in the operating room?’ Sometimes a care team approach is used, and I think everybody should be open and honest” about who will be playing which roles while you’re unconscious. Most hospitals have some protocol for the anesthesiologist to review the patient’s history and meet with them ahead of time and to make themselves available to answer any questions, and that’s your time to ask whatever questions you may have. “Even though we may not meet you for a very long time, it’s an important relationship to establish,” Peterson says.

4. What Should I Expect After the Procedure?

Anesthesia is great in that it prevents you from feeling any pain while the procedure is ongoing, but once that medical support ends, pain can become an issue for many people. “It’s very important for us these days to make sure that expectations about pain relief afterward are realistic,” Sibert says, noting that post-operative pain management has been implicated as a contributing factor to the current opioid epidemic. Talk to your doctor prior to the procedure about how post-operative pain will be managed, and if a narcotic is recommended, consider whether that’s something you’re comfortable with. If not, find out what alternatives to opioids are available. Sibert says there are lots of ways to control pain with a variety of non-narcotic pain killers, “but we do need patients to meet us halfway and not have unrealistic expectations of having zero pain after major surgery. Unfortunately, it just isn’t like that.”

Similarly, taking an active role in your own recovery is important, as following your doctor’s orders on physical therapy and any other rehabilitative methods you’re prescribed will often take some work on your part.

11 Things Your Orthopedic Specialist Wants You to Know

Original Article By healthgrades.com

Insights from the Bone and Joint Experts

Whether you have ongoing backaches or sustain Read more

After Years of Paralysis, A Man Walks the Length of a Football Field

Original Article By Emily Willingham | Scientific Journal

An electrical stimulation device combined with intensive rehabilitation restores walking ability to a spinal cord injury patient

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What is joint replacement surgery?

Original Article: National Institute of Arthritis and Musculoskeletal and Skin Diseases


What is joint replacement surgery?

Joint replacement surgery removes damaged or diseased parts of a joint and replaces them with new, man-made parts.

Replacing a joint can reduce pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.

Points To Remember About Joint Replacement Surgery

  • Joint replacement surgery removes damaged or diseased parts of a joint and replaces them with new, man-made parts.
  • The goals of joint replacement surgery are to relieve pain, help the joint work better, and improve walking and other movements.
  • Risks of problems after joint replacement surgery are much lower than they used to be.
  • An exercise program can reduce joint pain and stiffness.
  • Wearing away of the joint surface may become a problem after 15 to 20 years.

Why may joint replacement surgery be needed?

Joints may need to be replaced when they are damaged from:

  • Arthritis
  • Years of use
  • Disease

Your doctor will likely first suggest other treatments to reduce pain and help you move better, such as:

  • Walking aids, such as a cane or walker
  • An exercise program
  • Physical therapy
  • Medications

Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x-ray to look at the joint. If the x-ray shows damage and your joint hurts, you may need a joint replacement.


What happens during joint replacement surgery?

During joint replacement your doctors will:

An illustration showing a hip prosthesis that is used in hip replacement surgery.
Hip Replacement Location
  • Give you medicine so you won’t feel pain. The medicine may block the pain only in one part of the body, or it may put your whole body to sleep.
  • Replace the damaged joint with a new man-made joint.
  • Move you to a recovery room until you are fully awake or the numbness goes away.


What can I expect after joint replacement surgery?

With knee or hip surgery, you will probably need to stay in the hospital for a few days. If you are elderly or have additional disabilities, you may then need to spend several weeks in an intermediate-care facility before going home. You and your team of doctors will determine how long you stay in the hospital.

After hip or knee replacement, you will often stand or begin walking the day of surgery. At first, you will walk with a walker or crutches. You may have some temporary pain in the new joint because your muscles are weak from not being used. Also, your body is healing. The pain can be helped with medicines and should end in a few weeks or months.

Physical therapy can begin the day after surgery to help strengthen the muscles around the new joint and help you regain motion in the joint. If you have your shoulder joint replaced, you can usually begin exercising the same day of your surgery! A physical therapist will help you with gentle, range-of-motion exercises. Before you leave the hospital, your therapist will show you how to use a pulley device to help bend and extend your arm.


What are the complications of joint replacement surgery?

Complications after joint replacement surgery are much lower than they used to be. When problems do occur, most are treatable. Problems could include:

  • Infection.
  • Blood clots.
  • Loosening of the joint.
  • Ball of the new joint comes out of its socket.
  • Wear on joint replacements.
  • Nerve and blood vessel injury.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

How Do Broken Bones Heal?

Original Article By Hallie Levine

Bones are flexible enough to give a bit when physical force is applied, but if that force is too great, they’ll snap like a plastic ruler bent too far. Luckily, they also repair themselves naturally. Here’s how it works.

Adults are held up by a skeleton composed of 206 bones that protect the body’s vital organs. Though it’s a sturdy frame, it’s vulnerable to problems—think issues like like osteoporosis and stress fractures, says Chad Deal, MD, director of the Center for Osteoporosis and Metabolic Health at the Cleveland Clinic.

Bones are flexible enough to give a bit when physical force is applied, but if that force is too great, they’ll snap like a plastic ruler bent too far. Luckily, they also repair themselves naturally (even better with a cast). Here’s how bones heal.

1. Immediately after a fracture occurs, a blood clot and callus form around it.

2. New “threads” of bone cells start to grow on both sides of the fracture line toward one another.

3. Eventually, the fracture closes up and the callus is absorbed by the new cells. This process may

take from six weeks to a year.

 


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

orthopaedic surgeons, new mexico

Improving Success of Hip & Knee Replacement Surgery

Article by Johnathon Cluett, MD | Found on VeryWell

Hip and knee replacement surgery are some of the most common orthopedic surgeries offered. Every year, hundreds of thousands of patients undergo hip replacement or knee replacement for treatment of severe arthritis of their joints. Surgical treatment of arthritis with a joint replacement is one of the most successful surgical interventions, but there are complications that can occur, and when complications do occur they can be very serious. Complications may include ongoing pain, wound healing problems, stiffness, infection, and other problems. Read more

albuquerque, new mexico, orthopaedic doctors

New Surgical Strategy Offers Hope for Repairing Spinal Injuries

Article Found on MedicalNewsToday

Surgery to reconnect sensory neurons to the spinal cord after a traumatic spinal injury works because offshoots from the spinal cord complete the spinal circuit.

Scientists in the UK and Sweden previously developed a new surgical technique to reconnect sensory neurons to the spinal cord after traumatic spinal injuries. Now, they have gained new insight into how the technique works at a cellular level by recreating it in rats with implications for designing new therapies for injuries where the spinal cord itself is severed. Read more

Knee Replacement Surgery for Arthritis

Knee Replacement Surgery for Arthritis

Article Featured on WebMD

Who Needs Knee Replacement Surgery?

You and your doctor may consider knee replacement surgery if you have a stiff, painful knee that makes it difficult to perform even the simplest of activities, and other treatments are no longer working. This surgery is generally reserved for people over age 50 who have severe osteoarthritis.

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