ACL Injuries in Children and Adolescents

ACL Injuries in Children and Adolescents

Article Featured on Nationwide Children’s

It has been frequently emphasized that children are not simply “small adults.” Children and adults are different anatomically and physiologically in many ways. Knee injuries in children and adolescents frequently demonstrate these differences.

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Swollen Ankles and Feet

Swollen Ankles and Feet – Causes & Treatments

Article Featured on WebMD

Swollen ankles and swollen feet are common and usually not cause for concern, particularly if you have been standing or walking a lot. But feet and ankles that stay swollen or are accompanied by other symptoms could signal a serious health problem. We look at some possible causes of foot and ankle swelling and offer advice on when to call the doctor.

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Bone health: Tips to keep your bones healthy

Bone health: Tips to keep your bones healthy

Protecting your bone health is easier than you think. Understand how diet, physical activity and other lifestyle factors can affect your bone mass.

By Mayo Clinic Staff

Bones play many roles in the body — providing structure, protecting organs, anchoring muscles and storing calcium. While it’s important to build strong and healthy bones during childhood and adolescence, you can take steps during adulthood to protect bone health, too.

Why is bone health important?

Your bones are continuously changing — new bone is made and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more bone mass than you gain.

How likely you are to develop osteoporosis — a condition that causes bones to become weak and brittle — depends on how much bone mass you attain by the time you reach age 30 and how rapidly you lose it after that. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

What affects bone health?

A number of factors can affect bone health. For example:

  • The amount of calcium in your diet. A diet low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Physical activity. People who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts.
  • Tobacco and alcohol use. Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than one alcoholic drink a day for women or two alcoholic drinks a day for men may increase the risk of osteoporosis.
  • Gender. You’re at greater risk of osteoporosis if you’re a woman, because women have less bone tissue than do men.
  • Size. You’re at risk if you are extremely thin (with a body mass index of 19 or less) or have a small body frame because you might have less bone mass to draw from as you age.
  • Age. Your bones become thinner and weaker as you age.
  • Race and family history. You’re at greatest risk of osteoporosis if you’re white or of Asian descent. In addition, having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures.
  • Hormone levels. Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.
  • Eating disorders and other conditions. People who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery, and conditions such as Crohn’s disease, celiac disease and Cushing’s disease can affect your body’s ability to absorb calcium.
  • Certain medications. Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, is damaging to bone. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors.

What can I do to keep my bones healthy?

You can take a few simple steps to prevent or slow bone loss. For example:

  • Include plenty of calcium in your diet. For adults ages 19 to 50 and men ages 51 to 70, the Recommended Dietary Allowance (RDA) is 1,000 milligrams (mg) of calcium a day. The recommendation increases to 1,200 mg a day for women after age 50 and for men after age 70.

    Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about supplements.

  • Pay attention to vitamin D. Your body needs vitamin D to absorb calcium. For adults ages 19 to 70, the RDA of vitamin D is 600 international units (IUs) a day. The recommendation increases to 800 IUs a day for adults age 71 and older.

    Good sources of vitamin D include oily fish, such as salmon, trout, whitefish and tuna. Additionally, mushrooms, eggs and fortified foods, such as milk and cereals, are good sources of vitamin D. Sunlight also contributes to the body’s production of vitamin D. If you’re worried about getting enough vitamin D, ask your doctor about supplements.

  • Include physical activity in your daily routine. Weight-bearing exercises, such as walking, jogging, and climbing stairs, can help you build strong bones and slow bone loss.
  • Avoid substance abuse. Don’t smoke. If you are a woman, avoid drinking more than one alcoholic drink each day. If you are a man, avoid drinking more than two alcoholic drinks a day.

Enlist your doctor’s help

If you’re concerned about your bone health or your risk factors for osteoporosis, including a recent bone fracture, consult your doctor. He or she might recommend a bone density test. The results will help your doctor gauge your bone density and determine your rate of bone loss. By evaluating this information and your risk factors, your doctor can assess whether you might be a candidate for medication to help slow bone loss.

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.

Dr. Tripuraneni Featured in ABQ Magazine 2019 Top Docs!

Congratulations to Dr. Tripuraneni from ABQ The Magazine!

Dr. Tripuraneni Featured in ABQ Magazine 2019 Top Docs!Dr. Krishna Tripuraneni is not just one of the most respected orthopaedic surgeons in New Mexico, his reputation spans the entire country. Perhaps that’s why he was one of the physicians chosen by the Albuquerque Isotopes to be a team doctor.

Krishna Tripuraneni, MD, FAAOS is a board-certified orthopaedic surgeon who specializes in hip and knee replacement surgery. After completing his undergraduate and medical degrees at George Washington University, Dr. Tripuraneni completed his orthopaedic surgery residency at the University of New Mexico followed by a fellowship in total joint replacement at Stanford University.

Dr. Tripuraneni views his professional career as an opportunity to assist others and finds a deep satisfaction in facilitating people to lead healthier and happier lives.

His comprehensive, personalized approach and open communication with patients, as well as his desire for patients to return to an improved quality of life are integral in his daily interactions. He makes himself readily available to his patients and his empathetic understanding is vital to their satisfaction. His excellent technical skills, along with his compassionate care are the reasons patients travel from all over the state of New Mexico, as well as neighboring states, to seek his professional opinion.

His clinical care extends beyond joint replacement, as he continues to perform general orthopaedic procedures. Dr. Tripuraneni is involved in clinical research, has published numerous peer-reviewed articles on joint replacement, presented at national meetings, and volunteers his time as a member of national orthopaedic societies.

He is passionate about innovative medical care. He stays up to date with the latest orthopaedic research and integrates this into his practice in order to deliver top-notch clinical and surgical care for his patients. He has spearheaded same-day, outpatient discharges for hip and knee replacements in Albuquerque and is involved in a national, clinical study integrating everyday technology into post-surgical care. His excellent clinical and research care teams manage the numerous intricacies from beginning to end in order to ensure a positive experience for the patient.

Dr. Tripuraneni’s commitment to education extends to the numerous medical students and residents he has mentored over the years. He enjoys being one of the several team physicians for the Albuquerque Isotopes, with the added benefit of enjoying the games with family and friends!

During his free time, Dr. Tripuraneni enjoys sporting activities, staying healthy, traveling and spending time with family.

What can cause pain in the hand or wrist?

What can cause pain in the hand or wrist?

By Zawn Villines | Article Featured on Medical News Today

Hand pain is often the result of a recent injury or from overusing the hand or wrist. However, persistent or reoccurring pain in the hand may be the sign of an underlying condition. In this article, we describe the possible causes of pain in the hand and when to see a doctor.

We also cover some home remedies for hand pain.

Hand injuries

The hands and wrists contain many different bones, joints, and connective tissues, such as ligaments, tendons, nerves, and blood vessels. Injuries to the hand can damage these structures and lead to pain, swelling, bruising, and other symptoms.

Common causes of hand injuries can include:

  • knocks and blows
  • landing on the hands during a fall
  • jamming a finger
  • bending the fingers or wrist too far backward
  • repetitive strain, such as from long periods of typing, heavy lifting, or playing sports

Finger fractures and dislocations are common types of hand injury. The pain usually feels sudden and intense, and it may develop into throbbing or soreness over the course of several days.

Falls and severe blows can also fracture the wrist, causing sharp pain and swelling. People with fractures may require a cast. Less frequently, a doctor may need to set the bones back into place. Injuries to the muscles, ligaments, and tendons are called soft tissue injuries. People with soft tissue injuries do not usually require medical treatment, but ice and elevation can help relieve pain and swelling.

It is also important to rest or immobilize the hand while it recovers. Mallet finger, or baseball finger, is another common hand injury. This injury occurs when a sudden blow, such as from a ball, tears or stretches the extensor tendon in the finger. It can also happen if a person jams or cuts their finger.

A typical sign of mallet finger is a drooping fingertip that will not straighten without help. The finger may also be bruised, swollen, and painful. Splinting the injured finger can help with healing. In some cases, a person may need surgery or physical therapy.


Repetitive movements or overuse of the hands and wrists can cause the muscles, tendons, and nerves to become painful, sore, or tense. Pain and tension from muscles in the arms and shoulders can also radiate down to the hands.

This type of pain typically results from carrying out very repetitive or high-intensity activities for long periods of time. Holding the hands in awkward positions for too long can also lead to overuse injuries.

Common causes include:

  • typing or using a computer mouse
  • using tools
  • lifting heavy items
  • playing, or training for, sports

Overuse injuries usually respond well to rest, hot or cold packs, and gentle stretching. Taking over-the-counter (OTC) medications such as acetaminophen and ibuprofen may also help reduce pain and swelling.

A doctor may also recommend physical therapy or making adjustments to a person’s working and training habits to help prevent reinjury.

Ganglion cyst

Ganglion cysts are fluid-filled lumps that can develop near joints and tendons in the hand and wrist. These cysts can vary size, but they are often harmless and disappear without treatment.

However, they can sometimes be painful and may affect a person’s ability to use their hand or wrist. Researchers do not yet understand what causes ganglion cysts, but they tend to be more common in younger people and females.

Ganglion cysts do not usually require treatment. If a person has pain or difficulties moving a joint, a doctor may recommend draining the cyst or removing it surgically.

Trigger finger

Stenosing tenosynovitis, or “trigger finger,” occurs when the ring of connective tissue called the tendon sheath at the base of a thumb or finger becomes swollen. This swelling can affect the movement of the tendon, making it difficult or painful to move the affected finger or thumb.

A person may also notice a popping sensation when trying to move the finger, or a feeling that the finger is catching on something.

Treatment options for trigger finger may include:

  • resting the finger
  • immobilizing it with a splint
  • taking anti-inflammatory medications, such as ibuprofen
  • having steroid injections
  • seeking release of the tendon sheath when the above treatments fail

A doctor may also recommend surgery if other treatments are unsuccessful.


Scleroderma is a group of conditions that result in unusual growth of connective tissue under the skin or around internal organs. All types of scleroderma can cause the skin of the fingers to thicken and tighten, which can make them difficult to move. Systemic scleroderma can also narrow the blood vessels of the hand, which can lead to pain and tingling.

Scleroderma is a chronic condition with no cure. However, steroids, blood pressure medications, and immunosuppressants can help relieve symptoms and prevent the condition from progressing.

Raynaud’s phenomenon

Raynaud’s phenomenon is a condition in which the blood vessels in the fingers or toes temporarily narrow. It often occurs in response to cold temperatures or stress. During a flare-up, blood flow to hands becomes severely reduced. This may cause the fingers to lighten or become blue, and they may feel numb or painful.

When the blood flow begins to return, the hands may appear red or purple. The length of these attacks can vary from less than 1 minute to several hours. Other conditions, such as scleroderma, can cause Raynaud’s phenomenon. However, for most people with Raynaud’s, the cause is unknown.

There is no cure for Raynaud’s. However, making lifestyle changes and taking medications can help prevent flare-ups and reduce their severity. Treating any underlying conditions can also help.


Arthritis is a general term for more than 100 different disorders that cause pain, swelling, and stiffness in joints.

The most common type of arthritis is osteoarthritis, which occurs when the cartilage that protects a joint wears away over time. This wear and tear allows the bones in the joint to rub against each other, causing pain and stiffness.

Another common type of arthritis is rheumatoid arthritis, which occurs when a person’s immune system mistakenly attacks the tissues in the joints, which can cause inflammation and pain. Over time, this inflammation can lead to permanent joint damage.

Arthritis can affect any joint in the body, including in the hands and wrists. Treatment depends on the type of arthritis, but it can include making lifestyle changes, taking medications, exercising, and seeking physical therapy or occupational therapy.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when the median nerve, which runs through the wrist, becomes compressed or squeezed. Symptoms can start gradually and are often worse at night. They typically include pain, tingling, and numbness in the hand and arm. Carpal tunnel syndrome can also cause weakness in the affected hand. Some people may experience a loss of proprioception, which is a sense of where the hand is in space.

This condition can get worse with time, so early diagnosis and treatment is important. Treatment options include:

  • making lifestyle changes
  • wearing a splint
  • taking medications, including anti-inflammatory drugs and steroid injections
  • seeking physical therapy
  • having surgery


Osteoporosis is the gradual loss of bone mass, which causes the bones to become weak and brittle. This weakness increases a person’s risk of fracturing or breaking bones, particularly in the wrists and hips. Osteoporosis tends to develop slowly and is more common in females and older people.

Treatment for osteoporosis typically involves:

  • exercising to improve bone health, muscle strength, and mobility
  • taking medications to increase bone strength
  • making lifestyle changes to reduce the risk of falls and fractures
  • making dietary changes, such as taking calcium or vitamin D supplements to improve bone health

When to see a doctor

A person should see a doctor for severe, persistent, or reoccurring pain in the hands or wrists.

See a doctor for hand pain that:

  • does not get better with home treatment
  • gets steadily worse
  • does not respond to treatment that a doctor recommends
  • may be due to a fall or other injury
  • occurs along with other symptoms, such as arm pain, a fever, or exhaustion

Go to the emergency room for:

  • intense, sudden, unbearable hand pain
  • a suspected broken wrist or arm
  • a visible injury to the hand that causes very intense pain

Home remedies

Hand pain sometimes gets better with gentle stretching exercises.

To ease pain in the hands or wrists, a person can:

  • Rotate the wrists counter-clockwise and then clockwise. Repeat each movement 10 times.
  • Open the hands as widely as possible, spread the fingers apart, then close the hands into a tight fist. Repeat 10 times.
  • Use one hand to gently extend the fingers of the other hand back toward the chest for a gentle wrist stretch. Repeat five to 10 times.

A doctor or physical therapist may be able to recommend additional hand and wrist stretches.

RICE therapy can help with a range of minor injuries, including hand and wrist pain. RICE stands for rest, ice, compression, and elevation:

  • Rest. Avoid using the affected hand as much as possible.
  • Ice. Apply an ice or cold pack to the injured hand for 20 minutes several times per day.
  • Compression. Wrap the affected area in a soft bandage, splint, or cast.
  • Elevation. Keep the affected hand raised, such as by using a sling, above heart level.

Other home remedies for hand and wrist pain include:

  • Massage. Try massaging the painful area and surrounding muscles. Sometimes, massaging the arms or shoulders can help with hand pain.
  • Heat. Some pain responds well to heat. Consider alternating between heat and cold packs, 20 minutes on and 20 minutes off for each.
  • OTC medications. Taking nonsteroidal anti-inflammatory drugs such as ibuprofen can help with pain and inflammation from a wide variety of conditions.

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.

Exercise Might Slow Colon Cancer’s Advance

Exercise Might Slow Colon Cancer’s Advance


Exercise has countless benefits, even in small doses. And new research suggests the payoffs might extend to colon cancer patients. Short sessions of intense exercise may slow the growth of colon cancer, Australian researchers report. “We have shown that exercise may play a role in inhibiting the growth of colon cancer cells,” said lead author James Devin, from the University of Queensland.

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Walking, Not Riding, Boosts Health in Golfers With Knee Woes

Walking, Not Riding, Boosts Health in Golfers With Knee Woes

Walking the golf course instead of riding in a cart offers heart health benefits that may outweigh potential joint harm for golfers with knee osteoarthritis, a new small study reports. The study included 10 golfers with knee osteoarthritis who played two 18-hole rounds of golf. They walked the course in one round and used a golf cart in the other round.

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The Key to a Longer Life: Exercise More

The Key to a Longer Life: Exercise More

By Bert Mandelbaum, M.D. | Article Featured on US News

ABOUT 50 YEARS AGO, THE average life expectancy for men in the United States was around 67 years, and for women, it was approximately 74. Today, American men live to about 77 years old on average; women, to about 81. There’s no question that the average life expectancy has increased over the last several decades. Men are living approximately 10 years longer and women about seven years longer. But how can we maintain this positive trend, or even better, increase both the quantity and quality of those years?

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An Experts Guide to Avoiding Back Pain

An Expert’s Guide to Avoiding Back Pain

Article BY ROBERT PREIDT | Featured on US News

Back pain is a common problem in the United States, but there are ways to protect yourself, an expert says.

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Everyday 'Triggers' May Bring on A-Fib Episodes, Study Finds

Everyday ‘Triggers’ May Bring on A-Fib Episodes, Study Finds

BY STEVEN REINBERG | Article Featured on US News

Many older Americans are diagnosed with the irregular heartbeat known as atrial fibrillation, or “a-fib.” Now, research suggests that everyday foods, drinks or activities might trigger episodes of the stroke-linked condition.

The bad news: Triggers include coffee, alcohol and sleepless nights. The good news: These factors can all be avoided or reduced, according to researchers at the University of California, San Francisco.

They stressed that the study wasn’t focused on the underlying causes of atrial fibrillation, but rather factors linked to a-fib episodes in people already diagnosed.

“Almost all a-fib studies have to do with risk factors for the initial development of the disease,” said senior study author Dr. Gregory Marcus, associate chief of cardiology for research at the university. “This study focuses on specific exposures that cause an individual episode to occur.”

One-quarter of adults over 40 in the United States are at risk for a-fib, the study authors said. By 2050, nearly 6 million Americans may suffer from it.

In a-fib, electrical impulses that control the upper chambers of the heart — the atria — fire erratically, preventing the chambers from contracting normally. Over time, that can lead to a raised risk for blood clots and stroke. Many people with a-fib take blood thinners to reduce their odds for stroke.

Risk factors for an a-fib diagnosis include advanced age, heart disease, drinking alcohol and smoking. Men are more prone to the condition than women, although each gender is affected.

The new study investigated which factors might trigger individual a-fib episodes. To do so, Marcus and his colleagues asked nearly 1,300 patients with the condition if a prior episode was triggered by one of 11 factors.

Nearly three-quarters (74 percent) said there were triggers they felt were linked to an a-fib episode. Alcohol accounted for 35 percent of these triggers, caffeine for 28 percent, exercise for 23 percent and lack of sleep for 21 percent.

Most patients said a-fib was common after experiencing two different triggers.

The new findings could help patients better fight the condition and protect their heart, Marcus suggested.

“Better understanding of individual-level triggers may help empower patients, and represents a novel approach to improving quality of life and reducing health care use,” Marcus said in a university news release.

Two heart specialists who reviewed the new findings agreed, and added that the triggers found in the study can be reduced.

For example, “alcohol is a known cause of atrial fibrillation, either by direct stimulation of the heart or dehydration,” said Dr. Guy Mintz, who directs cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. He pointed to what doctors have nicknamed “Holiday Heart Syndrome” — a well-known cause of atrial fibrillation after binge drinking.

The caffeine found in coffee and other drinks also “acts as a direct stimulant of the heart and can also cause a diuretic [fluid-reducing] effect … leading to atrial fibrillation,” Mintz said.

“Good advice for patients with episodic atrial fibrillation would be to limit their alcohol intake to the American Heart Association guidelines of one drink per day for women, and one to two drinks per day for men, and not binge drink,” he said.

People with a-fib should also reduce their caffeine intake and drink plenty of water. “Patients planning to consume alcohol or caffeinated beverages should drink more water prior to going out and after returning from their evening activity to avoid dehydration,” Mintz advised.

As for sleeplessness, he theorized that people affected might have sleep apnea, which in turn might lower oxygen levels so that high blood pressure becomes more likely. “In my opinion, variation in blood pressure is a likely contributor to irregular heartbeats such as atrial fibrillation,” Mintz said.

And what about the finding that something as healthy as exercise might be an a-fib trigger for some?

Cardiologist Dr. Satjit Bhusri said that, in his experience, “exercise-induced atrial fibrillation is not common.” In fact, he wondered if patients in the new study were sometimes confusing “normal” heartbeat changes after exertion with an a-fib episode.

“One’s heart rate normally increases with exercise and can mimic the same palpitation feeling of atrial fibrillation,” said Bhusri, who practices at Lenox Hill Hospital in New York City.

Mintz agreed that the health benefits from exercise far outweigh any possible risks.

“Exercise is very important for heart health,” Mintz said, and “no one should read this study and come away with an interpretation that exercise is unhealthy. The American Heart Association recommends 150 minutes of moderate aerobic exercise or 75 minutes of vigorous aerobic exercise per week.”

The report was published online Feb. 14 in the journal HeartRhythm.

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.