Inside Orthopedics Today with focus on reconstruction & regenerative medicine in sports

Due to the nature of a hinge joint structure & weight-bearing requirements the knees are easily subject to injury. This is especially true when it comes to playing sports and athletics that can inflict trauma on the knee. Managing Acute Knee Injuries The supporting structures of the knees(medial and lateral collateral ligaments), the anterior and posterior cruciate ligaments, hamstrings, surrounding quadriceps, pes anserine tendons and iliotibial band. The medial and lateral menisci protect the articular cartilage surfaces. Given the complexity of the knee, taking a thorough history of the patient’s injury and symptoms is perhaps the most important part of making the diagnosis Knee Injury types and testing The anterior cruciate ligament (ACL) originates from the medial aspect of the lateral femoral condyle, twists degrees (adding tensile strength), and inserts onto a tubercle along the anterior tibial plateau. MRI scans for a possible torn ACL is done with the knee in 30 degrees flexion with the thigh stabilized, exerting a forward motion on the tibia. Any more than a few mm of motion would be abnormal. The pivot shift test is performed by lifting the distal leg, allowing the tibia to fall posteriorly, and adding mild internal rotation and valgus stress. If abnormal, the tibia will sublux further. The posterior cruciate ligament (PCL) is tested in a posterior direction and feeling for a firm or soft endpoint feel, which might indicate a partial or complete tear Links from the show notes: The acute swollen knee: diagnosis and management Knee Injury (ACL, MCL, LCL) Symptoms, Signs Stem Cell Therapy for Knee Injuries Management of acute knee injuries Common Knee Injuries Previous Episodes: Rotator Cuff Tears Shoulder & Elbow Pain : Do You Need Surgery? Balancing Work & Life After Suffering a Spinal Cord Injury  Regenerative vs Restorative Surgical Options for Knee Arthritis and Cartilage Injuries Advances in the Diagnosis and Treatment of Cervical or Lumbar Spine Degenerative Disease  Latest Advances in Rheumatoid Arthritis  Hip Replacement Alternatives Failed Back Syndrome Neck & Lower Back Pain Disclaimer - Nothing you hear on the Inside Orthopedics Today Podcast is intended as medical advice. You should always consult a physician before making any changes to your health plan. If the podcast has helped you to live better please tell someone else how to find the show and consider leaving a rating and review on iTunes. 

Back and neck pain are  the most widespread and most disabling types of pain and it can occur in a number of areas of the cervical and lumbar spine. The most common type of back pain is lower lumbar spinal stenosis. Self-management of Shoulder & Neck pain Another common form of pain that affects people of all ages and levels of mobility is sciatica. This pain often happens suddenly, radiating down the leg or foot and can result in peripheral neuropathy This week on our podcast we discuss neck and back pain solutions. If however your problems are severe and continues, your orthopedic doctor may offer alternative solutions for pain management. In some cases you may also need surgery to relieve pressure on the cervical spine or other treatment to treat problems that can cause this type of pain. Surgery can be very painful. However, if you have weak shoulders, back or pain in the hips. The issues may recur and it may become more severe over time. Links from the show notes: https://www.nhs.uk/conditions/back-pain/ https://medlineplus.gov/backpain.html https://stemcellthailand.org/therapies/degenerative-disc-disease-ddd/ https://frankhealth.e-monsite.com/ https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/back-pain Previous Episodes: Rotator Cuff Tears Shoulder & Elbow Pain : Do You Need Surgery? Balancing Work & Life After Suffering a Spinal Cord Injury  Regenerative vs Restorative Surgical Options for Knee Arthritis and Cartilage Injuries Advances in the Diagnosis and Treatment of Cervical or Lumbar Spine Degenerative Disease  Latest Advances in Rheumatoid Arthritis  Hip Replacement Alternatives Failed Back Syndrome Disclaimer - Nothing you hear on the Inside Orthopedics Today Podcast is intended as medical advice. You should always consult a physician before making any changes to your health plan. If the podcast has helped you to live better please tell someone else how to find the show and consider leaving a rating and review on iTunes. 

After having spine surgery, most expect your back or neck problem to be solved. But, sometimes, it doesn’t happen. Pain and other symptoms may return in a phenomenon known as failed back surgery (FBS). Also called failed back surgery syndrome and post-laminectomy syndrome, FBS can affect any level of your spine, and it can be a frustrating experience for patients and doctors alike. Risk Factors That Increase Chances of FBSS Several factors may influence whether you have failed back surgery syndrome after your spine surgery, and they may occur pre-operative (before your surgery), intraoperative (during your surgery due to complications), and post-operative (after your surgery) Treatments That Improve Your Quality of Life After Failed Back Surgery Haaving another spine surgery might not produce the outcomes you expected & can be extremely disappointing, but stem cell therapies may help reduce back pain and restore your ability to function in everyday life. Not all patient pain complaints can be fixed with spine surgery. Links from the show notes: https://www.ncbi.nlm.nih.gov/books/NBK539777/ https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2018/september/failed-back-surgery-syndrome https://www.doctorslounge.com/index.php/member/1551164 https://weillcornell.org/failed-back-surgery-syndrome Previous Episodes: Rotator Cuff Tears Shoulder & Elbow Pain : Do You Need Surgery? Balancing Work & Life After Suffering a Spinal Cord Injury  Regenerative vs Restorative Surgical Options for Knee Arthritis and Cartilage Injuries Advances in the Diagnosis and Treatment of Cervical or Lumbar Spine Degenerative Disease  Latest Advances in Rheumatoid Arthritis  Hip Replacement Alternatives Disclaimer - Nothing you hear on the Inside Orthopedics Today Podcast is intended as medical advice. You should always consult a physician before making any changes to your health plan. If the podcast has helped you to live better please tell someone else how to find the show and consider leaving a rating and review on iTunes. 

Arthroscopic joint replacement involves the doctor inserting a microdiscectomy through the hip joint and into the surrounding muscles and tissues. This helps to rebuild your cartilage and decrease pain but you may need to have more than one treatment. Medications that are used to treat hip osteoarthritis include non-steroidal anti-inflammatory drugs, analgesics, and steroidal solutions. . These medications can also be used to treat other conditions besides osteoarthritis to reduce the stiffness and pain caused by arthritis in the knees, hips, and ankles. In some cases, your doctor may recommend surgery to replace the damaged cartilage in your hip osteoarthritis or non-surgical stem cell treatment for hip. The femoral head is then replaced on the opposite side of the hip joint so that the femoral head is placed on the underside of the tibial surface. This allows the femoral head to better absorb shock and reduce friction that can cause bone spurs in your hip joint. Links from the show notes: https://www.hss.edu/condition-list_hip-replacement.asp https://www.nhs.uk/conditions/hip-replacement https://lwccareers.lindsey.edu/profiles/2679628-derrick-anderson https://www.u-tokyo.ac.jp/focus/en/features/f_00001.html https://www.aarp.org/health/conditions-treatments/info-2018/hip-replacement-alternative-fd.html Previous Episodes: Rotator Cuff Tears Shoulder & Elbow Pain : Do You Need Surgery?   Balancing Work & Life After Suffering a Spinal Cord Injury  Regenerative vs Restorative Surgical Options for Knee Arthritis and Cartilage Injuries Advances in the Diagnosis and Treatment of Cervical or Lumbar Spine Degenerative Disease  Latest Advances in Rheumatoid Arthritis  Disclaimer - Nothing you hear on the Inside Orthopedics Today Podcast is intended as medical advice. You should always consult a physician before making any changes to your health plan.  If the podcast has helped you to live better please tell someone else how to find the show and consider leaving a rating and review on iTunes. 

Rheumatoid arthritis (RA) is earmarked by systemic inflammation and damage to joints and surrounding tissues. This can be brought on by many different ways including injury and/or infection as a triggers, genetic predispositions and environmental factors to name a few. What is poorly understood is the role that hormones and mineral deficiency play in RA. We will also explore the impact of cortisol deficiency as a factor for chronic inflammation in shoulder/hip joints and immune function control. This is our first episode in 2022 so we want to start off with the most commonly asked subject and try to explain why patients with RA, Knee Osteoarthritis, Psoriatic Arthritis, Gout or Lupus should have regular lab tests & assessments to better figure out optimal treatment options for regenerating tissues and eliminating deficiencies. Links from the show notes: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648 https://www.nhs.uk/conditions/rheumatoid-arthritis/causes/ https://stemcellthailand.org/therapies/joint-inflammation-arthritis-osteoarthritis-gout/ https://arthritisaustralia.com.au/types-of-arthritis/rheumatoid-arthritis/ https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/   Previous Episodes: Rotator Cuff Tears Shoulder & Elbow Pain : Do You Need Surgery?   Balancing Work & Life After Suffering a Spinal Cord Injury  Regenerative vs Restorative Surgical Options for Knee Arthritis and Cartilage Injuries Advances in the Diagnosis and Treatment of Cervical or Lumbar Spine Degenerative Disease  Disclaimer - Nothing you hear on the Inside Orthopedics Today Podcast is intended as medical advice. You should always consult a physician before making any changes to your health plan.  If the podcast has helped you to live better please tell someone else how to find the show and consider leaving a rating and review on iTunes. 

Degenerative Disc Disease (DDD) is one of the most common orthopedic conditions in adults over the age of 50. Most of the time, it is caused by trauma to the spine resulting in a compression of nerves in the neck (cervical) or lower lumbar spine. This week on Inside Orthopedics Today Dr Jon Hauers discusses the latest trends and techniques for treatment of DDD. For many patients compression of nerve bundles can be due to a herniated disc spondylitis, spinal arthritis or acute injury to spinal nerve itself. It can also be caused by age, obesity, poor posture or other non-neuropathic factors. Unfortunately, traditional treatments are surgeries are not very effective for some types of DDD. The treatment for degenerative disc disease usually begins with non-invasive techniques which can offer enough symptom relief.  Non-invasive techniques of pain management can include manual manipulation, anti-inflammatories, steroid injections, electric stimulation, physical therapy and back braces. When medication does not work or is causing too much pain, then patients are treated by surgically removing the degenerative discs. If the bulges or herniations are large or severe, the surgeon may perform a cauterization procedure to stop the bleeding or use ultrasound to cauterize the area. After the procedure, most patients will experience severe pain in their legs, knees or feet, numbness in the arms and hands, weakness in the legs and toes or difficulty walking. If the bulges or herniations are in the cervical spine, the neck could become unstable and movement might become impossible.  Prevalence of spine degeneration diagnosis by type, age, gender, and obesity Cervical spine surgery ( spinal decompression) can also help avoid injuries to the shoulder joints due to poor posture. The procedure involves putting spinal decompression bracelets on the affected areas and gradually stretching them out until the patient experiences a full range of motion in the affected region. Degenerative disc diseases have been associated with a number of health risks, including pain, disability and even death. The symptoms normally develop slowly over time and the person may not notice any pain until it becomes painfully obvious. Some cases can also result in disc protrusion or herniated discs. Spinal decompression helps prevent the bulges and herniations from happening, but it does not reverse the problem. Therefore, it plays an important role in treating degenerative disc disease and preventing further damage. Links from the show notes: https://spine.keckmedicine.org/treatments-services/low-back-ddd/ https://stemcellthailand.org/therapies/degenerative-disc-disease-ddd/ https://pubmed.ncbi.nlm.nih.gov/32098249/ https://www.verywellhealth.com/lumbar-disc-replacement-2548506

There are a number of different types of arthritis that can affect the knees. However, the most common form is rheumatoid arthritis, which commonly affects people who are in their thirties or forties. People who are in their sixties and seventies are at the highest risk for developing this condition. However, there is a difference between knee oa rheumatoid arthritis and normal rheumatoid arthritis. In fact, the symptoms of both conditions often mirror each other, which makes it difficult for a person to accurately tell the difference between them. There are some prescription medications that are effective in treating knee osteoarthritis, and one such medication is the popular anti-inflammatory steroid, ibuprofen. It is important that you check with your doctor before taking any medications, particularly if you already have another medical condition. Studies have shown that women who take ibuprofen have a reduction in the severity of their osteoarthritis pain compared to those who don't take the medication. According to new research, anti-inflammatory medicines do not help prevent further damage to the cartilage lining but they do slow down the progression of the disease. This is a very beneficial result when you consider how fast this condition progresses once it begins. Other factors that can lead to knee osteoarthritis include infection, injury, trauma, and differential diagnosis. Many conditions that affect the bones around the joints can also contribute to this condition. These include bursitis, gout, and kidney stones. Bursitis refers to swelling in the bursa, which is necessary for protecting the joint against friction. Gout is a condition that involves the accumulation of uric acid crystals within the joints; these crystals cause intense pain, stiffness, and damage around the affected areas. Links from the show https://www.pennmedicine.org/news/news-releases/2021/january/new-treatment-target-discovered-that-halts-osteoarthritis-like-knee-cartilage-degeneration https://stemcellthailand.org/therapies/knee-injury-acl-mcl-pcl-surgery-alternative/ https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/minimally-invasive-total-knee-replacement https://hs.kku.ac.th/HUSOIPR/webboard/view_topic.php?id=140765 https://www.nytimes.com/2021/01/15/health/joint-replacement-baby-boomers-technology.html

Many people with spinal cord injuries want to work but worry about how they will be able to resume a normal life. People with spinal cord injuries can experience a loss of function around the entire body. This loss of function can be temporary or permanent. However, some people do make a full recovery. Spinal cord injuries can cause secondary conditions, such as pressure sores and blood clots. People with secondary conditions such as these will need long-term care. In this podcast, Emma Hasselbecker, explains the different options and benefits available to individuals with permanent disabilities so you can understand the process of getting back to work while maintaining coverage and coming out financially ahead. Links from the show notes: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury https://www.christopherreeve.org/living-with-paralysis/health/causes-of-paralysis/spinal-cord-injury https://www.hopkinsmedicine.org/health/conditions-and-diseases/acute-spinal-cord-injury https://dataverse.harvard.edu/dataset.xhtml?persistentId=doi:10.7910/DVN/HWRX90 https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-cord-injury

A rotator cuff tear is a very common cause of shoulder pain and disability among adults. Estimated say each year, almost 56 million people in across the world visit their orthopedic doctors because of a rotator cuff problem. Mike and Dave discuss the latest in the prevention and treatment of torn rotator cuffs. A torn rotator cuff can weaken your shoulder and limit daily activities, like combing your hair or getting dressed, may become painful and difficult to do. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. In most rotator cuff tears, the tendon is torn away from the bone and tears often take place in the supraspinatus tendon. If you have a rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time. Chronic shoulder and arm pain are good reasons to see your doctor. Early treatment can prevent your symptoms from getting worse. It will also get you back to your normal routine that much quicker. There is no evidence of better results from surgery performed near the time of injury versus later on and many doctors first recommend management of rotator cuff tears with physical therapy and other nonsurgical treatments. Non-Surgical treatments however do respond better closer to the time of injury The goal of any treatment is to reduce pain and restore function. There are several stem cell treatment options for a rotator cuff tear, and the best option is different for every person. In planning your treatment, your doctor will consider your age, activity level, general health, and the type of tear you have.  Links from the show notes: https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears/ https://orthop.washington.edu/patient-care/articles/shoulder/rotator-cuff-tear-when-to-repair-and-when-to-smooth-and-move-the https://stemcellthailand.org/therapies/shoulder-injuries-rotator-cuff-labrum/ https://www.uclahealth.org/ortho/shoulder https://www.bupa.co.uk/health-information/muscles-bones-joints/rotator-cuff-injury

Orthopedic injuries include any injury to the musculoskeletal system. Often, these injuries relating to the bones and joints are a result of an accident or trauma to the body.  Sometimes, though, injuries can become more common with getting older. Age alone can be a risk factor for orthopedic injuries and other conditions seen by orthopedic specialists. For example, broken hips, compression fractures and osteoporosis are much more common in elderly patients. As people age, their bones tend to lose density, which makes them more prone to breaks or compression fractures. Join us as we discuss some common acute orthopedic injuries