Conditions

Arthritis

Arthritis is a general term that we used to describe inflammation in one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsens with time and mileage. By far, the 2 most common types of arthritis are degenerative or osteoarthritis and rheumatoid arthritis. As a rule, most arthritis results in a breakdown or loss of the hard, slippery tissue (hyaline cartilage) that normally covers the ends of the bones where they join to form a joint. Treatment will vary depending on the type of arthritis and the extent of damage, but the earlier arthritis is identified and addressed, the longer you can expect to continue to function well without surgical intervention. Your evaluation will likely include x-rays and may include laboratory tests or an MRI evaluation as well. Arthritic symptoms are usually well managed initially with pharmacological treatment (either oral medications or intra-articular injections), physical therapy and activity modifications. More rarely, operative intervention is necessary to relieve pain and restore function.

Strain/sprains - what's the difference?

A strain is an injury to a muscle and/or tendon. Strains can be the result of overuse of muscles and tendons (chronic strain) or may be caused by a direct blow to an area of the body, overstretching, or excessive muscle contraction (acute strain). A sprain is an injury to a ligament, a fibrous band of connective tissue the joins the ends of one bone with another. Sprains are caused by trauma which overstretches and, in severe cases, ruptures the supporting ligaments. All sports and activities, even simply walking, carry some risk of a sprain. Pain, bruising, swelling and inflammation are common to all types of strains and sprains. While rest, ice, compression and elevation (RICE) will usually help minimize damage, it is usually important to have a medical evaluation to assess the severity of the injury and establish a treatment and rehabilitation plan. The majority of strains and sprains respond to conservative care, which may include bracing or physical therapy. Occasionally, an MRI is necessary to assess the degree of injury to the structure in question. Some injuries require surgical intervention to restore improved function.

Tendon and ligament tears

First, a bit of anatomy. Tendons connect muscles to bones. Ligaments connect bones to bones. Regardless, significant injuries to tendons and ligaments will often result in a loss of function or stability with regard to nearby joints. For example, a loss of the continuity of the rotator cuff tendons around the shoulder will result in the loss of motion and strength in the upper arm and a loss of the continuity of the quadriceps tendon about the knee will result in the loss of motion, stability and strength of the leg. Additionally, a loss of continuity of the stabilizing ligaments around the knee or ankle, while rarely impairing motion or strength, can result in significant instability, making it difficult to engage in any type of sports activities, occasionally interfering with simple ambulation. Diagnosis of tendon and ligament tears usually requires an MRI evaluation. Fortunately, many of these injuries can be managed conservatively with a brace and physical therapy. Occasionally, these injuries require operative intervention to restore improved function.

Fractures

Orthopedic surgery was founded on the treatment of broken bones. Actually, the origin of “orthopedics” (prior to the Age of surgical treatment) derived from the Greek words orthos ( “correct” or “straighten”) and paidion (“child”), and addressed the correction of spinal deformities in children. Obviously, it’s evolved quite a bit since the 18th century and our specialty now has the capability to manage a variety of fracture types and locations with an equally varied list of treatment options. Conservative treatment with braces and casts remains the treatment of choice for the majority of fractures that people encounter, but in the event that a fracture has lost opposition to other fracture segments (displacement), is out of alignment to the other fracture segments (angulation), is unstable (comminuted) or involves the loss of joint congruity (intra-articular involvement), surgery provides the best chance of an optimal outcome.

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