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FREQUENTLY ASKED QUESTIONS
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GENERAL ORTHOPAEDIC
What can I expect from my orthopaedic evaluation?
Plan on arriving a few minutes early for your appointment. You will
be asked to fill out a comprehensive medical history form which
should include all your current medications and dosages. (You can
save time by printing the medical history form before your
appointment -
Click here!)
A clinical exam will be performed by one of our providers and may
include x-rays. X-rays are done on-site by a certified radiology
technician.
After the evaluation, appropriate treatment will be rendered and any
follow-up appointments will be scheduled for you.
When should I see an orthopaedic doctor?
Principal Care Providers, Emergency Rooms, and Walk-in Clinics often
refer patients for an orthopaedic evaluation. If your insurance does
not require a referral Stability Orthopaedics sees patients for
joint pain, sports injuries, spinal problems as well as trauma and
fracture care.
What happens when I need surgery?
When our physician determines that you require surgery one of our
clinical staff members will arrange
with you an appropriate date and time for the surgery, as well as
schedule any other necessary appointments you'll need prior to the
surgery.
To help allay any fears and apprehensions about the surgery we
provide documentation from our extensive patient education library
to all our patients. Comprehensive videos and brochures that detail the
surgical procedures, treatments and rehabilitation methods are
available.
In addition, the providers at FoxCare Orthopaedics
are happy to speak with you about the surgery and answer any questions
or concerns you may have. A Registered Nurse will be available when the providers
are unavailable due to office and surgery schedules. TOTAL JOINT REPLACEMENT
Who should have a joint replacement?
When arthritic pain severely limits your ability to walk, work or
perform even simple activities, joint replacement should be
considered. The goal is to relieve the pain in the
joint caused by the damage done to the cartilage. The pain may be so
severe, a person will avoid using the joint, weakening the muscles
around the joint and making it even more difficult to move the
joint. A physical examination, possibly some laboratory tests and
x-rays will show the extent of damage to the joint. Total joint
replacement will be considered if other treatment options will not
relieve your pain and disability.
How long is the hospital stay?
The average
hospital stay for most joint replacement surgery is 3-5 days. In general, your orthopaedist will encourage you to use
your "new" joint shortly after your operation. After total hip or
knee replacement you will often stand and begin walking the day
after surgery. Initially, you will walk with a walker, crutches or a
cane. Most patients have some temporary pain in the
replaced joint because the surrounding muscles are weak from
inactivity and the tissues are healing, but it will end in a few
weeks or months. Exercise is an important part of the recovery
process. Your orthopaedic surgeon or the staff will discuss an
exercise program for you after surgery. This varies for different
joint replacements and for differing needs of each patient. After your surgery, you may be permitted to play
golf, walk and dance. However, more strenuous sports, such as running, may be discouraged. The motion of your joint will generally improve
after surgery. The extent of improvement will depend on how stiff
your joint was before the surgery.
Recovery varies with each person. Most
people gradually increase their activities over time and are back
playing golf in less than 15 weeks.
Blood conserving techniques in surgery now have minimized the need
for transfusion to less than 50%. The risk of
transmissible disease, such as AIDS or hepatitis, is almost
non-existent. Orthopaedic surgeons generally no longer recommend
that blood be “pre-deposited” before surgery.
As with any
surgery, there is a risk of complications but complications after
joint replacement are rare. To fight infection, we use ultraviolet
light in the operating room and the most powerful antibiotics known
to control the environment. We also use Coumadin to reduce the risk
of blood clots (DVT). Our personnel are limited to fully
trained and experienced nurses and technicians.
Why does a joint replacement recipient have to take
antibiotics before seeing a dentist?
Certain dental procedures or surgical procedures can
allow bacteria to transiently enter our bloodstream. Our bodies'
natural defenses are usually excellent at removing the bacteria
before they can cause problems. However, without antibiotic
coverage prior to dental procedures or other surgery, bacteria could
conceivably be deposited in the tissues around your total joint arthroplasty. An infection in the total joint components is a very
serious event and could lead to the need for further surgery
including removal of the artificial joint. SPORTS MEDICINE
Arthroscopy is a surgical procedure orthopaedic surgeons use to
visualize, diagnose and treat problems inside a joint. In an arthroscopic examination, an
orthopaedic surgeon makes a small incision in the patient's skin and
then inserts pencil-sized instruments that contain a small lens and
lighting system to magnify and illuminate the structures inside the
joint.
Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. By attaching the
arthroscope to a miniature television camera, the surgeon is able to
see the interior of the joint through this very small incision
rather than a large incision needed for surgery.
The television camera attached to the arthroscope
displays the image of the joint on a television screen, allowing the
surgeon to look, for example, throughout the knee-at cartilage and
ligaments, and under the kneecap. The surgeon can determine the
amount or type of injury, and then repair or correct the problem, if
it is necessary.
What are the ligaments in the knee?
The knee contains four ligaments that
connect the large bone in the upper leg (femur, or thighbone) to the
large bone in the lower leg (tibia, or shin bone). These ligaments
hold the bones together and help control the way the knee moves. Two of these ligaments,
the medial collateral
ligament (MCL) and lateral collateral ligament (LCL), are on either side of the knee. The other two ligaments
are inside the knee and cross each other as they run diagonally from
the bottom of the femur to the top of the tibia. The posterior cruciate ligament (PCL) connects to the back of the tibia, while the
anterior Injuries to the ACL are among the most common of all sports-related knee injuries. Each year
in the United States, approximately 250,000 people sustain a torn or
ruptured ACL. FRACTURE AND TRAUMA CARE
It takes 24-48 hours to dry, do not bump, lean on or dent the cast
during this time.
Do NOT get the cast wet.
Do NOT scratch under the cast, this could cause infection.
Do NOT attempt to trim or remove the cast yourself. SPINE SURGERY
What is the reason for most cases of back pain?
Most people have back pain without
any identifiable cause. There is frequently no history of a specific
injury or trauma. If there is an identifiable event, it is not
unusual for the pain to begin 24 hours later. There are many
structures in your neck and back which at times can be painful;
these include the muscles, ligaments, discs, and joints. Because of
the location of those structures, it is hard to tell which structure
actually hurts.
Does severe back pain mean that something is dramatically wrong? This is a logical assumption,
however it doesn't have to be true in the case of back pain. A
patient can have severe back pain and even leg pain and have a
normal physical examination and nearly normal MRI. More
importantly; this severe pain can be resolved without any specific
treatment.
I am having severe back and leg pain. Do I need an x-ray and
MRI? A person who sees a back
specialist may get an x-ray on the first visit. However, if the
pain has only been present for a short period of time (less than
2- 4 weeks), and your doctor has no reason to believe you have a
fracture (for example, osteoporosis, trauma, history of cancer,
etc) then even an x-ray may be postponed until a later time. In
the event of neurological problems such as weakness, paralysis or
loss of bladder control, an x-ray as well as a MRI
may be ordered.
Is a herniated disc the same as a slipped or ruptured disc? YES, a disc is a large structure made of cartilage.
Most people think of the disc as a shock absorber, shaped like a
jelly doughnut. The disc functions more like a universal joint. It
is a cartilage structure that is attached to two bones (vertebra)
that holds the bones together, but allows controlled motion in all
directions. The disc plays a large role in spinal stability and
shares this mechanical load with the facet joints and the
surrounding soft tissues
What does conservative and aggressive-conservative care mean? Most people want to be treated in
the least invasive manner possible. These terms describe the use
of medications, exercise, and physical therapy, as well as more
aggressive interventions such as epidural injections. These
techniques allow you to be more comfortable during the early phase
of a painful spine problem. They are not curative, rather they are
designed to give you relief while waiting for the symptoms to
settle down. In the long run, a consistent, but not
necessarily aggressive aerobic exercise program will help people
decrease the frequency of the spine symptoms. In addition, it is
important to understand the basic rules needed to protect your
back while staying active. This may help prevent recurrences
If I need surgery for a lumbar herniated disc, what should
I expect? Most disc surgery involves a
small incision in the back, a 45-90 minute surgery and usually a
one day hospitalization This is another confusing
subject. Spinal stenosis usually occurs in people over 50 but can
occur in younger persons. Spinal stenosis is usually caused by
degenerative arthritis or "wear and tear" arthritis. This type of
arthritis is also called osteoarthritis and is NOT related to
osteoporosis. The joints in this condition get larger and
sometimes change shape. Just look at a person's hands as they age,
the same thing happens in the spine. As the joints get larger they
begin to squeeze the nerves in your spine. This happens very
slowly, over many years. Eventually, a person develops symptoms
that frequently include heaviness in the legs, fatigue, leg pain,
numbness, and weakness. Most of these symptoms get worse with
walking and get better with a short period of rest. Surgery is
frequently needed to treat spinal stenosis. |
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