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A Simple Overview of Arthroscopic Rotator Cuff Repair

Shoulder Surgeon Houston TX
Rotator Cuff Repair Houston TX

If you have a rotator cuff injury, everyday activities may become difficult. Simple actions like combing your hair or tucking in your shirt can be painful.

Rotator cuff injuries can occur for many reasons & are often the result of repetitive strain. Any job or activity that requires repeated overhand motions, can lead to this type of injury. Sudden powerful raising of the arm against resistance or in an attempt to cushion a fall. In other cases, a rotator cuff injury may develop due to years of wear and tear.

In this blog, the fellowship-trained shoulder specialists at Advanced Orthopaedics & Sports Medicine will provide an overview of arthroscopic rotator cuff repair.

What is arthroscopy?
So, in simple terms, arthroscopy is defined as looking at the interior of a joint via a camera inserted through a small incision. Using this technique, the camera image is transmitted to a television screen so an orthopedic surgeon can closely examine the joint in great detail. Arthroscopy is used both for surgical procedures as well as for diagnostic purposes.

When is arthroscopic rotator cuff repair recommended?
Not all rotator cuff injuries require surgery, particularly if they’re treated early when symptoms first appear. However, you may be advised to have surgery if your symptoms have persisted for several months without improvement with non-surgical treatment, if you have suffered a severe rotator cuff tear, or if it’s a recent, acute injury or if your daily activities require you to do a lot of overhead reaching.

What does an arthroscopic rotator cuff repair involve?
There are numerous types of rotator cuff repair surgeries. The shoulder specialists at Advanced Orthopaedics will recommend the appropriate procedure depending upon the type of injury you have and your unique needs.

Arthroscopic rotator cuff repair offers several benefits over traditional open shoulder surgery, which may include:
• Fewer complications
• Less postoperative pain
• Faster recovery time

While proper healing and rehabilitation takes time, the arthroscopic procedure usually allows you to return to work, athletics, and daily activities faster than conventional surgery.

How long will recovery take after arthroscopic rotator cuff repair?
While the time frame varies from person to person, arthroscopic rotator cuff repair typically means a recovery period of several months, with immobilization directly following surgery and a guided physical therapy program starting after 2-4 weeks. Most people have a functional range of motion & strength for daily activities by 3 months after surgery and will continue to improve for 6 to 9 more months.

Looking for an arthroscopic rotator cuff repair surgeon in Houston?
Don’t be limited by the pain of a rotator cuff injury. Schedule a consultation at one of Advanced Orthopaedics & Sports Medicines’ numerous practice locations around Houston to get more details about arthroscopic rotator cuff repair, and to learn whether you are a candidate for this procedure.

Getting Back on Track after the Holidays

Sometimes our best intentions go out the window during the holidays, and we don’t follow through with our exercise & diet plans. That’s okay too. The holidays are for spending time with family and friends, enjoying traditions, and lots of high calorie foods. But now it’s time to get back on track with your exercise routine. Read on for some helpful tips to get over the laziness.

#1 Assess the damage

Get. On. The. Scale. It may be painful to see that you have gained a few pounds, but you need to know what you are dealing with. On the other hand, you might find that you didn’t do as much damage as you think. You probably will not see a dramatic weight gain. Either way, you need to be realistic about what your body needs to do now. So just weigh yourself and get it over with, and then don’t get on that scale for another week until you have had a chance to get back at your healthy habits.

#2 Let it go

If you had a lazy holiday, you should not feel bad about it. You should feel really good about what you have done for yourself by putting your needs first for a change. Any guilt or regret you are feeling should be pushed out the window now. You are actually lucky because you are most likely coming back with a fresh attitude and a renewed sense of your goals.

#3 Make a plan

Planning is so important when you are trying to start, or restart a healthy lifestyle. Don’t just rely on telling yourself that you will do it. Make a visible plan on pen and paper, or on a fitness app. Set a goal for yourself for your first week back exercising, and maybe also plan for a small reward to treat yourself to after that first week.

#4 Just do it

Healthy habits take at least three weeks to form.

Once you hit that point, you should be able to maintain your exercise habit fairly seamlessly. However, it takes way less time to break a healthy habit, as in one week. So your lazy holiday has the potential to derail your good exercise habits, but you can overcome it. You just need to get right back at it. If you wait any amount of time before exercising again, it’s only going to get harder. You need to start exercising again right away! You may be tired and have a million things to do, like unpacking and sorting mail, but just carve out 30 minutes to do some sort of physical activity. It will give you the energy you need to plow through those post-holiday chores, and will set the tone that you are going to exercise on a regular basis again.

5 Questions You Should Ask Before Any Orthopedic Surgery

After your doctor tells you surgery is necessary, you may be frightening and intimidating. There are some steps you can take to ease some of the stress involved prior to having orthopedic surgery. Asking your surgeon these five questions, may help you better understand what to expect and ease your anxieties and allow you to become better informed before surgery.

What exactly will the surgery and the recovery be like?

As with most professions, surgery has its own language that makes sense to the surgeon and the medical team, but sometimes not to the patient. Ask for specifics about preparation for the surgery, what will happen during the surgery, and what to expect during recovery.

How much experience does the surgeon have with the surgery & what outcomes has the surgeon experienced?

It is normal to be anxious about the surgery, and you will want to have a surgeon with experience — a surgeon who has a history of good results with the surgery.

Why is it necessary to have the surgery now?

Perhaps having the procedure now is not convenient for you. Find out if the surgery can be delayed without causing more harm and making the surgery more difficult or adding complications to recovery.

Are there other options?

Ask if there is therapy or other options that can delay the operation if possible. For those who do like to be involved in sports, surgery might be the best, and even the only, good choice.

What kind of anesthesia will be required?

If you experience complications with a certain kind of anesthesia, make certain the surgeon is aware of the complications — if necessary the surgeon can make adjustments to ensure your surgery will go as planned.

Asking questions and understanding why, when and how the procedure will take place will help ensure that you will have a positive experience with the surgery. An active and involved patient is knowledgeable and understands what will happen to his or her body, and will be more at ease with the procedure.

Healing a Rotator Cuff Tear

A torn rotator cuff will weaken your shoulder making many daily activities, like brushing your hair or dressing, painful and difficult to perform.

Your arm is kept in your shoulder socket by your rotator cuff. The rotator cuff is a network of four muscles that come together as tendons to form a covering, attaching the humerus to the shoulder blade and helps to lift and rotate your arm.

If the tear occurs with injury you may experience acute pain, a snapping sensation, and weakness of the arm. A rotator cuff tear may get larger over time if left untreated or with repetitive use or a re-injury to the shoulder. It is common for patients with known rotator cuff injury to have intense pain and weakness following a minor injury. If you are aware you have a rotator cuff tear, then worsening pain and decreasing strength may mean the tear is getting larger.

When a tear occurs, there is frequently degeneration of the muscles around the arm and loss of motion of the shoulder. Exercise or physical therapy programs are necessary to regain strength and improvement of shoulder function

If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. They can then make a diagnosis and begin treatment. The doctor may recommend an MRI (magnetic resonance imaging) to confirm the diagnosis.

Early diagnosis and treatment of a rotator cuff tear can avoid symptoms such as loss of strength and loss of motion from setting in.

If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and begin treatment.

Many rotator cuff tears can be treated without surgery. Anti-inflammatory medication, injections, and physical therapy may all be beneficial in treating symptoms of a cuff tear. The goals of treatment are to alleviate pain and reestablish strength to the injured shoulder.

Even though most tears cannot heal on their own, decent function can often be achieved without surgery.

If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment, surgery may be recommended. Frequently, patients who may require surgery report pain at night and complications lifting and reaching with the injured arm. Ongoing symptoms despite several months of medication and limited use of the arm are often reported.

Surgery is also recommended in active individuals who use the arm for overhead work or sports such as; Pitchers, swimmers, tennis players, and laborers.

Even though surgery repairs the injury in the tendon, the muscles around the arm remain weakened, and a full effort at rehabilitation is necessary for the procedure to be successful. Complete rehabilitation after surgery may take several months.

Your orthopaedic surgeon can prescribe an appropriate program based on your needs and the findings at surgery.

Jacel Brooks, MD

6 Tips for Your Child to Avoid Injury During the Sports Season

Sports-participation promotes physical and emotional wellness in children but too much physical activity can lead to injury. Overuse injury, is becoming a significant concern for orthopedic doctors at a time where the number of duel-sport athletes continues to grow.  Because of this, we’ve seen this type of injury become commonplace, with repetitive stress injuries affecting muscles, ligaments, tendons, bones and growth plates.  It’s important to remember that young athletes are still growing at a fast rate, putting them at a greater risk of developing an injury that could lead to long-term health issues.  Overuse injuries attribute to about 50 percent of all pediatric sports-related injuries, but there are preventative steps parents, coaches and even young athletes themselves can take: 

1. Pre-Participation Physical Examinations  Pre-participation physical exams are important for all adolescent athletes. These exams are used to screen for potential risk factors including injury history, flexibility, joint stability and anatomic misalignments.  Those with noted deficits should be referred to appropriate medical specialists, such as a physical therapists, for corrective rehabilitation in order to prevent injuries. 

2. Nutrition For Athletic Performance  Nutrition is vital to the body’s ability to perform, recover, and become stronger. Young and growing athletes exert a lot of energy during physical exercise and many do not consume enough calories to meet their energy demand.   This is a concern for orthopaedic doctors because poor nutrition can lead to decreases in bone density, overuse injuries and potential stress fractures. 

3. Proper Equipment Matters: Clothing and equipment vary from sport to sport and while it can be expensive to replace, the equipment from last season may not fit your child properly, potentially leading to injury.  Common overuse injuries involve the knee and foot, making shoe selection and replacement critical.

4. Stretching Can Aid in Prevention: The most common overuse injury across all sports is tendonitis. Depending on the severity, tendonitis can be intermittently or consistently painful. Warming up and cooling down with appropriate stretching is critical in preventing overuse injuries.  With that being said, young athletes should be taught how to properly stretch to avoid injury.

5. Rest is Key: It’s common for kids to feel pressured to play through the pain and while psychologically they feel tough, physically their bodies can only handle so much. Playing through the pain increases damage to the body and therefore recovery time. Any persistent pain or injury needs to be seen by an orthopaedic doctor immediately.  In addition, parents should be aware of warning signs including pain, swelling, changes in form or technique, and decreased interest in practice. 

6. Avoid Overdoing Any Single Sport:  Limit the number of teams your child plays on in a single season. Kids who play on more than one sports team could be physically overdoing it and are at risk for injuries.  The same applies to year-round sports; taking regular breaks and playing other sports can be essential for skill development and injury prevention. Several studies have shown a correlation between higher rate of overuse injuries and playing one sport year round.

Most athletes will likely experience sports-related injuries at some point, but can be prevented if caution is taken. It’s important to remember most of the time coaches are focused on a whole group of kids, not just yours, so encourage your child to speak up if something isn’t right.

Delayed Reporting in Concussions May lead to More Time Out of the Game!

Athletes who immediately stopped activity and reported symptoms of a concussion typically missed fewer days before returning to activity than athletes who delayed reporting such symptoms.

Although there is increased awareness about concussions and their consequences, many athletes fail to report their concussion symptoms to a medical professional or coach in order to continuing to participate in the sport. Researchers have found that athletes who are not immediately removed from activity are more likely to have a delayed recovery period of almost 5day compared to athletes who are immediately removed from sport. Athletes who fail to immediately report their symptoms and continue to play are also more than twice as likely to need more than a week before returning to play.

Overall, this research helps medical professionals and coaching staff by providing evidence that immediately reporting concussion symptoms may be associated with less time missed due to a concussion. It is believed that many athletes do not report symptoms for fear of not being able to participate; however, the studies suggests that not reporting symptoms may result not being able to play for a longer period of time. One reasonable explanation for these results is that athletes who withhold reporting their symptoms may actually be experiencing more head impacts, which may result in a more severe injury.

Questions for Discussion: What do you currently do to encourage your athletes to self-report concussions? Do you feel these approaches have been successful? Why or why not?

Preventing ACL Injuries

  • Mechanics: Valgus collapse is one of the most significant risk factors for ACL tear and is frequently the actual mechanism of the injury. All athletes must be taught to squat, lunge, jump, and land without knee and ankle collapse. Your form doesn’t need to be picture perfect, but if your knees and ankles are coming in on every rep, they’re going to have a bad time.

    When we are tired our bodies resort to our most comfortable and habitual movement patterns. Get in the habit of landing and bending your knees with proper mechanics. Learn proper planting and pivoting.

  • Strength: While quadriceps strength is seen as the best indicator of how well an athlete will perform after an ACL repair, it tends to be one of the lesser focuses in prehab and prevention. The reason is that most athletes overuse their quadriceps and are lacking proper use of their glutes. The glute medius in particular is very important in preventing valgus collapse. Lacking core and hip strength are also significant risk factors in ACL injuries.
  • Recovery: Professional athletes don’t play their sport year round and neither should you. Many injuries are the result of doing too much. All athletes need to pay as much attention to proper nutrition, sleeping, and adequate rest between competitive performances.

Exercise May Delay or Prevent Hip Surgery

Patients who have an exercise program are less likely to need replacement surgery.

People with mild to moderate hip osteoarthritis (OA) may be able to avoid hip surgery if they participate in a daily exercise routine. Studies show that people who participate in an exercise regimen for one hour a minimum of twice a week are less likely to need hip replacement surgery than those who do not have an exercise routine. Also, those who exercise report improved flexibility and ability to perform physical activities.

Exercise therapy can avoid the need for total hip replacement in people with hip OA. This may not apply to people with severe hip OA, knee OA or back pain.

Read more

Pro athletes may safely return to competition after lumbar microdiscectomy

Source: Healio

CHICAGO — The pooled rate of return to play following lumbar microdiscectomy for herniated disc nucleus was 83.5%, according to results presented at the North American Spine Society Annual Meeting, and the overall return to play rate for elite athletes with a herniated disc after this procedure was 84.5%.

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Satisfactory results seen in revision THA with acetabular reinforcement, HA granules, autograft

Source: Healio

Using acetabular revision for loosening as an endpoint, investigators of this study found more than 90% acetabular component survival at 10 years among patients who underwent revision total hip arthroplasty for acetabular bone deficiency using a Kerboull-type acetabular reinforcement device to support hydroxyapatite granules and structural autograft.

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