According to recent statistics, between 250,000 and 300,000 people experience ACL injuries each year, most of whom are athletes. A torn ACL (anterior cruciate ligament) can sideline a player for about six-to-nine months or more. Torn ACLs are typically repaired with a tissue graft, and there are many different types of grafts in use. In a recent article published by Orthopedics Today, a selection of orthopaedists discussed the benefits and drawbacks of several commonly used grafts, including the BPTB (bone-patella tendon-bone) graft. Dr. John Hoffman, our board certified orthopaedic surgeon, has performed over 1500 BPTB ACL grafts in his career. He agrees with the article’s overall assessment that this graft offers numerous advantages, particularly for athletes.
Choosing the ideal ACL graft for the patient can help to reduce downtime as well as to reduce the risk of a re-tear. Each graft has its pros and cons, and ultimately the right option will be a personal choice. One of the many benefits of a BPTB autograft—grafts harvested from the patient—is that the tissue quality is very similar to the natural ACL—and 1.5 times as strong. Furthermore, there appears to be a lower re-rupture rate with this method than with hamstring autografts, cadaver allografts (donated tissue), or other types of allografts. The BPTB graft connects bone to bone, rather than muscle to bone (as in a hamstring graft), typically providing greater strength and faster healing as a result. For these reasons and others, over 86 percent of NFL, 81 percent of NBA, and 70 percent of MLS physicians choose to utilize BPTB grafts to repair ACL tears in athletes.
Just as essential as graft choice, Dr. Hoffman explains, is the quality of the surgical technique. If a graft is improperly implanted or fixed, knee instability and re-rupture could occur. Therefore, patients should confirm that their orthopaedic surgeon has extensive experience performing arthroscopic ACL reconstruction with the chosen graft type.
Millions of people around the nation experience the symptoms of carpal tunnel syndrome. This common condition can cause pain, stiffness, weakness, and numbness in the hands. As a result, work and everyday activities can become difficult or uncomfortable. Many patients report difficulty sleeping. Fortunately, there is an easy way that may help prevent the development of carpal tunnel syndrome. Performing a few stretches throughout the day may help keep you pain-free.
To begin this stretch, hold your hands in front of you at about chest level with the palms together. This is called the prayer position. Slowly move your hands, palms still pressed together, down towards your waist, keeping your hands close to your body. When you feel a stretch, slowly move your hands back to the original position, and then begin again. Repeat a few times. This exercise should be performed every hour or so.
For this exercise, you will also begin by placing your hands together in a prayer position. You should then spread your fingers as wide as you can and lift your palms to create a “steeple” with your fingers still touching. Return to your starting position, keeping your fingers in contact the whole time, and begin again. Repeat this stretch about every hour.
Shake it Out
This one is even easier than the last exercise. Simply shake your hands out as if you were air-drying them after a wash. Many patients with carpal tunnel syndrome who wake at night find this maneuver helpful in reducing the symptoms and it can allow them to get back to sleep.
Hold your right arm out in front of you with your palm facing down. Bend your wrist up towards the ceiling. Take your left hand and use it to gently bend your wrist a little farther in the same direction until you notice a mild stretch in your forearm. Hold for about 20 or 30 seconds, release and repeat with the other arm. You may wish to perform this exercise a few times a day.
These simple maneuvers may help with mild cases of carpal tunnel syndrome. If symptoms persist, or if your numbness becomes constant, definitive treatment should be sought. Permanent nerve damage can occur if nerve compression goes untreated.
If you would like more information about carpal tunnel syndrome and treatment options, please contact us today. We can answer your questions or help you schedule a consultation.
As one of the most common hand conditions in the nation, carpal tunnel syndrome can make work, play, and simple tasks and even sleeping difficult or impossible. Fortunately, our experienced orthopaedic doctors can provide a number of non-surgical treatment options to help minimize discomfort caused by carpal tunnel syndrome. Here are four easy tips for relieving hand and wrist pain. In the event these approaches prove ineffective, our doctors are extensively trained in the latest endoscopic surgery techniques. Unlike traditional open surgery, minimally invasive endoscopic surgery typically requires no sutures and offers a shorter healing time.
Taking a break from using the affected hand for a few weeks can give the inflamed median nerve (the one that runs through the carpal tunnel and causes you pain) time to heal. You can also take small breaks at work by changing position or stretching your wrists.
Splints are the most common conservative treatment for carpal tunnel syndrome. Keeping your wrist in a neutral position throughout the night can prevent waking due to numbness and tingling in your hands, and it may help relieve daytime symptoms too.
3. Carpal Tunnel Exercises
Exercises and stretches can help reduce discomfort and keep pain from recurring. There are a number of carpal tunnel stretches you can perform right at your desk or where you work throughout the day to alleviate your symptoms. Our doctors can provide additional examples during your consultation.
4. Cortisone Shot
A more advanced but still non-surgical treatment option for carpal tunnel syndrome is a cortisone injection. This method also helps to reduce inflammation, but it’s not a cure. When the medication wears off, you may begin experiencing symptoms again.
These are just a few ideas to help achieve symptom relief of carpal tunnel syndrome. Our practice is committed to your health and well-being. If these tips do not relieve your symptoms, you should seek a professional evaluation, because untreated carpal tunnel syndrome can lead to permanent nerve damage. Our doctors can provide details of minimally invasive surgical options that require no sutures and allow faster recovery.
Have more questions about carpal tunnel syndrome? Contact our office today for more information or to schedule a consultation. We look forward to hearing from you soon.
Most health care plans include a deductible. The deductible is the amount you are obligated to pay before your health insurance begins covering the cost of certain treatments (or tests) either in full or with a co-payment. Health care plans are renewed yearly, typically at the end of the calendar year. That means your deductible will be reset on January 1st, 2016. At the end and at the beginning of each year, you have a unique opportunity that can help bring down your cost of your medical care. The Orthopaedic Specialists team want to help you maximize your benefits by scheduling treatment when it best suits your needs and goals. Here are some tips to make your health plan work better for you.
If your deductible is paid off or nearly paid off for 2015, now is a great time to schedule treatments or procedures. With the deductible close to or completely settled, your insurance should cover most (or potentially all) of the cost of your medical care. This can significantly lessen your financial burden for surgery or costly diagnostics like an MRI. It’s important to speak with your insurance provider to discuss the specifics of your coverage before proceeding.
If you’re not close to paying off the deductible, you can delay your procedure until the beginning of next year. Although the cost will be primarily your responsibility, you may eliminate a majority if not all of your deductible early in the year. Any further medical needs should then be covered, excepting co-pays or non-covered services. Again, you should review the terms of your plan before making any firm decisions. The Orthopaedic Specialists team has insurance specialists who can assist you with this decision.
Another option is to use your Flexible Spending Account (FSA) if you have one. This money is yours to use for medical needs as you see fit, but the funds disappear at the end of the year. December 31st, 2015 is coming up, so now is the time to schedule your treatment and use that line of revenue before it goes away.
Your health care plan should make the treatment you need more affordable, and we can help. Contact us today for more information or to schedule a consultation with one of our orthopaedic surgeons.
Whether performed as part of demanding exercise regimen or as an occupational duty, heavy lifting can place great strain on the biceps muscles and tendons. When overstressed, these tissues can be damaged, typically leading to significant pain and debilitation. If you’re suffering from a biceps injury or believe you may be, our team of experienced healthcare professionals can diagnose your condition and provide effective treatment options tailored to your specific needs.
There are three main types of biceps injuries: tendinitis, tendon dislocation, and tendon tear or rupture. Tendinitis usually occurs as a result of overuse and often can be healed with rest and time, particularly if the injury is minor. As with many biceps injuries, the discomfort may originate from the shoulder or the elbow. During your initial consultation, our doctors will determine the nature of your injury.
Tendon dislocation, sometimes called tendon instability or tendon subluxation, generally occurs as a result of complications from a shoulder injury, such as a rotator cuff tear, where the long head of the biceps tendon migrates out of the anatomical groove where it should sit. Generally the two conditions will need to be treated together.
Biceps tendon tear or rupture can occur as a result of overuse or traumatic injury. Tears can be partial or complete and can occur at the shoulder (long head) or at the elbow. Minor partial tears often can be addressed with non-surgical treatment. A full tear, also called a rupture, typically results in shortening of the muscle, creating a bulge. Biceps tendon tears of the long head can cause a “popeye” muscle in the arm. Tears of the biceps at the elbow result in weakness and should be surgically repaired to restore strength in active people. At Orthopaedic Specialists, we offer minimally invasive endoscopic surgical options for both of these conditions.
For more information about biceps injuries and the available surgical and non-surgical treatment options, or if you would like to schedule a consultation, please contact our office today.
The increasing cost of healthcare and the current state of our country’s healthcare system has made the importance of lower cost alternatives for care a hot topic. Cubital tunnel syndrome is the 2nd most common nerve compression occurring in the arm (carpal tunnel being the most common). There’s currently a lack of evidence linking cubital tunnel syndrome to workplace activities; nevertheless, this condition does have significant negative implications to both the employee and employer, and our physicians understand the unique nature of this problem. Let’s consider for a moment some of the costs associated with cubital tunnel syndrome.
Costs of Cubital Tunnel Syndrome to the EMPLOYEE
- Indirect costs: lost wages, loss of fringe benefits at your current position, work and life disruption (hospital visits, rehab, pain, etc.), and loss of productivity outside of work (child care, home repairs, etc.) while injured or during the recovery phase
- Direct costs: medical expenses and medications/rehab not covered by insurance
Costs of Cubital Tunnel Syndrome to the EMPLOYER
- Indirect costs: time spent on replacing employees and employee retraining, accident/injury investigation, workplace disruption, lost productivity, absenteeism
- Direct costs: higher insurance premiums, costs for legal services, medical expenses
Minimally Invasive Surgery for Cubital Tunnel Syndrome
A recent publication titled Setting expectations following endoscopic cubital tunnel release demonstrated that patients are able to get back to full duty 63 days sooner following endoscopic cubital tunnel release compared to the older, gold standard open surgical approach of anterior transposition of the ulnar nerve. The indirect and direct cost benefit of the staggering return-to-work difference is substantial to both the employee and employer.
The faster return to work following the minimally invasive procedure results in an estimated $436,000,000 potential annual savings in the U.S. (This calculation is based on an estimated number of cubital tunnel cases in the U.S. per year of 73,673 multiplied by 63 days faster recovery multiplied by the estimated $94.00 per day disability cost). Given the current economic state of what some would consider a healthcare crisis in the United States, we should be sensitive to what many would consider negligible differences that obviously add up when taken collectively for the entire nation.
For more information about cubital tunnel syndrome, or if you wish to schedule a consultation with one of our doctors, please contact us today.
From football to cross-country and basketball to gymnastics, fall and late fall sports are in full swing. While many injuries go unnoticed, parents and coaches need to know what to look for to keep kids in the game. Student athletes heading into a new fall season run the risk of injury. Pressure to win, growing bones and improper training can cause strains, sprains or worse.
“If you see a student athlete with difficulties, it’s time to pull them back,” agrees John Hoffman, MD, who is fellowship-trained in sports medicine at OS and also has a certificate of added qualification in Sports Medicine. “I have seen a noticeable increase in young athletes between the ages of 10-18 with sports-related injuries.”
Young women more prone to knee injuries The most common sports-related injuries in young female athletes are knee ligament injuries (ACL tears, meniscus tears) and anterior shoulder dislocations. Are female athletes more prone to ACL injuries? “Yes,” says Dr. Hoffman. “Women are four times more likely to have an ACL injury than men for the same number of hours they participate in sports. This is in part due to their weight, they are typically less strong and their ligaments aren’t as strong as well.”
How to know if a child is injured? “You’ll usually see swelling, pain, bruising, or deformity,” he says. “If that’s the case, the athlete should take an anti-inflammatory like Ibuprofen or Advil as well as employ the ‘RICE’ method: rest, ice, compression and elevation of the afflicted area. If symptoms haven’t resolved with those treatments after approximately a week, it’s time to see a doctor.”
Training Programs to Reduce Risk The American Association of Pediatrics published a report in May of this year, which outlined an approach to not only treating ACL injures in a less invasive manner that protects the still developing growth plates in younger athletes, but also recommended ways in which athletes can reduce the risk of injury. The research completed by the AAP, showed that specific types of pre-season strength training can reduce the risk of ACL injuries by as much as 72%, particularly in girls (http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Recommends-Training-Programs-to-Reduce-Risk-of-ACL-Tears-in-Young-Athletes.aspx#sthash.bfsuNQPM.dpuf).
For student athletes, preventing injury and reaching their potential means combining their personal desire to achieve with proven training techniques. Quad Cities Sports Acceleration program improves strength, power, agility, quickness, flexibility, and technique for athletes of all ages, ability and conditioning — no matter what the sport.
“We work with athletes starting at the age of 10 to those at a professional level, like most recently, Alex Tanney, NFL quarterback from the Tampa Bay Buccaneers,” says Ethan Holmes, Program Director for Quad Cities Sports Acceleration. We strive to ensure that our athletes have access to the most advanced and most effective performance-enhancing athletic performance training available, to help athletes not only improve in their sport but to do it safely.”
The program focuses on top-end speed, vertical jump increase, multi-directional quickness, first-step quickness, upper & lower body strength as well as core strength. Each athlete is trained in a stable and safe environment, with maximum results if each athlete puts forth the effort.
Following the intensive, systematic four-, six-, or eight-week program, Holmes says athletes can see improvement in the following areas:
Confidence: Acceleration helps each athlete understand themselves better, giving them greater self-confidence not only in their sport, but also in life.
Attitude: Each athlete hones a positive winning attitude that can be seen in the game as well as at home and school.
In the game: Acceleration is proven to reduce the risk of injury.
Performance: As athletes put forth their effort, they see results. This includes speed, quickness, reaction time, agility, recovery time and core strength/stability.
Proprietary Equipment: Super Treadmills, Plyo Press, 3PQ, Patented Cords & Patented Written Protocols.
Visit www.accelerationqc.com or call 563-355-7601. Acceleration is located at 3885 Elmore Avenue, Suite A-3; Davenport, IA, 52807. Like on Facebook at facebook.com/accelerationqc
For more information about the surgeons at Orthopaedic Specialists or the procedures that Dr. Hoffman performs, please visit www.osquadcities.com or call 563-344-9292 to schedule an appointment. Like us on Facebook at facebook.com/osquadcities
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