OSS

New York Times covers minimally invasive hip replacement surgery offered at OSS

Sunday, February 21st, 2010

We’re excited to see Jane Brody’s New York Times article this month on anterior approach hip replacement surgery. Orthopedic Specialists of Seattle is one of only two centers in the Pacific Northwest offering this technique, with over 4 years experience performing this minimally invasive hip replacement surgery. We’re able to offer this innovative approach to nearly all of our patients who have arthritis of the hip severe enough to warrant surgery. Patients benefit from the reduced risk of complications and dramatically increased rate of recovery following the procedure. To learn more, visit: http://www.nytimes.com/2010/02/09/health/09brod.html

What is a Rotator Cuff and How Can it be Injured?

Thursday, October 8th, 2009

The rotator cuff is a group of four tendons and muscles – supraspinatus, infraspinatus, teres minor and subscapularis. These muscles not only provide power to the shoulder, but also stabilize the shoulder joint, keeping the head of the humerus (upper arm bone) in place against the shoulder blade. Rotator cuff injury is a tear that occurs to one or more of these four tendons or muscles.

What are the Causes and Symptoms of Rotator Cuff Injuries?

The two main causes of a rotator cuff injury are acute tears, caused by trauma such as a fall, and chronic tears which are caused by degeneration of the tendon over time. Acute tears are more noticeable because they result in immediate pain and you may experience a snapping sensation or weakness of the arm. You may have developed a chronic tear if you notice some or all of these symptoms: pain while working, lifting, or reaching over your head, pain when sleeping on the affected shoulder, or a weakness in your arm. Both chronic and acute tears can worsen if not treated properly.

How do I Prevent a Rotator Cuff Injury?

One of the best ways to avoid rotator cuff injury is through adequate conditioning before putting strain on your shoulders with vigorous activities of any kind. Warming up is an essential routine before participating in any sporting activity. Stretching and strengthening exercises are very important when it comes to prevention of a rotator cuff injury.

Stretching and Strengthening Exercises

To help avoid injury to your shoulder muscles, try the following exercises. While conducting these exercises, take care to proceed gently and slowly.

* Stand upright, clasp your hands behind your back, and then keep your arms straight while you slowly lift them upwards until you feel resistance. Hold this position for 15 to 20 seconds and repeat it 3 to 4 times.

* Stand with your arm out in front of you with your forearm pointing upwards at right angle (90°). Place a stick or pole in your hand and let it fall behind your elbow. Pull the bottom of the stick forward with your other hand. Hold this stretch for 15 to 20 seconds, and then repeat it 3 to 4 times.

* Lie on your stomach on a table, keeping your left arm at shoulder level with your elbow bent at right angle, slowly raise your left hand to level with your shoulder. Lower your hand slowly and repeat it with your right arm.

* Lie on your right side with a rolled-up towel under your right armpit and stretch your right arm above your head. Your left arm should be at your side with your elbow bent at 90°. Roll your left shoulder out while raising the left forearm to level with your shoulder and then lower the arm slowly (like the backhand swing in tennis)

* Lie on your right side and keep your left arm along the upper side of your body with the right elbow bent at right angle. Let the right forearm rest on the table. Roll your right shoulder in while raising your right forearm up to your chest and then lower it slowly (like the forehand swing in tennis)

* Stand upright and move your right arm halfway between the front and the side of your body, thumb down. Raise your right arm to 45° angle. (the way you empty a can). Make sure not to lift beyond the point of discomfort or pain. Slowly lower your right arm and repeat the exercise with the left arm.

Tennis Elbow – Should I See a Doctor?

Thursday, October 8th, 2009

Lateral epicondylitis, commonly known as tennis elbow, is a painful condition where the outer part of the elbow becomes sore and tender due to repetitive motions that put a strain on the elbow. Tennis elbow is one of the most common repetitive stress injuries.

Common Causes of Tennis Elbow

While commonly referred to as tennis elbow, only 5% of the people afflicted with this injury are actually tennis players. In fact, the majority of people who suffer from tennis elbow are not athletes.

This condition can happen to anyone who uses their wrist repetitively. Some common activities known to cause tennis elbow are: typing, using a hammer or screwdriver, painting, as well as many activities performed by a plumber or gardener. The repetitive wrist movement causes degeneration in tendons that attach the forearm muscles to the arm bone.

Symptoms of Tennis Elbow

Symptoms and the intensity of pain may vary. People suffering from tennis elbow often have tenderness in the elbow and the back of the forearm, which worsens with repeated use of the elbow especially during twisting movements. Common symptoms of tennis elbow include:

• Pain while lifting or bending the arm

• Pain caused while twisting the forearm

• Pain when gripping small objects like pen especially while holding the pen and writing.

• Inability or difficulty in extending the forearm completely

• Persistent pain on the outside of the upper forearm just below the bend of the elbow and on certain occasions, radiating down towards the wrist.

My Elbow Hurts. Should I See a Doctor?

Tennis elbow most commonly affects people between the ages of 30 to 50. People may often attribute the pain to growing older and hope that by ignoring it, the pain will go away. However, if left untreated, tennis elbow can progress into a debilitating injury that could eventually require surgery.

Another common misconception about tennis elbow is that taking anti-inflammatory medications or using topical creams can cure tennis elbow. These methods only cover the pain, and rarely solve the underlying problem. Anti-inflammatory medication may still be used to help manage the pain, but it’s best to seek medical attention and get a plan of action first. If you find yourself experiencing the symptoms described above, it’s best to talk to a physician to receive a proper diagnosis and course of treatment.

What is the Treatment for Tennis Elbow?

Doctors can prescribe many different treatment options, ranging from modalities such as braces or physical therapy, all the way up to surgery or changing jobs to avoid the repetitive motion. Your doctor will most likely start with conservative measures, such as resting the affected arm, icing the elbow, or giving you a brace. They may also instruct you to take anti-inflammatory medication to reduce the swelling and manage pain. If these options do not resolve your tennis elbow, your doctor may recommend surgery, however surgery is only necessary in about 5% of cases. If you follow your doctors suggestions and refrain from straining the tendons even further, your tennis elbow should go away within a few weeks, but could last several months.

Orthopedic Surgeons of Seattle welcomes a new foot and ankle specialist, Mark Berkowitz, M.D.

Wednesday, September 23rd, 2009

On October 20th, Mark Berkowitz, M.D., a board-certified orthopedic surgeon, will join Orthopedic Specialists of Seattle. He has expertise in operative and non-operative treatment of all aspects of foot and ankle surgery, including arthroscopy, sports-related conditions, bunions, arthritis, and trauma. He joins the physician staff of Phillip Downer, M.D., Jon Franklin, M.D., Charlie Peterson, MD., Joel Shapiro, M.D., J. Michael Watt, M.D., and Wayne Weil, M.D.Dr. Berkowitz received his undergraduate degree at Princeton University where he graduated Summa Cum Laude and was recognized as Academic All-Ivy and Academic All-American as Captain of the varsity football team. He obtained his medical degree at Case Western Reserve University where he was elected to the prestigious Alpha Omega Alpha medical honor society.

After completing residency training, Dr. Berkowitz served as Chief of Foot and Ankle Surgery at Tripler Army Medical Center where he gained extensive experience treating a wide range of sports-related injuries in our active duty military population. He also deployed to Iraq in support of Operation Iraqi Freedom for which he received a Meritorious Service Medal.  He subsequently completed the prestigious Tampa Foot and Ankle / Lower Extremity Trauma Fellowship.

Dr. Berkowitz has completed numerous marathons and triathlons and currently enjoys tennis, running, and biking and especially playing with his two young children.

Meniscus Tear: Signs, Symptoms, and Signals

Thursday, August 27th, 2009

The word ëmeniscusí means crescent shaped structure and owes its origin to Greek. The C-shaped meniscus made of tough cartilage is wedged between the cartilage surfaces covering the three bones that form our knee joint. Meniscus aids the function of the joint by distributing weight and improving its stability. The function of meniscus is of grave importance for the general health of the knee. Meniscus tear or torn cartilage can severely impair the mobility of the knee joint.

Meniscus tear is one of the most common knee injuries that results in severe pain in the joint. It is especially common among athletes and sportsmen who play contact sports such as football, boxing, and hockey. There are two chief causes for meniscus tear ñ It can be due to traumatic injury, primarily seen in athletes or due to degenerative processes that are seen in older patients who have more brittle cartilages. Sudden twisting and turning or bending the knee joint is sometimes responsible for torn meniscus. Rotating the knee while slightly bent can cause meniscus tear.

Symptoms and Signs of Meniscus Tear Mishap

The primary symptoms of a meniscus tear are usually that of pain and swelling in the knee that makes it worse for the knee to bear more weight while doing activities such as running, or jogging. Joint locking or incapacity to completely straighten the joint is another common complaint that is especially painful while trying to get out of the car. These are the signs to look out for when in doubt about the possibility of suffering from a torn meniscus:

* sharp pain in the knee caused by even a minor movement
* swelling of the knee
* stiffness of the knee
* obvious presence of fluid in the knee

While these signs can be rectified without medical intervention, the following severe symptoms of meniscus tear require professional medical attention:

* inability to move your knee
* loss of balance when trying to stand
* locking, clicking, or popping within the knee
* extreme difficulty in straightening the knee
* piercing sensation in the inner and outer edges of the knee

Clinical Testing of Symptoms

The symptoms can be clinically tested by a physician to determine if the pain is caused because of a torn meniscus. The McMurray test is conducted to examine the swelling by pressing on the joint line on the affected side of the knee while stressing the meniscus to determine if it has produced tenderness that is typical of a torn meniscus. Steinmann test and Appley test are similar tests where the patient is sitting in the former and the latter involves a grinding motion while the patient lies flat with the knee bent at 90∞. Squatting and bending the knee can be quite painful especially with a meniscus tear since the movement of the joint if the meniscus is torn is often restricted. Cooperís sign, which is a symptom of pain in the affected knee that is usually felt when turning over in bed, is present in over 92% of tears. The twisting motion of the knee affected by meniscal tear results in the capsular attachment getting stretched and the meniscal fragment getting strained that causes the pain.

Meniscus Tear Treatment

Nonsurgical treatment involves adequate rest, administration of ice pack to the affected area, compression, knee elevation, physical therapy, and even wearing a temporary knee brace. Surgical repair is to sew the tear together. Partial meniscectomy removes the torn section while total meniscectomy removes the entire meniscus. The last option is general avoided as it increases the risk of osteoarthritis in the knee.