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About Orthopedic Specialists

Orthopedic Specialists of Seattle provides new and advanced procedures including endoscopic carpel tunnel release surgery for carpal tunnel syrome, complex joint restoration procedures, anterior approach hip replacement surgery, and more.

Proper Stretching to Avoid Injuries

How you stretch, why you stretch, and when you stretch are the keys to making stretching work for you. Stretching before physical activity improves flexibility, enhances athletic performance, and decreases the risk of activity-based injuries.

The more flexible you are when you exercise the more protected you are against injury by helping your joints move through their full range of motion. If a tendon is not stretched out, you could increase your risk of tendinopathy or tendinitis. When you adequately stretch out your muscles, tendons, and ligaments, you decrease the risk of microtrauma to your body’s structures and avoid overload and injury. … read more

Knee Arthroscopy

What is knee arthroscopy?

During the last two decades, the diagnosis and treatment of knee joint problems have improved thanks to a minimally invasive procedure called knee arthroscopy. This surgical technique allows orthopedic specialists to see inside the knee and to carry out diagnostic and treatment measures through tiny incisions. This approach to surgery reduces pain, minimizes scarring, and helps speed up the recovery period when compared to traditional “open” knee surgery.

How does arthroscopy of the knee work?

Arthroscopy involves the orthopedic surgeon to using a device known as an arthroscope. This instrument is a tiny, pen-shaped device that has a small video camera attached to the end. The arthroscope is inserted into the knee through small incisions and the camera relays images to a computer screen. Our orthopedic specialists can use these images to diagnose knee problems. Once that is done, the doctor can carry out the appropriate procedure in the same surgical setting.

What does knee arthroscopic surgery treat?

Orthopedic specialists can use arthroscopic surgery to perform a variety of procedures. These include the repair or reconstruction of torn ligaments, the removal of small loose bits of bone. The hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst… or cartilagecartilageThe hard, thin layer of white glossy tissue that covers the end of bone at a joint. This tissue allows motion, and repair or resection of torn meniscus tissue. Many of these conditions arise due to a knee injury or degeneration.

What are the benefits of arthroscopic surgery of the knee?

There are many benefits of knee arthroscopy when compared to traditional “open” surgery. With this procedure, you likely to experience less pain after the surgery and you have a lower risk of developing certain complications like infections or scarring. In addition, the hospital stay is shorter as most knee arthroscopic surgeries are performed on an outpatient basis in a freestanding surgery center. The greatest benefit is usually a quicker overall recovery.

What are the risks of knee arthroscopy?

All medical and surgical procedures have some risk. With knee arthroscopy, the risks are minimal and our orthopedic specialist will discuss these with you prior to your surgery. These risks depend on your current state of health, the type of surgery performed, and the extent of your injury or knee problem.

What should I expect before surgery?

Prior to an arthroscopic procedure, depending on your overall health you might have to see a primary care health professional for a general physical examination. In addition, you will need to tell the doctor about any medications you are taking and he may advise you to stop some of these before the procedure.

What should I expect after surgery?

You will need to start exercising the knee immediately after your procedure to restore range of motion and strength to the joint. While many patients get back to normal activities without much difficulty, plan to discuss this issue with your orthopedic specialist, as he may have a specific rehabilitation program for you to follow.

Immediately after your knee arthroscopy you will experience some swelling and discomfort of the knee. This will usually only last for a few days, however. Your doctor will prescribe specific medications that work to alleviate these symptoms and help you get back on your feet.

Also, you should expect to feel a little stiff when performing exercises early after surgery. Any activity that leads to significant discomfort should be stopped immediately and your orthopedic specialist should be notified. Our orthopedic surgeons request that you elevate your leg frequently and use ice to reduce swelling.

Common Wrist Fractures and Repair

I see many wrist fractures, these are among the most common along with symptoms and treatment.

Distal Radius Fracture

The most commonly broken wrist bone with a fall on an outstretched hand is a break of the distal radius. The radius is the larger of the two forearm bones and the end toward the wrist is called the distal end. When the area of the radius near the wrist breaks it is considered to be a fracture of the distal radius. Distal radius fractures are very common.

Symptoms of a distal radius fracture are immediate pain, bruising, swelling, and tenderness. Often times the wrist hangs in an odd or bent way, otherwise known as a deformity.

What are the risk factors for a distal radius fracture?
Osteoporosis is a risk factor for all types of fractures, especially a distal radius fracture. A broken wrist can happen in healthy bones as well. The majority of these types of fractures occur in people older than 60 years of age who fall from a standing position. The other subset of people who injure their wrist are young patients with a high impact fall, causing a break in an otherwise normal wrist.

How is a distal radius fracture treated without surgery?
Treatment for a distal radius fracture involves the nature of the fracture, the age and activity level of the person injured, and the orthopedic specialist’s personal preferences. The doctor can cast the broken bone if it is in good position and is stable. Sometimes the orthopedic specialist must straighten the bone (reduce it) before a cast is applied. This is what doctor’s call a closed reduction. The cast is usually worn for about 6 weeks and at that time the doctor could order physical therapy to help with rehabilitation.

What is involved in surgical treatment?
There are times when distal radius fractures result in the bone being so much out of place that it cannot be corrected without surgery. The orthopedic surgeon will make an incision to directly access the broken bones to improve alignment. The bone can be held in correct position with the use of a plate and screws, metal pins, an external fixator or any combination of techniques.

Scaphoid Fracture of the Wrist

The scaphoid bone is one of the small bones in the wrist, and it is the wrist bone that is most likely to break. It is located on the thumb side of the wrist in the area where the wrist bends. It can be easily located when the thumb is held in a “hitch-hiking” position. The scaphoid bone is at the base of the hollow made by the thumb tendons.

Symptoms it is fractured include pain, swelling, and tenderness at the base of the thumb. The pain will worsen when the person grips something or tries to move the thumb or wrist. A scaphoid fracture is usually caused by a fall onto an outstretched hand and is not always as painful as one might think.

What are the risk factors for a scaphoid fracture?
Anyone can fracture their scaphoid bone but it is more common in athletes who participate in activities where falls are common. Men aged 20 to 30 are most likely to experience this type of injury.

How is a scaphoid fracture treated without surgery?
If the bone is in proper position and has good blood supply, the orthopedic specialist may treat it by casting. The cast is usually worn for 12 weeks. Many opt for surgical stabilization to minimize the length of immobility.

What is involved in surgical treatment?
Due to the precarious nature of the blood supply to the scaphoid, the orthopedic specialist may recommend surgery to optimize healing and prevent long term wrist arthritis. During the procedure metal implants (such as screws and wires) are used to hold the scaphoid in place until the bone is completely healed. The surgeon makes an incision over the front or the back of the wrist to align the bone, insert the metal implants, and repair the damage.

In special situations where the bone is not healing well on its own, a bone graft may be needed to aid in healing. A bone graft is new bone that is place around the broken bone to help stimulate bone healing. This allows the bone pieces to heal together into a solid bone.

Sports Injuries of the Elbow in Children and Teens

Most elbow injuries in children occur during activities like sports and play, or are the result of accidents and falls. The risk of injury is greater for those who participate in contact sports such as football, soccer, wrestling.

Also, injuries risk is higher for those who engage in snowboarding, skateboarding, hockey, skiing, biking, or in-line skating. When an injury occurs in a child or teen, it can affect the growing end of the long bones of the arm called the growth plate. These types of injuries always need to be evaluated by an orthopedic specialist. … read more

Common Shoulder Injuries Related to Sports

Clavicle Fracture (Broken Collarbone)

A broken collarbone (clavicle) is a very common fracture that occurs in people of all ages but occurs more commonly with sports related injuries. The clavicle is located between the ribcage and the shoulder blade and it connects the arm to the body. The collarbone lies above many vital structures, such as nerves and blood vessels.

What causes a clavicle fracture?

Clavicle fractures are most often caused by a direct blow to the shoulder area. These types of injuries occur during a fall on an outstretched arm, a contact hit (when a football player collides with an opponent), or any other type of direct impact to the shoulder that can occur during sporting activities.

What are the symptoms of a broken collarbone?

These types of fractures can be very painful and make it difficult to move your arm. Other symptoms include a sagging shoulder, inability to lift the arm due to pain, a grinding sensation with arm movement, a deformity or “bump” along the collarbone area, bruising, swelling, and tenderness over the broken area.

How is a clavicle fracture treated without surgery?

Broken collarbones do not always require surgery. If the bone ends are not shifted out of place and line up correctly, you may be treated with an arm sling and rest. Basically, the orthopedic specialist will have you wear this to keep your arm in proper position while the collarbone heals.

Once your bone begins to heal, your doctor may order physical therapy for you to help you strengthen the muscle of your shoulder. The therapist will teach you exercises, too, to help prevent weakness and stiffness.

What is involved with surgical treatment?

If your bones are displaced (out of alignment) your orthopedic specialist may recommend surgery to align the bones. This is done to hold them in position while they heal.
During the procedure, the bone fragments are repositioned into normal alignment and held in place with special screws and metal plates that attach to the outer surface of the bone.

After your surgery, you may notice a small patch of numb skin below the incision but with time this is less noticeable. You will also be able to feel the plate through your skin. These plates and screws are not removed until long after the bone heals.

Dislocation of the Shoulder

Many athletes who play tennis, baseball, or football tend to experience a dislocated shoulder. The shoulder joint is the body’s most mobile joint, turning in many directions. This advantage puts this joint at risk for dislocation. A complete dislocation means that the humerus (upper arm bone) is all the way out of the socket.

What causes dislocation of the shoulder?

Your shoulder can become dislocated by throwing, hitting, and overuse. Many people who play softball or baseball injure their shoulder this way.

What are the symptoms of a dislocated shoulder?

Symptoms include numbness, weakness, bruising, and swelling of the shoulder area. Some dislocations are severe enough to tear tendons and ligaments and to damage nerves. The shoulder joint can be dislocated forward, backward, or downward. The muscles of the shoulder area may have spasms from the disruption, as well, leading to pain and stiffness.

How is a dislocated shoulder treated?

Your orthopedic specialist will have to place the ball of the humerus back into the joint socket. This procedure is called a closed reduction and no surgery is necessary. Once the shoulder is back in place, the pain stops immediately.

Shoulder Impingement (Rotator Cuff Tendinitis)

The rotator cuff is made up of tendons and muscles that allow for a great range of motion of your arm. This is a frequent source of pain for athletes and an area that is at risk for injury during sporting activities. Shoulder impingement is often referred to as rotator cuff tendinitis and is one of the most common causes of shoulder pain.

What causes rotator cuff tendinitis?

When you raise your arm to shoulder height, the space between the bone and rotator cuff narrows. The bone can rub against (or impinge on the tendon and the bursa, causing irritation and pain when the arm is used repeatedly. Young athletes who use their arms for overhead action are particularly vulnerable. This includes those who play tennis, softball and baseball, and swimmers.

What are the symptoms of shoulder impingement?

When the rotator cuff is irritated this can lead to local swelling and tenderness in the front aspect of the shoulder. You may also have pain and stiffness when you lift your arm. There is also a sensation of tenderness when the arm is lowered from an elevated position. Other symptoms include sudden pain when reaching or lifting, pain radiating from the front of the shoulder to the side of the arm, minor pain at rest, and pain when throwing or using the arm.

How is rotator cuff tendinitis treated without surgery?

Your orthopedic specialist wants to reduce your pain and restore function of your shoulder. He will consider your activity level, your age, and your general state of health. Many times shoulder impingement can be treated with medications and rest. It is not uncommon for athletes to be ordered physical therapy to help restore normal motion of the shoulder. Your therapist will teach you specific stretching and strengthening exercises to relieve your shoulder pain and help you get back to normal activities.

What is involved with surgical treatment?

The goal of surgery is to create more space for the rotator cuff and this involves removing a portion of the inflamed bursa. Your orthopedic specialist will perform an anterior acromioplasty, where part of the bone is removed to allow for movement of the rotator cuff. Many times, the surgeon opts to perform this procedure by way of arthroscope.

The arthroscopic technique allows for use of small thin surgical instruments to be inserted around puncture wounds around the shoulder. The doctor can see inside the shoulder through a small camera inserted into the joint that displays images onto a computer TV monitor.