Orthopaedics

Q: What is involved in a minimally invasive hip replacement and how might it be better than the traditional surgery?

A:

A minimally invasive hip replacement surgery may be a better option for some patients.  It involves a smaller initial incision and less muscle and tendon damage because the surgeon pushes these structures aside to reach the joint rather than just cutting through them as with the traditional surgery.  In most cases, the minimally invasive option involves a shorter stay in the hospital, less pain and a quicker return to work and normal activity.

Minimally invasive hip replacement surgery takes more time to complete and requires a high level of technical expertise on the part of the surgeon and the surgical team. It requires extensive training and experience along with specialized equipment.

Whether or not minimally invasive hip replacement is right for you is specific to your medical situation and will be determined by your physician.  It is crucial to adhere to all medical restrictions as defined by your surgeon. UM UCH has the expert staff, training and equipment to perform this procedure locally for the residents of Harford and Cecil County.

Raj Yalamanchili, MD
Director of Joint Replacement

Fellowship-trained Joint Replacement Surgeon

Q: How is a reverse total shoulder replacement different from a traditional total shoulder replacement?

A:

For decades, sufferers of severe shoulder arthritis have relied on traditional total shoulder replacement as a proven solution.  But for individuals with more complex shoulder issues, such as a torn rotator cuff, this was not the best option.  In recent years, a new shoulder replacement option called reverse total shoulder replacement has offered relief from pain and lack of mobility to those with more difficult shoulder problems.

In a traditional shoulder replacement, a plastic socket is placed in the shoulder and a metal ball and stem are inserted into the upper arm bone; the two fit together to form the new artificial joint. This solution still relies on a patient’s rotator cuff to move the arm.

Conversely, in a reverse total should replacement, the plastic socket is fitted into the arm bone and the metal ball is attached to the shoulder bone instead. This configuration is better for people with damaged rotator cuffs because the new joint does not rely on this muscle for movement of the arm.  Instead, the deltoid muscle is used to move the arm.

For more information regarding this procedure, please call 443-643-3130.

William P. Cook, MD
Orthopaedic Surgery

Q: What is osteoporosis and how is it treated?

A:

Osteoporosis is a disease in which the bone becomes less dense and, therefore, weaker.  It generally affects more women than men.  Someone with osteoporosis is more likely to break a bone if he/she falls down or sustains some other kind of skeletal injury.

Osteoporosis can be present for years without showing any symptoms and is prevalent in those that have a family history as well as in post-menopausal women. Smoking, drinking and a sedentary lifestyle can also increase your chances for developing osteoporosis. Diagnosis of osteoporosis is determined mainly by undergoing a bone density test which uses x-rays to measure the minerals in your bones.

Treatment of osteoporosis depends on a multifaceted approach.  You must increase your intake of calcium and Vitamin D as part of an overall healthy diet. Daily exercise is also a must and should include weight bearing exercises to help strengthen the bones and surrounding muscles.

There are several kinds of prescription medications that are routinely prescribed for osteoporosis that work by strengthening the bones and slowing the process of bone density loss. Some newer medications even promote new bone tissue growth.

John A. Prodoehl, M.D.
Orthopaedic Surgeon


Q: What happens during an ankle joint replacement? How long does the recovery take?

A:

The ankle is formed by three bones: the two bones of the lower leg- the tibia and fibula- come to an end resting on the talus bone in the ankle.  Wear and tear at the meeting point of these three bones is the main reason that patients seek to undergo ankle joint replacement surgery. The damage is usually due to either traumatic injury or degenerative conditions such as osteoarthritis which cause considerable pain, reduced mobility of the joint and sometimes swelling.

Replacement of the ankle joint consists removing the damaged areas of the ankle bones and cartilage and fitting new components on to the end of the tibia and the top of the talus that join together to form the new movable ankle joint.  Screws are placed just above the new joint to help provide more stability.  Tendons and ligaments are not affected because they are simply moved out of the way during the surgery.

Recovery usually takes about 12 weeks; during which physical therapy is essential to get the ankle back in to shape and the patient back to normal daily activities.
Douglas G. Wright, MD
Orthopedic  Surgery

Q: How is robotic assisted partial knee resurfacing and total hip replacement better than traditional knee and hip replacement surgery?

A:

MAKOplasty® partial knee resurfacing and total hip replacement, powered by robotic arm technology, enables surgeons to achieve a level of precision typically unattainable with conventional instrumentation. 

MAKOplasty® Partial Knee Resurfacing is a treatment option for adults with early to mid-stage osteoarthritis that has not yet progressed to all three compartments of the knee. It is less invasive than traditional total knee surgery. A pre-surgical plan is created based on a CT scan of the patient’s own knee, and the surgeon uses the robotic arm to resurface the diseased portion of the knee, sparing healthy bone and tissue for a more natural feeling knee and potential for shorter hospital stay and quicker recovery time. An implant is then secured in the joint to allow the knee to move smoothly again.

MAKOplasty® Total Hip Replacement offers the potential for a higher level of customized implant alignment and positioning, not always achieved in manual techniques.  Accurate alignment and positioning of hip implants are important factors affecting surgical outcomes and the lifespan of implants.
Edward G. O’Mara, MD
Orthopaedic Surgery

Q: Can physical therapy ease joint pain?

A:

A physical therapy program, under the guidance of a licensed physical therapist, can be highly beneficial for those in need of orthopedic pain relief.  It can help to reduce pain and increase mobility, often without the need for surgery and prescription medication. Treatment may range from passive therapy like hot/cold packs, to active therapy such as stretching and aerobics. Physical therapy programs are custom tailored for the individual, helping to pinpoint and address the cause of a patient’s pain. Some data suggests that in many cases, low impact treatments like physical therapy can be just as effective as surgery at managing some conditions, all at a fraction of the cost.

Even when surgery is determined to be the best course of action, a preoperative physical therapy plan can make a huge impact on the patient’s road to recovery, often reducing his/her need for postoperative care significantly.  The bottom line is this:  The stronger you are going into surgery, the stronger you’ll be coming out.

William P. Cook, MD
Orthopedic Surgery

Q: I have arthritis and frequent joint pain, so I’m not motivated to exercise. What advice can you share?

A:

It can be extremely difficult to motivate yourself to exercise when arthritis and joint pain are already taking their toll on you. However, the benefits of exercise are numerous, especially for individuals suffering from arthritic pain. Physical activity can actually help improve flexibility and decrease pain, and the benefits of exercise don’t stop there. A consistent exercise regimen can help you strengthen muscles around your joints, maintain healthy weight, give you more energy through the day, sleep better, and maintain a better mood overall.

To relieve joint pain before exercising, take a nonsteroidal anti-inflammatory drug or use a hot pack to soothe any achy spots. If you have access to a pool, swimming or aquatic aerobic exercise is the safest and least traumatic way to mobilize arthritic joints. If a pool is unavailable, walking is easy on your joints, you can do it just about anywhere, and it’s free. Try walking several days a week for 30 minutes, whether it’s in your neighborhood, at a mall or on a treadmill. You may also want to try yoga, which is a gentle exercise but a good workout. You can modify poses if needed as you go, and it will promote flexibility, muscle strength and relaxation.

Edward G. O'Mara, MD
Orthopedic Surgery