J. Scott Reid, MD, performed the first smart implant for knee replacement surgery in Oklahoma at Union Pines Surgery Center on the campus of Tulsa Bone & Joint today.
The PIQ tibial implant allows Dr. Reid and his staff to follow a patient through their postoperative course via a web-based application, allowing the orthopedic staff to remain more connected to the patient throughout their surgical journey.
“At Tulsa Bone and Joint, we strive to provide our patients access to cutting-edge technology,” said Dr. Reid. “Our ultimate goal is to improve the patient experience at Tulsa Bone and Joint, and we believe this technology helps us achieve this goal.”
Dr. Reid is a fellowship-trained, board-certified orthopedic surgeon specializing in knee, hip and shoulder replacements. He is a native Tulsan and has been in practice with Tulsa Bone & Joint since 2015. He is a U.S. Army veteran and served in Afghanistan.
Frequently, I see patients whose first question is, “Am I ready for replacement of my arthritic joint?”
This is not a question that is easy to answer, and the answer depends on many factors and variables:
- Joint Replacements have an excellent outcome, with greater than 90% of patients reporting that they are glad they proceeded with the surgery and are better than before surgery.
- Patients often ask if they are too old for surgery. Well, I believe that age is a relative factor. Some 50 year olds have multiple medical problems, while some 90 year olds have no medical issues and are not even taking any medications. So age must be evaluated by each individual.
- There are many treatments for arthritis of a joint:
- Activity modification
- Anti-inflammatory medications
- Anti-inflammatory injections
- Support aides, like canes or walkers
- Braces or shoe modifications
- Weight loss
- Physical strengthening
- The main reason for undergoing joint replacement is pain! However, limitation of activity or loss of function is another reason people think about undergoing surgery.
- The best answer to the question, “Am I ready for a joint replacement?” is, “You will know when it is time.”
If you want to discuss the options of surgical treatment for your arthritis, please make an appointment here or by calling 918-392-1400. By seeing you in person, myself or another member of our qualified joint replacement team can provide you an individualized assessment and discuss your concerns and expectations.
Many people wonder if they need a knee replacement, and secondly, are they ready for it? Yes, these are two separate questions. As a surgeon I will never tell one of my patients that they MUST have a knee replacement because that is a personal decision. However, I can ask a series of questions and make recommendations. So, if you think you might be ready for a knee replacement, ask yourself these questions.
• Do you have aching, throbbing knee pain that has bothered you on a daily basis for at least 2-3 months or longer?
• Does this pain keep you from doing activities you love or just basic activities of daily living, like walking around your house without pain?
• Have you already tried to manage your pain with anti-inflammatory medications (for example, Ibuprofen or Aleve), steroid injections into the knee itself or physical therapy without lasting relief?
If you find yourself answering yes to two or more of the above questions, then you may very well need a knee replacement. Then comes the second part of the question (“Are you ready for it?”), since a knee replacement is an elective surgery. This means that if your surgeon recommends a knee replacement for you, it should be done at a time that is convenient for you.
A total knee replacement is a large surgery with an extended recovery time. You will need to pick a time when you have the ability to dedicate at least 6 weeks to intensive recovery and rehabilitation right after surgery. It’s also important to pick a time when you can have a family member or friend available to help you at home after discharge for approximately 2 weeks. During that time, you will need someone to help with meals, to help you get to and from the bathroom, and to help as a cheerleader when you are doing your rehab exercises at home.
You will often start off with physical therapy 2 or 3 times a week so you can learn the exercises. These exercises will help you work on bending and straightening your knee after surgery. You will need to do those exercises on your own as well.
The first 6 weeks after surgery are the most difficult. By the end of this time, you are often ready to return to work, depending on just how physical your job is. It can take 6 months to 1 year to fully recover. This may seem like a long time, but in reality, it is a short time investment into a surgery that can give you excellent relief from your symptoms for 20+ years into the future.
Knee injuries are commonly seen in sports activities, but also occur in everyday activities. What course of action should you take if you have a knee injury?
Some injuries are caused by a direct blow to the knee, while others are the result of a twisting force often without contact. Fractures of the bones around the knee often require a direct contact mechanism, but many significant ligament and meniscal (cartilage) tears occur due to the twisting force of the injury. Some injuries are a combination of both mechanisms.
Symptoms to pay attention to are swelling, giving way (instability), and catching or locking with movement of the knee. Swelling can be immediately after the injury or may not show up for 24 hours. Giving way with weight bearing suggests a possible ligament injury. Catching or locking symptoms with knee motion is more indicative of meniscal or cartilage tears.
What Should I Do After a Knee Injury?
When a knee injury occurs, initial treatment should be rest, ice, compression, and elevation. Crutches are often helpful if you are unable to bear weight. If significant pain occurs with motion, then a straight leg brace, such as a knee immobilizer, is beneficial. If a bone fracture is suspected due to deformity at the knee, then a trip to the Emergency Room for x-rays is indicated. But most knee injuries do not require immediate evaluation and can wait a few days to be evaluated by a physician. Often times, the exam is more helpful after the initial pain of the injury has settled.
Orthopedic surgeons are specially trained to evaluate and treat injuries of the bone and joint system. They are the specialists regarding knee injuries. Evaluation by the Orthopedist will include the history of the injury, to include the mechanism of injury, as well as discussion of the symptoms of swelling, giving way, and locking or catching.
The examination at this time is very important. Based on location of pain, laxity of various ligaments, and results of certain manipulative tests, an experienced Orthopedist can narrow down the possible structures that have been injured. X-rays are usually taken to rule out subtle fractures or underlying structural problems of the bones. An MRI of the knee may be ordered but sometimes is not needed to establish the diagnosis.
What Will Treatment of My Knee Injury Be?
Many knee injuries will heal without surgery. Mild sprains of the collateral ligaments just need protection for a few weeks in a brace and do well. The torn ACL may need surgery, but there is no benefit to early surgery, and waiting a month may help with motion post-operatively. Meniscal tears usually require surgery within the first few weeks. Severe tears of the lateral collateral ligament and posterolateral structures need to be addressed within the first two weeks of injury. Multiligament injuries may require a staged surgical approach. Luckily, these injuries are not frequent.
In summary, knee injuries are common in sports and everyday activities. The majority of these injuries heal without surgery within 6-8 weeks. If symptoms are not improving significantly within a week, then evaluation by an Orthopedic Specialist is reasonable. History of the injury and examination of the knee, with x-ray studies if needed, will help guide the treatment plan. Discussion of the various treatment options can lead to the appropriate plan for each individual patient.
By Tony Jabbour, MD
All of us want our children to succeed. Many of us have children who have been playing a sport most of their lives and show potential for a college athletic scholarship. Sometimes it seems parents and coaches will go to great lengths to try to ensure their child can continue playing that sport, even when a physician has advised against it. They’re even willing to enter a risky game of Russian Roulette to ensure the child continues playing the sport.
More than 30 million children and teens participate in a variety of sports in the U.S. each year. Not surprisingly, about 10 percent will sustain an injury, sidelining them. Most injuries are simply mild strains or sprains. Some injuries, however, are devastating injuries, such as fractures, concussions, or major ligament injuries.
The highest rate of injuries in athletes occur in contact and collision sports. American Football, a collision sport, probably accounts for the majority of emergency room visits. Football injuries can include spine injuries, concussions, major knee ligament injuries, and shoulder dislocations.
Certified athletic trainers and sports medicine physicians’ goals are to provide a safe place to play and to assure safe return to sports after an injury. However, it seems the goal of some parents is to keep your athletic teenager in the game at all cost.
Our sports medicine team at Tulsa Bone & Joint works diligently with the athlete and the coaches to help return the athlete to play when it is safe to do so. The sports medicine physician makes the un-biased recommendation of whether or not an athlete can return to play, and coaches and parents usually agree.
Sometimes, though, parents seek other professional opinions to get clearance for their athlete to play. It seems like these parents are playing Russian Roulette with their child’s injury. Russian Roulette, by definition, is an activity that is potentially very dangerous. These parents’ primary goal is to keep the athlete playing yet another football game, instead of thinking of the dire, long-term consequences of their decision.
Here are the two injuries I see parents play Russian Roulette with their child’s injuries:
- ACL Injuries.
In regards to a torn knee ACL, usually we recommend that the athlete stop playing pivoting sports for a season until surgical reconstruction. When the ACL tears, it will not heal on its own. As a matter of fact, when the knee becomes unstable after an ACL tear, there is a very high likelihood that the athlete will cause more extensive knee cartilage damage upon return to playing. The more cartilage is damaged, the more arthritic changes will occur at a young age.
After the athlete is sidelined, many parents begin “shopping” for another physician that will clear their child to play again. Usually the second opinion doctor will put the athlete in a functional ACL brace that offers the athlete a false sense of security. However, the brace will not stop the athlete from damaging the knee further. It seems that the second opinion physician is just trying to appease the parent.
Unfortunately, many of these athletes that return to play with an unstable knee will damage more cartilage in their knee. This decision by the parents to return to play will cause lifelong problems for that athlete and will ultimately limit their sports’ career.
- Traumatic Shoulder Dislocation.
When a collision athlete develops a traumatic shoulder dislocation, the decision to stop playing for a season is best. A collision athlete with a dislocated shoulder has a 90 percent chance of re-dislocating his shoulder upon return to play football. If that shoulder is stabilized surgically, there is a 90 percent chance of not having a re-dislocation.
Unfortunately, some parents want their teen to keep playing, and they obtain a brace from another doctor. Sadly, just like with ACL injuries, I have seen many collision athletes sustain a second shoulder dislocation upon return to play. With subsequent shoulder dislocations, the athlete damages more cartilage and is destined to develop shoulder arthritis at a young age.
I recommend that parents ask the sports doctor many questions when their child is injured. Most importantly, ask yourself if the sports doctor is taking into account the potential lifelong consequences of your child’s ill-advised early return to play.