Orthopedic surgery can be applied in situations where non-surgical treatments have failed to provide relief from pain or address the underlying condition.

While every patient’s situation is unique, there are some common reasons that orthopedic surgery may be called for:

Severe Trauma or Injury

In cases of severe trauma or injury to the musculoskeletal system, orthopedic surgery may be necessary. These conditions include:

• Fractures that cannot be effectively treated with casting or immobilization alone
• Dislocations
• Severe ligament or tendon tears
• Complex joint injurie

Surgery is performed to realign bones, repair damaged tissues and restore stability and function.

Chronic Pain and Degenerative Conditions

Chronic pain that is caused by degenerative conditions like osteoarthritis, rheumatoid arthritis or spinal disc herniation may require orthopedic surgery after the gauntlet of non-surgical options have been exhausted.

Joint replacement surgeries such as hip or knee replacements can provide significant pain relief and improve mobility for individuals with severe joint damage.

Sports Injuries

Athletes who sustain sports injuries such as torn ligaments (ACL, MCL), meniscus tears or cartilage damage can benefit from orthopedic surgery. Depending on the severity and location of the injury, arthroscopic procedures or reconstructive surgeries may be utilized.

These surgeries intend to restore function, stability and range of motion, allowing athletes to get back in the game.

Congenital or Developmental Abnormalities

Orthopedic surgery may be in order for individuals who suffer from congenital or developmental abnormalities of the musculoskeletal system. These conditions can include scoliosis, hip dysplasia, or limb length discrepancies. Orthopedic surgery can:

• Correct deformities
• Improve function
• Prevent long-term complications

Such surgeries are typically performed on children or adolescents to optimize healthy growth and development.

Infection or Tumor

Orthopedic surgery may be necessary to treat infections or tumors that affect the musculoskeletal system.

Surgeries such as debridement (removal of infected tissues), bone grafting or tumor excision are ways to eliminate infections or remove cancerous or benign tumors. These procedures are essential for:

• Preventing the continuing spread of infection
• Preserving limb function
• Avoiding further potential malignancies

Considerations for Undergoing Surgery

The decision to undergo orthopedic surgery is made on a case-by-case basis, taking into consideration such factors such as the patient’s overall health, lifestyle, and goals.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, at the Orthopedic Performance Institute will work closely with you to assess your condition, explore more conservative treatment options, and determine whether surgery is the most appropriate course of action.

Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for more information or to schedule an examination.

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Sports medicine focuses on the prevention, diagnosis and treatment of musculoskeletal conditions involving the bones, muscles, tendons, ligaments, and joints. You don’t have to be a marathon runner to suffer from such injuries. Stress from repetitive use or even an injury caused by a fall can be treated by a sports medicine professional.

There are two basic categories of injuries treated in sports medicine care. The first involves acute injury and the second involves damage caused by wear and tear and disorders such as arthritis that tend to develop gradually.

Sports medicine professionals can help patients with these symptoms:

• Joint and muscle pain
• Bone fractures
• Foot pain
• Ankle injury
• Overuse injury
• Joint dislocation
• Muscle fatigue
• Sudden, non-emergency injuries

Getting Back Into the Game

The Orthopedic Performance Institute’s Dr. Alexandra Matthews specializes in non-surgical treatment of these injuries, which helps to get patients “back into play” quickly and with less trauma. This is accomplished by utilizing techniques such as platelet-rich plasma (PRP) injections, in which the patient’s own blood is utilized to speed up the healing process. There are also nerve block injections that can block the pain for up to 90 days.

Diagnostic ultrasound is another way the doctor can identify the injury and begin treatment quickly. The Orthopedic Performance Institute utilizes the most modern techniques.

If it is determined that a patient’s condition requires surgery, Dr. Matthews can refer them to an orthopedic surgeon whose knowledge and experience is appropriate to treat the condition.

Avoiding Injury

She also counsels patients on injury avoidance. This is accomplished by instructing them how to train correctly and wear the appropriate gear and footwear. Good nutrition plays an important part, too, as it’s vital to keep bones and muscles strong. Patients aged six years and up are welcome.

Don’t keep living with unnecessary pain. Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for an appointment today.

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Anatomy of the knee 

The knee is a marvel of design. Special ligaments are designed to protect it from injury and to keep it stable.

The femur (thigh bone), tibia (shinbone) and patella (kneecap) all comprise the knee joint. They’re connected to each other by four main ligaments that hold them together to keep the knee stable. The main ligaments are:

Collateral ligaments. Found on the side of the knee, the medial collateral ligament (LCL) protects the knee from unusual motion.

Cruciate ligaments. Found on the inside of the knee joint, they consist of the anterior cruciate ligament (ACL) in the front and the posterior cruciate ligament (PCL) in the back. These ligaments cross over to form an “X” to control the front and back motion of the knee.

The ACL prevents the knee from sliding in front of the femur and keeps the knee stable. The PCL keeps the shinbone from sliding back too far. Stronger than the ACL, it is injured less frequently.

Injuries can still happen, however — and one of the most frequently occurring is damage to the ACL.

Who Is at risk for ACL injuries?

Those who participate in high-impact sports such as soccer, football and basketball are most likely to injure their ACL. Depending on the severity of the injury, surgery may be required to get restored to full function.

When an ACL injury happens, damage to other structures can also occur, including articular cartilage, meniscus and other ligaments. These injuries are measured on a scale of severity.

Grade 1 sprains. Here, the ligament is mildly damaged, but it is still able to keep the knee stable.

Grade 2 sprains. Here, the ligament is stretched to the point where it becomes loose and is partially torn. This can be accompanied by a feeling of instability.

Grade 3 sprains. The ligament is completely torn and/or pulled off the bone, and the knee joint is rendered unstable.

Most ACL injuries involve complete tearing of the anterior cruciate ligament. Partial tears are rare.

What causes ACL injury?

• A sudden change in direction
• Stopping abruptly
• Decreasing speed while running
• Landing incorrectly (i.e., from a jump)
• Collision with another athlete (i.e., during a football tackle)

It has been reported that ACL injuries occur more frequently in female athletes than in males, possibly because of differences in physical condition and muscular strength.

What does an ACL injury feel like?

A popping noise, followed by a feeling that your knee is going to give out, is a most common symptom. Your knee will begin to swell within 24 hours. If you attempt to continue intense physical activity, you are in danger of making the injury even worse.

When is surgery required?

Your physician will be able to make the determination, but young athletes who regularly participate in intense sports are the most likely. Surgery may not be required for older athletes who participate in fewer such activities.

What do I do when I’m injured?

See your physician. You’ll be asked about what you were doing when the injury occurred. X-rays and MRIs may be performed so your doctor can see the extent of the injury. You may be referred to an orthopedic surgeon for further treatment.

Fortunately, there are now several advancements in treatment available that offer surgical and non-surgical solutions to ACL injuries. OPI’s physicians will determine the best course of action for you.

Trust the professionals at OPI

At the Orthopedic Performance Institute, our physicians are experts in the diagnosis and treatment of ACLs. They will be able to diagnose the severity of the injury, and whether or not you need surgery.

Dr. Alexandra Matthews, OPI’s sports medicine specialist, says: “Don’t ignore the pain or try to fight through it. Have a professional examine the injury as soon as possible.”

Let the Orthopedic Performance Institute help you to get back in the game! Contact them in San Antonio or Boerne at (210) 545-7171.

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Do you suffer from osteoarthritis pain in your knee? The Orthopedic Performance Institute has a treatment for you. We’re one of the few practices in the San Antonio area that offer iovera°. It’s safe, FDA-approved and performed right here in our office.

Do you have a knee replacement surgery scheduled? iovera° can also be used prior to your surgery to help relieve pain and make recovery easier. Patients who received iovera° as part of their recovery plan reported:

• Greater range of motion
• Less difficulty straightening their bent knee
• Less difficulty bending their straight knee

Additionally, studies have shown that iovera° can help reduce opioid use after knee replacement surgery. 68% less opioids were needed during the hospital stay and 45% less opioid medication was needed 12 weeks after surgery. Patients continued to have reduced stiffness at 30 days and improved ability to complete routine tasks at 90 days.

How does it work?

iovera° uses extreme cold to stop nerves from sending pain signals to your brain. Relief is felt immediately and can last up to 90 days.

The iovera° system is a handheld device that lets Dr. Matthews, our sports medicine specialist, apply just the right amount of extreme cold only to the nerves that needs to be targeted — the ones causing you pain. This process delivers immediate pain relief in the time it takes for a routine doctor’s visit, and it doesn’t hurt. iovera° does not contain medicine. It’s also safe and does not damage or destroy any surrounding tissue.

What does the procedure involve?

A numbing agent (topical or injected) is applied to minimize discomfort during treatment. iovera° treatment is not painful. Then, a small probe (called a “Smart Tip”) is inserted into the skin. Under the skin, a precise cold zone forms, which temporarily freezes the targeted nerve. Dr. Matthews will repeat this process until the targeted nerve is blocked. The entire treatment takes about 15 to 30 minutes.

How should I prepare?

It’s easy to prepare for the iovera° treatment. Wear loose-fitting, comfortable clothing that allows for easy access to the knee area (shorts are a good option).

Dr. Matthews will go over your medical history with you, including:

• Any daily medicines you take (e.g., blood thinners, pain medicine)
• Health history and health conditions you have now and/or have had in the past
• Any previous surgery, treatment, or trauma
• Any previous medical diagnosis regarding the treatment area
• If you have a history of keloid (a raised scar after an injury has healed) formation
• If you have a history of reactions to local anesthetics
• If you have a history of sensitivity to pain or cold
• Any open or infected wounds in the treatment area
• If you regularly use anticoagulants such as fish oil, Coumadin, aspirin, or NSAIDS [nonsteroidal anti-inflammatory drugs, such as ibuprofen]

On the day of the procedure, we will assess your pain, clean and mark the treatment area, and numb it prior to the procedure. Wear loose-fitting, comfortable clothing that allows for easy access to the knee area (shorts are a good option).

Are you seeking relief from knee pain and stiffness? Contact the Orthopedic Performance Institute in San Antonio for a consultation with Dr. Matthews about iovera°.

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A stress fracture occurs when muscles are fatigued and unable to protect bones from the exertion of sports or exercise. This results in tiny cracks in the bone. Bones that are weight-bearing, such as those in the foot and lower leg, are especially at risk for stress fractures.

What causes a stress fracture?

Typically, stress fractures are caused by engaging in activities too intensely or quickly. Other factors include surfaces a player isn’t used to; incorrect equipment (such as worn-out shoes); and playing too long and too vigorously.

What areas of the body are affected by stress fractures?

Predominantly in bones responsible for bearing weight. Those include the lower leg and the foot.

Who’s most likely to get stress fractures?

Athletes who participate in sports that involve a jot of running and jumping, such as track, tennis and basketball are susceptible to stress fractures. The activity of feet frequently striking the ground can cause them. Overuse is also a culprit.

Do women get more stress fractures than men?

It seems so. This is referred to by some orthopedic surgeons and sports medicine professionals as “the female athlete triad,” which is comprised of eating disorders (such as anorexia), an infrequent menstrual cycle and osteoporosis, all of which reduce bone mass and can lead to stress fractures.

How do I know when I have a stress fracture?

Pain! That’s the first signal. Resting the injury is the best thing you can do.

How are stress fractures identified?

X-rays are utilized. Sometimes, they won’t show up on regular X-rays, so a computed topography (CT) scan may be called for.

How are they treated?

Rest, above all. Avoid going back to the activity that caused the stress factor in the first place for six to eight weeks. If you resume the activity too quickly, it can result in larger, harder to heal fractures. Wore, it can become chronic and never heal properly.

How to prevent stress fractures

The American Academy of Orthopaedic Surgeons put together some guidelines.

• When starting a new sports activity, set incremental goals. As an example, if you begin running, build up your mileage on a weekly basis.
• Alternating activities that accomplish the same fitness goals can help to prevent stress fractures. Instead of running every day to meet cardiovascular goals, run on even days and bike on odd days. Also add strength training and flexibility exercises to the mix for the best results.
• Eat a healthy diet. Incorporate calcium and Vitamin D-rich foods in your meals.
• Use the correct equipment. Do not wear old or worn-out running shoes.
• If you suffer from pain or swelling, immediately stop the activity and rest for a few days. If continued pain persists, contact us at (210) 545-7171.

“If you have any concerns, an X-ray and office visit is a great place to start,” says Dr. Alexandra Matthews, Sports Medicine Specialist. “We can also discuss work out routines and safely increasing duration and intensity of exercise to prevent stress fractures.”

The post All About Stress Fractures appeared first on Orthopedic Performance.

At the Orthopedic Performance Institute, we’re dedicated to providing our patients with access to the latest and most advanced technology, and that includes imaging. That’s why we proudly offer C-arm fluoroscopy for joint injections.

Similar to an X-ray, fluoroscopy is an imaging technique that uses a continuous X-ray beam. Due to the benefit of real-time imaging, fluoroscopy is a useful tool to ensure joint injections are administered in the most precise and safe way possible—eliminating risks and possible negative results sometimes associated with joint injections.

Dr. Alexandra Matthews

What types of fluoroscopic guided injections are offered?

Intra-articular Steroid Injections
Pain and inflammation caused by osteoarthritis can be significantly reduced by Intraarticular Hip Injections. Patients with a good amount of fluid remaining in the joint usually respond well to Intraarticular Hip Injections. Corticosteroid injections guided directly into the arthritic joint space can relieve pain by reducing inflammation in the tendons and ligaments. Typically, one shot will last for several weeks or months but some people report long-term symptom reduction which remains for to 6 months or longer.

PRP (Platelet-Rich Plasma) Therapy Injections
Platelet-rich plasma therapy, sometimes called PRP therapy or autologous conditioned plasma (ACP) therapy, attempts to take advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, or even bone.

Stem Cell
Stem cell therapy promotes the reparative response of diseased, dysfunctional or injured tissue using stem cells. This procedure is less invasive than surgery and has the potential to speed up and augment repair.

The post Fluoroscopic Guided Injections — Providing Relief with Accuracy appeared first on Orthopedic Performance.

Reasons to exercise

Just like muscle, bone is made of living tissue that responds to exercise by becoming stronger. Young women and men who exercise regularly generally achieve greater peak bone mass (maximum bone density and strength) than those who do not. For most people, bone mass peaks during the third decade of life. After that time, we can begin to lose bone.

Women and men over the age of 20 can help prevent bone loss with regular exercise. Exercising can also help maintain muscle strength, coordination and balance, which in turn helps to prevent falls and related fractures. This is key for older adults and people who have been diagnosed with osteoporosis.

The best bone-building exercises

Weight-bearing and resistance exercises are the best for your bones, as they force you to work against gravity. These include walking, hiking, jogging, climbing stairs, playing tennis and dancing. Resistance exercises such as lifting weights can also help to strengthen bones.

Exercise tips

If you have health conditions such as heart trouble, high blood pressure, diabetes or obesity — or if you are age 40 or older, check with your doctor before you begin a regular exercise program.

According to the Surgeon General, the optimal goal is at least 30 minutes of physical activity on most days, preferably daily.

“When you begin an exercise routine, it’s common to have some muscle soreness and discomfort at the beginning,” says the Orthopedic Performance Institute’s Dr. Alexandra Matthews. “But if it’s painful and lasts more than 48 hours, you maybe working too hard or doing it wrong.”

Definitely stop exercising if you feel any chest pain or discomfort, and see your doctor before you start again.

Exercising with osteoporosis

If you have osteoporosis, ask your doctor which activities are safe for you. If you have low bone mass, experts recommend that you protect your spine by avoiding exercises or activities that flex, bend or twist it. You should avoid high-impact exercise to lower the risk of breaking a bone.

You also might want to consult with an exercise specialist to learn the proper progression of activity, how to stretch and strengthen muscles safely, and how to correct poor posture habits. An exercise specialist should have a degree in exercise physiology, physical education, physical therapy or a similar specialty. Be sure to ask if he or she is familiar with the special needs of people with osteoporosis.

Exercise is only one aspect of a complete osteoporosis prevention or treatment program, along with a diet rich in calcium and vitamin D. But proper exercise and diet may not be enough to stop bone loss caused by medical conditions, menopause or lifestyle choices such as tobacco use and excessive alcohol consumption.

It is important to speak with your doctor about your bone health. Discuss whether you should take a bone mineral density test. If you are diagnosed with low bone mass, ask what medications might help keep your bones strong.

If you’re planning on starting an exercise regimen for bone health, make an appointment with Dr. Alexandra Matthews, Sports Medicine specialist for the Orthopedic Performance Institute.

The post Exercise for Good Bone Health appeared first on Orthopedic Performance.

Who would benefit?

Who wouldn’t benefit? Athletes — runners, triathletes, or basketball, volleyball, and soccer players will benefit. This also includes adults who are thinking about jogging for exercise and want to prevent injury, or adults who are already running and continue to feel aches and pains. Beginner, intermediate or professional athletes — anyone can benefit from running technique improvement.

Running gait analysis includes inspecting:

Feet

• anatomy
• arch analysis
• shoe choice
• weight distribution

Knees

• Alignment

Hips

• anterior hip flexibility

Upper extremity

• alignment
• arm movement during stride

Overall

• flexibility
• training schedule
• diet
• breathing
• cadence
• posture

Why do I need a gait analysis?

The average runner takes 160-170 steps PER MINUTE of running. That’s approximately 10,000 steps an hour!

Gait analysis can lead to proper alignment and distribution of weight — which can prevent injuries to the muscles (think tendonitis), bones (stress fractures) and joints (meniscus injuries). In addition, analysis can make a runner more efficient — able to run longer distances using the same amount of energy.

What do I need to bring?

Running clothes, your running shoes, and you!

Dr. Alexandra Matthews, OPI’s Sports Medicine Specialist, will methodically perform your running gait analysis and provide you with the information you need to reach your peak performance. Contact us for an appointment today!

The post What Is Gait Analysis? appeared first on Orthopedic Performance.

Every step you take involves a remarkably intricate network of bones, muscles, tendons and ligaments. That complexity — combined with all the weight they carry — accounts for why feet can be so prone to problems, including bone fractures, arthritis and plantar fasciitis.

Potential Foot Problems

If left untreated, foot problems can worsen. Eventually, the pain can interfere with your ability to do even the most basic things, such as walking up stairs or down the street. If pain alters the way you walk, it can radiate to your knees, hips and back. These problems can multiply, limiting your activity and affecting your quality of life.

Several things can contribute to foot pain or numbness. Sports and physical activity can cause your feet to hurt or become numb. Going too far, too fast, or not warming up properly before exercise can increase your chances of painful or numbing injuries.

Excess weight puts extra stress on your feet. Poorly fitting shoes and other footwear are also common causes of foot problems.

Health disorders can also affect the feet. Lack of feeling in your feet could be a sign of a serious illness, such as diabetes, or a nerve disorder. See your doctor if you have unusual numbness in your feet or foot pain that is severe, comes on suddenly, or doesn’t improve with simple treatments such as rest or over-the-counter pain medications.

“Foot pain, even minor pain, can be nagging and effect every aspect of life, since you use your feet to walk!” says Dr. Alexandra Matthews, Sports Medicine Specialist with the Orthopedic Performance Institute. “There are some very conservative measures, like arch supports, correct toe spacing, correct show wear, to keep feet happy as and healthy, as well as more aggressive treatments that we use when appropriate.”

Keeping Your Feet Healthy

There are several ways to keep your feet healthy: Wear comfortable, well-fitting shoes. Wash your feet regularly (especially between your toes), wear clean socks, and try to rotate your shoes to give them time to air out.

The more you exercise your feet, the better the blood flow to them, which is essential for overall foot health. Walking is a great way to exercise your feet.

You can also try these foot exercises:

Sit down and rotate your ankles in one direction, then the other. In bare feet, sit in a chair and curl your toes, then spread them out. This helps stretch and strengthen your feet and maintain balance.

If you’re feeling any of the foot symptoms described here, an appointment with your doctor or an orthopedic specialist may be needed. The Orthopedic Performance Institute is here to help. We’re dedicated to helping you stay on your feet for life.

The post Facts About Your Feet appeared first on Orthopedic Performance.

Rheumatoid arthritis is a disease that affects your joints. It causes pain, swelling and stiffness. If joints on one side of your body have rheumatoid arthritis, usually the joints on the other side do too. It can affect any joint in the body. Rheumatoid arthritis can also make you feel sick and tired, and sometimes get fevers.

What’s the difference between rheumatoid arthritis and osteoarthritis (OA)?

RA is an autoimmune disorder that produces inflammatory joint symptoms throughout the body. OA is a degenerative condition that is the result of increased wear and tear on joints. OA may produce inflammatory symptoms as well, but it primarily destroys joint cartilage over time.

Both RA and OA are more prevalent in women than in men. RA can develop in patients aged 30 to 60 at any time. OA generally develops later in life. Courses of treatment can also vary.

What are the symptoms of rheumatoid arthritis?

Symptoms can range from mild to severe, including:

• Tender, warm and swollen joints
• Swollen joints on both sides of the body, such as your hands and wrists
• Swelling in other joints, including the neck, shoulders, elbows, hip, knees, ankles and feet
• A feeling of weariness and low energy
• Fever
• Pain and stillness lasting more than 30 minutes in the morning
• Symptoms that go on for years

What causes RA?

Doctors don’t know the exact cause, but they have identified several factors, The immune system normally attacks invaders to the body, such as a cold virus or bacteria, but with this type of arthritis, a person’s immune system attacks his or her own body tissues. Researchers are learning many things about why and how this happens.

Other causes of RA may include:

• Inherited genes
• Environmental factors
• Hormones

Is there a test for RA?

There is no single specific test. It can be difficult to diagnose because the symptoms are often the same as other kinds of joint disease and can take time to fully develop. Doctors use medical history, a physical exam, x-rays, imaging tests and lab tests to make a diagnosis.

How is RA treated?

Fortunately, physicians have many ways to treat the disease, including medications, surgery, regular check-ups and complementary therapies.

Most people with RA take medications to relieve pain, reduce swelling and to stop the disease from getting worse. What a doctor prescribes depends on:

• Your general healh
• How serious the disease is
• How serious it will become
• How long you will take the drug and how well it will work
• Possible side-effects

Depending upon the severity of the disease, surgery may be recommended. It can help to:

• Reduce pain
• Help your joint work more effectively
• Help you to resume your daily activities

Regular medical check-ups are essential in order for your doctor to:

• See if the disease is worsening
• Monitor the effectiveness of the medications
• Check for adverse side-effects
• Change treatment as necessary

Complementary therapies include special diets, vitamins and behavioral changes such as weight loss and joint care.

“Here are OPI we use a multi-disciplinary team approach to treating rheumatoid arthritis,” says Dr. Alexandra S. Matthews. “Often we work with rheumatologists, physical therapists and other health care providers to ensure maximal improvement in pain and quality of life.”

If you have any of the symptoms described above, contact Orthopedic Performance Institute today.

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