Joint Preservation Blog

January 6, 2009

recooperation from shoulder surgery

Typical shoulder surgery recovery.

Typical shoulder surgery recovery.

As a doctor, recooperation from shoulder surgery can be tough. The problem is that the severe degree of immobilization that’s needed (that big blue pillow) makes that arm/hand useless. Is there a better way? Well, if you have a rotator cuff tear, newer and much less invasive methods of treatment may be the answer, as with less trauma from the procedure comes quicker recovery times (read no blue pillow). How can this be possible? Trade the scapel for a needle. Rather than trying to sew ligaments back together or sewing a torn rotator cuff tendon, get stem cells to repair the damge. The doctor simply places the cells in the damaged area with an injection. Little trauma, little recovery. Sounds like science fiction? Not really, as this procedure using your own stem cells to repair the damage is now being used reduce recooperation times. No surgery, less recovery. To learn more, click the video below:

December 24, 2008

Sports Ankle Brace

Several years ago I injured my ankle while running. It didn’t completely heal, so as a physician, I set out to find the perfect sports ankle brace. My first stop was the then famous “air cast”. This was a great way to stop the circulation in my ankle, but did little to help the pain and swelling. The next sports ankle brace I tried was the old fashioned lace-up models. They were a nightmare to get on and off, but did supply some stability. After trying 10-12 braces, I finally settled on something that worked, the Bauerfeind Malleoloc.  This was an easy sports ankle brace to get on and off and actually provided some stability. Alas, after walking around with this thing for years, I finally decided to get the ligaments fixed using prolotherapy. This worked reasonably well and took a few injections. Today there are even newer ways to fix these ligaments with the injection of stem cells. The video below will provide more information:

December 15, 2008

torn shoulder ligaments cures

There are many ligaments that help to support the shoulder.  The shoulder ligaments are the duct tape that hold the bones together.  These include the coraco-acromial ligaments (the duct tape that holds the collar bone to the front of the shoulder blade).  Other ligaments include the joint capsule of the AC joint (duct tape that holds the AC joint together) and the shoulder joint capsule (the duct tape that holds the shoulder ball in the socket).  An injury that stretches these ligaments can cause instability, meaning that the duct tape can be stretched an lose it’s ability to hold these shoulder bones together as they move and as you use the shoulder.  This can cause many problems, including early arthritis and pain.  Torn shoulder ligament cures have traditionally been surgical.  However, newer non-surgical torn shoulder ligament cures are now available. 

Surgery for this area usually means sewing the torn ligament together or back to it’s attachment to the bone.  While for a complete tear of one of these ligaments this may the only way to get the two ends back together, for partial tears, this is an older method of repair that may have more problems than benefits.  For example, sewing a partially torn ligament often over tightens the ligament.  In addition, this surgical approach carries more risk of infection.  Newer treatments are all injection based.  This means that stem cells can be injected into the ligament to help it mend, rather than needing surgery.  The newer stem cell based treatments (links above) also mean much less down-time and immobilization for the patient. 

As an example, a patient with an AC joint injury often has chronic and painful popping and cracking in this joint between the front of the should blade and the collar bone.  The shoulder muscles underneath can become sore.  The surgical option is to sew a cadaver ligament or synthetic material around the injured ligaments to try and stabilize the joint.  However, there is huge down-time, with the patient being unable to use the area for months.  In addition, over tightening is common, and this leads to more arthritis.  The newer technique of injecting stem cells into the ligament requires no or little down-time and likely results in a more physiologic repair (without the over tightening) because the goal with this procedure is to get the ligament to heal back to it’s pre-injured state (or as close to it as possible).

August 28, 2008

Shoulder Surgery Recovery

As a doctor, because we use our upper extremities for everything, shoulder surgery recovery can be very difficult. Have you seen someone walking around in a sling with a big blue pillow between their arm and chest? Shoulder joint replacement surgery is notorious for a long, painful recovery. Rotator cuff surgery is also a very long and tough recovery, mostly because the stitches placed into the tendon must be kept immobile while the tear heals. So why all this suffering? Is there a better way? This post will explore if shoulder surgery recover from a rotator cuff tear can be shortened and if there is an alternative to shoulder joint replacement surgery.

The rotator cuff is simply a group of muscles that help to stabilize the shoulder. Think of them as the muscles that help keep the ball of the shoulder in it’s shallow joint while allowing for maximum alignment and mobility. When one of these muscles and/or their tendons (like the supraspinatus) gets torn, it’s a big problem. Patients often can’t lift their arm and have pain with any movement. This can be diagnosed on an MRI. If the tear is small, then sometimes it’ll heal on it’s own with therapy. However, many partial and complete tears fail to heal. When this happens, the traditional treatment is simply sewing up the tear and immobilizing the area. This is where the recovery problems begin. Immobilizing the shoulder is tough. Hence the crazy blue pillow shown below:

Typical shoulder surgery recovery.

Typical shoulder surgery recovery.

What happens when you immobilize the muscle for this long? Regrettably, it often causes to atrophy. This means the muscle starts to die off and this atrophy is associated with a poor outcome. How can you get around this atrophy? How about skipping the immobilization? Can you do this? Yes, the Regenexx procedure allows patients with partial rotator cuff tears to shorten their shoulder surgery recovery. Why, because it starts by skipping the surgery step. In this breakthrough procedure, your adult stem cells are injected into the rotator cuff tear under fluoroscopy (real time x-ray). Less trauma to fix the tear means less recovery. In addition, unlike simply sewing the tear and hoping for the best, the joint preservation team at The Center for Regenerative Medicine at the Centeno-Schultz Clinic places repair cells in the tear.

Shoulder Surgery Recovery

Shoulder Surgery Recovery

Check out the MRI pics above. Stem cells placed into the tear helped the tear heal without surgery. So if you want to avoid a lengthy recover with a crazy blue pillow, trade the surgery for a needle!

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