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Exercise helps defer age-related injuries, but should they occur New Orleans’ orthopaedic surgeons are there for you

Who’s treating the chronic aches and pains of many patients in New Orleans? A whole fixer1new class of orthopaedic surgeons whose state-of-the-art facilities and great hands are raising awareness on how to make the best health-care decisions when dealing with orthopaedic concerns.

This issue of New Orleans Living is devoted to keeping “you out there.” Our bones, joints and nerves take a beating every day, and our goal is to highlight the achievements of some of the area’s best orthopaedic surgeons and hospitals to keep you doing the things you love!

We believe strongly in staying active while allowing you to be in control of your own health-care choices. As we get older, our bodies begin to show signs of aging, both inside and out. Unfortunately, when it’s on the inside, we cannot see the damage, but there are signs. In this issue, these signs are addressed in a way that will inform and assist you in adding years to your life and enhancing the quality of life as you age.

It’s all part of our commitment to sharing healthy tips that are preventive in nature, so you can enhance your life and spend more time with those you love.

So if the spring in your step is not quite as light, you feel a little more sore for a little longer after a hard workout or your muscles aren’t quite as firm and toned as they used to be, then it may be time for a reality check.

If you are between the ages of 30 and 55, your body may be reminding you that you’re not twentysomething anymore, but that doesn’t mean you have to stop putting on your favorite dancing shoes. In fact, we think you should tango into your senior years.

The Bare Bonesfixer2

Once we hit our 30s, bone mass slowly starts to decrease, and in our 40s and 50s, permanent bone loss is occurring.

Weight-bearing exercises such as walking, weight-lifting, dancing, jogging and tennis signal our bodies to make more bone and to make it stronger. Stronger bones enable us to avoid osteoporosis, and, simply put, helps us avoid fractures from falls as we age.

Genetics aside, an active lifestyle and a healthy body weight are two things that also can help prevent arthritis, which can cause painful swelling of the joints.

Muscle Up

Though toned muscles are undoubtedly sexy, keep in mind that they also burn more calories, which helps keep us trim. Consider a weight-lifting program using lighter weights and more repetitions to build muscle without looking like a body builder. Stronger muscles, ligaments and tendons are more flexible and help your body absorb stress to fend off injuries.

Long-term regular exercises may slow the loss of muscle mass and prevent age-associated increases in weight. The American Academy of Orthopaedic Surgeons (AAOS) claims that an exercise program doesn’t have to be strenuous to be effective.

If you’re starting a new exercise regimen, consult your doctor first. Take things slowly. Begin and end with gentle stretching and be alert if your body signals that you’re overdoing it. You may experience a few aches and pains initially, but these should subside in a reasonable time frame. If the pain is sudden, severe or doesn’t stop after a few days of rest, talk to your doctor.

Knee and Hip Arthritis
As many as 36 million people in the U.S. have some form of arthritis. The most common forms are osteoarthritis (generally associated with aging) and rheumatoid arthritis (commonly referred to as crippling arthritis). Arthritis in its many forms may result in severe crippling, with pain and impaired joint mobility and function.

Treatment varies depending upon the severity of the disease. Initially the doctor may advise medication. Over the past several years there has been significant improvement in the medicines available. Other measures may on occasion be helpful, such as physical therapy and braces or splints. Injections of a cortisone-type drug into a painful joint frequently prove helpful. Newer forms of medications for injection into arthritic knee joints offer some promise.

Joint Replacement and Surgery in Arthritis
Patients with severe joint pain and impairment may be candidates for joint replacement surgery. These procedures, in a large percentage of cases, provide marked relief of pain and improvement in the patient’s ability to carry out the activities of daily living.

Refinements in technique and technology have made these procedures especially beneficial to those patients with severely damaged hips, knees or shoulders. In selected cases, the elbow may be successfully replaced. The surgery basically consists of implanting components made of metal and high-molecular-weight polyethylene, which conform to the joint involved.

If you are considering joint replacement surgery, you are not alone. Annually, 500,000 Americans make the decision to end their chronic joint pain by undergoing joint replacement surgery and are back enjoying their life and mobility.

The Touro Difference
The Gulf South Joint Replacement Center offers a unique program that includes the most recent arthroscopic, minimally invasive surgical procedures designed to return patients to an active lifestyle as quickly as possible. Each step of the program is carefully choreographed to give the best possible results.

Touro offers a variety of amenities to patients, including private, hotel-style rooms with panoramic views of the city, comfortable chairs that can be converted into beds, plasma television and even monogrammed bath robes. The unit incorporates a unique wellness-based approach to hip and knee replacements. This comprehensive program includes pre- and postoperative therapy in addition to surgery, as well as one-on-one assistance throughout the treatment process. Additionally, patients go through the program with other patients, creating an atmosphere of peer support and constant motivation.

Recent technological advances, minimally invasive surgical techniques and improved pain management have made joint replacement procedures safer, more precise and less painful than ever. Through the use of computer-assisted orthopaedic surgery (CAOS), Touro surgeons are able to map out the contours of a patient’s knee during surgery and create 3-D computer models. By using the model and the sensing equipment, the surgeon knows exactly where to make an incision and how to make it more precisely than with standard techniques.

For more information or to schedule a private tour, call 504-897-7103 or visit www.touro.com/jrc.

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The Spine
Spinal Stenosis
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Patients with pain in the legs, inability to walk distances, inability to stand erect or progressive weakness in the legs may be suffering from spinal stenosis. Spinal stenosis most commonly occurs as a result of degenerative changes in the spine. As a result of bone spurs, the area available for the spinal nerves to the lower extremities is decreased. This causes ischemic changes in those nerves when a person is in the upright or walking position.

Although spinal stenosis may occur as early as 40 years old, it has increasing incidence with age and is most common in the elderly population.

Decompression of the spinal canal through surgical means has very good results, alleviating the pain in up to 90 percent of the patients and usually greatly improving the patient’s walking ability and lifestyle.

Ochsner Spine Services
Ochsner Spine Services combines the skill and expertise of both orthopaedic spine surgeons and neurosurgeons to provide exceptional treatment for all spinal disorders in patients of all ages, from newborns to adults.

Ochsner Spine Center physicians offer treatments for the following spinal conditions:
• Neck, back, arm, and leg pain
• Extremity numbness or weakness
• Herniated disks and nerve root compression
• Spinal stenosis
• Degenerative spinal osteoarthritis and degenerative disc disease
• Acute and sub-acute spine injuries requiring stabilization and / or decompression of the spinal column
• Adult degenerative scoliosis and sagittal plane imbalance
• Congenital abnormalities of the spine
• Infantile, juvenile, and adolescent idiopathic scoliosis
• Minimally invasive scoliosis surgery
• Adult and pediatric kyphosis
• Spondylolisthesis and spondylolysis
• Acquired spine deformity resulting from diseases such as cerebral palsy, muscular dystrophy, neurofibromatosis, and Marfan’s syndrome
• Rheumatoid arthritis and ankylosing spondylitis
• Pathologic fractures including vertebral compression fractures
• Tumors of the spinal column
• Infections of the spine including tuberculosis
• Previous unsuccessful spine surgery
• Chiari I malformations and syringomyelia
• Cysts and vascular malformations of the spinal cord
• Peripheral nerve and brachial plexus injuries and tumor

Ochsner surgeons currently utilize cutting-edge technology in the treatment of these spinal disorders. In additional to traditional techniques, the Ochsner surgeons have expertise in minimally invasive surgery and motion preservation surgery, including total disk arthroplasty.

Please call Ochsner Spine Services if you have any questions or would like to schedule an appointment with any of our physicians: 504-842-2000.

Hand & Elbow
Services can range from relieving compressed nerves, such as carpal and cubital tunnel syndrome; reconstructing degenerative joints; reconstructing upper extremities deformed by rheumatoid arthritis; restoring function to those victims to strokes, brain injury and cerebral palsy; creating digits from toes; transplanting tissues to cover wounds; reattaching severed digits and limbs; repairing and reconstructing nerves, arteries, tendons and ligaments in the upper extremity; reconstructing congenital birth defects; fixer4reconstructing traumatized extremities, both acute and months to years after the injury; helping with sports injuries, like golfer’s and tennis elbow.

Carpal tunnel syndrome
There are many causes of carpal tunnel syndrome. The end result is that of compression of the median nerve, a major nerve of the hand and forearm at the wrist. Typical symptoms include weakness, aching pain, numbness and tingling in the fingers. Initially treatment consists of splinting, activity modification and, occasionally, medication. Injections are an option as well. Diagnosis can be made with a thorough examination of the neck, shoulder, arm and hand. Electrical studies are often helpful. Surgical correction often provides good results with a return to work usually by six weeks.

Source: American Academy of Orthopaedic Surgeons

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The Shoulder
We generally don’t pay much attention to our shoulders or their function. In fact, we take them for granted. We may take notice when a shoulder injury affects our hometown professional quarterback or pitcher, but it’s not just elite athletes who suffer rotator cuff tears, arthritis or other painful shoulder conditions. These debilitating conditions can affect everyone: younger and older patients, elite athletes and even the weekend warrior. But you do not have to live with shoulder pain.maki

Dr. Neil Maki of Thibodaux Orthopaedic and Sports Medicine Clinic answers some of your questions regarding rotator cuff tears.

What is the rotator cuff and what does it do?
The rotator cuff (RC) is a group of tendons which come together to insert on the upper or proximal humerus (arm) from four muscles (teres minor, infraspinatus, supraspinatus and subscapularis). These muscles take origin from the shoulder blade (scapula) and function to rotate the arm. They also stabilize the head of the humerus into the socket (glenoid) to allow the powerful deltoid muscle to elevate the arm overhead.

What causes a rotator cuff tear?
The main cause of RC tearing is aging and the degenerative process of wear and tear. RC tears are much more common as patients get older. Injury may be a also be a cause of RC tears. Generally these tears require surgery. Impingement by bony spurs compressing the RC is another cause of RC tears and this impingement often requires surgery to remove the spurs.

How would I know if I have one?
Night pain of the shoulder is the most common complaint of patients with RC tears. Pain with overhead activity and weakness is also often present too.

If I have a painful rotator cuff and keep using it, will this cause further damage?
Generally yes. It is important not to work through a painful shoulder. Rest, medications, and special rehab exercises may be used at this time.

When should I see a doctor for a rotator cuff tear?
See the doctor if shoulder pain or weakness persists despite a period of rest.

Can a rotator cuff tear be healed or strengthened without surgery? At what point does a rotator cuff tear require surgery to fix it?

Surgery is generally recommended if pain and/or weakness persists despite rest medications and therapy. In younger patients, if the RC tear is due to injury, surgery is generally recommended early.

What options are available for surgical repair?
Both arthroscopic and open techniques are used to repair RC tears. Arthroscopic techniques are less invasive, but sometimes open techniques are used and may obtain a more secure repair, and tendon transfers may be added to these repairs. Both techniques generally give patients very good results.

How important is rehabilitation in the treatment of a rotator cuff tear?
Rehabilitation is very important in the care of patients with RC tears. It should be guided by the surgeon because of the different types of repairs and the findings at surgery. Small tears, repaired easily, may allow for a more aggressive rehab program, whereas larger tears may require a longer period of immobilization following surgery before beginning an exercise program.