Month: October 2023

Patient Testimonial – Meet Timm Aldrich: Embracing a Life in Motion

Early Closure

Patient Testimonial Video: https://youtu.be/wXpyv-1M844?si=f4xdeHFBUSvtwWcD

Two years after his first knee replacement surgery, Timm Aldrich began to feel pain in his other knee that would not subside. Recognizing this pain, he knew he may have to go the surgical route once again but was confident in that decision since he had been through the process once before.

Throughout his life, the 63-year-old has been active. He’s run several 10ks, enjoys a competitive game of pickleball, and heads to the gym several times a week to keep in shape. This active lifestyle allowed him to receive non-operative treatment options for a few more years until he was ready to move forward with surgery.

“Timm is active, and the exercise and activities likely helped delay the arthritis in both knees,” says Dr. Richard Ursone, Tim’s Orthopedic Surgeon. “He had complete cartilage loss and had tried several years of nonoperative care including multiple steroids, and viscosupplementation injections, modified activities, and bracing.”

But after months of soreness in his knee, he knew it would only continue to get worse and it was time to take action.

“It was uncomfortable during the day and towards the evening, it was throbbing,” says Timm Aldrich, TSAOG knee replacement patient.

In July of 2023, Dr. Ursone performed Timm’s surgery with help from the MAKO robotic arm assisted knee application, created by Stryker. Using CT-based three-dimensional modeling of bone anatomy, Dr. Ursone created a personalized surgical plan for Timm, identifying the impact size, orientation, and alignment, based on his unique anatomy. TSAOG is the first medical group in Texas to provide this breakthrough advancement in an outpatient surgery center.

“The application allows surgeons to perform a customized ‘perfectly fitted’ knee replacement for the best functional outcome,” says Dr. Ursone. “It also minimizes surgical exposure to decrease pain after surgery and allow for a more rapid return of function.”

Within a week after surgery, Tim was back at TSAOG, doing everything he could to strengthen his knee in physical therapy.

“I’m a busy body and it’s hard for me to sit still,” adds Aldrich. But too much activity right after surgery can lead to a buildup of fluid in the leg, as was Tim’s case. His advice?

“You’re going to have days right after the surgery when you feel really good and you want to do a lot of stuff,” says Aldrich. “I always do too much. My advice is don’t overdo it, it slows the process.

“Timm is expected to return to an active lifestyle including most sports and activities,” says Dr. Ursone. “He presented in excellent physical shape and strength which always helps in the recovery process.”

How Long Does it Take a Torn Rotator Cuff to Heal Without Surgery

Location of Rotator Cuff
At TSAOG Orthopaedics & Spine our physicians will say that “We use surgery as a last resort.” for when other treatments and therapies fail to yield results. The rotator cuff is a complex of muscles and tendons that attach to bones in the shoulder girdle, this allows for the wide range of movement in our shoulders and arms. A rotator cuff tear is whenever a muscle or ligament in this area is partially or completely torn. This condition can be difficult to recover from for several factors. The shoulder is an area of the body with particularly poor circulation, and it is also one of the most used parts of our body. For these reasons rotator cuff recoveries can be more of a marathon than a sprint.

What Happens if A Rotator Cuff Injury is Left Untreated

Depending on the severity of the tear different outcomes are possible if a tear is left untreated. If the tear is minimal, and you allow time for rest and recovery there is a chance that it may heal on its own. Another thing to consider is your body’s healing factor. If you have diabetes, smoke, or consume alcohol, these things will affect your body’s ability to naturally heal. That said, if you neglect to let your body rest and recover, continual overuse may worsen the injury. If your rotator cuff tear is severe, being more than 90% of the tissue is torn, it is extremely unlikely that it will heal on its own without surgical intervention. Rotator cuff tears are serious conditions, if you suspect you may have one make an appointment with one of our shoulder specialists immediately.

How Long Does it Take for a Torn Rotator Cuff to Heal Without Surgery

The length of time a rotator cuff will take to heal without surgery can vary from person to person and is dependent upon a myriad of factors. Assuming the tear is minor, with proper rest and recovery it could take four to six weeks to be fully recovered from that tear. If the tear is worse than that, or if not given proper treatment those tears may never heal on their own. This is why even if the tear is minor, it is still important to seek the guidance of an orthopedic shoulder specialist. Attempting to restrict your movement on your own could potentially lead to other issues such as a frozen shoulder.

Surgery Alternatives for Torn Rotator Cuff

There is a plethora of nonsurgical alternatives to treat a torn rotator cuff. If you suspect you may have torn your rotator cuff, seek guidance from an orthopedic shoulder specialist immediately, so they can determine which treatment may be appropriate for you. The most common treatment is rest, avoid overusing that shoulder, avoid lifting heavy objects, lifting objects away from your body, and avoid lifting objects overhead. Another common treatment recommendation is physical therapy. Physical therapy is a fantastic way to strengthen the affected muscle in a safe and controlled environment, under the supervision of experts. Steroid injections are also another way to help treat a torn rotator cuff, these may help reduce inflammation and prevent the injury from being reaggravated.

When to Get Rotator Cuff Surgery

If after exhausting nonsurgical alternatives your pain is persistent and interrupts your daily activity, your shoulder specialist may recommend rotator cuff repair surgery. Sometimes the damage done to the muscle is too great for it to heal on its own, or with less aggressive treatments. Rotator cuff repair surgery has advanced greatly. TSAOG Orthopaedics & Spine has a host of shoulder specialists, and sports medicine surgeons trained in performing these complex surgeries. If you feel that your life has been impacted by shoulder pain or immobility, contact us today.

Remember Your Options

If you are diagnosed with a rotator cuff tear, do not worry, as mentioned earlier there is a wide array of non-surgical alternatives to keep in mind when it comes to your shoulder health. There is no need to allow this injury to dictate how you live your life. Contact TSAOG Orthopaedics & Spine and ask to speak to one of our shoulder specialists. They are trained to assist you in navigating your shoulder injury in a way that best suits your needs. If you have pain and need assistance, contact TSAOG Orthopaedics & Spine today.

Looking for a Shoulder Specialist in the San Antonio, TX Area?

Schedule an Appointment with a TSAOG Rotator Cuff Specialist

How To Reduce Foot and Ankle Swelling After Surgery

Edema Swelling

Ankle surgery has made many technological advancements in recent years that have aided in the reduction of trauma to the tissue, however, inflammation and swelling will still be expected post-surgery. While this response is nothing to be worried about, it may be beneficial to mitigate the amount of swelling you go through to begin physical therapy and decrease the time it takes to resume regular activity. Here you will learn why and how you should implement effective strategies to help reduce foot and ankle swelling after surgery.

Why Should You Attempt to Decrease Swelling After Surgery?

The weeks immediately following surgery are crucial to the recovery process, it is also the time when swelling will tend to be most aggressive. Taking steps to decrease swelling can have several important benefits such as aiding in a faster recovery, improving mobility, and enhancing comfort. Next, you will learn some helpful tips on how to reduce swelling post-surgery.

What You Can Do to Reduce Swelling

Following your procedure, many things can be done to control and reduce swelling of the lower extremities. Your physician will provide you with a list of post-surgical instructions and guidelines to follow. Additionally, here are some effective tips that can be coupled with their guidance, that you can implement to help alleviate swelling throughout your recovery.

Adequate Amounts of Rest Is Crucial to the Healing Process

An important foundation for a successful recovery is ensuring that you get enough rest. The body naturally releases hormones that promote healing during sleep. By securing 8 hours of restful sleep per night you increase the effectiveness of your body’s natural recovery systems. While not the only thing you should do to reduce swelling, never underestimate the power of a good night’s sleep.

Elevate the Foot or Ankle

Elevation of the affected area can be a huge help when it comes to swelling reduction.
Veins rely on a system called the “Manual Muscle Pump” and a series of one-way valves to return blood to the heart from the lower extremities while working against gravity. Do what you can to help your body get blood back to the heart for circulation. Your provider may have specific instructions regarding the duration and frequency of leg elevation after surgery; follow guidelines as instructed.

Ice Down the Foot or Ankle Regularly

Applying ice packs to the affected area is known as a modality called “Cryotherapy.”
Your physician may recommend you apply a cold compress to the affected area multiple times throughout the day, always be sure to leave a one-hour gap of time between cold compress treatments. Cryotherapy is most effective on acute injuries, meaning the first few days after surgery. It is important to note you should also avoid using hot compresses as it may unintentionally increase swelling.

Wear Relaxed Fit Clothing

When choosing post-surgery clothing, prioritize comfort, ease of dressing, and suitability for your specific recovery needs. While recovering, wearing relaxed-fit clothing is a practical and comfortable choice that can contribute to a smoother recovery process. It is recommended to avoid wearing overly tight clothing around the affected area, for example, tight-fitting pants, socks, leggings, etc. unless otherwise specified by your physician. The exception to this would be if you are instructed to wear compression socks/stockings.

Use Compression Socks for Severe Swelling

Compression stockings, also known as compression socks, are specialized garments that your physician may recommend you wear post-surgery. These garments are designed to promote better blood circulation and help decrease swelling. These are used as a valuable tool during recovery, if needed, always follow your healthcare provider’s recommendations and guidelines when using compression stockings.

Regularly Take Your Prescribed Medications

Often after surgery your physician may prescribe a list of medications such as anti-inflammatory and/or pain medications, take these as prescribed. If you are going to go the over-the-counter route, be sure to advise your doctor of any medications that you are taking to avoid any potential negative complications.

Avoid Smoking or Consuming Alcohol After Foot or Ankle Surgery

Smoking and alcohol both negatively impact circulation, do what you can to avoid these after surgery to avoid any potential negative side effects. Also, do not consume alcohol while on prescribed medications where it is contraindicated.

If You Are Struggling with Your Foot or Ankle, Contact Us Today

If you have been struggling with chronic pain in your foot or ankle, contact us today to set up an appointment with one of our specialists.

Looking for a Foot and Ankle Specialist in the San Antonio, TX Area?

Schedule an Appointment with a TSAOG Foot and Ankle Specialist

What is the Best Treatment for Rotator Cuff Injury

tearing rotator cuff
The shoulder is the most flexible joint in our entire body, this flexibility is all thanks to the rotator cuff. The rotator cuff and the muscles that comprise it are incredibly important to how we function in our daily lives. Injuries to the rotator cuff are one of the more frequent injuries encountered by Joint Surgeons. Fortunately, this means that much study has been done to find the most effective ways to treat injuries to the shoulder, and rotator cuff. These treatments can range from injections to surgery, and each option has its own benefits. At TSAOG Orthopaedics and Spine surgery is usually our last line of defense, and our orthopedic specialists pride themselves on using the full breadth of treatment options at their disposal.

Immobilization or rest

Strains, sprains, and tendonitis are all quite common injuries to the rotator cuff, and depending on their severity all of them may be able to heal with immobilization or rest. Simply allowing time for your muscles and tendons to recover naturally may be all the treatment that is required for these overuse injuries.

Physical therapy

Physical therapy is another common, non-invasive treatment method for a rotator cuff injury. Physical Therapy can help restore range of motion as well as stability to your rotator cuff. If you have a frozen shoulder lots of stretching exercises can be used to help gradually restore the lost mobility. Staying on a consistent therapy routine can help you get back to normal, without the need for more advanced treatments

Activity Modification

Modifying regular activities may be another way to restore your shoulder’s health. There are movements that put more intense loads on the shoulder and rotator cuff. The lessening or modification of these movements can have a strong impact on your shoulder. For instance, lifting heavy objects overhead or away from your body can put undue stress on through your shoulder and potentially lead to aggravating the joint more than it already i

Steroid injections

Steroid injections can be useful if other methods of shoulder treatment are not yielding results. Steroid injections can be useful for reducing pain and inflammation in the joint. With the reduction of inflammation in the joint, not only will you experience less painful movement, but it can also potentially help prevent further degradation of the soft tissue by reducing scraping on hard surfaces.

NSAIDs

NSAIDs can also be a useful method of reducing inflammation in the shoulder, while it is normal and expected to experience swelling throughout the healing process, excessive swelling can be painful, and act as a barrier to recovery.

Platelet Rich Plasma Injections

This treatment is new, but it shows great promise in increasing recovery ability. This process takes the patient’s own blood, spins it in a centrifuge, then takes the serum with the highest platelet counts and injects it into the affected area to aid the healing process. If you are interested in this type of treatment, ask our primary care physicians if it may be appropriate for you.

When is surgery appropriate

Surgery may be indicated if these symptoms are chronic and prevent you from living your life as you would normally. Some injuries to the shoulder may be too severe to heal naturally, for example a rotator cuff tear, a labral tear, or in some cases adhesive capsulitis. Our surgeons are well versed in arthroscopic surgery, and we also have multiple surgeons capable of performing robotic assisted surgery with the Stryker Mako. These surgeries are meant to be minimally invasive and provide the quickest recovery times if surgery is unavoidable. Shoulder injuries can be complicated, but getting treatment does not have to be. Allow our orthopaedic specialists to walk you through it every step of the way. Book an examination at TSAOG Orthopaedics & Spine if you are experiencing pain in the shoulder that is inhibiting your daily activities, or find that your range of motion in your arm and shoulder is restricted.

Looking for a Shoulder Specialist in the San Antonio, TX Area?

Schedule an Appointment with a TSAOG Shoulder Specialist

When and When Not to Have Rotator Cuff Repair Surgery

injured rotator cuff
When trying to understand when to have a rotator cuff repair surgery it is important, first, to understand what the rotator cuff is. The rotator cuff is a complex structure consisting of four muscles and tendons surrounding the shoulder joint. The shoulder joint is one of, if not the most mobile joints in the body. This mobility is exceedingly useful in our daily lives, it is what allows us to put holiday decorations on shelves high above our heads or scratch that pestering itch on our backs. This in turn means whenever an injury affects the shoulder it affects our daily lives that much more. A wide world of injuries can affect the shoulder, some more serious than others. Next, we will cover which may heal on their own, and which need more serious attention.

When not to have rotator cuff surgery

Before we continue, please note, any advice in this article should come second to the advice rendered by your medical provider. Now we may begin looking at some injuries that if given time and proper rest may be able to heal without surgical intervention. Here are three common rotator cuff conditions that do not usually need surgery to be resolved.
  • Tendonitis
  • Bursitis
  • Rotator Cuff Strain
One of the most common injuries is tendonitis, this is usually a result of overusing a certain muscle group. If you are performing highly repetitive tasks using your arms and upper body, this could put your rotator cuff muscles in an overused and weakened state. Another common injury is Bursitis, this is the inflammation of the bursa. Bursa are tiny fluid filled sacs which usually act as a cushion, or smooth surface for muscles to glide over. Similarly to tendonitis, bursitis can be resultant from overuse. Our last common injury that can be resolved non surgically is the rotator cuff strain. A muscle strain occurs when the fibers of a muscle are overstretched to the point of tearing. Strains come in various levels, or grades, low grade strains occur when there are microtears in the muscle fibers and can result from sudden forceful movements in the shoulder joint. Strains may take longer to heal than tendonitis and bursitis, and it may be best to visit your medical provider to ensure that something more serious hasn’t taken place. However, like the other injuries so far, the best way to heal from a muscle strain is to reduce the load on that muscle and get plenty of rest.

When to Have Rotator Cuff Surgery?

Now we will turn our focus onto conditions which may need surgical intervention to heal properly. Far and away the most common injury in this category is a rotator cuff tear. As mentioned earlier, many muscles are at play in the rotator cuff; these muscles are small, and weak when compared to other muscles in the body. The rotator cuff is also unique in that lies in what is known as a “Watershed Area”. These areas throughout the body are uniquely hypo-vascular, meaning that they lack excess blood supply. Blood flow is critical in the healing process and so it being limited in the rotator cuff makes injuries especially difficult to recover from. Tears occur similarly to a strain, with sudden forceful movements. Tears are often also associated with a significant amount of pain. If an event like this happened to you, and you notice that the pain gets worse with rest, or sleeping, and persists longer than a few days you may need to go and see your medical provider. Rotator cuff deterioration doesn’t only occur from sudden forceful movements however, they can also be the result of deterioration throughout one’s life. Those with forward posture, or those who do repetitive arm movements regularly, for example a cashier who is scanning and bagging items frequently, may also be susceptible to fraying their rotator cuff tendons. While these motions seem innocuous when added up over the course of a lifetime, they can slowly wear away at the tendons in the rotator cuff, eventually leading to a tear.

When to See a Doctor For a Torn Rotator Cuff

While not every injury to the rotator cuff was covered in this article, something to take away is to be mindful of overusing your shoulders. Like all muscles, those in the rotator cuff need time to rest as well. Be cautious when lifting heavy objects, especially when they are away from your body, or if they are overhead. If you find yourself in persistent and chronic pain, it may be time to go and see a medical provider and have them assess your shoulder. Not all conditions must be treated surgically. Many can be remedied with rest, stretching, or even physical therapy. However, if left unchecked a less severe condition may worsen and require more intensive care than it would have if treated promptly.

Looking for a Shoulder Specialist in the San Antonio, TX Area?

Schedule an Appointment with a TSAOG Rotator Cuff Specialist

TSAOG’s Dr. Dustin B. Rinehart, M.D. Makes TV Appearance on KSAT 12’s SA Live

Dr Rinehart Headshot

San Antonio, TX: TSAOG, a leading orthopedic care practice, is pleased to announce the successful TV appearance of Dr. Dustin B. Rinehart, M.D. on KSAT 12’s SA Live on September 18, 2023.

Dr. Dustin B. Rinehart, M.D. is a new and welcomed addition to the TSAOG team. Dr. Rinehart is a board-eligible orthopedic surgeon and is fellowship-trained in joint replacement. He treats patients aged 18 years of age and older.

During Dr. Rinehart’s appearance on SA Live, he discussed hip arthritis as well as the surgical and non-surgical treatment options that TSAOG offers. Hip arthritis occurs when the cartilage, or padding, has been worn out, leaving the ball and socket joint in a bone-on-bone state. Dr. Rinehart offered valuable tips on when to seek medical attention for those possibly experiencing hip arthritis. According to Dr. Rinehart, the causes of hip arthritis can vary, such as an underlying diagnosis, a previous injury, or simply wearing out the cartilage over time. Treatment options for hip arthritis begin with non-surgical methods such as applying heat or ice, activity modification, or topical anti-inflammatories and medications. For those requiring orthopedic surgery, most knee and hip replacement procedures have patients up and walking the same day.

Existing and potential patients of Dr. Rinehart are invited to watch the feature on SA Live to learn more about TSAOG’s approach to treating hip arthritis.