Foot and Ankle Overview Archives

Shoulder Replacement Surgery FAQ

Wysłany na styczeń 5, 2023kwiecień 21, 2023 przez andrew

This article was first published at Dr. Nolan Horner’s professional website.

Shoulder replacement surgery is one of the most common procedures I perform. The most common reasons patients require shoulder replacement surgery is due to osteoarthritis of the shoulder, however it may also be indicated in patients with large rotator cuff tears and/or fractures of the shoulder. Below is a list of the most common questions patients ask me about shoulder replacement surgery.

Q: Will I need any tests done before I am ready for surgery?

A: After the decision has been made to proceed with shoulder replacement surgery, typically two things are required prior to your surgical date.

A CT scan of the shoulder – I use the CT scan of the shoulder to plan each patient’s surgery to determine which shoulder replacement components will best fit an individual patient’s anatomy. Also, in many cases I use the CT scan to have custom patient specific instrumentation made to ensure that the implants are placed in an optimal position.
Pre-operative clearance from your primary care physician to ensure that there are no medical conditions that would make undergoing shoulder replacement surgery unsafe.

Q: How long is the surgery?

A: The length of the surgery can vary significantly depending on the patient’s anatomy, but on average it takes approximately 1.5-2 hours to complete.

Q: What is the recovery like after shoulder replacement surgery?

A: Typically, patient will have to be in a sling for 4-6 weeks after the surgery. After the sling is discontinued patients can move the shoulder as they tolerate, however I will ask patients to limit heavy lifting until ~10-12 weeks after the surgery. Patients should begin physical therapy 2-4 weeks after surgery and will continue until about 3-4 months after the surgery.

Q: What are the benefits of shoulder replacement surgery?

A: Most patients will experience resolution of most of their pain with activities of daily living. Most patients will experience significant improvements in their range of motion after surgery as well. Depending on patients’ pre-operative limitations, patients are often able to perform activities that they were unable to perform prior to the surgery.

Q: Will I have to stay in hospital over night after my shoulder replacement surgery?

A: Most patients I treat with shoulder replacements go home only a couple hours after the surgery is complete. In some cases, depending on a patient’s medical history and functional status, I may ask them to stay in hospital overnight for observation.

Q: What is the difference between an anatomic total shoulder replacement and a reverse total shoulder replacement?

A: The shoulder is a ball and socket joint, with the glenoid forming the socket and the humeral head making up the ball portion of the joint. In an anatomic shoulder replacement the humeral head is replaced with a new ball shaped prosthesis and a new prosthetic cup is placed where the glenoid was previously located. In a reverse total shoulder replacement, the anatomy is flipped, and the prosthetic cup is placed where the humeral head was, and the new ball of the shoulder is placed on the glenoid. A reverse total shoulder arthroplasty is more ideal in patients with issues with their rotator cuff as the change in anatomy allows for the deltoid to perform many of the functions of the rotator cuff.

Q: How do I know when I am “ready” for shoulder replacement surgery

A: The timing of shoulder replacement varies depending on the individual patient. Generally once patients reach the point that they feel their shoulder is affecting their everyday life, despite having tried non-operative treatment options such as therapy, anti-inflammatory medications, and cortisone injections. Patients who choose to undergo shoulder replacement surgery often will state that they must restrict some activities that they do as a result of their shoulder and/or that their shoulder affects their sleep.

Q: What are the risks associated with shoulder replacement surgery?

A: Overall shoulder replacement surgery is safe with low risks of complications for most patients. However, with any surgical procedures there are risks. Risks include (but are not limited to) risk of fracture of the bone, dislocation of the prosthesis, persistent pain, stiffness, infection, wound complications, medical complications, risks of anesthetic, as well as others.

Q: What type of anesthetic is used?

A: The majority of shoulder replacements I do are done with both a general anesthetic and a nerve block. The general anesthetic means that you will be completely asleep during the procedure and that you will not remember any parts of the operation. The nerve block means that your arm will be numb for approximately 24 hours after the operation. This is highly effective at controlling pain during the first day after the surgery, which is typically the most painful portion of the procedure.

Q: Am I too young for shoulder replacement surgery?

A: There is no specific age cut-off for shoulder replacement surgery. The decision to proceed with shoulder replacement surgery in younger patients is based off several factors including the age of the patient, the severity of symptoms and the appropriateness of alternative treatment options. More modern shoulder replacement implants that I use in my practice are bone preserving and therefore more suitable for younger patients who many require a revision in their lifetime, as more of the native bone stock is maintained in the initial operation.

Dr. Nolan Horner is an orthopedic surgeon with a specialization in sports and shoulder surgery. He works in the Chicagoland area and has offices in Chicago, Oak Park, Oak Brook and St. Charles.

Meniscal Surgery FAQ

Wysłany na styczeń 5, 2023luty 17, 2023 przez andrew

This article was first published at Dr. Nolan Horner’s professional website.

Arthroscopic meniscal surgery is a surgical procedure that is used to repair or remove damaged meniscal tissue in the knee. Here are some common questions I get asked about the procedure: 1. What is the purpose of arthroscopic meniscal surgery? The purpose of arthroscopic meniscal surgery is to repair or remove damaged meniscal tissue in the knee joint. The meniscus is a C-shaped piece of cartilage that cushions and stabilizes the knee joint. When the meniscus is damaged, it can cause pain, stiffness, and difficulty with movement.

2. How is arthroscopic meniscal surgery performed? Arthroscopic meniscal surgery is usually performed under general anesthesia. During the procedure, the surgeon makes two small incisions around the knee and inserts a small camera, called an arthroscope, into the joint. The camera allows the surgeon to view the inside of the knee on a monitor, and small surgical instruments can be inserted through the other incisions to repair or remove the damaged tissue HairLossClinic.ca. 3. What is the difference between meniscal repair and partial meniscectomy? Meniscal repair refers to a surgical procedure in which the damaged portion of the meniscus is repaired using suture type material. The goal of meniscal repair is to preserve as much of the meniscus as possible since the meniscus plays an important role in the stability and function of the knee joint. Partial meniscectomy, also known as partial meniscal resection, refers to a surgical procedure in which a portion of the damaged meniscus is removed. This is typically done when the damage to the meniscus is too extensive to repair, or when the patient has significant degenerative changes in the knee joint. In these cases, as little of the meniscus is removed as possible to alleviate the patient’s symptoms while maintaining as much of the integrity of the meniscus as possible. The decision to perform meniscal repair or partial meniscectomy will depend on the extent and location of the damage to the meniscus, as well as the patient’s age, overall health, and the presence of any other knee problems. In some cases, a combination of both procedures may be necessary.

4. How long does the recovery process take after arthroscopic meniscal surgery?

In general, for a partial meniscectomy, patients do not require a brace or crutches after surgery and can begin fully weightbearing from the same day after surgery. Patients will begin physical therapy within 1 week after surgery and continue therapy for 6-10 weeks. Full clearance for return to all sports is typically 6-10 weeks from surgery. Many patients return to work just a few days after surgery

For a meniscal repair, patients will require use of a brace and crutches for 4-6 weeks after surgery. Physical therapy will begin 2 weeks after surgery.

My specific and more detailed rehabilitation protocols can be found under the rehabilitation portion of my website.

5. Is arthroscopic meniscal surgery effective?

Arthroscopic meniscal surgery is effective for relieving pain and improving function in people with damaged meniscus tissue. However, the long-term success of the surgery can depend on the extent of the meniscal damage, the amount of osteoarthritis in patient’s knee, the patient’s age and overall health, and their commitment to the rehabilitation process.

6. How long does the surgery take?

Meniscal surgery is typically performed on an outpatient basis, which means that the patient can go home the same day as the procedure. The length of the surgery will depend on the extent of the damage to the meniscus and the specific type of surgery being performed. In general, meniscal surgery is a relatively quick procedure and can usually be completed in 30 minutes to an hour.

7. When can I drive again after meniscal surgery?

In general, it is usually safe to drive when you are no longer taking pain medication and your knee is strong enough to support the weight of your body. Generally, for partial meniscectomy patients this is 1-2 weeks after surgery. For patients with a meniscal repair, it may take 4-6 weeks to be able to drive if their right knee is the surgical side, for left knee meniscal repairs it can be as soon as 1 week after surgery.

Before you start driving again, it is important to make sure that you have full control of the pedals, can easily reach the steering wheel and other controls, and have the physical strength and mobility to safely operate the vehicle. You should also be able to safely enter and exit the vehicle and perform an emergency stop if necessary.

It is always a good idea to check with your doctor before starting to drive again after meniscal repair surgery, to ensure that you are ready and that it is safe for you to do so.

8. What are the risks of arthroscopic meniscal surgery?

As with any surgery, there are risks associated with arthroscopic meniscal surgery. These risks include infection, bleeding, and reactions to the anesthesia. There is also a risk of injury to the blood vessels, nerves, or other structures in the knee. However, due to the minimally invasive nature of arthroscopic meniscal surgery the rates of complications are generally very low.

Dr. Nolan Horner is an orthopedic surgeon with a specialization in sports and shoulder surgery. He works in the Chicagoland area and has offices in Chicago, Oak Park, Oak Brook and St. Charles.

Patient of the Month: Greg Widerski

Wysłany na grudzień 6, 2022luty 1, 2024 przez andrew

Meet our December patient of the month, Greg Widerski!

Originally from Chicago, Greg has lived in different parts of the country and the world, and has worked in the technology industry for over two decades. He settled back in the Chicago area with his wife and daughters, and Greg and his family moved from a condo in the city to a more spacious home in the suburbs in 2020. Their new digs feature increased living space, acreage, and even a pool!

Unfortunately, the building of their pool is what caused Greg to end up at Genesis Orthopedics & Sports Medicine in the first place. The construction team building the pool left lots of large equipment in Greg’s family’s yard during the building process, and one particular day, a crane was left atop a slightly uneven pile of dirt. Late that night, Greg heard a loud thump. It was pouring rain, and he went outside barefoot, in his pajamas, to see what had caused the commotion. The limestone steps to his backyard had standing water on them, and slick algae had formed from all the rain; in the darkness, Greg slipped on the step, flew into the air, and landed on the step, slamming his foot and toes against the limestone. Limping and bloody, he managed to hobble back into his house. His first thought as he laid down on the couch and mentally assessed the stinging pain in his foot was, “How am I going to explain this to my wife?!”

The next day, Greg went into an urgent care center to get his foot looked at. The x-ray he received there was low-quality and he didn’t get much information or advice. An internet search showed him that there was a Genesis location nearby and open, and he quickly called and made an appointment there.

At Genesis, Greg was given a high-quality x-ray, which showed that four of his toes were broken, all in a straight line. Elliot Johnson showed him the x-ray and exactly where the break had occurred, which Greg appreciated. He was also given a boot to wear, advice on when and where to wear it, exercises to do, signs to watch out for, pain medication, and a timeline for recovery. He scheduled a follow-up appointment, but was told that if everything seemed to be healing well, that it was not necessary for him to return unless he wanted to.

After about a month, Greg had full mobility and feeling back in his toes and foot. He did not feel a follow-up appointment was needed, and liked that the folks at Genesis did not push him to have one unnecessarily. When asked if he would recommend Genesis to friends or family in need of orthopedics care, Greg gave an emphatic, “Of course!”

We are so pleased that Greg experienced a full and speedy recovery, and are honored that he chose Genesis for his care.

Patient of the Month: Lu Korver

Wysłany na listopad 11, 2022luty 1, 2024 przez andrew

Our Patient of the Month for November is Lu Korver! Lu a lifelong Chicagoan and a longtime patient of Genesis Orthopedics & Sports Medicine.

Lu knew Dr. Shadid from his time at Wheaton College, and trusted him and his practice before even becoming a patient there. When she had a stress fracture on her leg in the early 2000’s and needed a boot, she knew she could count on Genesis for the best care. Lu has also frequented Genesis for rotator cuff surgery, an injured pointer finger, and most recently for a sciatic nerve issue. Lu’s trust in Genesis’ treatments goes beyond just herself – both her children have also been patients for various injuries.

Lu has worked with a variety of providers at Genesis over the years, and has been pleased with how each provider takes the time to listen and treat their patients with personalized care. She also comments that the office staff is incredibly friendly and goes “above and beyond to help,” and that the nurses and physician assistants are “incredible.” Overall, Lu observes that all the folks at Genesis “do great work and treat people kindly – you can tell they love their jobs.”

We are so happy that Lu is feeling great health-wise, with plenty of energy to spend time with her kids, daughter-in-law, and two young granddaughters, and appreciate that she “would highly recommend Genesis to everybody.” From everyone at Genesis, thanks for choosing and trusting our practice!

Dr. Nolan Horner publishes in JAMA October 2022 edition

Wysłany na październik 20, 2022luty 1, 2024 przez andrew

We’re excited to announce that Genesis orthopedic surgeon Dr. Nolan Horner was recently featured in the Journal of the American Medical Association (JAMA) – October edition (Volume 328, Issue 13). JAMA is one of the top and most selective medical journals in the world. The paper is listed below, along with a video from the editor of JAMA discussing Dr. Horner’s paper:

As of October 10th, 2022 Dr. Nolan Horner has been cited 1,000 times by other medical researchers, had papers read 21,808 times, and has published 86 papers advancing medical knowledge in orthopedics and sports medicine. Learn more at his ResearchGate page here.

Dr. Nolan Horner publishes in AJSM August 2022 edition

Wysłany na październik 13, 2022luty 1, 2024 przez andrew

We’re excited to announce that Genesis orthopedic surgeon Dr. Nolan Horner recently had two publications featured in the prestigious American Journal of Sports Medicine – August edition (Volume 50, Issue 10). The two papers are listed below:

Patient of the Month: Esther Grossman

Wysłany na wrzesień 2, 2022luty 1, 2024 przez andrew

Our September Patient of the Month is Esther Grossman – a retired preschool teacher, wife of almost 40 years, mother of nine, and grandmother of over 20 grandchildren!

Esther’s retirement goals of going on walks with her husband and children and playing actively with her grandkids were hard to maintain due to chronic knee pain, decreased flexibility, and ongoing mobility challenges. She sought out physical therapy and exercised regularly, but neither of these interventions helped long-term with her pain or mobility. Her knee pain became so debilitating that she thought she had a torn meniscus; an orthopedic doctor discovered that she actually had advanced osteoarthritis in both knees. She received cortisone and hyaluronic acid injections, but these, too, failed to reduce her pain long-term. Since she was in her late 50’s, her doctor suggested that she wait until she was 65 and eligible for Medicare to pursue knee replacement surgery, but Esther decided to seek out a second opinion.

That’s when she discovered Dr. Shadid and Genesis Orthopedics & Sports Medicine. She watched one of his webinars and was drawn to his message of making joint replacement accessible to all, regardless of insurance status. She made an appointment for an evaluation right away.

Esther first met with Mr. Johnson, PA, who she described as incredibly clear and helpful in his explanations. When she asked his opinion on a knee replacement, she was relieved by his response of, “You never have to tell a patient they need a knee replacement; they’ll tell you.” Esther felt like she was finally heard. She was able to schedule both knee replacement surgeries with Dr. Strotman, and was happy that the office was willing and able to work with her timeframe so that she could attend one of her son’s graduations in Spokane, Washington this summer.

Post-surgeries, Esther is starting to feel like her old self, and is grateful to Genesis Orthopedics & Sports Medicine for helping her get there. From Dr. Strotman’s thoughtful decision in sealing her incision with glue rather than stitches so that she has optimal potential for regaining much of her range of motion, to the care with which Danielle, the scheduler, ensured that insurance glitches were worked out before her surgery dates, Esther has already taken it upon herself to recommend Genesis to friends and family– especially those who have exclaimed, “Wow, what did you do?!” after seeing her in discomfort for years. She is now able to enjoy her daily walks, including stopping to chat with neighbors, and can sit on the floor to play with her grandchildren.

Thanks for choosing Genesis, Esther!

Dr. Nolan Horner joins Genesis

Wysłany na sierpień 17, 2022luty 1, 2024 przez andrew

We’re thrilled to announce Dr. Nolan Horner is joining Genesis Orthopedics & Sports Medicine on August 29th 2022!

Dr. Horner will join us from his role as a Sports Fellow (Orthopaedic Surgery) at Rush University Medical Center where he served as one of the team physicians for the Chicago Bulls, Chicago White Sox, and the Chicago Fire.

Dr. Horner holds a Bachelor of Science: Chemistry (Honours) with Distinction from Queen’s University and a Doctor of Medicine from the Michael G. DeGroote School of Medicine at McMaster University, and completed his 5 year Orthopedic residency at McMaster University.

He’s contributed to more than 100 medical research publications and his academic and medical achievements can be found below:

March 2021 – Canadian Orthopaedic Foundation Basic Science Scholarship

December 2020 – Most Outstanding Resident – Department of Surgery 2020

November 2018 – 98th percentile Orthopaedic In-Training Examination (OITE) Score

November 2017 – 99th percentile Orthopaedic In-Training Examination (OITE) Score

August 2013 – Student Travel Award – 57th International Conference on Analytical Science and Spectroscopy

May 2013 – Best Poster Award – 57th International Conference on Analytical Science and Spectroscopy

May 2013 – Student Travel Award – Canadian Chemistry Conference and Exhibition

May 2013 – Best Undergraduate Thesis Queen’s University *Runner-up*

May 2013 – Society of Chemical Industry Award

August 2012 – Queen Elizabeth II Scholarship 2012

December 2011 – Published study “A simple method using on-line continuous leaching and ion exchange chromatography coupled to inductively coupled plasma mass spectrometry for the speciation analysis of bio-accessible arsenic in rice” – featured on the cover of Analytica Chimica Acta.

August 2011 – Queen Elizabeth II Scholarship 2011

August 2011 – Student Travel Award – 55th International Conference on Analytical Science and Spectroscopy

August 2010 – Queen Elizabeth II Scholarship 2010

August 2010 – Annie Bentley Lillie Prize in Calculus

August 2009 – Queen Elizabeth II Scholarship 2009

August 2009 – Lena MacNeil Scholarship

Please join us in welcoming Dr. Horner to Genesis Orthopedics & Sports Medicine, and feel free to learn more about Dr. Horner at his page on our website.

Patient of the Month: Karen Poulsen

Wysłany na sierpień 3, 2022luty 1, 2024 przez andrew

Meet our August Patient of the Month, Karen Poulsen– a passionate and young-at-heart Professional Organizer.

Karen has always had a natural talent for organizing, and she started her business in 2016. It took off; she even has over 100 5-star reviews on Thumbtack! In 2018, Karen moved to Fort Lauderdale, Florida to help her niece care for her newborn daughter. While living there, she decided to volunteer with a local animal shelter on their “take a dog to work day.” Karen had fostered over 30 dogs in her lifetime, and knows dogs very well. She was set to volunteer for a 90-pound Rottweiler, who she described as having a personality like “Garfield the cat” while she interacted with him and the handler for 45 minutes. Unfortunately, as they were finishing up their initial meeting, the dog suddenly and viciously attacked her, biting her neck and face and narrowly missing her vein. She was sent backwards and was unconscious for most of the attack, but was told by doctors that it was “a miracle that she lived.”

Karen slowly recovered from the attack, but started having mysterious pains in her left leg that grew worse over time. She would have episodes of getting “stuck” after sitting down, unable to stand back up due to the pain. She moved back to Chicago, and finally was referred to Genesis Orthopedics by her doctor. At her first appointment, she was standing in the waiting room, not wanting to sit down in case she couldn’t stand up again. Dr. Shadid saw right away where Karen’s pain was coming from– bone on bone osteoarthritis in her left hip; she would need hip replacement surgery as soon as possible. Upon getting the diagnosis and treatment plan, Karen “cried tears of joy”; she had never gotten any answers for her pain up until then.

Karen got her hip surgery with Dr. Strotman on June 16, and has been in physical therapy since then. Since her surgery, Karen’s physical and mental health have improved greatly; her friends and family have told her they “can’t believe she is recovering like this [so well].” Karen was even able to enjoy an Alaskan cruise this summer, and her business has continued to thrive, with her taking on new clients. Karen is looking forward to starting aquatic exercises to help her continue to strengthen her left leg, and her hope is to be back to 100% by her birthday in December, six months after her surgery. With her zest for life– she finds physical therapy “fun,” always making the PT’s laugh, and says she “thinks she’s 35”– Karen is sure to accomplish her goal.

Patient of the Month: George Kapustin

Wysłany na październik 8, 2021luty 1, 2024 przez andrew

We’re excited to announce that our October Patient of the Month is George Kapustin.

Five years ago, George couldn’t work anymore because of intense pain, which was diagnosed as sciatica-related. George, who works in construction and drives a semi-truck, had physical therapy and took medication with poor results. “I thought that pain was normal, when in fact I was just hurting myself more,” he says. At last, in a physical therapy session, one of the therapists told him that his severe limitations of movement indicated severe hip degeneration.

George came to Genesis, where Dr. Shadid performed total replacement of his right hip.

“I woke up in the recovery room at about two o’clock and minutes later they took me down to physical therapy. They taught me how to stand and how to sit properly. That was 45 minutes. They gave me my discharge papers and I left with a walker. Incredible.”

George’s fantastic attitude and diminished pain have improved his life. “I can walk miles at a time without a problem. Before, I walked with a limp and I couldn’t walk far. Now I’m not limited to anything.”

Of Dr. Shadid and his team, he says “I met him before surgery and after surgery, and I couldn’t believe that it turned out this good. I’m a real skeptic and I thought, ‘It’s going to be just like before,’ and I can’t tell you how much better I feel. Now I have mobility back, and that’s the big game changer. The staff has always been incredibly helpful for me. They checked up on me, and the procedure gave me results like I never had before. I’m really pleased with the whole thing. The surgery, the staff, everything about it. I’m thrilled.”

George is an inspiration of grit and determination As he says, “Just existing is just that, it’s not quality of life. Living is more [than that].” That’s why he is our October Patient of the Month.

Kategoria: Foot and Ankle Overview