Many of the problems orthopedists treat involve the joints, places in the body where two or more bones meet. Humans have three different kinds of joints: fibrous (in the skull), cartilaginous (in the spine) and synovial (the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet). This last type is what we usually refer to when we say "joint." Ligaments connect bones to each other, and tendons connect muscles and bones.
These parts of our bodies can be damaged from a traumatic injury, disease, congenital disorder or the natural aging process. Commonly treated conditions include arthritis, back pain, carpal tunnel syndrome, bone fractures, sprains and strains, knee and shoulder problems, tendon and ligament tears, osteoporosis, sports injuries, and pediatric conditions such as club foot. Patients may be infants, adolescents, middle-aged or elderly.
The introduction of minimally invasive techniques has meant that many patients can be examined and treated through tiny incisions, minimizing the trauma of "open" surgery and allowing them to enjoy a faster recovery and return to regular activities.
Arthritis and certain knee injuries and diseases can damage the cartilage that normally cushions the knee joint, leading to pain and stiffness. A knee replacement may be recommended when more conservative treatments -- such as anti-inflammatory medications and cortisone injections -- fail to relieve pain or improve movement.
During a total knee replacement, the entire joint is replaced with an artificial prosthesis. The surgery itself lasts between one-and-a-half and three hours. After the procedure, patients usually experience immediate relief from joint pain. Physical therapy starts right away to speed healing and to ensure that the patient enjoys full use of the joint. Knee replacements today last about 20 years in 85-90% of well-selected patients.
One of these conditions is an injury to a small structure in the shoulder called the labrum. A labral tear can cause pain and a catching sensation in the shoulder. Labral tears can be very difficult to diagnose.
Labral tears are often caused by a direct injury to the shoulder, such as falling on an outstretched hand. The labrum can also become torn from the wear and tear of activity, a condition called overuse. An injured labrum can lead to shoulder instability. The extra motion of the humerus within the socket causes additional damage to the labrum. An extremely unstable shoulder may slip or dislocate. This can also cause the labrum to tear.
The biceps tendon attaches to the front part of the labrum. The biceps is the large muscle on the front of your upper arm. Sports can cause injuries to the labrum when the biceps tendon pulls sharply against the front of the labrum. Baseball pitchers are prone to labral tears because the action of throwing causes the biceps tendon to pull strongly against the top part of the labrum. Weightlifters can have similar problems when pressing weights overhead. Golfers may tear their labrum if their club strikes the ground during the golf swing.
Nearly one in three adults suffers from the swollen, stiff and painful joints of arthritis. Arthritis is the most common chronic ailment among the elderly, although it can affect people of any age, including children.
There are over 100 different types of arthritic diseases. The most common is osteoarthritis, a degenerative joint disease in which the cartilage protecting the bone ends wears away. Rheumatoid arthritis is a chronic condition in which the body’s own immune system attacks the joint lining.
Treatment for most forms of arthritis involves a combination of anti-inflammatory medication and devices to relieve stress on the joint (canes, crutches or splints). Regular exercise, weight loss for overweight patients, and cortisone injections may also be helpful. In severe cases, orthopedic surgery such as joint replacement may be the only way to improve or restore function and relieve pain.