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Common Questions in Orthopedics

Written by The Midwest Bone and Joint Institute on September 5, 2013

“I tore the rotator cuff in my shoulder, do I need surgery?”


It depends on they type of tear, the size of the tear, and the amount of pain and disability in the shoulder.

Initially, the goal is to treat patients with shoulder pain due to most rotator cuff tears with anti-inflammatory medications and physical therapy.

A rehabilitation program can be therapeutic by improving range of motion, increasing strength in the shoulder, and decreasing pain.

A cortisone injection may be beneficial to directly decrease inflammation and limit pain.

Although most partial rotator cuff tears may not require surgical repair, complete rotator cuff tears and partial tears that fail conservative treatment usually do require surgery.

Rotator cuff tears are fixed surgically with minimally inva- sive techniques, which decreases postoperative pain and leads to a quicker recovery.

Are there any new ways to treat tendinitis/overuse injuries?

Yes. Platelet Enriched Plasma (PRP) Therapy is a new, minimally invasive injectable therapy used to treat many common orthopedic conditions such as tendinitis and muscle injury.

A PRP injection is prepared by taking a patient’s own blood and isolating a high concentration of platelets.

Platelets are a normal component of blood that play a significant role in helping recruit cells that repair tissue and speed the rate of recovery.

PRP therapy is currently being used to treat patients with tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), Achilles tendinitis, rotator cuff tendinitis, plantar fasciitis and patellar tendinitis.

The use of PRP therapy in sports medicine has the poten- tial to lead to higher rates of healing, a faster rehabilitation after injury, and a quicker return to athletics.

This procedure is less expensive than surgery and can potentially improve tissue healing and get patients back to their activities quickly and safely.

The physicians of the Midwest Bone & Joint Institute are one of the few facilities in the area offering this new cutting edge treatment.

When will I know it’s time to get my joint replaced?

This answer is different for each person. Treatment of hip and knee arthritis is directed
at the reduction of pain and improvement of function.

Many nonoperative treatments are available and are typically offered before surgery is con- sidered. Once your surgeon has diagnosed a painful joint due to arthritis and offered a joint replacement as a solution, the choice is up to you. The indi- cations for joint replacement are pain and disability of func- tion. Age is not disqualifying, as teenagers through nonagenar- ians may find benefit in joint replacement surgery. There is also no limit to the time waited before replacement. There is no circumstance where surgery can no longer be performed because a patient waited too long.

Who should I have perform my joint replacement surgery?

All hip and knee replacement surgery is performed by orthopedic surgeons.

Some surgeons complete an additional year, called Fellowship, to gain expertise in the specialized field of joint replacement.

More important, study shows that surgeons who perform at least 100 joint replacements per year have a much higher rate of patient satisfaction and a much lower rate of complication.

This volume guideline is not location dependent as a University Center has no advantage over your community hospital when your surgeon is experienced.

Why should I get an epidural for my back pain? Aren’t I just going to need surgery anyway?

Epidural steroid injections can offer longstanding pain relief, sometimes for years. And the rates of complications associated with injections are much lower than with surgery.

However, it doesn’t make sense to continue to try them when they don’t work. As a general rule, if the first two or three injections have not helped, then the fourth and onward are probably not going to help either.

Also, short-term relief from an epidural can indicate that surgery will also be beneficial.

Are there minimally invasive options for spine surgery?

Advancements in surgical techniques over the last 10 years have allowed us to use smaller incisions while achieving the same surgical results. You should discuss this with your surgeon.