Our physicians' practice is
limited to orthopedic surgery which is that specialty
of medicine relating to the musculoskeletal system.
Some of the orthopedists in this practice further
specialize in more limited fields of orthopedics,
such as total joint replacements, spine surgery and
hand surgery.
Treatment
Various modes of treatment may be used. All modes
have limitations and their own risks. We want you to
understand what are reasonable goals of treatment,
the advantage of one method compared to a second
method and common complications of surgery. If at any
time you do not understand the options offered you,
please ask.
Orthopedic surgery involves the diagnosis and
treatment of injuries and diseases of the muscles,
tendons, bones, joints and ligaments. Both operative
and non-operative care is included. [Back to Top]
Fracture care can be as simple as splinting or
physical therapy. In some cases, a closed reduction,
which involves the manipulation of the broken bones
by hand or traction, may be needed. Most often a cast
will be applied to hold the fracture in place. Other
times it may be necessary to repair the broken bones
by surgery. This could require the application of a
thin metal plate to the side of the bone with
surgical screws and sometimes involve the passage of
a metal rod down the middle of the bone, most
frequently in the femur (thighbone) or the tibia
(shin bone). These techniques are used when it is
impossible to hold the fractured bones together by
casting or other means, or if the surface of a joint
is not lined up well. [Back to Top]
Arthroscopy is the evaluation and treatment of
problems of the joint using a fiber optic telescope.
This procedure enables the physician to evaluate a
joint using small incisions while at the same time,
allowing a wide range of surgical procedures. These
procedures can involve the removal or repair of tears
of the cartilage, repair of ligaments, or removal of
loose pieces of bone or cartilage. The most common
joint treated by this method is the knee, but other
joints such as the shoulder, elbow, wrist and ankle
can also benefit from this procedure. [Back to Top]
We, at Orthopedic Associates, practice the current
state-of-the-art procedures in spine surgery. These
procedures include disc excisions from the lower back
and spinal fusions entering surgically from either
the front or the back of the patient. In addition, we
also perform disc removal or fusions of the neck.
Although not all spinal problems can be helped with
surgery, in selected cases, patients have reported
significant relief with carefully selected
procedures. [Back to
Top]
Sports Medicine originates from the needs and wishes
of athletes to return to their highest level of
activity as soon as possible after an injury. Sports
Medicine specialists have developed many techniques
used in this type of rehabilitation such as
arthroscopy of the knee, shoulder and elbow. We feel
that this approach can benefit all of our patients
that seek to return to their previous level of
activity, whether they are athletes or not.
[Back to Top]
Orthopedic Associates provides surgical and
non-surgical care for foot and ankle problems. The
surgeons on staff provide expert management for all
types of problems including ankle and foot injuries,
diabetic foot care, arthritis, corns and calluses,
bunions, flat feet and sports related injuries. Care
is provided for all age groups, from infants to
senior citizens.
The physicians at Orthopedic Associates are experts
at diagnosing and treating foot ailments with
non-operative methods. However, if the problem
requires surgery, expert surgeons with multiple years
of experience are available to provide care.
[Back to Top]
Pediatric Orthopedics is the management of children's
problems that are associated with the normal growth
and development of the child. A newborn child born
with dislocated hip or another abnormality such as
club foot, can be treated at this early stage. As the
child continues to grow, other problems may develop
such as abnormalities in their gait, hip problems, or
spinal problems like scoliosis. The Pediatric
Orthopedist addresses these issues and provides
timely treatment to assure normal growth and
development. [Back to
Top]
The practice of hand surgery is a field of medicine
dedicated to evaluation, diagnosis, and treatment of
a variety of disorders that would effect the use and
function of the hand. These would include congenital
hand differences, nerve compression syndromes such as
carpal tunnel syndrome, infections of the hand and
traumatic injuries of the hand including tendon,
nerve and soft tissue injury. Also included are
fractures of the hand or wrist and rheumatoid
arthritis of the hand. Many patients can be
effectively treated with non-operative methods, but
some problems may require surgical treatment.
[Back to Top]
FACT: Bones, like muscles, stay strong by using
them.
FACT: After menopause, a woman may lose bone density
at a rate of 2% a year.
FACT: Men also lose bone mass, although not so
rapidly, and should use the same precautionary
measures.
FACT: Coffee, alcohol and nicotine as well as some
drugs increase the rate of bone loss.
Osteoporosis is a current topic that affects us all.
The term osteoporosis refers to bones that have less
bone mass and as a result, fracture more easily.
Our bones continue to add bone mass and as a result
become stronger until age 25. Past age 25 the average
person loses one-half percent of his bone mass each
year. Women past menopause have an average loss of 2%
of their bone mass a year. Even though osteoporosis
is a normal process of aging, several simple
preventative measures can lessen the rate of bone
loss.
In order to minimize the chance of hip fractures,
compression fractures of the spine and other
fractures, the three following measures should be
employed:
-
Exercise: Walk a minimum of 1 mile, 5 days a week.
You may substitute other exercises, which cause
impact loading of the bones (Example: jogging,
aerobics, and tennis. Swimming is wonderful for
your health but it is not as effective in
maintaining bone strength!)
-
Vitamin D: It is necessary to have 400 units of
Vitamin D a day. Sunlight is a source of Vitamin D
but you must have your skin exposed to sunlight
daily, so you must take a supplement most days in
this area. 400 units of Vitamin D are contained in
most multi-vitamins. Check the label or ask your
pharmacist for assistance.
-
Calcium: It is currently felt that one's daily
intake of calcium for optimal bone density and
maintenance varies depending on one's age.
Currently the recommended daily intake requirement
of calcium is:
Child: 400-700 mg/day
Adolescent to young adult (10-25): 1000-1300
mg/day
Adults: 400-500 mg/day
Pregnant women: 1500 mg/day
Breast feeding women: 2000 mg/day
Middle aged adult: 750-800 mg/day
Postmenopausal women and older men: 1500 mg/day
Since too much calcium may be as detrimental as too
little calcium, one has to be careful to calculate
the daily intake based on dietary intake plus
supplements.
Dairy Equivalents
Each Dairy Equivalent contains approximately 250 mg
of calcium. The following are the 6 most commonly
eaten dairy equivalents:
1 Large glass of milk (8oz.)- SKIM MILK has the
same amount of calcium as whole milk.
1 Large helping of cottage cheese.
1 Small container of yogurt.
1 Large scoop of ice cream.
2 Large pieces of cheese.
1 Large helping of spinach.
Most of us with higher calcium needs are unable to
meet this basic daily requirement by diet alone
(either because of not liking the necessary foods or
not wanting to consume the calories contained in
them). Tablets containing calcium are sold in various
forms such as Oystershell, calcium carbonate, and
calcium gluconate.
Only the weight due to the calcium in the supplement
counts toward daily calcium requirement. Sodium Free
TumsTM contain approximately 200 milligrams of
calcium in each tablet. If Sodium Free TumsTM are
used, they should be purchased in bulk.
The following is an example that is both effective
and economical for a person requiring 1500 milligrams
of calcium a day:
1 mile walk, 5 days a week
1 multi-vitamin tablet containing 400 units of
Vitamin D each morning
2 Sodium Free TumsTM at breakfast
2 Sodium Free TumsTM at lunch
3 Sodium Free TumsTM at dinner
IMPORTANT: For each Dairy Equivalent eaten, eliminate
one TumsTM.
Example:
Breakfast:
At breakfast one should have a combination of
dairy equivalents plus Sodium Free TumsTM that
equals 2.
1 Large glass of milk and 1 yogurt; or
1 Large glass of mild and 1 TumsTM; or
2 TumsTM
Lunch:
At lunch one should have a combination of dairy
equivalents plus TumsTM that equals 2.
1 Large helping of cottage cheese and 1 large
helping of ice cream; or
1 Large helping of cottage cheese and 1 TumsTM
tablet; or
2 TumsTM
Dinner:
At dinner one should have a combination of dairy
equivalents plus TumsTM that equals 3.
1 Large glass of milk and 1 helping of spinach and
2 large pieces of cheese; or
1 Large glass of milk and 1 large helping of
spinach and 1 TumsTM; or
1 Large glass of milk and 2 TumsTM; or
3 TumsTM
The overall effect of this program will be more
positive if you follow it compulsively, and start it
early in your life.
The positive effects of the regime will help
everyone. Ideally it should start when you are a
child and continue for your entire life.
NOTE: Several drugs have been developed in the last
few years that may aid in lessening the rate of bone
loss. Your family physician can advise you as to
whether these drugs may be appropriate for you.
[Back to Top]
Arthritis is a group of diseases that affect joints.
The surfaces of the joints progressively become worn
and irritated. This leads to increasing pain and
decreasing function. During the last thirty years,
arthritis of the hip, knee and shoulder, as well as
other smaller joints, has increasingly been treated
with an operation called total joint replacement.
Currently almost 500,000 hip and knee total joint
replacements are performed annually in the U.S.
During surgery the worn and irritated surfaces of the
joint are removed and replaced with metal (stainless
steel, titanium, or chrome-cobalt alloy) and plastic
(high-density polyethylene) surfaces. These
components must be rigidly attached to the bone. Two
methods of attaching them are: 1) using bone cement
(methylmethacrylate) or 2) press fitting a component
that has a porous surface which allows bone ingrowth
to lock it in place.
These are significant operations but, as a rule, are
well tolerated by people even in their eighties and
nineties. The ideal candidate for this surgery is
someone who is at least 50 years old, in relatively
good health, and does not have to do extensive
pounding (such as running and jumping) or heavy
lifting after surgery.
After surgery, the average patient is in the hospital
from three to five days. Most patients report having
less pain within several days, while for some, it
takes three to six weeks. The patient's joint
function usually improves for more than one year. It
is not unusual for a person who could walk less than
a block before surgery to walk over a mile at a time
after surgery. Also, because of limited ambulation
preoperatively, many people have decreased their
cardiac function. With the increase in activity after
surgery, much of this lost function can be regained.
At ten years after surgery, well over 90% of hip and
knee replacements are still good and functioning, and
at 20 years, over 80% are still good and functioning.
Although these total joint replacements can never be
normal joints, they are quite predictable in
lessening pain and increasing function. Almost one
third of our patients tell us they with they had had
the surgery done sooner. Of all the patients that we
treat at Orthopedic Associates, those with a total
joint replacement are often the most satisfied and
grateful because they have less pain, increased
function and have maintained their independence.
TOP OF PAGE
 Orthopedic Associates,
P.C.
65 Pennsylvania Avenue
Binghamton, New York 13903
Phone: Main Office Phone: 607-723-5393
Spine Center
607-773-BACK
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