Elbow

Biceps Tendon Surgery

The biceps tendon attaches muscles to the shoulder in two separate places and helps bend the elbow and rotate the forearm.  Injury to the tendon can occur as a result of age, inactivity or over-activity, and can result in inflammation or a partial or complete tear. These injuries can cause severe pain, bruising and weakness.

Treatment for biceps tendon injuries may only require rest and anti-inflammatory medications, but more severe cases may require surgery. Surgical treatment depends on the type and severity of the condition. Most of these procedures can be performed through arthroscopy to reduce incision size and recovery time. Theses surgeries can include simply shaving away the torn fibers, removing the torn tendon stump and reattaching the remaining tendon (tenodesis), or completely reattaching torn tendons with screws and sutures.

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Elbow Arthroscopy

Arthroscopy is a type of surgery that uses an arthroscope (thin fiber optic camera) to visualize the area to be operated on, as well as multiple small portals which the surgeon’s tools are manipulated through. This procedure offers patients a relatively shorter recovery time as opposed to conventional “open” surgery. Much less soft tissue is injured during the operation, leaving less room for post-surgery complications.

Elbow arthroscopy is generally used for simple manipulations of the joint. For instance, a patient with a compound fracture may have multiple fragments of the bone removed through arthroscopic surgery, but a replacement prosthetic most likely would not fit through a portal. It is also very useful for arthritis, as tools capable of debriding can be inserted and used to smooth out the problematic bone surfaces in a minimally invasive manner.

The arthroscopic procedures are commonly used to confirm and examine abnormalities occurring in patients. This diagnostic use is helpful in ensuring that the patient will be recovering in the shortest amount of time possible.

However, arthroscopy is not nearly as prevalent in elbow surgery as it is in other joint specialties such as the knee. This is because the small structure of the joint requires very specialized training so the surgeon does not to disturb the multiple nerves crossing the joint. This forms an inherent risk in any procedure in the elbow, but more so in arthroscopy due to its nature of camera insertion.

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Elbow Replacement

Elbow replacement is a surgical procedure performed to treat severe elbow damage caused by osteoarthritis, broken bones, tissue damage or tumors, as well as to correct previously failed outcomes from other elbow surgery. The elbow joint is made up of the upper arm (humerus) and the forearm (ulna), both of which can become damaged and lead to pain and stiffness within the joint.

This procedure is performed under general anesthesia and involves removing the damaged ends of the humerus and ulna bones and replacing them with prosthetic replacements. These devices are held in place with bone cement and joined together with a hinge. The arm is then placed in a splint to keep it stable while it heals. Physical therapy usually lasts about three months, with most patients benefiting from restored strength and range of motion.

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Platelet Rich Plasma (PRP) Therapy : A New Direction in Musculoskeletal Treatment

What is Platelet Rich Plasma (PRP) Therapy ?

Platelet Rich Plasma (PRP) therapy is a new method for treatment of musculoskeletal ailments. The treatment is surprisingly simple and safe when compared with many medications or surgery often used for the same conditions. PRP therapy is done by obtaining a sample of blood from a patient, isolating the platelets into a concentrated dose and injecting them into an injured area. PRP is a potentially promising solution to accelerate healing of tendon injuries, which have traditionally been slow to heal themselves.

How long has Platelet Rich Plasma (PRP) been used?

The first documented use of PRP was in 1987 following open heart surgery. Since then it has been used in numerous other fields such as orthopedics, neurosurgery, ophthalmology, dentistry, cosmetic surgery, urology and ENT surgery. It is frequently used by orthopedic doctors as part of surgery, and has recently gained popularity as a separate procedure as well.

How does PRP work?

The science behind PRP therapy is based on concentrating platelets, specialized cells in our blood that are responsible for wound healing, and injecting these cells into an area of injury. Platelets function to clot blood and release growth factors, which stimulate repair of soft tissue. By concentrating the platelets, we can concentrate the growth factors up to eight times their normal levels. This allows a sports medicine physician to introduce a “supercharged dose” of healing activity into a particular area.

How is PRP therapy done?

In the doctor’s office, a sample of blood (about 1 ounce) is obtained and placed into a special container. This container of blood is then spun in a centrifuge, which separates the blood into three main layers: plasma, the liquid component of blood; red blood cells, which carry oxygen; and the PRP, which contains the platelets and white blood cells. The PRP is then carefully extracted using an optical sensor into a separate syringe for injection into the patient’s injured area. The entire procedure takes about one hour.

How is a PRP injection different from a cortisone (steroid) injection?

Cortisone (steroid) injections work by reducing the body’s own inflammation in an injured area and slowing the body’s attempt to heal itself. PRP is designed to do the opposite: to stimulate a large healing response to overcome an injury faster.

What are the side effects?

The injection itself can be painful and the arm may be sore for a few days after the procedure. Other potential adverse reactions, although rare, may include infection, skin discoloration, calcification or worsening of the initial symptoms. Because the procedure uses your own blood, there is no risk of disease transmission or rejection.

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