Patient Education

The following information is intended to provide you with general information about orthopedics and orthopedic care. It is not intended to be a substitute for medical advice and information provided by your health care provider. Any decision you make regarding your health care options should be made after consulting a qualified physician.

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.

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.

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.

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.

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.

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.

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..

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.

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.

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.

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:

  1. 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!)
  2. 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.
  3. 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.

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.


Contact us today to learn more about the services we offer or to request an appointment.

  • Orthopedic Associates, P.C.
  • 65 Pennsylvania Ave • Binghamton, NY 13903
  • (607) 723-5393

The information listed on this site is common guidance and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. Should you have a medical emergency, phone 911.