Orthopedics

Orthopedic surgeons, physiatrists, and their patients writing on KevinMD about musculoskeletal care: back pain and the procedures that can weaken a young spine, knee and joint surgery, spinal stenosis treated least invasive first, non-opioid pain management and how it is paid, orthopedic residency and the women entering it, and what a patient in pain needs to be asked. Two maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words and Surgeons and surgery: what surgeons say, in their own words.

To have success and fulfillment, sometimes you have to edit your life

Nancy Yen Shipley, MD

Physician

August 24, 2019

This year, I learned that to have success and fulfillment, you don’t just do, sometimes you have to undo.

What do I mean by that? The process of undoing — or editing — it a key part of different areas of our lives. For example, we edit in medicine all the time. Think about the medical student’s SOAP note: the subjective story, the objective findings, the assessment, and the plan. Imagine …

The physician who became a chronic pain patient in seconds

Linda Girgis, MD

Physician

August 2, 2019

It took me decades of studying, training, hard work, and sleepless nights to become a doctor. In approximately five years, I became a successful writer, editor, columnist, and a whole array of other titles assigned to that type of work. In under 3 seconds, I became a chronic pain patient for the rest of my life.

Around this time last year, I was taking my two dogs outdoors when they spotted …

The history of viewing bones through telescopes

Roy A. Meals, MD

Conditions and Diseases

June 25, 2019

It is probable that primitive man’s curiosity markedly increased soon after he stood up and started walking on just his feet. He could both peek into caves and drop back onto all fours to peer down badger holes. Looking into his family’s mouths and ears soon followed. Many generations later, his progeny developed metal tubes and glimpsed human interiors through all of our natural orifices. Lighting, however, was always an …

Fasting for Ramadan and being the on-call orthopedic trauma resident

Adil Shahzad Ahmed, MD

Physician

June 20, 2019

A patient groans in agony lying atop a rigid spine board, carried by paramedics into the ER, his neck in a protective collar. The paramedics shout a summary of the accident. Monitors are attached to the man, flashing and beeping the cadence of vital signs. Nurses and physicians swarm. Gloved hands comb through brown hair for bumps or lacerations. They remove his clothes, feeling for pulses in the neck and …

How to take out a bone loan

Roy A. Meals, MD

Conditions and Diseases

June 11, 2019

After a severe fracture or removal of a tumor, what happens if a segment of bone is missing? The bone ends will try to grow into one another just as they do after routine fractures, but the lack of immobilization and the gap may be insurmountable despite how hard the bone tries to repair itself. The void instead fills with gristle-like scar tissue, which cannot restore stability. A wobbly false …

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How to take out a bone loan

The inspiring story of a female orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

June 10, 2019

As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.

I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …

The journey from hand surgeon to entrepreneur

Eric George, MD

Physician

June 7, 2019

An excerpt from We: Ditch the Me Mindset and Change the World.

We use them to greet friends, congratulate acquaintances, and embrace loved ones.

To lay bricks, perform surgeries, and sculpt artwork.

Everyone uses them thousands of times a day in a variety of different ways.

It took me years to recognize …

The journey from a low GPA to an orthopaedic surgeon

Nancy Yen Shipley, MD

Physician

May 27, 2019

I’m an orthopaedic surgeon, but if you told me I’d be here when I graduated from college, I’d be laughing at you. When I got started in college, I thought I was going to be pre-med and apply to medical school. It was not a well-thought-out decision. I thought that this was what good Chinese-American children do: Grow up to become doctors. It became clear that this goal was parent-driven …

Does running cause arthritis?

Nancy Yen Shipley, MD

Conditions and Diseases

April 15, 2019

In general, physical activity is important in maintaining your health. Many people falsely believe that running can cause arthritis but research show that this isn’t necessarily true.

In reality, walking, running or strenuous exercise can significantly decrease risk of any knee osteoarthritis. Doctors are still trying to understand how running can improve knee arthritis, with continual research studies.

Osteoarthritis (OA) is the most common form of arthritis caused by trauma or overuse …

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Does running cause arthritis?

Why it’s important to remove the sutures you place

Jay Talsania, MD

Conditions and Diseases

March 31, 2019

As a surgeon who has been practicing for more than 20 years, I have had a front row seat to both positive and negative changes that have taken place in our evolving medical field. As a community hand surgeon who values many of the recent advances in hand surgery, there is one piece of tried-and-true advice that I still find helpful in my practice to this day: Remove your own …

An orthopedic surgeon’s guide to tennis elbow

Nancy Yen Shipley, MD

Conditions and Diseases

March 15, 2019

As a sports medicine orthopaedic surgeon, I often see patients with complaints at their elbow. One of the more common diagnoses is tennis elbow, otherwise known as lateral epicondylitis. Surprisingly, most of my patients with this condition don’t even play tennis! Many types of repetitive arm movement can lead to tennis elbow. It all has to do with the tendons in our arms.

Tendons are the structures that hold muscle to …

How to prevent ski injuries: tips from an orthopedic surgeon

Nancy Yen Shipley, MD

Conditions and Diseases

March 7, 2019

Ski season is here, and it’s time to think about how we can avoid injuries on the slopes. As an orthopaedic surgeon, I most often see knee injuries, but also plenty of wrist, elbow and shoulder injuries as well.

Hopefully, you’ve done some pre-season conditioning — but if not, go ahead and start now! Obviously, avoid a heavy workout the day before your first ski day, but if you have time …

The history and physical often falls by the wayside in modern medicine. That’s a shame.

Lindsey Migliore, DO

Conditions and Diseases

February 11, 2019

Did you feel a pop?

It is a simple question that we rattle off to complete our musculoskeletal history. The answer may or may not give higher suspicion for a diagnosis of tear over sprains.

But have you — the provider — ever felt a pop?

Like any good physiatrist, I try to fill my extracurricular time with physical activity. This inevitably led to the formation of a residency street hockey team.

Ten minutes …

Twitch, Fortnite, and the emergence of eSports medicine

Lindsey Migliore, DO

Physician

February 8, 2019

Here is a simple question: In terms of social media engagements, who is the most popular athlete in the world?

Super Bowl sensation and apparent immortal Tom Brady? Nope.

Philanthropist Lebron James? Not even close.

International superstar Cristiano Ronaldo? It used to be.

Tyler Blevins.

For those of you now drawing a blank, unable to conjure up a face to fit the name, go ask your kids if they have ever heard …

How to cut avocados: tips from an orthopedic surgeon

Nancy Yen Shipley, MD

Conditions and Diseases

February 7, 2019

Love avocados, but hate cutting them. They are slippery little rascals and are responsible for many nasty hand injuries.

Stab wounds from using knives in the kitchen are not fun but are reported daily. Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery.

Many of us do not think about how much you use “your hands for your senses.”

Until you lose that ability …

An orthopedic surgeon’s bone broth journey

Roy A. Meals, MD

Physician

January 19, 2019

Many cooks traditionally use broth derived from simmered bones of fish, fowl, or four-footed critters to flavor soups and sauces. Recently, bone-broth bars have popped up around the country and serve a non-caffeinated, nutritious alternative to tea or coffee. In some of these health-conscious establishments, the owners claim that these drinks also have filling, cleansing, and detoxing capabilities.

I decided to see if a daily cup of bone broth should be …

A tipping point for women physicians at the podium

Jennifer Weiss, MD

Physician

December 28, 2018

It has been suggested that once leadership of an organization is made up of 30 percent women, integration and increased success are enjoyed. As an orthopaedic surgeon, the feeling of being surrounded by so many women is not something that I have experienced. But last week I felt something close.

The International Pediatric Orthopaedic Symposium (IPOS) has been held in Orlando, Florida, for the past 12 …

The challenge of no to arthroscopic surgery

Eric Bohm, MD and Ivan Wong, MD

Conditions and Diseases

December 6, 2018

Nearly half of Canadians aged 65 and over experience osteoarthritis in their knees. Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage on the ends of bones wears down over time leading to pain, stiffness and decreased mobility. It frequently occurs in the hips and knees — and can be quite painful.

To help improve mobility and treat joint pain, it has been …

What this physician learned after coming back from a medical crisis

Linda Girgis, MD

Physician

November 30, 2018

Medical crises come in many forms: from illnesses to sudden injuries. Most often the victims are unsuspecting. They may be gradual in onset or happen in seconds. There are many causes, from faulty drivers to electrolyte disturbances. Mine was caused by a squirrel, a routine yard rodent. In less than three seconds, I went from a practicing physician with a heavy patient load to temporarily disabled.

Returning home from a busy …

The increasingly obfuscated medical algorithms for simple problems

James A. Amis, MD

Conditions and Diseases

November 23, 2018

A physical therapist, commenting on my blog, recently shared an excellent point of view with me:

As a therapist myself, I don’t know that I’d want to be betting on that differential diagnosis of tear, rupture, etc. when giving online advice. What is good treatment for one, can be disastrous for the other. Seeing someone in person can make all the difference, especially with the amount of self-diagnosis that the internet …

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The increasingly obfuscated medical algorithms for simple problems