Frequently Asked Questions, from The Center for Orthopaedics - KPLC 7 News, Lake Charles, Louisiana

Frequently Asked Questions, from The Center for Orthopaedics

Q: What causes ganglings, and is there any cure for them?

A: We don't know what causes them but the treatment is often removal

Q: Do I need to see an orthopedic doctor to determine what type of arthritis I have in my left wrist or should I go to a rheumatologist for this?

A: It would be quicker to see an orthopaedist who can start lab work.  If lab work comes out positive then a referral to a rheumatologist would be necessary.

Q: Last Sunday the lid to the washing machine fell down and closed on my pinky finger.  Since that time I do have the ability to somewhat bend/move it but it still hurts every now and then.  What should I do? Co-workers think I should have it x-rayed to see if it is broken but my husband has said that nothing can be done if it is actually broken. Any suggestions?

A: X-rays should be taken to ensure there is no fracture. Additionally, a mallet finger needs early splint treatment. Most minor finger injuries need early range of motion. I would be glad to help you.

Q: I have major problems with the joints all over my body. I have pain in all of my joints but all at different times on different days. One day I'll wake up and my knee will be hurting then by the end of the day it will be all the way through my hips and down to my ankle, this will last a couple days and then all of a sudden stop and a few days later some other part would be in pain. My biggest problems are in my knees and wrists but it gets bad in my shoulders, elbows, hips and ankles as well. I've continuously read up on this and I thought that I might have a form of Rheumatoids or Osteoarthritis but when I was tested for both, found I had neither. I was also tested for Psoriatic Arthritis to because I have Psoriasis Legions on my ankles but that came up negative as well. At the time that the tests were done though I was under care of an orthopaedic doctor and taking anti-inflammatories. Could this have affected the results? I have recently grown calcium deposits on my wrists and they have been diagnosed as Carpal Boss, although no one has really been able to tell me what that means. What it means to me is that I have a bone sticking out of my wrist that is painful to touch, it only gets worse through physical therapy and wearing a brace around it is painful. My thumbs get stiff and locked in place and when I can't move them anymore I have to pull them to pop them and when I do I feel a painful pop in my elbow as well. No one has been able to tell me why this happens. In every single one of my joints when I move them they pop repeatedly either back and forth or I can move them in a circular motion and they pop all the way around, it's really disgusting and painful and my orthopaedic doctor can't explain that either. Could it all be connected, could I have some weird disorder. I'm desperate for answers, I am a 27 year old mother of 5 and would like my active lifestyle back. I used to cheerlead in grade school and that's around when all the weird popping started but back then it wasn't painful. I've also been told by docs that I have hyperextendability and have been diagnosed as having possible Fibromyalgia but again they are not really sure. Any suggestions on what I should do or test to look into that may help me figure this out?

A: You needs to see a rheumatologist.  If you have already seen one perhaps you should get a second opinion.

Q: What are different afflictions that can cause pain in hip joints? I am only 28, 5 foot 3 inches, and 115 lbs. pretty healthy and active but find when I stretch or hold my legs in certain positions they will hurt or I get a very sharp uncomfortable pain shoot through them? What remedies could help w/ this or what kind of exercises would help with this if any?

A
: You probably have hip dysplasia.  If you are having a lot of sharp pain your hips you really need to be seen.

Q: I am having a lot of burning around my left ankle and foot due to neuropathy but my leg stays numb - I can't feel it when I shave could something else be causing a problem. I had fracture my ankle about 5 years ago and cast it to early and to tight messed up some nerves.

A: I would first want to know what is the cause of the neuropathy.  Many people are diagnosed as having neuropathy when there are other causative factors that are treatable such as impingment of nerves in the lower back.  One sided or unilateral neuropathy usually does not occur without a causative factor like this.  Diabetic or ideopathic (cause unknown) neuropathy usually affects both legs in a symmetrical pattern.  Once the cause is found for the neuropathy then treatment regimen can be tailored for you.  Hope this helps!

Q: I had a grandmother whom had rhumetoid arthritis until she died will I inherite her condition. I was told about 5 years ago that I had developed arthritis in my left wrist which I broke in a fall 10 years ago while visiting an aunt of mine. my wrist doesn't hurt all time but since I have been working a baby quilt for onw of my nieces whom is going to be having twins my left wrist has starting hurting when ever I would turn it a certain way to do my embrodiery. do you think I need to see an arthipedic doctor about this?

A: It is doubtful you will get RA.  If you are having pain in just one wrist you should see an orthopaedic.

Q: Recently my hip started like cracking or poping a lot when I walk or bend over, etc. This has been going on now for about 3 weeks and sometimes it hurts and it's sore to move around and sometimes it's not. Was wondering if this could be something to worry about?

A: Thank you for your question. Dr. Noble provided the following answer.

Yes this is likely related to arthritis or possibly even a cartilage tear of the labrum.

Q: I had a terrible bike wreck in August 2006 and am now on social security. My leg was badly crushed when the bike landed on top of me. I now have a foot that the toes on are severely clawed and has both loss of feeling in areas and hyper sensitivity in others. I recently was told that no one in the Lake Charles area will accept my Medicaid or medicare. What can I do to see a local doctor instead of having to travel all the way to Shreveport. Please I am desperate and need help I cannot afford to travel and am unable to walk without a cane. I fall often and want to get off pain killers.

A: Thank you for your question. Dr. Green provided the following answer.

Unfortunately, it sounds like the effects of the injury will be difficult to treat and get you relief no matter where you end up going.  The first thing to do is get a thorough evaluation as to where the pain and spasticity are coming from, then this will set you in the right direction of a specialist that may be able to help whether they are a foot & ankle, nerve, or rehab specialist.  Different doctors can see or not see different insurances and that can sometimes be a difficult hurdle.  We accept both medicare and medicaid here...the only problem is if I had to refer you to someone else we may run into the same situation.  I hope this helps.

Q: Are replacement ankles available yet?

A: Thank you for your question. Dr. Green provided the following answer.

There are ankle replacements available.  They have been around for quite some time now but are far from being as successful as we have gotten with knee replacements.  The ankles take quite a brunt of the force in everyday walking and this makes it hard for the replacements to last an extended period of time.  There are some newer components on the market that are exciting for the future of ankle replacement but as with all new things only time will tell if we have improved on the overall success of the procedure.  Ankle fusions are also successful surgeries in treating end stage ankle arthritis and have been well researched on long term results.  Patient selection comes into play with either replacement or fusion and you and your physician can determine which is right for you.

Q: What are some do and don't in having knee replacement in one knee at a time to both knees at the same time?

A: Thank you for your question. Dr. Noble provided the following answer.

The major problem with both knees is the extent of surgery and the difficulty in recovering.  It has been my practice to do only one at a time. It is a little like doing cataract surgery.  They never do both at same time because a complication could cause total blindness. 

Q: I am 34 and when I was a toddler I had 2 surgeries for very bad club feet. Now there are times that my ankles hurt so bad I can hardly walk. I am on arth. meds but still having problems. What can be done?

A: Thank you for your question. Dr. Green provided the following answer.

Unfortunately sometimes with as extensive of corrective surgery for club foot that it sounds like you had people have a tendency to put added stress and strain on the hind foot and ankles from compensation over the years.  Although the surgery allowed you to have a mobile active lifestyle sometimes arthritis or other "wear and tear" aspects come into play even with a successful surgery.  There are a number of conservative options to help you relieve some of the pain you are having including anti-inflammatories, either oral or inject able, to custom orthotic devices which can fit into your shoes keeping adequate alignment to help limit some of the unnecessary motion your hind foot and ankle are going through to compensate.

Q: I am a male 60 years old and weight 185 lbs., never smoked, get plenty of exercise and for the last year I have been experiencing numbness in the middle of right foot. When i wear my work boots, it feels light my boots are too tight. The boots I had before the ones I have know had a padded top and just above the top of the boots my legs would swell and the next morning the swelling would be gone. I am worried about the numbness, what should I do?

A: Thank you for your question. Dr. Green provided the following answer.

Numbness can be caused from pressure on the nerves on top of the foot with tight shoes or boots however it is not a very common cause.  Sensations of numbness can be from a variety of reasons from neuropathy to neuropraxia like with tight shoes.  A simple physical exam could possibly lead you in the right direction.  If more detailed testing is needed for nerve symptoms they are usually minimal or non-invasive.

Q: I have a 14 year old daughter who is a cheerleader. Her ankle hurts her and when she walks it clicks on every step she makes. Just wondering if that is something we should have looked at?

A: Thank you for your question. Dr. Green provided the following answer.

About 90% of the time people who develop a clicking noise in their ankles when they walk have a peroneal dislocation. When an ankle is sprained, one of the peroneal tendons can be torn or damaged along with the lateral ankle ligaments. Over time it can flop out of position, causing a clicking sound, often when the ankle is flexed, as it does when going up or down stairs. Usually patients can reproduce the sound, and sometimes you can see the tendon pop around the outside of the ankle. If it isn't painful and doesn't bother you, you don't need to do anything about it, but if it becomes painful you should look into it before the tendon becomes irritated or even degenerates. Orthotics inside the shoes can be a simple way to help alleviate this popping and in several cases surgery is required to repair the tendon(s) and the structure that holds it in its proper place.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

This response if for informational purposes only and does not take the place of a medical exam or individual diagnosis.

Q: I have been trying to begin walking for exercise.  Twice I have started out walking for ten minutes on an indoor track for two days in a row.  I wanted to try and ease into it.  My knees (left more than right) swell up like I have fluid on them and I can't bend them without pain.  I usually sit "indian style" at home, but I can't even sit comfortably. Help??

A: Thank you for your question. Dr. Noble provided the following answer.

Likely has early osteoarthritis or degenerative meniscal tears.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: How long does a person have to be off of work that has a bone bank disk replacement in their neck?

A: Dr. James Perry provided the following answer.

This can vary for each patient.  It depends on what type of work patients perform and their pain tolerance.  Most patients return to work within 2-6 weeks.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

This response if for informational purposes only and does not take the place of a medical exam or individual diagnosis.

Q: I had a hip replacement in 1999 and in 2008 had to have it remove because of infection. Now the infection is gone. But I have no hip joint. Can anything be done to replace it again?

A: Thank you for your question. Dr. John W. Noble, Jr., MD provided the following answer.

It depends on multiple factors.  I would recommend that you see a joint revision expert.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

This response if for informational purposes only and does not take the place of a medical exam or individual diagnosis.

Q: What is minimum age for knee replacement?

A: Thank you for your question. Dr. Geoffrey Collins provided the following answer.

It is usually 50 years of age, except for special circumstances.


For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

This response if for informational purposes only and does not take the place of a medical exam or individual diagnosis.

Q: My son detached ligaments in his knee about 6 years ago. The Dr. said we needed to wait until he was older to repair due to the fact he was growing and they would have to drill into the bone to reattach. He is now 16 years old and for the last several months the knee swells and you can see he is in pain. However he has a fear of being put to sleep to repair the knee. Is it time for me to force him to have the knee repaired.

A: This depends on the ligament.  It could probably is the ACL ligament.  If he is experiencing swelling and giving way, probably best treated with an ACL ligament injury.

 For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: I have had 2 laminectomies. The last one helped with the excruciating pain in the right hip. I continue to experience back pain something that I'm living with everyday. Is there an answer to being pain free or less pain without another surgery? Thank you.

A: Thank you for your question. Dr. John W. Noble, Jr. provided the following answer. Yes. There are other non-surgical options that can help with chronic pain after laminectomies, yet every case is different.  Only a comprehensive examination will tell.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: Is there a nonsurgical procedure for knees?  I thought I saw an orthopaedic physician in December on the 11:30 KPLC show that did injections on knees.

A: You are probably talking about viscosupplementation or joint fluid therapy.  These are completed as a series of injections.  There are many different brand names used like Supartz, Synvisc, and Hyalgan.

Q: My husband is 56.
He is a large boned person but I can't get him to cut down on his eating.
The last time he went to a Doctor was 5 years ago.
At that point he weighed 318lbs.
He was told that he had high blood pressure and they wanted to do more test on his liver,He wouldn't go back.
I know he has to be around 400lbs now.
He's a painter and his knees are causing him severe pain.
For many years now he has taken atleast 15 Ibuprofen everyday.
He's a heavy drinker.
I have tried everything to get him to go to a Doctor,and I have even tried to put him on a diet but while he's out working,he eats fast food.
Is the weight causing his knee pain?
By the way,he's 5'11".
Please tell me what to do.
Thank you

A: Dr. Noble stated that he probably has knee arthritis and that this is more prevalent in overweight people.  He needs to cut down on the NSAIDS and may need to consider obesity surgery.  At this point in time, he is too heavy for a knee replacement.

Q: I've had pain in my right hip joint for 2-3 months now.  It does not hurt to walk or run but hurts terribly to spread the leg.  Ibuprofen does not help at all.  Exercising does not help.

A: Dr. Noble stated that you need to evaluated by an Orthopaedist.  He suspects that you have a possible labral tear.

Q:  I recently heard some information concerning a recall on certain types of screws that is used in knee surgery procedures, is this true and how can I find out if I am at risk.

A: Dr. Noble stated that he has not of any recalls.  It is probably best to search the internet for this.

Q: Hi, I am a 21 year old female college student.  I have a large
bump on the top of my left wrist. When I push on it a little, it causes a
little pain, and on some days it makes my wrist just aches!  Some people
have told me it's a calcium deposit or a cyst.  What do you think?

A: Dr. Collins provided the following answer.

Your description almost always indicates a ganglion cyst. A ganglion cyst is similar to an egg in a bicycle tire and represents a breach of the wrist capsule. It would be very rare for it to be a calcium deposit. Cyst's, when painful, usually require surgery. Down time is minimal, and successful removal without a recurrence is usually around 90%.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: My right shoulder has sharp pain in it when I raise it or try to
throw a ball. Now when I move my shoulder up and down there is a popping
in the collar bone area. I am a bus driver and occasionally when I reach
to open the door there is a painful pinching in the collar bone area.
what can be done about it and if surgery how long is the recovery? I am 50
yrs old.

A: Dr. Collins provided the following answer.

Usually that is a sign of impingement or the rotator cuff being irritated when the arm is lifted. Most patients respond well to an injection and no surgery is required. If an injection does not solve the problem, the next step is an MRI. Surgery for impingement when necessary, requires little down time.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

This response if for informational purposes only and does not take the place of a medical exam or individual diagnosis.

Q: I was coming down a 4ft. ladder at work and missed the last step and landed on my right foot and so did all 240 pounds of me. I had x-rays of both my calf area which was hurting at first and found nothing. The next day my knee was swollen and feeling weak. I can't put all of my weight on it, I can't straighten it 100% and I can only bend it so far. Again it doesn't hurt it just feels strange and it is still swollen. What do you think?

A: Dr. Treme provided the following answer.

With a fall like that, I would encourage you to have the knee evaluated.  X-rays usually will show a fracture though sometimes they are not visible for several days after the injury.  Another possibility is that you sustained an injury to one of the internal structures of the knee like a ligament or meniscus.  That would require an MRI to be fully evaluated.  Have your knee examined by your orthopaedic surgeon to get to the bottom of this.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: I ruptured the quads in both legs in a fall. I had them sewn back together. How long should it take for me to walk again?

A: Dr. Treme provided the following answer.

Recovery from that particular surgery can take 3-4 months to regain good function and up to one year to know what your final function will be.  Because it involves both tendons, recovery may be a bit slower and ambulation will be slowed until adequate healing has occurred.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: My 13yr/ old daughter was diagnosed with Osgood Schlatter. At what age should she out grow the pain?

A: Dr. Treme provided the following answer.

The majority of pain from O-S generally resolves once growth is complete (around the age of 15 or 16 for women).  On, occasion we will see symptoms persist but that is rare.  Frequently, patients are left with a prominence at the tibial tubercle that may affect kneeling but this is not usually painful except in that position.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: 12 years ago I broke both bones in my right forearm. They put metal plates with screws to heal it, now I am always in pain, no one seems to know what to do. It swells to where I can't move it, my general doctor gave me Celebrex and the swelling went down but now it's come back. I take Tylenol Arthritis just to get relief. No one wants to operate cause it looks like the plates are a part of my bones now. Please tell me if any of you can help. I have United Health Care Insurance and I really need something to help with the pain.

A: Dr. Treme provided the following answer.

Removal of plates and screws does not predictably lead to pain relief after surgery.  Your pain may be residual from the original injury.  Rarely patients will have a reaction to the metallic implants that can cause symptoms such as these.  It would be difficult to know if you would benefit from plate removal without seeing your x-rays.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: I had ankle surgery in 1999, I have a plate and 6 screws on the outside of my ankle and 2 screws on the inside. I have done aerobics and strength training for 3 years. I recently started running the GoRun program in Lake Charles. My right knee and my right ankle have started to ache. Is it ok to take ibuprofen daily? Should I be icing them daily? Should I have the hardware removed? Should I wear supportive braces on the knee and ankle? Thank you for your help.A: Dr. Treme provided the following answer.

The pain you are experiencing may be from your previous ankle injury, from your recent increase in activity, or a combination of the two.  No problem taking Ibuprofen and using ice as needed.  If you continue to have problems then you may consider seeing your orthopaedist for x-rays of the ankle and knee.  Regarding removal of the implants, rarely does that lead to pain relief unless a definite point of irritation can be identified. Because of this, we do not routinely remove plates and screws.  Again, evaluation with an exam and x-rays may help to answer that question.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

Q: I have a work related injury of the shoulder and was sent to
have an MRI. What does the white spots that appear on the MRI mean. one
certain area shoes quite a bit and there is an area that has just a
couple of white lines. What does this mean?

 

A: Dr. Geoffrey Collins provided the following answer:

MRI's differentiate between tissues with and without water.  Objects with more water show up white: inflammation, swelling, rotator cuff tears.Objects without water show up black: tendons, ligaments, and some parts of bone.  All of the grays show tissues with moderate amounts of water.  Hope this answers your questions.

Q: About 6 months ago my right knee began to be sore when I would lift my leg to get dressed. I thought it would go away but it still hurts but only in the right knee. so it wouldn't be arthritis?

A: Dr. Gehron Treme provided the following answer:

Your symptoms could be consistent with arthritis; however, if the pain is mostly when you lift the leg and not so much when you walk then the pain could be coming from a different location.  The pain may be from the knee cap or from a cartilage tear inside the knee.  The problem could be answered with an X-Ray and an exam to identify the most likely source of pain.

Q: I have had 3 knee surgeries since Oct. 07.  I fell and hit my knee on a hard surface.  The impact spot began to swell, it looked like a golf ball on my knee.   The swelling has gone
down some but it is still a good size knot and that was a couple of weeks ago.  I am not sure if there is anything I can do to help the knot to go away.  It is very noticeable.  Any suggestion? 

A: Dr. Geoffrey Collins provided the following answer:

It sounds as though you have either a hematoma (localized collection of blood) or bursitis over your knee.  Both can be caused by a direct blow to the knee.  Generally they will resolve with time but can take a while (weeks to months) to completely disappear.  If the area becomes red and inflamed then it could represent an infection and should be addressed sooner.  If there is no infection, then time should resolve the problem.  Unfortunately there is not a whole lot to do in the meantime to hurry the process along.


Q: I am having pain all the time in my neck and shoulder and it keeps me up occasionally all night. When I get up or roll over I can't stand to move.

A: Dr. Geoffrey Collins provided the following answer:
This is likely related to a cervical disc or nerve root problem but sometimes shoulder problems will cause this problem.  A good history and physical are essential plus xrays and possibly MRI could diagnose this.

Q: My left knee makes craking noises when walking getting up from a sitting position ect. after extended use there is acute pain and swelling. Also there is pain when touch pressure is applied to the area around the knee cap.

A: Dr. Geoffrey Collins provided the following answer:
First the issue of "cracking".  Knees, and joints in general, frequently make a multitude of noises.  These noises are generally harmless.  However, when there is pain accompanied by these sounds then there is more reason for concern. Given that you are experiencing swelling and pain with use and the knee is tender to touch, I would recommend that you have your knee evaluated at least by your primary care physician and probably by an orthopaedist.  Joints that swell with use almost always have an internal problem that should be addressed.

Q: My report from the hospital says I have an Anterior Labral Tear.  What is this and what can be done? 

A: Dr. Geoffrey Collins provided the following answer:
Many labral tears are actually a normal variant of shoulder anatomy.  Depending on the nature of your injury, if it is torn it will require surgery to be repaired.  If it is not torn there may be some other source of shoulder pain that may be able to be treated with therapy or and injection.  I would recommend a complete evaluation by a qualified shoulder specialist.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236). Thank you.

Q: When I rotate or move my left shoulder around I can hear clicks plus it hurts me periodically... It feels as though the muscle or something has calcified and there is something hard or a lump or stone inside. My right shoulder does not do this. I am 24yo and when I was 11yo had a compression break of spine 4,5,6. That healed ok and not sure if it contributed to my shoulder. My shoulder started hurting me recently. I am very active, fit and exercise often doing yoga, body core and flow, kick boxing, running, bike riding and more. What could this be and can it be corrected.

A: Dr. Geoffrey Collins provided the following answer:
Most commonly your symptoms can be caused by shoulder bursitis that could be resolved with an injection and strengthening program. Only rarely would surgery be required. I would recommend a complete shoulder exam by a qualified shoulder specialist.

Q: Are there any alternatives to knee replacement surgery? I have arthritis in the knee and neuropathy in the legs and feet.

A: Dr. Geoffrey Collins provided the following answer:
The treatment options available depend on the severity of the arthritis. In general, initial intervention starts with anti-inflammatory medication like Advil. Next, cortisone shots can be helpful for temporary relief, and depending on the pattern of the arthritis, other new injections can be tried. Unfortunately, for advanced arthritis that has not responded to these treatments,a knee replacement is the only real option that provides long term, durable, and predictable pain relief. In order to get her the best plan for the knees you might consider having x-rays reviewed by an orthopaedic surgeon and have a discussion regarding the options available.

Q: What does it mean if I have back pain several years after surgery?

A: Dr. Geoffrey Collins provided the following answer:
It is not uncommon to have pain return several years after surgery.  There are many potential causes for lower back pain after surgery, and treatment options will vary depending on the problem.  The most important thing to do is to remain active with a healthy diet and lifestyle.  This includes losing excessive weight, avoid smoking, maintaining flexibility, and strengthening the "core" muscles.  Prior to initiating any specific program, I highly recommend an evaluation from a spine specialist for a comprehensive evaluation.

For more information or to schedule an appointment, please call our office at 721-7CFO (7236).  Thank you.

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