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What type of procedures are offered in this practice? |
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Please view our Procedures
page for an overview of our procedural services.
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What hospital do you use? |
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The Augusta Medical Center in Fishersville, Virginia.
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Are procedures done in the office? |
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Small procedures requiring local anesthesia are performed in the office.
These include carpal tunnel release, trigger finger, toe nail ablation,
and pin removal.
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Do residents assist with surgery? |
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The
Augusta Medical Center is not a teaching hospital. Only surgeons and
surgical staff assist with surgery.
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Do you have an affiliation with the University of
Virginia’s Medical Center? |
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Although our
practice and our hospital have no official affiliation with the
University, we enjoy a healthy working relationship with the orthopedic
department at UVA.
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Do I need a referral? |
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It
depends on the type of insurance you have. If you aren’t sure, call
your insurance company to ask.
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Would you recommend the glucosamine and chondroitin sulfate arthritis treatment? |
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One of the newest treatments for osteoarthritis are two
supplements naturally found in the body that are essential to the
metabolism of cartilage. These supplements, glucosamine and chondroitin
sulfate, have been claimed to ease pain and stiffness associated with
osteoarthritis. Currently these supplements are in the last stages of
clinical testing to show objective improvements. The multi-center study
results are due out by the end of this year.
These supplements are not regulated by the Food and Drug
Administration. There is no quality control of these products, and while
Natalie Eddington, PhD, a
pharmacist and associate professor in the School
of Pharmacy at the University of Maryland, has tested about thirty brands
of these two supplements, a few contained significantly less of the
substance than the label claimed. To be on the safe side, read all labels
carefully and avoid chondroitin made from shark cartilage because the
quality is inconsistent. Also, buy these supplements locally and not
through the mail. The average cost should be one to three dollars a day
and will probably not be covered by insurance.
The recommended dosage is 1,500mg glucosamine and
1,200mg chondroitin per day. If this works, over several months the dosage
can be decreased. While glucosamine has been shown in a few studies to
ease pain, most chondroitin studies have been done with an injectable form
rather than pill form which may not be absorbed as well by the body. These
supplements can be taken along with nonsteroidal anti-inflammatory drugs (NSAID)
for six to eight weeks. After this time, the NSAIDs can be stopped to see
whether there is a change in pain or stiffness.
Not everyone will benefit from these supplements. If no
change in pain or stiffness is seen within three months, it is not likely
a change will ever be seen. Most people in the studies began to benefit
from the supplements in six to eight weeks while others only experienced
partial relief and still had to take NSAIDs for full relief. Others never
showed any relief in the study.
With all new treatments, see your doctor first to see if
you’re a candidate for the treatment. Also be sure that these
supplements will not interfere with other medications you may be taking,
especially those to treat diabetes or blood-thinning medication. These
supplements do not treat tumors, stress fractures, rheumatoid
arthritis,
or gout so be sure your joint pain is attributed to osteoarthritis. These
supplements should not be given to children nor should pregnant women take
them because there have not been enough studies conducted. Lastly, do not
stop proven pain management techniques such as exercise, maintaining a
healthy weight, or taking medications prescribed by your doctor.
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What is injection therapy and is it right for me?
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If you or someone you know suffers from the pain of osteoarthritis
(OA), it most likely has caused both pain and limited movement. It is
estimated that almost 14 million Americans suffer from OA of the knee.
In a normal knee, there is joint fluid that acts as a lubricant and a
cushion. In OA, this fluid may have lost these features and fails to
protect the knee cartilage. Injection therapy is like lubrication of the knee.
Synvisc is administered in three injections over a 3-week period.
Lubrication and pain relief can last for up to 6 month. Some patients
can feel relief immediately―in others, the full effect may take
5-9 weeks to develop.
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What is Synvisc? |
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Synvisc is used in injection therapy and can act as a “shock absorber” to cushion the knee. It can
reduce pain and increase motion. Synvisc
is not a drug. It is made from a substance found in normal joint
fluid. Synvisc is administered in three injections over a 3-week period.
Lubrication and pain relief can last for up to 6 month. Some patients
can feel relief immediately―in others, the full effect may take
5-9 weeks to develop. Synvisc
is NOT a cure. It is an additional means of reducing pain and
increasing mobility to work with your arthritis medicines and
exercise. If you would like to know more about Synvisc,
ask your doctor or call 1-800-99WYETH.
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What is Osteoporosis?
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Every postmenopausal woman should be evaluated for
her “risk” of osteoporosis. Osteoporosis is a “silent” risk
factor for fracture just as high blood pressure is for stroke. 13-18% of
postmenopausal women in the US have osteoporosis. An additional 30-50%
have low bone density (thickness) at the hip. More than 10 million
people total in the US have osteoporosis of the hip. Almost one of every
two white women will experience an osteoporotic fracture in their
lifetime. There is a significant, although lower, risk for non-white
women and men. Hip fractures are associated with 10-20% mortality within
1 year; up to 25% of patients need long-term nursing care.
Any woman >65 years old with hip or spine
fracture should be evaluated. Bone mineral density (BMD) studies should
be done for any woman at risk. A BMD scan is a specialized x-ray to
measure the thickness and strength of bone. Calcium supplements,
hormones, and special medicines to enable the body to keep more calcium
may be recommended based on BMD studies. Dietary
calcium intake should be 1200mg/day
and Vitamin D intake should be 400-800IU/day.
Regular exercise and muscle strengthening is also recommended. All
patients should be advised to avoid tobacco and use alcohol in
moderation.
For additional information, contact the National
Osteoporosis Foundation at http://www.nof.org.
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Where do I find out information about my particular disease or
condition?
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Our links guide will direct you to several sources of orthopedic patient
information. Click on our LINKS button to get to our links list.
Each link has a search engine: type in what you are looking for
and print out the results. If one link does not provide the
necessary information, try a different one.
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Do I need to take antibiotics if I have a joint
replacement or cages prior to dental procedures or other surgery?
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Infection can occur in total joint replacements long after surgery. If a
joint replacement is exposed to bacteria in the blood stream, the
bacteria can collect and cause an infection. It is uncommon for an
infection to occur long after surgery, but it is possible. For that
reason, we recommend that you receive antibiotics if you should have any
of the following procedures...read more
and print an information sheet.
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What
can I expect pre- and post-operatively for arthroscopy of the
knee at your hospital?
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After surgery you will usually be allowed to put as much weight on your
operated leg as tolerated. You may need to use crutches or a walker for several days. Most people need to use crutches
for about two days, but this can vary due to pain and swelling. Occasionally your physician may need
to alter your instructions after surgery.
Make sure that you understand
and follow any new instructions. Strengthening
and range of motion exercises are a vital part of your
rehab or recovery from this surgery. Your exercise program is divided up into three phases...read more
and print an information sheet.
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Links to Orthopedic Resources