WHAT IS A SPORTS MEDICINE DOCTOR?

If you or your child sustain an injury during exercise, sports participation, or any type of physical activity, you may be advised to see a sports medicine trained doctor for treatment. A sports medicine trained doctor has specialized training in both the treatment and prevention of sports-related injuries and is also knowledgeable about preventing injury in active people. These specialized doctors are board certified and have extensive additional training through residencies and fellowships.

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WOMEN'S HEALTH AND FITNESS

While many women strive for the finish line with nutrition and exercise, there is another competitor: good posture. As the fashion industry seeks to improve our appearance with sportswear, the battle exists between what looks good and what is truly reinforcing our hard efforts to sustain good posture.   Research shows we spend upwards of 5,000 repetitions of forward bending a day. Whether we are bending over to brush our teeth, tie our shoes or do the infamous leaning over a cellphone or….

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JOINT REPLACEMENT AND YOUR HEALTH AND WELL-BEING

Joint replacement is indicated for patients who are experiencing intolerable pain and problems with daily functioning. In other words, they have end-stage arthritis. The X-rays of this type of arthritis usually show “bone on bone.” We all want to maximize our health and well-being, so common questions from these patients include, “When should I have joint replacement?” and “What will happen if I wait?”

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JOINT REPLACEMENT AND YOUR HEALTH AND WELL-BEING

to treat or become untreatable. We usually have to make a decision about treatment that will make us healthy again or prolong our life. If we delay treatment, we may miss an opportunity for a cure or shortened disease process.


Pain is the No. 1 criteria for deciding when to have a joint replacement. It is not based on how stiff the joint is or how much noise it makes or whether it is swelling. All these symptoms are secondary signs of arthritis and we can usually live and function with them if it does not hurt.


Pain that interferes with daily function is the standard we use to judge the impact of the arthritis. We assess criteria such as if it gets difficult to walk or if every step hurts; if it is difficult to go upstairs and you need a banister; if you need arms on a chair because it is difficult to get up; and especially if the pain wakes you up or keeps you awake.


So if we know pain and dysfunction tell us when to have a joint replacement, why not just have it? If we know arthritis is incurable and it slowly progresses despite the best of modern medicine, why not have replacement surgery as soon as the

diagnosis of arthritis is made? That way you won’t have to experience the pain and you can get ahead of it. But joint replacement is not a benign procedure. There are risks to be weighed against the benefits.


The risks rates are very low but the risks themselves are very real. There are risks with early and late complications with the surgery. Anesthesia risks can range from nausea to serious heart and lung complications. The surgery can result in issues such as bleeding, pain, blood clots, infection, fracture and dislocation. Long- term complications can include infection, loosening, incomplete pain relief and failure of the components. Basically, it is best to wait until your life is miserable from pain before you have the surgery.


A good analogy is to think of it like a dirty car that needs to be washed. The dirtier the car gets, the better it looks when it is washed! The worse the joint pain is, the more you will appreciate the surgery, and you are much more willing to accept the risks of the procedure. We know a patient is ready for surgery when he or she comes in and says, “Doc, I don’t care if you cut it off!” or “I don’t care what you do, just make it stop hurting.”


The operation has improved over the years. Many joint replacements can be performed as same-day surgery, allowing the patient to sleep in his or her own bed that night. The surgery is not a life-saving but a lifestyle-saving procedure. It does not improve health but it does improve well-being. It is an excellent choice when all else fails. So the best advice on when to do it is to realize you’ll know when it is time.  

GREG D’ANGELO, M.D.

Dr. D’Angelo is a senior partner in Bluegrass Orthopaedics.  Dr. D’Angelo has specialty training in adult joint reconstruction of  knees and hips.  He has also been fellowship trained in arthroscopic (minimally invasive) joint surgery as well.  He has performed thousands of knee and hip surgery procedures.  He has an interest in performing minimally invasive surgery such as the anterior approach for hips and partial knee replacement as well as developing techniques that minimize post operative pain and for rapid mobilization and rehabilitation.  

more articles by Greg D'Angelo

Joint replacement is indicated for patients who are experiencing intolerable pain and problems with daily functioning. In other words, they have end-stage arthritis. The X-rays of this type of arthritis usually show “bone on bone.” We all want to maximize our health and well-being, so common questions from these patients include, “When should I have joint replacement?” and “What will happen if I wait?”


Joint replacement surgery is one of the largest line-item expenses for Medicare, but it is also one of the most successful and cost-effective surgeries performed in the United States. It provides pain relief for the patient and adds net revenue to the economy with improvements in function and income- earning potential. It can contribute greatly to a patient’s well-being but not to their health.


Replacing a joint is different than most surgeries. In contrast to most of the medical treatment we receive, joint replacement will not improve health or prolong life. We get vaccines, take medicines and have surgery to prevent or cure a disease. These diseases can adversely affect our health and therefore our well-being. Pain in our joints is rarely a sign of a life-threatening condition. Pain anywhere else in our bodies raises a concern for possible serious health conditions.


So how do you decide if or when to have a joint replacement? After all, most other medical treatments have to be obtained in a certain timeframe to be effective or the disease will get more difficult