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Dear Dr Ganjianpour, thank you for performing my hip replacement surgery. I am very grateful to you. Because of you, I am able to do everything that I want with no more pain.
You are an unbelievable surgeon; you gave me my life back. Thank you for my shoulder surgery and fixing my torn rotator cuff.
I cannot begin to tell you how lucky I am that I was referred to you by my friend. Because of that you were able to make me better with no surgery, good physical therapy regimen and recommendations
Mary more testimonials
Arthritis can cause the joint to become painful. Rheumatoid arthritis is an autoimmune disorder that causes inflammation of the joints throughout the body. Osteoarthritis can occur after an injury, or can be caused by excess body weight, a genetic predisposition, or just normal wear and tear. Over time, the cartilage is damaged and worn away, and eventually the bones rub directly against one another. This is what causes the pain and permanently damages the joint.
The knee works as a hinge joint, joining the femur (thigh bone) to the tibia (shin bone). Cartilage acts as a cushion between the bones, preventing them from grinding directly against one another. Muscles and tendons connect the bones and keep the joint stable. In a healthy knee, all of these factors work together seamlessly.
Knee Arthritis and Treatments
There are a number of things that can help, including physical therapy, exercise, losing weight, using a brace or cane, and taking pain-relieving medications. Unfortunately, the improvement is often only temporary. When these options have been exhausted, knee replacement may be the answer. In a total knee replacement procedure, the damaged areas of the knee joint are removed and replaced with a combination of implants that allow the joint to glide, bear weight, and perform like a natural knee. This procedure involves resurfacing and replacing the damaged portions of the knee, including the compartments at the end of the femur (thigh bone), the top of the tibia (shin bone), and the underside of the knee cap.
Prior to deciding that a total knee replacement is the best treatment option, the orthopedic surgeon performs a thorough physical examination of the patient, including range of motion testing and x-rays, a complete medical history is taken, and all alternatives are discussed with the patient. There are many factors used to determine if a patient is a candidate for total knee replacement in general. Within two weeks of the surgery, most patients are able to walk with a cane or with no support at all. Some patients are even able to resume most normal activities (other than driving) within seven to ten days after surgery. Of course, these recovery times vary with each individual. The goal of a successful total knee replacement is to relive pain and stiffness, and allow a return to normal daily activities.
Minimally Invasive Total Knee Replacement
Traditional knee replacement surgery has been proven to be highly successful at alleviating pain and restoring mobility in an Arthritic knee joint. However, rehabilitation after traditional surgery can be lengthy and painful. People often postponed knee replacement, not wanting to be away from work and everyday activities for months. The traditional surgical scars are 8-12 inches. Minimally Invasive knee arthroplasty (TKA), uses the same implants as traditional total knee replacement, but is less invasive and uses 3-5 inch incisions. The benefits of Minimally Invasive Total Knee Replacement include:
- Less trauma to muscles and tendons – the quadriceps tendon and muscles are avoided.
- Smaller, less conspicuous incisions – 3 to 5 inches vs. 8 to 12 inches.
- Shorter total rehabilitation.
- Less blood loss.
- Less pain.
- Shorter hospital stay.
- Fast return to activity and work.
As with every surgery, the results of the “Minimally invasive total knee replacement” depend on the patient’s personal circumstances, including a variety of factors such as weight, activity level, bone quality, and compliance with the physical therapy program.
The hip is a ball and socket joint, and is the largest weight bearing joint in the body. It includes the head (ball) of your thigh bone, or femur, where it joins with your pelvis, or acetabulum (socket). The hip is surrounded by muscles and ligaments. A dense, fibrous capsule, which encloses the joint like an envelope, helps hold the femoral head and acetabulum together. These soft tissues, which surround and unite the hip joint, are crucial to its stability. The surface of the hip joint is cartilage. It is this cartilage which is worn out in the process of arthritis. The treatment for arthritis in its early stages is medication and exercise. When it becomes terminal arthritis with complete loss of the cartilage, then there is bone rubbing against bone. This causes significant enough pain and stiffness that patients elect to have the surgery of total hip replacement. The conservative treatments of hip-arthritis is similar to the conservative treatments for the knee-arthritis.
Minimally Invasive Total Hip Replacement
Total hip replacement is an operation which provides a new joint surface and substitutes for the lost cartilage. Most commonly, this operation is performed by removing the bony ball and replacing it with a metal ball. The metal ball is held in the correct position by a stem (or rod) that goes into the middle of the femur (thigh bone). Most often this stem is permanently fixed to the body by bone ingrowth of the patient’s bone into the metal. In the acetabulum (pelvic side of the hip joint), a metal shell is placed against the bone and again, the bone grows into the rough surface of the metal. This gives permanent fixation. Into the metal shell is placed a liner which locks into place. This liner is most commonly plastic. Currently the plastic being used is called a highly cross-linked polyethylene. In minimally invasive total hip replacement the surgery is done through a 3 inch incision, which results in less cutting and damage to soft tissue and muscles. Minimally invasive surgery allows for less scarring, faster recovery and less pain after surgery.
There are many causes of shoulder pain. The most common causes of pain are: Tendinitis, bursitis, impingement, arthritis, tears. A rotator cuff tear is actual damage to one or more of the tendons. Rotator cuff tears vary in locations and severity, but the majority involves the supraspinatus tendon. They can occur during acute injuries such as falls on an outstretched arm or during throwing activities. They also can occur slowly over time, as with aging the quality of the tissue becomes less elastic. People over the age of 50 have a 40 percent chance of having a tear, but as many as 56 percent of people with rotator cuff injuries require surgery and the symptoms can be managed with injections, medication and physical therapy.
Diagnosis and Treatment
Diagnosis of any of these syndromes requires an examination by a physician. An X-ray, and often an MRI, are necessary in making a clear diagnosis. It is important for a person to seek medical attention in these cases, not only to rule-out any other disease pathology, but because long-standing non-use or guarding a symptomatic shoulder can lead to adhesive capsulitis, or frozen shoulder. In a frozen shoulder, the capsule surrounding the joint becomes adhered with scar tissue causing severe limitation of range of motion and pain. Therapy for treatment of a frozen shoulder is lengthy and painful, so prevention is the key. Treatment of many of the symptoms associated with the above diagnoses can be resolved with rest, ice, medication, injections and physical therapy. With the proper strengthening and stretching program, instruction on posture and body mechanics and activity modification, many of the symptoms can be managed. Ongoing symptoms can often be relieved with steroid injections by a physician or oral anti-inflammatory medicines. In more severe cases, surgical intervention is necessary and can be done with an arthroscopic or open procedure and may involve repair of torn tendons, shaving bone spurs and decompression of the joint. Recovery time after surgery varies and usually involves at least one month of physical therapy. Shoulder symptoms can be caused not only from rotator cuff tendonitis or tears but from a number of other sources that must be diagnosed by a physician.
The most frequent Sport Injuries
- Shoulder injuries: Labral tear, Rotator Cuff tear, Other ligament tears
- Knee injuries: Meniscus tear, ACL tear, Other ligament tears
Anesthesia and Pain Management
We are one of the only centers that use special combination of medications and injections during Pre-operative and Intra-operative period that allows the patient to be almost pain free during the post-operative period. An important aspect of a surgery is the anesthesia care – during surgery, recovery and the first days in rehabilitation. Our goal is to reduce your anxiety and keep you safe and comfortable throughout your hospital stay. We will stay by your side through the surgery, monitoring and observing from the time you go to sleep until you are safely awakened and in the recovery room. After surgery, our anesthesiologists remain involved in pain control to help speed recovery. We have a dedicated group of specialists, physicians, and anesthesiologists who provide services exclusively for patients undergoing many types of orthopaedic surgery, including joint replacement surgery. Of interest to many patients is that our team of anesthesiologist is particularly experienced in treating older patients. Many of whom often have health concerns unrelated to their surgery, such as high blood pressure or heart disease. During your Pre-Op class you will learn more about anesthesia and much more to help you be confident, well-informed, and comfortable. During the pre-operative and post-operative period special combination of medications are used to allow the patient to almost be completely pain free.
The most frequent causes of pain in other body parts are: