Orthopedic Conditions

Does Anesthesia Increase Surgery Dementia Risk?

This morning’s study is near and dear to my heart. When I was a medical student, my father broke his hip and needed surgery. After surgery in the hospital where I was training, he experienced severe postoperative delirium. It was epic “sundowning,” which foreshadowed his upcoming dementia and slow descent into his own personal hell…read more

Epidural Steroid Side Effects: Repeated Injections Cause Diminishing Relief

On the surface, as a nonsurgical way to relieve pain and inflammation, epidural steroid injections seem like a great idea. However, when we dive beneath the surface, we find that epidural steroid side effects are pretty awful. I’ve observed many times, that for some patients, that while that first shot seems nothing short of miraculous,…read more

Is Injecting Bupivacaine or Lidocaine into a Joint Malpractice?

This week a patient sent a note that her mom was to undergo surgery and the anesthesia crew was planning on using the local anesthetic bupivacaine. She knew from reading the blog that this wasn’t a  good idea, so let’s explore just how nasty this drug is to joints and why doctors are still using…read more

My New Annual All Stem Cell Type Orthopedic Infographic

As I promised yesterday, for the first year ever, I have updated my orthopedic stem-cell-research infographic to include other stem cell sources outside of bone marrow. It’s exciting to finally have enough data on fat to believe that it will be a factor in what’s best for orthopedic patients. (Click here for a larger view)…read more

2017 Orthopedic Bone Marrow Stem Cell Research Infographic

Every year for the last four to five or so, I have compiled a list of the published bone marrow stem cell research. Since I’ve updated this every spring, here’s my 2017 edition. Overall, 2016–2017 has been a mixed year for bone marrow stem cell publications. The good news is that we’ve seen higher quality,…read more

Loose Ligamentum Teres? A New Injection May Help

The ligamentum teres, which lives in your hip, is the red-headed stepchild of ligaments. I say that because most doctors couldn’t tell you where it lives, and the ones who know it’s in the hip mostly ignore it. Yet this ligament is critical for hip stability in dancers, figure skaters, and other athletes who use…read more

Disc Replacement Side Effects: New Research Is Concerning

The whole idea behind disc replacement is that it should have fewer side effects than fusing the spine. The artificial disc allows motion, which is, in theory, similar to a normal biologic disc. However, what if an artificial disc ended up distorting normal motion so badly that it still caused the disc above and below…read more

Outcomes, Complication Rates, and Stem Cell Procedures

Given the quite reasonable concerns this past week over the blinding of three women by a stem cell clinic injecting fat stem cells into eyes, I thought it was time to take a look at stem-cell-procedure complications. All medical procedures have complications. So what bar can we use to see if those complications are reasonable, and…read more