Orthopedic surgery

Orthopedic Surgery vs PRP and the Double Standard in Orthobiologics

Orthopedic surgery has one of the poorest evidence bases of any medical specialty. That’s not my opinion, but that of an academic writing in the British Medical Journal. Interventional Orthobiologics as a field, while new, has pretty solid and evolving evidence. However, both insurers and surgeons often complain that we need more orthobiologics research while…read more

Shoulder Labral Tear Surgery Pros and Cons

Quick links: What is a shoulder labral tear? What are the causes of labral tears? What is shoulder instability? How is a labral tear related to shoulder instability? What happens if you have shoulder instability after labral tear surgery? I evaluated a patient this week who shows off the warts of our modern orthopedic care…read more

Toe Joint Fusion Recovery: One Patient’s Story

On this page: Big toe arthritis and hallux rigidus Problems with toe joint fusion A patient’s story This week I met a patient who had a toe joint fusion. However, this was a disaster of sorts. The good news was that her toe felt better, but the bad news was that her ankle felt worse.…read more

Knee MCL Surgery? Not for this Avid Biker…

If you read this blog, you know that every once in a while I’ll write about an interesting patient result. While I see patients every day who are doing well and avoiding surgery, I also want to make sure that the patients I chose to write about have something unique and newsworthy. This is the…read more

Can a Broken Orthopedic Surgery Care System Fix Itself with Interventional Orthopedics?

For many reasons of perverse incentives, the American healthcare system is the world’s most expensive way ever devised to deliver healthcare. One of the biggest line items in any health plan is elective orthopedic surgery costs. Hence, reducing that cost saves any employer big bucks. One of the ways to bend that spending curve down…read more

More Stem Cell TMJ Success Without Surgery

I like blogging about what I experience on a day-to-day basis, so this one is about a patient I followed up on this week who had severe TMJ arthritis and was contemplating a joint replacement. She was eating only smoothies, so how did she do and what did we do to help her? Let’s dive…read more

The State of Orthopedic Surgery Research: Poor Grades for Common Procedures

Dr. Centeno discusses the poor evidence base for common orthopedic surgeries. Meaning that we have good evidence they are ineffective.

Avoid Ulnar Shortening Surgery: What’s Causing My Pain if It’s Not My Ulna Bone?

A few years back, I blogged on the barbaric procedure known as ulnar shortening. A patient who was about to pull the trigger on this surgery wrote me and wanted me to blog on what could be causing the pain he experiences. Hence, this morning’s blog. What Is Ulnar Variance or a Long Ulna? The…read more