Shoulder Trauma (Fractures and Dislocations)

Tag Archives: Las Vegas

Shoulder Trauma (Fractures and Dislocations) | Las Vegas Orthopedic Shoulder trauma or dislocations and fractures of the shoulder may occur due to injuries resulting from a fall onto the shoulder or accidents that fracture the shoulder blade or collar bone. Shoulder injuries are common, and nearly everyone injures their shoulder at some point in life.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide treatments for shoulder trauma to patients in Las Vegas, Nevada, and surrounding communities.

Types of Shoulder Injuries

Fracture

A fracture refers to a broken bone. Shoulder fractures commonly involve the collar bone, the top of the upper arm bone, or the shoulder blade.

Dislocation

A dislocation takes place when the bones on the opposite sides of a joint do not line up. A dislocation of the collar bone joint is known as a separated shoulder. Another type of dislocation can disrupt the connection between the breastbone and the clavicle. The ball and socket joint of the shoulder can be dislocated toward the front or the back.

Soft Tissue Injury

Soft tissue injuries involve tears of the tendons, ligaments, muscles and joint capsule of the shoulder, which may include labral tears and rotator cuff tears.

Treatment of Shoulder Fracture

Clavicle Fractures

Clavicle fractures are usually treated without surgery. If a compound fracture has occurred or the bone is severely out of place, a surgery may be required.

Proximal Humerus Fractures

If the bone fragments have not been displaced, the fracture of proximal humerus can be treated without surgery. Surgery may be necessary if the fragments have moved out of position.

Scapula Fractures

Scalpula fractures are often treated without surgery. The treatment will involve immobilization of the shoulder with a sling, pain medications, and ice therapy. Only about 10 to 20 percent of scalpula fractures will require surgery.

Treatment of Shoulder Separation

In case of a shoulder separation, the treatment is based on how severe the injury is, what is the direction of the separation, and what are the physical requirements of the patient. If the shoulder separation is less severe, it is mostly possible to avoid surgery.

Severe separations that occur in the upward direction or dislocations in the downward or backward directions will generally require surgery. The surgical treatment will involve repair of the ligaments. Those in the profession of manual labor or professional athletes may often be treated with surgery. However, the results of the surgery may be unpredictable, depending on the specific case.

Treatment of Shoulder Dislocation

The initial shoulder dislocation treatment involves putting the joint back in the socket. This is performed with the patient under mild sedation and IV pain medications. The surgeon will pull on the shoulder until the joint is realigned, and reduction is confirmed on an x-ray.

The shoulder is then placed in a sling or a special brace. Younger patients or those who experience repeated dislocations and persistent instability will usually require surgery. Surgery will involve repair of the torn soft tissue. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9394

Dislocated Shoulder | Las Vegas Orthopedic Surgeon The most mobile joint in the body is the shoulder. The shoulder’s ability to turn in many directions enables a person to perform different tasks involving hands and arms. However, the flexibility and mobility of the shoulder also makes this joint vulnerable to dislocation. A dislocated shoulder can cause pain and cut down the functionality of the connected hand and arm.

Dr. Steven Thomas and Dr. Gregory Bigler are board certified orthopedic surgeons providing a range of treatments for knees, shoulders, and other areas. They will treat the shoulder dislocation problem using advanced techniques and involving minimal time and discomfort for the patient. Dr. Thomas and Dr. Bigler provide these treatments to patients in Las Vegas, Nevada, and surrounding communities.

How does it occur?

A partial dislocation, clinically known as subluxation, will occur when the head of the humerus or the upper arm bone is partially out of the shoulder socket. A complete dislocation of the shoulder occurs when it is all the way out of the socket. Both partial and complete dislocation will make the shoulder unstable and cause pain and discomfort.

Dislocation of the shoulder joint can occur backward, forward or downward. A common type of shoulder dislocation is anterior instability when the shoulder slips forward. In this situation, the upper arm bone shifts forward and down out of its joint. It may occur when the arm is put in a throwing position.

Symptoms and Diagnosis

Some of the common symptoms in case of partial or complete shoulder dislocation are swelling, numbness, weakness and bruising in the shoulder joint. In some cases, the dislocation may cause a tear in the tendons or ligaments in the shoulder or damage the shoulder nerves.

The disruption in the shoulder joint may cause the muscles to have spasms, which will increase the pain. If the shoulder dislocates time and again, it will be diagnosed as shoulder instability. The surgeon will examine the shoulder and may order an x-ray. The surgeon should know how the dislocated occurred and whether the patient has previously had a shoulder dislocation.

Treatment and Rehabilitation

The surgeon will perform a process called closed reduction to restore the shoulder in its correct position. In this process, the ball of the humerus or the upper arm bone will be placed back into the joint socket. Once the shoulder joint is back in its position, severe pain will stop almost immediately.

As part of rehabilitation, the surgeon may immobilize the shoulder in a sling or another device for a few weeks after the treatment. The patient will require adequate rest, and should ice the sore area three to four times a day. Once the swelling and pain subsides, the surgeon or a physiotherapist will prescribe rehabilitation exercises.

These exercises are designed to help restore the range of motion of the shoulder and strengthen shoulder muscles. Stellar rehabilitation will help prevent future shoulder dislocations. The exercises will initially focus on gentle muscle toning, and gradually weight training exercises will be added. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada for shoulder dislocation treatments.

Common Shoulder Injuries | Las Vegas Orthopedic Surgery Nearly 7.5 million Americans visit every year to the doctor’s office for a shoulder problem, including injuries related to the shoulder and upper arm. Athletic activities, such as tennis, swimming, weightlifting and pitching, are a common cause of shoulder injuries.

Other activities involving repetitive, overhead motion as well as injuries caused during everyday activities may also result in shoulder injuries. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide treatments for shoulder injuries to patients in Las Vegas, Nevada, and surrounding communities.

Basic Injuries

Most injuries and problems related to the shoulder involve the tendons, muscles and ligaments, rather than the bones. Athletes are particularly vulnerable to shoulder problems because they go through repetitive, intensive training routines involving shoulder movement.

If an individual tends to ignore the pain and leave the shoulder injury untreated, it will only aggravate the condition and may lead to further issues. Some people may underestimate the extent of their shoulder injury if they get used to weakness in the arm, steady pain, or limited motion of the shoulder joint.

Shoulder problems are grouped into the following categories by orthopedic surgeons:

Instability

If one of the shoulder joints shifts or is forced out of its natural place, it can create shoulder instability. This may lead to dislocation of the one the shoulder joints. Patients with instability condition will feel pain when they attempt to raise their arm. They may also feel as if the shoulder is slipping out of place.

Impingement

Excessive rubbing of the shoulder muscles against the top portion of the shoulder blade may cause impingement. Problem of impingement may occur during activities that involve excessive overhead arm motion. Inflammation in the shoulder should be immediately treated to avoid more serious damage.

Rotator Cuff Injuries

A key component of the shoulder is the rotator cuff, and almost half of all shoulder injuries are related to the rotator cuff. The rotator cuff muscles help to lift the arm and reach overhead. If the rotator cuff is injured, the patient may sometimes fail to recover the full shoulder function required for athletic activities.

Dr. Thomas and Dr. Bigler are board certified orthopedic surgeons receiving patients from Las Vegas, Nevada, and nearby areas for shoulder injury treatments.

Treatments

Serious shoulder injuries may be prevented with early diagnosis and treatment. The surgeon will first prefer to apply non-surgical treatments, which will include shoulder exercises. The orthopedic surgeon may recommend a series of exercises designed to provide strength to the shoulder muscles.

Wall Push-ups

Stand facing a wall and place hands on the wall. Keep your feet shoulder-width apart. Perform slow push-ups five times twice a day.

Shoulder Press-ups

Sit upright in an armrest chair, with feet touching the floor. Make use of the arms to slow get up from the chair. Repeat five times twice a day.

To reduce the pain and swelling, the surgeon may prescribe anti-inflammatory medications. Surgery may have to be performed in severe cases that do not improve with physical therapy.

Clavicle Fracture (Broken Collarbone) | Las Vegas Orthopedic Surgery A broken collarbone is clinically called a clavicle fracture, which may occur commonly in people of all ages. The clavicle is situated above various important nerves and blood vessels. However, these vital structures are rarely damaged when the clavicle fracture occurs, even though the bone ends may move when they are fractured.

Dr. Steven Thomas and Dr. Gregory Bigler are board certified orthopedic surgeons providing treatments for clavicle fracture and various other procedures. Patients in Las Vegas, Nevada, and surrounding communities have an opportunity to receive treatments from Dr. Thomas and Dr. Bigler.

Causes and Symptoms

A direct blow to the shoulder is a common cause of clavicle fractures. This may occur during a vehicle collision or a fall onto the shoulder. Sometimes a clavicle fracture may also be caused due to a fall onto an outstretched arm. Babies may suffer from these fractures during the passage through the birth canal.

Persistent pain, which may make it difficult to move the arm, is a key symptom of clavicle fractures. Some of the other symptoms may include:

The shoulder is drooping down and forward
Arm cannot be lifted because of pain
Grinding sensation if an attempt is made to lift the arm
A bump or deformity over the break
Tenderness, bruising, and swelling over the collarbone

Non-Surgical Treatment

Surgery may be avoided if the broken ends of the bones have not moved and are aligned correctly. In such cases, the broken collarbone will heal without surgery. A simple arm support such as a sling or wrap may be used for comfort immediately after the fracture. These supports will keep the arm in position while it heals.

Pain medications, including acetaminophen, can be used to help relieve pain as the fracture heals. While the patient is using the sling, the muscle strength in the shoulder is likely to weaken. Once the bone starts to heal, the pain will reduce and the surgeon may begin gentle elbow and shoulder exercises. More strenuous exercises may be progressively started as the fracture is completely healed.

Surgical Treatment

If the bones are displaced, surgery may be necessary. Surgery will align the bones precisely and hold them in position while they heal. Shoulder strength will improve as the patient recovers after surgery. Metal plates and screws may used to provide support internally, and will usually be left in place after the bone has healed.

Pins may also be used to hold the fracture in safe position after the bone ends have been replaced in the right position. Pin placement will require smaller incisions than those used for plates. However, pins usually irritate the skin and will be removed once the fracture has healed.

Rehabilitation

Following the treatment, specific physical exercises will help to restore movement and provide strength to the shoulder. The surgeon may provide the patient with a home therapy plan or recommend working with a physical therapist. Established board certified orthopedic surgeons Dr. Thomas and Dr. Bigler, who have performed magnificent work in the past, receive patients from Las Vegas, Nevada, and nearby areas for clavicle fracture treatments.

Chronic Shoulder Instability | Las Vegas Orthopedic Surgery

The shoulder is the most moveable joint in the body, but this greater range of motion may also become the cause of instability. Shoulder instability occurs when overuse or injury causes the head of the upper arm bone to be forced out of the shoulder socket. Once the dislocation has occurred, the shoulder is vulnerable to repeat episodes.

When a loose shoulder repeatedly slips out of position, it is known as chronic shoulder instability. Dr. Steven Thomas and Dr. Gregory Bigler are board certified orthopedic surgeons providing treatments for shoulder instability to patients in Las Vegas, Nevada, and surrounding communities.

Causes

Shoulder Dislocation

Initial shoulder dislocation is often caused due to a severe injury or trauma. A severe first dislocation may trigger continued dislocations, creating shoulder instability.

Repetitive Strain

Some sports activities such as swimming, volleyball, and tennis and certain types of jobs require repetitive overhead motion. This can lead to looser ligaments over time, which can make it difficult to maintain shoulder stability and sometimes cause a painful, unstable shoulder.

Multidirectional Instability

In a few patients, shoulder may feel loose or dislocate in several directions without any history of repetitive strain or injury. In such patients, the ball may dislocate out the back, front, or bottom of the shoulder. These patients have naturally loose ligaments in their body.

Symptoms

Some of the common signs of chronic shoulder instability include:

Pain caused by injury to the shoulder
Repeated dislocations of the shoulder
Repeated episodes of the shoulder giving out
A persistent feeling of the shoulder becoming loose or slipping in and out of the joint

Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas for treatment of shoulder instability.

Treatment

The surgeon may first try to treat chronic shoulder instability with non-surgical treatment options. Surgery may be recommended only if the pain and instability fails to improve.

Non-Surgical Treatment

The patient will be asked to make some modifications in their lifestyle and avoid certain physical activities that may aggravate the symptoms. NSAIDs and aspirin may be prescribed to mitigate pain and swelling.

Physical therapy is a key part of non-surgical treatment for shoulder instability. The therapist will create a home exercise program to strengthen shoulder muscles and work on shoulder control to improve stability.

Surgical Treatment

Torn or stretched ligaments may be repaired with surgery in order to ensure that they are able to holder the shoulder joint firmly in its position. Surgical repair for Bankart lesions may also be performed. Sutures and anchors will be used to reattach the bone and the ligament.

Arthroscopic surgery can be used to repair soft tissues in the shoulder using very small incisions. The procedure can be performed on an outpatient basis. The surgeon will view the internal shoulder structures with a tiny camera and perform the surgery using ultra-thin instruments.

A few patients may require an open surgical procedure. This will involve a larger incision over the shoulder, allowing the surgeon to perform the repair under direct visualization.

Shoulder Surgery | Las Vegas Orthopedic Surgeons Shoulder is the body’s most flexible joint, but this flexibility also makes it vulnerable to injury and instability. In case of mild problems, non-invasive solutions may first be recommended to treat the shoulder. However, if there is a delay in surgical repair, the shoulder joint may be difficult to treat later.

Correct diagnosis and treatment will make all the difference in the long run for shoulder function. The Knee and Shoulder Institute, headed by board certified orthopedic surgeons, Dr. Steven Thomas and Dr. Gregory Bigler, provides shoulder surgery to patients in Las Vegas, Nevada and surrounding communities.

Bursitis or Tendinitis

Overuse of the shoulder from repetitive activities such as swimming, painting, weight lifting or certain types of factory jobs may cause impingement of the rotator cuff. At an early stage, the problems may be addressed by modifying the specific motion that is causing the symptoms of pain and with a shoulder rehabilitation plan. If the problem does not resolve, shoulder surgery may be performed.

Partial Rotator Cuff Tears

Chronic inflammation and the development of spurs on the acromion underside may occur due to partial thickness rotator cuff tears. The first line of treatment will usually be conservative and non-invasive, such as modification of activity and mild exercise. Cortisone injections may be used in a few cases. In a situation where non-invasive treatment fails, shoulder surgery may have to be performed to remove the spurs and to repair the rotator cuff.

Full-Thickness Rotator Cuff Tears

Falls, heavy lifting, partial thickness rotator cuff tears or impingement may cause full-thickness rotator cuff tears. Although non-invasive solutions are successful in many cases, but some patients may experience persistent pain and may require surgical repair.

The surgeon may apply the arthroscopic surgical technique to enable shaving of spurs, examination of the rotator cuff, and repair of the tears. It will be followed by a comprehensive rehabilitation program to restore normal shoulder function.

Shoulder Instability

Subluxation and dislocation are two main forms of shoulder instability. A subluxation refers to a partial dislocation, where the shoulder is partially out of the shoulder socket. Shoulder dislocations may occur repeatedly due to instability.

In case of repeated dislocations, shoulder surgery may be necessary. The surgeon may recommend open or arthroscopic surgery. Either procedure will be followed by extensive rehabilitation, usually along with the physical therapy.

Fractured Collarbone or Arm Bone

A fall on the side of the shoulder may cause a fractured collarbone. The injury is usually treated in a non-invasive way with a splint or sling. But a severely displaced fracture may require surgical repair.

A fractured head of the arm bone or humerus may occur as a result of a fall on an outstretched arm. If the bone is displaced or fragmented, it may require surgical repair. In some cases, the bone may have to be replaced with an artificial joint.

Shoulder Replacement

If the patient suffers from painful shoulders and limited motion, with no relief from previous surgical or non-surgical treatments, the surgeon may recommend shoulder replacement surgery. It may involve replacement of the head of the shoulder bone or replacement of the entire shoulder socket.

Shoulder Arthroscopy | Las Vegas Orthopedic Surgeons Orthopedic surgeons may use shoulder arthroscopy to examine, diagnose and repair problems related to the shoulder joint. The procedure involves insertion of a tiny camera, called an arthroscope, inside the shoulder joint. The camera transmits images of the inside structure to a monitor, which the surgeon uses as a guide to perform intricate surgery in a precise manner.

Arthroscopy makes the shoulder joint surgery less invasive, less painful, and cuts down the recovery time. The size of incisions is much smaller than those required in a traditional, open surgery. The Knee and Shoulder Institute, headed by board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler, provides shoulder arthroscopy to patients in Las Vegas, Nevada and surrounding communities.

Candidacy

Patients suffering from a painful condition of the shoulder joint that does not respond to non-invasive treatments may make good candidates for shoulder arthroscopy. Disease or injury to the shoulder joint can create inflammation, which will lead to pain and stiffness in the shoulder.

The candidate may suffer from overuse or age-related wear and tear of the shoulder joint, apart from disease or injury. The surgeon will examine the shoulder joint for possible damage to the rotator cuff, labrum, tendons, articular cartilage, and other soft issues around the joint.

Key Arthroscopic Procedures

Arthroscopic procedures related to shoulder joint will commonly include:

Rotator cuff repair
Bone spur removal
Repair of ligaments
Removal or repair of the labrum
Repair for recurrent shoulder dislocation
Removal of inflamed tissue or loose cartilage

In rare cases, procedures such as shoulder fracture repair, nerve release and excision of cysts may also be performed using arthroscopy.

Procedure

In the surgery room, the patient will be positioned to enable the surgeon to adjust the arthroscope and gain a clear view of the inner structure of the shoulder. The surgical team will remove hair in the area, if required, and then disinfect the shoulder skin. The surgeon will inject fluid into the shoulder to inflate the joint, which allows for an easier view of all the underlying structures.

A small puncture in the shoulder will then be made to insert the arthroscope. Images from the arthroscope will be projected on the monitor to show the surgeon the inside of the shoulder and any damage. Once the problem is targeted, the surgeon will insert miniature instruments through separate incisions to begin the repair.

Tasks such as cutting, shaving, grasping, and suturing will involve specialized instruments. Special devices may be used to anchor stitches into bone. Once the surgery is completed, the surgeon may close the incisions with sutures or steri-strips and cover the area with a bandage. Board certified orthopedic surgeons Dr. Bigler and Dr. Thomas receive patients from Las Vegas, Nevada and nearby areas.

Recovery

Shoulder arthroscopy will involve a relatively faster and smoother recovery. The patient can return home the same day of the surgery, and may need mild pain medications for the first two to three days. In case of more extensive surgery, the pain may last longer. The shoulder will completely recover in a few weeks, but the patient can resume most of the regular activities after a week or 10 days.

Rotator Cuff Tears: Surgical Treatment Options | Vegas Orthopedics Surgery to repair a torn rotator cuff will usually involve reattaching the tendon to the head of the upper arm bone or humerus. If the tear is only partial, the surgeon may only perform a smoothing or trimming procedure called a debridement. If a full tear has occurred within the thickest part of the tendon, it will be repaired by suturing the two sides back together.

The Knee and Shoulder Institute, headed by experienced, board certified orthopedic surgeons, Dr. Steven Thomas and Dr. Gregory Bigler, provides advanced surgical treatments for rotator cuff tears. Patients in Las Vegas, Nevada and surrounding communities have an opportunity to receive treatments from Dr. Thomas and Dr. Bigler.

Options for Surgical Repair

Innovative surgical techniques have made the rotator cuff repair procedures less invasive than before. Several treatment approaches are available today, and each has its own pros and cons. However, in every treatment option, the goal is to get the tendon to heal.

The most commonly used techniques for rotator cuff repair include traditional open repair surgery, arthroscopic surgery, and mini-open repair surgery. Patients typically report similar strength improvement, pain relief and overall satisfaction with all three techniques.

Traditional Open Repair Surgery

If the tear is complicated or large, or additional reconstruction such as a tendon transfer is necessary, the surgeon may recommend a traditional open surgical incision. The surgeon will make a several centimeters long incision over the shoulder and detach the shoulder muscle to gain better access to the torn tendon. Through the incision, the surgeon will remove bone spurs from the underside of the acromion.

All-Arthroscopic Repair Surgery

This procedure will involve the surgical insertion of a tiny camera called an arthroscope inside the shoulder joint. The surgeon will be able to view the underlying structures on a screen, and use these pictures as a guide to perform precise repair with miniature surgical tools.

The surgeon can perform this procedure with very small incisions because the tiny arthroscope will enable clear viewing of the inside structure without have to create a large incision. The repair to the torn rotator cuff with arthroscopic surgery can be performed on an outpatient basis, and will involve less pain, less risk and less downtime.

Mini-Open Repair Surgery
Using advanced technology and instruments, the surgeon can perform a mini-open repair procedure. The incision is relatively smaller than in the case of traditional open surgery, and will typically be three to five centimeters in length. Arthroscopy is used in this technique to examine and treat damage to other structures within the joint.

Bone spurs are often removed arthroscopically, which eliminates the need to detach the deltoid muscle. Once the arthroscopic part is over, the surgeon will repair the rotator cuff through the mini-open incision. In case of tendon repair, the surgeon will view the shoulder structure directly and not through the camera. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas.

Recovery

The surgeon will usually prescribe pain medications for the first few days after the procedure. If the pain persists beyond a few days, the patient should contact the surgeon. Rehabilitation plays a critical part in helping the patient to return to their normal daily routine.

Rotator Cuff and Shoulder Conditioning Program | Las Vegas Orthopedic Following a shoulder injury or surgery, an exercise condition program may be necessary to support the patient’s return to normal activities and restore regular movement of the shoulder. A well-structured condition program will give the patient the strength and confidence to even resume sports and other vigorous activities.

Rotator cuff and shoulder condition program involves a variety of exercises. To ensure safety and effectiveness, the program should be performed under the surgeon’s guidance and the supervision of a physical therapist. Exercise regimen in each case will be customized to best meet the patient’s rehabilitation needs.

The Knee and Shoulder Institute, led by board certified orthopedic surgeons, Dr. Steven Thomas and Dr. Gregory Bigler, provides state of the art orthopedic care, including recovery and rehabilitation support. The practice provides rotator cuff and shoulder condition program to patients in Las Vegas, Nevada and surrounding communities.

Program Benefits

Rotator cuff and shoulder conditioning program will provide the following benefits:

Increased Shoulder Strength

The program will help to strengthen the muscles that provide support to the shoulder. This will enable the shoulder joint to gain stability. Increased strength of the shoulder muscles will relieve pain and prevent further injury.

Greater Flexibility

The program is designed to stretch the muscles that have been strengthened. This will restore range of motion and prevent injury. Gentle stretching and strengthening exercises will keep the muscles long and flexible and help to reduce muscle soreness.

Muscle Groups Benefitting from the Program

The shoulder conditioning program will target specific muscle groups, which include:

Deltoids (front, back and over the shoulder)
Trapezius muscles (upper back)
Rhomboid muscles (upper back)
Teres muscles (supporting the shoulder joint)
Supraspinatus (supporting the shoulder joint)
Infraspinatus (supporting the shoulder joint)
Subscapularis (front of shoulder)
Biceps (front of upper arm)
Triceps (back of upper arm)

Program Duration

The shoulder condition program should be followed for about four to six weeks, unless otherwise recommended by the surgeon or the physical therapist. Following full recovery of the shoulder movement and function, the patient can continue the exercises as a maintenance program for lifelong protection and health of the shoulders.

The patient should ideally continue to perform the exercises two to three times a week to maintain strength and range of motion in the shoulders. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas for shoulder treatments.

Getting Started

Warm-up

Prior to starting the exercises as per the shoulder conditioning program, the patient should warm up with five to 10 minutes of low impact activity, such as riding a stationary bicycle or walking.

Stretching Exercises

After the warm-up, the patient should perform stretching exercises as advised by the physical therapist before progressing to strengthening exercises. Once the strengthening exercises are over, the stretching exercises should be repeated to end the regimen.

Alertness to Pain

If the patient feels pain at any point during the exercise regimen, they should not ignore it. They should ask the surgeon or the physical therapist for advice before continuing with the program.

Revision Total Knee Replacement | Las Vegas Orthopedic Surgeon Total knee replacement is one of the most successful surgeries, provided the procedure is performed by a qualified and experienced surgeon. However, over a period of time, total knee replacement may fail for various reasons. In such cases, the patient will experience persistent pain and swelling in the knee. Stiffness and instability may hamper the daily routine activities of the patient.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler of the Knee and Shoulder Institute provide total knee replacement as well as revision total knee replacement procedures. Patients in Las Vegas, Nevada and surrounding communities have an opportunity to receive these advanced procedures at the fully integrated practice of Dr. Thomas and Dr. Bigler.

Overview of Revision Surgery

In case of revision total knee replacement surgery, the orthopedic surgeon will replace some or all parts of the original prosthesis. Revision surgery is more complex than the primary knee replacement procedure, involves more detailed planning and the use of specialized implants and tools to create desired outcomes.

Revision surgery will vary from one patient to another. Some patients may only require replacement of one implant or component of the prosthesis, while some others may need all three components – tibial, femoral, and patellar – to be replaced. The bone around the knee may have to be reconstructed with bone grafting or augments.

Standard total knee implants may not be used for revision knee replacement because of the damage to the bone. The surgeon will usually prefer to use specialized implants with thicker and longer stems that fit deeper into the bone for added support. Board certified orthopedic surgeons Dr. Bigler and Dr. Thomas receive patients from Las Vegas, Nevada and nearby areas for revision total knee replacement surgery.

Surgical Procedure

Revision total knee replacement procedure is typically performed using general anesthesia, and the surgery may take about two to three hours. The surgeon will follow the incision line created during the primary procedure. The kneecap and tendons will be moved to the side through the incision to reveal the knee joint.

The surgeon will then assess the soft tissue in the knee to ensure there is no infection. All the metal and plastic components of the prosthesis will be examined to identify the ones that have become loose, worn, or shifted out of position. The original implant will be removed with precision to preserve the maximum amount of bone.

If the primary procedure had involved the use of cement, this too will be removed. Thereafter, the surgeon will prepare the bone surfaces for the revision implant. In case of substantive bone loss, the surgeon may add platform blocks and metal augments to the main components for extra support. Bone autografting may be used in exceptional situations.

Finally, the surgeon will insert the specialized revision implant, repair the surrounding damaged soft tissue, and test the motion of the joint. Incisions will be closed carefully with sutures. Recovery will usually involve hospital stay for a few days. Pain management and physical therapy will be a part of the recovery process.

Contact Us

702.933.9393

9499 West Charleston, Suite 200
Las Vegas, NV 89117