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JOINT PRESERVATION

HIP & KNEE (HIP AND KNEE)

Joint preservation is the use of non-surgical or surgical means to preserve a deteriorating joint to delay or avoid joint replacement surgery. Joint preservation procedures reduce the risk of complications from implant surgery and infection.

 

When cartilage deteriorates due to osteoarthritis, it causes persistent joint pain that interferes with daily life. Our consultants will aim to restore normal movement and alleviate pain to the joint whether it’s a shoulder, hip, knee or ankle.

CHAD ZEHMS, MD: Orthopedic Sports Medicine

Speciality: Joint Preservation

OPTIM ORTHOPEDICS JOINT PRESERVATION

Joint Preservation vs. Replacement: What’s Your Best Option

If you're dealing with persistent or chronic discomfort in your joints, you might believe that joint replacement surgery is your only path towards relief. However, it could be worthwhile to consider a range of less invasive alternatives that can assist in maintaining your mobility as you get older. Given the growing number of individuals keen on staying active into their 60s, 70s, and beyond, a significant amount of recent research has been dedicated to improving joint health and replacement technologies.

Enduring joint pain does not necessarily equate to needing a joint replacement surgery. This procedure is typically reserved for advanced stages of degenerative arthritis, also known as osteoarthritis, when other treatments have proven unsuccessful. The majority of joint pain causes, such as those affecting the knee, hip, shoulder, and ankle, can often be managed through methods that are far less invasive.

How can you tell if your arthritis or other forms of joint damage require medical intervention? As a rule of thumb, it's advisable to consult a doctor if your joint pain impedes your activities for over three days without any signs of improvement, or if you experience repeated bouts of the same discomfort over a period of several weeks or months.

Our People Make The Difference

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Behind every treatment or procedure is a specially trained, highly experienced professional who’s dedicated to giving you the best care possible so that you can get back to life—quickly, safely, and confidently. They’re experts at what they do, and we’re proud to have them as part of our team.

Chad Zehms, MD

SPORTS MEDICINE (KNEE, HIP AND SHOULDER)

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Residency

Naval Medical Center (Portsmouth, VA)

Fellowship

Steadman Philippon Sports Medicine Clinic (Vail, CO)

Board Certification American Board of Orthopedic Surgery
Professional Affiliations Alpha Omega Alpha Honor Medical Society
American Orthopaedic Society for Sports Medicine
Medical School Medical College of Wisconsin (Milwaukee, WI)

Wesley Stroud Jr, MD
SPORTS MEDICINE (KNEE, HIP AND SHOULDER)

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Residency

Orthopedic Surgery at UAB Hospital (Birmingham, Alabama)

Fellowship

Andrews Sports Medicine and Orthopaedic Center (Birmingham, Alabama)

Board Eligible: American Board of Orthopedic Surgery
Society Memberships Arthroscopy Association of North America (AANA)American Academy of Orthopedic Surgeons (AAOS)

American Orthopedic Society for Sports Medicine (AOSSM) 

Medical School Mercer University (Svannah, Georgia)

Amir Shahien, MD
SPORTS MEDICINE (KNEE, HIP AND SHOULDER)

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Board Certification American Board of Orthopedic Surgery Eligable
Residency

Boston University School of Medicine/ Boston Medical Center (Boston, MA)

Fellowship

American Sports Medicine Institute - Andrews Sports Medicine and Orthopedic Center (Birmingham, AL)

Medical School Louisiana State University School of Medicine (New Orleans, LA)

David Sedory, MD

SPORTS MEDICINE (KNEE, HIP AND SHOULDER)

Residency

Brooke Army Medical Center (San Antonio, TX)

Internship

Brooke Army Medical Center (San Antonio, TX)

Board Certification American Board of Orthopedic Surgery 
Society Memberships Orthopaedic Trauma Association
Society of Military Orthopaedic Surgeons
Fellow of American Academy of Orthopaedic Surgeons (AAOS)
Medical School Case Western Reserve University School of Medicine
(Cleveland, OH)
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HIP CONDITIONS

Avascular Necrosis
Avascular Necrosis (Osteonecrosis) of the Hip
Bursitis of the Hip (Trochanteric Bursitis)
Femoroacetabular Impingement (FAI)
Femur Fractures
Hip Dislocation
Hip Fracture
Iliotibial Band Syndrome (ITBS)
Inflammatory Arthritis
Inflammatory Arthritis of the Hip
Labral Tear of the Hip (Acetabular Labrum Tear)
Loose Bodies in the Hip
Osteoarthritis
Osteoarthritis of the Hip
Osteonecrosis
Sacroiliac Joint Pain

KNEE CONDITIONS

Anterior Cruciate Ligament Tear (ACL Tear)
Arthritis of the Knee
Avascular Necrosis (Osteonecrosis) 
Care of Aging Knee
Deep Vein Thrombosis (DVT)
Fractures of the Tibial Spine
Lateral Collateral Ligament (LCL) Injury
Meniscal Tears
Meniscus Tear
Minimally Invasive TKA
Osteoarthritis of the Knee
Patellar Fracture
Patellar Tendinitis
Patellar Tendon Tear
Patellofemoral Pain Syndrome
Prepatellar Bursitis (Kneecap Bursitis)
Quadriceps Tendon Tear
Septic Arthritis (of the Knee)
Supracondylar Femoral Fracture

Root Causes Behind Joint Discomfort

Joint damage can occur abruptly, or it might develop progressively, initially causing occasional discomfort that intensifies over time. The origins of joint pain could involve the following:

  • Tendonitis or tendon degeneration

  • Bursitis

  • Osteonecrosis

  • Cartilage loss from trauma, or wear and tear

  • Muscle strain

  • Meniscus or labrum cartilage

  • Arthritis

  • Injury from a fall or accident with bone or soft tissue trauma

  • Inherited abnormalities in the joint

The majority of joint pain causes do not necessitate surgery. Indeed, even with osteoarthritis, surgical intervention is not always the initial preference. Regardless of the origin of the discomfort, it's advisable to maintain the health of your joints for as long as possible, especially if you're an active individual at a younger age.

Joint replacement procedures have become significantly safer and the recovery period quicker. It's possible to be discharged from the hospital on the same day or a day post-surgery. However, it's essential to note that these are major surgeries and should not be decided upon lightly.

The longevity of joint replacement techniques and associated components has improved over time. Nonetheless, as mechanical entities, they are prone to loosening, stiffness, complications, and infection. Such issues may necessitate subsequent surgeries in the future, which are typically more complex and not as successful as the initial operation.

Dr. Sedory points out, "Currently, the average life expectancy extends into the 80s, with future generations likely to reach their 90s. An active individual in their 50s who undergoes a knee or hip joint replacement may need one or two more surgeries throughout their lifetime. Therefore, we aim to delay this procedure until later in life, if possible."

What is joint preservation — and when is it the best option

The objective of joint preservation is to prevent injury, lessen inflammation, and safeguard cartilage. These factors are considered when your doctor assesses your treatment options:

  • Age: Younger individuals often experience more successful outcomes from preservation techniques.

  • Weight: Carrying excess weight places additional stress and demand on your joints. Each pound shed alleviates three to five pounds of pressure on the hip, knee, or ankle. For arthritic joints, weight loss is the most beneficial action one can take.

  • Muscle Strength and Conditioning: Muscles power movement and also act as shock absorbers, safeguarding your joints. Maintaining or improving muscle strength and flexibility lessens joint stress and pain.

  • Severity: Small areas of cartilage thinning or erosion can sometimes be managed by your doctor through minimally invasive procedures. However, if the cartilage is nearly entirely eroded—leaving bone to rub against bone—or if the bone underneath the cartilage is deteriorating, surgery can sometimes be the best solution, although injections may still provide relief in such circumstances.

  • Location: While many joint preservation techniques are focused on the knees, there are also an increasing number of alternatives for hip and shoulder replacement.

Injections

Hyaluronic acid or corticosteroid injections can alleviate inflammation in the joint lining for many patients. These treatments can be effective for a variety of joints and have been extensively researched, although the results vary. However, it's important to note that not all insurance providers may cover the cost of these injections.

Partial Replacement

This method is typically utilized by physicians when a smaller region of your joint has been damaged. The advantage of this technique is that the majority of the bone can be preserved as smaller artificial components are used to replace specific sections of your joint. While this treatment is effective in many joints, it requires careful application and isn't suitable for all situations.

It's important to understand that a partial replacement in one area of the joint does not necessarily inhibit degeneration in other parts of the joint. Consequently, partial replacements may not have the same lifespan as a full joint replacement. However, they do offer the benefit of preserving the option for a full replacement in the future.

Cartilage Transplant

With this approach, your medical team will cultivate, transplant, or utilize a cartilage replacement, positioning it in the damaged area. Additionally, they can prompt the bone within your joint to boost cartilage growth. It's important to note that no single technique has been definitively identified as superior, and much research and development still remains to be undertaken.

Platelet-Rich Plasma

Your blood is teeming with platelets - with hundreds of thousands of them present in every milliliter of blood. These platelets carry chemicals capable of encouraging tissue repair, decreasing inflammation, and activating your body's natural healing response.

Non-surgical options for treating joint pain

Certain emerging joint preservation procedures are viewed as experimental.

Doctors have been employing various other preservation methods for many years. These alternatives include:

DAVID SEDORY, MD - Joint Preservation
AMIR SHAHIEN, MD - Joint Preservation
CHAD ZEHMS, MD - Joint Preservation
DAVID PALMER, MD - Joint Preservation

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