Bringing Multispecialty Expertise to Dover, NH

When it comes to orthopedic care, residents of Dover and the surrounding areas have plenty of options to choose from. But if you’re looking for a practice that delivers a unique combination of multispecialty expertise, compassion and patient-focused care, Atlantic Orthopaedics & Sports Medicine stands out. With a team of surgeons and specialists who treat the full range of orthopedic issues, including fractures and trauma, arthritis, pain management, and arthroscopic and joint replacement surgeries, AOSM offers an unmatched level of comprehensive care.

Unlike other practices that may focus on one or two areas like knees and hips, our highly skilled team brings a diverse range of specialties that cover the entire musculoskeletal system–from the neck and spine to shoulders, elbows and wrists, to knees, hips, feet and ankles. Our orthopedic surgeons bring a wealth of knowledge gleaned from top universities, world class residencies, and prestigious fellowships. Knee and hip specialist Dr. Akhilesh Sastry is recognized as the first surgeon to perform a robotic-assisted total knee replacement in New Hampshire and was among the first 15 surgeons to perform the operation worldwide. The newest addition to our team, Dr. Abigail Boduch, completed her Orthopedic Surgery Residency and Orthopedic Trauma Fellowship at Brown University, a Sports Medicine Fellowship at the University of Pittsburgh, then served as assistant team physician to the Pittsburgh Steelers before returning to her home state of NH to join our practice. This breadth of experience means that patients receive complete, cohesive care in one place, ensuring that treatment is coordinated between providers and handled by someone who truly understands their unique condition and goals.

Another benefit that sets Atlantic Orthopaedics apart is the level of care and compassion our team offers. As the largest physician-owned orthopedic practice in New Hampshire, we are uniquely equipped to prioritize patient experience. When physicians, rather than executives, determine how a practice is run, it fundamentally changes the approach to care, allowing for a more personal touch. Our doctors themselves shape the way care is delivered and have put systems and processes in place that put patients first. From consultation to treatment to recovery, our team is dedicated to providing the best possible patient experience, while maintaining the highest standards of medical care.

Choosing Atlantic Orthopaedics means choosing a practice that’s genuinely invested in the well-being of every patient. It means being treated by the best doctors around, whose comprehensive expertise and commitment to compassionate care truly sets them apart. We believe in taking the time to really listen to our patients, to understand their unique needs, so we create a treatment plan that aligns with their goals and lifestyle. Whether you’re an athlete dealing with a sports injury or someone managing chronic joint pain, Atlantic Orthopaedics is here to provide the care and support you need to feel your best. Contact us to learn more about how we can help you get back to doing what you love, pain-free.

To stay updated on announcements and our opening date at the new Dover location, sign up for our email list here!

Read what our patients have to say:

“Recently had my 2nd hip replacement procedure by Dr. Sastry and Dr. Cusson. These guys do a great job! Was again impressed by their expertise. Also, all staff associates at their surgical center were terrific. Like my 1st operation, I’m hoping to be back on the tennis court within 10 weeks. Thank you Atlantic!” – Steven G.

“You will not find a doctor better than Dr. Lehn. Always makes you feel comfortable about the procedure you are having and always takes the time to answer your questions. So grateful to have his expertise in treating my back issues.” – Joanne P.

“Doctor McMahon is great. He spent time explaining the procedure, listened and answered all my questions. It was an excellent experience.” – Ed P.

Dr. William Sutherland Retires After 34 Years at AOSM

Atlantic Orthopaedics & Sports Medicine has officially announced that Dr. Sutherland will retire at the end of 2024, after thirty-four years as an orthopedic surgeon in the New Hampshire Seacoast community. As one of the first surgeons to join Atlantic Orthopaedics & Sports Medicine, Dr. Sutherland’s impact on the practice cannot be overstated.

“Dr. Sutherland has been a cornerstone of the Seacoast community for 34 years. His dedication and leadership have profoundly shaped our organization and inspired many surgeons who have followed in his footsteps. Dr. Sutherland has always led with both professionalism and warmth.

I first met Dr. Sutherland as a recent graduate, working for one of our partners. We were heading into an important meeting when he greeted me with a big smile, patted me on the shoulder, and fixed my collar, which had popped up over my tie in the back. That moment perfectly captured his thoughtful nature. Time and time again, he has put others, including his patients, ahead of himself.

His presence around the office will be deeply missed—not only as a colleague but as our office Santa Claus and a dear friend. His infectious laugh, generous spirit, and the joy he brought to our practice culture are truly irreplaceable. While we will miss his daily contributions, we look forward to following his journey in this next stage of life, confident that he will continue to make a meaningful impact in our community,” said Matt Lane, Executive Director at Atlantic Orthopaedics & Sports Medicine.

In a letter to his patients, Dr. Sutherland said, “It is with a mixture of emotions that I announce my retirement from orthopedics at the end of this year. I would like to express my profound gratitude to you for your trust, the privilege to listen to and care for you, and to know you on a personal level over these last 34 years. What I will miss the most are the relationships I have formed with you; I feel deeply blessed to be part of your lives.

The opportunity to work with such caring, hardworking, and talented staff at Atlantic Orthopedics & Sports Medicine, our outpatient surgery center NECOS, and at Portsmouth and York Hospitals has truly been a gift. I feel confident that your continued care at Sports Medicine Atlantic Orthopedics will be excellent.”

Dr. Sutherland plans to contribute to the seacoast community and continue to use his skills on medical mission trips. He also is looking forward to spending more time with his family, bicycling, learning to speak better Greek, and ‘maybe’ finish hiking the New Hampshire 4000 footers! Help us wish Dr. Sutherland a very happy retirement.

Get to Know Dr. Abigail Boduch

We’re excited to welcome the newest member of our team, Dr. Abigail Boduch. An orthopedic surgeon who specializes in Sports Medicine and Trauma, Dr. Boduch has experience treating athletes at all levels, from professional to high school, and looks forward to being part of our local sports community. An alumna of Winnacunnet High School and UNH, Dr. Boduch recently returned “home” to the Seacoast to join us at Atlantic Orthopaedics.

To help our patients get to know her better, we recently asked Dr. Boduch some questions about her roots on the Seacoast, her favorite part of her job, and how she likes to spend her free time.

How do you feel about moving back to the NH Seacoast?
I loved growing up here. The beauty of the Seacoast, as well as the access to the ocean and mountains, has never been lost on me. It is a wonderful place to live. The community has always meant so much to me and I am grateful to be back. I feel very fortunate to be able to provide care for the people in what I have always considered “my community”.

What made you want to join the practice at Atlantic Orthopaedics & Sports Medicine?
It really stood out to me how much everyone was invested and interested in each other’s lives at work and outside of work. I was also impressed by the level of care provided for the patients. Everyone I interacted with exemplified the team mentality I love about orthopedics. The partners talked about doing hard cases together and collaborating on patients to provide the best care possible.

What made you pursue orthopedic surgery over other specialties?
I liked most specialties I rotated through during medical school and think I would’ve been happy in a lot of areas of medicine. I enjoy talking to patients and getting to know their stories, which is a large part of most medical fields. Orthopedics stood out to me because it is very tangible. Patients tell you what the problem is and, based on anatomy knowledge, you have a diagnosis and usually can work to find a solution that improves the symptoms. It is all about getting people back to what they love to do. Keeping mobility has such a direct impact on everyone’s day to day life that it is very rewarding to be able to help patients maintain that for as long as possible.

I also love how in orthopedics I am part of a team again. I played sports in high school and college and liked the team dynamics. Surgical fields in general have a team mentality, as it takes a lot of people working together to operate, but I think orthopedics stood out as the most team oriented. In the office we rely on physical therapists to guide our patients through post op rehabilitation or work closely with the therapists for non-operative treatments.

What is your specialty?
My specialty is Sports Medicine/Trauma. Sports injuries of the shoulder, elbow, and knee. Injuries to tendons, ligaments, cartilage and other soft tissues. Treatments with arthroscopic and open approaches for the shoulder and knee. Trauma, focusing on fractures of the extremities.

Sports Medicine specifically adds the aspect of team coverage. During my fellowship, I was fortunate to cover the Pittsburgh Steelers and Penguins, which was a great experience. But I like the idea of sports team coverage more on the community level. Getting to be the team doctor for a high school gets you into the community and I like feeling like I am part of the sports community again.

What is the most rewarding part of your job?
The relationships I have with patients are the most rewarding. Gaining the trust of a patient to care for them is a privilege. This relationship includes listening to their symptoms, being able to validate them by explaining what I think is the cause and lastly deciding how to move forward together. On the surface this is getting people back into their activities, whether it is a sporting activity or getting back to daily activities in less pain. But for me it is the relationship and trust that is required to do that which is the most rewarding.

What are your favorite things to do when you’re not working?
I enjoy spending time with my husband and our family. We like to take advantage of everything NH has to offer. We enjoy camping, hiking and paddleboarding. We also love to ski and are looking forward to being close to the NH mountains again.

Please join us in welcoming Dr. Boduch to Atlantic Orthopaedics & Sports Medicine. Her background, knowledge, and experience are a perfect complement to our team. If you’re suffering from an injury like a ligament or muscle tear, or experiencing persistent signs of tendonitis, cartilage deterioration to the shoulder, elbow or knee, schedule a consultation with Dr. Boduch. Our specialists will work with you every step of the way to diagnose and treat your condition so you can get back to doing what you love.

Dr. Sastry Leads Stryker’s First National Champions Meeting: A Milestone in Modern Robotic Surgery

Dr. Sastry, a renowned orthopedic surgeon, continues to make waves in the medical world as one of four distinguished faculty members leading a pivotal program at Stryker’s first National Champions Meeting in India. The event, held from September 11th to 16th, 2024, brought together nearly 400 surgeons for an in-depth exploration of “Modern Robotic Concepts in Total Hip & Knee with Mako.” Reflecting on the experience, Dr. Sastry shared, “It’s always wonderful to attend champions meetings. It puts people who share a passion for technology together in one room. This group is striving to move the narrative forward and impact change for patients’ lives for the better. I am honored and grateful to be part of this faculty for that reason.” This meeting, a landmark in Dr. Sastry’s career, is a testament to his long-standing expertise and contribution to the field of robotic surgery.

Stryker’s National Champions Meeting: An Overview

Stryker Corporation is a global leader in medical technology, specializing in surgical equipment and implants. Founded in 1941 by Dr. Homer Stryker, an orthopedic surgeon, the company has consistently been at the forefront of innovation, particularly in orthopedics and robotics. Stryker’s dedication to improving patient outcomes is evident through its diverse product offerings, which include cutting-edge robotics, implants, and advanced surgical tools. Over the years, the company has set a high standard for quality, precision, and innovation, making it a trusted name in hospitals and clinics worldwide.

Stryker’s National Champions Meeting is a platform for top surgeons to gather, exchange knowledge, and discuss the latest advancements in orthopedic surgery. The event offers a unique opportunity for professionals to engage with pioneering technologies like the Mako robotic system, which has revolutionized how surgeons perform total hip and knee replacements.

Mako: A Game-Changer in Orthopedic Surgery

One of the focal points of the meeting was the Mako robotic arm-assisted surgical platform, a revolutionary tool that has transformed the field of orthopedic surgery. Developed by Stryker, Mako allows for greater precision and control during total hip and knee replacement procedures. Surgeons can create personalized surgical plans using 3D models based on each patient’s anatomy, ensuring the best possible outcomes.

The technology’s real-time data and guidance offer unparalleled accuracy, reducing the margin for error and improving recovery times for patients. With Mako, surgeons can better plan, execute, and evaluate each procedure, leading to reduced pain and shorter hospital stays for patients.

Dr. Sastry’s Leadership in Robotic Surgery

Dr. Sastry’s role at Stryker’s National Champions Meeting is the culmination of years of dedication to advancing robotic surgery. As one of the most respected voices in the field, he has taught numerous Mako training courses, helping fellow surgeons integrate this cutting-edge technology into their practice. His commitment to innovation and education has positioned him as a leader in orthopedic surgery in the Seacoast community and beyond.

At the event, Dr. Sastry led discussions on modern techniques and strategies for using Mako in total hip and knee replacements. His presentation provided invaluable insights into optimizing surgical outcomes through robotics, drawing on his extensive experience and knowledge. The event was not only a highlight of Dr. Sastry’s career but also a moment of great significance for the medical community in India.

The Future of Orthopedic Surgery

As more surgeons adopt technologies like Mako, patients will benefit from improved outcomes, faster recovery times, and a better overall surgical experience. Stryker’s commitment to innovation and education continues to pave the way for a new era in orthopedic surgery, with experts like Dr. Sastry leading the charge.

What You Should Know About Your Bones and Joints

From October 12 – 20, 2024, Bone and Joint Health National Awareness Week shines a spotlight on the importance of maintaining healthy bones and joints. The week serves as a reminder about how essential it is to prioritize musculoskeletal health, given the widespread impact of bone and joint disorders, which affect millions of people worldwide.

From osteoporosis to arthritis, bone fractures to tendonitis, bone and joint issues affect well-being, mobility, independence, and can significantly reduce overall quality of life. The team at Atlantic Orthopaedics is here to help individuals suffering from these conditions with comprehensive care, advanced treatments, and patient education focused on prevention.

Why Bone and Joint Health Matters

It goes without saying that bones and joints play a fundamental role in daily life, supporting your body, protecting vital organs, and allowing you to move freely. But over time the wear and tear on joints or weakening of bones can lead to serious conditions that make even simple activities like walking, bending, and lifting painful and difficult.

What Are the Most Common Causes of Bone and Joint Pain?

Arthritis: a condition that causes inflammation in the joints, leading to stiffness, pain, and reduced range of motion.

There are many types of arthritis, and the condition can affect the hands and wrists, knees, hips, feet and ankles, shoulders, or spine. Depending on the type of arthritis, causes can range from normal wear and tear due to aging (osteoarthritis), immune system disorder (rheumatoid arthritis), or too much uric acid in the blood (gout), among others. Risk factors for developing arthritis also vary, and may include smoking, family history, lack of exercise, obesity, and autoimmune disease.

Osteoporosis: a condition that causes the bones to become brittle and fragile, due to loss of tissue, increasing the risk of fractures and broken bones. Osteoporosis occurs when the body doesn’t create enough new bone to keep up with bone loss.

In addition to bones that easily fracture, signs of osteoporosis can include back pain, reduced height, and stooped or hunched posture. Risk factors are varied, and include both lifestyle choices–alcohol consumption, smoking, and sitting for long periods of time–and factors over which you have no control–age, race, gender, family history, and body frame. The likelihood of developing osteoporosis increases with age, and the condition is more common in women, people of Caucasian or Asian descent, and individuals with small body frames (less bone mass). Osteoporosis is more likely to develop in people who are underweight, have decreased sex hormones, don’t get enough calcium, or have medical issues like overactive thyroid, rheumatoid arthritis, inflammatory bowel syndrome, or celiac disease.

Tendonitis and Bursitis: Inflammation of the tendons or bursae are conditions that lead to the breakdown of the soft tissue that connects bones to muscles. Tendons are bands of tissue, and bursae are sacs of fluid that cushion the joints.

Tendonitis and bursitis are most often the result of repetitive motion or overuse. Tennis elbow and swimmer’s shoulder are types of tendonitis, and people who work in professions that involve repeated motions, like house painting and carpentry, are also susceptible to the condition. Tendonitis and bursitis can also be caused by injury, and may affect the shoulder, knee, hip, wrist, ankle, or elbow.

Injuries: Traumatic injuries, like those caused by sports or accidents, can damage bones and joints, requiring immediate and ongoing care.

Atlantic Orthopaedics understands the profound impact that bone and joint issues can have on your life. Our team of expert orthopedic surgeons and medical professionals are dedicated to providing personalized care to help you manage pain, restore function, and get back to doing the activities you love. We offer a range of services, from preventative care to advanced surgical techniques to address the unique needs of each patient.

What Is Involved in Treating Bone and Joint Issues?

Comprehensive Evaluation and Diagnosis: We begin by conducting a thorough evaluation of your condition, using advanced diagnostic tools to identify the root cause of your bone or joint issues. Then we work with you to create a customized treatment plan tailored to your lifestyle and goals.

Non-Surgical Treatments: For many patients, non-surgical options are the first line of defense for bone and joint problems. These treatments may include physical therapy, medication management, and injections, with a focus on relieving pain, improving mobility, and preventing further damage.

Surgical Solutions: When surgery is necessary, our board-certified orthopedic surgeons use cutting-edge technology and techniques, like robotic-assisted joint replacement, to provide the best possible outcomes for our patients. Our team of specialists have expertise performing a range of advanced surgical procedures, from minimally invasive arthroscopic surgery to total joint replacement.

Bone and Joint Health Awareness Week is a perfect time to take proactive steps toward improving your long-term bone and joint health. Whether you’re dealing with arthritis, osteoporosis, or recovering from a sports injury, don’t let pain hold you back. Contact us to learn more about how we can help you live an active, pain-free life.

What You Need to Know About Feet and Ankles

Your feet and ankles are the foundation of your body, supporting you through all your daily activities, and maintaining their health is important for mobility and overall wellbeing. The ankle is a complex joint that’s located at the junction of three bones: the talus (connects the leg to the foot), fibula (on the outside of the calf), and tibia (the larger shinbone). It acts as a hinge between the leg and the foot, enabling the foot to rotate or pivot.

The following tips can help keep your feet and ankles in good health:

Wear Proper Footwear
Choosing the right shoes can make a significant difference in the long-term health of your feet and ankles. Shoes, sneakers, or sandals should provide adequate support, cushioning, and a good fit to prevent issues like blisters, bunions, and plantar fasciitis. Avoid wearing high heels or shoes with poor arch support for long periods of time.

Exercise Regularly and Avoid Smoking
Strengthening the muscles in your feet and ankles can improve stability and prevent injuries. Exercises like heel raises, toe curls, and ankle circles help with both strength and mobility. Smoking is known to increase inflammation in the body, which can lead to rheumatoid arthritis, a common cause of joint damage. Smokers who undergo joint replacement are also at greater risk of surgical complications and increased healing time.

Maintain a Healthy Weight
Excess pounds put additional stress on your feet and ankles, increasing the risk of conditions like osteoarthritis and tendonitis. Maintaining a healthy weight through diet and exercise will reduce excess pressure on your lower extremities and promote overall joint health.

Listen to Your Body
Pay attention to signs of pain or discomfort in your feet and ankles. Early intervention can prevent minor issues from becoming more serious problems. Don’t wait to consult a foot & ankle specialist if you’re experiencing persistent pain or swelling.

Atlantic Orthopaedics’ own Dr. Cameron Eilts is a board-certified Doctor of Podiatric Medicine and specialist in total ankle replacement surgery. Dr. Eilts was inspired to pursue podiatry due to his own history of sports-related injuries of the foot and ankle. He brings years of experience and expertise in the field and believes in approaching every patient with empathy and compassion. Dr. Eilts has been with Atlantic Orthopaedics since 2011, treating patients with a wide range of conditions, from sprained ankles to arthritis to diabetic limb care.

A recent patient of Dr. Eilts had this to say:

“Dr. Eilts is a great surgeon! Very intelligent, a good listener, and thoroughly explains everything. He provided a high level of attention and good advice during every follow-up appointment after my ankle surgery and thinks outside of the box for the best solution for each challenge I’ve had.”

Conditions like osteoarthritis, rheumatoid arthritis, or posttraumatic arthritis from past injury to the joint can compromise foot and ankle function, leading to pain, swelling, and difficulty in movement. For patients who have not found relief through conservative treatments like anti-inflammatory medications, orthotics, or physical therapy, total ankle replacement may be the best option.

When should you consider ankle replacement surgery?

Patients with advanced arthritis, who have significant pain and limited mobility, are good candidates for the procedure. Ankle replacement surgery is not recommended for people with severe deformities, poor bone quality, active ankle infection, or neuromuscular disorders affecting the ankle joint. Most patients who undergo total ankle replacement experience relief from pain and improved mobility and can return to an active lifestyle.

What is involved in the procedure?

Before surgery, a thorough evaluation with imaging is done to assess the extent of the damage and tailor the procedure to the specific patient. Total ankle replacement surgery involves removing the damaged portions of the ankle joint and replacing them with prosthetic components that are inserted to recreate the joint, eliminating pain and restoring normal ankle function. The implant has two metal parts, with a plastic piece between them that allows them to glide smoothly.

What can I expect in recovery?

Immediately after surgery, the joint will be elevated to reduce swelling and encourage wound healing. Patients will then use crutches or a knee walker and wear a splint or boot for several weeks to immobilize the joint, until the foot and ankle can bear weight. Physical therapy is recommended to increase strength and restore range of motion during rehabilitation. Follow-up visits with your orthopedic surgeon will ensure that there are no post-op complications, and the ankle is healing properly.

If you’re suffering from severe ankle pain and reduced mobility, total ankle replacement surgery offers the potential for significant pain relief and a return to an active lifestyle. Schedule a consultation to determine the best course of treatment for your specific needs, whether surgical or non-surgical. Dr. Eilts and the team at Atlantic Orthopaedics are committed to providing comprehensive care to help every patient achieve optimal health and get back to doing what they love.

Is it Too Late for Joint Replacement Surgery?

When is joint replacement surgery called for?

Patients suffering from chronic knee or hip pain know that it can seriously impact mobility as well as overall quality of life. In addition to pain, symptoms may include swelling, stiffness, muscle weakness, and limited range of motion. Causes range from rheumatoid or osteoarthritis to trauma to repetitive strain on the joint. After diagnosis, non-surgical treatments like anti-inflammatory medications, physical therapy, and injections are the first course of action when treating persistent joint pain, but these methods aren’t always effective.

What is involved in joint replacement surgery?

The surgical screening process begins with a full clinical evaluation, using advanced imaging to determine the extent of the joint damage. The orthopedic surgeon will make an incision to access the damaged bone, tendon, and tissue, and replace the knee or hip joint with a prosthetic made of plastic, metal, or ceramic. The procedure can be done using a conventional approach or with robotic-assistance. The physicians at Atlantic Orthopaedics are at the forefront of innovation in knee and hip replacement techniques and technology and have pioneered the use of minimally-invasive robotic-assisted surgery.

What can I expect after surgery?

Commitment to post-operative care is a key factor in long term success. Recovery time will vary based on the individual patient’s response to the procedure and the surgical approach used. Proper recovery usually includes daily movement of the affected joint, physical therapy, and wound care management, along with a post-op follow up with your surgeon.

What if I’ve waited too long to be eligible for joint replacement surgery?

Because damage to cartilage, ligaments, and bone is progressive and won’t improve on its own, some patients wonder if there’s a point at which joint damage is too severe to be corrected by surgery. Atlantic Orthopaedics’ Dr. Michael Morwood, a fellowship-trained orthopedic surgeon who specializes in knee and hip replacement, answers this question.

Is there a point when hip or knee replacement surgery can’t be done?

The short answer is no. We can always individualize our treatment plan for every patient. Joint replacement surgery can be performed on a person of any age, no matter how severe the damage. There are cases where the pain and deformity are so great that the procedure or the post-op recovery are more challenging. Everyone is unique, with their own unique anatomy, and our training as orthopedic surgeons gives us the ability to handle the challenges involved in each individual case.

If non-surgical treatments have not alleviated your joint pain, schedule an appointment to talk with an orthopedic specialist about whether replacement surgery is right for you. Relief from pain is possible, and it is never too late to get back to doing the things you love!

Watch the Morwood Minute episode HERE.

Dr. Meyer Published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS)

Updated August 2024
We’re excited to share the news that our own Dr. Meyer made the cover of the August issue of JAAOS (Journal of the American Academy of Orthopaedic Surgeons), one of the largest journals in orthopedics with almost 40,000 subscribers. His article, “Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment,” reflects his dedication to furthering his knowledge and sharing his expertise with the orthopedic community. It’s Dr. Meyer’s hope that his publication in the go-to journal for surgeons and trainees will be used to improve patient care around the world. It’s a testament to Dr. Meyer’s skills and training in upper extremity trauma, and a proud moment for Atlantic Orthopaedics.

May 2024
We are thrilled to announce that Dr. Maximilian Meyer, an orthopedic upper extremity surgeon at Atlantic Orthopaedics, has recently published a groundbreaking paper on elbow trauma in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). This prestigious journal is recognized as one of the leading publications in the field of orthopedic surgery, dedicated to disseminating high-quality, peer-reviewed research that advances the understanding and treatment of musculoskeletal conditions. Dr. Meyer’s latest contribution underscores his commitment to advancing orthopedic knowledge and improving patient care.

The paper, titled “Complex Elbow Fracture-Dislocations: An Algorithmic Approach to Treatment,” examines various types of complex elbow injuries, including the “terrible triad,” trans-olecranon fracture-dislocations, and anteromedial coronoid fractures, which can result from different traumatic mechanisms. The paper provides insights into the latest surgical techniques and management strategies aimed at restoring joint stability, preventing long-term complications, and improving patient outcomes By sharing his expertise and findings, Dr. Meyer continues to contribute significantly to the orthopedic community, ensuring that patients receive the most effective and up-to-date treatments. We encourage our readers to explore this significant publication in JAAOS, reflecting the cutting-edge advancements in orthopedic surgery.

Click here to read the paper.

Understanding Osteoarthritis vs. Rheumatoid Arthritis

Arthritis is extremely common. In fact, over five hundred million people worldwide show symptoms associated with the condition. But not all arthritis is the same. The two most prevalent types are Rheumatoid Arthritis (RA) and Osteoarthritis (OA), and understanding the distinctions between the two can help patients manage their symptoms more effectively and seek the appropriate treatment.

What is Rheumatoid Arthritis?

Rheumatoid Arthritis is an autoimmune disorder, meaning the body’s immune system mistakenly attacks its own tissues, specifically the synovium–the lining of the membranes that surround the joints and help it move smoothly. This causes inflammation that can lead to joint damage and deformities over time. Patients might also experience systemic symptoms like fatigue, fever, and loss of appetite. Onset can occur at any age, but RA is most commonly diagnosed in adults between age 30-60. 1.5 million people in the U.S. have RA, and women are three times more likely than men to develop the condition. The exact cause is unknown, but genetic and environmental factors play a significant role.

Treatment for rheumatoid arthritis may include physical therapy and low impact exercise to improve mobility, anti-inflammatory medications to alleviate pain, steroids, corticosteroids to reduce inflammation, disease-modifying antirheumatic drugs (DMARDs) or biologics to slow the progression, and joint replacement surgery. There is no cure for RA, but the goal of treatment is to limit joint damage and put the disease into remission.

What is Osteoarthritis?

Osteoarthritis, on the other hand, is a degenerative joint disease that primarily affects the cartilage–the tissue that covers the ends of the bones in a joint. Over time, the cartilage breaks down, causing bones to rub against each other. This leads to pain, swelling, and decreased mobility. Unlike RA, OA is generally associated with wear and tear of the joints. Symptoms, including pain, tenderness, stiffness, and loss of flexibility, are typically localized to the affected joints. Risk factors for osteoarthritis include age, joint injuries, repetitive stress on the joint, and obesity.

Atlantic Orthopaedics’ Dr. Akhil Sastry is a board-certified orthopedic surgeon who specializes in hip and knee joint replacement. He is a pioneer of robotic-assisted total knee replacement and has performed the surgery over 1,000 times. A recent patient had this to say about his experience with Dr. Sastry:

“I had an excellent experience and result with Dr. Sastry. He worked with me prior to surgery to ensure I could continue the activities important to me despite having osteoarthritis in the knee. After a year and a half, we agreed that I needed surgery and Dr. Sastry gave me a partial knee replacement. The pre op communication and approach were not only effective but used the latest practices to minimize pain and recover quickly. The entire surgical team helped make the surgery itself a success. But the proof is in the result, after 8 weeks of physical therapy, I am back doing the sports I love like tennis and bike riding. I am very grateful to Dr. Sastry and his team.”

Below, Dr. Sastry answers a frequently asked question about osteoarthritis.

What are the best ways to handle osteoarthritis in my knee and what are the options for treatment for a very active senior who wants to stay active?*

Treatment options range from weight loss, low impact exercises (biking, elliptical, swimming), over the counter anti-inflammatory medications, injections, and joint replacement surgeries. Depending on the severity of disease and the limitations that are inflicted, an orthopedic surgeon can implement a treatment program that would be the most suitable for your needs.

Managing Osteoarthritis in the Knee: Treatment Options for Active Seniors

Physical activity: Staying active is one of the most effective ways to manage knee osteoarthritis. Gentle exercise like walking or swimming can help maintain joint flexibility and strengthen the muscles around the knee, providing better support and joint stability.
Weight management: Maintaining a healthy weight reduces the stress on your knees. Even a small amount of weight loss can significantly decrease the load on your knee joints, alleviating pain and slowing the progression of OA. A diet rich in anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids can also help improve symptoms.
Physical therapy: A physical therapist can create a personalized exercise program to improve your knee’s strength and flexibility. They can also teach you techniques to modify your movements to reduce pain and prevent further damage.
Injections: Corticosteroid injections can provide temporary pain relief by reducing inflammation in the knee joint. Hyaluronic acid injections, which mimic the natural fluid in your knee, can also help lubricate the joint.
Surgical options: If conservative treatments aren’t providing sufficient relief and your mobility is impaired, surgery may be advised. Arthroscopy, a minimally invasive procedure, can be used to remove damaged cartilage or bone fragments. In more severe cases, partial or total knee replacement surgery might be necessary. These procedures can significantly reduce pain and improve function, allowing you to remain active.

If you are suffering from joint pain due to arthritis, don’t delay getting treatment. There are many options, both non-surgical and surgical, that can improve your quality of life and get you back to doing the activities you love. Schedule a consultation with Dr. Sastry to discuss a treatment plan tailored to your needs and lifestyle.

*Medical Disclosure: The information provided on this blog is for educational and informational purposes only. While we strive to provide accurate and up-to-date information, we do not dispense medical advice or treatments to individuals who have not been seen by a healthcare professional.

It’s crucial to understand that every individual’s medical situation is unique, and what may work for one person may not necessarily work for another. Additionally, individuals may have underlying health conditions, allergies, or other factors that require personalized attention and consultation with a qualified healthcare provider.

Therefore, we strongly advise individuals to consult with a licensed healthcare professional before initiating any new treatments, making changes to their current treatment regimen, or addressing any medical concerns. This includes seeking professional guidance for managing allergies, assessing potential medication interactions, and ensuring overall safety and efficacy of any suggested treatments.

We are not liable for any actions taken based on the information provided on this blog. The responsibility for healthcare decisions lies solely with the individual and their healthcare provider. If you have any questions or concerns regarding your health, please consult a qualified healthcare professional promptly.

Coping with Hand Arthritis: Tips for Daily Activities and Pain Management

Is painful hand arthritis affecting your ability to perform daily tasks and engage in the activities you love? Hand arthritis can be debilitating and negatively impact overall quality of life. The good news is that there are treatments, both non-surgical and surgical, that can alleviate pain caused by hand arthritis.

Hand arthritis is a disease that attacks the tissues surrounding your joints and most commonly affects the knuckle joints closest to the nails (distal interphalangeal joints) and the basal thumb joint (carpometacarpal arthritis). There are many types of hand arthritis, but osteoarthritis, rheumatoid arthritis, and psoriatic arthritis are the most common. Osteoarthritis causes the cartilage at the end of bones to degenerate is usually the result of wear and tear associated with aging. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that can affect patients of any age. It causes the body’s immune system to attack its own tissue, eroding first the cartilage and then the bone. Psoriatic arthritis affects the skin and joints, causing swelling, stiffness, and pain.

Dr. Maximilian Meyer is a hand and upper extremity surgeon at Atlantic Orthopaedics who specializes in treatment of the fingers, hand, wrist, forearm, and elbow. His philosophy centers on listening to and working together with his patients to create individual care plans that help them return to an active lifestyle. Dr. Meyer stays up to date on the latest scientific evidence and advanced techniques, and is committed to providing compassionate orthopedic care.

We asked Dr. Meyer to answer some frequently asked questions* about hand arthritis.

What are a few tips you would give your patients to cope with hand arthritis and pain management?

There are a variety of non-surgical treatment options available for hand arthritis, including bracing, topical and systemic anti-inflammatories, and injections. Additionally, working closely with a hand therapist can lead to significant improvements in pain and function. Surgery is typically reserved for patients whose symptoms have not responded to conservative treatments, and who feel that their hand arthritis limits their quality of life. When this happens, surgery can both relieve pain and improve hand function. My role as a surgeon is to help patients better understand the impact of arthritis on their hands, so that they can pick the treatment that is best for them.

Are there any exercises that can help with hand arthritis pain management?

Arthritis in the hands typically presents with both pain and with stiffness. Both symptoms can often be improved with low-impact exercises that emphasize joint motion and tendon gliding. I commonly recommend the “6-pack” hand exercises for patients with stiffness, either from arthritis or after sustaining hand trauma. By systematically isolating and improving motion of the major joints in the hand with these exercises, patients often find that they are able to do more with less pain. The exercises are simple to do and illustrations that make it easier to visualize can be found online.

Straight: straighten your fingers as much as possible.
Tabletop: make a tabletop shape with your fingers by bending at the knuckles, keeping your wrist straight.
Hook: bend and straighten your fingers, keeping your knuckles and wrist straight.
Fist: make a fist, bending each joint as much as possible.
Open and Close: straighten and open your fingers as if you are waving and then bring them back together.
Thumb to Tip: make an “O” shape by touching your thumb to each fingertip, one at a time, opening your hand wide after each finger.

What are the signs it’s time to see an expert like yourself for hand arthritis pain?

It is never too early to see a hand surgeon for arthritis, as we can help guide non-operative treatments and relay patient-specific information to hand therapists prior to starting therapy.

Patient Question: I have severe arthritis in my right hand. It affects everything I do from drying my hair, brushing my teeth, driving. How can I learn to deal with this excruciating pain?

Hand arthritis should not reach the point where it interferes with daily activities or with quality of life. If this occurs, surgical intervention in the form of joint-sparing procedures, joint replacement, or joint fusion can lead to significant improvements in hand function. I would encourage a visit to our office to explore treatment options.

If you’re suffering from arthritis in your hands, there are many options available that can alleviate pain and help you get back to the activities you love. Schedule a consultation with Dr. Meyer to learn more.

How the MILD Procedure Helped an 86-Year-Old Woman Get Her Life Back

In early 2023, 85-year-old Jackie Freehart reached to put something away in a kitchen cupboard and fell backwards, injuring her back. It was so painful that she needed her son’s help to get up from the kitchen floor. After two days of waiting for the pain to stop, she went to the hospital to get checked out. Jackie was seen by Atlantic Orthopaedics pain management specialist, Dr. Lehn, who told her that she had Spinal Stenosis, a condition that occurs when the channel inside the spine narrows, putting pressure on the spinal cord and nerves, and causing pain when standing or walking. Spinal Stenosis can be the result of an injury like Jackie’s, or just the normal wear and tear that comes with aging.

Dr. Lehn listened closely to Jackie’s story and suggested she try conservative treatments for the pain first, rather than rushing into surgery. “I was so impressed with Dr. Lehn,” Jackie said. “He doesn’t rush but takes the time to explain things. He doesn’t give orders. He gave me a choice.” She decided to try physical therapy, and then Cortisone shots, but found that neither one helped, at least not for long. “Getting in and out of bed was the worst thing,” Jackie said. “I just couldn’t get comfortable. The only position I could sleep in was lying on my side, but turning from one side to the other was painful and difficult.”

At her next visit, Dr. Lehn told her about a procedure for Spinal Stenosis called MILD, short for minimally invasive lumbar decompression. MILD is a minimally invasive alternative to traditional spinal surgery where the surgeon inserts a spinal decompression device through a tiny incision in the back, using it to remove the tissue that’s pressing on the spinal nerves. The procedure takes less than an hour and is performed with local anesthesia so patients can go home the same day. Dr. Lehn gave Jackie a brochure about MILD to take home and asked her to think about it. In the meantime, she continued to get Cortisone shots in the hopes that it would provide relief.

When she returned to Dr. Lehn a few months later for her Cortisone shot, he mentioned that he had done the MILD procedure on a 90-year-old patient the day before and she had walked out of the hospital on her own. “I had read the brochure and I Googled it,” Jackie said, “and we talked about it twice before I got serious about it. He didn’t try to coerce me into it.” About 7 months after her fall and still in pain, Jackie made up her mind to undergo the procedure.

“Dr. Lehn explained everything, so I knew what to expect,” she said. “He was very reassuring and I was not a bit nervous when I went in.” Dr. Lehn performed the MILD procedure at NECOS in Portsmouth in August of 2023. Jackie woke up soon after and walked out with the help of a walker. She was still in some pain when she left the hospital and it continued for the next day. But two days after the surgery, Jackie reported, she was pain-free. “The recovery was almost miraculous!” she said. “Now I have no pain going to bed. I’m not fearful about it. I can sleep and I feel like myself again.” Jackie can get around now with just a cane. She recently attended a baby shower and is back to walking at the mall three days a week. “I can cook again, which is my passion,” she said. “I have company over now.”

When asked if she would recommend the MILD procedure and Dr. Lehn to her friends, Jackie didn’t hesitate. “I can’t say enough wonderful things about Dr. Lehn. The whole staff was incredible, very helpful and kind,” she said. “This procedure is worth it for anyone having this pain, because quality of life is so important.” Jackie was so pleased with the care she received that she wanted to show her gratitude to everyone at Atlantic Orthopaedics. “I didn’t know what to do other than say thank you,” she said. “I told my son I wanted to do something more, and so we went out and got a great big basket of cookies and brought them for the staff.” Now, eight months after she had the procedure, Jackie remains pain-free. “I’m so glad I had it done,” she said. “I feel like I have my life back.”

Exactech Computer-Assisted Shoulder Replacement

Patients suffering from severe shoulder pain know that it can impact every aspect of life, from mobility to sleep to the ability to perform basic daily tasks like getting dressed or pushing a grocery cart. The shoulder is a ball and socket joint, comparable to the hip, and has a greater range of motion than any other joint. It’s made up of three bones: the humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone), which converge at the socket. The head of the humerus is the “ball” that fits into the glenoid cavity, the “socket” part of the scapula, and is stabilized by a ring of cartilage called the glenoid labrum. Damage to this protective cartilage can cause the bones to rub together, leading to joint pain that can be debilitating.

Damage to the shoulder joint can occur as a result of osteoarthritis, rheumatoid arthritis, rotator cuff tear arthropathy, or bone deterioration caused by restricted blood (avascular necrosis), among other conditions. For patients who haven’t found relief with non-surgical treatments like physical therapy or steroid injections, shoulder replacement surgery may be recommended. The outpatient procedure involves making an incision to access the shoulder joint. The surgeon then removes the damaged cartilage or parts of bone, and replaces them with metal and/or plastic implants.

X-rays have traditionally been used to assess a patient’s shoulder before replacement surgery, but x-ray doesn’t provide a comprehensive view of the joint. Now, some orthopedic surgeons–including our own Dr. Noerdlinger–have embraced a state-of-the-art technology called Exactech Guided Personalized Surgery that creates a detailed 3D model of the shoulder joint. The visual map allows the surgeon to plan and virtually simulate the surgery in advance, and utilize computer-assisted guidance during the procedure. The replacement surgery can be tailored according to the individual patient’s unique anatomy, allowing for optimal implant placement. Exactech GPS enhances precision and accuracy, resulting in better functionality, fewer complications, and an expedited recovery process.

Specializing in shoulder surgery (both Arthroscopic & Shoulder Replacements), our own Dr. Noerdlinger has been voted Top Orthopedic Surgeon by New Hampshire Magazine every year from 2017 to 2023. Dr. Noerdlinger performed 140 replacement surgeries in 2023 and is recognized as one of the top shoulder surgeons in New England. Below, he answers some questions about Exactech GPS.

In your own words, how does this procedure benefit your patients?
The Exactech GPS system allows surgeons to place the shoulder replacement in the most accurate position, which improves outcomes.

Who is a good candidate for Exactech Guided Personalized Surgery?
Anyone considering a shoulder replacement.

Where do you perform this procedure?
I perform the surgery at NECOS and at York Hospital.

Anything else you’d like current or future patients to know about this procedure and how it would benefit them?
Patients considering a shoulder replacement should know that it’s an outpatient procedure and the recovery is quicker than many think. Patients often don’t need post-operative physical therapy. For a Reverse Total Shoulder Replacement, patients can expect to wear a sling for one week, and patients undergoing Anatomic Total Shoulder Replacement can expect to wear a sling for about 6 weeks.

If you’re suffering from shoulder pain and reduced joint function, schedule a consultation with Dr. Noerdlinger to find out if you’re a candidate for Exactech GPS-assisted shoulder replacement surgery. Don’t postpone getting help, so you can get back to enjoying the activities you love.