When Foot Pain Isn’t Just Foot Pain: Knowing When to See a Specialist

We all know the feeling of foot pain after a long day on your feet, a weekend of yardwork, or a strenuous workout or sporting event. But what happens when that discomfort doesn’t go away and starts to interfere with your daily life? That’s when it may be time to get checked out by a specialist.

At Atlantic Orthopaedics & Sports Medicine, Dr. Cameron Eilts has been helping patients find relief from foot and ankle pain since 2011. Whether it’s a sprained ankle, complications from diabetes, or chronic heel pain, Dr. Eilts focuses on understanding each patient’s unique needs and finding the right treatment—surgical or not—to relieve the pain and get them moving again.

Common Causes of Foot & Ankle Pain

Foot and ankle pain can come from many sources. Some of the most common include:

Plantar Fasciitis
Symptoms: A sharp, stabbing pain in the heel that’s often worst in the morning.
Cause: strain or small tears in the plantar fascia, a thick band of tissue along the bottom of the foot, often due to overuse, poor arch support, or tight calf muscles.

Arthritis
Symptoms: Stiffness, swelling, and discomfort in the joints of the foot or ankle.
Cause: Results from wear and tear (osteoarthritis), autoimmune conditions (like rheumatoid arthritis), or post-injury degeneration that leads to joint inflammation and cartilage breakdown.

Tendonitis
Symptoms: Pain due to inflammation of the tendons.
Cause: Typically caused by repetitive stress or sudden increases in activity, leading to inflammation of tendons that connect muscle to bone.

Ankle Sprains
Symptoms: Ankle pain due to overstretched or torn ligaments.
Cause: Often a result of sudden twisting, rolling, or impact during sports or uneven walking.

Diabetic Foot Issues
Symptoms: Include nerve damage and reduced blood flow that can lead to infection, ulcers, and decreased healing ability.
Cause: Stems from long-term high blood sugar

While these conditions vary widely, the goal is always the same: relieve pain, restore function, and prevent further damage.

Not All Foot & Ankle Issues Require Surgery

One of the most common misconceptions about seeing an orthopedic specialist is the fear that surgery is the only option. Dr. Eilts emphasizes a conservative approach to treatment whenever possible. Many patients find non-surgical relief through physical therapy, injections to reduce inflammation, or bracing to immobilize and protect the area so it can heal.

When It Might Be Time to Consider Surgery

Of course, not all pain can be resolved non-surgically. If conservative treatments haven’t worked, or if your condition is worsening, surgical intervention might be the best path forward. Here are a few signs that it’s time to see a foot and ankle specialist like Dr. Eilts:

Chronic pain that doesn’t improve with rest or conservative care

Recurrent sprains or instability in the ankle

Numbness, tingling, or visible deformities

Limited mobility affecting your quality of life

Dr. Eilts takes the time to evaluate each case individually, using a physical exam and advanced imaging and diagnostics, to create a treatment plan tailored to your specific condition and lifestyle. If surgery is needed, he will walk you through every step of the process, from pre-op preparation to post-op rehab.

Don’t Wait on the Pain

The longer foot and ankle pain goes untreated, the harder it can be to fix. Trying to “tough it out” can sometimes do more harm than good. Whether you’re dealing with nagging heel pain, recurring ankle sprains, or diabetic foot concerns, Dr. Eilts and the team at Atlantic Orthopaedics are here to help. With a focus on personalized care and a full range of treatment options, we’re ready to set you on the path to recovery–so you can get back to doing the things you love as soon as possible.

If you’re suffering from foot or ankle pain, don’t wait it out. Get in touch to schedule an appointment with Dr. Eilts today.

The BEAR Procedure: A Revolutionary Approach to ACL Repair

ACL tears are one of the most common knee injuries, sidelining more than 100,000 Americans every year. Traditionally, repairing a torn ACL (Anterior Cruciate Ligament) required surgical reconstruction using tissue from another part of the patient’s body or donor tissue. While often effective, this procedure is invasive and requires a lengthy recovery time. But now, thanks to advancements in orthopedic surgery, patients suffering from a torn ACL have an alternative called Bridge Enhanced ACL Restoration, also known as BEAR.

What is the BEAR Procedure?

BEAR is a breakthrough in ACL repair that enables the body to naturally heal on its own. Because synovial fluid, which reduces friction in the knee, prevents formation of blood clots that are necessary for healing, the ACL does not have the ability to heal itself. In the BEAR procedure, instead of removing the damaged ACL and replacing it with donor tissue, a special implant is used to bridge the torn ends of the ligament. This creates an ideal healing environment, enabling the ACL to heal, typically within eight weeks.

Meet Dr. Welch: Maine’s First BEAR Surgeon

At Atlantic Orthopaedics & Sports Medicine, we’re proud to have Dr. Welch, a pioneer in ACL repair, on our team. Dr. Welch was the first surgeon in Maine to perform the BEAR procedure and remains one of the few specialists in the region to offer it. He performs the surgery at York Hospital and at the New England Center for Orthopedic Surgery in Portsmouth, providing patients with a cutting-edge alternative to traditional ACL reconstruction.

Why Choose the BEAR Procedure?

For many patients, BEAR offers significant advantages over traditional ACL surgery:

Preserves your own tissue: unlike reconstruction, which requires a graft from another part of the body or a donor, BEAR allows your ACL to heal naturally.

Better post-operative knee function: because the original ACL is preserved, patients tend to experience less pain and less muscle weakness after surgery.

Less invasive: the surgery is an outpatient procedure, and does not require harvesting tissue from another part of the body

No donor tissue risks: There’s no concern over donor graft quality

Faster healing timeline

Real Results: A Patient’s Journey Back to Running

Patients who undergo the BEAR procedure are seeing amazing outcomes, including Rachel, who recently shared her experience:

“Thanks to Dr. Welch at Atlantic Orthopaedics & Sports Medicine for the amazing BEAR procedure and Shantelle and Ian at Coppola Physical Therapy for helping me get back on the road as quickly as I did. I’m so lucky to have this team and my family and friends cheering me on.”

Six months after her surgery, Rachel was back to running–something that once felt impossible. Her success story is just one of many that demonstrate the life-changing potential of this innovative ACL repair method.

Who is Eligible for BEAR?

The BEAR implant was cleared by the FDA for patients who meet the following criteria:

Must be at least 14 years old.
Must have a complete ACL rupture, as confirmed by MRI.
Must have an ACL stump attached to the tibia.

The team at Atlantic Orthopaedics & Sports Medicine are committed to bringing the latest advancements in orthopedic care to our patients. Dr. Welch continues to be at the forefront of ACL treatment, helping patients regain knee strength and mobility with a less invasive approach than traditional reconstruction. If you’ve suffered an ACL tear and are exploring your options, the BEAR procedure may be the right choice for you. Contact Atlantic Orthopaedics today to schedule a consultation with Dr. Welch and learn more.

FREE Seminar – Orthopedic Sports Medicine and Taking Care of the Female Athlete

Join Dr. Abigail Boduch for Orthopedic Sports Medicine and Taking Care of the Female Athlete on:

Tuesday, April 15th at 6:00pm
Wells Public Library
1434 Post Road Wells, ME 04090

This FREE informative event will explore the unique orthopedic challenges female athletes face and the best ways to prevent and treat injuries. Whether you’re an athlete, coach, parent, or simply interested in sports medicine, this is a great opportunity to learn from Dr. Boduch and ask questions. Don’t miss out—mark your calendar and bring a friend!

Must register to attend, please click HERE.

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.

Relief From Hip Pain – How Arthroscopy Can Alleviate Pain and Restore Function

Hip pain can be debilitating, affecting everything from mobility to sleep to overall quality of life. The hip joint is where the thigh bone (femur) connects to the pelvis and is used constantly when one walks, bends, and supports his/her upper body.

Who is a good candidate for Hip Arthroscopy?

Hip pain has varied causes; in young people the most common cause is a labral tear–damage to the soft tissue lining the inside of the hip socket (acetabulum). A Labral tear can occur from repetitive wear over time, impingement from an underlying problem with the joint structure, or trauma from a sports injury or accident.

For patients who suffer from a labral tear –and who have not found relief from conservative treatments like rest, over-the-counter pain relievers and physical therapy–hip arthroscopy may be the answer. It’s a minimally invasive procedure that can restore hip function and alleviate pain.

Patients with osteoarthritis, cysts, or ankylosis (fusion) of the hip joint are not good candidates for hip arthroscopy.

What is involved in the Hip Arthroscopy procedure?

First, an orthopedic specialist will determine whether hip arthroscopy is appropriate based on a physical exam and x-ray or MRI imaging. Unlike open surgery, arthroscopy only requires a small incision through which a camera (arthroscope) is inserted. This gives the surgeon a clear, magnified view of the interior of the hip joint during the procedure. The surgeon will then repair or remove the damaged labrum, bone impingement, or loose bodies. Performed in an outpatient setting , arthroscopic hip surgery usually leads to less post-operative pain and shorter recovery time than open hip surgery.

Surgical Expertise + State of the Art Technology

Dr. Tyler Welch is a board certified orthopedic surgeon who has performed approximately 300 hip arthroscopy procedures – In addition to his extensive experience, Dr. Welch utilizes state-of-the-art technology, including “HipMap” software that generates a detailed 3D image of the hip structure in advance of the procedure. Used as a planning tool, this advanced imaging enables him to precisely target the surgery and minimize disruption to surrounding tissue.

Another innovative device employed by Dr. Welch is the Guardian, a cutting-edge operating table designed to hold the patient comfortably and securely in place, while providing the surgeon greater range of motion and visibility during the procedure. Traditionally, achieving proper positioning for hip surgery required the use of a post between the patient’s legs, a technique that can cause groin pain . The Guardian table has eliminated post-operative groin pain.

Below, we asked Dr. Welch a few questions about hip arthroscopy.

Where do you perform this procedure?
I perform hip arthroscopy at NECOS and at York Hospital.

Are you still the only practice in the Seacoast that uses the Guardian Table for this procedure?
That’s right, I’m still the only surgeon on the Seacoast that uses the Guardian Table.

Anything else you’d like current or future patients to know about this procedure and how it would benefit them?
What is nice about hip arthroscopy is that it is a relatively straightforward recovery. Crutches are only required for about one week, and most patients make significant gains within 4-6 weeks. It is not too painful, and I have found that most patients only require pain medication for the first 24-48 hours.

Also, surgery is reliable for the right patient. As long as the patient has hip impingement without any sign of arthritis, surgery typically alleviates pain and eliminates most symptoms.

If you suffer from hip pain, don’t ignore it. Atlantic Orthopaedics and Sports Medicine offers treatments–both surgical and non-surgical–that can alleviate hip pain and restore your quality of life. If you think that hip arthroscopy may be right for you, schedule a consultation with Dr. Welch to learn more.

A Solution for a Common Orthopedic Injury – Distal Radius Fracture Repair for Wrist Fractures

Along with cold weather, snow, and ice, winter in the Northeast means an increase in distal radius (wrist) fractures, most of which occur from landing on an outstretched hand after a slip and fall. These fractures result in pain, limited range of motion, and decreased wrist function. For patients with a fracture that is significantly displaced, surgical intervention may be recommended.

Our orthopedic surgeon, Dr. Meyer, specializes in treating upper extremity injuries (fingers, hand, wrist, and elbow), and understands the tremendous impact that wrist fractures can have on patients’ lives. In patients who are candidates for surgery, he has seen excellent outcomes from Distal Radius Fracture ORIF (open reduction and internal fixation, which means fixing the bone in its native position with a plate and screws).

Below, we asked Dr. Meyer some questions about the procedure.

Q: In your own words, how does this procedure benefit your patients?

A: Distal radius fractures are the most common fracture of the upper extremity (shoulder, elbow, wrist, and hand). The radius bone is part of the forearm, and the distal (end-portion) of the radius supports the bones of the wrist. Certain distal radius fractures are stable and will heal well with a period of immobilization in a cast. Other distal radius fractures are unstable and often benefit from surgery to align the fracture pieces in a more anatomic position.

When surgery is performed, a combination of a plate and small screws are used to hold the bones in the optimal position. Surgery for displaced distal radius fractures have been shown to lead to excellent outcomes, including near-complete return of motion and grip strength and very low rates of persistent pain and disability. The majority of patients sustaining these injuries are able to return to their jobs and hobbies without limitation.

Q: Who is a good candidate for this procedure?

A: Anyone who sustains a broken wrist should be evaluated with a physical exam and a set of x-rays. A wide range of both patient-related factors (age, medical history, functional demands from jobs/hobbies, smoking status, etc.) and injury-related factors (mechanism of injury, fracture alignment/displacement, etc) are used to help guide the decision between treating a wrist fracture with a cast (no surgery) versus performing surgical fixation.

Q: Where do you perform this procedure?

A: I perform surgical fixation of distal radius fractures at the New England Center for Orthopedic Surgery (NECOS), Portsmouth Regional Hospital, and York Hospital.

Q: Tell us about a recent success story.

A: A 65 year old woman presented to my office after slipping on black ice and injuring her wrist. She had a displaced distal radius fracture that significantly limited her wrist motion. She is an elementary school teacher, and her two biggest goals were to optimize her long-term wrist function and to return to activity quickly. We discussed the treatment options, and she chose surgery in order to accelerate her rehabilitation, minimize her time in a cast, and give herself the best chance for healing her wrist injury in an anatomic position.

We fixed her wrist with a plate and screws. The surgery took a little over an hour and she was back to work the same week. Within two weeks, she was out of her splint and working on gentle wrist range of motion exercises. She is an avid pianist, and found that playing piano helped to improve her wrist and finger motion in the early post-operative period. Six weeks after surgery, we started gentle strengthening. By the 2.5 month-mark, she was cleared for full strengthening and return to all activities. Now, she is back to all school-related activities and does not feel limited at all by her wrist.

Q: Anything else you’d like current or future patients to know about this procedure and how it would benefit them?

A: These fractures occur most commonly after a slip and fall onto an outstretched hand. Here in the Seacoast, we see a large upstick in the number of patients sustaining distal radius fractures during the wintertime. Whether it is slipping on ice or falling while skiing or skating, these injuries can unfortunately happen at any time. The best way to treat a wrist fracture is to not have one! So, my best advice is to make sure to tread carefully when walking, skating, and skiing. Furthermore, many patients in their 60’s and 70’s have osteoporosis (thin bones that are more prone to fracture). With several months of cold and cloudy weather in the Seacoast, many of us also have low calcium and Vitamin D levels. I would encourage patients to discuss their bone density and calcium and Vitamin D levels with their primary care physicians in order to make sure their bone health is optimized to start off the new year.

If you’ve suffered a wrist fracture, it’s important to consult with an orthopedic specialist as soon as possible. Dr. Meyer’s treatment philosophy centers on listening to patients and working together to find solutions, both surgical and non-surgical, that help them resume a pain-free active lifestyle. Contact us to schedule an appointment with Dr. Meyer today.

Relief From Lower Back Pain With SI Fusion

Living with chronic lower back pain can have a profound impact on not just your physical well-being, but your overall quality of life. Many people suffer from back pain due to dysfunction in the sacroiliac (SI) joint, which connects the bottom of the spine (sacrum) to the pelvis (ilium). These two joints, one on each side act as a shock absorber for the spine and play a crucial role in stability and weight bearing ability, transferring pressure from the lower back to the legs. The SI joint can be damaged by traumatic injury, a degenerative condition, or tissue loosening from things such as connective tissue disorders and pregnancy. Patients with SI dysfunction will feel pain in the low back, especially when walking, standing up from a seated position, or lifting. Other symptoms can include numbness or tingling in the lower extremities; pain in the pelvis, hip, or groin; pain radiating down the legs; or buckling in the legs.

Diagnosing SI Dysfunction

Because low back pain can be a symptom of other conditions like sciatica, diagnosis is usually done with a physical exam, followed by an injection that will temporarily block the pain if it’s originating in the sacroiliac joint. In some cases, the pain can be managed with anti-inflammatory medications, physical therapy, or steroid injections, but for patients who haven’t responded to those treatments there is a minimally invasive procedure called SI Fusion that may offer sustained relief.

What is the SI Fusion Procedure?

SI Fusion, short for sacroiliac joint fusion, is a minimally invasive procedure in which the surgeon inserts an implant into the SI joint space. Guided by real-time imaging, a small incision is made and the implant is fixed in place, fusing the sacrum to the ilium in order to limit movement. This fusion, by restricting excessive motion in the SI joint, restores stability and alleviates pain.

What Does the Recovery From SI Fusion Involve?

Because the procedure is minimally invasive, the risk of complications is low and recovery times are quicker than with traditional open surgery. Patients can expect to be mobile immediately after the procedure, and most experience rapid pain relief. Post-operative physical therapy may be recommended to restore function in the joint and aid recovery.

Below, a Q&A about SI Fusion with pain management specialist Dr. Lehn:

How does this procedure benefit your patients?

15-30% of low back pain comes from the SI joint. The SI joint can be a difficult pain to treat as many times PT, medications, and injections only provide temporary relief.

Who is a good candidate for an SI fusion?

If a patient has 90% relief of pain from a SI injection and the pain keeps returning despite exercise, medications, and repeated injections, then they can be considered for SI fusion.

Where do you perform this procedure?

The procedure is performed in the operating room but is done with minimal sedation, and the patient can walk out of the recovery room and go home the same day as the procedure.

Do you have a recent patient success story to share?

One patient had her left side done in June and felt so good she came back in September to have the other side done! She is very happy and back to her very active lifestyle.

Anything else you’d like current or future patients to know about this procedure and how it could benefit them?

This is a very minimally invasive procedure with minimal downtime. The pain from the procedure is minimal. Unfortunately, intense activity is limited for 6 weeks but patients are up and walking the same day. Fusions sound really big and dangerous, but it is essentially a stabilization procedure. SI joints are often painful due to excessive movement. The SI stabilization procedure takes away the additional movement and helps return the patient to a normal functioning joint.For patients grappling with chronic lower back pain caused by SI dysfunction, the SI Fusion procedure can provide long-term pain relief and renewed quality of life. If you suffer from pain that hasn’t responded to non-surgical treatments, schedule a consultation with Dr. Lehn to explore whether SI Fusion is right for you. Take your first steps toward a pain-free future!

Voted Best Podiatrist 2023

Since 1987, our team of board-certified orthopedic physicians have delivered the highest level of care to the Seacoast community. Serving athletes and residents alike, we operate as the area’s premier orthopedic and sports medicine practice. It’s what we love to do, and because of that we were recently voted “Best Podiatrist” by the Seacoast NH community in the 2023 Best of the Seacoast awards and we couldn’t be more proud of our foot and ankle team for this accomplishment.

If you’re suffering from foot or ankle pain, don’t ignore it. Come see our foot and ankle specialists in Portsmouth, NH, or York, ME, led by Dr. Eilts. Our teams will evaluate the extent and severity of your foot or ankle pain and recommend the treatment that’s best for you. Contact us with questions or schedule an appointment online to have your hip pain evaluated and treated. Our offices can be reached at 603-431-1121 (Portsmouth, NH) and 207-363-3490 (York, ME).

Will Injections Help or Do I Need Surgery? The Straight Facts About Cortisone Shots

Cortisone is a potent anti-inflammatory medication that can be used to treat a wide range of orthopedic conditions, but Cortisone shots are not a one-size-fits-all solution. For some patients, injections can be highly effective, but in other cases it may be time to consider surgery.

According to orthopedic surgeon Dr. Noerdlinger, there are three common misconceptions people have about cortisone shots:

1. Cortisone is Just Temporary

Although the effects can be temporary, there are cases where Cortisone can offer long lasting pain relief for years.

2. Cortisone Only Masks the Pain

Novocain, such as lidocaine, will mask pain, but Cortisone decreases the inflammation which is causing the pain. The analogy is taking a steroid to decrease the inflammation from a sore throat. The steroid effect of the Cortisone decreases the inflammation and allows the joint to move more freely, enabling the patient to rehabilitate the joint more effectively.

3. Cortisone Damages Tissue

Used judiciously, cortisone will not damage tissue. Just like taking a bottle of Tylenol will destroy the liver, large amounts of cortisone–in a short time period, in the same body part–can weaken the collagen fibers. But, like Tylenol, where it is ok to finish off the bottle over the course of a year, intermittent Cortisone injections are permissible.

While Cortisone shots can be incredibly beneficial for some, there are situations where surgical intervention may be necessary:

1. Loss of Function

If your orthopedic condition has progressed to the point where it severely limits your ability to participate in daily activities and compromises your quality of life, it may be time to consider surgery.

2. Structural Damage

In patients with significant structural damage to a joint, such as advanced osteoarthritis with bone-on-bone contact, joint replacement surgery may be the best solution to restore function and relieve pain.

3. Repeated Injections are Ineffective

If you find yourself needing frequent Cortisone injections for the same issue, it indicates that the underlying problem can’t be managed with injections alone. If Cortisone offers only temporary relief, it might be time to have a discussion with your orthopedic specialist about surgical options.

Cortisone is a valuable tool in orthopedic care, providing pain relief and delaying the need for surgery in some patients. But it’s important to recognize the limitations of injections and to know when it’s time to consider the next step–surgical intervention like joint replacement. One scenario in which cortisone injections are not recommended is in the setting of fixable rotator cuff tears in patients considering surgery. Studies show that re-rupture rates and infection rates are higher in patients undergoing rotator cuff repairs who receive cortisone injections before surgery.

Your orthopedic specialist is your best resource in determining the most appropriate treatment plan for your specific condition, symptoms, and goals. Whether it’s cortisone injections or joint replacement surgery, the ultimate aim is to help you regain function, eliminate pain, and enjoy a high quality of life.

Knee Pain From a Dislocated Kneecap?

Patella Instability Surgery Can Provide Relief!

What Is Patellar Instability?

When the kneecap shifts out of its normal alignment, you may feel pain, trouble walking, a buckling or locking sensation, or a feeling of the knee “giving way.” Patella instability can impact daily life and make it difficult to stay active.

How Does the Patella Instability Procedure Work?

In this procedure, the surgeon carefully realigns the patella within the femoral groove to ensure proper tracking during knee movement. The specific surgical technique can vary based on factors like the patient’s age, and the severity of the injury. In the Medial Patellofemoral Ligament (MPFL) Reconstruction procedure that Dr. Welch describes below, the patient’s ligament was reconstructed to stabilize the patella on the inside of the knee. In cases of severe instability, the surgeon may also reposition the tibial tubercle–the bony bump below the patella–to improve patellar tracking.

What Can I Expect Post-Surgery?

Patients can expect to go home the same day as the procedure. Recovery time varies and patients will need to use crutches and wear a knee brace for a period of time, typically 4-6 weeks. Physical therapy is also an important part of the recovery process.

We sat down for a Q&A with our Orthopedic Surgeon and Sports Medicine Specialist Dr. Welch.

In your own words, how does this procedure benefit your patients?

Patella instability is a condition in which the patella (kneecap) dislocates from the femur (thigh bone). Most patients are young, often teenagers. Fortunately we can fix this condition surgically. This procedure benefits patients because it generally restores one’s confidence and his/her ability to play sports.

Who is a good candidate for the Patella Instability Procedure?

A good candidate for patella instability surgery is anyone who has had at least one patella dislocation or multiple subluxations (partial dislocations).

Where do you perform this procedure?

I perform this procedure at New England Center for Orthopedic Surgery (NECOS) in Portsmouth and at York Hospital in York, Maine.

Do you have a recent patient success story you can share?

Recently, a 15 year old male high school student came to see me with his family. The patient had sustained two dislocations prior to his visit with me. These dislocation events are painful and stressful, and the young man was apprehensive about playing sports ever again unless we fixed his knee. He underwent a procedure–a medial patella femoral ligament (MPFL) reconstruction–to stabilize his patella. Surgery was straightforward and he recovered nicely. He required crutches for 10 days and a brace for four weeks. After six weeks, he had normal motion and no swelling in his knee. I cleared him to return to sports three months after surgery.

Anything else you’d like current or future patients to know about this procedure and how it would benefit them?

There are a few important things to consider regarding patella instability surgery. The procedure is very reliable – dozens of studies have demonstrated success rates in the 90-95% range, and my experience has been similar. The vast majority of these patients are happy because they regain “trust” in their respective knees, and recovery is straightforward. Further, patients usually return to the same level of activity that they had prior to the dislocation(s).

If you have knee pain from dislocation, visit our website to learn more about Arthroscopic Knee Surgery or schedule a consultation with Dr. Welc h.

Is Pain in Your Thumb Holding You Back?

CMC Arthroplasty As A Solution For Thumb Pain

If you’re experiencing pain and stiffness at the base of your thumb, you might be dealing with CMC (carpometacarpal) arthritis. But don’t worry – you’re not alone. There are effective treatment options available for this common thumb condition that can provide much-needed pain relief and restore motion.

What are the symptoms of CMC arthritis?

Common symptoms include pain at the base of the thumb, especially during pinch and grip activities. The joint also may become swollen and tender to the touch. Typically, CMC arthritis decreases mobility in the thumb, and weakness may develop that makes it difficult to grasp objects.

What causes CMC arthritis?

CMC arthritis is a degenerative condition, often attributed to the aging process. Other contributing factors can include:

Repetitive use: activities that require repetitive thumb movements can accelerate joint wear and tear.
Trauma: a previous thumb injury can increase the risk of developing CMC arthritis.
Genetics: genetic history may predispose some people to joint degeneration.
Inflammatory conditions: certain immune or inflammatory conditions can contribute to CMC arthritis.

Atlantic Orthopaedics’ hand surgeon Dr. Meyer answers some common questions about CMC Arthroplasty, a life-changing procedure for patients suffering from advanced thumb arthritis.

In your own words, how does this procedure benefit your patients?
Arthritis at the base of the thumb (CMC arthritis) is a common source of pain and disability for adults, affecting one in three women and one in eight men over the course of their lifetime. A variety of treatment options exist, starting with conservative management (bracing, therapy, anti-inflammatories, corticosteroid injections) and progressing to surgery. For advanced thumb CMC arthritis that does not respond to the above treatments, CMC arthroplasty can provide lasting pain relief and improvement in thumb strength and motion.

There are a variety of surgical techniques for CMC arthroplasty. Most involve the removal of the painful, arthritic bone at the base of the thumb (trapezium) and use of a nearby tendon to stabilize the thumb in its native position. Recent innovations in the field of hand surgery have allowed for the use of a non-absorbable suture instead of a patient’s own tendon to maintain the thumb’s resting position. This procedure, termed a suture-button suspensionplasty, avoids complications from harvesting nearby tendons and allows for accelerated rehabilitation and recovery after surgery. While most other techniques require between four to six weeks of immobilization in a cast, I allow my patients to start gentle motion after their first post-operative visit (approximately 10 days after surgery) when using this technique.

Who is a good candidate for this procedure?
Thumb CMC arthritis can affect anyone, but it becomes more prevalent with older age. This procedure is typically indicated for middle-age and elderly adults who have painful arthritis at the base of their thumb that limits their daily activities.

Where do you perform this procedure ?
I perform thumb CMC arthroplasty procedures at NECOS, Portsmouth Regional Hospital, and York Hospital.

Do you have a recent patient success story you can share?
A 65-year-old retired professional pianist presented to the office with painful thumb CMC arthritis that failed to improve with bracing and steroid injections. Alleviating pain and preserving thumb motion were her biggest priorities. Due to her activity level, we elected to perform a CMC arthroplasty using the suture-button suspensionplasty technique.

Her surgery and post-operative course both progressed very smoothly. She was seen at her first post-operative visit and transitioned to a removable brace that allowed for gentle motion. At six weeks, she began gentle strengthening under the guidance of our occupational therapy team. At three months, she was cleared to return to full activity. She is back to playing piano and feels that her motion is even better than before surgery because she is no longer limited by pain. We were thrilled to help her get back to one of her favorite activities and to enable her to keep teaching other aspiring pianists. Anything else you’d like current or future patients to know about this procedure and how it would benefit them?
Thumb CMC arthroplasty yields excellent results, but it is not the only treatment recommendation for patients with thumb CMC arthritis. There are a variety of non-surgical and surgical treatments that can help with pain at the base of the thumb prior to considering a CMC arthroplasty. Every patient evaluation begins with a thorough clinical history, physical examination, and radiographs (x-rays) of the hand. From there, I work with each patient to understand their goals before we collectively decide on an appropriate treatment plan moving forward.

CMC arthritis can be a debilitating condition, but there is help available. For many patients, CMC Arthroplasty has proven to be an effective way to alleviate pain and restore quality of life. If you’re suffering from pain and limited function in your thumb, schedule a consultation with Dr. Meyer to discuss whether CMC Arthroplasty may be right for you.

Free Lunch & Learn with Dr. Meyer on Battling Hand Arthritis

Dr. Maximilian A. Meyer is a fellowship-trained hand and upper extremity surgeon who specializes in the treatment of both acute injuries and chronic conditions of the fingers, hand, wrist, forearm, and elbow.

Join him for lunch on Thursday, October 26th from 12:00-1:00pm at the York Public Library as he talks about arthritis of the hand and how he evaluates and treats this very common problem.

Lunch will be provided courtesy of York Hospital. Attendees will receive a boxed lunch to take home following the presentation.

Spots are limited. Click HERE to register today!

Dr. Meyer understands the tremendous impact that hand and arm problems can have on patients’ lives. His treatment philosophy centers on listening to and working together with patients to create individualized care plans -both surgical and non-surgical – that help them return to an active lifestyle. Using the latest scientific evidence and advanced techniques, Dr. Meyer is dedicated to delivering outstanding orthopedic care with compassion every day.