 |
 |
|
|
Will a torn rotator cuff require surgery?
The answer to this question depends on the condition of the other shoulder muscles and the age of the patient. Many older
patients have no symptoms with a rotator cuff tear and continue to function without pain or disability. In one study, up to
40% of patients over the age of 70 had no symptoms with a tear of the rotator cuff tendons. The goal of physical therapy is to
maximize the function of the remaining tendons, and hopefully avoid surgery. In the younger age groups, particularly when tears
are caused by a sudden injury, early surgery is generally recommended to insure a successful treatment outcome.
What is physical therapy likely to do to make mechanical impingement better?
Physical therapy is the mainstay of treatment for impingement. The vast majority of patients improve with therapy and oral
anti-inflammatory medication. Strong rotator cuff muscles can relieve impingement symptoms by exerting a downward force on
the humeral head, opening up the space available under the acromion. Spurs that develop beneath the acromion cannot be resolved
with physical therapy, but the healthier the rotator cuff is, the less likely it is that surgery will be required.
Can the ACL heal by itself?
Some knee ligaments, such as the medial collateral ligament (MCL), heal reliably without surgery. Some partially torn ACLs,
particularly in children and adolescents, may also heal without surgery. However, a complete tear of the ACL rarely heals.
This is probably due to the amount of energy involved in the injury, the lack of blood supply, and the interior location of the
ACL. The torn ACL may scar back to the intact PCL within the knee, but this rarely returns stability to the knee. In fact, even
when the ends of a torn ligament are sutured together (called a primary or direct repair), the ligament does not reliably heal.
Therefore, surgery for a complete ACL tear (an ACL reconstruction) involves replacing the ACL with other tissue (a graft).
Is surgery always needed for an ACL tear?
Surgery is not required for all ACL injuries. Partial tears, in which a physical examination shows a relatively stable knee, may
be treated with bracing and rehabilitation. Even some patients with complete ACL tears do not need reconstruction. These "copers"
are typically older patients with lower physical activity, who do not participate in pivoting and cutting activities.
What is hip replacement?
It is a metal and plastic covering for raw, arthritic bone ends. It replaces cartilage that has worn away over the years. Hip
replacement can eliminate pain and allow you to move easily with less discomfort.
Who should have a hip replacement?
When arthritis hip pain severely limits your ability to walk, work, or perform even simple activities, hip replacement may be
considered.
|
|
|
|
|
|
|
|
|
 |
|
