How to Treat a Sprained Ankle

Symptoms, Diagnosis, Treatment, and Recovery

What is an Sprained Ankle?

An ankle sprain usually occurs when the ankle is twisted, causing injury to the soft tissue of the ankle. This occurs most commonly during athletic activities or with awkward falls from a curb or a step. They are one of the most common injuries that we treat in our practice. It is also estimated that millions of people suffer an ankle sprain each day.

Ankle Sprain Grades

Graphic displaying various grades of a Sprained Ankle

Within the ankle there are numerous tendons and ligaments however, when an Ankle Sprain occurs, it typically involves the ligaments specifically.

To define, a ligament is a thick band of tissue that connects bone to bone. A sprain of the ankle results in the stretching or tearing of one or more of these ligaments.

There are a few different severities, otherwise referred to as ‘grades’, of an Ankle Sprain. These grades range from one (1) to three (3).

A Grade One (1) ankle sprains is a stretch of the ligaments.

Grade Two (2) ankle sprains are partial tears of the ligaments within the ankle.

A Grade Three (3) ankle sprain is a complete tear of the ligaments.

High Ankle Sprains vs Low Ankle Sprains

If you’ve injured your ankle before, you may have heard the terms ‘High Ankle Sprain’ and ‘Low Ankle Sprains’. To differentiate the two, a High Ankle Sprain is when the sprain damage occurs at the high ankle ligaments that connect from the tibia to the fibula.

Sprained Ankle Types

Alternatively, a Low Ankle Sprain involves the ligaments just below the ankle joint, commonly referred to as the subtalar joint. Click here to learn more about the subtalar joint and additional Ankle Anatomy.

Low ankle sprains can be further classified as Inversion Sprains or Eversion Sprains. The majority of ankle sprains tend to be inversion ankle sprains and occur when the ankle rolls inwards. Whereas, an eversion ankle sprains occurs when the ankle rolls outward.

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Low-Eversion-Ankle-Sprain-Grade-Graphic-600x429

How to Treat a Sprained Ankle

Sprained Ankle Symptoms

Soon after the initial injury occurs, the ankle will become swollen, painful, and can be accompanied by excessive bruising. You will also notice moving or walking on the ankle can be very difficult due to the pain and swelling.

Ankle Sprain Diagnosis

At Colorado Springs Orthopaedic Group (CSOG) and within our orthopaedic urgent care, CSOG Express Care, we can help make the initial diagnosis of an ankle sprain through an in-person examination. In conjunction with this exam, we will take X-ray images of your ankle to confirm that there is not a break in any of the ankle bones. Many patients ask if an MRI is needed to confirm the degree of an ankle sprain. To answer this, an MRI of your ankle is not always apart of the initial image ordering. It can however, be warranted and ordered if your ankle fails to improve after a period of prescribed physical rehabilitation.

Sprained Ankle Treatment and Recovery

Treatment can begin by using the PRICE principle: Protection, Rest, Ice, Compression, and Elevation.

In addition to using the PRICE principle, a walking boot or brace is used to protect your ankle and allow the ankle ligaments to rest in a favorable position.

Crutches can also help prevent any weight bearing on the ankle, and casts may be used in severe ankle sprain cases. The healing of the ligaments usually takes around six (6) weeks, but the swelling may be present for several months.

After one (1) to three (3) weeks of rest and rehabilitation, we can begin Physical Therapy and proceed based upon the sprain’s severity. Depending upon the degree (grade) of the ligament damage, long term physical therapy and/or surgery may be suggested.

Chronic Ankle Sprains

Chronic ankle sprains are generally considered those that occur repeatedly however, they can also be sprains that have failed to improve over a significant period of time. This is usually the result of inadequate initial treatment of a recent ankle sprain or due to a very severe original ankle sprain.

When the ankle is not treated correctly after the initial sprain, then the ligaments can heal in a stretched out fashion leading to what’s known as a “loose” ankle. Those with loose ankles tend to have a lack of confidence in their ankle stability and suffer from weak ankles that may hurt and give out frequently.

If this is the case, when you are seen by a physician at Colorado Springs Orthopaedic Group, they may refer you to our in-house orthotic team at Audubon Orthotics and Prosthetics Services, to fit you with a stabilizing ankle brace in efforts of preventing future re-injury.

If you have suffered an ankle sprain or have experienced multiple ankle sprains, do not hesitate to reach out to the Foot and Ankle Center at CSOG. After a thorough evaluation to include X-Ray and potentially MRI imaging, our team will work with you to develop an individualized plan to make sure you regain confidence in your ankle stability for the long term.

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Developed by the Colorado Springs Orthopaedic Group Foot and Ankle Center Team

Brad D. Dresher, MD Orthopaedic Foot and Ankle Doctor, specializing in ankle arthritis, bunions, and much more.

The Basics of Ankle Anatomy and Foot Anatomy

Basic anatomy for any joint structure within the body includes bones, joints, muscles, tendons, and ligaments. For our purposes, we will be discussing Ankle Anatomy and Foot Anatomy structures specifically.

Terms to Know:

Lateral: outside
Posterior: backside
Anterior: frontside
Medial: inside
Distal: situated away from the center of the body
Proximal: situated closer to the center of the body than distal

Anatomy of a Joint Structure

A joint is a part of a body where two or more bones meet. The ends of these bones are covered by Cartilage. To define, Cartilage is a connective tissue structure that helps provide shock absorbing properties when performing activities. In addition to cartilage, Synovial Fluid presents within each joint space and promotes smooth movement of the joint. There are also important connective tissues called Tendons and Ligaments that make up each body structure. A tendon is a tissue that connects muscle to bone. Similarly, ligaments connect bone to bone.

Ankle Anatomy

The ankle joint is formed where the bones of the lower leg, the Tibia and Fibula, meet the Talus. With this, the portion of the fibula, located at the ankle level, is referred to as the Lateral Malleolus while the portion of the tibia at the ankle level is referred to as the Medial Malleolus. These two (2) ankle bones are commonly fractured in injuries. Additionally, just below the ankle joint is the Subtalar Joint, which is located between the Talus and the Calcaneus. The Calcaneus is also known as the heel bone.

Each of these joint junctions are responsible for allowing movement of the ankle in four different directions: Plantarflexion, Dorsiflexion, Inversion, Eversion. To demonstrate these directions, point your foot. Your ankle is in the Plantarflexed position. Now, bring your toes towards your head. This is the Dorsiflexion position. From here, if you move your toes inwards you will be in the Inverted position. Alternatively, if you move your toes outwards, you will be in the Everted position.

In many cases, normal wear and tear from aging can predispose the ankle joint to arthritis. However, wearing appropriate footwear for your activities and performing ankle strengthening and stretching exercises can delay the onset of arthritis. Tune into our blog Osteoarthritis vs Rheumatoid Arthritis to learn more about the causes of arthritis and ways to prevent or delay its onset.

Muscular and Tendon Anatomy of the Ankle

The posterior side of the lower leg houses the calf muscles. These muscles attach to the Achilles tendon, which is the largest tendon in the body. This is exposed to large amounts of force in activities such as running or jumping, making it prone to injury. The Tibialis Posterior muscle also lives in the posterior side of the lower leg. Continuing, the tendon associated with this muscle crosses over the middle portion of the ankle and is called the Posterior Tibialis Tendon. Those with flat feet may be at risk for additional strain on this tendon, which if not addressed, can lead to tendonitis.

ligaments and tendons of the foot, Ankle anatomy, ankle bones Achilles-Tendon-Conditions

The lateral compartment of the lower leg contains two muscles, the Peroneal Brevis and the Peroneal Longus muscles. Subsequently, the tendons of these muscles travel on the outside of the ankle and can also be subject to strain with overuse. Other important structures over the lateral ankle include three (3) lateral ligaments: the Anterior Talofibular Ligament (ATFL), the Calcaneofibular Ligament (CFL), and the Posterior Talofibular Ligaments (PTFL). These structures are vital for stability of the ankle. Injury to these ligaments, as commonly seen with ankle sprains, can lead to long-term instability if not treated properly. Visit our blog What to do for a Sprained Ankle to learn more about how to treat an ankle sprain.

Ankle Bones, ankle anatomy, Ankle-Joint-Ligaments ankle bones, ligaments and tendons of the foot

Foot Anatomy

The feet each contain 26 bones as well as many soft tissue structures including tendons, ligaments, nerves, and vascular structures. In medical discussion, the foot is often broken down into three (3) portions: the Hindfoot, Midfoot, and Forefoot.

The Hindfoot

The Hindfoot contains the talus and calcaneus, otherwise known as the ankle bone (Talus) and heel bone (Calcaneus). As mentioned previously, these two (2) bones join to make up the Subtalar Joint and allow the foot to rotate in multiple directions at the ankle level. Additionally, the Plantar Fascia Tendon runs from the calcaneus to the end of the metatarsal bones located in the forefoot.

The Midfoot

The midfoot houses the five (5) tarsal bones and three (3) ligaments. These ligaments are referred to as the Lisfranc Joint Complex and connect the midfoot to the forefoot. The five metatarsal bones, to include the navicular, cuboid, and three (3) cuneiform bones, all help to form the arches of the foot. Alone, the midfoot bones do not provide all the stability for the midfoot. The Midfoot Ligament Complex is also responsible for providing stability. This complex of Lisfranc ligaments includes the Dorsal Lisfranc Ligament, the Interosseous Lisfranc Ligament, and Plantar Lisfranc Ligament. These ligaments help maintain alignment of the tarsal and metatarsal bones and act as shock absorbers during activity.

The Forefoot

Within the forefoot, you will find the metatarsals and the toe bones, medically known as the Proximal, Medial, and Distal Phalanges. The Distal Phalanges are located at the end of each toe while the Proximal Phalanges are situated closest to the metatarsals and allow the toes to bend. You will also find the four (4) deep transverse metatarsal ligaments within the forefoot. These ligaments help to stabilize the metatarsal bones and prevent the foot’s arch from widening or collapsing. These forefoot structures are key to navigating various surfaces and maintaining balance when performing activities such as walking, running, pivoting, or jumping.

Due to their weightbearing capacities and vital function in performing day-to-day activities, the feet and ankles can be subject to many different conditions that may cause discomfort. Because of this, Arthritis in the joints of the feet can occur secondary to routine wear and tear or following injuries. Additionally, different deformities such as flat feet, high arches, bunions, hammertoes, or mallet toes may occur. These deformities can result in pain, calluses, and difficulty wearing shoes. If you are experiencing any of these symptoms or conditions, please give our office a call and we will design a treatment plan based on your personal needs and get you back to the lifestyle you enjoy.

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The intricacies of ankle anatomy and foot anatomy can cause various injuries or conditions to become very complex. For more information on conditions of the foot and ankle and treatment options available, check out our blog series developed by our providers within the Foot and Ankle Center.

Developed by the Colorado Springs Orthopaedic Group Foot and Ankle Center

Brad Dresher, MD

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New FDA Approved Drug-Free Treatment for Painful Diabetic Neuropathy

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What is Diabetic Neuropathy?

Diabetic Neuropathy is chronic nerve damage in the upper and lower extremities caused by constantly high blood sugars. It is a chronic debilitating condition which can interfere with a person’s sleep, their functionality, and their overall quality of life.

Around 34 million Americans have diabetes (CDC, 2020) and roughly half of all adults with diabetes will suffer from Diabetic Neuropathy in their lifetime (Hicks, 2019). Of those, it’s estimated approximately 2.3 million will suffer from Painful Diabetic Neuropathy (PDN) with no relief by using current treatments and conventional medical management (Schmader, KE., 2020).

What are the Typical Symptoms of Painful Diabetic Neuropathy (PDN)?

Those who suffer from Painful Diabetic Neuropathy typically have daily continuous pain. Typical symptoms of include tingling, numbness, and pain in the extremities. This nerve damage can make patients more vulnerable to falls, burns, infections, ulcers, and long-term complications.

What Treatment Options are there to Relieve Chronic Pain from Diabetic Neuropathy?

Current treatment options aim to relieve the chronic pain that is frequently seen with Diabetic Neuropathy. These treatments often include pain medicines such as Tylenol or Aspirin. NSAIDS such as Ibuprofen or Advil, however, are not recommended for diabetic patients. Some patients with Diabetic Neuropathy are also treated with nerve medications including Neurontin (Gapapentin), Lyrica, and Topomax. When patients don’t respond to these medications, narcotics or opioids are often used.

Although narcotics can lessen pain, they have significant long term consequences including dependence, decreased benefit over time, and abuse. New federal guidelines aimed at reducing opioid misuse and abuse have resulted in many physicians denying or limiting opioid therapy for some chronic pain patients. Physicians are constantly looking to improve clinical and interventional tools to treat complex chronic pain. One of these advancements includes the development of Spinal Cord Stimulation (SCS).

Spinal cord stimulation has been available since the 1960s and uses a device called a Spinal Cord Stimulator to treat chronic pain. This small device is placed on the spinal cord to calm the spinal nerves and suppress the pain responses to the brain. As a result, pain lessens for the patient. Each device is programable to the individual patient’s needs. Additionally, Spinal Cord Stimulation allows for patients to go through a weeklong trial period to test their response to the device before permanent implantation.

There are many types of Spinal Cord Stimulators and the technology and programming options that come with them have made many advancements in recent years. These advancements have shown to provide better pain relief for many chronic pain conditions. Most recently, Spinal Cord Stimulation for Painful Diabetic Neuropathy (HFX™ for PDN) developed by Nevro, received FDA indication and approval to treat Painful Diabetic Neuropathy.

Who is HFX™ for PDN for and what does Spinal Cord Stimulator Surgery entail?

Patients suffering from Painful Diabetic Neuropathy specifically, who have not responded well to conventional medicine treatments are typically good candidates for a Nevro HFX™ for PDN Spinal Cord Stimulator trial. During this trial period, a temporary version of the stimulator is placed through a needle without undergoing surgery. The patient will then use this device for one week and monitor their pain levels, activity level improvements, and their need for pain medicine. At the end of the trial, the device is removed. Ninety percent (90%) of patients who go through the trial have enough to success to make the decision to move forward with a permanent stimulator (Diabetes Care, 2021).

Once this decision has been made, a permanent spinal cord stimulator can be implanted with a quick outpatient surgery. With any outpatient surgery, the patient is able to go home and recover the same day as surgery. The permanent implant procedure is done through two small incisions. After the incisions are made, a paddle with metal contacts is placed against the spinal cord and a rechargeable battery is placed below the skin.

What is the Average Recovery Time from Spinal Cord Stimulator Surgery?

Moderate activity is limited, and strenuous activity is restricted for approximately six weeks post-surgery. This recovery time ensures that the device is received well, and the body has time to heal. However, despite this dedicated recovery time, many patients can feel pain relief in as little as a few days after their operation.

Recovery is quick with approximately eighty six percent (86%) of patients with Painful Diabetic Neuropathy experiencing substantial, long-term relief after 12-months (JDST, 2021). Additional details of the study can be found here.

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Stay tuned, ongoing studies are showing great success using Spinal Cord Stimulation (SCS) to help treat additional types of Neuropathy such as Peripheral Neuropathy.

Click Here for additional Data on Nevro’s HFX™ for PDN or visit https://www.hfxforpdn.com/

Dr. Roger Sung, MD Colorado Springs Orthopaedic Group

Dr. Sung is a Fellowship-Trained and Board-Certified Orthopedic Surgeon who specializes in Cervical, Thoracic, Lumbar, and Sacroiliac surgery, Microsurgery, and Minimally Invasive Spine Surgery techniques. He also performs complex spine reconstruction using minimally invasive techniques.

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Cartilage Restoration: Innovative Treatment for Knee Pain in Active Individuals

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What is Cartilage?

Articular (or hyaline) cartilage is a tissue in the body that lines the ends of the bones, providing a smooth surface for movement of the joint. It also serves as a shock absorber during activities. When there is an injury to the cartilage in a joint, it does not heal on its own as there is no direct blood supply to aid in this process. Instead, cartilage continues to deteriorate over time, especially with continued activity. This leads to a disease called Osteoarthritis. Fortunately, there are now procedures available to restore the cartilage in a joint without having to go through a joint replacement. The most common joint for a Cartilage Restoration procedure is the knee.

Treatment Options for Cartilage Disorders

There is a spectrum of treatment options for treating cartilage disorders including palliative, reparative, resurfacing, and reconstruction. Palliative treatment is known as Chondral Debridement, where the uneven surface of damaged cartilage is smoothed out during arthroscopic surgery. This does not replace injured cartilage but may relieve pain as there is no longer a loose flap of tissue moving abnormally in the joint. This may be an option for a patient with only a partial thickness cartilage injury or an older patient who does not participate in demanding activities. The recovery time for this procedure is minimal. The patient can be full weight bearing and does not have any range of motion restrictions after surgery.

When there is a very small, focal lesion of missing cartilage, the patient may be a candidate for a reparative procedure known as Marrow Stimulation. This procedure is sometimes referred to as Microfracture. With this procedure, holes are made directly into the lesion allowing bone marrow to escape into the defect. This allows for healing of the lesion with a substance known as Fibrocartilage, which acts similarly to innate articular cartilage when in a small area. This is a simple arthroscopic procedure but does require some restrictions during subsequent rehabilitation to allow the Fibrocartilage to develop and heal.

Cartilage Restoration for Active Individuals

When we think of true “Cartilage Restoration” procedures, there are really two different types – Resurfacing and Reconstruction.

Resurfacing: “Repaving the Street”

When the lesion is too large for microfracture but still only involves the surface of the bone, then a resurfacing procedure is warranted. There are several ways to resurface the end of the bone with new cartilage. One technique is to take the patient’s own unused cells out during an arthroscopic procedure and send them to a lab to be grown into new cartilage cells, which would then be placed over the lesion that is missing cartilage. This process is known as Autologous Chondrocyte Implantation and requires two surgical procedures – one to harvest the cells and another to put them into the defect. The benefits of this procedure are that it uses the patient’s own cells and is able to resurface a large area of damage. The recovery depends on where in the knee these cells are placed, but generally range of motion is encouraged early as cells adhere to the bone and proliferate right away. Patients are able to ride a bike within weeks and even start running after just a few months.

Another resurfacing technique is done by Allograft Implantation. Rather than two separate surgeries, this can be done in one arthroscopic or minimally invasive procedure. The defect is debrided, and the donor cells are pasted into place and fixated with a type of biologic glue. Similarly, patients progressively return to their normal activities within several weeks as the cells grow into real articulating cartilage.

Pre Cartilage Resurfacing Of The Patella

Post Cartilage Resurfacing Of The Patella

Reconstruction: “Filling the Pothole”

When a cartilage defect extends beyond the surface to involve the underlying bone, a structural graft is necessary in a reconstructive procedure to restore the cartilage. The size of the injured cartilage determines whether the cartilage can be obtained from the patient or must come from a donor. If it is a smaller lesion, then a cartilage plug (includes underlying bone) may be taken from a place in the joint that does not need it and placed into the defect. This procedure is called Osteochondral Autograft Transplantation and is typically done with a minimally invasive open incision. However, when the size of the defect is too large to take it from another place, donor tissue is required. In this case, a plug can be made to fit the size of the void after the missing cartilage and damaged underlying bone is removed. Even an oval shaped plug can be fashioned to fill a large, long defect over the weightbearing surface of the knee, which is termed a BioUni. These procedures are called Osteochondral Allograft Transplantations and may be an alternative to partial or total joint replacement for the right patient. Although they do take longer to heal compared to a cartilage resurfacing procedure, the patients generally return to activity within a few months and have excellent outcomes.

Large Cartilage Defect Of The Medial Femoral Condyle

Cartilage Graft Being Placed Into Defect

Cartilage Graft Placed Into Defect

Small Cartilage Defect Of The Medial Femoral Condyle

Harvested Cartilage Graft Ready for Placement

Large Cartilage Defect Of The Medial Femoral Condyle

Reconstruction Innovation

There is a very exciting new procedure using the Osteochondral Allograft Transplantation concept to replace the entire undersurface of the patella (kneecap). The patella cartilage is especially vulnerable to injury in athletes, specifically runners. Here in Colorado Springs, we see many patients with this problem who are told that their only options are to stop being active, live with the pain, or get a partial or total knee replacement. This procedure provides an opportunity to restore their cartilage and get them back to activities within a matter of months. We are excited to announce that Dr. Jamie Friedman is the first orthopaedic surgeon to bring this technology to the state of Colorado. The first patient to undergo this procedure here in Colorado Springs is currently doing his physical therapy and has registered to run a marathon this coming June.

Pre Total Biologic Resurfacing Of The Patella

Donor Patella Ready For Placement

Post Total Biologic Resurfacing Of The Patella

Cartilage Restoration and Joint Deformity: Knocked-Kneed and Bowlegged

Finally, one aspect of Cartilage Restoration that is often overlooked is the alignment of the joint itself. Many people are born either knock-kneed or bowlegged, but if there is too much of this deformity in the joint, it puts additional pressure on one side of the knee. If the underlying problem of leg malalignment isn’t addressed, it can cause continued damage to the existing cartilage and a cartilage restoration procedure may fail. In this case, the patient may be a candidate for realignment surgery to balance out the knee joint in conjunction with restoring the damaged cartilage. If the patient is too knock-kneed (Genu Valgum), then they may need what is called a Distal Femoral Osteotomy. This is when the bottom end of the thigh bone (Femur) is cut and straightened out with an opening wedge. If the patient is too bowlegged (Genu Varum) then they may need what is called a High Tibial Osteotomy. This procedure involves cutting the top end of the shin bone (Tibia) to straighten out the joint with an opening wedge. Although these deformity correction procedures require the longest recovery (several months), they save the patient from a joint replacement and have great long-term outcomes.

Valgus Malalignment Pre Distal Femoral Osteotomy Surgery For Knocked Knee

Valgus Malalignment Post Distal Femoral Osteotomy Surgery For Knocked Knee

Varus Malalignment Pre High Tibial Osteotomy Surgery For Bow Legged Knee

Varus Malalignment Post High Tibial Osteotomy Surgery For Bow Legged Knee

Is Cartilage Restoration right for you?

So, who is the right candidate for a Cartilage Restoration procedure? The ideal patient is young, active, and motivated. These patients are typically considered too young for a partial or total knee replacement (18-45 years old) and are still involved in an active lifestyle such as team sports, running, hiking, biking, skiing, etc. Patients who currently have pain in their knee with these activities are first assessed in the clinic and with x-ray images. Typically, advanced imaging with an MRI is necessary to fully characterize the cartilage and the underlying bone. If the surgery does not require a donor graft, then the surgical procedure can be scheduled right away. If a donor graft is necessary, then this graft must be ordered, and surgery is not scheduled until a match is found, which usually takes 4-8 weeks.

Cartilage Restoration Recovery

Cartilage Restoration procedures do take some time to recover from – weeks to months – but the patients who are determined to follow the rehabilitation protocols have great outcomes. The goal of Cartilage Restoration is to get patients back to the activities that they love to do without having a joint replacement.

Developed by the Colorado Springs Orthopaedic Group Sports Medicine Team

The Anterior Cruciate Ligament (ACL) and Sports Injuries

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We have all seen it before. An athlete is running and attempts to change directions and suddenly falls to the ground. They instinctively grab their knee. What could have possibly caused an athlete who has made that same maneuver many times to fall so suddenly? Before we answer the question, lets take a closer look at how our knees and the Anterior Cruciate Ligament are made and how they function.

ACL Anatomy

We often think of a knee as a simple hinge joint. One that straightens and bends or extends and flexes. The reality is much more complicated than that. The knee has three planes of motion with six different directions! Beyond flexion and extension there is also side to side motion as well as rotation. Each step involves varying degrees of each of these motions.

Ligaments are the structures that attach bone to bone and provide stability to the knee while still allowing the freedom of movement needed to walk, jump, skip, or run. There are four ligaments in our knee, the medial and lateral collateral ligaments on the inside and outside, and the anterior and posterior cruciate ligaments located in the middle of the knee. The medial and lateral collateral ligaments keep the knee from bending too far inside or outside. Alternatively, the anterior and posterior cruciate ligaments keep the knee from sliding too far forward or backward. This combination of all four ligaments is what keeps our bones appropriately aligned and provides stability to our knees.

Functions of the ACL

Now let’s go back to our athlete. One of the most common causes of sudden instability when changing directions is a tear of the Anterior Cruciate Ligament (ACL). This happens because the ACL has two primary functions. We have already talked about the first function, to keep the knee from sliding too far forward, this is medically known as Anterior Translation. The other function of the ACL is to keep the knee stable during rotation. The ACL and PCL are called “cruciate” ligaments because they cross over one another. This orientation gives significant stability to rotation in the knee. When an athlete plants their foot to change direction, the ACL is at maximum tension preventing both rotation and anterior translation. When the force from the athlete’s pivot is too much, the ligament fails. This causes sudden instability in the knee which can damage other structures in addition to the ACL.

One of the earliest symptoms of an ACL tear is significant swelling inside the knee joint. Because the ligament is located inside the knee, the tear causes bleeding inside the joint resulting in large amounts of swelling. It is often very difficult to walk immediately following an ACL injury. Patients with torn ACLs will often say their knee feels tight and it may be difficult to bend or straighten their knee.

Treatment Options for an Anterior Cruciate Ligament Injury

In the days following an Anterior Cruciate Ligament tear, the swelling will often subside, and motion will return. Many people can walk without needing crutches or a brace. Patients will often describe a sensation of feeling like their knee is unstable when they walk. Unfortunately, a torn ACL will not heal on its own. Our knee joint is filled with lubricating fluid that allows the joint to move smoothly. This is great for motion but limits the ability of structures inside the knee to heal. Because of the limited healing ability, the most typical treatment recommendation is an ACL reconstruction, or “rebuilding”, of the ligament, commonly performed using arthroscopic techniques.

There are two primary ways to rebuild the ligament. For younger patients, the preference is typically to use the patient’s own tissue to reconstruct the ACL. The most common tissue types used are the patellar tendon underneath the kneecap, hamstring tendon from the back of the thigh, or quadriceps tendon from the front of the thigh. Each tissue, or graft, has its own strengths and weaknesses and all have been used with great success. Surgeon and patient preference is often the deciding factor on which graft is best. Another commonly used tissue is called an allograft. This comes from a donor and is sterilized prior to the procedure to limit risk of infection or rejection.

Surgery typically takes 1-2 hours depending on the type of graft chosen and if any additional procedures need to be done at the same time as the reconstruction. Treating an ACL tear without surgery is rare. The lack of stability and increased motion in the knee following ACL injury is thought to increase risk of arthritis and additional damage in the future.

ACL Recovery Time

Postoperative ACL rehabilitation focuses on early range of motion and appropriate strengthening exercises to increase function while protecting the graft. Full graft incorporation is thought to occur 6 months following surgery although some studies show that the graft continues to evolve even up to 1 year following surgery. Objective criteria are typically used to guide return to sport protocols such as return of normal motion, strength the same as the other leg, and an appropriate time interval.

Good news for our athlete, Anterior Cruciate Ligament tears are commonly treated successfully, and athletes often return to the same type of sports activities. While the road to recovery may take several months, we can often expect to see that athlete competing at a high-level by the next season.

Developed by Dr. Craig Yager, Board Certified Sports Medicine Surgeon

ACL Injury Prevention with Tessa Kothe, DPT

Spinal Cord Stimulation (SCS) for Diabetic Neuropathy

In this Medical Minute, Dr. Roger Sung discusses a new drug-free treatment, Spinal Cord Stimulation (SCS) for diabetic neuropathy. We will discuss what diabetic neuropathy is, what spinal cord stimulation (SCS) is and how it works to treat Diabetic Neuropathy, and what to expect post-operation.

What is Diabetic Neuropathy?

Diabetic neuropathy is a type of nerve damage that is caused by high blood sugar within the body. This high level of blood sugar can injure nerves most commonly the nerves in the legs and feet. Symptoms generally include numbness or pain, but can also include digestive track issues, urinary tract issues, and issues with the blood vessels and heart.

For some individuals, symptoms are mild, but in some, more extreme cases can be extremely painful and disabling. According to the Mayo Clinic, nearly 50% of individuals with diabetes experience burning, tingling, and numbness associated with diabetic specific neuropathy.

If you or someone you know is struggling with painful diabetic neuropathy, this new drug-free treatment offered at Colorado Springs Orthopaedic Group may be an option.

What Drug-Free Treatment for Diabetic Neuropathy is available?

In collaboration with Nevro, a medical device company focused on individualized solutions for those suffering from chronic pain, we at Colorado Springs Orthopaedic Group are proud to offer the latest technology advancement, HFX™ for Painful Diabetic Neuropathy (PDN), a drug-free treatment addressing PDN through use of advanced spinal cord stimulation technology. Spinal cord stimulators (SCS) are electronic devices implanted against the spinal cord to disrupt nerve signals that are sent to the brain and cause pain. Through settings on the device’s remote control, patients can independently control their pain levels and find relief from living with PDN.

Studies have shown patients who have tried HFX™ for PDN, received 76% pain relief within the first six months of implantation. While there are some medication options to treat diabetic neuropathy, these medications generally have side effects. We believe this innovative treatment is a great Drug-free option for patients experiencing the pain and discomfort associated with PDN.

What does the Spinal Cord Stimulator Operation Entail?

After a thorough evaluation with one of our Board-Certified Spine Surgeons, they will determine if a patient is an appropriate candidate for HFX™ for PDN. If the patient and Surgeon agree to move forward with this treatment option, the surgeon will schedule the patient for an initial 7-day trial of the device. During the trial procedure, the surgeon will implant a temporary spinal cord stimulator along the patient’s spine and provide them with the tools and education to independently manage their pain throughout the next week. These trials allow patients to experience the device before they commit to receiving the permanent implant.

If the trial spinal cord stimulator implant is determined be an effective treatment for that patient, they will schedule the patient for their outpatient procedure that implants the permanent version of the device.

What is the Recovery Time for Spinal Cord Stimulation (SCS)?

The recovery time for the spinal cord stimulation implant operation is about six weeks however, many Patients are only generally sore for about one week. Moderate activity is limited during this time and strenuous activity is restricted for approximately six weeks post-operation to ensure that the device is received well, and the body has time to heal. Despite this recovery time, patients can feel pain relief in as little as a few days after their operation.

If you would like to see if this drug-free treatment can benefit you, call the Colorado Springs Orthopaedic Group at (719) 632-7669 to schedule a consultation!

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Your CSOG Patient Portal

• What is the Patient Portal?
• What can you do with the Patient Portal?
• Setting Up Your Account
• Logging Back In

What is the CSOG Patient Portal?

The Patient Portal is a secure, online platform that allows you to access your health information and communicate with your healthcare provider’s office.

In your CSOG patient portal you can view your office notes, securely message your provider, see your scheduled appointments, and request a prescription refill

What can you do with the Patient Portal?

• Skip the phone call – get answers to your questions more efficiently
• View your office notes
• Message your provider’s office
• See your scheduled appointments
• Request prescription refills
• Update your health information
• Request documents (notes, lab or imaging orders)

Note: Any personal information you share on the Patient Portal is secure. Your name, social security number, password and protected health information are only accessible to you.

Setting Up Your Account

Options to view your visit summary, see scheduled appointments, message your provider’s office, and more:

Click the green tab, then Download Displayable, then OPEN to view this document

Click the green tab to update patient medical history forms

Logging Back In

- Open the Internet and go to CSOG.net
- Click the “Patient Portal”link

Email the Billing Office
For Patient Portal Information help call (719)632-7669

Spinal Cord Stimulation Review: Nevro Testimonial

“Thanks to HFX*, I no longer manage my day based on when I need to take the next pain pill,”

said John, whose back pain began in 2003 when he was injured while overseas with the military. In 2016, thirteen years after his initial injury, John underwent a spinal fusion but was then in a serious car accident that caused his back and leg pain to return.

John had been an active guy who played competitive hockey, participated in highly physical activities during his military career and kept up with his four young children. “However, my progressive back and leg pain reduced my activity level to almost nothing,” he explained. “I had to walk with a cane and take medication to control my pain level.”

After many other attempts to find relief, John was referred to Dr. Roger Sung, who recommended an HFX trial. “I had such significant pain relief during my April 2019 trial that it was like night and day,” John said. “I was even able to drastically reduce my doses of pain medications.” He decided to move forward with his HFX implant in June 2019.

“I have had 60-70% pain relief consistently with HFX and no longer walk with a cane or take medication,” John said. “I have truly regained my life with HFX.”

This is just one spinal cord stimulation review on the Nevro SCS system specifically. See what other patients have to say as they give their Spinal Cord Stimulation Reviews on our YouTube channel. Learn More about the Nevro SCS systems at www.NevroHFX.com

#NevroHFX #ChronicPain

Results may vary. Important safety & risk information: www.nevrohfx.com/safety

*HFX is a comprehensive solution that includes a Senza spinal cord stimulation system and support services for the treatment of chronic pain

What is an MRI & When is an MRI Needed?

Welcome to a Medical Minute segment with Dr. David Matthews a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses what is an MRI is & when MRIs are needed.

What is an MRI?

MRI (magnetic resonance imaging) is a way of using magnetic gradients and radio waves to capture images within specific areas of the human body.

When does a patient need an MRI?

Dependent upon the location and severity of an injury, there are cases where an x-ray image cannot detail the condition of soft tissues such as ligaments or tendons. Therefore, your physician may order an MRI to deeper evaluate the condition of such tissues.

How are they used in orthopedics?

MRIs are often ordered by your physician soon after your initial evaluation to capture detailed images of the injured body part and assist your physician with developing your individualized treatment plan.

What are the risks of an MRI?

As MRI machines are comprised of extremely high-powered magnets, it is required to remove any metals from your body prior to entering the machine. This may also include any implants or pacemakers therefore, it is crucial for patients to inform their physician and MRI technician of any implanted devices prior to scheduling an MRI. If the metal on your person is removable and all metal objects are removed prior to entrance, then the risks of having an MRI are minimal. Please call our MRI department at 719-867-7315 with any questions you have or to schedule your appointment.

Visit www.CSOG.net to learn more.

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What is Arthroscopic Surgery? Medical Minutes with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses the common question: ‘What is Arthroscopic Surgery?’

What is Arthroscopic Surgery?

Arthroscopic surgery is a minimally invasive technique where the physician accesses the joint through small incisions with a pencil-sized camera. This small camera allows the surgeon to see within the joint and repair the injured structures without making large incisions. This allows for quicker recovery times, and studies have shown improved long-term patient outcomes using this technique. Arthroscopic surgery is typically used to treat larger joints such as the shoulder, hip, knee, ankle, and some cases the thumb joint.

Is arthroscopic surgery better than traditional surgery?

Dr. Jones believes it depends on what injury needs to be treated and the severity of such injury when deciding between traditional or arthroscopic surgical techniques. There are some surgeries that provide better outcomes when using arthroscopically such as rotator cuff tears, ligament tears within the shoulder, and meniscus tears within the knee. However, other surgeries such as joint replacements or spinal surgeries are typically performed by way of traditional or alternative minimally invasive surgical methods.

To learn more about arthroscopic surgery options or to schedule an appointment with any one of our 16 fellowship-trained Orthopedic Physicians, call us at (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Joint Cartilage Restoration in Colorado Springs

Many Colorado Springs patients may wonder if joint cartilage restoration is the best treatment option for their joint issues. Joint pain and stiffness can be quite debilitating and worsen over time. Most people experience cartilage problems in their knees. However, it can also occur in the shoulder, elbow, hand, wrist, ankle, or hips. Unfortunately, cartilage does not heal on its own due to the lack of direct blood supply. One treatment for a cartilage injury or disease is to restore the cartilage rather than replace the joint.

If you are experiencing joint pain caused by cartilage damage, call us today to schedule a consultation and discuss treatment options with one of our Cartilage Restoration Specialists at Colorado Springs Orthopaedic Group. We can provide you an accurate diagnosis to determine the cause of your problem. We can also recommend an optimal treatment plan to help you become pain-free and active again. Call 719-632-7669 to schedule.

Below you will find additional information on the various Cartilage Restoration treatment options for joint pain offered at Colorado Springs Orthopaedic Group.

Causes

The general causes of cartilage damage include chronic or acute injury, trauma, disease, or degeneration. In all cases, the cartilage has been compromised and no longer provides smooth gliding or cushioning of the joint.

Cartilage Injury or Trauma:

If you fall or sustain a traumatic sports injury, you can tear or separate joint cartilage. Usually, the pain will be sharp and sudden. It is also possible to damage ligaments or tendons in the joint area at the same time. Thus, the pain, inflammation, and stiffness you experience could be caused by compounding injuries. Your joint may also lock-up, give way, or feel unstable when trying to bear weight on it.

Cartilage Disease or Degeneration:

Arthritis, specifically osteoarthritis, is the most common cause of joint pain. With arthritis, the cartilage is damaged and inflamed from long-term wear and tear. Sometimes the pain is persistent. Other times it can come and go, even while resting. Most often, the pain worsens when you try to use the joint or place weight upon it. You may also experience a grinding or clicking sensation. These symptoms can be exasperated by living a high-impact, rigorous lifestyle or by carrying extra body weight. To some degree, cartilage degeneration can be genetic.

Other Joint Issues That Have Similar Symptoms

Rheumatoid arthritis: Rheumatoid arthritis (RA) is a disease where your immune system attacks the lining of your joints. RA can cause pain and disfigurement.

Gout: Gout is caused by the buildup of uric acid in the joint. The acids crystalize and cause a flare-up of sudden and intense pain. Gout is common in the knees, fingers, and toes.

How to Restore Cartilage in Joints Naturally

Cartilage does not have a direct blood supply to bring healing nutrients to the tissue therefore, it generally does not heal on its own. In some cases, conservative treatment methods such as physical therapy can help with strengthening a joint, taking pressure off of the damaged cartilage however, if the damage or degeneration is too severe, surgery may be required to restore function and decrease the associated pain.

Cartilage Restoration Joint Surgery

With Cartilage Restoration Joint Surgery, your physician may elect to repair the damaged cartilage in one of two ways:

Cartilage Repair
The damaged cartilage may be removed using certain techniques, and the bone is resurfaced, like “repaving a street.” During the operation, the physician may use different innovative systems to accomplish this such as MACI©, DeNovo© (Zimmer-Biomet), or Biocartilage/Cartiform© (Arthrex). When the MACI© procedure is used, cartilage cells are retrieved from the patient, sent to a lab for processing, and later implanted back into the same patient to provide a smooth surface of their own cartilage. With the other options, cartilage cells from a donor are used to fill in the defect and provide an even cartilage surface. In both cases, the joint biology is restored, leaving no area of damaged cartilage.

Cartilage Reconstruction
If the bone underneath the cartilage is also damaged, the physician may perform a cartilage reconstruction procedure, similar to “filling in the pothole.” If the lesion is small, then healthy cartilage from an unused part of the knee may be transplanted to the area that needs it. This procedure is called an Osteochondral Autograft Transplant (OATs). For larger areas of damage, you may need a donor “plug” to fill in the defect. This procedure is called Osteochondral Allograft Transplantation (OCA). In both cases, the joint surface is restored with new cartilage and underlying bone.

Procedure

Typically, cartilage restoration joint surgeries can be done arthroscopically or with minimally invasive techniques. This means your physician will insert a camera called an arthroscope through small incisions made around the joint allowing the physician to see in detail within the joint. Minimally Invasive procedures are procedures where smaller incisions, compared to traditional open surgeries, are made allowing for less damage to the surrounding structures and for the body to heal at an accelerated rate, inevitably shortening the recovery time. These minimally invasive procedures also decrease the chance of infection and typically reduce scarring.
A typical joint restoration surgery can take anywhere between 1 to 4 hours to complete and is usually an outpatient procedure that allows you to recover in the comfort of your own home, the same day as surgery.

Our Cartilage Restoration Doctors

At Colorado Springs Orthopaedic Group, we are fortunate to have highly skilled and compassionate cartilage restoration joint surgeons who specialize in the diagnosis and treatment of all conditions affecting the joints and associated cartilage.

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two cartilage restoration surgery centers in Colorado Springs:

North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

Contact us today at 719-632-7669 to schedule a consultation and learn if cartilage restoration for joint pain is right for you. We are ready and dedicated to helping you get pain-free!

Visit us at www.csog.net to learn more.

Rotator Cuff Injuries & Surgery with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses rotator cuff injuries & surgery and what to do if you suspect an injury to your rotator cuff.

What muscles are involved within the rotator cuff?

The rotator cuff is composed of four muscles that surround the shoulder joint and keep it in place. Those four muscles are:

- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis

The Supraspinatus is by far the most common tear that Dr. Jones’ sees in patients. This is the tendon that is right on top of your shoulder.

What is the difference between a rotator cuff tear and a rotator cuff tendonitis?

Most rotator cuff tears result from overuse or recurrent injuries. Over time, without proper treatment, these recurring minor injuries can result in rotator cuff tendonitis. Most patients who have rotator cuff tendonitis experience pain, especially when weightlifting or when lifting objects in specific directions such as overhead or in front of the body. Those with suspected rotator cuff tears may experience a much more intense pain and can sometimes feel a crunching or popping when they move the shoulder in various directions.

Does a rotator cuff tear require surgery?

There are patients who have rotator cuff tears who do not need surgery. Some may not even know when they have a rotator cuff tear as pain intensities will vary person to person. Dr. Jones’ believes the first step to recovery is to always try conservative treatment options prior to discussing surgery. These conservative treatment options may include physical therapy or injection therapy to control pain and strengthen the supporting shoulder muscles.

What is the timeframe for athletes to play sports again after a rotator cuff tear?

All patients should take excessive caution for the first three to four months after surgery as the shoulder joint will take time to mature and heal. Additionally, the better the patient’s overall health, the better the healing process will go. Recovery time to get back to full activity without restrictions is estimated to take between six to twelve months.

What are the symptoms of a rotator cuff tear?

Symptoms of a rotator cuff tear include pain with lifting, especially if a patient is lifting something out away from their body or overhead. Another symptom is pain at night that either wakes them from their sleep or prevents them from falling asleep entirely.

To learn more about rotator cuff injuries and custom-tailored treatment options visit us at www.CSOG.net. To schedule an appointment, please call (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Accelerated Recovery Knee Replacement Surgery

Welcome to a Medical Minute segment with fellowship-trained, board-certified Joint Replacement Surgeon, Dr. Michael Feign, DO of Colorado Springs Orthopedic Group (CSOG). Join Dr. Feign as he discusses accelerated recovery knee replacement surgery and how technology advancements of Total Knee Replacement have accelerated the recovery processes as well as how to determine a successful surgery. Learn more about how to schedule an initial consultation with one of the Joint Replacement Specialists within the Comprehensive Joint Replacement program at CSOG.

Within the last 15 years, there have been many innovative technological advancements specific to Total Knee Replacement procedures. Since their initial development, a knee replacement surgery generally entails resurfacing an arthritic surface by placing an implant on top of the surface, providing the patient with better mobility, smoother motion within the joint, and less overall pain. With a 96-98% success rate, these procedures are used to help qualified patients get back to the activities they love to do as quickly as possible. The method of replacing an arthritic joint with an implant has not changed significantly in recent years however, advances in the material used for implants and the customization of each implant have shown to drastically improve patient outcomes when accompanied by advancements within pre- and post-operative patient care.

With traditional procedure technologies, patients were required to stay within the surgical facility for upwards of 5-6 days after surgery with little to no movement or physical therapy performed during at least the first 3-4 days. Now, with new technological advancements, patients may be required to stay at the facility for one night, with many patients capable of going home on the same day. This allows for those patients to recover in the comfort of their own home. In most cases, patients will now move around and perform low intensity physical therapy just hours after surgery. Incorporating this movement immediately after surgery is a key piece in initiating the recovery process.

The most influential changes within Total Joint Replacement procedures and the piece that has helped accelerate the recovery process, has been advancements within individualizing pre- and post-operative patient care. These advancements include how surgeons are able to prepare and customize implants prior to surgery, improvement within the process of preparing the patient for surgery when administering anesthesia, optimizing the patient’s health, strength and mobility before surgery through individually prescribed physical therapy, as well as improvements in post-operative pain management through the use of temporary nerve blocks and pain pumps.

Even though the outcome of these surgeries has been great for many years, Dr. Feign and his team are always trying to improve techniques to ensure the best outcomes and overall patient satisfaction. Measurement of a successful procedure can vary from physician to physician. Dr. Feign believes success occurs through use of a quality implant, the surgeon being well trained, the implant being well balanced, the right size and right positioning for the patient, as well as optimizing the patient and their individual needs to obtain their most optimal health. He personally measures a procedure’s success by frequently checking in with patients, even years after their procedure, and ensuring that same person is doing well with the same knee replacement and continues to do so 10 -15 years down the road.

The average recovery time for a knee replacement generally takes about one year. Within two to three months, most patients are back to doing normal day to day activities without assistance from others.

For more information or to schedule an appointment with one of the Joint Replacement Specialists of the Comprehensive Joint Replacement Program at Colorado Springs Orthopaedic Group, call (719) 632-7669 or visit www.CSOG.net.

Orthopaedic Walk-in Clinic in Colorado Springs

Welcome to a Medical Minute segment with Dr. Eric Jepson, fellowship-trained, board-certified Orthopedic Joint Replacement specialist as he discusses the walk-in orthopaedic Express Care clinic at Colorado Springs Orthopedic Group where no appointment is needed and we’ll have you in and out within half the time of the ER.

Express Care is an Orthopedic Urgent Care located within Colorado Springs Orthopedic Group. We are here to help expedite the treatment process of any acute or sudden-onset injuries.

Come on into our Walk-In Clinic

Often times, after someone has experienced an injury, they will go to the emergency department and wait upwards of several hours to be seen. Instead, you can be evaluated and initially treated by the providers at CSOG’s Express Care for the same injuries in half the time. After initial evaluation and treatment, each patient seen in Express Care is then scheduled for a follow up visit with one of our 18 fellowship-trained orthopedic specialists. During this follow-up visit, our specialists will review any x-ray images and further develop your customized treatment plan.

Please note, if you have a significant and emergent injury, it is recommended that you go to the emergency department.

Some of the many common injuries we see within our Express Care clinic include:

Ankle sprains and fractures
Hand, wrist, and upper extremity injuries
Sports injuries
We can also help if a new back pain symptom presents itself.

Sports Physicals

We also offer Sports Physicals for all local school districts for only $25. No insurance or appointment needed.

When seen within Express Care, you are guaranteed to be treated properly and efficiently by one of our highly trained orthopedic providers. Additionally, you do not need a referral to be seen within Express Care.

Where to find us

Our Express Care clinic is located at 4110 Briargate Parkway. Across the parking lot from Memorial North and Children’s Hospitals on the first floor within suite 145.

We are open Monday through Friday from 9 a.m. to 5 p.m., Saturdays from 8 a.m. to 12 p.m., and are closed on Sundays.

To learn more about the Express Care at Colorado Springs Orthopaedic Group, call us today at (719) 632-7669 or visit www.csog.net.

Knee Cartilage Restoration in Colorado Springs

Colorado Springs Orthopaedic Group is now offering several advanced knee cartilage restoration procedures to save patients from an early joint replacement. With knee cartilage restoration, the joint can be reconstructed or resurfaced, which helps the patient return to normal activities without pain. These surgical procedures have been successful in elite athletes and active adults, allowing them to return to their sport without any restrictions.

You might ask, ‘can cartilage be restored?’ Cartilage lacks a direct blood supply necessary to heal on its own; however, cartilage restoration procedures provide a viable option to restore cartilage to a fully functional state.

Below you will find additional information on the various Cartilage Restoration treatment options for joint pain offered at Colorado Springs Orthopaedic Group.

Cartilage Restoration Surgery in Colorado Springs

Dr. Jamie Friedman, fellowship-trained Sports Medicine physician is specifically trained to perform advanced Cartilage Restoration procedures.

Surface Cartilage Lesions
These occur when the cartilage damage extends only to the surface of the cartilage and has not affected the underlying bone. There are two primary procedures to address this type of injury:

Biocartilage allograft transplantation:: is a single procedure that can be done arthroscopically or as an open procedure. During the operation, Dr. Friedman utilizes one of several innovative systems to take cartilage cells from a donor and places them within the area of damaged cartilage to fill in the defect, providing an even cartilage surface for the bones to move smoothly across. This restores the joint biology, leaving no damaged cartilage.

Cartilage defect of the trochlea
(underneath the knee cap)

Cartilage defect debrided for clean edges

New cells implanted and sealed with fibrin glue

Autologous Cell Implantation:This is a two-stage surgery however allows the patient’s own cells to be used. During the operation, Dr. Friedman utilizes an innovative system called MACI©. When the MACI© system is used, cartilage cells are biopsied from the patient, sent to a lab, and later implanted back into the same patient to provide restored cartilage. The surgery to harvest the cells is done arthroscopically, while the implantation is done as a minimally invasive open surgery through a small incision.

Below are examples of MACI© on the Medial Femoral Condyle:

Biopsy of cartilage from a place that doesn’t use it

Debridement of two separate lesions on the condyle

Implantation of the cells grown from the biopsy

Structural Cartilage Lesions

When the damage extends past the cartilage and affects the underlying bone, there are two types of procedures to treat this injury:

Osteochondral Autograft Transplantation (OATs):used for smaller lesions and is not used on the patella. As shown below, the Osteochondral Autograft Transplantation takes a cartilage “plug”, or a bone graft with cartilage, from a different place in the patient’s knee, and Dr. Friedman puts it into the defect.

Osteochondral Allograft Transplantation (OCA):This procedure works for larger lesions. In fact, this procedure can be used to do BioUni, which covers the entire condyle similar to a partial knee replacement. This method can work on almost any surface of the knee, including the patella. The Osteochondral Allograft Transplantation works by taking a cartilage “plug” from a donor that matches the same contour and places it into the defect. Below is an example of OCA on a patella:

Large cartilage defect under the patella

The defect is debrided to make room for the graft

A cartilage graft is placed into the defect

Below is an example of OCA on the medial femoral condyle:

Large cartilage defect of the medial femoral condyle

A cartilage graft is placed into the defect

Malalignment of the Leg

There are two types of coronal malalignment of the leg:

Valgus Malalignment of the Knee:This is where a patient is too “knock-kneed”, which causes excessive pressure on the outside, or lateral, part of the knee. Dr. Friedman uses a distal femoral osteotomy to correct this. Below are before and after images of the distal femoral osteotomy procedure.

This leg is too “knock-kneed”, which causes too much pressure on the outside of the knee

After the procedure, the leg is more straight

Varus Malalignment of the Knee:This is where a patient is too “bow-legged”, which causes a lot of pressure on the inside, or medial, part of the knee. Dr. Friedman uses a high tibial osteotomy to correct this. Below are before and after images of this procedure.

This leg is too “bow-legged”, causing too much pressure on the inside of the knee

After high tibial osteotomy, the leg is more straight

Our Cartilage Restoration Doctors

At Colorado Springs Orthopaedic Group, many of our physicians have extensive training and experience in knee cartilage restoration surgery and will ensure your treatment is a seamless process.

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two convenient cartilage restoration clinics in Colorado Springs:

North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

Learn if you are a candidate to restore cartilage in the knee or another joint and call 719-632-7669 to schedule an appointment at CSOG for a medical evaluation and consultation.

ACL Tears & Reconstruction with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses ACL tears and reconstructions.

What is the ACL?

The ACL is one of the four main ligaments within the knee joint and is the commonly injured ligament within the knee. The ACL’s role is to provide stability when performing movements such as pivoting or twisting.

How does an ACL tear occur?

Many ACL tears arise from sports related injuries such as skiing, court sports, or field sports. These injuries can occur through non-contact and contact related incidents. An example of a non-contact ACL injury is when an athlete is running, they plant their foot and then pivot without rotating the planted foot with the upper leg causing excessive strain on this ligament. ACL injuries can also be from contact incidents such as a slide tackle in soccer, where another player hits the player’s knee in the opposing direction from which the player’s body is already moving.

How can an athlete prevent an ACL injury?

Proper conditioning and strengthening programs can help prevent ACL tears. There are even specific ACL prevention programs offered that teach how to jump, land, and cut, building the surrounding muscle tissue to support these ligaments within the knee. Training movement patterns in the lateral plane of motion is a great place to start with ACL injury prevention.

What do I do for an ACL tear?

One of the worst things you can do after an ACL tear is wait a few weeks until your knee starts feeling better, the swelling has dissipated and then the patient tries to perform the same activities that lead to injury. As ligaments have a reduced blood supply in comparison to their surrounding musculature, in many cases continuing activity without treatment could potentially lead to further extensive damage. Dr. Jones sees this occur quite often and urges patients to seek orthopedic medical attention, especially if you feel a ‘pop’ during initial injury. Our fellowship-trained Sports Medicine Program Physicians at Colorado Springs Orthopaedic Group specialize in ACL repairs and reconstructions. Give us at call at 719-632-7669 or visit our Walk-in Express Care Clinic if you suspect an ACL tear.

What are ACL treatment options?

The majority of ACL tears will require either an ACL Repair or ACL Reconstruction surgery to ensure proper healing and prevent future instability within the knee. Your physician will recommend the best ACL treatment option dependent upon the severity of the initial tear. With an ACL repair, the surgeon will reattach the torn ligament to its corresponding boney structure through use of minimally invasive arthroscopic techniques. During an ACL reconstruction, the most common ACL treatment, the surgeon will replace the damaged ligament with a new ligament either from another part of the patient’s body or from a donor using minimally invasive arthroscopic techniques.

To learn more about ACL injuries, or to schedule an appointment with one of our fellowship-trained orthopedic surgeons at Colorado Springs Orthopaedic Group, please call (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Shoulder Fractures with Colorado Springs Orthopaedic Group

Welcome to a Medical Minute segment with Dr. Christopher Jones, MD, fellowship-trained, board-certified Orthopedic Sports Medicine Surgeon as he discusses shoulder fractures, how technology advancements have influenced the treatment process, and the typical recovery time to heal from a clavicle fracture.

What is the most common type of shoulder fracture?

The most common shoulder fracture that Dr. Jones’ and his team sees are clavicle fractures. Mountain biking is very common in the Colorado Springs community and people fall off their bikes and break their clavicles quite often.

If someone hurts their shoulder, at what point should they be seen by a physician?

If someone has broken their clavicle, they are going to feel it, hear it, and therefore know it. They are going to feel pain and there may be some visible evidence of deformity, significant bleeding, bruising, or tenting of the skin. Anyone experiencing these symptoms should be seen right away.

How has the treatment process of clavicle fractures changed over time?

There have been quite a few improvements to how clavicle fractures are treated now vs traditional methods. Historically, clavicle fractures were treated non-operatively. However, in recent studies, physicians are finding that these fractures typically do not heal as well as they thought they did when left untreated. During the injury evaluation process, there is a certain criteria that needs to be looked at such as x-rays, skin, and other things that would tell a physician if the patient needs surgery. Dependent upon these findings, the physician will develop a customized treatment plan to ensure efficient healing.

What type of procedure is used to treat clavicle fractures?

The clavicle will typically break in three different areas – either in the mid-shaft, which is the most common type of clavicle fracture, medial, and/or lateral segments of the bone. Treatment plans will vary drastically based on where the fracture is located however, plates and screws are the most commonly utilized tools to stabilize and piece the fracture back together. In some cases, a rod is inserted down the center of the bone.

What is the recovery time?

The average healing time of a clavicle facture that has not been treated operatively is approximately 16 weeks. Treating a clavicle fracture operatively significantly reduces the recovery time down to an average of 12 weeks. Recovery will vary dependent upon a patient’s diligence with their prescribed post-operative physical rehabilitation protocols.

To schedule your initial consultation, call us today at 719-632-7669.

To learn more about the comprehensive services available at Colorado Springs Orthopaedic Group, visit www.CSOG.net

Minimally Invasive Foot & Ankle Surgery with Dr. Simpson

Welcome to a Medical Minute segment with G. Alex Simpson, DO, Orthopedic Foot and Ankle Surgeon with Colorado Springs Orthopaedic Group as he discusses the latest advancements in Minimally Invasive Foot & Ankle Surgery and how to schedule an appointment with any one of our Fellowship Trained Orthopedic physicians.

Minimally Invasive Surgery (MIS) is described from Dr. Simpson as “how we can operate on a patient without making a big incision.” With smaller incisions, there is less damage done to any surrounding structures which allows for decreased recovery time, minimized pain, and a much lower risk for infection.

There are many different types of Foot and Ankle specific injuries or conditions where MIS can be used for treatment. Some of which include hammertoes, bunions, tendon injuries, cartilage injuries, and even plantar fasciitis. Talk with your physician to see if you might be a candidate for MIS as eligibility may vary case to case dependent on the severity of injury as well as the patient’s overall health. In most cases MIS is an outpatient procedure, allowing the patient to go home and recover the same day as surgery.

MIS techniques have been shown to help accelerate the recovery and rehabilitation process as well as significant improvements in outcome longevity. Recovery timelines will vary dependent upon the type of injury treated and the severity of such injury.

Call us today at 719-632-7669 to see if Minimally Invasive Foot and Ankle Surgery is the right treatment for your foot and ankle condition.

Visit www.csog.net to learn more.

Ankle Fusion Vs. Ankle Replacement in Colorado Springs

Welcome to a Medical Minute segment with G. Alex Simpson, DO, Board Certified Orthopedic Foot and Ankle Specialist at Colorado Springs Orthopaedic Group where he discusses ankle fusion vs. ankle replacement procedures. In this segment Dr. Simpson also discusses injuries that can initiate the onset of arthritis in the ankle.

During an ankle fusion, the surgeon will fuse the ankle bones together disabling movement within the joint. The goal of this procedure is to decrease pain within the joint. Alternatively, an ankle replacement replaces the tibiotalar joint (ankle joint) where your shinbone (tibia) sits on top of your foot bone (talus). This procedure does allow for movement within the joint after surgery.

Both Ankle Fusions and Ankle Replacements can be used to treat ankle arthritis.

What to Expect

After discussing symptoms and reviewing diagnostic imaging, your physician will work with you to develop a detailed treatment plan comprised of the most efficient treatment method to fit your needs. The right treatment typically varies upon:

your natural anatomical bone placement
your body’s natural movement translation within the joint
quality of bone density
your routine physical activity habits.

For those not eligible for a replacement, an ankle fusion remains a great treatment option for ankle arthritis.

Some examples of injuries that may lead to the onset of ankle arthritis include:

a bad ankle sprain that was never been treated
an ankle break where the bones are out of position for any period of time and where they may have healed in an abnormal way.

How We Can Help

At CSOG, we offer a wide variety of services that can help patients accelerate their recovery processes. At both locations, our Audubon Orthotic and Prosthetic Services team can custom fit you to any necessary braces, orthotics, or stability boots. We also offer injection therapies, such as cortisone injections and in-house physical therapy services as conservative treatment options. These conservative options, specifically physical therapy, can help delay the onset of ankle arthritis as well as help accelerate your rehabilitation post-surgery.

When comparing ankle fusion vs. ankle replacement to choose which procedures are best for you, call us at 719-632-7669 today to schedule a consultation.

Visit www.CSOG.net to learn more.

Cartilage Restoration Procedures in Colorado Springs

Articular cartilage is a smooth, white tissue that acts as a cushion between specific bones and allows your joints to move smoothly. When compromised due to traumatic or overuse injuries, you may experience significant pain and restricted mobility. Unfortunately, cartilage lacks a direct blood supply therefore, it does not heal on its own when damaged. Without treatment or alteration in perpetual activities, this can lead to the onset of early arthritis. However, with technological advancements, such as cartilage restoration procedures, joint preservation is possible for active individuals who may be too young to qualify for a joint replacement or would prefer not to receive a total joint replacement.

Fellowship-trained Sports Medicine Physician, Dr. Jamie Friedman of Colorado Springs Orthopaedic Group, is specifically trained in several advanced Cartilage Restoration procedures addressing:

Treatment for Surface Cartilage Lesions
- Autologous cell implantation
- Biocartilage cell allograft implantation
Treatment for Structural Cartilage Lesions
- Osteochondral Autograft Transplantation (OATs)
- Osteochondral Allograft Transplantation (OCA)
Treatment for Malalignment of the leg
- High Tibial Osteotomy (HTO)
- Distal Femoral Osteotomy (DFO)

With Cartilage Restoration, the joint can be resurfaced or reconstructed to a natural smooth surface allowing the patient to return to their normal activities with reduced or non-existent pain.

“I’m excited to bring Cartilage Restoration procedures to Colorado Springs. We have such an active population here, and nobody wants to be limited by joint pain. My goal is to get both the elite athlete and weekend warrior back to the activities they love. Cartilage Restoration makes this possible with minimally invasive techniques that provide many years of unrestricted activity without pain. Saving a patient from an early knee replacement is very rewarding.”
– Dr. Jamie Friedman, MD.

Cartilage Restoration Surgery

Cartilage Restoration is a treatment option that can delay or prevent the need for joint replacement surgery especially in younger adults. Each procedure type replaces the damaged cartilage and provides the knee joint with both the necessary shock absorbing and smooth gliding mechanisms to allow activities performed by the patient to occur without pain.

The best candidates for Cartilage Restoration surgery can range; however, are most commonly active young adults or those who have severe pain and are too young for a partial or total knee replacement.

Cartilage Damage Symptoms

Common causes of cartilage damage include repetitive wear and tear on the joint, a traumatic injury, or a sports injury. With sports or traumatic injuries, the twisting or jarring of the joint can cause the cartilage to tear or separate. It is common for cartilage damage to occur at the same time when ligaments or tendons around the joint are injured. For example, during an ACL or MCL tear, it is common to see a meniscus or articular cartilage injury.

Most symptoms present with increased pain or swelling after a particular activity or at the end of an active day. They may also have mechanical symptoms such as painful clicking or catching when the knee is bent or straightened. In very advanced cartilage loss, patients may be severely limited by this pain.

Symptoms indicating you may have cartilage damage include:
- Stiffness or pain within the joint
- Swelling of the joint
- Reduced range of motion
- Painful clicking or catching when you bend or straighten your knee
- Weakness or the feeling of being unstable

The presentation of pain will vary from patient to patient. For some, the pain is a persistent ache. For others, the pain comes and goes, and can be induced when suddenly bearing weight on the joint. You might also notice that your joint does not bend or twist as far as it used to. This limited range of motion could be caused by swelling, discomfort, or a mechanical issue within the joint.

Types of Cartilage Restoration

Dr. Friedman specializes in arthroscopic or minimally invasive Cartilage Restoration procedures. The below details the three main types of Cartilage Restoration procedures that are performed at Colorado Springs Orthopaedic Group.

Surface Cartilage Lesions:
This can be thought of as ‘repaving the street’. Dr. Friedman uses this technique when the cartilage problem is only on the surface.

Structural Cartilage Lesions:
This can be thought of as ‘filling in the potholes.’ Dr. Friedman uses this technique when the cartilage problem involves the underlying bone.

Malalignment of the Leg:
There are two types of Coronal Malalignment of the leg. Someone may either be too ‘knock-kneed’ also called genu valgus or someone may be too ‘bow-legged’ also called genu varum. An osteotomy is the corrective procedure to realign the knee joint in either case.

Cartilage Restoration Recovery Time

Recovery time for a Cartilage Restoration procedure will vary dependent upon which surgery is performed, adherence to physical therapy protocols, and the overall health status of each patient. On average, a patient will be partially weight-bearing for six weeks; however, they will start their rehab right away. As the cartilage continues to heal, the patient will increase their range of motion, strength, and balance typically returning to normal activities within three months. Overall, you can anticipate between four to six months to fully recover and return to more rigorous activities and sports.

Cartilage Restoration Physician:

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two cartilage restoration surgery centers in Colorado Springs:
North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

You do not have to live with pain. If you are suffering from joint pain and suspect cartilage damaged, contact us at 719-632-7669 to schedule your initial consultation.

Visit us at www.csog.net to learn more.

CSOG Comprehensive Joint Replacement Program

Welcome to a Medical Minute segment with Dr. Tyler Bron, MD, Orthopedic Joint Replacement Surgeon as he introduces the New Comprehensive Joint Replacement Program at Colorado Springs Orthopedic Group.

Comprised of our four fellowship-trained Joint Replacement Surgeons and their teams, you can guarantee we will be with you every step of the way through your entire treatment journey! From initial consultation to post-operative rehabilitation, our clinical and case management teams will have you back on your feet as quickly as possible. When you become a patient of the Comprehensive Joint Replacement Program here at CSOG, you can expect a customized treatment plan designed specifically towards the severity of your condition using the most innovative and effective treatment methods available today.

Not only do our surgeons specialize in traditional joint replacements methods, they also specialize in minimally invasive surgical (MIS) techniques such as robotic assisted minimally invasive joint replacement procedures.

Outpatient total joint procedures performed in our ambulatory surgery center, The Orthopedic and Spine Center of Southern Colorado or within our community hospitals, allow the patient to recovery in the comfort of their own home the same day as surgery. Discuss with your physician if outpatient surgery is right for you as eligibility for these procedures may vary upon the severity of your injury or condition as well as your overall health.

CSOG has the largest group of fellowship-trained joint surgeons in southern Colorado and together have a combined 72 years of joint replacement experience. They pride themselves on the team approach, especially with severe cases our team of joint surgeons will meet and discuss in depth the most efficient treatment options to accelerate your recovery and get you back on your feet, doing the things you love to do, as quickly as possible.

To schedule your initial consultation, call us at 719-632-7669 today!

Visit www.CSOG.net to learn more.

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ACL Injuries With Dr. Friedman

Welcome to a Medical Minute segment with Dr. Jamie Friedman, Fellowship-trained Orthopedic Sports Medicine physician at Colorado Springs Orthopaedic Group as she discusses what an ACL injury is, how it is diagnosed, and what the typical recovery time after ACL surgery is.

What is an ACL injury?

An ACL, also known as the Anterior Cruciate Ligament, is a double bundle structure in the middle of the knee. It connects the femur to the tibia and one of the four main ligaments that provides stability within the knee. The ACL helps provide stability to the tibia, preventing it to slide too far forward as well as aids in stabilizing the knee during rotation and lateral movement patterns.

What are the most common ways to injure your ACL?

The most common way to injure your ACL is from a

non-contact activity where a pivoting action occurs. Activities that would cause this pivoting action include high intensity sports such as soccer, basketball, or skiing. Occasionally, ACL injuries can be caused by traumatic injuries such as a motor vehicle collision.

What are the symptoms of a torn ACL?

Typically, when a patient injures their ACL, they may feel or even hear a pop in their knee which is followed by immediate swelling of the knee joint. The swelling may be so severe that they have trouble bending or straightening their knee. They may also feel that their knee is giving away or that they can’t trust their knee to walk or do certain activities. This is a symptom caused by the instability from injuring this ligament.

How is an ACL injury diagnosed?

An ACL injury can be diagnosed through clinical examination and imagining, such as an MRI, to assess the integrity of the ACL and its surrounding structures.

When is surgery necessary for an ACL injury?

It is almost unavoidable to not have ACL surgery after a complete rupture.

What is the recovery time for ACL surgery?

After any ACL surgery, the patient will be placed in a knee brace and prescribed physical therapy exercises. During rehabilitation, the patient will work on range of motion, as well as strengthening of the lower extremity under supervision of their physical therapist. Typically, around the three-month mark, patients can return to light activities such as jogging or running in a straight line. From four to six months, dependent upon recovery progress, the patient can typically return to activities that involve jumping and pivoting. Most patients can return to normal activities after 6 months. For athletes, the recovery may be extending to nine to twelve months before they return to full sport competition to ensure proper recovery and strengthening.

To learn more about ACL injuries, custom-tailored treatment options or to schedule an appointment, call us at (719) 632-7669.

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Physical Therapy for Sciatic Nerve Pain in Colorado Springs

Living in Colorado, many of us thrive off experiencing the outdoors. However, there are some instances where one may start to experience nerve pain in your lower back and leg while enjoying our great landscapes. If this occurs, you may benefit from specialized physical therapy for sciatic nerve pain.

Pinched human sciatic nerve, anatomical vision. 3D Render.

Sciatica is a pain that radiates down the leg along the sciatic nerve. The sciatic nerve starts in your lower lumbar spine, specifically between your L4-S2 segments. It runs down each leg, supplying the upper legs with motor functions and the lower legs with motor and sensory functions.

What Causes Sciatic Nerve Pain?

There are various reasons why you may be affected by sciatica. In many cases, it may be caused by a herniated disk or a bone spur, which can pinch or aggravate the sciatic nerve. Another cause may be due to a lack of strength within the gluteal and piriformis muscles of the hips which can compress on the sciatic nerve during certain activities. As with any condition, there are various severities in which Sciatica can present.

Typically, mild to moderate sciatica will go away on its own. However, if you experience sciatic nerve pain for longer than a week, we recommend contacting your physician as specific treatment may be needed to alleviate the pain. With most mild to moderate sciatic nerve pain, your physician may refer you to a physical therapist to strengthen the surrounding musculatures as an initial conservative treatment method. At Colorado Springs Orthopedic Group, Physical therapy for sciatica is one of the many neuromuscular conditions our Physical Therapists specialize in and treat daily. This type of rehabilitation has been shown to be a highly effective treatment for alleviating mild to moderate sciatic nerve pain.

Please note, if you are experiencing severe sciatica pain caused by a traumatic injury, such as an auto accident or sports injury, seek medical attention as soon as possible. Likewise, if your pain significantly worsens in a short amount of time, we recommend seeing an orthopedic physician promptly. Our walk-in orthopedic urgent care, Express Care is open Monday through Friday, 7 am-5 pm and Saturdays 8 am-12 pm.

Sciatic Nerve Pain Symptoms

Symptoms of sciatica include radiating pain in the lower spine, pelvis, and hips, or in the buttocks and down the back of your leg. Women who are in the mid to late stages of pregnancy may experience mild to moderate sciatic pain as well due to compression on the nerve.

Some patients may experience sudden sharp pain when sneezing or coughing, causing extreme discomfort. Long periods of sitting can also aggravate the sciatic nerve and may require specific stretching or physical therapy exercises to help alleviate this pain.

Chiropractor or Physical Therapy for Sciatica?

Most can typically achieve sciatic pain relief by seeing a chiropractor or physical therapist. The type of treatment you choose is primarily a personal preference depending on what you hope to accomplish. Both medical professionals have training specific to evaluating and treating sciatica. Chiropractors can assist by assessing where bones may be misaligned or pinching the nerve. Alternatively, Physical Therapists can assess where muscular imbalances may be present and help you gain strength in the lagging areas. This focus can show great results by alleviating any compensation that may be resulting from or causing sciatic pain.

Chiropractic Adjustments for Sciatica:

The purpose of a chiropractic adjustment is to achieve short-term pain relief and is a hands-on manipulation technique of the musculoskeletal system. These adjustments can provide temporary pain relief as it allows for the surrounding musculatures to relax and increases the mobility within the adjusted joint. For example, a lumbar spine adjustment may reduce pressure on the sciatic nerve, temporarily easing the pain. Depending upon the source of sciatic pain however, a patient may only see temporary relief as imbalances within correlating muscular structures may pull on the joint during various activities.

A Japanese woman getting a foot massage at a seitai clinic

Physical Therapy for Sciatica:

With physical therapy, the aim is to promote long-term healing and restore optimal function to the body. Physical therapy treatments may include hands-on mobilization of specific joints, muscles, tendons, and ligaments. By assessing where specific muscles may be compensating for lack of strength within other correlating muscles and diligently performing strengthening exercises to correct these compensations, physical therapy specific to the treatment of sciatica can drastically improve range of motion, total body strength, and blood flow to the affected extremities. For example, properly activating and strengthening the gluteal muscles, can help rehabilitate the symptoms of a herniated disk, reducing the severity of sciatic nerve pain.

Benefits and Outcomes of Physical Therapy for Sciatica:

The primary benefits of physical therapy for treating sciatica include pain relief, improved range of motion, and restored motor skills and body functionality. Physical therapy for sciatica is also less expensive and less invasive than other methods, such as surgery, injection therapy, or medications. Most patients who are diligent with their recommended restorative physical therapy plan state their pain has reduced dramatically within a few weeks to a few months. On average, these patients experience long-term pain relief with less chance of the pain recurring.

The total number and the frequency of your physical therapy sessions will depend upon the severity of your sciatica, adherence to treatment, and the pain relief experienced throughout treatment.

Our Colorado Physical & Occupational Therapists

At Colorado Springs Orthopaedic Group, we work with some of the most elite Physical Therapists in Colorado Springs. Our teams are highly trained and highly experienced in their specialties. Contact CSOG’s Physical Therapy department today to request a list of our physical therapists and their teams.

To make an appointment at our North Campus location call (719) 867-7320

To make an appointment at our South Campus location call (719) 622-4524

Hip Labral Repair Vs Hip Reconstruction With Dr. Huang

Welcome to another Medical Minute segment with Dr. Michael Huang, Board-certified Orthopedic Sports Medicine physician at Colorado Springs Orthopaedic Group as he discusses the differences between labral repairs and reconstructions within the hip joint and when one surgery may be recommended over the other.

Hip labral repair vs hip reconstruction

The labrum is an O-ring shaped piece of cartilage surrounding the acetabulum, also known as the hip socket, that provides extra stability within the hip joint. The labrum can tear from overuse performing certain activities or from traumatic events. Unfortunately, a labral tear does not heal on it’s own due to the lack of direct blood supply as with any cartilage tear.
If conservative treatment options, such as physical therapy, injection therapy, or medications do not provide long-lasting relief, then surgery to repair the damaged cartilage may be the recommended next treatment option.

Both procedures, a hip labral repair and a hip reconstruction are surgeries utilized to treat labral tears within the hip. A Labral Repair is where the surgeon reattaches the labral tissue to the acetabulum. Once this is completed, the patient goes through an extensive rehabilitation process to ensure proper healing and restore functionality. Alternatively, when the tissue has been severely torn or a previous repair may have failed, surgeons may elect to perform a labral reconstruction. During this procedure, the surgeon will take a piece soft tissue, typically from the iliotibial band (IT Band) or hamstring tendon of either the patient or a donor and reconstruct the labral structure. This procedure can include either a partial or full reconstruction variant upon the severity of the initial tear.

What activities can lead to a labrum tear?

Labrum tears can occur in many ways however, many patients have a pre-disposition to a labral tear due to their hip anatomy. Athletic activities such as hockey, collision sports or general weightlifters who perform squats or box jumps on a routine basis may be at risk for a tear, especially if they have an anatomical pre-disposition.

Minimally invasive hip repair and hip reconstruction

Both hip repair and a hip reconstruction are relatively new procedures to be done arthroscopically. Arthroscopy procedures allow the surgery to be performed in a minimally invasive manner, preserving as much soft tissue as possible. Hip reconstruction surgeries are naturally more involved than a labral repair surgery therefore, recovery may vary based on the procedure performed. Both procedures are typically classified as Outpatient surgeries where the patient can return home the same day without staying in the hospital or surgery center overnight.

What questions should a patient ask a hip surgeon?

Due to hip arthroscopy being a relatively new category in general, there are not a lot of orthopedic surgeons that do hip arthroscopy surgeries. Dr. Huang’s first piece of advice is ensuring that the surgeon has experience and is very familiar with the procedure.

Dr. Huang also recommends that if there is a decision that needs to be made between labral repair and consideration for reconstruction, then it would be advantageous for the patient to ask the surgeon if they do reconstruction surgery. This is necessary because even among the surgeons that do hip arthroscopy repair, not all of them do reconstruction because it is technically much more demanding.

Colorado Springs Orthopaedic Group is fortunate enough to have experience in arthroscopic repair and reconstruction and have multiple physicians with a vast amount of experience performing both procedures. To learn more or to schedule an appointment, call us at (719) 632-7669.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Platelet-Rich Plasma Therapy (PRP) With Dr. Jones | Colorado Springs Orthopaedic Group

Welcome to a Medical Minute segment on platelet-rich plasma therapy (PRP) with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group.

The video below will cover what platelet-rich plasma therapy (PRP) is and how it can help heal an injury and avoid possible surgery.

What is PRP Therapy and where is it derived from?

PRP stands for Platelet-Rich Plasma and is derived from a patient’s blood. By way of centrifuge, the physician will separate out the platelets which are cells within our blood that help promote clotting and healing as they possess essential growth factors. There are two types of PRP. PRP that are made up of white blood cells, and PRP that do not include any white blood cells. If a patient is utilizing PRP the process is simple; the patient comes in for their appointment, the physician or physician assistant will draw the blood, and the blood is then spun within a centrifuge to separate out the different cells. That process takes between 7-20 minutes. Once the cells are ready, the physician will then inject the cells within the patient’s injured body part. The injection process typically takes less than one minute to complete.

What injuries can PRP help heal?

For ligament or tendon injuries, PRP can help a patient’s ability to heal by increasing the growth factor concentration. Injuries such as MCL tears or tennis elbow are commonly treated with PRP. PRP can also be used to treat arthritis or cartilage injuries because it helps diminish inflammation in the joint, which then diminishes pain symptoms.

Where do you recommend PRP versus surgery?

Dr. Jones recommends PRP versus surgery when diagnosing degenerative tendon injuries, where surgery may not be the most ideal initial treatment option.

How is PRP associated with Stem Cells?

Stem cell treatments have become popular and are in the same treatment family as PRP due to a similar goal of enhancing the patient’s ability to heal injuries or to fight off inflammation. However, stem cells do not exist within PRP.

What is the typical outcome or success rate for those patients who have underwent PRP treatments?

Dr. Jones has seen outstanding outcomes from patients who have utilized PRP treatments. He was an early adopter of the treatment and started using PRP treatments 12 years ago. As PRP treatments have advanced over the years and additional literature has shown great success with its use, the more Dr. Jones recommends it. For example, in tennis elbow, PRP treatment studies have shown a 90% success rate.

If you have been experiencing pain, or have additional questions about PRP, call us today to schedule an appointment with Dr. Jones at Colorado Springs Orthopaedic Group!

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

General Orthopedics at Colorado Springs Orthopaedic Group

At Colorado Springs Orthopaedic Group, our physicians specialize in General Orthopedics and are trained to thoroughly assess a wide variety of bone conditions. These conditions range from head to toe and are conditions that may have affected surrounding structures within the joints, such as muscles, cartilage, tendons, and ligaments.

As one of our patients, you can expect to have very detailed and thorough discussions with your physician regarding your diagnosis and treatment options available to fit your general orthopedic needs. Our providers share information in easy to understand terms and actively encourage you to participate in your treatment’s decision-making process. Your care is about you and we want you to feel comfortable with the decisions made to help you get back to your pain-free lifestyle.

The most common General Orthopedics disorders and diseases include:

Fractures
Arthritis
Sprains and strains
Bursitis and tendonitis
Ligament and tendon tears
Cartilage Tears

Many injuries or conditions can be resolved with non-surgical treatment options such as physical or occupational therapy, cortisone injections, viscosupplementation, or PRP therapy. However, if you and your doctor determine that surgery is the best treatment option, our surgeons specialize in a number of minimally invasive procedures proven to accelerate the recovery process.

Arthroscopy

Arthroscopic procedures allow the surgeon to operate through smaller incisions with use of a miniature camera, also known as a scope, which enables the surgeon to view the joint with great detail while preserving the surrounding tissues, such as muscles and tendons. Arthroscopy has shown a number of recovery and longevity benefits compared to traditional surgical methods such as:

Smaller incisions enabling the surgeon to cut through less surrounding tissues, decreasing the chance for severe scarring.
Accelerate the recovery process as the surrounding musculature is not damaged to such great extents
Shorter recovery period
Decreased risk of infection

As with any procedures, candidacy for an arthroscopic procedure may vary dependent upon the severity of the injury and the patients overall health status. Discuss with your physician to see if arthroscopy is the best treatment option for you.

Call us at 719-632-7669 to schedule your initial consultation.

Orthopedic Trauma & Fracture Care in Colorado Springs

Trauma can occur from any injury that endured enough force to cause a fracture or significant damage within the body. Care for simple fractures (such as a transverse, longitudinal or stress fractures) may require only casting or splinting. Common causes of fractures include motor vehicle accidents, sports injuries, and falls. Care for severe or complex fractures (such as open fractures, pelvic fractures, femoral, tibial, etc.) often require surgical intervention.

The types of orthopedic trauma & fracture care we see include but are not limited to:

Simple Fractures:
- Transverse fractures
- Longitudinal fractures
- Stress fractures
Complex Fractures, to include but are not limited too:
- Open fractures
- Femoral fractures
- Non-healing fractures
- Fractures with deformity/angulation
- Fractures of the pelvis and acetabulum (hip joint)
- Joint (intra-articular) fractures
- Foot and ankle fractures
- Post-traumatic reconstruction

Every physician at Colorado Springs Orthopedic Group is trained to treat all types of traumas and fractures. After a thorough examination of the injury, your physician will order the appropriate imaging, such as x-rays or an MRI, to appropriately diagnose and develop a treatment plan best suited for the injury. Each treatment plan is customized to every patient and the needs of their injury.

Young girl wearing an arm brace seeking trauma & fracture care

For the highest quality orthopedic trauma & fracture care in El Paso County, call Colorado Springs Orthopaedic Group at (719) 632-7669.

Need to be seen today? Walk into our Orthopedic Urgent Care clinic, Express Care for immediate examination performed by one of our board-certified orthopedic trained Physician Assistants. With limited wait times and on-site imaging services, our Express Care team can have you on the road to recovery quicker and at a much lower cost than the ER. After your initial examination, you’ll be scheduled with one of our fellowship-trained orthopedic physicians to further discuss your customized treatment plan. Call 719-622-4550 or visit us at https://www.csog.net/services/our-express-care to learn more.

Common Ski & Snowboarding Injury Treatments with Dr. Huang

Welcome to a Medical Minute segment with Dr. Michael Huang, a board-certified physician at the Colorado Springs Orthopaedic Group, speaking today about common ski & snowboarding injury treatments.

The video below will cover how to best treat winter sports injuries such as injuries from skiing or snowboarding.

What are the most common ski and snowboard knee injuries?

The most common knee injuries are typically soft tissue injuries such as meniscus tears and ligament tears. Within the ligament tear category, the most common, and well known are anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries.

What happens if the ACL or MCL injury occurs while on skis or snowboards?

Skiing and snowboarding can cause ACL, MCL, or other injuries because the board under your feet puts a lot of strain on your knees. Skiing has been well studied and it has been found that the athlete gets in what is called the ‘backseat’ position which produces a rotational force across the knee that has been demonstrated to tear the ACL, MCL and sometimes the meniscus.

Exercises to prevent common ski and snowboarding injuries

Within the last few decades, there has been a lot of focus on preventing knee injuries. Before the ski season starts, gyms have even started to offer ski conditioning classes which Dr. Huang finds very beneficial. Courses such as these place an emphasis on building strength and coordination within plyometric movements, increasing cardiovascular fitness, as well as strengthening the core and hip stabilizer muscles.

To schedule an appointment with Dr. Huang, call our offices at: (719) 632-7669.
To learn more visit us at www.csog.net.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

The Comprehensive Joint Replacement Program

As Part of Colorado Springs Orthopaedic Group’s Comprehensive Joint Replacement Program,
our fellowship-trained joint replacement specialists will provide you with the
most comprehensive treatment possible to help you return to your active lifestyle.
We are here to help you get back out there, doing the things you love to do.

When you first visit us at Colorado Springs Orthopaedic Group, you’ll be introduced to our clinical team consisting of your Physician, Physician Assistant, Medical Assistant, Surgery Scheduler, and Case Manager. As part of the Comprehensive Joint Replacement Program, this group of individuals will be your direct line of contact to answer any questions or concerns you may have as you continue throughout your entire recovery process.

During your initial consultation, your physician will discuss recommended treatment options with you and design a comprehensive treatment plan to get you on the road to recovery. Our physicians will exhaust all conservative treatment options prior to recommending surgery. However, in severe cases or cases where conservative treatments have not provided adequate pain relief, surgery may be deemed necessary.

Schedule your inital consultation with one of our fellowship-trained Orthopedic Joint Specialists by calling 719-632-7669.
Consult with your physician for a proper diagnosis and recommended next steps. Our Total Joint Physicians will exhaust all conservative treatment measures prior to discussing surgery if your case allows.
If all conservative treatment options have been exhausted and your pain is still significant, surgery may be recommended. At this time you will be introduced to your case manager who will help you prepare for a smooth procedure and be your patient advocacy contact.
After surgery, you will be introduced to your post operative recovery team, including your lead physical therapist who will be with you every step of the way from the moment you leave the operating room to your post operative rehabilitation journey.

“Whether it’s from a recent surgery or surgery from years ago, our Comprehensive Joint Replacement Specialist can correct even the most complicated Total Knees and Total Hips.”

Our Comprehensive Joint Replacement Program Teams:

Clinical Team
Surgical Team
Post Operative Recovery Team

Specializing in:

Inpatient vs Outpatient
Total Joint Replacements
Accelerated Recovery
Joint Replacements

Arthritis and MAKO
Robotic Assisted Joint
Replacement Surgery
Complex Joint Revisions

Arthritis Team and MAKO Robotic Assisted Joint Replacement Surgery Complex Joint Revisions

Comprehensive Joint Replacement Program Specialists

What to Expect Pre-Operation

Have you ever walked into the hospital or medical practice intimidated and unsure of who would be taking care of you? Not anymore. At Colorado Springs Orthopaedic Group you can expect to know exactly who to contact every step of the way. During your initial consultation, your physician will discuss your symptoms, order any appropriate imaging from our in-house MRI and X-Ray services, and diagnose your symptoms with the highest standard of education and care for your lifestyle. From here, you can expect to either:

a) Try various conservative treatment methods such as Physical Therapy, weight loss, or injection therapies.

b) Discuss surgical options dependent on the severity of your symptoms.

If surgery is the chosen path, our clinical team will work with your insurance to find the best options available and ensure you are ready to go upon the day of surgery. It is highly important to communicate with your clinical team and ask any questions or concerns you may have and diligently follow instructions as provided.

What to Expect Post- Operation

Within 24 hours after your surgery, you will be introduced to your Physical Therapist Lead who will guide you through initial rehabilitation exercises. At this time, you will be prescribed at-home exercises that are critical to a smooth recovery.

Inpatient vs. Outpatient Recovery

Inpatient Surgery means that you will stay a minimum of one night in the hospital or surgery center under the watchful eye of your nursing team.
Outpatient Surgery provides the capability for you to recover within the comfort of your home the day of surgery, eliminating facility fees and the stress of staying in an unfamiliar area.

Case Management

Every patient in the Comprehensive Joint Replacement Program is dedicated to one of our board-certified Case Managers. They will be your direct patient care advocate from your initial consultation to graduation from post-operative Physical Therapy.

“Within about 24 hours after surgery, I never had another need for crutches, a cane, walker, anything like that and it has been absolutely fantastic.”

Accelerated Recovery Joint Replacements

One of the primary focuses of the Comprehensive Joint Replacement Program is to have patients mobile within hours after their surgery. Over the course of the last 10-15 years, advancements within surgical techinques such as smaller incisions and the anesthesia techniques, have enabled patients to recover not only much quicker but also recover in the comfort of their own home either the day following surgery or in many cases, the same day. Within hours after surgery, patients will be introduced to their post operative Physical Therapist who will demonstrate exercises enabling them to get up and move around the same day as their operation. Through extensive studies, ensuring same day mobility has proven to show drastically improved outcomes for patients and their overall recovery time.

Total Knee Replacements

There are three bones that come together to form your knee joint: the Femur (thigh bone), Tibia (shin bone) and Patella (kneecap). Attached to these bones are three primary muscles groups that assist in knee flexion, allowing you to walk, run, and step up and down stairs. These muscles are your quadricep, hamstring, and calf muscles. Lastly, your tendons and ligaments surrounding these structures help to keep the femur, tibia and patella secured within the joint.

Our physicians typically recommend conservative treatment options such as physical therapy, steroid injections, and weight loss prior to discussing surgical options. However, if all conservative options have been exhausted, your physician will discuss surgical treatment options such as a partial or total knee replacement. Once you and your physician have decided to move forward with surgery, your physician may elect to use traditional Knee Replacement techniques or Mako Robotic Assistance navigation software to customize your knee replacement implants specific to your individual anatomy. This customization process allows for a seamless implant fitting once in the operating room.

Total Hip Replacements

There are many conditions that can arise within the hip joint. Most commonly, patients complain of symptoms associated with bursitis, tendinitis, muscle strains, labral tears, and arthritis. Dependent on the severity of your symptoms, conservative treatment options may be recommended, with surgery as the last option. Our Joint Replacement surgeons specialize in both traditional Hip Replacement techniques as well as Robotic Assisted Hip Replacements.

Robotic-Assisted Minimally
Invasive Surgery: MAKO

Mako Robotic-Assisted Navigation has shown significant improvement in replacement longevity and overall patient outcomes for those patients who qualify for these procedures.

Did you know the average Total Joint Replacement can now last you over 20 years compared to the estimated 10-15 years in early 2000s?

Call us today at 719-632-7669 to learn how we can help you live a sustained pain free life.

Mako Robotic Joint Replacement Systems utilized for Knee Replacement and Hip Replacement

“From the onset of being treated within this group, I have been treated with the upmost respect and feel very fortunate to be a patient there. The entire staff is great. And I could not have asked for one of the best doctors there.” – Dr. Tyler Bron

Complex Total Joint Revisions

In some cases, due to a variety of reasons, a Total Joint Replacement can fail. Some common reasons a failure may occur are normal wear and loosening of the joint while some causes may be due to infection within the joint. If this occurs, our Total Joint Replacement Specialists will assess and recommend revision procedures specific to your case.

Call us today at 719-632-7669.

Dr. Tyler Bron, MD Colorado Springs Orthopaedic Group

Tyler R. Bron, MD

Dr. Bron has completed a fellowship in Adult Reconstruction, specializing in the treatment of arthritic hip and knee conditions.

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Dr. Eric Jepson, DO Colorado Springs Orthopaedic Group

Eric K. Jepson, DO

As a board-certified orthopedic surgeon, Dr. Jepson’s specializes in the treatment of complex knee and hip problems, revision surgery, and new procedures for the treatment of arthritis.

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Dr. Theodore Stringer, MD Colorado Springs Orthopaedic Group

Theodore L. Stringer, MD

Dr. Stringer focuses on total joint replacement and arthritis management of the hip and knee.

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Michael Feign, DO

As a Board-Certified Orthopaedic Surgeon, Dr. Feign specializes in the treatment of complex hip and knee injuries, hip and knee arthritis and Total Joint Replacements.

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Total Shoulder Replacement with Dr. Christopher Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group. The video below will cover what a total shoulder replacement is, and when this surgery may be recommended.

What is a Total Shoulder Replacement Surgery?

A total shoulder replacement is when you are replacing the “ball and socket” of the joint with a metal humeral head and a metal-lined socket placed within the shoulder socket also known as the glenoid fossa. This surgery is typically necessary when a patient has a complete breakdown of all the cartilage within their shoulder joint, resulting in a loss of mobility and significant pain. Regaining shoulder mobility, functionality, and eliminating pain are the primary reasons to undergo a total shoulder replacement surgery.

What is the Lifespan of a Total Shoulder Replacement Surgery?

The vast majority of patients who require a total shoulder replacement have a genetic component of arthritis therefore, the younger a patient is when receiving a shoulder replacement, the more likely it is they may need a revision later in life. Current studies show that the average lifespan of a total replacement is approximately 20 years for 85% of patients. As these statistics are based on dated implant technologies, innovative advancements within implant technologies are showing drastic improvements in replacement longevity. Surgeons are hopeful these advancements will increase the lifespan of such implants.

What is the Recovery time of a Total Shoulder Replacement Surgery?

The full recovery time for any shoulder surgery averages around a year and may vary upon the severity of the initial injury and the procedure used to treat such injury. With this, the vast number of patients who have had shoulder surgery notice significantly less pain within six weeks after surgery.

Total Shoulder Replacement Surgery Technology and Innovations

As total shoulder replacement technologies continue to advance, many of the newer implants have a strong focus on bone preservation. In addition to utilizing the latest implants, Colorado Springs Orthopaedic Group also utilizes a groundbreaking innovation tool of three-dimension operative planning. This technology allows the physician to customize the shoulder procedure to the individual patient’s needs on the computer prior to walking into the operating room. To do this, they download the patient’s imaging into the software allowing the physician to place the implants in precise alignment with the bony anatomy allowing the physician to know exactly where to place the implant prior to walking into the operating room. This optimizes the patient’s recovery outcomes and the replacement’s longevity.

Reverse Total Shoulder Replacement Surgery

With Reverse Total Shoulder Replacement Surgery, the physician will swap the ball and socket around. This surgery is completed when the patient does not have a rotator cuff.
Call us at 719-632-7669 to schedule your initial consultation with one of our fellowship-trained, board-certified Orthopedic Shoulder Specialists today!

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

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Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

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Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

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John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

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Cartilage Restoration Procedure With Dr. Jamie Friedman

Welcome to a Medical Minute segment with Dr. Jamie Friedman, Fellowship-trained Orthopedic Sports Medicine physician at the Colorado Springs Orthopaedic Group. Join Dr. Friedman in the video linked below as she discusses cartilage restoration procedures, what specific injuries they can be utilized as a treatment option for, and how they can help delay the need for a total knee replacement for the appropriate patients.

What is cartilage restoration?

Cartilage restoration, also known as Articular Cartilage Restoration, helps the bones articulate or glide smoothly against each other when the natural cartilage has worn or been previously injured. Articular cartilage also provides a shock absorber for the knee joint, especially since it is a weight-bearing joint. Unfortunately, when the cartilage is injured, it does not heal itself because there is not a direct blood supply to it. This can lead to early arthritis if not treated appropriately.

What are some of the symptoms of a cartilage injury?

Cartilage injuries can either occur with a traumatic injury or over time with a repetitive motion such as general wear and tear on the joint. A patient will typically have increased pain or swelling after a particular activity or at the end of an active day. They may also have mechanical symptoms such as painful clicking or catching when they bend or straighten their knee. In very advanced cartilage loss, patients may be severely limited by this pain.

Who is a good candidate for a cartilage restoration procedure?

The best candidate for a cartilage restoration surgery is typically an active young adult. This prevents them from going on and developing early arthritis. These are also patients that have severe pain and likely too young for a partial or total knee replacement.

What are the cartilage restoration procedures that CSOG offers?

There is a wide variety of cartilage restoration procedures that CSOG is able to perform to help with joint pain. Some of the most advanced techniques are arthroscopic or minimally invasive surgery with a small incision near the joint. When the cartilage itself is the only thing involved, the physician will take cells from the patient, or from a donor, send them to a lab, and once the cells are returned, place them over the cartilage defect – kind of like filling in a pothole in the street. This is called Chondrocyte Implantation.

If the bone underneath the cartilage is also affected, then the physician will need to take a plug from the patient or a donor and put that into the defect. This is called Osteochondral Autograft Transplantation.

What is the recovery time for a cartilage restoration procedure?

It depends on what surgery is performed, but in general, the patient will be partially weight-bearing for six to eight weeks while allowing that cartilage to heal. At about two to three months, more range of motion gets added along with strength and balancing activities. It takes about four to six months to get back to a patient’s normal activities. Even though this is a longer recovery period than some of the other surgeries available, it has been shown to be greatly beneficial to eliminate the patient’s pain and save them from an early knee replacement.

To schedule an appointment with Dr. Friedman, call our offices at (719) 632-7669.

Physicians:

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Jammed Fingers & Finger Injuries with Dr. Dale Cassidy

Welcome to a Medical Minute segment with Dr. Dale Cassidy, a Board-Certified Orthopedic Hand physician at the Colorado Springs Orthopaedic Group. The video below will cover jammed fingers & finger injuries that we commonly see from our Colorado Springs clients.

Types of Finger Injuries

Sports injuries, falls, or hitting your finger the wrong way are some of the most common finger injuries seen here at Colorado Springs Orthopaedic Group. These experiences can result in jammed, sprained, or even broken fingers.

Jammed Finger & Finger Injury X-Rays & Treatment

Dr. Cassidy and his team utilize various imagining such as x-rays as the first step in the diagnosis process. Often times a patient may think they have a jammed finger. However, the x-ray images can show a more serious diagnosis. Depending on the severity of the injury it could be treated with a splint or brace. More extreme injuries may result in the need for physical therapy or could even require surgery.

Contact Colorado Springs Orthopaedic Group for Jammed Finger & Finger Injury Treatment

Colorado Springs Orthopaedic Group’s Hand and Nerve Center comprised of our two fellowship-trained board-certified physicians and physician assistants can put help provide a diagnosis and custom treatment options for even the most complex hand and nerve injuries.

Visit www.CSOG.net or call us at 719-632-7669 to schedule your initial consultation today!

Physicians:

Dale Cassidy, MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.
> Dale Cassidy, MD, MBA

Jeffry T. Watson, MD

Dr. Watson’s clinical interests include adult and pediatric conditions of the upper limb, such as arthritic and post-traumatic reconstruction, microvascular surgery, and treatment of complicated fractures.
> Jeffry T. Watson, MD

Physical Therapy Exercises for Hip Pain with Cristin McGetrick

Welcome to a Medical Minute segment with Cristin McGetrick, DPT, CSCS, TSAC-F at the Colorado Springs Orthopaedic Group. Tune into the video linked below as Cristin demonstrates 5 physical therapy exercises for hip pain that can be performed in the comfort of your home.

When the hips are weak, many patients notice a significant decrease in their ability to balance as well as increased pain in their knees and feet. Therefore, when we see this type of weakness, we want to focus primarily on strengthening those hips as they provide stability throughout the entire body.

Contact Colorado Springs Orthopaedic Group for More Information About Physical Therapy Exercises for Hip Pain

To learn more, visit www.csog.net or call us today to schedule your initial evaluation. A referral may be necessary depending upon your insurance coverage.
To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Arthritis Types, Symptoms & Treatments with Dr. Tyler Bron

Welcome to a Medical Minute segment with Dr. Tyler Bron, one of four fellowship-trained Orthopaedic physicians at Colorado Springs Orthopaedic Group. The video below will cover what arthritis is and discuss the different arthritis types, symptoms & treatments available at CSOG.

Arthritis Types: Osteoarthritis vs. Rheumatoid Arthritis

Arthritis comes in several different forms including Osteoarthritis and Rheumatoid arthritis. Osteoarthritis causes the cartilage, that lies between and protects the bones, to break down. Once this cartilage wears down, the bones become exposed to each other causing them to then rub against each other. This rubbing can cause inflammation and send pain signals to the brain. This is contrasted with Rheumatoid arthritis, which is caused by your body’s own immune system degrading the cartilage.

Who does Arthritis affect?

Arthritis can affect those of any gender or age, however, is most commonly seen when people get older. Arthritis, specifically Rheumatoid Arthritis, has a strong genetic component. Osteoarthritis is the most common form of arthritis and is known as “wear and tear arthritis” where previous joint injuries, overuse injuries, or obesity can be the primary cause.

Arthritis Symptoms

The most common symptoms of arthritis include an ache or dull pain that is constant and gets worse throughout the day depending on how active you are. As it progresses, the pain becomes more debilitating. Occasionally, arthritis progresses to the point where individuals are not able to live their desired active lifestyle. We recommend seeing an orthopedic specialist prior to this point.

Arthritis Treatment Options

There are non-surgical treatment options to treat arthritis. At Colorado Springs Orthopaedic Group, our physicians believe that in most cases, non-surgical treatment is the best place to start. Non-surgical interventions include weight loss, activity modification, avoiding high-impact sports activities, physical therapy, and the prescription of anti-inflammatory medications. Depending on the severity of your case, your physician may suggest a steroid injection that acts as an anti-inflammatory treatment. Once a patient has tried the above non-surgical options without experiencing long-lasting relief, then surgery may be a recommended option.

Colorado Springs Orthopaedic Group’s board-certified and fellowship-trained joint physicians can put together a custom-tailored program for both diagnosis and treatment.

Tyler R. Bron, MD

Dr. Bron has completed a fellowship in Adult Reconstruction, specializing in the treatment of arthritic hip and knee conditions.

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Eric K. Jepson, DO

As a board-certified orthopedic surgeon, Dr. Jepson’s specializes in the treatment of complex knee and hip problems, revision surgery, and new procedures for the treatment of arthritis.

VIEW BIO

Theodore L. Stringer, MD

Dr. Stringer focuses on total joint replacement and arthritis management of the hip and knee.

VIEW BIO

Michael Feign, DO

As a Board-Certified Orthopaedic Surgeon, Dr. Feign specializes in the treatment of complex hip and knee injuries, hip and knee arthritis and Total Joint Replacements.

VIEW BIO

Weightlifting After Shoulder Surgery with Matthew Kudron

Welcome to a Medical Minute segment with Matthew Kudron, Physical Therapy Supervisor at the Colorado Springs Orthopaedic Group located off Briargate Parkway. The video below will cover the recommended timeframe and physical therapy needed to return to weightlifting after shoulder surgery.

Common Shoulder Surgeries

Common shoulder surgeries include rotator cuff repairs, labral repairs, and total shoulder replacements. Within these different surgeries, there are different timeframes in which a patient may return to activities such as weightlifting and high-intensity upper body activities. The progression through recovery after shoulder surgery may vary. However, a typical timeframe one can begin increasing their activity intensity, specifically with overhead weightlifting after shoulder surgery, can range between three to six months. We strongly recommend diligently following all physical therapy protocols prescribed by your physician and physical therapist to ensure proper recovery.

Recovery Milestones

Within these protocols prescribed by your physician and physical therapist, there are three main recovery milestones that need to occur before getting into weightlifting after shoulder surgery. The first is tissue healing, the second is achieving full range of motion and the third is building full strength of both the rotator cuff and the muscles that help stabilize the shoulder blade.

Weightlifting Exercises After Shoulder Surgery

Some of the exercises that are generally safe after shoulder surgery include bicep curls, triceps pulldowns, and rotator cuff exercises. However please follow your physical therapist’s instructions prior to attempting any of these exercises. Some exercises to avoid are those exercises where you cannot see your hands, such as a triceps dip exercise, or exercises where your arms are in a position extended away from your body or in a wide-grip position. These exercises may put the shoulder in a vulnerable position as demonstrated in the video above.

Contact Us to Schedule Physical Therapy to Help with Weightlifting After Shoulder Surgery

To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Physical Therapy Pain Management with Danielle White

Welcome to a Medical Minute segment with Danielle White, one of 18 physical therapists at Colorado Springs Orthopaedic Group. The video below will cover how the brain experiences pain and helps one manage such pain through physical therapy pain management.

The definition of pain is an unpleasant sensory or emotional experience. Pain is caused by a stimulus to your tissues and is personalized for everyone. Chronic pain is defined as any pain that lasts for three to six months or more. If you have chronic pain the best thing is to focus on what you can do and not what you can’t. There are four main things to focus on that can help alleviate pain is to:

Educate the nerves
Create good sleep habits
Perform aerobic exercise
Set recovery goals

To learn more about pain management visit one of Colorado Springs Orthopaedic Group’s physical therapists today.

To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Annie’s story: from debilitating pain to enjoying gardening, scuba diving, and hiking again

Dr. Roger Sung is a board-certified and fellowship-trained physician who joined The Spine Center at Colorado Springs Orthopaedic Group in 2007. He believes in ‘making it a priority to provide all his patients with education and individualized treatment so they can return to the activities they love with the least invasive options possible’. Read through the following patient testimonials and watch the video to see how much Dr. Sung’s work is impacting lives throughout Colorado Springs.

Dr. Roger Sung Specializes in:

Cervical & Lumbar Spine Surgery
Minimally Invasive Spine Surgery
Adult Scoliosis/ Degenerative Spine
Artificial Disc Replacement
Lateral Spine Surgery
Spinal Cord Stimulation
Minimally Invasive SI Joint Fusion
Spine Trauma

Here are just a few patients testimonials and what they have to say about their experience with Dr. Sung:

“Dr. Sung did a spinal fusion on my back, because of severe pain in my legs, 6 months ago. I am totally recovered, have no more pain, and can hike, bike and garden again. I am over the top pleased with this outcome! During my recovery, the PA and MA were very helpful in answering questions and adjusting medications. I highly recommend Dr. Sung and his staff.”

“Sung is a straightforward doctor and a very good surgeon. He has my utmost confidence. He’s performed four spinal procedures on me and I would wholeheartedly recommend him.”

“Absolutely blown away by the level of caring and exceptional surgery I had with dr Sung and Colorado Springs Ortho! I felt as though I was the president of the United States with how I was treated by this amazing staff! Lower back fusion and disc replacement…..and I’m not joking when I say the most pain I had was the IV the day before. Don’t be scared or worried at all with Dr. Sung! He is an absolute ROCK STAR in his field and I can’t say enough positive words about him and CoSprings Ortho!”

Our Spine Physicians:

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.
> Roger D. Sung, MD

James M. Bee, MD

Dr. Bee’s interests include the full range of spinal disorders of the cervical, thoracic, and lumbar spine. Scoliosis and the treatment of spine shrinkage and fractures from osteoporosis are a couple examples.
> James M. Bee, MD

Paul Stanton, DO

Dr. Paul Stanton is a board-certified orthopedic surgeon with surgical expertise in all aspects of spinal surgery, including minimally invasive techniques and complex reconstructive techniques for the cervical spine, adult spinal deformity, and degenerative scoliosis.
> Paul Stanton, DO

Spinal Cord Stimulators for Chronic Pain with Dr. Roger Sung

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s Dr. Roger Sung discussing chronic pain management through the use of spinal cord stimulators.

When a patient experiences chronic pain, what is the best option for them?

As every orthopaedic case is unique, if the pain begins to affect daily life we recommend scheduling an appointment with an orthopaedic doctor. With this, we recommend finding a doctor who specializes in the body region where pain is at it’s worst.

After a full evaluation to find the source of your chronic pain, our physicians at Colorado Springs Orthopaedic Group work diligently to create individualized treatment plans for every patient. From there, your physician will continue to adapt that individualized plan to best suit your specific needs as you work through the recovery process.

What is a spinal cord stimulator?

A spinal cord stimulator (SCS) is a battery-operated implant that sits along the spinal cord and aids in alleviating nerve tension by sending mild electronic pulses to the nerves. These pulses interrupt the transmission of pain signals to the brain and have shown great success in alleviating chronic pain.

The surgery for a spinal cord stimulator implant takes approximately one hour when performed in our outpatient surgery center, The Orthopaedic Spine Center of Southern Colorado (OSCSC).

Try before you buy?

The best news with this type of chronic pain treatment is that you can actually trial the stimulator before electing to have the permanent implant placed. This is a one-of-a-kind treatment option in that you and your physician can give the spinal cord stimulator trial implant a test run to see if this treatment will work for you. This trial run is typically between 5-7 days where you will have direct access to a qualified SCS representative who can help you learn the intricacies of the stimulator remote. This representative will be your direct contact if any setting adjustments need to be made moving forward.

How customizable is a spinal cord stimulator?

After meeting with your SCS representative, you are able to fully customize your device, independently choosing the intensity and schedule at which you prefer your device to operate at. With recent technological advancements, these adjustments can be made at the touch of your fingertips by utilizing an application on your phone. Patients will also receive a remote from which they can program their stimulator from as well.

What is the success rate of spinal cord stimulators?

Patients that respond well to this treatment are likely to see at least 50-75% improvement in their pain. These devices can last upwards of 10-25 years, while only requiring battery replacements as needed. Please contact your SCS representative or our office at 719-632-7669 if you are in need of a spinal cord stimulator battery replacement.

How long is the Spinal Cord Stimulator Recovery Time?

The surgical procedures for both trial and permanent stimulator implantations are performed as outpatient surgeries and can be completed within approximately one hour. Patients can expect to recover from the permanent implant procedures within 2-4 weeks. Many noticing significant chronic pain relief just days after surgery. Please note, these timelines will very case by case.

Think Spinal Cord Stimulation might be right for you?

Give us a call at 719-632-7669 to schedule an initial evaluation. Our Spine Center Doctors are ready to help get you back to living how you want to live.

Our Spine Physicians:

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.

James M. Bee, MD

Paul Stanton, DO

Robert Harper, MD

Dr. Robert Harper is a fellowship-trained orthopaedic spine surgeon specializing in cervical, thoracic, lumbar, and sacroiliac joint minimally invasive surgical techniques.

Most Common Mountain Bike Injuries With Dr. Michael Huang

Colorado Springs is known for beautiful mountains, parks, and reserves that are home to miles and miles of amazing trails, which attract mountain bikers from around the world. In this episode of Medical Minutes, we discuss the most common mountain bike injuries Dr. Michael Huang sees each year.

What are some of the most common mountain bike injuries that you see at Colorado Springs Orthopaedic Group?

One of the most common injuries seen at Colorado Springs Orthopaedic Group is clavicle fractures, more commonly known as collar bone fractures. These injuries generally happen when a mountain biker loses control and hits their shoulder after falling forward over their bike’s handlebars. Depending on if the break is well aligned or displaced can create a vast difference in the patient’s treatment plan. If the clavicle break is well aligned, there may not be a need for surgery. However, if the bones are displaced, surgery may be necessary to ensure proper healing.

What is the recovery time for a mountain bike clavicle bone fracture?

The recovery time may vary depending on the location as well as the severity of the fracture. For example, a fracture located in the middle of the collar bone, also known as a mid-shaft fracture, may take anywhere between 3-4 months to heal fully. Treatments plans often include the use of a sling and rehabilitation.

What is an AC Separation caused by mountain biking?

AC Separation, or Acromial Clavicular Joint Separation, is often confused with a Shoulder Dislocation. However, AC Separations occur when the Acromial Clavicular Joint (AC Joint), located at the end of the collar bone, is separated. This injury can cause pain when reaching across the body as well as cause the shoulder to droop. Recovery timelines may vary depending upon the severity of the joint separation.

What is a rotator cuff tear?

The Rotator Cuff encompasses four muscles. These muscles include the subscapularis, supraspinatus, infraspinatus, and teres minor. Tears within the Rotator Cuff tendons that attach these four muscles to the shoulder bones are typically diagnosed through an MRI and are best treated through surgery as tendon tears do not heal on their own.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

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Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

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Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

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The Medial Collateral Ligament (MCL)

MCL vs ACL

ACL or MCL Injury?

Symptoms of an ACL injury differ from an MCL injury by:

1.) How the injury occurred.

2.) Location of the pain.

First, recognize ‘how‘ you injured your knee.

An ACL injury typically occurs with a sudden stop or turn or twist of the knee. ACL injuries are common in start-and-stop sports such as soccer, football, basketball, and skiing.
An MCL injury, in contrast, most often occurs with a hit to the outside of the knee. The impact causes the knee to buckle inward and strains the ligament.

Next, ‘where‘ you feel pain can be evidence of either an ACL or MCL injury. Both ligaments are on the front of the knee however, your anterior cruciate ligament (ACL) sits more towards the middle of your knee. So, you may feel a sharp pain ‘in‘ or ‘below‘ your knee cap. The medial collateral ligament (MCL) runs along the inner side of your leg thus, you will experience pain on the ‘inside‘ of your knee.

With both an ACL or MCL injury, you may hear or feel a ‘popping’ sensation, though ACL injuries traditionally having a more obvious ‘pop’ than MCL injuries.

Also, know that it is possible to injure your MCL and ACL at the same time. In that case, you could experience most or all the above symptoms.

Symptoms

MCL Injury Symptoms

Symptoms of a less severe MCL sprain or tear may include:

Tenderness, aching
Swelling
Stiffness
Bruising

Symptoms of a more severe MCL tear may include:

Significant to unbearable pain
Instability or looseness of the joint
Excessive swelling
Excessive Bruising
Reduced range of motion

Recovery Time

Recovery time depends upon the severity of your MCL injury and whether you have surgery or not:

MCL Injury Recovery (No Surgery)

A mild to moderate MCL injury heals in a few days to several weeks. This is without surgery but is recommended to include rest, self-care such as ice and elevation, bracing or wrapping the knee, and physical therapy.

MCL Injury Recovery (With Surgery)

The sports medicine orthopedic physicians at Colorado Springs Orthopaedic Group believe in exhausting all conservative treatment options prior to discussing surgery. Some of the non-surgical options include physical therapy, cortisone injections, viscosupplementation, or PRP therapy.

If surgery is deemed necessary, then recovery could take four to six weeks after surgery to heal. At that time, you should be able to return to the majority of your normal activities as designated by your physician. However, it may take 6 to 12 months for the injury to heal to full health and integrity. We recommend that you follow your physician’s post-operative recovery and therapy protocols attentively. Once the MCL has fully healed, most experience successful long-term results including a full return to sports.

If you experience pain and stiffness on the inner side of your knee, it may be a medial collateral ligament (MCL) injury. The pain could be mild to severe, and the injury could be the result of an impact that caused the knee to violently bend or twist inward. Many MCL injuries occur during sports or rigorous physical activity. The ligament can also become injured through repeated stress such as running or jumping.

Your MCL (medial collateral ligament) is a thick band of tissue that runs from your thigh (femur) to your shinbone (tibia) about 4-6 inches from the knee. Its job is to keep the leg from bending too far inward. It also works with your ACL and PCL to stabilize your knee and allows rotation.

When strained too much, the ligament can sprain or tear. In some cases, the MCL can heal on its own and not even be that painful. But in severe cases, the pain can be excruciating, and surgery may be required to repair it.

If you suspect an MCL injury, visit our Express Care clinic to be seen the same day or call us at (719) 632-7669 to schedule with one of our Orthopedic sports specialized orthopedic physicians who specialize in MCL injuries to discuss the best treatment options for your specific situation. Contact our office today to schedule a medical consultation at:

CSOG: (719) 632-7669

Express Care- (719) 622-4550

Walk-in Clinic where you will be seen the same day by one of our board-certified Physician Assistants and scheduled with a fellowship-trained physician for a follow-up visit.

Types of MCL Injury

Grade 1: you have a ligament sprain, but not a tear. You likely do not need surgery.
Grade 2: you have a partial ligament tear. You may or may not need surgery.
Grade 3: you have a complete ligament tear. You are more likely to need surgery.

MCL Injury Testing

Assessment of an MCL injury should include:

Physical exam
MRI
X-rays

MCL Injury Home Therapy

Home therapy for an MCL injury may include:

Icing/cold packs
Elevating the leg while resting
Crutches
Knee brace
Anti-inflammatory medication
Specific stretches and therapy exercises

If MCL Injury Requires Surgery:

Generally, surgery is not required for an MCL injury unless it is a Grade 3 injury or does not heal with home care and therapy. You may also need surgery if you have other combined knee complications.

Cost for MCL Injury Surgery

Please contact your insurance carrier to discuss your specific cost estimates. You can reach our office at (719) 632-7669 to further discuss payment options.

Procedures

Surgery might be your best option to repair and/or reconstruct the knee:

MCL Repair

To repair the MCL, your surgeon will identify the torn portion of the ligament and reattach it to itself or the bone where it tore away from.

MCL Reconstruction

To reconstruct the MCL, your surgeon replaces the damaged ligament with a healthy tendon graft which will then become a new ligament.

Your surgeon may use minimally invasive surgery methods to complete your MCL surgery. This allows for faster recovery time and reduces the chance of infection and excessive scarring.

Benefits

The advantages and benefits of MCL surgery include:

Pain reduction
Improved mobility
Faster recovery
Reduced muscle atrophy
High patient satisfaction rates

Risks

The disadvantages and risks of MCL surgery include:

Infection
Scarring
Re-tear of the ligament

Preparing for an MCL Surgery

To prepare for your MCL surgery, your doctor will give you instructions for the following:

Medical Exam: This is to make sure you are healthy enough for surgery. A medical clearance form will need to be filled out before surgery.
Pre-op Appointment: Before surgery, a pre-op appointment will be scheduled to answer any questions you may have and understand the surgery in more detail.
Medications: You may need to stop taking medications and supplements.
Diet: You may need to limit certain foods and drink. You will also likely need to fast before surgery and stop consuming all tobacco products.
Transportation: Arrange to have someone drive you home from the surgery center. This should be a close friend or relative you know well. The vehicle should be easy to get in and out of.
Clothing: Wear comfortable clothing and shoes that are easy to take off and put on.
Home: Prepare your home with safety and comfort features. This may include grab bars, ramps, and furniture to help you rest and move about.

Postoperative Care

What to Expect After MCL Injury

Your postoperative care and instructions may include:

Medications: CSOG will prescribe a variety of medications to help the recovery go smoothly. Remember that most of these medications are as needed.
Knee brace: Most knee arthroscopy procedures don’t require a brace however, if you are required one, it will be placed on you before leaving the operating room.
Control swelling: Elevate your leg and keep using cold compression/ ice packs
Suggested early rehabilitation exercises
Pain and anti-inflammatory medications
Follow up physical exams

MCL Injury Therapy Rehab Exercises

Your physician will tell you when you are ready to return to normal activity. For your rehabilitation, your physician will prescribe specific rehabilitative exercises and stretches. This may include:

Hamstring stretches
Calf stretches
Quadriceps isometric strengthening
Straight leg raises
Ankle flexing and rotations
Knee flexion and sitting knee flexion

With these exercises, you do not need to stand or put weight on the surgery leg. As you progress throughout recovery, your physician will request for you to meet with a physical therapist to carry out your physician-prescribed rehabilitation protocols.

During rehabilitation, your exercises will progress with intensity. Be sure to listen to your body. If an exercise becomes painful, stop.

If You Suffer Pain from an MCL Injury

An MCL injury can heal on its own or with therapy; however, if you still have pain and discomfort after proper rest and at-home treatment, call us at (719) 632-7669 to consult with any one of our Fellowship Trained Knee Specialists to see what treatment options are available to restore pain-free knee function.

o Physical Therapy for the Knee
o Meniscus Repair Therapy
o Hip & Knee Replacement Testimonials

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

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Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

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Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

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Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

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Meniscus Repair Surgery

Symptoms

Localized pain, stiffness, and swelling in the knee are common symptoms of a torn meniscus. The pain may worsen with movement or bending of the joint. You might also feel a ‘catching’ sensation, giving way or buckling, or your knee might feel like it “locks up”. These can all be potential signs of a meniscus tear.

Your doctor will most likely use the following tests to confirm a meniscus tear:

Physical exam
MRI
X-ray
Arthroscopy

Recovery

Typically after a meniscus repair surgery, you can return to non-strenuous everyday activity within a few weeks however, it can take 3 to 6 months to fully recover. At that time, you should be able to return to your active lifestyle.

Of course, your total recovery time will depend upon your health and the severity of the injury. Diligent compliance with your post-operative Physical therapy program will also help reduce the time to full recovery.

Procedures

Meniscus repair surgery is a common and highly successful procedure in the US. There are more than 750,000 orthopedic knee arthroscopy procedures performed each year and it has a better than 90 percent patient satisfaction rate.

The surgery to repair a meniscus tear is primarily arthroscopic or minimally invasive. The surgeon makes small incisions introduce the arthroscope (camera). He or she can then see and do the entire surgery ‘inside’ your leg. This reduces the chance of infection. It also reduces your recovery time. Your surgeon will insert sutures or fixation devices to mend the meniscus tear. Sometimes, the repair will require incisions as well.

Meniscus Tears

What is a meniscus? The knee has a specialized soft tissue structure called a meniscus. It is made mostly of collagen. It sits between the bottom of the femur (thigh bone) and the top of the tibia (shin bone) and acts as a cushion or pad. A torn meniscus is a tear of this specialized structure. Unfortunately, when a meniscus tears, it does not heal due to its poor blood supply. If you have a meniscus tear, depending on the severity of your tear, you may be a candidate for meniscus repair surgery. Meniscus repairs are typically an outpatient surgical procedure that aims to restore the full function of the knee through a variety of minimally invasive techniques. If conservative treatments have been exhausted to heal a meniscus tear, surgery may be the next best treatment to help you return to your active lifestyle.

The meniscus can be injured in various ways; however, the most common occur from rapid turning or twisting or applying high amounts of vertical load (weight) without proper activation of supporting muscles, such as squatting heavy weight without properly warming up or activating the appropriate muscles. Meniscus injuries may result from sudden trauma to the knee or can occur as a result of chronic wear and tear of the joint.

The meniscus tear will not heal on its own; however, the pain and inflammation can and often will decrease on its own with proper rest and cautious exercise. If you’re still experiencing pain after taking proper precautions, it’s recommended to speak with your orthopedic physician. A torn meniscus needs immediate care when the knee “locks” or isn’t able to complexly bend or straighten. Contact our office today to schedule an initial consultation and learn if meniscus repair surgery is right for you:

Call (719) 632-7669

Meniscectomy vs. Meniscus Repair

Meniscectomy is another surgical treatment for injured meniscus. Rather than ‘repair,” the surgeon fully or partially ‘removes‘ or ‘trims‘ the meniscus. This is typically performed when the torn portion of the meniscus is small, or the tear pattern will not benefit from “repair” stitches. Remember that the majority of the meniscus does not have a blood supply, so its ability to heal is severely diminished.

A meniscectomy may be your best treatment option if:

The meniscus has significantly deteriorated tissue
Parts of the meniscus are almost completely torn already

Types of Meniscus Repair

There are four basic types of meniscus repair:

Open technique
Inside-out technique
Outside-in technique
All-inside technique

The technique used will depend upon the severity and location of the meniscus tear.

What Types of Meniscus Repair Require Surgery?

You will likely need surgery to repair your meniscus if:

You have multiple tears
Your knee is ‘locked up’
You have advanced tissue deterioration
You have also damaged the MCL

What Is The Meniscus Tear Recovery Time Without Surgery?

You may recover from a meniscus tear without surgery within 4 to 8 weeks. Recovery times will vary upon your health, resting appropriately, and the severity of your injury.

Treatments

Surgery is just one treatment option to repair a torn meniscus. Other treatment options include:

Exercise and physical therapy
Anti-inflammatory medications
Joint aspiration and injection
Knee braces

Benefits

The benefits and advantages of meniscus repair surgery include:

Faster recovery
Pain reduction
Restored function and mobility of the knee
Mitigates further degeneration of the knee

Risks

The risks and disadvantages of meniscus repair surgery include:

Anesthesia
Infection
Scarring
Further medical complications and pain
Re-tear of the meniscus

Preparing for Meniscus Repair Surgery

Preparation for your meniscus repair surgery includes:

Medications: You may be required to stop taking specific medicines and supplements prior to surgery. Cutting down or stopping smoking will decrease the risk of infection and blood clots and improve healing.
Diet: Your physician may recommend a weight loss program and you will likely be required to fast for several hours before surgery.
Transportation: be sure to arrange your post-surgery transportation plan prior to surgery day.
Home: we also recommend making home arrangements for the first several days post-surgery since mobility will be impaired.

Post-Operative Care

What to Expect After Meniscus Repair

You may or may not have a hospital stay after your surgery. Your doctor will give you post-operative care instructions. This may include:

Wound and bandage cleaning
Pain and anti-inflammatory medications
Diet and supplements
Therapy and exercises

You will also need a follow-up appointment to check progress and remove sutures. Contact your doctor immediately if you experience increased pain or other medical problems.

Physical Therapy Post Meniscus Repair

Your doctor will likely refer you to a physical therapist for post-surgery rehabilitation. Dependent upon your knee and overall health, your physical therapy program may last several weeks to a year.

Physical therapy aims to safely restore knee strength and mobility. Physical therapists receive special movement training to best provide you with exercises and stretches and work directly with your physicians to ensure you receive the best overall treatment. To help you recover from your meniscus repair surgery, CSOG offers on-site physical and occupational therapy.

Cost of Meniscus Repair Surgery

Please contact your insurance provider to discuss coverage details.

To make an appointment at our North Campus location call. (719) 867-7320

To make an appointment at our South Campus location call. (719) 622-4524

Our Orthopaedic Doctors

At Colorado Springs Orthopaedic Group, you have access to top knee repair surgeons. Our doctors are board-certified and committed to delivering the highest quality of care.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Is a Meniscus Repair Surgery Right for You?

Surgery is a significant medical treatment option, and it is not for everyone. Call our office to schedule a consultation and learn if meniscus repair surgery is right for you.

o Physical Therapy for the Knee
o MCL Repair Surgery
o Hip & Knee Replacement Testimonials

xvision™ with Dr. Roger Sung

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s Dr. Roger Sung as we discuss xvision™ Spine System and using augmented reality in the operating room.

What is xvision™ Spine System?

xvision™ Spine System provides surgeons the ability to see the patient’s anatomy in real-time through the use of an augmented reality headset. This technology allows surgeons the ability to perform complex surgeries with increased accuracy and speed.

How is the xvision™ Spine System Utilized?

At Colorado Springs Orthopaedic Group, the xvision™ Spine System is currently used during spinal fusions, Scoliosis, and Kyphosis procedures. We anticipate seeing augmented reality surgery systems becoming available for additional spine procedures and subspecialties in the foreseeable future.

How Does xvision™ Spine System’s Augmented Reality Technology Improve the Outcome for the Patient?

xvision™ allows surgeons to perform one- and two-layer spine fusions as outpatient surgeries, so many patients are able to go home the same day as surgery. When in the operating room, xvision™ provides surgeons the ability to work within smaller incisions, which helps lessen the damage to any surrounding musculature. Less damage to the surrounding musculature allows for a much quicker recovery time. Typical recovery time for procedures such as a lumbar fusion can vary. However through the use of xvision™, patients can return to their daily much quicker than with traditional lumbar fusion methods.

“At the risk of sounding too positive, [recovery] has been just outstanding. The day after surgery, my leg pain was gone and it hasn’t been back.” – xvision™ patient of Dr. Sung’s

The Spine Center Physician

LEARN MORE ABOUT DR. SUNG

Minimally Invasive Spine Surgery with Dr. Paul Stanton

Welcome to a Medical Minute segment with Dr. Paul Stanton, Orthopaedic Spine Surgeon at Colorado Springs Orthopaedic Group as he discusses minimally invasive spine surgery for Anterior and Posterior Lumbar Fusions.

What is the difference between Anterior and Posterior Lumbar Fusions?

There are multiple avenues in which a surgeon can perform lumbar spine surgery. Which procedure type is to be utilized is dependent on:

the type of procedure being done
complexity of the case
the patients current health status
the patient’s surgical history

These factors also help the surgeon determine which angle (anterior, posterior, lateral, etc.) to utilize during the procedure as well.

What is Minimally Invasive Spine Surgery?

The goal of any minimally invasive surgery is to achieve the best possible outcome with the least amount of damage to the surrounding musculature. Preserving the surrounding musculature is key to optimizing a patient’s recovery, and getting them back to their normal range of function. Minimally Invasive Surgical techniques, help us achieve this function in an accelerated and less invasive manner.

What type of injuries is an Anterior or Posterior Lumbar Fusion commonly used for?

Anterior and Posterior surgery methods can be used for many cases including spinal instability, spinal deformity, collapse, fractures, and trauma.

The spine physicians at Colorado Springs Orthopaedic Group believe in customizing treatment plans specific to each patient and their individual case. For those appropriate candidates, conservative care options such as physical therapy, manipulation, or injections may be recommended. In the event a patient has exhausted conservative treatment options, with little to no progress in pain relief, then surgery may be needed to help achieve full recovery.

What is the Average Recovery Time for an Anterior and Posterior Lumbar Fusion?

Recovery time varies depending on each case, however the recovery time for lumbar reconstruction, using minimally invasive techniques, averages a few months to a year. These timelines are estimated to achieve full recovery. With most minimally invasive spine surgery, Anterior and Posterior Lumbar Fusions specifically, patients will often be required get up and walk around on the day of surgery. This reduces the chance for complications that can arise from immobility post-surgery.

What is the Average Hospital Stay after a Minimally Invasive Anterior and Posterior Lumbar Fusion?

It is typical for this surgery to require a hospital stay of one to two nights. This is significantly less than more invasive surgery techniques which typically require between 5-7 days in the hospital.

How does Recovery Differ Between Traditional Open Spine Surgery and Minimally Invasive Spine Surgery?

There is a significant difference in the recovery experience between minimally invasive surgery and traditional surgery methods. Because minimally invasive surgery techniques reduce the damage of the surrounding musculatures, patients can return to normal function much quicker than patients that undergo traditional open surgery methods.

What Age Range can Undergo Anterior or Posterior Lumbar Fusion Surgery?

Minimally invasive anterior and posterior surgery techniques can be used for individuals of any age. There are a few exceptions depending on a patient’s prior surgical history however, most can benefit from a minimally invasive surgery techniques.

What do your patients say after receiving this type of surgery?

Patients are incredibly excited to get back to their daily routines and be pain free again. Check out Annie’s story and her experience with the CSOG Spine Center here.

Call us today at 719-632-7669 to schedule your appointment with one of the Physicians at Colorado Springs Orthopaedic Group! Visit us at www.csog.net to learn more.

The Spine Center Physicians

Paul Stanton, DO

Dr. Paul Stanton is a board-certified orthopedic surgeon with surgical expertise in all aspects of spinal surgery. Some of his most commonly utilized techniques include minimally invasive techniques and complex reconstructive techniques. These techniques are used often to help those with conditions of the cervical spine, adult spinal deformity, and degenerative scoliosis.

James M. Bee, MD

Dr. Bee’s interests include the full range of spinal disorders of the cervical, thoracic, and lumbar spine.

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.

Robert Harper, MD

Dr Harper is a fellowship-trained orthopaedic spine surgeon specializing in cervical, thoracic, lumbar, and sacroiliac joint minimally invasive surgical techniques.

Physical Therapy for The Knee

Knee Pain and Common Knee Injuries

There are numerous reasons why you might be experiencing knee pain such as an acute traumatic injury, degenerative disease such as Osteoarthritis or Rheumatoid Arthritis, or natural deterioration of muscle, bone, nerves, and connective tissue. Other common reasons you may benefit from physical therapy for the knee include:

Knee surgery or replacement Post-Operative Rehabilitation
Runner’s knee
Knee sprain
Dislocated knee
Knee bursitis
Above-knee amputation
Torn meniscus
Knock knees or bow-legged knees
Muscular Imbalance Corrective Exercise
Knee arthritis

How Long Is Physical Therapy?

How Long Does Physical Therapy Take?

Depending on the severity of an injury, most patients can recover and return to normal activities within a few weeks to a few months when compliant with their prescribed recovery plan. The total length and frequency of your sessions will depend upon the severity of your injury. However, most range from one to three days per week, anywhere between 45 to 60 minutes per session.

Physical Therapy Cost

Relative to surgical treatments, physical therapy is much less expensive. Depending on the medical necessity deemed by your insurance provider in conjunction with a recommendation from your initial Physical Therapy evaluation and/or an orthopedic physician referral, a typical patient may only need upwards of 10 to 20 treatments in total.

Physical Therapy Costs with Insurance

Fortunately, most insurances cover the cost of medically necessary physical therapy treatment however, you may be required to pay a deductible or copay with each visit. Contact your insurance provider to discuss physical therapy out-of-pocket costs associated with your benefit plan. Depending on your insurance cost, some practices offer a cash pay rate that may be an alternative option as well. Call us at 719-632-7669 for more information.

Physical Therapy Costs without Insurance

Out-of-pocket costs depend on your physical therapy plan however, some practices offer a cash pay rate that may be an alternative option. Call us at 719-632-7669 to discuss self-pay options.

Musculoskeletal and Joint pain typically stem from either a lack of strength or lack of mobility within a joint and its surrounding structures. These structures can include your skeletal muscles, tendons, and ligaments. Physical Therapy is one of, if not the most recommended conservative treatments by orthopedic physicians and aims to restore full function from various conditions and injuries. Through proper evaluation and exercise prescription by a licensed physical therapist, you could be back to living your pain-free life within a few weeks or a few months depending on the severity of your pain.

Call (719) 632-7669 to schedule a consultation with one of our physical therapists today or visit us at Colorado Springs Orthopaedic Group.

Types of Physical Therapy Exercises for Knee

The following physical therapy exercises for knee pain are just some of the exercises that can help strengthen the knee after experiencing an injury or surgical procedure. During your first Physical Therapy visit, your Physical Therapist will prescribe additional exercises to address your specific symptoms.

Warmup:

Walk or bike for 5 to 10 minutes.
Raise your knee and grab it with your hands. Hug your knee towards you and balance in place for 10 to 20 seconds on each leg. Repeat 3 to 4 times with each leg.
Do 5 to 10 bodyweight squats to a pain free depth or depth designated by your physical therapy protocols. During each bend, think about pushing the floor away from you through with your weight evenly distributed between your heels and your toes. Use supportive assistance as needed.

Wall Squats:

Stand with your back to a smooth wall and your feet set just slightly in front of you. Cross your arms or have your hands on your hips. Next, slowly bend your knees allowing your upper body to lower down the wall in a controlled and stabilized manner. If you need to, hold on to a chair placed either in front or to one side of you for balance.
Lower yourself until your knees are bent at a 90-degree angle or at an angle prescribed by your physical therapist. A few notes to keep in mind:
- Try not bend your knees further than 90 degrees and prevent your your knees from going over your toes.
- Keep your feet flat to the ground and your weight evenly distributed between your heels and toes.
- Try not to lift your heels or toes as you squat down.
- Keep your head in a neutral position looking straight in front of you.
- It might help to have a mirror in front of you to watch your form as you perform the exercise.
Hold the squat for 3 to 5 seconds, then push evenly through your feet to stand back up. Immediately stop the exercise if you experience any sharp pains that escalate over a 3 out of 10 on the pain scale or pain that lingers after you perform the exercise.
- You should experience a slight burn in your quadricep, hamstring, and glute muscles. You may experience some mild pain in your knee with these. So long as it is not above a 3 out of 10 on the pain scale and the pain does not linger afterward, some discomfort is ok.
Repeat for 2 to 3 sets, 5 to 10 reps each set or as prescribed by your physical therapist.

Additional Wall Squat Tips:

The goal is to see an increase in strength and exercise endurance over a period of time, this is also referred to as progressive overload. A modification for this exercise would be to place a stability ball between your back and the wall and carefully squat down while keeping tension on the ball. This modification will allow for greater range of motion and add fluidity to the movement for those learning initial squat mechanics.

Lateral Walks:

With a small resistance band placed just above your ankles, stand with your feet shoulder-width apart. Place your hands on your hips as you keep your head in a neutral position looking straight ahead.
Keeping your legs straight with just a slight bend in your knees, press your knees slightly outwards to put tension on the band and activate your gluteal muscles. Now, take a step to your left to create additional tension on the band. Now, move your right foot in towards the left so that your feet are once again shoulder width apart and the band is stretched to a moderate tension. We want to keep constant tension on the band and your glutes engaged throughout the entire movement.
The resistance band should make it a bit difficult to take the step. If it is too tight, lengthen the resistance band or move to a band with less tension. If it is too easy, shorten the resistance band between your feet or move to a band with higher tension. Hold on to a chair if you are having trouble balancing. It might also help to have a wall mirror in front of you to watch your form as you perform the exercise.
Repeat 5 to 10 times stepping in the same direction, pause and then repeat going the opposite direction, i.e., leading with the right foot to return to your starting position.
You will feel this movement primarily in your gluteal region which will help strengthen the muscles that help you move side to side. Immediately stop the exercise if you feel any sharp pain above a 3 out of 10 on the pain scale or if the pain lingers after you perform the exercise.

As you become stronger, aim to increase the tension on the restriction band.

What to Expect at Your First Physical Therapy Session

Your first visit to any physical therapy clinic will include an evaluation of your injury condition. PTs are also trained to assess the cause of your pain, not just in the treatment of symptoms.

Before your first visit, it might be beneficial to create a list of questions that you would like to discuss with your PT. We also recommend informing your PT of any past medical history, previous treatments, and current medications during your initial evaluation. If you are scheduled to be seen with one of our highly trained physical therapists here at Colorado Springs Orthopaedic Group, please complete your patient intake form found of our website www.csog.net prior to your initial appointment.

During your first visit, your PT may perform tests and certain movements to determine your condition as well as ask detailed questions about your mobility, current movement and activity restrictions, and your level of pain associated with such movements or activities. From there, they will discuss a recommended treatment plan specific to your injury, pain, and associated symptoms.

Benefits

The primary benefits of physical therapy to treat knee issues can include:

Faster recovery
Safer recovery
Less expensive
High patient satisfaction rates
Eliminates or reduces the need for surgery.
Eliminates or reduces the need for medications.
Promotes muscle strengthening that can carry over into your daily life and hopefully promote life-long exercise and activity habits.

Patient Advantages

Much to the patient’s advantage, Colorado is a Direct Access state, which means you can see a physical therapist for the first line of care without a doctor’s referral. However, some insurances require an insurance authorization or physician referral prior to seeing a physical therapist. Contact your insurance provider to discuss your benefit requirements and procedures.

For those patients who are referred to Physical Therapy by an orthopedic physician post-surgery, diligent compliance with your physical therapy plan will be crucial to optimizing your post-operative recovery. Repair or Reconstruction procedures addressing the MCL, ACL, PCL, LCL or Meniscus are just some of the types of procedures performed on the knee that will require post-operative rehabilitation.

Specialized Care

Physical therapists (or PTs) are movement specialists trained in kinesiology and have their Doctoral Degree in Physical Therapy education. This education is also known as a Doctorate in Physical Therapy (DPT). These specialists are trained to diagnose an injury based on specific evaluation criteria and will prescribe strength and mobility treatment plans as applicable to each case. They are also trained to know when physical therapy is not your best treatment option. In the event your pain cannot be treated by way of physical therapy, you may be referred to an orthopedic physician for proper diagnosis and to discuss further treatment options.

Our Physical & Occupational Therapists

At Colorado Springs Orthopaedic Group, we work with some of the most highly trained and highly skilled physical therapists. Contact our office at 719-632-7669 to schedule an appointment with either our north or south physical therapy locations.

North Location

4110 Briargate Parkway, Suite 145,

Colorado Springs, CO 80920

(719) 867-7320

South Location

1259 Lake Plaza Drive, Suite 100,

Colorado Springs, CO 80906

(719) 622-4524

Woman walking with crutches during physiotherapy

Is Physical Therapy Right for You?

If you are tired of living in pain, let us help! Physical therapy for the knee is one of the common treatment options available at Colorado Springs Orthopaedic Group.

o Minimally Invasive Surgery
o Top Docs of Colorado Springs
o Doctors With X-Ray Vision Technology

Hip Labral Reconstruction: “Pull-Through” Technique

There is a new hip labral reconstruction technique, developed by Colorado Springs Orthopaedic Group’s Sports Medicine expert, Michael J. Huang, MD. that is revolutionizing the field of sports medicine. Learn more about his new “pull-through” technique and how it is being used to treat sports injuries.

New Hip Labral Reconstruction Technique leads to increased accuracy and efficiency

Pioneered by Dr. Michael Huang of Colorado Springs Orthopaedic Group, a new “pull-through” technique for Arthroscopic Labral Reconstruction in the hip has been shown to lead to better outcomes in hip preservation due to the more efficient use of the graft. Alternative Arthroscopic techniques require the surgeon to manipulate the surgical graft significantly, leaving the graft vulnerable to fraying. With this innovative “pull-through” technique, there is minimal manipulation of the surgical graft, eliminating the potential for fraying and providing additional longevity to the procedure.

Further, Nakashima et al. reported significant improvements in postoperative outcomes for patients who underwent this modified technique after two years post-surgery. In addition to this, Domb et al. found significant improvements to patient outcomes five years after surgery if they underwent this modified technique.

To read the full article, please see below:
Pull Through Technique.PDF

Michael J. Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

> Michael J. Huang, MD

MRI Scan With Colorado Orthopaedic Group’s Lead MRI Technician

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s lead MRI technologist, Adolfo Trevino. In this segment, we will discuss what to expect during an MRI scan.

What is an MRI Tesla?

An MRI Tesla is the strength rating for the magnet that is within the MRI Machine. At Colorado Springs Orthopedic Group, our magnet strength rates at a 1.5 Tesla, which is the industry standard for MRI scans.

What can you expect when receiving an MRI Scan?

At Colorado Springs Orthopedic Group, you can rest easy knowing that we will make you feel comfortable during your MRI experience. Each patient is provided with a button that allows you to communicate with your MRI Technician at any point during your MRI scan. Your technician will also check in with you frequently to make sure you are doing well, check if you need a quick break, or answer any questions you may have throughout the session.

Why is it important to tell your MRI technician if you have any metal implants?

For your own health and safety, it is crucial to disclose any metal implants you have to your technician prior to entering the machine as any MRI machine uses high-powered magnets to take the imaging. With this, certain metals can pose a safety concern if not disclosed and addressed prior to your MRI session.

What is a C-Arm?

A C-Arm is an x-ray machine that is used by certified health professionals to help increase accuracy when administering injection therapies to the appropriate patients.

Why chose Colorado Springs Orthopedic Group to perform your next MRI Scan?

Most patients can expect to receive their MRI results within 1-2 business days when seen at Colorado Springs Orthopedic Group. Our mission is to ensure every patient is provided with the highest quality imaging quickly and efficiently.

Hours: 6:00 am – 8:00 pm Mon.- Sat.
MRI Direct Phone: (719) 867-7315
Direct Fax: (719) 633-9912
Email: [email protected]

Cubital Tunnel Syndrome Symptoms & Treatment with Dr. Jeffry T. Watson

Welcome to a Medical Minute segment with Dr. Jeffry Watson, Orthopaedic Hand Surgeon at Colorado Springs Orthopaedic Group as he discusses Cubital Tunnel Syndrome and the treatment options available.

What is the difference between Cubital Tunnel Syndrome and Carpal Tunnel Syndrome?

Both Cubital Tunnel Syndrome and Carpal Tunnel Syndrome involve nerve compression. Carpal Tunnel Syndrome is median nerve compression and can occur where the median nerve goes through the ‘Carpal Tunnel’ in the wrist. Cubital Tunnel Syndrome is when the ulnar nerve—commonly known as the “funny bone”—is compressed. The ulnar nerve is one of the three main nerves in your arm and can be constricted in many places between your neck to your hand. However, the most commonplace for nerve compression is by your elbow. Pressure on the ulnar nerve causes symptoms of numbness, and tingling in the hand, specifically on the pinky and part of the ring finger. Other symptoms including aching and a weak grip.

What are the treatment options for Cubital Tunnel Syndrome?

Often, there is not a specific cause of Cubital Tunnel Syndrome and many patients will develop it naturally. Patients can develop symptoms from sleeping with their elbows flexed. Often Cubital Tunnel Syndrome can go away with the conservative treatment option of wearing a night splint. However, if a patient is getting and staying numb or having any muscle changes, then surgery may be required to relieve the pressure on the nerve.

What surgery options are available for Cubital Tunnel syndrome?

Ulnar nerve decompression (also known as ulnar nerve transposition) is a surgical treatment option for Cubital Tunnel Syndrome. This surgery relieves the pressure on the ulnar nerve. To do this, an incision is made on the backside of your elbow and the nerve is moved from the back to the front of your elbow. This new nerve placement takes the external compression and tension off the nerve and allows for better local blood flow to the nerve.

What is the recovery time for an ulnar nerve decompression?

After ulnar nerve decompression surgery, a patient may have some swelling, soreness, and bruising around the elbow that may limit the movement and use of the arm. A patient will be able to perform basic daily household activities such as cooking or getting dressed but will be limited from performing any strenuous activities for about a month after surgery. This includes any activities that involve vigorous pushing, pulling, or throwing.

What happens if you do not treat Cubital Tunnel Syndrome?

If a patient does not treat Cubital Tunnel Syndrome and the nerve is under enough pressure for a long period, it can undergo scarring on the inside of the nerve. This can cause long-term numbness or can weaken the muscles in the hand that the nerve controls. If too much time has passed, even with surgical treatment to remove the pressure, the numbness may not go away, therefore we recommend seeking professional advise sooner rather than later.

Our Hand & Upper Extremity Physicians

Jeffry T. Watson MD

> Jeffry T. Watson

Dale Cassidy
MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.

>Dale Cassidy, MD, MBA

How to fit and use Crutches, Canes, and Walkers

Welcome to another Medical Minute segment. Here, Haeleigh Little, a certified orthotic fitter from Colorado Springs Orthopaedic Group reviews how to properly fit and use crutches, canes, and walkers.

WHAT IS THE #1 THING PATIENTS STRUGGLE WITH WHEN FITTING WALKING ASSISTANCE DEVICES?

The number one thing patients struggle with is getting the height correct. The height for all of these devices will depend on body type. Most crutches will have markers that will allow for adjustments, but each body is different. Fit can change depending on each individual’s body length, leg length, and arm length.

WHAT HAPPENS IF ANY PIECE OF EQUIPMENT IS NOT FITTED PROPERLY?

If a piece of equipment is not fitted properly, then the ultimate concern is the risk of injury. If the crutch or cane is not properly fitted to a patient’s particular height, you risk injury to the shoulders, elbows, and wrists because you are now relying on those parts of the body to walk.

HOW TO FIT CRUTCHES

Typically, you will want your crutches to sit approximately two or three finger widths below the armpit. If the crutches are too short, you can risk putting excessive pressure on internal structures and muscles within the armpit. Next, you will want to ensure the crutch allows for a slight bend in the elbow, that way in the case of a fall, you do not hyperextend your arm, potentially causing injury.

HOW TO FIT CANES AND WALKERS

When fitting a cane, hold your arm down at your side, the top of the cane should hit at your wrist. You can do the same for measuring walkers, however you will want it to hit a bit above your wrist to compensate for slight bend your elbows as you walk with the device.

ANY OTHER TIPS?

The biggest tip we recommend for all patients to follow is: go slow, listen to your body, and be aware of your surroundings when using any form of walking assistance equipment.

HOW CAN SOMEONE SCHEDULE AN APPOINTMENT?

To schedule an appointment, please call the office at 719-632-7669. Colorado Springs Orthopaedic Group does require a prescription for walking assistance devices so you will want to make sure you have talked to either your orthopedic physician or family physician prior to scheduling your appointment.
With these tips, you can safely fit crutches, canes, and walkers, and be on the path toward healing.

Physicians

Eric K Jepson, DO

As a board-certified orthopedic surgeon, Dr. Jepson’s specializes in the treatment of complex knee and hip problems, revision surgery, and new procedures for the treatment of arthritis.

> Eric K Jepson, DO

Tyler R. Bron, MD

Dr. Bron has completed a fellowship in Adult Reconstruction, specializing in the treatment of arthritic hip and knee conditions.

>Tyler R. Bron, MD

Theodore L. Stringer, MD

Dr. Stringer focuses on total joint replacement and arthritis management of the hip and knee.

>Theodore L. Stringer, MD

All About Arthritis with Dr. Jepson

Welcome to a Medical Minute segment with Dr. Eric Jepson, a fellowship-trained Joint Replacement physician at the Colorado Springs Orthopaedic Group.

The video below will cover what arthritis is, particularly arthritis in the knee, the symptoms, and treatment options available.

What is arthritis in the knee?

Arthritis in the knee is when the cartilage in the knee wears down. This lack of padding causes the primary symptom, which is pain within the joint. Over time this affects the alignment and mechanics of your joints, as well as your range of motion.

How does arthritis of the knee differ from other parts of the body?

The biggest difference between arthritis in the knee versus other parts of the body is that the knee is a weight-bearing joint. This pain in the knee impacts people performing day-to-day activities. When arthritis starts to impact someone’s daily activities, that is when they usually call the experts at Colorado Springs Orthopaedic Group to find out what their options are.

How do you treat arthritis in the knee?

Dr. Jepson’s philosophy for arthritis is to start with conservative treatment options first. Conservative treatment options include activity modification, physical therapy, cortisone or gel injections, or the use of anti-inflammatory and over-the-counter medications. While these conservative treatments do not treat the underlining condition of arthritis, they change the symptoms and help avoid having to go on to surgical treatment.

The last treatment option for arthritis in the knee is knee replacement surgery. Knee replacement surgery is often very successful and predictable; however, it is still surgery, so Dr. Jepson uses this as the last treatment option.

How do you determine which procedure to use for knee arthritis?

Dr. Jepson determines which procedure and treatment options are right for each patient after consulting with them. Treatment options often depend on how much they impact the patient’s quality of life. Dr. Jepson utilizes conservative methods first, such as physical therapy, or even simple steps such as encouraging and maintaining an ideal body weight. If these simple, conservative options are not helping, then Dr. Jepson will try injections or anti-inflammatory medications as the next step and progress along the treatment cascade from there.

What is the average recovery time for knee replacement surgery?

Knee replacement surgeries are incredibly predictable procedures that have improved greatly over the last ten years. Typically, the patients can stay in the hospital or surgery center overnight; however, now offered through Colorado Springs Orthopaedic Group, many can now go home the same day as surgery! After surgery, patients are up and moving right away. The physicians at Colorado Springs Orthopaedic Group get patients involved in physical therapy immediately after a knee replacement surgery, and after two weeks patients can expect to be able to tell a significant difference from before the surgery. By six weeks, Dr. Jepson expects that patients are starting to return to normal activities.

What is the average recovery time for partial knee replacement surgery?

To perform a partial knee replacement surgery, a patient must have arthritis in only one part of the knee. If a patient has this particular unique circumstance, then a partial knee replacement surgery is an excellent procedure. For most patients, a partial knee replacement surgery has a quicker recovery time and is less invasive.

Colorado Springs Orthopaedic Group’s fellowship-trained joint replacement physicians can put together a custom-tailored program for both diagnosis and treatment. Call to schedule an appointment today at 719-632-7669.

Tyler R. Bron, MD

Dr. Bron has completed a fellowship in Adult Reconstruction, specializing in the treatment of arthritic hip and knee conditions.

VIEW BIO

Eric K. Jepson, DO

As a board-certified orthopedic surgeon, Dr. Jepson’s specializes in the treatment of complex knee and hip problems, revision surgery, and new procedures for the treatment of arthritis.

VIEW BIO

Theodore L. Stringer, MD

Dr. Stringer focuses on total joint replacement and arthritis management of the hip and knee.

VIEW BIO

Carpal Tunnel Syndrome
with Dr. Watson

Welcome to a Medical Minute segment with Dr. Jeffry Watson, Orthopaedic Hand Surgeon at Colorado Springs Orthopaedic Group as he discusses Carpal Tunnel Syndrome and the treatment options available.

Carpal tunnel syndrome is when the median nerve is compressed and is one of the most common injuries the hand physicians at Colorado Springs Orthopaedic Group see. The median nerve goes through a passage in your wrist called the ‘Carpal Tunnel’ to give the medial half of your ring finger, your thumb, index and middle fingers the ability to move. The carpal tunnel also controls most of your thumb muscles.

Often there is not a specific cause of carpal tunnel syndrome and many patients will develop it naturally, however, in some instances, it may be the result of a traumatic injury. When swelling occurs on the median nerve, it results in less blood flow to that area. The oxygen deprivation causes symptoms such as numbness or painful tingling primarily in those three aforementioned fingers. The symptoms can worsen at night when most people sleep with their wrist in a flexed position, which puts pressure on the median nerve.

Initial conservative at-home treatment options include wearing a carpal tunnel splint at night, making sure that it is worn tight enough that your wrist doesn’t flex as you sleep but still allows for proper blood flow to the wrist and hand structures. If after diligent compliance with conservative treatment options, you still notice symptoms, we recommend seeing one of our Fellowship-trained Orthopaedic Hand Physicians at Colorado Springs Orthopaedic Group to discuss additional conservative and operative treatment options.

Our Hand & Upper Extremity Physicians

Jeffry T. Watson MD

>Jeffry T. Watson

Dale Cassidy
MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.

>Dale Cassidy, MD, MBA

Hip and Knee Replacement Testimonials

Get back to doing the things you enjoy and find out if a hip or knee replacement is right for you with Colorado Springs Orthopaedic Physician, Dr. Tyler Bron. Dr. Bron specializes in complex hip and knee replacement surgery. He is one of the few surgeons in Colorado who uses the Mako Robotic Arm to assist in total knee replacements which allows him to be more precise in preparing existing bones and placing the implants.

Dr. Bron strives to be available to his patients to provide as much information as needed to ensure they are comfortable with any decisions made regarding treatment. As a general principle, he believes in conservative measures when appropriate and proceed to surgery only when necessary.

Dr. Bron believes that life is too short to live in pain and shares that “advances in surgical procedures for both hip and knee replacements can get you up on your feet and enjoying life”. Here are just a few of his patients and what they have to say about their experience.

Our Featured Knee and Hip Replacement Doctor

Dr. Tyler R. Bron, MD

Fellowship
Adult Reconstruction Fellowship, University of Colorado, Aurora, CO
Residency
Orthopedic Surgery, University of Kansas, Wichita, KS
Medical School
University of Kansas School of Medicine, Kansas City, KS
Undergraduate
BS Biochemistry, University of Kansas, Lawrence, KS
Visit Dr.Bron’s page

Medical Minute: Sacroiliac (Si) Joint With Dr. Paul Stanton

Welcome to a Medical Minute segment with Dr. Paul Stanton from the Colorado Springs Orthopaedic Group. The video below will cover what the Sacroiliac (Si) Joint is, how you can diagnosis an SI Joint disorder and the treatment options available.

The SI joint is the joint that links the spine and the pelvis. Pain in this area can often be difficult to diagnose and most patients have a difficult time locating exactly what joint is giving them trouble – whether it is the hip, back, or the Sacroiliac (Si) Joint. If you are not able to find pain relief through conservative treatments at home, we recommend visiting one of our spine surgeons at Colorado Springs Orthopaedic Group to properly diagnose your condition through physical examination, imagining, injury history assessment and diagnostic injections.

Treatment options for the Sacroiliac (Si) Joint will vary dependent on the severity of your case however may include, physical therapy, injections, pain management, or manual manipulation. If those options fail and do not provide long-lasting relief, then surgery may be the recommended option.

Colorado Springs Orthopaedic Group’s board-certified spine surgeons will put together a customized program specific for your diagnosis and recommended treatment.

Our Spine Physicians

Paul Stanton, DO

> Paul Stanton, DO

James M. Bee, MD

> James M. Bee, MD

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery. He also performs complex spine reconstruction via minimally invasive techniques.

> Roger D. Sung, MD

Hand Surgery in Colorado Springs

Hand surgery may be recommended for an injury, deficiency, or ailment that causes frequent pain, limited range of motion, loss of feeling, or deformation. The condition may affect your fingers, hand, wrist, and forearm. As a result, even basic life tasks may become difficult. It can be challenging to eat, dress, exercise, lift objects, or you may simply dislike how your hands look.

Hand surgery may be an optimal solution for damaged or infected tendons, muscles, nerves, or bones, especially if therapy and medications are not enough. Thankfully, hand surgery is a successful and safe procedure with high satisfaction rates that aims to permanently restore hand, finger, wrist function, and appearance.

Call (719) 632-7669 to schedule a consultation with one of our hand surgeons today or visit us at Colorado Springs Orthopaedic Group.

Types of Hand Surgery

Types of hand surgery include the following:

Bone Fixation
Joint Replacement
Tendon and Muscle Repair
Fasciotomy
Replantation
Drainage
Skin Graft and Skin Flaps

Recovery Time

Hand surgery recovery time can take several weeks to several months. Although the recovery time for hand surgeries completed with a minimally invasive technique is typically three times faster than traditional open surgery. Recovery time depends upon:

The complexity of the hand surgery
Total number of procedures needed
The health of the patient

Hospital Stay

Most hand surgeries are outpatient and do not require an overnight stay at the hospital.

Cost

Hand surgery in the United States costs $7,000 to $15,000. At CSOG, we accept cash or credit card payments and accept all major insurances.

Costs with Insurance

Your insurance may cover part or the entire cost of your hand surgery. Know that insurance may not cover elective or cosmetic procedures. Contact your insurance provider for coverage details.

Hand Surgery with Modern Technology

If we were to compare modern hand surgery of today with the technology of several years ago the difference would be astounding. Surgery has improved so dramatically over the past decade with modern technologies and advancements.

10 Years Ago: A patient who may have received hand surgery several years ago would have had to frequently change out her bandages. She also would have received a lot of physical therapy and had noticeable scarring.

Today: If that same patient were to receive surgery on her hand utilizing minimally invasive techniques, her recovery would be three times faster, her incisions would be so small that the doctors could use glue instead of bandages to close them (so there would be no need to change out bandages), and she would also experience minimal scarring. In fact, the scarring might not even be visible.

Causes for Hand Surgery

There are many reasons a person may elect to have hand surgery including injury, infection, a degenerative issue such as trigger finger or carpal tunnel syndrome, or a pre-existing defect or deformity.

Hand Injury or Infection

Hand injuries include fractures, sprains, and dislocations. Symptoms include sharp pain, swelling, and limited range of motion. Common causes include falling, sports injury, or an automobile accident.

Signs of infection: swelling, tenderness, stiffness, discoloration, numbness or lack of feeling, or oozing from the injured area.

Degenerative
Disease

Degenerative diseases of the hand include:

Carpal tunnel syndrome
Tennis elbow
Trigger finger
Osteoarthritis
Rheumatoid arthritis

Patients with degenerative diseases typically experience chronic, nagging pain and swelling. Common causes include genetics, aging, and prolonged aggravation of the joints.

Hand Defect or Deformity

A hand defect or deformity can include:

Cysts or lumps
Unnatural growths or shape
Crooked or bent fingers
Partially or fully missing fingers

A hand defect or deformity may not be a painful or debilitating condition but may simply be cosmetic. Such deformities may have naturally occurred at birth or developed over time.

Hand Surgery Ortho vs. Plastics

In some countries, hand surgery is its own medical specialty. In the U.S., both orthopaedic surgeons and plastic surgeons can perform hand surgeries. Both receive added certified medical training to perform hand surgeries.

Plastic surgeons tend to specialize in skin and soft tissue repair. This includes reconstructive and replants operations to treat amputations, burns, and cosmetic deformities.

Orthopaedic surgeons treat all facets of hand injury and disease. This includes issues affecting bone, nerves, and tendons in the hand, wrist, and forearm.

Procedures

Hand surgery is more involved than other reconstructive procedures since the hand and wrist are small, complex joints; hand surgery requires surgeons to receive adequate medical training and refine medical techniques to perform hand operations.

Bone Fixation:

The orthopaedic surgeon can repair bone fractures and breaks with open or microsurgery. The surgeon first aligns the bones. Then, the surgeon inserts pins, wires, and screws to hold the bones together. The aim is to mend the bones together to restore integrity and function.

Joint Replacement:

A surgeon can replace a damaged or deteriorated joint with an artificial joint. The replaced joint could be a knuckle or wrist. The surgeon may use minimally invasive surgery to complete the replacement. Fewer incisions reduce the chance of infection and speed up recovery time. Artificial joints may be metal, plastic, rubber, or other body tissue. The aim is to reduce joint pain and restore full function and integrity.

Drainage:

If a sore or infection develops, the surgeon can drain and clean pus from infected areas. The surgeon may also use debridement to clean and decontaminate a hand infection. The aim is to remove infection and allow full healing.

Tendon and Muscle Repair:

Your surgeon can repair torn or severed tendons and muscles. The procedure is difficult due to small and intricate structures. Often, the surgeon will use microsurgery or open surgery to complete the repair. The aim is to restore full strength, integrity, and motion to the fingers, hand, or wrist.

Nerve Repair:

Your surgeon can repair and reattach damaged or severed nerves. This is a complex procedure. Often, the surgeon will use microsurgery to mend the nerves together. In some cases, the surgeon may use a nerve from another area of the body as a replacement. The aim is to restore hand function and feeling to the hand.

Skin Graft and Skin Flaps:

A skin graft or skin flap involves taking skin from another body part to repair hand skin. The surgeon first removes damaged skin. Replacement skin is then attached to form healthy skin. The aim is to restore hand function, appearance, and allow routine healing.

Fasciotomy:

Fasciotomy is the relief of painful compartmental pressure in hand. The surgeon can cut and scrape damaged tissue, causing the pressure. The aim is to reduce pain and improve the function of the hand or wrist.

Replantation:

Replantation is the reattachment of a severed finger or full hand. Microsurgery allows the surgeon to reattach ligaments, tissue, and nerves. The aim is to restore as much normal function as possible.

Treatment

Hand surgery is often not the first option of treatment for hand injury or disease. Your doctor (or doctors) may first prescribe medications, injections, splints, or therapy. But if medicine and therapy are not enough, surgery is a standard permanent treatment option for:

Sports-related injuries
Carpal tunnel syndrome
Wrist pain
Cuts and severs
Creating or extending fingers from other joints
Degenerative diseases
Defective and deformed fingers and joints

Benefits

The primary benefits of hand surgery are:

Permanent treatment
Reduce pain
Restore hand function

Commonly Used To:

Reattach and repair torn tendons and muscle
Repair damaged nerves
Realign and mend broken or fractured bones
Replace joints
Remove or scrape diseased or deteriorated tissue
Reattach severed fingers

Disadvantages

The disadvantages of hand surgery are:

Higher cost than non-surgical procedures
Chance of complications from surgery
Longer recovery time

Postoperative Care
Risks

Postoperative Care

Your hand doctor will give you detailed at-home care instructions. Follow the instructions carefully to best assure optimal outcomes and avoid other complications. Your hand doctor will also let you know when you can expect to return to regular activity. In the meantime, protect your surgical wound and avoid strenuous activity. If you experience increased pain or other medical symptoms, get medical help immediately.

Risks

All surgeries have risks. Likewise, hand surgery can introduce the chance of complications, to include:

Bleeding
Clotting
Pain or discomfort
Infection
Nerve or tissue damage

Always consult with a board-certified hand doctor about likely outcomes and risks.

Our Orthopaedic Hand Doctors

At Colorado Springs Orthopaedic Group, we strive to provide the highest quality care. Our board-certified hand doctors receive extensive hand surgery training and they are some of the most practiced surgeons in Colorado.

Our Specialists for Hand Surgery

We are so fortunate to have some of the most talented and caring hand doctors. Please take a moment to get to know them:

Jeffrey T. Watson, MD

Dr. Watson is a board-certified orthopaedic hand surgeon. He specializes in adult and pediatric reconstructive and microvascular hand surgery.

>Jeffry T. Watson, MD

Dale Cassidy, MD, MBA

Dr. Cassidy is a board-certified orthopaedic hand surgeon. He specializes in hand trauma, arthritis, carpal tunnel syndrome, and tendon repair.

> Dale Cassidy, MD, MBA

Is Hand Surgery Right for You?

Hand surgery is a severe medical treatment consideration. Find out if hand surgery is your best treatment option. Schedule your Colorado Springs Orthopaedic Group consultation today. Call (719) 632-7669 now to schedule your appointment.

o Minimally Invasive Surgery
o Top Docs of Colorado Springs
o Doctors With X-Ray Vision Technology

Doctors With X-Ray Vision: Augmented Reality for Spine Surgery

Advanced Medical Technology | xvision™ Spine system

Colorado Springs Orthopaedic Group is now offering a new standard of care in surgery, giving our doctors x-ray vision during surgery! Dr. Roger Sung, MD and his Physician Assistant, Kelsey Chrane with Colorado Springs Orthopaedic Group, are now offering spine surgery with the Augmedics xvision Spine System, a groundbreaking augmented reality (AR) guidance system that allows surgeons to “see-through” a patient’s anatomy as if they have “x-ray vision.”

We Are Proud To Announce XVS Image Guiding System for Spine Surgery

Colorado Springs Orthopaedic Group introduces xvision™ Spine system (or XVS) as our newest technology equipped with an image guiding system for spine surgery. xvision™ equipped with this groundbreaking technology, allows for better accuracy and efficiency within the operating room.

Dr. Roger Sung is the first to use xvision™ in Colorado for surgery.
Kelsey Chrane is the first PA and the first woman in the world to utilize this technology.
Colorado Springs Orthopaedic Group is the 4th practice in the nation to offer this technology.

As we continue to invest in innovative surgical technologies and techniques, providing our patients with the best there is in healthcare, please contact us at (719) 632-7669 to learn more about the xvision™ Augmented Reality Spine System and to schedule your personal consultation today.

X-ray Vision Achieved with New Cutting-Edge Technology

xvision™ Spine system is a cutting-edge technology that allows our surgeons to ‘see-through’ a patient’s body as if they have X-ray vision. The surgeon can focus directly on the patient and not have to look away to a digital screen. This allows the surgeon to place implants with greater precision for the best minimally invasive spine procedure outcomes possible.

The Future of Surgery

At Colorado Springs Orthopaedic Group, we constantly invest in the latest orthopaedic techniques and technology. We feel the XVS technology from Augmedics is the future of surgery. XVS is designed to give our surgeons better control and visualization resulting in more efficient, less invasive, and safer surgeries.

“Moving here to Colorado Springs, I never dreamed that I would have the opportunity to use Augmented reality and the technology that’s brand new in surgery; that I would be the first woman and the first physician assistant in the world to be able to use this technology, and that we would be the first facility in Colorado to use this technology. Having the opportunity to be involved with a technology that is so new and cutting edge has been incredibly rewarding and also has been really gratifying to know that even here in Colorado Springs, I am still able to be involved in the most cutting edge technology and medicine that is available.”

– Kelsey Chrane, PA-C
First Woman and First Physician Assistant in the U.S to use and offer xvision Augmented Reality.

Groundbreaking Augmented Reality | xvision™ Spine System (XVS)

The spine is a complex part of the body. It is an intricate structure of bones, muscles, tendons, ligaments, nerves, and discs which makes spine surgery, specifically multi-level complex surgery a more difficult and delicate procedure. Now, with the XVS augmented reality technology we can better navigate these complex procedures. The primary advantages of XVS over other image-guided systems include:

Personalized procedures
More accurate spinal implant placement
Faster
Safer
Less radiation exposure for the physician during the procedure

Benefits
How xvision™ Works

Benefits

Benefits of X-ray Vision with Surgery

With XVS, surgeons can:

Meet 98.9% implant placement accuracy
Move small muscles aside instead of detaching them
Minimize incisions
Operate faster
Operate safer
Better align anatomy for more successful outcomes
Reduce patient recovery time

How xvision™ Works

How xvision™ Augmented Reality Headsets Work

Augmedics’ xvision™ Spine system is an augmented reality (AR) surgical guidance system. It is the first AR system to be utilized in spine surgeries. The surgeon can look directly at the patient and ‘virtually’ see the anatomy through the skin. It is as if the surgeon has ‘X-ray vision.’

Here’s how XVS works …

Instead of looking up or to the side at monitors displaying the patient’s anatomy, the surgeon sees everything through the AR headset, allowing surgeons to maintain their focus directly on the patient. They can likewise move freely around the operating room due to the wireless system. This gives the surgeon better control and visualization, which may lead to surgeries that are easier, faster, and safer to perform.

The headset includes a transparent near-eye-display that determines the position of tools utilized in surgery. It then projects the patient’s CT data in real-time onto the surgeon’s retina, allowing them to look at both the patient while seeing the navigation data.

The AR Guidance System consists of several technology components:

Transparent AR display: all 3D anatomical and instrument data projects on a heads-up display. Thus, the operating field is not obstructed.
Built-in surgical tracking system: the surgeon sees accurate, real-time tool positioning.
Integrated headlight: shines a light on the focus surgery area.
Personalized headset: the headset is custom-fit for each user.
Powerful high-speed processor: eliminates data lag for instant visual tracking.
Wireless system: allows free movement about the operating room.

Our Featured Doctor

Roger D. Sung, MD

Dr. Roger Sung is a board-certified orthopaedic surgeon at Colorado Springs Orthopaedic Group. He specializes in complex spine reconstruction and minimally invasive techniques. He is also the first in Colorado Springs to use the xvision™ Spine system. This technique allows for faster, easier, and more accurate surgery.

“Augmented reality is a way to look at a patient’s anatomy in three dimensions ‘live’ in the operating room through a headset. It’s like having x-ray vision as it allows us to peek inside. We can take complicated, complex spine anatomy and simplify it to allow for better precision and accuracy in surgery. This lets us work through smaller incisions with less trauma to the tissues. Patients can have a quicker recovery and better long-term outcome.”

– Dr. Roger Sung, MD, First Physician in Colorado to use and offer xvision AR.

> Roger D. Sung, MD

Will My Surgery Qualify for XVS?

Not all patients are a candidate for the xvision™ as each patient’s diagnosis will vary however, to learn if xvision™ is right for you, give us a call today at (719) 632-7669 to schedule an appointment with Dr. Sung.

Minimally Invasive Surgery

For patients, ‘minimally invasive surgery’ means ‘smaller incisions than traditional surgery.’ Minimally invasive surgery is also known as a laparoscopic surgery, band-aid surgery, or keyhole surgery. At Colorado Springs Orthopaedic Group, our doctors prefer to use minimally invasive surgery whenever possible, as it is more beneficial for our patients’ overall success and recovery time.

Procedure

The procedure for minimally invasive surgery consists of several small incisions (only a few millimeters long). Next, your surgeon will insert a small endoscope (a long, thin tube with a camera and light on the end) through one of the incisions. The endoscope displays the entire procedure on a large video screen to help your surgeon clearly ‘see inside your body.’ Once the endoscope is in place, your surgeon inserts small surgical tools through the other incisions. The instruments are so small that the surgeon operates the tools by remote control. When complete, the surgeon removes all the devices. Your incisions often do not require more than bandages to heal, and the risk of infection is minimal.

Recovery Time

Recovery time after minimally invasive surgery is typically three times faster than traditional open surgery.

The recovery time for each patient can vary as it depends on the size and complexity of the procedure; however, it is often much shorter than traditional surgery.

Hospital Stay

The average hospital stay for minimally invasive surgery is substantially less than traditional surgery. For instance, the average hospital stay for someone who has recently had a minimally invasive spine surgery is less than 2 days compared to open spine surgery of 3 to 4 days. Depending on the type of surgery, for many, minimally invasive procedures are out-patient surgery where patients can return home the same day.

Cost

Minimally invasive surgery can cost thousands less than traditional surgery due to reduced hospital time, medications, and follow-up care. For most, surgery costs depend upon the complexity and severity of your medical condition. Additional fees may include anesthesia, hospitalization, physical therapy, and medications.

Costs with Insurance

Although your insurance provider likely covers the cost of most rehabilitative procedures, most elective procedures are not covered by insurance. Contact your insurance provider for coverage details. Please ask our office administration about financing and payment options.

Traditional Surgery vs. Minimally Invasive Surgery

With traditional surgery (or open surgery), the incisions are more extensive and take longer to heal. Stitches or staples are used to close the incisions and will have to be removed via a follow-up appointment. There is a higher risk of infection with traditional surgery because the incisions are much larger. Since traditional surgery requires larger incisions, the patient may experience more discomfort for a longer period. Thus, due to higher risks and longer recovery time, more and more surgeons opt for less invasive options if they can achieve the desired outcomes. At Colorado Springs Orthopaedic Group, our doctors choose minimally invasive surgery for our patients unless the procedure or patient is not the right candidate for minimally invasive surgery.

Advantages of Minimally Invasive Surgery

The primary benefit of minimally invasive surgery is that a patient can achieve the same results but with a lower chance of infection, less pain, minimal scarring, and faster recovery time.

At Colorado Springs Orthopaedic Group, we’re committed to optimal patient outcomes and safety. Our doctors have extensive experience, world-class training and are considered elite specialists in their field. (See Top Doc Awards)

To learn whether you would be the right candidate, speak with your orthopaedic surgeon.

Call (719) 632-7669 now to schedule your appointment.

Treatments

Minimally invasive surgery can be done on any joint, including shoulder, elbow, wrist, hip, knee, and ankle. Labrum surgery can even be used to repair torn tendons and is commonly used for total joint replacement surgery for sports injuries or arthritis. At Colorado Springs Orthopaedic Group, we may elect minimally invasive surgery for:

Spine or back surgery
Scoliosis surgery
Hip surgery
Bunion surgery
Knee surgery
Bone spurs
Sports injuries
Meniscus rotator cuff
Knee meniscus

Benefits

Minimally invasive surgery has advantages over traditional surgery. The notable benefits are:

Small incisions (5 to 10 millimeters)
Less pain
Less scarring
Faster recovery
Less blood loss
Lower rate of complications
Shorter or no hospital stay (outpatient procedure)

Commonly Used To:

Repair torn tendons
Replace total joints

Disadvantages

Some disadvantages of minimally invasive surgery are:

It is a more complex procedure; therefore, it takes longer to perform than traditional surgery.
There is a risk of trocar injuries caused by the insertion of the endoscopic and surgery tools. A trocar is a surgical instrument with a three-sided cutting point enclosed in a tube, used for withdrawing fluid from a body cavity.

Despite some disadvantages, minimally invasive surgery has high patient satisfaction rates, and many doctors recommend it over traditional surgery. Thus, when possible, more and more patients and doctors opt for minimally invasive procedures.

Types of Minimally Invasive Surgery

This technique was quickly adopted by specialists in varying medical fields. Orthopedic surgeons use the method to diagnose and treat joint injuries and diseases. There are two main procedure types, arthroscopic and laparoscopic surgery.

Arthroscopic Surgery:

Arthroscopic surgery, coming from the Greek word “artho” meaning “joint”, is a type of surgery for the joints and spine. Arthroscopic procedures may include surgeries of the hip, foot, ankle, knee, shoulder, elbow, and wrist. During the procedure, the surgeon inserts an arthroscope through a small incision, which allows them to see the joint area on a video screen. A small remote-control surgical device is then used to operate.

Laparoscopic Surgery:

“Laparo” means “flank, side” in Greek. With laparoscopic surgery, the surgeon uses an endoscopic tool called a laparoscope. It’s generally used for operations in the spine, abdomen or pelvis. Laparoscopic surgery may include treatment of wound infections, muscle tears, or hernia repair. Again, the surgeon uses a robot to perform the operation with small surgical tools.

Postoperative Care
Risks

Postoperative Care

You may experience discomfort post-surgery. Therefore, your surgeon will give you detailed recovery and self-care instructions. Prescribed medications and physical therapy may also aid in recovery.

One of the benefits of minimally invasive surgery is that it is usually an outpatient procedure, so you will likely not need to stay overnight. Though, you should always have a friend or relative to help you home after the procedure. Also, avoid strenuous activity for several days. Be sure to rest your body, drink plenty of fluids, and stay comfortable. Your doctor will let you know when you can resume full routine activities.

If you experience unusual pain or have complications, contact your doctor. Likewise, get immediate medical help for dizziness, nausea, or irregular heartbeat.

Risks

Risks exist with any type of surgery; however, the risks associated with minimally invasive surgery are significantly reduced because of the smaller surgical incisions. Lower risk and faster recovery rates are why doctors prefer this type of surgery to traditional open surgery. Although minimally invasive surgery is typically less risky than conventional surgery, there can still be complications with anesthesia, infection, bleeding, and minimal scarring.

Surgery is a serious medical consideration. Be sure to talk to your doctor about patient safety. It is always important to clarify the risks, beneficial outcomes, and complete medical history before opting for any surgery type.

Our Certified Doctors

At Colorado Springs Orthopaedic Group, we are one of Colorado’s largest and most respected orthopaedic practices. Our doctors are highly recommended, and we are known as one of the best centers for minimally invasive surgery. Our doctors have extensive experience in spine and various sports injuries, including total joint, knee scopes, sports injuries, and rotator cuff reconstruction.

Our Specialists for Minimally Invasive Surgery

Michael J. Huang, MD

Doctor Huang is a board-certified orthopaedic surgeon. He is also a Colorado Springs Top Doc 2018. He specializes in sports injuries and total hips.

>Michael J. Huang, MD

Tyler R. Bron, MD

Doctor Bron is a board-certified orthopaedic surgeon. He specializes in total knees and hips. Dr. Bron has additional training for using the unique CT-guided Mako Robotic Arm for knee replacements.

> Tyler R. Bron, MD

Is Minimally Invasive Surgery Right for You?

If you’ve been injured or suffer from pain, see a specialist as soon as possible. Sometimes ignoring pain or an injury can make it worse. Call to schedule an appointment with one of our specialists at Colorado Springs Orthopaedic Group. During your initial consultation, our board-certified orthopaedic surgeons work with you to devise the best medical plan.

As every patient and situation is different, surgery may or may not be the best answer.

To learn whether you would be the right candidate for minimally invasive surgery, speak with your orthopaedic surgeon.

Call (719) 632-7669 now to schedule your appointment.

Spinal Fusion Surgery

Senior couple discussing X-ray with doctor.

Procedure

Many Americans suffer from a number of back issues. Spine and back issues can include a spine deformity, instability, and weakness of the back, or a herniated disk. Moreover, many have exhausted other medical treatments to fix the issue. If this applies to you, you may be a candidate for spinal fusion surgery.

What Is Spinal Fusion?

With spinal fusion surgery, spine vertebrae are ‘welded’ together. They connect and heal together. This then corrects and stabilizes your back and reduces pain. There are always risks to surgery, but satisfaction and success rates are high. Spinal fusion surgery is a permanent and common procedure. More than 30 million Americans undergo surgery each year and the procedure has been a successful and safe treatment option for decades.

Again, the aim of spinal fusion is to reduce pain-causing movement between vertebrae. There are two primary parts to the surgery:

Bone Graft: The first goal is to decompress the pain-causing spinal cord and nerves. The surgeon then packs real or artificial bone graft between the vertebrae. This is how they fuse together – much like the healing of broken bones.
Hardware: Screws, plates, and rods are next inserted to better hold the fusion together. This is called internal fixation.

How Long Does Spinal Fusion Surgery Take?

The length of surgery for spinal fusion can take 2 to 7 hours. It depends upon the severity and complexity of the procedure. It also depends upon the health of the patient and the number of vertebrae fused.

Recovery Time

Physical therapy often starts 6 to 12 weeks after surgery.
Your doctor may also prescribe medication to manage your pain. Talk to your doctor if you have concerns about prescription pain medicines.

Hospital Stay

It is likely you will spend a few days recovering in the hospital. After that, be patient. Do not try to return to life as normal too soon. You will receive at-home care instructions. Follow them best you can! You will also likely begin a physical rehabilitation plan.

Cost

In all, a spinal fusion procedure can cost $14,000 to $30,000. In most cases, spinal fusion is covered by insurance. Talk to your insurance provider for coverage details. Do know that with most surgeries, there can be several bills of charges. This includes the surgeon, surgery center, hospital, anesthesiologist, and pharmacy.

Costs With Insurance

Contact your insurance provider for coverage details. If you are unsure about your coverage details, give us a call. We are happy to guide you through the process.

Why Spinal Fusion?

Your spine is literally the ‘backbone’ of your orthopaedic health. Aging, disease, and deformities can deteriorate your back over time. Weak or deformed vertebrae can cause chronic back pain. As a result, you may also have limited physical ability and range of motion. You might also be inhibited from living your desired active lifestyle. Spinal fusion could be your solution.

At Colorado Springs Orthopaedic Group, our doctors are committed to restoring our patients’ health and overall wellbeing. (See Top Doc Awards)

Talk to one of our back and spine doctors at Colorado Springs Orthopaedic Group (CSOG) to discuss if a spinal fusion surgical procedure is right for you.

Call (719) 632-7669 now to schedule your appointment.

Treatments

Spinal fusion can help with:

Deformed neck or back
Spinal stenosis
Spondylolisthesis
Scoliosis
Tumor
Infection
Degenerative disk disease
Weakness or instability
Fractured vertebra
Herniated disk

Benefits

The benefits and advantages of spinal fusion surgery include:

Pain relief
Pressure relief
Back stability
Improved vertebra integrity

Longterm Results:

Spinal fusion is a permanent treatment to help alleviate pain and improve daily routine.

Disadvantages

Immobilizing vertebrae can limit or change how your back moves and rotates, but with reduced pain, your range of motion should improve.

Also, it is important that you are in optimal health. You should not smoke and you should maintain a healthy body weight. Follow post-surgery instructions without exception and do not engage in sports or physical activity that puts undue stress on your back.

Always consult with your surgeon about your risks for any medical procedure.

Advanced Surgical Techniques

Spinal fusion surgery is open surgery. Although, more and more surgeons are using a minimally invasive surgery technique. The technique used will depend upon the complexity of your medical condition. Post-surgery rehabilitation may also include wearing a brace, physical therapy, exercise, and stretches.

cervical, thoracic, and lumber spine image sectioning out each

Regions of Your Spine:

There are three regions of your spine for a spinal fusion procedure:

Cervical spine
Thoracic spine
Lumbar spine

Types of Spinal Fusion Surgery:

Anterior cervical discectomy and fusion
Anterior lumbar interbody fusion
Lateral lumbar interbody fusion
Posterior lumbar interbody fusion
Scoliosis fusion surgery
Transforaminal lumbar interbody fusion

Life After Spinal Fusion Surgery
Risks

Life After Spinal Fusion Surgery

Ah, the big question … can I go back to doing all the things I love to do again? Again, talk to your doctor about safe and realistic lifestyle expectations. Certainly, the goal is to return you to as-close-to-normal orthopaedic health as possible, but post-surgery life may have some limitations. You are still susceptible to further injury or disease. This might be the time to find alternative lifestyle activities. Find something that doesn’t threaten your spine health. You don’t want to risk further back injury or degeneration.

Risks

Like any surgery, spinal fusion has risks and disadvantages, including infection, blood loss, blood clots, pain at the graft site, nerve damage, change of/restricted motion, recurring symptoms, pseudarthrosis (not enough bone formation), post-surgery recovery time, and pain.

Our Certified Orthopaedic Doctors

CSOG strives to provide nothing but the best possible care for our patients. To do that, we insist on putting together the best possible healthcare team.

Our Spine Specialists

James M. Bee, MD

Doctor Bee is a board-certified orthopaedic surgeon who specializes in spine surgeries. Dr. Bee’s medical expertise includes a full range of spinal disorders of the cervical, thoracic, and lumbar spine. Scoliosis and the treatment of spine shrinkage and fractures from osteoporosis.

> James M. Bee, MD

Roger D. Sung, MD

We are so fortunate to have Roger D. Sung, MD, on our physician staff! Dr. Sung is regularly recognized as a Top Doc in his medical peers in Colorado Springs. His surgical expertise is in spinal fusion and spine stimulators. He also specializes in microsurgery and minimally invasive spine surgery. Dr. Sung was the first doctor to use the new xvision™ system at CSOG. He has been in practice with us since 2000.

> Roger D. Sung, MD

Paul Stanton, DO

> Paul Stanton, DO

Is Spinal Fusion Right for You?

You do not have to live with chronic back pain, but surgery is a considerable choice to make. Give us a call at Colorado Springs Orthopaedics Group. We will get you scheduled for your first consultation with a board-certified orthopaedic surgeon. During your consultation, we will discuss your treatment options, along with risks, and likely outcomes. But rest assured that at CSOG, your care is in the best hands possible!

Call (719) 632-7669 now to schedule your appointment.

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