Frequently Asked Questions…
What type of procedures are offered in this practice?
Please view our Procedures page for an overview of our procedural services.
What hospital do you use?
Augusta Health in Fishersville, Virginia.
Are procedures done in the office?
Small procedures requiring local anesthesia are performed in the office. These include carpal tunnel release, trigger finger, toe nail ablation, and pin removal.
What is injection therapy and is it right for me?
If you or someone you know suffers from the pain of osteoarthritis (OA), it most likely has caused both pain and limited movement. It is estimated that almost 14 million Americans suffer from OA of the knee. In a normal knee, there is joint fluid that acts as a lubricant and a cushion. In OA, this fluid may have lost these features and fails to protect the knee cartilage. Injection therapy is like lubrication of the knee.
A lubricant injection is administered in three injections over a 3-week period. Lubrication and pain relief can last for up to 6 month. Some patients can feel relief immediately―in others, the full effect may take 5-9 weeks to develop.
Do residents assist with surgery?
Augusta Health is not a teaching hospital. Only surgeons and surgical staff assist with surgery.
Do you have an affiliation with the University of Virginia’s Medical Center?
Although our practice and our hospital have no official affiliation with the University, we enjoy a healthy working relationship with the orthopedic department at UVA.
Do I need a referral?
It depends on the type of insurance you have. If you aren’t sure, call your insurance company to ask.
What is Osteoporosis?
Every postmenopausal woman should be evaluated for her “risk” of osteoporosis. Osteoporosis is a “silent” risk factor for fracture just as high blood pressure is for stroke. 13-18% of postmenopausal women in the US have osteoporosis. An additional 30-50% have low bone density (thickness) at the hip. More than 10 million people total in the US have osteoporosis of the hip. Almost one of every two white women will experience an osteoporotic fracture in their lifetime. There is a significant, although lower, risk for non-white women and men. Hip fractures are associated with 10-20% mortality within 1 year; up to 25% of patients need long-term nursing care.
Any woman >65 years old with hip or spine fracture should be evaluated. Bone mineral density (BMD) studies should be done for any woman at risk. A BMD scan is a specialized x-ray to measure the thickness and strength of bone. Calcium supplements, hormones, and special medicines to enable the body to keep more calcium may be recommended based on BMD studies. Dietary calcium intake should be 1200mg/day and Vitamin D intake should be 400-800IU/day. Regular exercise and muscle strengthening is also recommended. All patients should be advised to avoid tobacco and use alcohol in moderation.
For additional information, contact the National Osteoporosis Foundation at http://www.nof.org.
Where do I find out information about my particular disease or condition?
Our links guide will direct you to several sources of orthopedic patient information. Click on our LINKS button to get to our links list. Each link has a search engine: type in what you are looking for and print out the results. If one link does not provide the necessary information, try a different one.
Do I need to take antibiotics if I have a joint replacement or cages prior to dental procedures or other surgery?
Infection can occur in total joint replacements long after surgery. If a joint replacement is exposed to bacteria in the blood stream, the bacteria can collect and cause an infection. It is uncommon for an infection to occur long after surgery, but it is possible. For that reason, we recommend that you receive antibiotics if you should have any of the following procedures…read more and print an information sheet.
What can I expect pre- and post-operatively for arthroscopy of the knee at your hospital?
After surgery you will usually be allowed to put as much weight on your operated leg as tolerated. You may need to use crutches or a walker for several days. Most people need to use crutches for about two days, but this can vary due to pain and swelling. Occasionally your physician may need to alter your instructions after surgery.
Make sure that you understand and follow any new instructions. Strengthening and range of motion exercises are a vital part of your rehab or recovery from this surgery. Your exercise program is divided up into three phases…read more and print an information sheet.
What is Euflexxa?
Euflexxa is used in injection therapy and can act as a “shock absorber” to cushion the knee. It can reduce pain and increase motion. Euflexxa is not a drug. It is made from a substance found in normal joint fluid. Euflexxa is administered in three injections over a 3-week period. Lubrication and pain relief can last for up to 6 month. Some patients can feel relief immediately―in others, the full effect may take 5-9 weeks to develop. Euflexxa is NOT a cure. It is an additional means of reducing pain and increasing mobility to work with your arthritis medicines and exercise. If you would like to know more about Euflexxa visit http://www.euflexxa.com/ or call Ferring at 1-973-796-1600.
Would you recommend the glucosamine and chondroitin sulfate arthritis treatment?
One of the newest treatments for osteoarthritis are two supplements naturally found in the body that are essential to the metabolism of cartilage. These supplements, glucosamine and chondroitin sulfate, have been claimed to ease pain and stiffness associated with osteoarthritis. Currently these supplements are in the last stages of clinical testing to show objective improvements. The multi-center study results are due out by the end of this year.
|More Glucosamine links:
Glucosamine Resource Center
These supplements are not regulated by the Food and Drug Administration. There is no quality control of these products, and while Natalie Eddington, PhD, a pharmacist and associate professor in the School of Pharmacy at the University of Maryland, has tested about thirty brands of these two supplements, a few contained significantly less of the substance than the label claimed. To be on the safe side, read all labels carefully and avoid chondroitin made from shark cartilage because the quality is inconsistent. Also, buy these supplements locally and not through the mail. The average cost should be one to three dollars a day and will probably not be covered by insurance.
The recommended dosage is 1,500mg glucosamine and 1,200mg chondroitin per day. If this works, over several months the dosage can be decreased. While glucosamine has been shown in a few studies to ease pain, most chondroitin studies have been done with an injectable form rather than pill form which may not be absorbed as well by the body. These supplements can be taken along with nonsteroidal anti-inflammatory drugs (NSAID) for six to eight weeks. After this time, the NSAIDs can be stopped to see whether there is a change in pain or stiffness.
Not everyone will benefit from these supplements. If no change in pain or stiffness is seen within three months, it is not likely a change will ever be seen. Most people in the studies began to benefit from the supplements in six to eight weeks while others only experienced partial relief and still had to take NSAIDs for full relief. Others never showed any relief in the study.
With all new treatments, see your doctor first to see if you’re a candidate for the treatment. Also be sure that these supplements will not interfere with other medications you may be taking, especially those to treat diabetes or blood-thinning medication. These supplements do not treat tumors, stress fractures, rheumatoid arthritis, or gout so be sure your joint pain is attributed to osteoarthritis. These supplements should not be given to children nor should pregnant women take them because there have not been enough studies conducted. Lastly, do not stop proven pain management techniques such as exercise, maintaining a healthy weight, or taking medications prescribed by your doctor.