Category: information

Could a SynVisc injection help your knee feel better?

Posted on by Bengobec

Knee Pain Treatment

April, 2021

Could a SynVisc injection help your knee feel better?

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by Fremont Orthopedics Staff

SynVisc Injections for Chronic Knee Pain

Orthopaedic specialists at Fremont Orthopaedics offer SynVisc injections for patients with chronic knee pain associated with osteoarthritis. Knee pain from osteoarthritis is caused by cartilage loss, depletion of the joint (synovial) fluid, and the formation of bone spurs, which cause bone surfaces to rub against each other.

SynVisc (Hylan GF-20) belongs to a class of medications known as “viscosupplements.” SynVisc is a gel-like fluid made from a natural substance known as hyaluronan. The SynVisc fluid is similar to the normal, healthy joint fluid known as synovial fluid. Synovial fluid is the fluid that cushions and lubricates joints. SynVisc supplements your knee fluid to lubricate and improve the knee joint’s natural shock absorbing abilities. This is intended to provide patients with decreased knee pain and stiffness, along with increased knee mobility.

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Decreased Pain and Improved Mobility

Patients typically receive a series of 3 SynVisc injections that are scheduled 2 weeks apart. The provider uses a sterile needle and syringe to administer the SynVisc into the “intra-articular space,” which is the space between the bone surfaces that comprise the knee joint.

Generally, patients report that they start to experience pain relief and mobility improvements within one week to one month following SynVisc injections. The symptom relief should last 3-6 months, and sometimes as long as 12 months.  It is important to note that SynVisc does not cure the underlying osteoarthritis, but can allow patients to maintain their lifestyle or increase their activity level with decreased pain and improved mobility.

To schedule an evaluation for an arthritic or painful knee joint, call Fremont Orthopaedics at (307) 332-9720. Our providers will be happy to discuss SynVisc and other arthritis treatment options.

How Does Nutrition Affect Bone Healing?

Posted on by Bengobec

Nutrition and Bone Health

March 2020

How Does Nutrition Affect Bone Healing?

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By Jesse Morse-Brady, FNP-BC

The human body has a remarkable ability to heal injured tissues, including bones. There are many different internal mechanisms and types of cells that contribute to healing which can be altered by nutrition and lifestyle factors. Following any fracture (broken bone) or surgery that involves the bones, patients can optimize their bone healing through careful attention to nutrient consumption.

Calcium

The most important nutrients for bone health are calcium and Vitamin D, which can be obtained from dietary sources or from supplements. Calcium is an essential “building block” for bones, and should be consumed as a part of each meal. The recommended daily intake of calcium is different based on age and gender, so it is important to talk to your healthcare provider about how much calcium is recommended for you. Many foods contain calcium, and there are many supplements available to help maintain an adequate calcium level for bone health.

Vitamin D

Vitamin D is central to your body’s ability to absorb calcium and make bone cells. Exposure to sunshine helps your body to make Vitamin D, which you can also obtain from food and supplements. Living in areas with limited sunshine or long winters can increase the risk of Vitamin D deficiency, which is associated with several health concerns, including impaired bone health.

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Avoidance of Nicotine and Alcohol

Both nicotine and alcohol impair the body’s ability to absorb calcium, which is harmful to bone healing and long-term bone health. Nicotine in any form (smoking, chewing, or vaping) decreases blood flow to the bones, which can further slow the healing process. Women who drink more than 1 alcoholic beverage per day, and men who have more than 2 alcoholic beverages per day, may have decreased Vitamin D and calcium absorption, and may be at a higher risk for falls and injuries. Avoiding or reducing the intake of these substances can help to improve or maintain the health of your bones and other tissues.

Avoidance of Nicotine and Alcohol

Remember…

Eating a well-rounded diet, with plenty of fresh, non-processed foods, is an important way to promote healthy bones and whole-body wellness!

This document contains general guidelines and is not a substitute to your provider’s instructions or an alternative to seeking appropriate medical care or follow-up appointments. For questions or concerns, seek professional medical attention. For medical emergencies, call 911.

To schedule an appointment,

Call us at 307-332-9720

Could Injection Therapy Help You?

Posted on by Bengobec

Injection Therapy

January 27

Could Injection Therapy Help You?

Fremont Orthopaedics, Orthopedics, Lander, Riverton

by the Fremont Orthopaedics Staff

Pain Relief and Improved Motion Through Steroid Injections

When people experience pain in a joint such as a knee, hip, ankle, shoulder, or elbow that develops over time, and is not related to a traumatic injury, the underlying cause may be a degenerative condition or inflammatory process. This sort of pain often indicates the development of osteoarthritis, tendonitis, or bursitis. Osteoarthritis results from degeneration, or “wearing down,” of the cartilage that protects the ends of bones where they form a joint. This process causes damage to the joint structures, typically resulting in pain, swelling, and stiffness. Repetitive use or motion may result in inflammatory conditions called tendonitis or bursitis. Tendonitis is irritation of the tendons, the fibrous tissue that attach muscles to bones. Bursitis occurs when small, fluid filled sacks that cushion the joints become inflamed. Many patients experience significant improvements in pain, swelling, and joint mobility after receiving a steroid injection.

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How does an injection help with pain and inflammation?

The injection usually contains a mixture of two medications that are injected directly into the structures that are inflamed and painful. One is a local anesthetic (or “numbing medicine”) that offers immediate pain relief. The second is a corticosteroid (or “steroid”). Steroids are powerful anti-inflammatory medications that may offer long acting relief of pain and swelling. Bursitis, tendonitis, and some other forms of inflammation can resolve with injection therapy and rehabilitation. Chronic conditions, such as arthritis, are unlikely to be cured through injection therapy. However, many patients experience significant improvements in pain and stiffness while the steroid medication is active in their joint.

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How long does the injection take to work and how long does it last?

Although patient results can vary, the numbing medication typically takes effect within 15 minutes and helps to relieve pain following the injection, while also confirming that the medications are in the desired locations. This numbing effect will gradually wear off over the next 6-12 hours. The steroid medication will take effect more slowly, starting to reduce inflammation over the next 2-3 days. Most patients experience the peak effect of the steroid within 4-7 days and continue to experience pain relief and improved mobility for 2-4 months or more, while the steroid medicine remains active. Tendonitis or bursitis may completely resolve following a single injection. Patients with chronic conditions such as osteoarthritis may opt to periodically repeat injections based on their individual progress and goals.

How do I know if I am a good candidate for injection therapy?

Our providers help patients decide if injection therapy may be a good option for them through a clinic visit that includes an examination, a thorough discussion, and often x-rays. Steroid injections are one component of your treatment plan. You and your provider may also discuss other treatment options such as physical therapy, bracing, or other medication options. Provider recommendations are tailored to each patient’s unique lifestyle and recovery goals.

To schedule an appointment, Call us at 307-332-9720

Wide Awake Hand Surgery – “WALANT”

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Wide Awake Hand Surgery

June 2019

Wide Awake Hand Surgery – “WALANT”

Fremont Orthopaedics, Orthopedics, Lander, Riverton

Dr. Francisco explains wide awake hand surgery.

Hand Surgery has traditionally been performed with the use of a tourniquet in order to provide better visualization. However, a tourniquet can be quite painful for the awake patient, making anesthesia necessary.

An alternative to tourniquet hand surgery is to use two medications administered locally to accomplish surgery in a safe, painless manner.  Lidocaine blocks pain, and epinephrine stops bleeding.  This technique is known as “WALANT”-Wide Awake Local Anesthesia No Tourniquet. Because the patient no longer requires anesthesia, these procedures can be performed in an office based setting, utilizing a sterile field and instruments.

WALANT hand surgery is very similar to going to the dentist for a procedure.  There is no need for fasting or preoperative testing. Fremont Orthopaedics is now offering WALANT for select procedures, including trigger finger release, cyst removal, carpal tunnel release, nailbed repair, and tendon repair. Talk to our surgeons to find out whether WALANT surgery could be an option for you.

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The Advantages of WALANT Hand Surgery Are: 

  • No need to spend time and money to obtain preoperative testing (labwork, EKG, etc)
  • Avoid costs associated with anesthesia (anesthesiologist, medications, monitoring)
  • No need for IV
  • Spend less time and money at surgery center
    • Less time spent preoperatively being interviewed by anesthesiologist
    • Less time spent postoperatively being monitored by recovery nurse
  • Get to talk to surgeon during the surgery for post-operative advice on how to care for hand, rehabilitation, etc.
  • Get to see repaired structures working during the surgery. (For example, repair of tendon lacerations or tendon transfer to ensure appropriate tension)
    • For the patient this can improve understanding of the repaired pathology to enhance compliance in rehabilitation
    • For the surgeon, the ability to see a repaired structure in action can avoid complications and increase likelihood of good outcome
  • No need to fast and can resume regular diet immediately
  • No need to change medication schedules
    • Diabetics can maintain their medication regimen since their diet is uninterrupted
    • Patients who require blood thinners can generally continue them. Avoid risks associated with being off blood thinner

Patient Satisfactions:

100 consecutive patients were polled postoperatively

  • 91% found it was less painful or comparable to procedures done under local at the dentist’s office.
  • 86% would prefer to be awake for further hand surgery
  • 90% would recommend wide awake surgery to a friend
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[1]Teo I, Lam W, Muthayya P, Steele K, Alexander S, Miller G.  Patients’ perspective on wide-awake hand surgery-100 consecutive cases. J Hand Surg Eur Vol. 2013 38(9)