• Educación del paciente: Liberación del túnel carpiano

    Posted by Orthopaedic Specialists

    Descripción general de la liberación del túnel carpiano
    Especialistas Ortopédicos 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    La cirugía de liberación del túnel carpiano se realiza como un procedimiento ambulatorio.
    A su llegada al centro quirúrgico, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería.

    Anestesia

    La siguiente persona que conocerá es el médico de anestesia. En este momento, el anestesiólogo discutirá el proceso y abordará cualquier pregunta o inquietud que tenga sobre la anestesia.

    Usted irá a la sala de operaciones donde se realiza la cirugía de liberación del túnel carpiano. Luego, el anestesiólogo administrará una breve anestesia general, para que esté completamente dormido durante el procedimiento. Debido a que es una anestesia general, usted no escuchará ni verá nada de lo que sucede en la sala de operaciones.

    Procedimiento quirúrgico

    El Dr. Grossfeld luego realizará la liberación del túnel carpiano. Este procedimiento dura entre 15 y 30 minutos. Tenga en cuenta que después de regresar a la sala de operaciones, toma alrededor de 30-40 minutos irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 1 a 2 horas.

    El Dr. Grossfeld hará una incisión sobre el área donde se encuentra el túnel carpiano. Ella liberará el tejido apretado que está presionando el nervio mediano causando el entumecimiento / hormigueo y dolor. La incisión se cierra con 2 capas de suturas. La capa profunda se cierra con una capa de sutura que es soluble. La capa de piel se cerrará con una sutura que se retirará en la primera visita postoperatoria.

    El Dr. Grossfeld inyectará un medicamento anestésico de acción prolongada en el sitio quirúrgico, que durará de 6 a 8 horas.

    Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD, que son un apósito esponjoso más grande, seguido de un acolchado de yeso. Luego se aplicará una férula de yeso para que no pueda doblar la muñeca. En su primera visita postoperatoria, se le retirará la férula y se le colocará en una muñequera simple.

    Una visión general de la cirugía de liberación del túnel carpiano con el Dr. Grossfeld. Una visión general de la cirugía de liberación del túnel carpiano con el Dr. Grossfeld.

    Noche de Cirugía

    Es muy importante que te mantengas al tanto del dolor.

    Ella recomienda que configure su despertador y tome su medicamento para el dolor cada 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas o Meloxicam 15 mg cada 24 horas puede ayudar a controlar el dolor. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal.

    Primera visita postoperatoria

    Su primera visita postoperatoria será de 14 a 18 días después de la cirugía. Usted será visto en la oficina en ese momento y le quitarán las suturas. El Dr. Grossfeld o Bess Fley, PA-C responderán cualquier otra pregunta.

    Fisioterapia

    La fisioterapia se puede ordenar en función de la hinchazón, el rango de movimiento y la fuerza.

    Conducción

    La mayoría de las personas comenzarán a conducir una vez que hayan dejado de tomar todos los analgésicos. Conducir podría ser dentro de un par de días si se siente cómodo conduciendo un vehículo con una mano. El uso completo de la mano es típicamente con 2 semanas.

    Regreso al trabajo

    Si trabaja en un trabajo de tipo laboral, lo más probable es que no regrese a ese trabajo hasta que sea liberado al 100%. Esto podría ser de 2 a 3 meses dependiendo de la descripción de su trabajo.
    Si su empleador tiene opciones de trabajo ligero, lo más probable es que sea liberado en cualquier lugar entre una o dos semanas de regreso al trabajo liviano, y generalmente el servicio liviano no requerirá el uso del lado quirúrgico / el lado en el que se realiza su cirugía, excepto para tareas simples como usar una computadora o contestar un teléfono.

    Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre una y cuatro semanas. El regreso al trabajo también dependía del nivel de dolor y la descripción del trabajo. La mayoría de las personas tienen muy poco dolor después de esta cirugía, pero algunas tienen más. El dolor es muy personal y diferente de persona a persona.

    FMLA y papeleo de discapacidad

    Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

    Patient Education: Carpal Tunnel Release

    Posted by Orthopaedic Specialists

    Carpal Tunnel Release Surgery Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Carpal Tunnel Release surgery is performed as an outpatient procedure.

    Upon arrival at the surgicenter you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team.

    Anesthesia

    The next person you will meet is the anesthesia doctor. At this time the anesthesiologist will discuss the process and address any questions or concerns you have about the anesthesia.

    You will go to the operating room where the surgery is performed. The anesthesiologist will then administer a brief general anesthesia, so you are completely asleep for the procedure. Because it is a general anesthesia, you will not hear or see anything going on in the operating room

    Surgical Procedure

    Dr. Grossfeld will then perform the carpal tunnel release. This procedure takes between 15-30 minutes. Keep in mind after you head back to the operating room it takes about 30-40 minutes to go to sleep and get positioned on the operating room bed, so your family may not see you for 1 to 2 hours.

    Dr. Grossfeld will make an incision over the area where the carpal tunnel is located. She will release the tight tissue that is pressing on the median nerve causing the numbness/tingling and pain. The incision is closed with 2 layers of sutures. The deep layer is closed with a suture layer that is dissolvable. The skin layer will be closed with a suture that will be removed at the first post operative visit.

    Dr. Grossfeld will inject a long-acting numbing medication into the surgical site, which will last for 6-8 hours.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites followed by ABD pads, which are a larger fluffy dressing, followed by cast padding. A plaster splint will then be applied so you are unable to bend your wrist. At your first post operative visit the splint will be removed and you will be placed into a simple wrist brace.

    An overview of Carpal Tunnel Release Surgery with Dr. Grossfeld. A step-by-step guide on carpal tunnel release surgery with Dr. Grossfeld.

    Night of Surgery

    It is very important that you stay on top of the pain.

    She recommends that you set your alarm clock and take your pain medication every 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours or Meloxicam 15 mg every 24 hours can help control pain. Do not use either Motrin or Meloxicam if you are on blood thinners or have a history of stomach ulcers or kidney disease.

    First Post-Operative Visit

    Your first post operative visit will be 14- 18 days post-surgery. You will be seen in the office at that time and have the sutures removed. Dr Grossfeld or Bess Fley, PA-C will answer any other questions.

    Physical Therapy

    PT may be ordered based on swelling, range of motion and strength.

    Driving

    Most people will start driving once they are off all pain medication. Driving could be within a couple days if you feel comfortable driving a vehicle with one hand. Full use of the hand is typically with 2 weeks.

    Return to Work

    If you work a labor type job, you will most likely not return back to that job until you are released 100%. This could be 2-3 months depending on your job description.
    If your employer has light duty options, you will most likely be released anywhere between one to two weeks back to light duty, and typically light duty will not require the use of the surgical side/the side your surgery is performed on, except for simple tasks such as using a computer or answering a phone.

    If you have an office type job, you can most likely get back to work between one to four weeks. Return to work also depended on pain level and job description. Most people have very little pain after this surgery but some have more. Pain is very personal and different from person to person.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

    Bess Fley, PA-C, June 2023 Newsletter: Little League Shoulder

    Posted by Orthopaedic Specialists

    Sports Medicine in Louisville, KY, Orthopaedic Specialists, Bess Fley PA-C, Dr. Stacie Grossfeld Supervising Doctor doe injuries like little league shoulder.

    From the Desk of Bess Fley: Little League Shoulder

    Spending the day at the ballpark might be a dream come true for all the aspiring ‘Babe Ruth’s and ‘Jackie Robinson’s, and for all their enthusiasm and energy, it might seem like a win-win situation to let them practice and play all day and come home tired. However, did you know that there’s a very common, yet preventable injury that children are at risk for when they repeat the pitching motion frequently? Learn more about Proximal Humeral Epiphysitis (Little League Shoulder) in the pediatric patient below!

    What is Little League Shoulder?

    Proximal Humeral Epiphysitis – aka ‘Little League Shoulder’ – is a common overuse injury in the pediatric population that occurs when the growth plate of the shoulder becomes inflamed and widens. This condition’s symptoms are most commonly the complaint of pain in the front part of the shoulder and develops in children’s cases more due to the fact that they have increased plasticity of their bones, open growth plates, and less muscle mass.

    Bess Fley talks about the optimal amount of pitches young pitchers should be doing per day to avoid injury.

    Treatments

    Typically, with 4-6 weeks of rest and NSAIDs, patients can return to baseball, softball, or their other sports pain-free if the injury is solely Proximal Humeral Epiphysitis. While the growth plate will appear widened on x-ray, MRI would be able to tell if there was a more extensive injury, such as a fracture, but the treatment is mostly the same.

    Prevention Methods

    In order to prevent this from happening, becoming a master of the fundamentals is important before adding in more complex pitches. Pitch counts at every practice and game are also an important to track in order to help prevent this injury.

    Bess Fley talks about the optimal amount of pitches young pitchers should be doing per day to avoid injury.

    An easy way to do this accurately is to:

    1. Keep an App

    Our favorite is called Pitch X-Pitch Counter, which can be downloaded and tracks data long-term with the option to add up to 3 players for free before a one-time purchase for unlimited players.

    2. Keep Track Manually,

    There are also handheld options available if you don’t want to keep your phone in hand as you count, such as these low-cost options on Amazon.

    If you or someone you love has suffered a Little League Shoulder injury in the Louisville, Kentucky-area, Orthopaedic Specialists, PLLC can help! Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Patient of the Month: Chris Schardein

    Posted by Orthopaedic Specialists

    Meet this month’s patient in the spotlight, Chris Schardein!

    Chris Schardein is May's Patient of the Month for Orthopaedic Specialists.

    Chris Schardein and her husband, Bill, are the proud owners of 2 and 3/8 acres in Fern Creek, where they have been growing daylilies since 1996. Their flower journey dates back even further to 1989, though, when they had only a 1/2-acre lot in Hikes Point, but it has grown into something even bigger than their lot – into national recognition and a full-time adventure.

    Chris Schardein is May's Patient of the Month for Orthopaedic Specialists.Ever since they outgrew their Hikes Point location, this Fern Creek lot has given more space to expand the collection of flowers and plants that Chris and Bill have accrued over the years. From the first daylily that Bill Schardein won with at a club meeting in 1989 to over 850 named cultivars in 20 garden settings throughout their property, the couple, even at the ages of 76 and 72, have flourished in their gardening endeavors. This came to a head in 1999, when they were approved by the regional officers to be added to the National Registry for Daylilies, where they have been registered since.

    With a hobby that has turned into a year-round job, Chris says that she gets plenty of exercise just doing what she needs to in order to keep her flowers and other cultivars healthy and thriving, but that doesn’t stop her and her husband from making the trip to the gym three times a week in order to complete cardio and strength exercises. During the winter, when many flowers are dormant, Chris fills her time in the greenhouse with other plants that need her time and attention as well as addressing other details of their carefully-kept garden, such as repainting decorative concrete statues that spruce up their garden beds.

    Chris Schardein is May's Patient of the Month for Orthopaedic Specialists.

    A Quick Injury Turnaround 

    While she counts herself luck that she hasn’t had many injuries over the years of manual work in the garden, just recently this spring, Chris fell while laying down mulch on the garden beds, injuring her hand and ribs. She was able to be ushered into the office for x-rays on both afflicted areas, and a cortisone shot that she received from Orthopaedic Specialists helped with the pain and arthritis in her hands, but her ribs continued to cause her pain over the next two months of recovery.

    Chris Schardein is May's Patient of the Month for Orthopaedic Specialists.While it disrupted her sleep and kept her from doing what she needed to in the garden, as long as she did not lift too much weight, Chris was able to get a few of her tasks done without her hand pain to worry about.

    “Luckily, I was far enough ahead on the mulch that it didn’t set me back too much!” she wrote to us optimistically. “I’m lucky that my injury – while nothing could have been done for the ribs – did not slow me down as much as I had thought it might at first. I always like to see Dr. Grossfeld and her staff for problems like this, as they always make me feel at home and like I’m one of the family when I’m in the office. I never long waits to be in the exam room or to see the doctor, and for that, I’m very thankful!”

    If you or someone you love has suffered an sports related or fall injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Educación del paciente: Cirugía del manguito rotador

    Posted by Orthopaedic Specialists

    Descripción General de la Cirugía del Manguito Rotador
    Especialistas Ortopédicos 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    La cirugía del manguito rotador se realiza como un procedimiento ambulatorio.

    • No coma ni beba después del tiempo dado por el personal del Dr. Grossfeld
    • Use ropa holgada
    • Traiga información del seguro e identificación con foto
    • Lista de medicamentos y alergias a medicamentos
    • Haga arreglos para que alguien conduzca a casa después del procedimiento

    A su llegada al centro de cirugía, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería. Se medirán los signos vitales, como la presión arterial y la temperatura.

    Se proporcionará una bata de hospital limpia. Todas las joyas, dentaduras postizas, lentes de contacto y esmalte de uñas deben ser quitados. Se iniciará una vía intravenosa para administrarle líquidos y medicamentos durante y después del procedimiento. Su hombro será frotado y afeitado en preparación para la cirugía. Un anestesiólogo discutirá el tipo de anestesia que se utilizará. El Dr. Grossfeld confirmará e inicializará el sitio quirúrgico correcto con un rotulador.

    Anestesia

    Antes del procedimiento, se reunirá con el anestesiólogo. En ese momento, discutirán su historial médico / de anestesia pasada con usted. El anestesiólogo colocará un bloqueo nervioso para adormecer el hombro y el brazo. El medicamento anestésico durará 18 horas. Esta es una excelente manera de reducir el dolor postoperatorio. Incluso después de que el bloqueo nervioso desaparece, su nivel de dolor se reduce debido al efecto antidolor del bloqueo nervioso.

    Después de colocar el bloqueo nervioso, usted irá al quirófano donde se realiza la cirugía. El anestesiólogo administrará una anestesia general, por lo que usted está completamente dormido para el procedimiento. Usted no oirá ni verá nada que suceda en la sala de operaciones.

    Procedimiento quirúrgico

    El Dr. Grossfeld realizará la reparación del manguito rotador artroscópicamente. Este procedimiento dura entre 45-90 minutos. Después de regresar a la sala de operaciones, toma alrededor de 40-50 minutos para irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 2.5 horas, dependiendo de qué tan extenso sea el procedimiento quirúrgico. El Dr. Grossfeld hará de cinco a seis incisiones pequeñas que miden menos de 1/2 pulgada de largo alrededor de la articulación del hombro. Se colocará una pequeña cámara de alta definición, aproximadamente del tamaño de un lápiz, en la articulación del hombro. Después de insertar la cámara, se completa la inspección de toda la articulación del hombro. Se ve cada compartimento del hombro. Se identificará la ubicación del desgarro del manguito rotador. Si hay espolones óseos, se eliminarán. La extirpación del espolón óseo se denomina descompresión subacromial y/o escisión de la articulación AC. Cualquier otro hallazgo anormal también se abordará en el momento de la cirugía y la reparación.

    Una descripción quirúrgica de la cirugía del manguito rotador con la Dra. Stacie Grossfeld de Louisville, KY.

    La reparación del manguito rotador se realiza colocando tres o cuatro anclajes de sutura en el hueso del hombro.

    Los anclajes de sutura están hechos de un hueso sintético, los anclajes se incorporarán a su propio hueso. La imagen de la izquierda es un anclaje de sutura utilizado para reparar los manguitos rotadores rotos.

    Una descripción quirúrgica de la cirugía del manguito rotador con la Dra. Stacie Grossfeld de Louisville, KY.

    La primera imagen de arriba revela el anclaje atornillado en el hueso del hombro (la x marca el tendón del manguito rotador desgarrado). La imagen del medio muestra el anclaje de sutura asegurado en el hueso del hombro. La última imagen muestra cómo las suturas ahora están “ancladas” en el húmero y listas para ser suturadas a través del tendón del manguito rotador desgarrado.

    Una descripción quirúrgica de la cirugía del manguito rotador con la Dra. Stacie Grossfeld de Louisville, KY.

    Las imágenes de arriba muestran cómo se cose la sutura a través del tendón del manguito rotador desgarrado. Las suturas se pegan a través del tendón del manguito rotador desgarrado con un instrumento especial diseñado específicamente para la tarea.

    Una descripción quirúrgica de la cirugía del manguito rotador con la Dra. Stacie Grossfeld de Louisville, KY.

    Las tres imágenes de arriba muestran los nudos que están atados para sostener el tendón desgarrado contra el hueso del hombro. La segunda y tercera imagen muestran el segundo juego de anclajes que refuerzan la reparación. La imagen final es un tendón del manguito rotador reparado.

    El tendón reparado se volverá a unir al hueso. Las suturas están ahí para sostener el tendón de forma segura contra el hueso mientras se lleva a cabo el proceso de curación.

    Si hay espolones óseos, se eliminarán con una pequeña herramienta similar a un Dremel.
    El sitio de incisión/sitios portal se cierran con una sutura de color azul llamada Prolene. Las suturas se retirarán cuando lo vean en el consultorio entre 10 y 14 días después de la cirugía.

    Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD que son un apósito esponjoso más grande, seguido de cinta quirúrgica. Su cabstrillo de hombro especializado se instalará en la sala de operaciones.

    Recibirá un conjunto detallado de instrucciones sobre el cuidado de la herida al ser dado de alta del centro quirúrgico.

    Noche de Cirugía

    Es muy importante que te mantengas al tanto del dolor. El hielo es clave. Use hielo tanto como sea posible. El Dr. Grossfeld recomienda el uso continuo de hielo durante todo el día. La regla es que no puedes usar demasiado hielo. Ya sea una unidad Polar Care o bolsas de guisantes congelados: úselo continuamente durante 6-7 días después de la cirugía.

    Las unidades Polar Care están disponibles para la compra de especialistas ortopédicos por $150.00. No están cubiertos por el seguro. Polar Care es una máquina de hielo motorizada que consiste en una envoltura de neopreno que se coloca sobre el hombro operatorio y un refrigerador que se llena con hielo y agua. Una manguera se conecta a una envoltura de neopreno que rodea el hombro y empujará el agua a través de la envoltura de neopreno durante un máximo de nueve horas. Por favor, congele ocho botellas de agua antes de su cirugía. Coloca cuatro botellas de agua congelada en la unidad Polar Care. Luego, llénate con agua. Esto mantendrá el agua más fría por más tiempo. Cuando las cuatro botellas de agua se descongelen, reemplácelas con cuatro botellas congeladas más y vuelva a colocar las botellas descongeladas en el congelador. Continúe repitiendo este ciclo. Use hielo durante todo el día, incluso cuando duerma. El hielo es la mejor fuente de control del dolor y la hinchazón.

    Configure su despertador y tome su medicamento para el dolor cada 4 a 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas O Meloxicam 15 mg cada 24 horas también puede ayudar a reducir el dolor postoperatorio. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal

    Dormir en un sillón reclinable, en posición vertical o usar muchas almohadas para apoyar el hombro será más cómodo. Algunas personas dormirán en un sillón reclinable hasta 4 semanas después de la cirugía. Acostarse en la cama permite que su hombro ruede hacia atrás, lo que tira de la reparación y causará dolor.

    Uso de cabestrillo

    Se despertará en la sala de recuperación con el cabestrillo puesto. Ocasionalmente, puede quitarse el cabestrillo mientras descansa (NO dormido), siempre y cuando coloque el brazo contra el vientre. Cuando duerme, el cabestrillo debe estar puesto.

    Apósito quirúrgico

    Se colocará un vendaje, que consiste en almohadillas de gasa 4×4, almohadillas ABD y cinta quirúrgica especial en el sitio quirúrgico (s). Consulte las órdenes postoperatorias que se le dieron el día de la cirugía para conocer los detalles del cambio de vendaje.

    Los apósitos para comprar antes del día de la cirugía son: 10-15 almohadillas de gasa 4×4, una envoltura as extra de 6 pulgadas, peróxido, cinta de papel y curitas impermeables. Los kits están disponibles para su compra en Orthopaedic Specialists.

    Primera visita postoperatoria

    Su primera visita postoperatoria será de 10 a 14 días después de la cirugía. Las suturas serán retiradas por un asistente. El Dr. Grossfeld o Bess Fley, PA-C revisarán su informe operativo, fotos quirúrgicas y responderán cualquier pregunta restante. Se puede ordenar fisioterapia. Por lo general, la fisioterapia es solo una o dos veces por semana durante las primeras seis semanas. El TP variará de persona a persona según el tamaño del desgarro y la calidad de la reparación.

    Ejercicios en el hogar y fisioterapia

    Se darán ejercicios para hacer post operatorio. Un enlace a estos ejercicios está en las instrucciones / órdenes postoperatorias dadas el día de su cirugía. El enlace le mostrará cómo hacer algunos ejercicios postoperatorios suaves. Un juego de poleas, que se puede comprar en nuestra oficina por $ 20, le permite trabajar en ejercicios de rango de movimiento pasivo en casa después de la cirugía.

    La fisioterapia se divide en tres bloques de 6 semanas. Las primeras 6 semanas asistirás una vez a la semana para trabajar en ejercicios suaves de rango de movimiento pasivo.

    La segunda terapia de seis semanas implica un rango activo de movimiento del hombro con un fortalecimiento suave. Asistirá de 1 a 3 veces a la semana, dependiendo de su reparación y otros factores.

    Las terceras seis semanas de fisioterapia implican aumentar el rango de movimiento y fortalecer aún más. Esto es aproximadamente una recuperación de cinco a seis meses antes de que vuelva a sus actividades normales que involucran el hombro operado.

    Conducción

    Puede comenzar a conducir después de dejar de tomar todos los analgésicos narcóticos. Una vez que comience a conducir, su cabestrillo debe quitarse mientras conduce. Se recomienda colocar su mano, del lado operatorio, en la parte inferior del volante y su mano no quirúrgica en la parte superior del volante para hacer la mayor parte del trabajo.

    Regreso al trabajo

    Si trabaja en un trabajo de tipo laboral, es posible que no regrese hasta que sea liberado al 100%. Sin embargo, si su empleador puede acomodar opciones de trabajo ligero, puede regresar tan pronto como dos a cuatro semanas después de la cirugía. Las opciones de trabajo ligero no requieren el uso de la extremidad quirúrgica, excepto para tareas simples como el uso de una computadora.

    Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre dos y cuatro semanas. El regreso al trabajo también depende del nivel de dolor. Algunas personas tienen mucho dolor después de esta cirugía en particular, algunas personas tienen muy poco. El dolor es muy personal, y le proporcionaremos analgésicos de acuerdo con nuestra política de oficina y la ley del estado de Kentucky. Los medicamentos para el dolor se recetarán adecuadamente en cuanto a dosis, cantidad y tiempo.

    FMLA y papeleo de discapacidad

    Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

    Patient Education: Rotator Cuff Surgery

    Posted by Orthopaedic Specialists

    Rotator Cuff Surgery Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Preparation For Surgery; The Night Before

    • Rotator cuff surgery is performed as an outpatient procedure.
    • Do not eat or drink after time given by Dr. Grossfeld’s staff
    • Wear loose-fitting clothing
    • Bring Insurance information and picture ID
    • List of medications and drug allergies
    • Arrange for someone to drive home after procedure

    Upon arrival at the surgery center you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team. Vital signs, such as blood pressure and temperature, will be measured.

    A clean hospital gown will be provided. All jewelry, dentures, contact lenses, and nail polish must be removed. An IV will be started to give you fluids and medication during and after the procedure. Your shoulder will be scrubbed and shaved in preparation for surgery. An anesthesiologist will discuss the type of anesthesia which will be used. Dr. Grossfeld will confirm and initial the correct surgical site with a marking pen.

    Anesthesia

    Prior to the procedure you will meet the anesthesiologist. At that time, they will discuss your medical/past anesthesia history with you. The anesthesiologist will place a nerve block to numb your shoulder and arm. The numbing medicine will last for 18 hours. This is a great way to reduce post operative pain. Even after the nerve block wears off, your pain level is reduced because of the anti-pain effect of the nerve block.

    After the nerve block is placed, you will go to the operating room where the surgery is performed. The anesthesiologist will administer a general anesthesia, so you are completely asleep for the procedure. You will not hear or see anything going on in the operating room.

    Surgical Procedure

    Dr. Grossfeld will perform the rotator cuff repair arthroscopically. This procedure takes between 45-90 minutes. After you head back to the operating room it takes about 40-50 minutes to go to sleep and get positioned on the operating room bed, so your family may not see you for 2.5 hours depending on how extensive the surgical procedure. Dr. Grossfeld will make five to six small incisions that are less than a ½ an inch in length around the shoulder joint. A small high-definition camera, about the size of a pencil, will be placed into the shoulder joint. After the camera is inserted, inspection of the whole shoulder joint is completed. Each compartment of the shoulder is viewed. The location of the rotator cuff tear will be identified. If there are any bone spurs those will be removed. Removal of the bone spur is called a subacromial decompression, and/or an AC joint excision. Any other abnormal findings will also be addressed at the time of the surgery and repair.

    An overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The repair of the rotator cuff is done by placing three or four suture anchors into the shoulder bone.
    Suture anchors are made out of a synthetic bone, the anchors will incorporate into your own bone. The image to the left is a suture anchor used to repair torn rotator cuffs.

    A surgical overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The first image above reveals the anchor being screwed into the shoulder bone (the x marks the torn rotator cuff tendon). The middle image shows the suture anchor secured into the shoulder bone. The last image shows how the sutures are now “anchored” into the humerus and ready to be sutured through the torn rotator cuff tendon.

    An overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The images above show how the suture is sewn through the torn rotator cuff tendon. The sutures are pasted through the torn rotator cuff tendon with a special instrument designed specifically for the task.

    An overview of rotator cuff surgery when you schedule with Dr. Stacie Grossfeld of Louisville, KY.

    The three images above show the knots that are tied to hold the torn tendon against the shoulder bone. The second and third image show the second set of anchors that reinforce the repair. The final picture is a repaired rotator cuff tendon.
    The repaired tendon will be reattached to the bone. The sutures are there to hold the tendon securely up against the bone while the healing process takes place.

    If there are any bone spurs, they will be removed with a small tool that similar to a Dremel.
    The incision site/portal sites are closed with a blue colored suture called Prolene. The sutures will be removed when you are seen in the office at 10 to 14 days post-surgery.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites followed by ABD pads which are a larger fluffy dressing, followed by surgical tape. Your specialized shoulder sling will be fitted in the operating room.

    You will get a detailed set of instructions on wound care upon discharge from the surgery center.

    Night of Surgery

    It is very important you stay on top of the pain. Ice is key. Use ice as MUCH as possible. Dr. Grossfeld recommends continuous use of ice around the clock. The rule is you cannot use too much ice. Whether it is a Polar Care unit or bags of frozen peas: use it continuously for 6-7 days after surgery.

    Polar Care units are available for purchase Orthopaedic Specialists for $150.00. They are not covered by insurance. Polar Care is a motorized ice machine which consist of a neoprene wrap that gets placed over the operative shoulder and a cooler that is filled with ice and water. A hose connects to a neoprene wrap that goes around the shoulder, and will push water through the neoprene wrap for up to nine hours. Please freeze eight water bottles before your surgery. Put four frozen water bottles into the Polar Care unit. Then, fill with water. This will keep the with water colder longer. When the four water bottles defrost, replace with four more frozen bottles and put the defrosted bottles back into the freezer. Continue to repeat this cycle. Use ice around the clock, even when sleeping. Ice is the best source of pain control and swelling.

    Set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours OR Meloxicam 15 mg every 24 hours can also help to reduce post operative pain. Do not use Motrin or Meloxicam if you are on blood thinner or have a history of stomach ulcers or kidney disease

    Sleeping in a recliner, in an upright position, or using lots of pillows to support your shoulder will be more comfortable. Some people will sleep in a recliner for up to 4 weeks after surgery. Lying flat in bed allows your shoulder to roll back which tugs on the repair, and will cause pain.

    Sling Use

    You will wake up in the recovery room with your sling on. Occasionally you may take the sling off while at rest, (NOT asleep), as long as you place your arm against your belly. When asleep the sling must be on.

    Surgical Dressing

    A dressing, consisting of 4×4 gauze pads, ABD pads and special surgical tape will be placed on the surgical site(s). Please refer to your post operative orders given to you the day of surgery for dressing change details.

    Dressings to purchase before your surgery day are: 10-15 4×4 gauze pads, an extra 6-inch ace wrap, peroxide, paper tape and waterproof Band-Aids. Kits are available for purchase at Orthopaedic Specialists.

    First Post-Operative Visit

    Your first post operative visit will be 10-14 days post-surgery. Sutures will be removed by an assistant. Dr Grossfeld or Bess Fley, PA-C will go over your operative report, surgical photos, and answer any remaining questions. Physical therapy may be ordered. Typically, physical therapy is only once or twice a week for the first six weeks. PT will vary from person to person based on the size of the tear and repair quality.

    Home Exercises & Physical Therapy

    Exercises will be given to do post op. A link to these exercises is on the post operative instructions/orders given the day of your surgery. The link will show you how to do some gentle post operative exercises. A set of pulleys, which can be purchased from our office for $20, allow you to work on passive range of motion exercises at home after the surgery.

    Physical therapy is divided into three 6-week blocks. The first 6 weeks you will attend once a week to work on gentle passive range of motion exercises.

    The second six weeks therapy involves active range of motion of the shoulder with some gentle strengthening. You will attend 1-3 times a week, depending on your repair and other factors.
    The third six weeks of physical therapy involves increasing range of motion and further strengthening. This is about a five-to-six-month recovery before you are back to your normal activities involving the operative shoulder.

    Driving

    You may begin to drive after you’re off all narcotic pain medications. Once you begin driving your sling needs to be taken off while driving. It is recommended you place your hand, of the operative side, at the bottom of the steering wheel and your non-surgical hand at the top of the steering wheel to do most of the work.

    Return to Work

    If you work a labor type job, you may not return until you are released 100%. However, if your employer can accommodate light duty options you may return as soon as two to four weeks after surgery. Light duty options require no use of the surgical extremity, except for simple tasks such as using a computer.

    If you have an office type job, you can most likely get back to work between two to four weeks. Return to work also is dependent upon pain level. Some people have a lot of pain after this particular surgery, some people have very little. Pain is very personal, and we will supply you with pain medication in accordance to our office policy and Kentucky state law. Pain medication will be prescribed appropriately in regards dosages, amount, and time.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

    Bess Fley, PA-C, May 2023 Newsletter: Tennis Elbow

    Posted by Orthopaedic Specialists

    Sports Medicine in Louisville, KY, Orthopaedic Specialists, Bess Fley PA-C, Dr. Stacie Grossfeld Supervising Doctor

    From the Desk of Bess Fley: Tennis Elbow

    It’s that time of year when everyone is itching to get outside and enjoy the nice weather, and what better way than to play tennis or pickleball? Below, we’ll will discuss tips for both on and off the court to help prevent and successfully treat tennis elbow.

    What is Tennis Elbow?

    Tennis elbow, a.k.a. lateral epicondylitis, is when repetitive movement causes inflammation of the tendon that connects the elbow to the forearm muscles. This tendon is called the common extensor tendon. Read below for some easy prevention tips, signs of injury, what puts you at higher risk for developing this condition, and what you can do to treat it.

    Bess Fley, P.A., at Orthopaedic Specialists in Louisville, KY treats a variety of different injuries, including tennis elbow.

    Risk Factors for Lateral Epicondylitis

    • Playing a racket sport for more than 2 hours at a time
    • Poor form
    • Increased age
    • Those who work jobs with repetitive movements

    Physical Symptoms

    • Pain over the outside of the elbow (lateral epicondyle)
    • Pain with forced wrist extension

    Treatment Options

    Tennis Modifications That May Help

    • Book a private lesson at your club to work on form
    • Decrease the tension in the strings
    • Double grip the racket to decrease grip strength
    • Add a shock absorber

    If you or anyone you know is struggling with nagging tennis elbow, come in and see us! Not every treatment option is ideal for every patient, so we will discuss the risks and benefits to tailor a treatment plan that will best serve you!

    If you or someone you love has suffered a tennis elbow injury in the Louisville, Kentucky-area, Orthopaedic Specialists, PLLC can help! Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Patient of the Month: Joyce Koch

    Posted by Orthopaedic Specialists

    Meet this month’s patient in the spotlight, Joyce Koch!

    Joyce Koch suffered from arthritis in her knees, which Dr. Stacie Grossfeld at Orthopedic Specialists in Louisville, KY was originally treating her for, when she was rear-ended twice and needed physical therapy for back pain.

    If you were previously a student at St. Agnes, Assumption High School, or Presentation Academy, then Joyce’s name might be familiar. Having been a teacher since 1968, with 29 years spent at Assumption High School and the other 24 spent between Presentation Academy and St. Agnes teaching English and math, Joyce has had a long career in the Louisville educational field.

    What makes Joyce a true spotlight patient, though, is that she sought opportunities to become better and initiated changes in her community that benefited the students she taught, the teachers she worked alongside, and her school as a whole.

    When mainstream technology and computers became popular in the early 80’s, Joyce saw it as an opportunity to grow and took it, obtaining a degree in computer education at Spalding University along with her higher education degrees she already had in other areas. This led her to become first the technology coordinator at Assumption, and then the IT Director 9 years later, where she led the school in becoming leaders in educational technology for 20 years.

    Joyce Koch was a teacher at Assumption High School, Presentation Academy, and St. Agnes before she was injured in a car accident and needed physical therapy in Louisville from Dr. Grossfeld at Orthopaedic Specialists.

    Now retired since 2021, Joyce would have liked to have spent her last few years working as she always had: with pep, passion and without any pain. For much of her life, Joyce was able to enjoy being a mother, teaching, reading, yoga, stretching, and walking for miles without any difficulties. In fact, she belongs to 2 different book clubs, listens to audiobooks regularly, and lives her life with the motto that, “You always have time for the things you put first,” – something that she always managed to apply to her stretching routine! She loves walking through Louisville’s myriad of beautiful parks, and was even in the habit of walking the mile from her home to school every day when she was working at Assumption High School.

    Her time doing what she loved was cut short unexpectedly, though, when she experienced a series of injuries that put her out of commission in 2019.

    Joyce’s Story

    One After Another

    Before her recent injuries, Joyce’s relationship with Dr. Grossfeld and Orthopaedic Specialists dates back to 2005, when an instructional yoga video with her daughters triggered an arthritis flair-up in her right knee. This particular injury didn’t seem all that serious – when Dr. Grossfeld headed her PT, her pain went away and she had no complications until 2019, when her other knee began giving out on her. Deciding to take her issue to Dr. Grossfeld again, she made an appointment, but before she was able to address her knee, she was rear-ended in a car accident and began experiencing back pain that was much worse than her knee pain.

    Dr. Grossfeld was able to address her pain and injuries with medications and another bout of physical therapy, this time for her back, but before she experienced relief, less than a month from her accident, Joyce was rear-ended again, which worsened her condition to the point that standing and walking caused her severe pain. Now using a cane and having difficulties sleeping that also led to a pop-up case of temporomandibular disorder (TMD), Joyce felt it was time to take a leave of absence so that she could focus on resolving her pain. Dr. Grossfeld was able to send her to a pain specialist, who diagnosed a pinched nerve in her vertebrae that would require a series of treatments over the course of a few weeks.

    But, in the midst of her pain, the world was hit by the pandemic and Joyce’s pain center closed, leaving her without treatment until June of 2020. Even struggling with pain, Joyce managed to contribute to Assumption’s success during the age of online learning before her injury ever happened – she’d had the foresight to begin teaching the teachers about online instruction and how to navigate that world a whole year before, and her colleagues and students had never been more grateful, even as she was on leave.

    By the time she was able to receive treatment, Joyce’s back pain had caused her knees to worsen without the ability to walk or keep stretching, which led to her right knee replacement in 2021. But, as her right knee improved, Joyce found that her left knee’s development was moving in the opposite direction. Sure enough, Dr. Grossfeld completed a knee arthroscopy surgery to remove a meniscal tear in her left knee, which fixed her pain until her arthritis came back and she was sent to get her left knee replaced.

    Recovery and Joyce Today

    From her original concerns until her last knee replacement surgery, Joyce says that her recovery took around a total of 3 years. At the height of her pain, Joyce felt unable to do most things that she loved, including walking, stretching, and even cooking! While she tried to supplement some parts, like taking up water-walking at Dr. Grossfeld’s advice, the lack of sleep and weakness her injuries caused left her mood suffering.

    These factors combined with the effects of the pandemic caused her retirement to come earlier than she intended, but it allowed her to put 100% into getting better and back to a quality of life that was as close to where she was before as possible.

    Joyce Koch was the IT Director at Assumption High School and a leader in educational technology. When she was rear-ended and injured her back, Dr. Grossfeld at Orthopaedic Specialists in Louisville gave her the diagnoses and physical therapy she needed to recover.

    (Pictured Above: Mary Lang, President of Assumption High School, and Joyce Koch on March 22, 2023, when she was awarded a “Distinguished Educator” trophy and an honorary diploma.)

    “Dr. Grossfeld truly listens to what you are feeling and hones in on the correct plan of action. She and her staff are caring, compassionate people treating the whole person, not simply one offending joint. I have recommended them to my family and friends who feel the same way about them as I,” Joyce says, having done plenty of physical therapy and treatments with Dr. Grossfeld throughout the time she was injured and recovering.

    With the help of Dr. Grossfeld’s diagnoses and recovery methods, now, with the back pain under control and both knees replaced, Joyce is back to stretching first thing in the morning for 20-30 minutes to start her day and is able to walk 3 or 4 miles a day as she had before. Sleeping through the night and the ability to cook homemade meals every night once more has become normal, and Joyce says that the work was difficult in many ways, but that she’s grateful to be back to doing what she loves!

    If you or someone you love has suffered a knee or back injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Educación del paciente: Reparación del codo de tenista

    Posted by Orthopaedic Specialists

    Descripción General de la Reparación del Codo de Tenista
    Especialistas Ortopédicos 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    La cirugía de codo de tenista se realiza como un procedimiento ambulatorio.

    A su llegada al centro quirúrgico, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería.

    Anestesia

    La siguiente persona que conocerá es el médico de anestesia. En este momento, el anestesiólogo discutirá el proceso y abordará cualquier pregunta o inquietud que tenga sobre la anestesia. El anestesiólogo puede colocar un bloqueo nervioso para adormecer su brazo o el Dr. Grossfeld puede inyectar un anestésico local al final del procedimiento.

    Usted irá al quirófano donde se realiza la cirugía. Luego, el anestesiólogo administrará una anestesia general, por lo que estará completamente dormido para el procedimiento. Debido a que es una anestesia general, no escuchará ni verá nada de lo que sucede en la sala de operaciones.

    Procedimiento quirúrgico

    Una visión general de la cirugía de reparación del codo de tenista con el Dr. Grossfeld.

    El Dr. Grossfeld luego realizará la cirugía de codo de tenista. Este procedimiento dura entre 30-40 minutos. Tenga en cuenta que después de regresar a la sala de operaciones, toma entre 40 y 60 minutos irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 1.5 a 2 horas, dependiendo de qué tan extenso sea el procedimiento quirúrgico y qué deba solucionarse.

    El Dr. Grossfeld hará una incisión alrededor de la articulación del codo. Ella desbridará cualquier tendón no saludable y reparará el tendón desgarrado.

    Los anclajes de sutura están hechos de un hueso sintético, por lo que los anclajes se incorporarán realmente a su propio hueso. Los anclajes de sutura se colocan en el hueso que luego “ancla la sutura” y esas suturas se cosen a través del tendón extensor común para reparar el tendón dañado. La incisión se cierra con 2 capas de suturas que son solubles. Habrá tiras blancas estériles que también se utilizan para ayudar a cerrar el sitio de la incisión.

    Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD, que son un apósito esponjoso más grande, seguido de un relleno de yeso. Luego se aplicará una férula de yeso para que no pueda doblar el codo o la muñeca. En su primera visita postoperatoria, se retirará la férula y se le colocará un aparato ortopédico para el codo que permita un poco de movimiento del codo. También se le colocará una férula para la muñeca para limitar el movimiento de la muñeca.

    Una visión general de la cirugía de reparación del codo de tenista con el Dr. Grossfeld.

    Noche de Cirugía

    Es muy importante que te mantengas al tanto del dolor.

    Ella recomienda que configure su despertador y tome su medicamento para el dolor cada 4 a 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas o Meloxicam 15 mg cada 24 horas puede ayudar a controlar el dolor. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal.

    Primera visita postoperatoria

    Su primera visita postoperatoria será de 10 a 14 días después de la cirugía. Usted será visto en la oficina en ese momento y le quitarán los extremos de las suturas. El Dr. Grossfeld o Bess Fley, PA-C responderán cualquier otra pregunta.

    Fisioterapia

    La fisioterapia no se iniciará hasta la semana 6-7 después de la cirugía después de que se suspendan los frenillos. Esto es aproximadamente una recuperación de tres a cuatro meses antes de que vuelva a sus actividades normales que involucran el codo operatorio.

    Conducción

    La mayoría de las personas comenzarán a conducir una vez que hayan dejado de tomar todos los analgésicos y se haya retirado la férula en la primera visita postoperatoria: 10-14 días después de la cirugía.

    Regreso al trabajo

    Si trabaja en un trabajo de tipo laboral, lo más probable es que no regrese a ese trabajo hasta que sea liberado al 100%. Esto podría ser de 3 a 4 meses dependiendo de la descripción de su trabajo.
    Si su empleador tiene opciones de trabajo ligero, lo más probable es que sea liberado en cualquier lugar entre dos y cuatro semanas de regreso al trabajo liviano, y generalmente el servicio liviano no requerirá el uso del lado quirúrgico / el lado en el que se realiza su cirugía, excepto para tareas simples como usar una computadora o contestar un teléfono.

    Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre una y cuatro semanas. El regreso al trabajo también dependía del nivel de dolor y la descripción del trabajo. Algunas personas tienen mucho dolor después de esta cirugía en particular, algunas personas tienen muy poco. El dolor es muy personal y diferente de persona a persona.

    FMLA y papeleo de discapacidad

    Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

    Patient Education: Tennis Elbow Repair

    Posted by Orthopaedic Specialists

    Tennis Elbow Repair Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Tennis Elbow surgery is performed as an outpatient procedure. Upon arrival at the surgicenter you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team.

    A step-by-step guide of the tennis elbow repair surgery with Dr. Grossfeld in Louisville, KY.

    Anesthesia

    The next person you will meet is the anesthesia doctor. At this time the anesthesiologist will discuss the process and address any questions or concerns you have about the anesthesia. The anesthesiologist may place a nerve block to numb up your arm or Dr. Grossfeld may inject a local anesthetic at the end of the procedure.

    You will go to the operating room where the surgery is performed. The anesthesiologist will then administer a general anesthesia, so you are completely asleep for the procedure. Because it is a general anesthesia you will not hear or see anything going on in the operating room.

    Surgical Procedure

    Dr. Grossfeld will then perform the tennis elbow surgery. This procedure takes between 30-40 minutes. Keep in mind after you head back to the operating room it takes about 40-60 minutes to go to sleep and get positioned on the operating room bed so your family may not see you for 1.5 to 2 hours depending on how extensive the surgical procedure is and what needs to be fixed.

    Dr. Grossfeld will make one incision around the elbow joint. She will debride any unhealthy tendon and repair the torn tendon.

    The suture anchors are made out of a synthetic bone so the anchors will actually incorporate into your own bone. The suture anchors are placed into the bone which then “anchors the suture” and those sutures are then sewn through the common extensor tendon to repair the damaged tendon. The incision is closed with 2 layers of sutures that are dissolvable. There will be white sterile strips that are also used to help close the incision site.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites, followed by ABD pads, which are a larger fluffy dressing, followed by cast padding. A plaster splint will then be applied so you are unable to bend your elbow or wrist. At your first post operative visit the splint will be removed and you will be placed into an elbow brace that allows some elbow motion. You will also be placed in a wrist splint to limit wrist motion.

    An overview to tennis elbow repair surgery with Dr. Grossfeld.

    Night of Surgery

    It is very important that you stay on top of the pain.

    She recommends that you set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours or Meloxicam 15 mg every 24 hours can help control pain. Do not use either Motrin or Meloxicam if you are on blood thinners or have a history of stomach ulcers or kidney disease.

    First Post-Operative Visit

    Your first post operative visit will be 10-14 days post-surgery. You will be seen in the office at that time and have the ends of the sutures removed. Dr Grossfeld or Bess Fley, PA-C will answer any other questions.

    Physical Therapy

    PT will not be started until your 6-7th week after surgery after the braces are discontinued. This is about a three to four month recovery before you are back to your normal activities involving the operative elbow.

    Driving

    Most people will start driving once they are off all pain medication and the splint has been removed at the first post operative visit: 10-14 days after surgery.

    Return to Work

    If you work a labor type job, you will most likely not return back to that job until you are released 100%. This could be 3-4 months depending on your job description.

    If your employer has light duty options, you will most likely be released anywhere between two to four weeks back to light duty, and typically light duty will not require the use of the surgical side/the side your surgery is performed on, except for simple tasks such as using a computer or answering a phone.

    If you have an office type job, you can most likely get back to work between one to four weeks. Return to work also depended on pain level and job description. Some people have a lot of pain after this particular surgery, some people have very little. Pain is very personal and different from person to person.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.