Submitted by Brian Nagy, DPM

The mention of foot surgery can cause a frightening reaction for many people. Even just hearing the word “surgery” can cause them to run in the other direction. The need to use their feet every day increases their anxiety because they feel like they can’t afford to be off their feet.

This no longer has to be the case. With the advancements in surgical techniques and podiatry, minimally invasive surgery (MIS) makes it possible for patients to leave the hospital the same day as the surgery – without crutches or significant time off their feet. Read More ▸

Submitted by Brian Nagy, DPM

Feet are the foundation of the body. Fixing the foundation is critical to overall health. Experiencing pain in the body and feet is a warning sign that something is wrong. Instead of ignoring it, it’s important to slow down and evaluate what is going on. What most people don’t realize is that foot misalignment may be causing the pain. Read More ▸

Moby Parsons, M.D.

The knee joint has three compartments each of which can develop arthritis individually or collectively. These include the medial (inside), lateral (outside) and patellofemoral (knee cap) compartments. A substantial number of knees develop arthritis that is limited to the medial compartment with preservation of the other areas. Read More ▸

Moby Parsons, M.D.

1. Same-day means that you can actually go home just a few hours after surgery. Programs that call themselves same day and keep patients for 23 hours are not really same-day.
2. Many studies have now demonstrated that going home the same day is safe for a majority of patients provided no major medical problems that require active management around the time of surgery.
3. A majority of patients recognize that home is the best place to recover.
4. Preparation for surgery is key to success and same-day joint replacement requires that patients understand this process and take and active role in getting ready for surgery.
5. Modern techniques in anesthesia and pain management allow patients to recover quickly and be up and moving soon after surgery.
6. Rapid recovery programs involve much more than the surgery and include methods that reduce surgical stress such proper nutrition and hydration around the time of surgery.
7. Same-day discharge requires that much of the post-discharge care is coordinated in advance of surgery.
8. Experience is important and well-established programs are essential for patient success.
9. Outpatient surgery is the future of joint replacement and the percentage of patients that go directly home will continue to increase as time goes by.
10. As more of these cases are ultimately shifted to the ambulatory setting, the aggregate cost of joint replacement care will drastically decline, potentially saving billions of dollars in healthcare spend.

Moby Parsons, M.D.

Thirty years ago, patients who underwent total hip and knee replacement would often spend 2 weeks in the hospital, with the first several days spent on bed rest. Ten years ago, a four-day hospital stay was standard of care and at least 50% of patients would then transfer from the hospital to an inpatient rehabilitation center. Slowly, over time, hospital duration of stay has shorted to three days, then two and finally one overnight for many patients, and the percentage of patients going from the hospital to a rehab center has similarly declined so that now only 10-20% of patients require this. What used to keep patients in the hospital was primarily management of postoperative pain. Read More ▸

By Benjamin J. Schwartz, MD

When Courtney Gilman limped into my clinic, it was hard to believe he was walking let alone working as a tennis professional. Courtney had all the classic signs: stiffness, groin pain, difficulty sleeping at night, abnormal gait, and significant limitation in his quality of life and activities of daily living. A physical exam revealed decreased rotation of his hip and reproduction of thigh and groin pain with resisted flexion of his leg. X-rays performed in the office confirmed what I already knew, Courtney was a classic case of advanced arthritis of the hip. Read More ▸

By Moby Parsons, M.D.

Long-term fixation of the artificial socket component (glenoid) remains the principal problems in shoulder replacement. Traditional designs have relied on using bone cement to affix the glenoid component to the underlying bone. With repetitive shoulder use, the bond between the cement and bone can loosen leading to failure of the component and the potential need for revision surgery. This illustration demonstrates progressive loosening due to cement debonding. Signs of impending loosening on x-ray may occur within the first few years after shoulder replacement indicating the probability of eventual failure for these patients. Read More ▸