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The physicians of Greater Dallas Orthopaedics have been supportive of a community outreach program educating the members of their local community. The mission of this program has been to offer free educational seminars and workshops in the community that they serve. Several topics have been covered during these sessions and have included arthritis management, types of injuries, preventive measures, and treatment options.

This year they have focused these seminars on common conditions and treatments of shoulder hip and knee pain, Minimally Invasive Treatments for Hip, Knee, Shoulder and Elbow Pain, Tennis Elbow, Anterior hip replacement, Partial knee replacement, and non-surgical management of arthritis. The participation in these sessions has been excellent and the feedback from these seminars has been very supportive, demonstrating an absolute interest as well as a need in the community for continued education. Participants have enjoyed the open question and answer time with the Physicians.

Dr Hohman, a fellowship trained orthopaedic surgeon, specializes in total joint replacements (minimally invasive muscle sparing anterior total hip replacements/ minimally invasive partial/ total knee replacements) was most recently volunteering his time at the Red and Black Robotics Camp at Coppell High (pictured below answering the questions from the attendees), discussing the advances of robotics in orthopaedic surgery.

The physicians of Greater Dallas Orthopaedics are dedicated to serving you and our local community and can be seen caring for their patients at all of the local major health institutions. We also share news and related stories of importance in Orthopedic care with the community through the seminars. Any upcoming community outreach programs undertaken by our staff within the community will be highlighted through our office (214) 252- 7039 and website (www.GDOrtho.com). Please feel free to utilize the patient education and other educational resources that are available.

Dr Donald W Hohman MD is a fellowship trained orthopaedic surgeon specializing in total joint replacements of the hip and knee. Dr Hohman sees patients in the greater Dallas area with office visits available in both Dallas. If you have any further questions, he can be reached at 214-252-7039- feel free to utilize the educational material available through the web site www.GDOrtho.com

Please feel free to review the educational material provided and hear what his patients have to say on Dr Hohman’s YouTube channel or through social media:

https://www.youtube.com/channel/UChB-RySMGPyeohvO0PXvdXw

https://www.facebook.com/DrHohman

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The minimally invasive muscle sparing direct anterior approach (DAA) to the hip was initially described in the 19th century and has been used sporadically for total hip arthroplasty/ replacement (THA). In the past decade, enthusiasm for the approach has been reintroduced because of increased demand for minimally invasive techniques. New surgical instruments and tables designed specifically for use with the DAA for THA have made the approach more accessible to hip arthritis patients who are in need of total hip replacement.  The goal of this approach is to hopefully perform surgery that results in less muscle damage and pain as well as rapid recovery.  

Traditionally, elective total hip arthroplasty (THA) has been done with one of two approaches, direct lateral or posterior. Several years ago, in conjunction with increased demand from the general public for minimally invasive surgery, other approaches began to receive more attention and be used more frequently for performing these common procedures. Some of these approaches have had very high complication rates and fortunately only limited use. The direct anterior approach (DAA) to the hip appears to have sustained its popularity.  The approach is unique in that it takes advantage of a natural interval between 2 muscles.  There are no muscles which are removed from the bones, and the operation is performed between these muscles in order to implant the total hip components. This is important because there may be less muscle damage and pain as well as rapid recovery after hip arthroplasty. Most US surgeons’ familiarity with the approach is limited, but these possible improved outcomes have generated powerful interest in the DAA.

Additional benefits to this approach include the opportunity to avoid what is known as hip precautions following the total hip replacement.  Hip precautions are activity restrictions as well as positioning limitations which traditional total hip replacement patients must follow for the remainder of their life with the hip replacement in order to avoid dislocation of the hip.  Anterior hip replacement patients are not required to follow such precautions and the risk of dislocation with this approach is one of the lowest reported in the medical literature.  For additional educational information and several patient testimonials please feel free to view Dr Hohman’s YouTube site or review the information available on Facebook.

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

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Exercise, Arthritis and Diabetes

Although physical activity can potentially reduce the symptoms of arthritis, research suggests that over half of the people with arthritis of the hip and knee are not participating in adequate physical activity. If that is the case, then one may ask which types of exercise intervention are the most effective in relieving pain and improving function in people with hip and knee osteoarthritis? In addition to the specific types of activities, several other factors need to be considered as well. For example, individual experiences and attitudes toward exercise must be accounted for. Everyone has a different level of social support and has likely received some sort of advice from a health care professional.

 

Current international guidelines recommend therapeutic exercise (land or water based) are a central part of an effective management strategy of osteoarthritis. Research from studying patients attempting to manage their hip and knee osteoarthritis has demonstrated that exercise interventions that are able to combine strengthening exercises with flexibility and aerobic exercise are most likely to improve outcomes of pain and function.

 

We must also consider that positive physical activity experiences are recognized predictors of increased physical activity among people with arthritis. It is important that whichever activity is chosen, this activity needs to be the most likely to result in an overall positive experience. Improved physical activity confidence and social support are also associated with increased physical activity. Participating in these activities with someone who has a similar motivation will help to keep you involved and interested. It is important to consider these contributing factors when planning physical activity strategies for people with arthritis.

 

Increasing your activity will not only help your pain from arthritis but if you have diabetes improving your blood sugar control can help your joints as well as the rest of your health. Osteoarthritis and type 2 diabetes mellitus often coexist in older adults. Those with diabetes are more susceptible to developing arthritis, which has been traditionally attributed to common risk factors, namely, age and obesity. Alterations in lipid metabolism and hyperglycemia (high blood sugar) might directly impact the health of the cartilage and the bone that supports the joint surface, contributing to the development/progression of arthritis. In order for individuals who may have both conditions to adequately manage these issues they must have an understanding of the associated risk factors so that they may use this information to discuss options with their health care provides. The emerging links between diabetes and arthritis further emphasizes the importance of physical activity and the implications of safe and effective physical activity on your overall health and well-being.

 

There is plenty of scientific evidence that has accumulated to show significant benefit of exercise over no exercise. An approach combining exercises to increase strength, flexibility, and aerobic capacity is most likely to be effective for relieving pain, improving function, and keeping you healthy.

 

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

Like us on Facebook- Dr Hohman/ and take a look at our patient testimonials and educational material available through the site.

http://www.healthgrades.com/physician/dr-donald-hohman-y9vv6rz

http://orthodoc.aaos.org/hohman/index.cfm

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Can a Partial Knee/ unicompartmental knee replacement (UKR) Relieve your Knee Pain?

There are many different kinds of arthritic conditions that can affect the human body. Osteoarthritis, or degenerative joint disease, is the most common form of arthritis. The bones in a joint are covered with a tough, lubricating tissue called cartilage (the cushion in the joints) to help provide smooth, pain-free motion to the joint. As the layer of cartilage wears away, bone begins to rub against bone (“bone-on-bone”), causing the irritation, swelling, stiffness, and discomfort commonly associated with arthritis.

In some patients, only one part of the knee is damaged, while the remaining parts are completely healthy. In these cases, it is possible to replace only the damaged part of the knee with a metal and plastic implant. With a partial knee, only the damaged cartilage of the knee is replaced. The healthy parts are preserved. In the past decade, there has been a major increase in the use of unicompartmental knee replacement (UKR/ partial knee replacement) as surgical techniques have been refined. UKR has shown to be a reliable operation for isolated unicompartmental arthritis. UKRs now account for 8% to 10% of knee replacement procedures. Recent studies have suggested excellent medium- and long-term results of UKR. Overall, results have shown 85% to 90% survivorship at 10 years, with as many as 90% of patients reporting that they are very satisfied with the procedure and they have reported excellent subjective and objective outcomes. Recent studies suggest that unicompartmental replacement allows a high percentage of patients to return to presurgical sport and activity participation.

UKR has seen a revival in popularity because of the fewer and less severe complications in patients when compared to total knee replacement in appropriately selected patients. Improved component designs and advanced surgical techniques have promoted excellent results. Expanded indications to include the very young and the elderly have also shown similar clinical outcomes. Nonetheless, the success of unicompartmental replacement depends on proper surgical technique and patient selection. Long-term studies have shown that unicompartmental knee replacement is an alternative to total knee replacement.

These procedures can usually be done through a smaller incision and patients generally recover more quickly. Recent research has demonstrated that modern unicompartmental implants, evaluated at a an average of twenty years of follow-up in patients with osteoarthritis that was limited to one compartment of the knee, provided durable pain relief and long-term restoration of knee function without compromising future conversion to conventional total knee replacement. While there are some limitations to what can be accomplished with a partial knee replacement, regardless of its limitations, the functional benefits and lower risks of UKR make it an appealing treatment option for unicompartmental disease.

Dr Donald W Hohman MD is a fellowship trained orthopaedic surgeon specializing in total joint replacements of the hip and knee. Dr Hohman sees patients in the greater Dallas area with office visits available in Dallas. If you have any further questions, he can be reached at 214-252-7039- feel free to utilize the educational material available through the web site www.GDOrtho.com or social media outlets, https://www.facebook.com/DrHohman.

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Surgical interventions, including arthroscopic partial meniscectomy and loose body removal, are only recommended in osteoarthritic patients with mechanical symptoms. For patients with severe pain associated with osteoarthritis, surgical interventions such as high tibial osteotomy, total knee replacement, or partial knee arthroplasty, are often recommended. These procedures are considered end–stage surgical interventions and may be associated with complications.

If you’ve been suffering from chronic achy knees and have not responded to ibuprofen, injections, knee surgery, knee braces or physical therapy he may be a candidate for a minimally invasive solution.  A procedure known as subchondroplasty treats bone defects in chronic bone marrow lesions, which is an abnormal swelling in the soft bone below the joint surface.  Oftentimes patients who have bone marrow lesions suffer from pain, decreased function and cartilage destruction.  The condition typically leads to severe osteoarthritis and for some patients, total knee replacement.  Subchondroplasty is a much simpler and less expensive procedure which may offer the ability to extend the life of the knee by several years by supporting these areas which for whatever reason seem to be weak and causing pain.

During the procedure the surgeon uses a guide and special instrument to access the affected area which has been identified on MRI.  A special bone substitute material is injected into a small incision in the knee which allows new healthy bone to repair the defect.  This is typically done as an outpatient procedure and takes approximately 45 minutes or less and usually requires only a short period of rehabilitation, typically 6 weeks, as compared to 4-6 months for a knee replacement. Subchondroplasty is one of the most recent orthopaedic advancements with the hope of preserving the joint and avoiding further surgery.

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

https://www.facebook.com/DrHohman

http://www.healthgrades.com/physician/dr-donald-hohman-y9vv6rz

http://orthodoc.aaos.org/hohman/index.cfm

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Pin on Pinterest

Partial Knee/ unicompartmental knee replacement (UKR)

There are many different kinds of arthritic conditions that can affect the human body. Osteoarthritis, or degenerative joint disease, is the most common form of arthritis. The bones in a joint are covered with a tough, lubricating tissue called cartilage (the cushion in the joints) to help provide smooth, pain-free motion to the joint. As the layer of cartilage wears away, bone begins to rub against bone (“bone-on-bone”), causing the irritation, swelling, stiffness, and discomfort commonly associated with arthritis.

In some patients, only one part of the knee is damaged, while the remaining parts are completely healthy. In these cases, it is possible to replace only the damaged part of the knee with a metal and plastic implant. With a partial knee, only the damaged cartilage of the knee is replaced. The healthy parts are preserved. In the past decade, there has been a major increase in the use of unicompartmental knee replacement (UKR/ partial knee replacement) as surgical techniques have been refined. UKR has shown to be a reliable operation for isolated unicompartmental arthritis. UKRs now account for 8% to 10% of knee replacement procedures. Recent studies have suggested excellent medium- and long-term results of UKR. Overall, results have shown 85% to 90% survivorship at 10 years, with as many as 90% of patients reporting that they are very satisfied with the procedure and they have reported excellent subjective and objective outcomes. Recent studies suggest that unicompartmental replacement allows a high percentage of patients to return to presurgical sport and activity participation.

UKR has seen a revival in popularity because of the fewer and less severe complications in patients when compared to total knee replacement in appropriately selected patients. Improved component designs and advanced surgical techniques have promoted excellent results. Expanded indications to include the very young and the elderly have also shown similar clinical outcomes. Nonetheless, the success of unicompartmental replacement depends on proper surgical technique and patient selection. Long-term studies have shown that unicompartmental knee replacement is an alternative to total knee replacement.

These procedures can usually be done through a smaller incision and patients generally recover more quickly. Recent research has demonstrated that modern unicompartmental implants, evaluated at a an average of twenty years of follow-up in patients with osteoarthritis that was limited to one compartment of the knee, provided durable pain relief and long-term restoration of knee function without compromising future conversion to conventional total knee replacement. While there are some limitations to what can be accomplished with a partial knee replacement, regardless of its limitations, the functional benefits and lower risks of UKR make it an appealing treatment option for unicompartmental disease.

Dr Donald W Hohman MD is a fellowship trained orthopaedic surgeon specializing in total joint replacements of the hip and knee. Dr Hohman sees patients in the greater Dallas area with office visits available in Dallas. If you have any further questions, he can be reached at 214-252-7039- feel free to utilize the educational material available through the web site www.GDOrtho.com or social media outlets.

 https://www.youtube.com/channel/UCvQO_7jnsUZkFlEyjaVkG6w

http://orthodoc.aaos.org/hohman/index.cfm

http://www.healthgrades.com/physician/dr-donald-hohman-y9vv6rz

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Pin on Pinterest

Minimally invasive muscle sparing anterior hip replacement

The minimally invasive muscle sparing direct anterior approach (DAA) to the hip was initially described in the 19th century and has been used sporadically for total hip arthroplasty/ replacement (THA). In the past decade, enthusiasm for the approach has been reintroduced because of increased demand for minimally invasive techniques. New surgical instruments and tables designed specifically for use with the DAA for THA have made the approach more accessible to hip arthritis patients who are in need of total hip replacement.  The goal of this approach is to hopefully perform surgery that results in less muscle damage and pain as well as rapid recovery.  

Traditionally, elective total hip arthroplasty (THA) has been done with one of two approaches, direct lateral or posterior. Several years ago, in conjunction with increased demand from the general public for minimally invasive surgery, other approaches began to receive more attention and be used more frequently for performing these common procedures. Some of these approaches have had very high complication rates and fortunately only limited use. The direct anterior approach (DAA) to the hip appears to have sustained its popularity.  The approach is unique in that it takes advantage of a natural interval between 2 muscles.  There are no muscles which are removed from the bones, and the operation is performed between these muscles in order to implant the total hip components. This is important because there may be less muscle damage and pain as well as rapid recovery after hip arthroplasty. Most US surgeons’ familiarity with the approach is limited, but these possible improved outcomes have generated powerful interest in the DAA.

Additional benefits to this approach include the opportunity to avoid what is known as hip precautions following the total hip replacement.  Hip precautions are activity restrictions as well as positioning limitations which traditional total hip replacement patients must follow for the remainder of their life with the hip replacement in order to avoid dislocation of the hip.  Anterior hip replacement patients are not required to follow such precautions and the risk of dislocation with this approach is one of the lowest reported in the medical literature.  For additional educational information and several patient testimonials please feel free to view Dr Hohman’s YouTube site or review the information available on Facebook.

https://www.youtube.com/channel/UCvQO_7jnsUZkFlEyjaVkG6w

https://www.facebook.com/DrHohman

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

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There have been various changes in the management of surgical patients during the past several years, including less soft tissue damage during surgery, improved pain control, early mobility after surgery, and new rehabilitation protocols.  All of these have led to earlier hospital discharge after total joint replacements.  The average duration of hospitalization has decreased for patients who underwent total knee replacement in the United States by more than half of what it was only 10 years prior. There is significant evidence to suggest that patients who are discharged early have similar functional results, and outcomes are equivalent to patients who remained in the hospital longer.  There is a change in the way patients are cared for on the horizon and selected patients who receive the appropriate preoperative education are very likely to have a successful and safe experience when discharged on the day of surgery. Outpatient total knee, partial knee and total hip protocols have been described. The success of these strategies have been attributed to multiple factors, including improvements in surgical techniques with less soft tissue damage, improved pain management with a focus on controlling pain with multiple strategies , early mobilization to ensure the fastest recovery, changes in rehabilitation techniques, and in some circumstances discharges to inpatient rehabilitation facilities. Patients who are indicated for a total hip or knee replacement, and who are considered sufficiently healthy for early discharge, may be candidates for these accelerated pathways to successful joint replacement. These strategic pathways combine preoperative patient education, oral pain medications, early mobilization, and intensive physical therapy. The goal is to allow safe discharge from the hospital or specialized facility on the day of surgery.

View success stories here- https://www.youtube.com/channel/UCvQO_7jnsUZkFlEyjaVkG6w

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

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Osteoarthritis in Adults

Osteoarthritis refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. It is the most common form of arthritis, and one of the leading causes of pain and disability worldwide. The most commonly affected peripheral joints are the knees, hips and small hand joints. Although pain, reduced function and effects on a person’s ability to carry out their day-to-day activities can be important consequences of osteoarthritis, pain in itself is of course a complex issue, and associated with changes in mood and sleep. There is often a poor link between changes on an X-ray and symptoms: minimal changes can be associated with a lot of pain and modest structural changes to joints often can occur without with minimal accompanying symptoms. Contrary to popular belief, osteoarthritis is not caused by ageing and does not necessarily deteriorate. There are a number of management and treatment options (both pharmacological and non-pharmacological) that have varying degrees of success.

Various guidelines address the interventions for control of symptoms and improving function. Osteoarthritis is characterized pathologically by localized loss of cartilage, remodeling of adjacent bone and associated inflammation. A variety of traumas may trigger the need for a joint to repair itself. Osteoarthritis includes a slow but efficient repair process that often compensates for the initial trauma, resulting in a structurally altered but symptom-free joint. In some people, because of either overwhelming trauma or compromised repair, the process cannot compensate, resulting in eventual presentation with symptomatic osteoarthritis; this might be thought of as ‘joint failure’. This in part explains the extreme variability in clinical presentation and outcome that can be observed between people, and also at different joints in the same person. There are limitations to the published evidence on treating osteoarthritis. Most studies have focused on knee osteoarthritis, and are often of short duration using single therapies. Although most trials have looked at single joint involvement, in reality many people have pain in more than one joint, which may alter the effectiveness of interventions.

Whichever guidelines one chooses to follow, the mainstay of treatment for symptomatic arthritis remains remarkably similar for the hip or the knee.  Patients can oftentimes be encouraged to learn than 1 pound of weight loss up top can translate into 6 pounds less on each knee with each step.  This means that a 5 pound weight loss could result in a 30 pound difference with each step on each knee, and oftentimes this makes a significant difference for patient in the management of their symptoms.  Nonsteroidal anti-inflammatory medications can be very helpful in relieving the inflammation which is associated with the osteoarthritis process.  Oftentimes a brace can help relieve pressure in the affected compartment.  Symptomatic relief remains the goal of management as surgical procedures in the management of arthritis and their best results when they are performed for their pain relieving benefit.

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com or his office can be reached at 214-252-7039.

https://www.youtube.com/channel/UCvQO_7jnsUZkFlEyjaVkG6w

http://www.healthgrades.com/physician/dr-donald-hohman-y9vv6rz

http://orthodoc.aaos.org/hohman/index.cfm

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Robotics in Orthopaedic Surgery

Robotic systems have been used in surgery since the 1980s and first became used in orthopaedic surgery in the early 1990s for use in planning of total hip replacements and optimal positioning of final implants. The use of robotic systems has subsequently increased, with promising short-term x-ray confirmed outcomes when compared with standard techniques in orthopaedic procedures. Robotic systems can be used as haptic (or surgeon-guided) devices.  Haptic systems with continued technological improvements have become widely used in surgical procedures. Specifically, the use of tactile systems in unicompartmental knee replacement (UKR) has addressed some of the historical and well recognized mechanisms of failure of non-robotic UKR. These systems assist with increasing the accuracy of the alignment of the components and produce more consistent ligament balance. Short-term improvements in clinical and x-ray outcomes have increased the popularity of robot-assisted UKR. Robot-assisted orthopaedic surgery has the potential for improving surgical outcomes and returning patients to their desired level of activity. There are different types of robotic systems available for use in orthopaedics and considering the indications and limitations of these technologies are important for patients to understand.

The number of total joint arthroplasty procedures performed in the United States has steadily been increasing. However, the number performed utilizing robotic systems are very few in comparison. The evidence for the benefits of robotic systems is growing with short-term improvements in clinical and x-ray outcomes having been described. It is well known that patients are well informed about the benefits and have realistic expectations following conventional joint replacements. However, robotic systems in orthopaedic surgery are relatively new and it is important for patients to have realistic expectations in order to improve patient satisfaction with their orthopaedic procedures.

Donald Hohman MD is a fellowship trained Orthopaedic Surgeon specializing in joint replacements of the hip and knee. He completed his specialty training at the Brigham and Women’s Hospital of the Harvard Medical School- Boston, MA. If you have any further questions please feel free to utilize the educational material provided on the website www.GDOrtho.com / like Dr Hohman on facebook for patient testimonials, or his office can be reached at 214-252-7039.

 

http://www.healthgrades.com/physician/dr-donald-hohman-y9vv6rz

 

http://orthodoc.aaos.org/hohman/index.cfm