Orthopaedic Surgery

Call now to schedule your consultation with Dr. Colquhoun (209) 216-3510

Location

RMC Map

1801 Colorado Avenue, Suite 150
Turlock, California 95382
Phone: (209) 216-3510
Fax: (209) 216-3515

Click on the map above to get directions.

Hours

Mon-Friday 8am-5pm

FAQ Conservative Treatment

What is osteoarthritis?

Osteoarthritis is the “wear and tear” type breakdown of the cartilage in the joints. It sometimes is hereditary, but often is related to prior injury to the joint. Once the cartilage is gone, the bones rub together, as seen on x-ray as “bone on bone”.

How do I prevent osteoarthritis?

Healthy lifestyle choices including regular low impact exercise, flexibility training, a balanced diet, weight management and injury avoidance all help promote healthy aging, including the onset of osteoarthritis and other chronic diseases.

Is there anything I can take to help prevent osteoarthritis?

There is no supplement known to mainstream medicine that is proven to prevent the onset of osteoarthritis. If you think you have found something that helps you, run an experiment on yourself. Without changing other variables, take the supplement for a few weeks, then stop for a few weeks. Repeat this a few times until you decide for yourself if you really feel better.

What are common nonoperative treatment options for osteoarthritis?

Activity modification, ice, heat, topicals, wraps, physical therapy, anti-inflammatory medications, acetaminophen, tramadol, narcotic pain medications, corticosteroid injections and viscosupplementation injections.

When should I modify my activities?

When symptoms of osteoarthritis flare up, it is reasonable to modify your activities for a short time. Activity modification is not something recommended for long periods of time. When you remain inactive, the rest of your body takes a hit. Blood pressure, cholesterol, diabetes, cardiopulmonary function, weight management, mood, and other vital parameters are harmed.

Should I alternate ice and heat?

In the winter, people like more heat than ice. In the summer, people like more ice than heat. An old injury usually responds better to heat. A fresh injury responds better to ice. There is no finite answer. Find the rhythm your body responds to.

Are prescription topicals better than those found over the counter?

Most prescription topicals are no better than those found over the counter. Those with menthol tend to smell more like “medicine” but can be effective. We generally recommend Biofreeze. If the smell bothers you, try Aspercreme.

What kind of a wrap should I wear?

Find one that you like. There are different materials and designs. Try multiple wraps and find what works for you. If you wear it too much, you may find that it irritates you.

Are anti-inflammatory medications safe?

They are generally safe at the over the counter dose. Patients on blood thinners, with a history of heart disease, poorly controlled blood pressure, kidney disease, ulcers, reflux or gastric bypass surgery should use caution or abstain from these types of medications. When in doubt, talk to your primary care doctor, cardiologist or other medical subspecialist you see.

The safest prescription anti-inflammatory medication is celecoxib (Celebrex). It is safe for patients taking blood thinners and generally better tolerated by patients with ulcers, reflux or who have had gastric bypass surgery. Celecoxib is now available as a generic at a greatly reduced cost. Most insurance plans still don’t like to cover it though. Tower Pharmacy graciously offers celecoxib at a cash price just over their cost for our patients.

Is acetaminophen (Tylenol) safe?

Over the counter doses of acetaminophen are safe for those without liver dysfunction. Just make sure you take into account any acetaminophen you are already taking in your prescription pain medications.

Is it safe to take an anti-inflammatory medication with acetaminophen and prescription pain medication?

Yes, these medications can be taken at the same time, with the same glass of water, as long as the dose of acetaminophen from all sources is not more than 1000mg every six hours.

What is a steroid injection?

It is an injection of a mixture of local anesthetic and a corticosteroid.

How do steroid injections work?

The local anesthetic numbs the area of concern immediately. The steroid decreases inflammation.

How many steroid injections can I get per year?

Generally speaking, we do not like to give hip/knee steroid injections to people under 30 years old. For patients between 30 and about 45, one or two per year is about all we like to give. For those over 45, three or four per year is the limit. For elderly people with degenerative conditions who are not surgical candidates, we can give injections as often as once per month as a form of palliative care. Some areas should never be injected. Other areas should only be injected two or three times.

What are “rooster comb” injections?

These are injections of material harvested from birds, or synthetic material of similar characteristics, that mimic natural joint fluid. There are several brands. The number of injections vary between 1 and five. In our office we predominately use a five injection series of Supartz. We sometimes use different injections per insurance company requirements or patient request.

What are the side effects of injections?

Theoretically, there is a chance of getting a joint infection from any injection. That is why we use a sterile technique to clean the area thoroughly before giving an injection. More realistically, those with diabetes are most at risk of an adverse reaction from a corticosteroid injection. Brittle diabetics should not receive them. Every once in a great while someone can get a “pseudoseptic” reaction from a viscosupplementation injection.


FAQ Operative Treatment

How do I know when I’m ready for joint replacement surgery?

When significant pain persists in spite of conservative treatment, when that pain interferes with the ability to perform activities of daily living, the participation in low impact exercise or when it interferes with low impact hobbies then it’s time to consider joint replacement surgery.

I was fine until a few weeks / months ago, and now you are telling me I have bone on bone osteoarthritis?

Many people have osteoarthritis but are minimally symptomatic. Often there is a minor injury or period of overuse that makes patients with preexisting osteoarthritis become symptomatic. Since there is no known cure for osteoarthritis, the goal of initial conservative treatment is to treat the symptoms. Sometimes patients with bone on bone osteoarthritis on x-ray can function at a high level for quite some time.

My pain is not that bad, I can do everything I want to do, but you are telling me I still need surgery?

Sometimes patients develop a significant limp from a stiff hip, a knock knee or a bow leg that doesn’t seem to cause much pain in the involved joint. In these cases the deformity can affect the low back or other joints due to gait disturbance. Over time the deformity can progress to the point that it becomes very difficult to fix. In these cases, it’s often wise to proceed with joint replacement surgery.

How old is too old for joint replacement surgery?

There are many factors to consider besides age when determining if a patient is a candidate for joint replacement surgery. There are patients of all ages who are not surgical candidates. There are patients well into their nineties that are surgical candidates.

How young is too young for joint replacement surgery?

We are comfortable performing joint replacements on patients over 35.

Which approach to the hip does your team use for hip replacement surgery?

The direct anterior “muscle sparing” approach.

Does your team use the quad sparing approach for knee replacement surgery?

Yes, the curved incision along the inner margin of the knee allows patients to kneel better after knee replacement surgery.

What implants do you use for hip and knee replacement surgery?

We use Smith & Nephew predominantly for elective total hip and knee replacement surgery and Biomet for partial knee replacement surgery.

How do you close your incisions after hip / knee replacement surgery?

We use glue and tape, not staples.

How long does the tape and glue stay on my hip / knee?

Usually it stays on for about three weeks. When it starts to peel off it can be trimmed. Any remaining tape can be removed after three weeks. It’s not good to peel the tape off sooner because the incision can open up.

What do I do if my incision is draining after hip / knee replacement surgery?

The tape and glue are designed to seal the incision. Sometimes the seal is not perfect and there is drainage. If there is drainage, a gauze dressing should be placed over the area of concern and changed daily until the dressing subsides. If the drainage lasts more than a few days, please call us.

When is it safe to shower after hip / knee replacement surgery?

The tape and glue are designed to seal the incision. If the incision is completely clean and dry it is safe to shower.

How long do I need to stay after my hip / knee replacement surgery?

As long as your pain is controlled and you can walk independently, it is safe to go home if you have someone to stay with you for a few nights. Some patients choose to go home the day of surgery. Most patients stay overnight. Some patients with other significant debilitating medical problems stay two or even three nights. Any patient needing to go to a rehabilitation center is required by law to stay three nights.

Do you do double knee replacement surgery?

We perform double knee replacement surgery upon request in patients under 75 years old with no history of heart disease and in good general health. These patients generally stay two nights in the hospital, but sometimes stay three nights and go to a rehabilitation facility. We can also stage double knee replacements two weeks to several months apart.

Do I need to take antibiotics before getting dental work after hip / knee replacement surgery?

Yes, for life.

© 2015 Romeo Medical Clinic | Phone: (209) 216-3510 | Fax: (209) 216-3515 | 1801 Colorado Ave, Ste 150 Turlock, CA 95382