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Home , Dislocated shoulder, Joint replacement, Knee replacement, Shoulder replacement

The Handbook FROM SOUTHERN & JOINT SPECIALISTS

FINDING YOUR WAY BACK TO AN ACTIVE LIFE WITH

FIND OUT WHAT’S CAUSING YOUR

HOME EXERCISES THAT RELIEVE JOINT PAIN

ROBOTIC AND ADVANCES IN , KNEE & REPLACEMENT TREATING It’s estimated that 25% of us experience in shock absorption. Considering the What is causing your knee pain? the inside. knee pain. The good news is that many meniscus layer is only about one-fourth Pain is broken down into two • Pain from problems: Inflamed times, the cause can be soft tissue of an inch thick, this padding does a categories: acute or chronic. If you fall that connect the knee cap to the or injury and can be treated with a minor remarkable job of softening impact and down and hurt your knee or twist your shin bone can cause pain. procedure. The key is to understand vibration when our feet hit the ground knee, that is called “acute” knee pain. what may be causing your knee pain and when , running and jumping. This Chronic pain is something that occurs When knee surgery is necessary how the amazing knee joint enables us to underscores the importance of injury more gradually over time, often getting When nonsurgical treatment walk, run, jump and turn. prevention when it comes to the knee. worse as weeks, months and years go by. options – like therapy, injections and anti- The knee joint is comprised of four Once you damage the shock absorber, Unlike acute pain which can be linked inflammatory – fail to relieve . The largest of these is the , you are that much more susceptible to to a specific accident – like when you fall or pain symptoms, the only way to heal a or bone. Also found in the knee and damage to the joint. twist your knee – chronic pain is more like knee problem may be through surgery. is the , sometimes called the shin When we are young, the meniscus an ache that is not linked to any event. Also, when joint surfaces have eroded bone. Alongside the tibia, on the outside is tough. But it can tear as a result of During your visit to Southern Bone away because of arthritis, then knee of the leg, is the fibula. The fourth a sports injury. As we reach our 50s, and Joint Specialists, the knee specialist surgery may be unavoidable. About 20% bone found in the knee is the or meniscus can tear with just a slight twist will ask when and how your pain started of knee patients require surgery. kneecap. It’s cradled within the patellar of the knee. During arthroscopic surgery to learn more about the potential cause of tendon, and lies directly in front of of the knee, the knee surgeon can pain. Next, the the knee surgeon will use Surgery to repair a torn ACL the femur. The patella assists in knee repair and remove the torn part of the his hands to move the knee joint to test One of the most common knee extension, increasing leverage by lifting meniscus, while at the same time trying for stability. Diagnostic test like X-rays will injuries is a torn ACL. The Anterior the quadriceps and patellar tendons to preserve as much of it as possible. provide a visual of your knee joint. Cruciate (ACL) works a lot like a away from the joint. guide wire that keeps the femur and the Both the lower end of the femur and Knee pain from ligament injury The most common cause of knee pain tibia stable. When an athlete tears their upper end of the tibia are covered with connect one bone to Use the knee pain flow chart in this ACL, usually it is from a sudden twist on articular , a smooth rubbery another. They are made up of tough handbook to self diagnose your knee pain. the knee joint. This can cause an audible material, which allows one surface to collagen fibers that straighten when force Most causes of acute knee pain fall into pop or at least a great deal of pain. The glide one upon the other with minimal is applied and permits the ligaments to the following categories: main hallmark signs of a torn ACL is the friction. Sandwiched between the two endure large internal stresses during • Knee cap pain: Pain from a knee cap audible pop, a feeling of instability in the are meniscus tissue, which acts as normal joint motion. The four major usually becomes most noticeable when knee, nausea and swelling. an additional cushion for the joint. ligaments of the knee are: walking up stairs, going down stairs, Torn ACLs are one of the most In addition to the meniscus, there 1. the anterior cruciate ligament running or sitting. common problems associated with is articular cartilage covering the ends 2. the posterior cruciate ligament • Pain from a torn meniscus: If the sports. It is important to understand your of the femur and tibia, and the back of 3. the medial collateral ligament meniscus is torn, stretched or out of place, options if you have a torn ACL. the patella. Articular cartilage is found 4. the lateral collateral ligament pain may occur when the joint is moved. Repairing the torn ACL does NOT throughout the body anywhere two The stability of the knee is largely due You often get mechanical symptoms involve sewing two torn ends together. bones meet and glide against each other. to how all four ligaments work together. of clicking, popping or locking with a Instead, think of your ACL as a rubber They are the structures that ultimately meniscal tear. band. Once it snaps, it can not be sewn Knee pain from meniscus injury hold the tibia and femur together, while • Pain from ligament tears: When the ACL together. Instead, you have to replace Our are fortified with an extra permitting motion. is torn, it is often because the leg rotates the rubber band completely. And that layer of cartilage just between the femur The anterior cruciate ligament (ACL) while the stays planted on the ground. is exactly what the knee surgeon does. and tibia. Meniscus tissue protects the is deep within the knee. It crisscrosses Often times an ACL tear is accompanied They harvest a ligament from another articular cartilage by spreading out the the posterior cruciate ligament (PCL) and by a loud popping sound from the knee area of your body, attach one end to your forces placed on the joint surfaces during keeps the tibia from sliding too far forward and the support of the knee gives way. A shin, thread it through your knee and movement. To imagine how valuable this in relation to the femur. The PCL does the posterior cruciate injury happens when anchor the other end to your femur. function is, consider that forces on the opposite. It prevents the tibia from sliding the knee is forced backwards or when it Some knee surgeons use a knee range from about twice our body excessively backwards. The ligaments that receives a hard impact. A medial collateral patellar tendon while most others use weight during normal walking, to more provide sidewise stability to the knee are ligament injury most commonly occurs a hamstring ligament. There are pros than four times our body weight when the medial collateral ligament (MCL) and when the knee is hit from the outside and cons to each. Harvesting a patellar running, twisting or jumping. lateral collateral ligament (LCL). These while a lateral collateral ligament injury tendon from the front of the knee makes The meniscus also plays a role ligaments limit side-to-side motion. occurs when the knee is impacted from for a more painful recovery and painful

Page 2 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 3 TREATING KNEE PAIN TREATING KNEE PAIN

3688 Veterans MeMorial Dr. Hattiesburg, Ms 39401 appointMents, referrals & 2nD opinions: 601-554-7400 online encyclopeDia about spine & ortHopeDics at: soutHernboneanDJoint.coM

joint, which can be complex surgery, and months or a year for full recovery to involve removing more healthy bone. activity. Consequently, before even considering surgery Who Is A Candidate? as an option, generally an orthopedic Knee replacement is typically a surgeon will try to find other ways of procedure reserved for those who are relieving knee pain symptoms. over 50 years of age who are in relatively For instance, , good health. In fact, 70 percent of knee anti-inflammatory , steroid replacements are done on those over the medication and walking aids may be used age of 65. for knee pain stemming from arthritis. Knee replacement candidates will However, when other treatments fail to find it comforting to know that they provide pain relief, knee replacement will be able to resume some athletics surgery may be the only option left. following surgery such as hiking, biking, Artificial knee joint replacement swimming, doubles tennis and golf. surgery typically lasts less than two Also, those who are overweight are hours. The knee is opened up and the not good candidates as the artificial joint kneecap is moved out of the way. The (just as the natural knee) is designed knee surgeon then shaves off the bottom to carry a weight in proportion to the of the femur and the top of the tibia. The person’s body. Too much weight on the is then fitted and glued to the artificial joint can cause it to be damaged bones with surgical cement. The knee is and subsequent knee will be then sutured back together. necessary. After surgery, the patient will Consequently, most knee surgeons probably require the aid of a walker for will require an obese or morbidly obese a few days before putting full weight on candidate to lose signifant weight before the leg. Most patients are 85% recovered they perform a knee replacement reconstruction is an outpatient procedure after six weeks, but it may take up to 6 surgery. and you should be able to leave one hour or so after hour surgery is completed.

Knee Replacement Surgery While ligament and meniscus tears are relatively easy to resolve and enable the person to return to running and full activity, knee pain from an arthritic knee joint is more serious. Each year there are more than 600,000 knee joint replacement rehabilitation. However, professional the strength of the ligament is sufficient. surgeries. Many of these are preventable athletes who are used to pain from Using an arthroscope, the knee because degenerative knee joints are training are more able to tolerate this surgeon can repair the knee through often caused by . Sadly, one-third approach, especially considering that two tiny half-inch incisions instead of a of Americans now are obese or morbidly the patellar tendon is viewed by some longer incision which requires a longer obese, and the knee joint was never surgeons to be a higher performance recovery and causes a bigger . The designed to carry a heavy moving object. replacement for the torn ligament than surgeon will remove a strand from the Because the life of an artificial knee the hamstring. patellar tendon or hamstring, which will joint is about 15 to 20 years, a knee Using a hamstring ligament is less ultimately become the new ACL. A hole Most knee pain relates to soft tissue injury to the meniscus, articular cartilage or surgeon will attempt to delay surgery to painful after surgery during rehab, and is then drilled through the shin bone and ligaments in the knee which can be treated with minor arthroscopic surgery. In many avoid having to remove a worn out knee some surgeons feel that for most people, the new ACL is threaded through. ACL cases the person is able to get back to running and other activities.

Page 4 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 5 KNEE EXERCISES AFTER TREATMENT DIAGNOSING SHOULDER PROBLEMS

Treating knee pain from ligament or meniscus injury will require special Start position exercises that improve the strength and flexibility in the knee joint. This will help prevent additional injury. A chair is essential to provide support. Finish position WHAT CAUSES Standing Knee Raises Stand behind a chair. Bend operative leg at the knee. Hold knee in bent position for 5 seconds. Return to ground. Do 10 repetitions on each side, repeat 3 times Shoulder pain? a day. Do you have shoulder pain? You’re not tendons. A majority of these problems fall approach 100 pitches to prevent overuse alone. About 8% of Americans have into three major categories: tendonitis/ syndrome and permanent damage to the Seated Knee Extension shoulder pain, according to the American bursitis, Injury/instability and arthritis. joint. Start position Academy of Orthopedic Surgeons. Sometimes rotator cuff problems Sit down in a chair. Straighten leg at the The good news is that unlike hip joint Tendonitis can respond well to non-surgical Finish position knee. Hold knee out for 5 seconds. Return pain which is often linked to arthritis, A tendon is a cord which connects treatment options. This can include the to the ground. Alternate sides. Do 10 shoulder pain is often linked to injury of muscle to bone or other tissue. Similar to “RICE” approach: (REST from the activity repetitions on each side, repeat 3 times the ligaments, tendons and rotator cuff the wearing process on the sole of a shoe causing the pain, apply ICE to the injured a day. mechanism. which eventually splits from overuse, area, COMPRESS the injured area, and The shoulder is composed of most tendinitis is a result of the wearing ELEVATE the injured area above the heart three bones: the upper (), process that takes place over a period of to reduce swelling). the shoulder blade (scapula), and the years. collarbone (). The upper arm Bursitis bone fits into a rounded socket in the Rotator Cuff Tears In some cases, excessive use of shoulder blade. The muscles and tendons As the most flexible joint in the body, the shoulder leads to and Chair Knee Extension keep the arm bone centered in the the shoulder is capable of performing a swelling of a bursa, a condition called While seated, keep one leg on the ground shoulder socket. These tissues are known wide range of activities. However, with bursitis. Bursas are fluid-filled sacs and place operative leg on a chair in front as the rotator cuff and cover the top this incredible range of motion, the located around the joints which lessen of you. Press knee down towards chair and of the upper arm bone and attach it to is at high risk for instability. the friction caused by movement of the hold for 20 seconds. Do 10 repetitions, the shoulder blade. The function of the The instability can lead to pain. Overuse joint. Sometimes the many tissues in the repeat 3 times a day. rotator cuff is to raise and lower the arm. can lead to rotator cuff tears. Causes of shoulder become inflamed and painful, a can be improper lifting, which in turn may limit the use of the Common causes of shoulder pain falling down, or repetitive strain on the shoulder. The joint may stiffen as a result, Rather than bone or joint surface shoulder. Baseball pitchers, for example, a condition known as a “frozen shoulder.” issues, most shoulder pain is caused by have the number of pitches counted The good news is that this condition can the soft tissues, muscles, ligaments, and and are pulled from the game as they often resolve itself. Pumps Start position Dislocated shoulder Lie on your back, or sit in a chair as shown, A shoulder can be partially dislocated and point your foot on the operative leg or fully dislocated. This can happen from away from body. Then flex foot up towards falling or from contact sports like football. Finish position body, holding for 5 seconds. Do 10 reps A hard hit pulls the arm out of the every hour. shoulder socket. It will swell up, become numb and weak, and bruise. Those who diagnose and treat themselves with home remedies and exercises do so at their own risk. ALWAYS discontinue any exercise that causes Arthritis pain. Arthritis can also cause shoulder pain. There are many types of arthritis,

Page 6 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 7 SHOULDER SURGERIES SHOULDER EXERCISES

but generally it involves wear and tear by suturing the torn tendon back to the joint replacement surgery. Shoulder Some shoulder pain can be caused by ligament strain. changes with inflammation of the joint, humerus. Recovery from surgery can be replacement surgery has been around These exercises with a Sportcord can help strengthen causing swelling, pain and stiffness. quicker and less painful, which explains since the 1950s and was originally used the shoulder and increase flexibility. why professional athletes elect for for severe fractures, but because of its Treatment of shoulder pain surgery to speed return to their sport. success, it has since been broadened to Start position Finish position Shoulder Internal Rotation Your shoulder surgeon at Southern During surgery for a rotator cuff tear, address arthritis. Keep the Theraband around waist level. Use the arm Bone and Joint Specialists may first the surgeon removes debris from the Each year, 53,000 people in the U.S. recommend a series of exercises to damaged shoulder cuff tendon. Next, if have surgery and right next to the band, keeping your in at your strengthen the muscles around the bone spurs are present, the surgeon will most patients are under 50 years of age. side. Turn your arm towards your stomach. Keep your shoulder. The physical therapist at the smooth the acromion area to prevent the In one study, 93% of patients got back to arm parallel to the ground. Return to starting position clinic can help restore stability and acromion from pinching the tendon. activity and were satisfied with the result slowly. Repeat. balance to the shoulder and provide of their shoulder replacement surgery. relief from pain and instability. Non- Shoulder Impingement Surgery Reverse shoulder replacement is steroidal anti-inflammatory medicines This minimally invasive procedure is another variation that was developed Shoulder External Rotation (i.e. ibuprofen) can help with the pain often performed on an outpatient basis. in the 1980s. This is used for those with Keep the Theraband around waist level. Use the arm and inflammation. Steroid injections may Shoulder impingement helps relieve pain completely torn rotator cuffs or have Start position Finish position opposite from the band, keeping your elbow in at your also be used to reduce inflammation and by decompressing the small enclosed had a shoulder replacement surgery side. Turn your arm away from your stomach. Keep pain, making the rehab process easier. area around the rotator tendon of the that did not relieve symptoms or restore your arm parallel to the ground. Return to starting Sometimes, however, for those shoulder joint. During the procedure, motion significantly. In reverse shoulder position slowly. Repeat. problems that can not be treated non- the bursa is removed and the orthopedic replacement surgery, the position of the surgically, the patient may have to surgeon trims back the acromion bone ball and socket are “reversed” where the undergo one of the following surgeries to to allow for normal pain-free motion. In ball is applied to the shoulder and the completely fix the issue. most cases, this procedure is performed plastic socket is attached to the upper arthroscopically. arm. This enables the person to lift the arm using a different muscle than the Military Press Using a scope with a camera and Shoulder Replacement Surgery rotator cuff. While sitting on a ball or chair, with dumbbells in Start position Finish position cutting device in the end, the orthopedic Arthritis or injury can also damage Shoulder replacement surgery has each hand, position your at shoulder level as surgeon is able to operate through a few the shoulder joint preventing a person one of the best outcomes in helping shown, and then press upward to the ceiling. Do 10 small half inch incisions to fix rotator cuff from lifting their arm. In severe cases, people back to activity, with 93% of repetitions. Try to do 3 sets. tears. The rotator cuff tear is repaired the only treatment available is shoulder patients able to return to golf. Shoulder replacement

Arm – Triceps Pulldowns Anchor your Theraband or Sportcord at the top of door frame. Grasp the ends/handles, and pull down Start position Finish position toward your , keeping your upper arms by the side of your body. Hold for 5 seconds, then relax. Repeat 10 times.

Shoulder Extension Hold the Theraband slightly below waist level, keeping the band right next to your side. Pull band across your body, stopping when you reach slightly over Start position Finish position your head. Return to starting position slowly. Repeat.

Those who diagnose and treat themselves with home remedies and exercises do so at their own risk. ALWAYS discontinue any exercise that causes pain.

Page 8 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 9 TREATING HIP PAIN

Body weight and hip pain Surgery tendons in order to access the area being Our hips form and develop in mass The goal of hip replacement surgery fixed. Direct anterior hip replacement WHEN IT’S TIME FOR and strength in proportion to the amount is to restore function to the hip joint for uses a technique that doesn’t require of weight our body was designed to hold. an average of 15 to 20 years, which is the cutting of muscles or tendons to expose So if you are a small woman, your hips typical life of a artificial hip joint. the joint being treated. are meant to hold a smaller amount of This explains why hip surgeons HIP REPLACEMENT weight than if you are a six-foot tall man. try to delay — where possible — hip Advances in hip surgery Unlike the knee and shoulder joints which Causes of Hip Pain covering on the ends of bones gradually Although the body is very adaptable replacement surgery so the artificial hip Hip replacement has improved have ligaments, muscles and tendons Some of the causes of hip pain wears away, becoming frayed and rough. and can learn to hold different weights, joint outlives the patient. That’s because greatly over the past 10 years. Years ago that can all cause pain symptoms — and include arthritis, , excess It typically develops due to many years a point can be reached where the body removing a worn out artificial hip joint is all hip replacements were done in the can respond to non-surgical options and body weight, and of use and affects people middle-aged is simply not comfortable supporting very complex surgery. hospital and involved several days of less invasive surgical procedures like mechanical abnormalities. and older. Osteoarthritis targets hands excess weight. Consequently, in the United States, recovery in the hospital. Today, about 15 arthroscopy to remove torn cartilage — Once the hip joint becomes arthritic and weight-bearing joints, such as knees, about 65 percent of hip replacements are percent of hip replacements are done in the hip joint is different. there are few treatment options other hips, feet and back. Risk Factors include: Avascular Necrosis on patients in their mid 60s. It is also not an ambulatory surgery center with the Most pain originating from the hip than hip joint replacement with an • Age – 45 years or older Avascular necrosis occurs when the recommended for the extremely obese patient going home later in the day or the area is often caused by arthritis that artificial hip implant. • Gender- majority are women tissue in the joints literally die when the as their extreme weight would destroy next morning. damages the surface of the ball and Sadly, excess body weight puts an • Hereditary conditions like defective blood supply is cut off to the bones. This the implant prematurely. In a “traditional total hip socket joint, causing painful bone-on- extra load on a degenerating hip joint and cartilage and malformed joints can be a temporary blood supply loss or Hip replacement surgery replaces replacement,” the incision can be up to bone friction that can make walking can worsen the pain symptoms. More • Joint injuries from trauma or sports a permanent loss. Causes of avascular the surfaces of the joint that glide over 12 inches long. The hip surgeon then excruciatingly painful. than one-third of Americans are now • Obesity necrosis can include alcoholism, steroids, each other. In the ball-and-socket joint, removes the top of the thigh bone obese, which is 20% over normal body • Diseases that damage cartilage or blood disorders. In the early stages of the ball is replaced with a ceramic or and removes the arthritic bone in the weight. The best way to avoid needing avascular necrosis, pain only occurs when metal ball. An incision is made to gain hip socket. A new ball and socket joint hip replacement surgery is by reducing Symptoms pressure is put on the joint. However, as access to the hip joint. The surgeon then implant replaces the arthritic joint. A your weight to the normal recommended • Pain and inflammation the necrosis worsens the pain is present removes the diseased bone and cartilage. ceramic, metal, or plastic spacer is put weight range for your body size. For a 6 • Swelling and stiffness even while resting. In many cases, the The socket is smoothed down and a metal between the head and the socket so they foot tall man, normal body weight would • Loss of range of motion blood supply is lost permanently and the cup with a plastic, ceramic, or metal liner can glide smoothly against each other. be about 184 pounds. • “Sticking” and weakness damaged tissue must be removed and is placed into it. In “mini total hip replacement” Osteoarthritis is the most common • Loose fragments of cartilage cause replaced with a hip replacement. the incisions are smaller and different form of arthritis, affecting over 21 locking or “sticking.” Anterior Hip Replacement instruments are used prepare the bones million Americans. Three times as many • Joint may lose strength and buckle or Mechanical Abnormalities Direct Anterior Hip Replacement is and insert the new artificial joint. The women suffer from the disease than lock. Mechanical abnormalities are a surgery method that is an alternative surgery can involve a smaller incision of men. Osteoarthritis occurs when the rare, but can stem from childhood to the standard hip replacement surgery. about 4 to 6 inches. Or the surgeon makes disfigurement or fractures that never In the past, hip replacement surgery two incisions with each being about 2 healed properly. Initially, the body will required cutting certain muscles and inches long. In mini hip replacement X-ray try to compensate for the abnormality. However, as time passes, this will create wear and tear on other parts of the body. Ultimately, the remedy for this can be hip Each year in the U.S. more than 450,000 hip replacements replacement. are done and that is increasing because of two trends. First, baby boomers are now in their 60s and 70s and they expect to maintain an active life. The second reason is that one- Those with fragile bones that may third of Americans now are obese, which puts more wear easily break have osteoporosis. The and tear on the hip joint. Advances in hip replacement, disease is the result of lower than average including the use of robotic technology, has made the amounts of phosphate and calcium in the procedure safe and effective at restoring the ability to walk bones, which causes them to become without pain and enjoy an active retirement. porous and brittle. Your hip surgeon will determine if this is a complication for joint surgery.

Page 10 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 11 TREATING HIP PAIN HIP STRENGTHENING EXERCISES

Hip exercises will be an important part of recovery after hip replacement surgery to increase flexibility and restore the range of motion to the hip joint.

Hip Abduction – Standing Stand behind a chair for balance. With your operative leg, keep it straight and raise it out to the side with feet pointing forward. Hold in extended position for 5 seconds. Return to start position. Do 10 repetitions on each side, repeat 3 times a day.

Start position Finish position Straight Leg Raise Lie on your back. Bend your left leg. Extend right leg. Slowly lift right leg off floor without letting the knee bend. Do 15 repetitions once a day. Start position Finish position Repeat exercise to the other leg.

images are used to guide the surgeon. BEFORE hip replacement surgery While there will be some pain during A mini hip replacement provides the It’s important to make some the first month as you regain strength and following benefits: adjustments to your home to help your movement in the hip joint, it’s important • Because the incisions are smaller, recovery, including the following: to follow your surgeon’s instructions. This there is less damage to soft tissues. • Install a higher toilet seat. may include walking and to avoid sitting • Recovery is faster and less painful. • Put a seat in your shower or bathtub. for too long. • Outcomes studies imply the results • Install a hand-held shower spray. Longer term, your new hip joint match traditional hip replacement. • Remove things that could trip you up, should enable you to return to an active Ankle Pumps like cords and rugs. life without hip pain. Your hip surgeon Lie on your back, or sit in a chair as shown, and Robotic technology for hip surgery will provide recommendations on point your foot on the operative leg away from New robotic technology has AFTER hip replacement surgery approved activities. Generally low-impact emerged that uses the power of the After surgery, the patient will sports are safe after having a total hip body. Then flex foot up towards body, holding computer to create 3D images of probably require the aid of a walker for replacement. This includes golf, tennis, Start position Finish position for 5 seconds. Do 10 reps every hour. the damaged hip joint. In advance of a few days before putting full weight on biking, hiking, swimming and low-impact surgery, the hip surgeon uses the robotic the hip joint. Physical therapy will be aerobic exercise. technology and CT-scan images to map necessary to strengthen the hip joint out the optimal cuts which then use a muscles after surgery and improve the robotic arm to assist in the precise bone range of motion. Some patients are able cuts. The robotic technology can be to speed recovery over a month, while helpful in sparing bone during surgery others might need several months to Heel Slide by just removing the damaged arthritic return to walking. At home, you’ll need Lie on your back. Slowly slide one bone and leaving as much healthy bone to keep the incision site dry until your heel towards your buttocks. Return as possible. stitches come out to prevent . to start position. Alternate sides. Do Start position Finish position The other benefit is that the mapping For the first week after surgery, daily 10 repetitions on each side, repeat 3 and robotic arm accuracy improves the activities and moving around will be hard times a day. alignment and placement of the artificial to do on your own. You will need a person joint which can improve the function of to help out as you recover, otherwise you Those who diagnose and treat themselves the joint after surgery. may need to stay at a rehab hospital as with home remedies and exercises do so you regain strength. at their own risk. ALWAYS discontinue any exercise that causes pain. © 2021 • CENTERS OF EXCELLENCE FOR BETTER FOR HEALTHCARE OF EXCELLENCE P ri z m © 2021 • CENTERS opyright C

Page 12 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 13 it may be necessary to take at least 2-4 dressing and undressing. What to Expect preparing for weeks off. Your surgeon can sign a work Use a steady object or railing for You will most likely begin by reading, release if needed. balance, or have someone assist you, filling out, and signing forms, so it is very when changing clothes. If you have a important that you arrive to the hospital Exercise pet, consider having a family member or ambulatory surgery center on time. Building strength before surgery or a friend watch it after surgery. The After completing all paperwork, the Joint Replacement is one of they most important ways to objective is to eliminate as many tripping nurses will take you to a pre-op area ensure a successful recovery after the hazards as possible, so your recovery can where you will put on a hospital gown If you’ve exhausted all the non-surgical during recovery from joint replacement loss plan should begin immediately to surgery. This Joint Handbook offers many be as comfortable as possible. and an intravenous line (IV) will be treatment options for your joint pain, surgery. The issue with the dentist is that provide the greatest opportunity to meet exercises you can do to strengthen joint started in your arm. This IV will allow it may be determined that you need bacteria is spread via the blood stream your goal weight prior to surgery. This can areas. Always ask your physician if an Medications the anesthesiologist to give you fluids hip, knee or shoulder joint replacement with dental work and if you have a joint be achieved through a combination of a exercise is safe to do with your injured Many over the counter supplements and medications during the surgery. It is surgery. If so, will need to do several replacement operation the bacteria can healthy diet and exercise. Your physician joint. Begin exercising 6-8 weeks before or medications may need to be stopped common that the anesthesiologist will things to prepare for your joint end up in the joint causing an infection. may recommend the help of a dietitian surgery to give the muscles adequate two weeks before surgery. Be honest and come to visit you in your hospital room replacement surgery: Some doctors recommend for all patients to help meet your weight loss goal. time to gain strength. complete with your surgeon about what and run over a few things before your to take one dose of before Ultimately, the less weight pushing on a you are taking, and they will tell you what surgery. Also, your surgeon may put his 4-8 weeks prior to surgery any dental work for the rest of their new joint, the greater the lifespan of a Two weeks before surgery should be stopped before surgery. initials on the joint that is going tobe It is necessary that the patient takes lives. It is not recommended to return to healthy new joint. You will need to do some things replaced. This is done to prevent any certain preparation and precautionary the dentist for at least six months after around your home to make it more Health check confusion in the operating room. measures before surgery. Surgery may surgery. Quit smoking comfortable and safe for you after Be sure to notify your surgeon if make moving around and completing In addition to obvious breathing surgery. You need to prepare your bathing you do not feel well, have contracted an After surgery everyday activities difficult until the body Diet and weight loss problems, smoking can actually slow area with cleansing supplies and hand illness, had exposure to Covid, or if you After the surgery you will be taken to begins to recover, so it is important that The patient should begin a healthy down the healing process after surgery. grips for stability if possible. Remove any think you have an infection of some kind. a recovery room for one hour. Nurses will the patient is thoroughly prepared. This diet including whole grains, fruits and It is recommended that the patient takes floor rugs or furniture that could get in Certain conditions or may monitor your blood pressure, breathing, section will cover many of the steps the vegetables, protein, and iron rich foods at steps to decrease smoking or to quit your way. warrant rescheduling of your surgery pulse and temperature. Nurses may patient should take to be comfortable least 6 weeks before surgery. Drink plenty smoking completely. This process can be Prepare a meal list filled with until you are feeling better. instruct you to perform deep breathing and safe after surgery. of water or healthy fruit juices to ensure very difficult, so begin trying to decrease nutrients to help speed your recovery. and coughing exercises to help get your body is as healthy as it can be. smoking months before surgery. Ask your Consider preparing meals ahead of time, Transportation oxygen back into cells after undergoing Clean bill of health Because the more body weight you physician for help if needed. and freezing them for use after surgery. Make sure you have arranged for anesthesia. It is important that the patient is place on an artificial hip or knee joint, the Place anything you expect to need transportation from the hospital after In the recovery room, you may healthy as possible before undergoing faster it can wear out, your surgeon at Work release following surgery at a reachable level. you are done recuperating from your be instructed to perform certain surgery. It is advised that the patient Southern Bone and Joint Specialists may Be sure to take necessary steps to Plan some comfortable outfits surgery. Also, make sure the car has exercises that work the new artificial visits the dentist at least four weeks recommend that you lose excess weight inform your employer that you will be and place them in an area that is easily space for you to extend your legs, if you joint. It is important to engage in these before surgery in order to ensure that before undergoing surgery. Losing weight missing work after surgery. Depending on accessible, allowing plenty of room for are undergoing knee or hip surgery. there will be no dental complications is not an overnight process, so a weight the level of activity required by your job,

TESTS & DIAGNOSTICS IN ADVANCE OF YOUR SURGERY Most patients require preoperative blood tests (like a , etc.) and other routine health assessments in advance of any surgery. With joint replacement becoming more minimally invasive and faster than in previous decades, there can be less need for blood during surgery. If blood is needed, there are two types of blood transfusions : • Autologous is your own blood. It is the safest option. • Allogeneic blood transfusion is receiving blood from a blood bank donor. Most joint replacement specialists do not use blood bank donations, but are sure to have the patients blood typed and cross-matched if a blood bank is needed in an emergency. exercises and activities because it aids therapist to help you with gain strength requires you to stand. red or black and blue marks on the , in a successful recovery by increasing and recover the correct range of motion Some life long restrictions you need or chest pain. circulation throughout the body. in the new joint. to observe to protect your new joint After surgery you may feel pain, You may also have a catheter in It is recommended that after include avoiding running on hard surfaces, swelling, minor bloody drainage coming Robotic Surgery place. This is a tube that allows urine surgery, you have someone stay with you contact sports that could dislodge the from incision site, numbness around the to drain from the bladder. Do not be after you return home from the hospital. implant, or extreme sports that could incision, and a low-grade temperature. alarmed if you do not have a bowel If necessary, arrangements can also be cause a fall and dislocation. These have This is all normal. Southern Bone & Joint surgeons use the precision movement for a few days because made to stay at a rehabilitation facility the highest chances of damaging your It is important to let your doctor of robotic technology to map out in advance the pain medicine you received via IV after your surgery. joint. If you stay healthy, active and avoid know if you have extreme swelling or and orally, as well as the anesthetic The surgeon may recommend the heavy impact, then the new joint should high amounts of drainage at the incision precision cuts that spare bone and improve patient administered during surgery, can cause use of a walker for a few weeks as you last about 15 to 20 years. site, have high fever or are unable to bear outcomes from joint replacement. constipation. recover and regain strength in the joint. It After surgery, the surgeon will weight on your operated leg. may be from two to six weeks to be able typically encourage you to get out of bed Deep vein (DVT) is a Decades ago an orthopedic surgeon would treat all types of joint problems. With Recovery and rehab after surgery to operate a car efficiently. It will take and be as active as possible. Doing joint blood clot that forms in a deep vein. If not ever-increasing new technology and treatment advances specific to different After surgery, your surgeon at around two to four weeks to go back to exercises while in bed will help increase treated, the clot can travel to your lungs joints and bones, that’s changed dramatically. Over the past 15 years, orthopedics Southern Bone and Joint Specialists will work if your job requires you to sit all day, circulation and stops blood clots. There and cause life-threatening complications. has become super-specialized with surgeons now becoming fellowship-trained in require you to work with our physical and around eight to 12 weeks if your job are always inherent risks with any major Common symptoms usually occur a specific body part, such as foot/ankle or hand/arm or spine. surgery, but medications are given suddenly and in only one leg. They include Because of this super specialization in orthopedics, Southern Bone and Joint to reduce the risk of blood clots and pain in the deep muscle, swelling, aching Specialists is organized into CLINICAL CARE CENTERS which provide patients the antibiotics to help ward off infection after or tenderness. If the clot has moved to most advanced technology and care specific to their orthopedic injury or pain the lung you may experience shortness surgery. symptom. You will be instructed to take of breath or chest pain. This is a medical One example is the use of new Robotic Surgery Technology. The hip and anticoagulant medication, like Coumadin, emergency, and you should call 911. knee surgeons make use of Mako Robotic Surgery that improves the outcomes to reduce the chance of clots. Coumadin from hip and knee replacement. The technology enables the joint replacement () helps keep your blood from Pain medication clotting, but can increase your risk for You will be prescribed pain surgeon to map out in advance of surgery the optimal cuts in the bone for bleeding. medication to make you more the best surgical outcome and to spare as much bone as possible. In a clinical There are other medications, both comfortable. It is very important that you study, the Mako Robotic Surgery system created more accurate placement and by mouth and by injection, that are given take the medication as directed by your alignment of hip implants. This resulted in Less likelihood of ; to thin the blood and prevent blood surgeon. It is best to take pain medication reduced blood loss because the procedure was faster; and patients reporting clots. Don’t take any other medications with food and before pain begins. Do not that the hip implant had the feeling of a natural hip joint. without checking with your surgeon first. consume alcohol or attempt to drive Prior to surgery, the surgeon at Southern Bone and Joint Specialists uses a Report immediately to your surgeon if while on pain medication. You can use CT scan of the patient’s hip joint to generate a 3D virtual model of the patient’s ice and anti-inflammatory drugs like Advil you experience bleeding that doesn’t unique joint space. The 3D model enables the surgeon to visualize the joint stop in 10 minutes, coughing up blood, to reduce pain after you have stopped better than with a traditional x-ray. This enables the surgeon to precisely map diarrhea, dark urine or stool, dizziness, your blood thinner. out in advance the optimal cuts that spare the most bone and while improving the placement and positioning of the artificial joint implant. The Day of Surgery: What to do What NOT to do Return to activity with your new joint It should be your goal to maintain a ;; Sleep on clean linens the night before to prevent germs. :: Do not take medications that contain or ibuprofen for ;; Wear something comfortable & easy to get out of. seven days before your surgery. healthy lifestyle years after the surgery ;; Pack an extra outfit and extra underwear. :: Do not take any medications the day of your surgery unless has taken place. The artificial joint ;; Bathe or shower the night before the surgery. your doctor approves so. operates best and has a longer lifespan ;; Use some type of antibacterial to help clean all areas of your :: Do not eat or drink anything after midnight the night before when there is less weight pushing down body. Do not apply any perfumes or lotions after showering. your surgery or the morning of your surgery. on it. Practice healthy eating and exercise ;; Use clean towel for drying. :: Do not swallow any liquid the morning of the surgery. to lose weight and keep it off. Your new ;; Bring eyeglasses. Do not wear contacts. :: Do not smoke the morning of your surgery. joint will thank you for it. ;; It is important to be on time for your surgery. :: Do not chew gum or eat candy on the morning of your surgery. With that said, keep in mind that ;; Read all papers thoroughly and sign what is needed. :: Do not wear any makeup, nail polish, or jewelry including any artificial joints are subject to damage and ;; Bring driver’s license, insurance card, and /medicaid type of ring. wear-and-tear. Generally speaking, the card (if applicable). :: Do not apply any perfumes or scented lotions. goal is for an artificial joint to last 15 to ;; Most recovery rooms do not provide the patient their :: Do not shave the affected area. belongings. They monitor the patient for one hour and then :: Do not take insulin (unless instructed otherwise). 20 years. Although joint replacement will they go to their rooms. Once in their rooms it would be good help you get back to activity, remember to have books, playing cards, etc. that an artificial joint is never quite as ;; Notify the doctor of all the medications you take, and what effective as the healthy, natural joint you medications you want to take after surgery. were born with.

Page 16 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 17 Southern Bone and Joint Specialists Physicians 3688 Veterans Memorial Dr. Hattiesburg, MS 39401 appointments, referrals & 2nd opinions: 601-554-7400 Joint Replacement arthroscopy & sports medicine Online encyclopedia about orthopedics and spine care at: SouthernBoneandJoint.com Jacob Folse, M.D. Hunter Berry, M.D. Orthopedic Surgeon • Fellowship-trained in Joint Replacement Orthopedic Surgeon • Fellowship-trained in Sports Medicine Dr. Folse is a fellowship-trained joint replacement Orthopedic surgeon, received Dr. Berry received his sports medicine fellowship from the University of Texas his medical degree from Louisiana State University Health Sciences Center. Health Science Center. He has served as an assistant team physician for the Texans, UNDERSTANDING JOINT PAIN SYMPTOMS & He completed an internship in Greenville, S.C. and an Orthopedic residency at Rockets, Astros, Dynamo, University of Houston, and Texas 6-A North Shore high University of Mississippi Medical Center. He completed his fellowship at Southern school. He is involved in player evaluation at the NFL Scouting Combine. Joint Replacement Institute in Nashville, Tenn. WHEN YOU NEED TO SEE THE DOCTOR Robert Dews, M.D. Neal Gregg, D.O. Board-certified Orthopedic Surgeon • Fellowship-trained in Sports Medicine Board-certified Orthopedic Surgeon Dr. Dews is a board-certified, fellowship-trained, sports medicine Orthopedic TRAUMA, FALL, FRACTURE: Dr. Gregg is a board-certified general Orthopedic surgeon. He completed an surgeon. He completed an AO Trauma fellowship at Watauga Orthopedics and TRAUMA: Orthopedic residency from the Medical College of Georgia. Dr. Gregg is an adjunct a sports medicine fellowship at Mississippi Sports Medicine. Dr. Dews currently Any time there is trauma (fall, impact, car accident) HAND: clinical professor at William Carey University College of Osteopathic Medicine. serves as a sports medicine physician for the University of Southern Mississippi along with pain, a bone or joint could have fractured. NUMBNESS/WEAKNESS IN ARM / HAND: and William Carey University. X-rays will be needed to check for broken bones. See an Numbness or weakness in the arm or hand can James Sikes, M.D. orthopedic specialist or an Emergency Room. be an emergency symptom related to a herniated Board-certified Orthopedic Surgeon Lance Line, M.D. disc in the . Left untreated, the symptom Dr. Sikes is a board-certified Orthopedic surgeon and joined Southern Bone and Board-certified Orthopedic Surgeon, Fellowship-trained in Sports Medicine can become permanent. You should see a spine Joint Specialists in 2002. Dr. Sikes was an instructor for the AO/ASIF Fracture specialist within 3 days. Dr. Line maintains an active sports medicine practice with a interest SHOULDER: Management Foundation. Dr. Sikes is also certified in MAKOplasty, partial knee in shoulder conditions in Hattiesburg since 1995. He is currently a team physician resurfacing procedure using the RIO Robotic Arm Interactive Orthopedic System. for the University of Southern Mississippi. Following Orthopedic residency, he FROZEN SHOULDER can develop from NUMB FINGERS: Numbness in the tips of the overuse or inflammation. fingers can relate to Carpal Tunnel Syndrome. completed a one-year fellowship in Sports Medicine and Arthroscopy in Richmond, BURSITIS can make it difficult to raise the Watchful waiting with the use of a brace can be Ross Ward, M.D. VA which included an internship with the Pittsburgh Steelers professional football arm with twinges of pain. tried for a couple months. Numbness, if ignored Board-certified Orthopedic Surgeon program. Dr. Line was recently named as a volunteer Olympic team physician. TENDONITIS is inflammation of the over several months, can become permanent Dr. Ward is a board-certified Orthopedic surgeon, completed his residency and tendon which connects muscle to bone. and lifelong, along with weakness in grip. internship at the University of Texas Southwestern. Dr. Ward is also certified Chris Penton, M.D. Self care for all three can include anti- Treatment can include a 30-minute surgery to in MAKOplasty, partial knee resurfacing procedure using the RIO Robotic Arm Board-certified, Fellowship-trained in Non-Surgical Sports Medicine inflammatories and R-I-C-E: Rest, Ice, relieve the tightness in the wrist. Interactive Orthopedic System. He has special interest in total joints, foot and Christopher Penton, M.D. is fellowship-trained in non-surgical sports medicine. Compression & Elevation. Rest your ankle and shoulder. Penton received his bachelor’s degree in biology from Mississipppi College and shoulder for a day or so, using ice for 10 HIP PAIN not linked to dislocation due to trauma, fall or car his medical degree from the University of Mississippi. He completed a diagnostic minutes at a time. Compress the shoulder accident, is often linked to bursitis (inflammation of the joint) radiology residency and a family medicine residency in Texas. Penton then snugly with an elastic band (not tightly) or degeneration of the hip joint due to arthritis which damages foot & ankle completed a sports medicine fellowship at JPS Health in Arlington, Texas. and lie down with the shoulder elevated. the surface of the top of the thigh bone and the socket within An orthopedic surgeon can provide a the pelvis. steroid injection to improve motion and John Kosko, M.D. Douglas Rouse, M.D. • Self care for hip joint pain can include: anti-inflammatories; relieve pain. Orthopedic Surgeon • Fellowship-trained in Foot and Ankle Board-certified Orthopedic Surgeon • Fellowship-trained in Sports Medicine rest; ice or heat; and physical therapy. Dr. Kosko is a board-certified, fellowship-trained foot and ankle Orthopedic Dr. Rouse is one of the founders of Southern Bone and Joint Specialists, P.A. and • Visit an orthopedic surgeon for a thorough evaluation for the specialist. Dr. Kosko, a Greenwood native, received his doctor of medicine degree native of Hattiesburg. He completed a one-year fellowship in arthroscopy and KNEE: cause of your hip joint pain and treatment options. You should magna cum laude from the University of Mississippi School of Medicine. He sports medicine at the Toronto Western Hospital in Toronto, Ontario with Dr. HIP: see a doctor when you have a hip joint that appears deformed, completed an Orthopedic residency from the University of Mississippi Medical TORN ACL: A torn anterior cruciate if you are unable to move your leg or hip, or bear weight on Robert Jackson, the first orthopaedist in North America to perform arthroscopy. Center. At UMC, he received the Department of Orthopedics OITE Award, Resident ligament can involve an audible the leg. Research Award, Citizenship Award and Best Orthopedic Teaching Resident. He “pop” followed by a feeling of nausea • Long term treatment for an arthritic hip joint is hip joint THE SPINE CENTER and instability. A complete ACL replacement through artificial hip replacement or mini hip completed a fellowship in foot and ankle reconstruction from OrthoCarolina Foot tear will require surgery where a replacement. Hip replacement is often delayed where possible and Ankle Institute in Charlotte, N.C. He completed an AO Fellowship in Luzern, Hallie Bell, M.D. new ligament is harvested from the to minimize the likelihood of the patient outliving the artificial Switzerland. Board-certified Neurologist • Fellowship-trained in Neurophysiology hamstring or patellor tendon. joint which would require a complex revision surgery and a Dr. Bell is a board-certified neurologist. She completed her fellowship in BURSITIS can cause inflammation of second artificial joint surgery. Rob Robertson, M.D. neurophysiology at University of Mississippi Medical Center. She has 16 years of the “bursae” in the joint resulting in Orthopedic Surgeon • Fellowship-trained in Foot and Ankle experience in electrodiagnostic medicine. Dr. Hallie Bell specializes in non-surgical pain upon movement. ANKLE PAIN at the back of the leg above the ankle can Dr. Robertson is a fellowship-trained foot and ankle specialist, received his doctor spine care, including EMG diagnostic procedures. involve pain on the be related to a sprained or ruptured Achilles tendon, of medicine degree from the University of Mississippi School of Medicine. He lower leg following exercise or stress. which can be accompanied by a pop while performing completed an orthopedic residency from the University of Mississippi School James Antinnes, M.D. DISLOCATION occurs with an injury an activity, followed by intense pain and impaired ability of Medicine where he received the Department of Orthopedics OITE Award. or fall moving the knee “out of joint.” to walk. A torn Achilles tendon may require surgery. Board-certified Orthopedic Surgeon • Fellowship-trained Spine Surgeon Robertson completed a fellowship in foot and ankle from Medstar Union TORN MENISCUS can be caused by ANKLE SWELLING following activity or awkward Dr. Antinnes is a board-certified, fellowship-trained orthpaedic surgeon. He was an injury during activity. landing on the ankle can relate to a . If the Memorial Hospital in Baltimore, Md. selected for a prestigious spine research fellowship in Zurich, Switzerland where ARTHRITIC KNEE can be common swelling and pain does not self resolve over several days, he lived for three years, devoting his time researching the cervical and lumbar with age and can worsen when the an orthopedic surgeon should evaluate the ankle. Other hand & arm spine. He furthered his training in San Francisco at the University of California, person is overweight or obese. Long persistent ankle joint pain can be caused by arthritis. where he completed a fellowship in spinal deformities. term treatment may include knee ANKLE: PAIN IN THE HEEL is often plantar fascitis and may Rocco Barbieri, M.D. replacement. require an orthopedic surgeon evaluation & treatment. Board-certified Orthopedic Surgeon David Lee, M.D. Self care for many knee pain ailments PAIN IN THE BIG TOE JOINT can caused by a bunion Fellowship-trained in Hand and Upper Extremity Board-certified Neurological Surgeon • Fellowship-trained Spine Surgeon can include anti-inflammatories and (bone spur) that causes a deformed and painful toe joint. Dr. Barbieri is a board-certified, fellowship-trained hand and upper extremity Dr. Lee is a fellowship-trained spinal neurosurgeon. Dr. Lee received his medical ice. An orthopedic surgeon can Surgery may be required to remove the bunion. Orthopedic surgeon. Dr. Barbieri was fellowship trained in Reconstructive Surgery degree from the University of Mississippi Medical Center where he also completed provide a knee injection to relieve FOOT: of the Hand and Upper Extremity at the University of Mississippi Medical Center. pain, or drain the knee of excess his residency and neurosurgical spinal fellowship. He completed accumulated fluid in the knee. A NUMBNESS/WEAKNESS IN LEG OR FOOT: He received additional instruction in the art of microvascular tissue transfer. the University of Mississippi Medical Center’s first combined Orthopedic & person should see an orthopedic Numbness or weakness in the leg or foot can be an Neurosurgical spinal fellowship. surgeon for a complete evaluation emergency symptom related to a herniated disc in the back. Constantine Charoglu, M.D. to determine the cause of knee pain. Left untreated, the symptom can become permanent. You Board-certified Orthopedic Surgeon Michael Patterson, M.D. should see a spine specialist within 3 days. Fellowship-trained in Hand and Micro Surgery Board-Certified Orthopedic Surgeon • Fellowship-trained Spine Surgeon Dr. Charoglu is a board-certified, fellowship-trained hand specialist, completed Dr. Patterson is a board-certified, fellowship-trained spine Orthopedic surgeon. Those who self diagnose and self treat themselves do so at their own risk. We accept no responsibility for any his residency at New Jersey Medical School and his fellowship in hand and micro problems that may result from the use or misuse of educational information intended to be helpful guidance. He received extensive training in surgery of the cervical spine, or neck, during

Copyright © 2021 Prizm Development, Inc. • All Rights Reserved • Centers of Excellence for Better Healthcare BETTER FOR HEALTHCARE OF EXCELLENCE P ri z m © 2021 • CENTERS opyright surgery at the Hand Center of Western New York at the State University of New his fellowship. This training included such advanced techniques as cervical C York. , taught to him by Jack Zigler M.D., formerly the director of the Rancho Los Amigos Spinal Cord Injury Service in Los Angeles. Born and raised in Page 18 • SouthernBoneandJoint.com the South, Dr. Patterson has strong family SouthernBoneandJoint.comand professional ties to Mississippi. • 19 PRSRT STD U.S. POSTAGE PAID 3688 Veterans Memorial Dr. Hattiesburg, MS 39401 FT WORTH TX

MAIN CLINIC LOCATION: 3688 Veterans Memorial Drive Hattiesburg, MS 39401 Phone: 601.554.7400 [email protected]

SATELLITE LOCATIONS:

LAUREL, MS 1515 Jefferson, St. Laurel, MS 39440 Tuesday-Thursday, First Monday of each month

Picayune, MS 128 Highland Park, #100, Picayune, MS 39466 Appointments & Referrals: Monday-Friday, Phone: 601.358.9692 601-554-7400 Columbia, MS 3688 Veterans Memorial Dr., 1215 Hwy 98, Columbia, MS 39429 Hattiesburg, Mississippi 39401 Monday & Wednesday, every other Tuesday Online spine encyclopedia about back and neck pain at: Wiggins, MS SouthernBoneandJoint.com 1428 South Azalea Drive, Wiggins, MS 39577 Monday & Wednesday, every other Tuesday JOINT HANDBOOK, Southern Bone and Joint Specialists is one Home Remedy Book & of the largest orthopedic groups in the educational Internet site The best healthcare care comes from State of Mississippi. The board-certified We believe the best healthcare quality a specialized approach. Consequently, and fellowship-trained orthopedic comes from a well-informed health Southern Bone and Joint Specialists is specialists are referred sports medicine care consumer. As a community service, organized into CLINICAL CARE CENTERS and joint pain patients from across the Southern Bone & Joint Specialists that provides the most advanced Mississippi and Gulf Coast region. distributes to residents of Mississippi treatment options. Southern Bone and Joint Specialists is an educational Joint Handbook on Joint Replacement Center based in a modern 60,000 sf freestanding orthopedic problems; a Back to Life Sport Medicine Center building in Hattiesburg, Mississippi and Journal on advances in spine care; and Foot & Ankle Center maintains satellite offices around the a 36-page Home Remedy Book for back State. Its clinic locations are within easy and neck pain. It has an educational web Upper Extremity Center driving distance from across Mississippi, site at SouthernBoneandJoint.com with Trauma / Urgent Care Alabama, Louisiana and the Florida symptom charts, home remedies, medical The Spine Center Gulf Coast. Our orthopedic specialists illustrations that address all orthopedic THE SPINE CENTER is credentialed by Blue Cross Blue and spine care issues. Shield as Blue Distinction for Spine Surgery to receive address: ; Arthritic Blue Cross spine patients from across the Mississippi Joint Replacement Surgery; Hand and and Gulf Coast region. Microvascular Surgery; Foot and Ankle Reconstruction; Arthroscopy and Sports Medicine; Trauma Management; Physical Medicine and Rehab; Spine Disorders; Direct Anterior Hip Procedure; and Partial © 2021 • CENTERS OF EXCELLENCE FOR BETTER FOR HEALTHCARE OF EXCELLENCE P ri z m © 2021 • CENTERS opyright

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