1) Question: What is arthroscopy, and how does it compare to other surgical techniques?

Answer: Arthroscopy is a minimally invasive surgery technique that utilizes a fiber optic camera (arthroscope) to allow a surgeon to view an affected joint without requiring a large incision. From the Greek "arthro" (joint) and "skopein" (to look), arthroscopy reflects the surgeon's ability to "look within the joint".
When compared to traditional open surgery, the capability to perform a surgical procedure through a small incision provides several potential benefits, including reduced tissue damage, blood loss, and scarring. Likewise, the less invasive surgical technique often leads to a shorter recovery period.

2) Question: What is total joint replacement, and when is it an appropriate solution to chronic pain?

Answer: A total joint replacement procedure involves the complete removal of a damaged or arthritic joint, and its replacement with an artificial joint implant, called a prosthesis.
While a single traumatic event may require a total joint replacement, the procedure is often indicated as a treatment for chronic joint pain. Commonly replaced joints include the hip and knee, which can become worn due to age, weight, or disease, such as osteoarthritis.
Total joint replacement is only recommended when non-surgical treatment methods, such as physical therapy and medication, fail to alleviate joint pain.

3) Question: What are common sports medicine injuries and treatments?

Answer:Sports medicine is a branch of orthopedics that specializes in the treatment of injuries suffered due to athletic activity. Joints commonly affected by sports injuries include the knee (ACL/MCL tears, meniscal tears, Runner's Knee) and the shoulder (rotator cuff tears, dislocation). While injuries are common to athletic activities, non-athletic traumatic events, such as a fall, can also lead to many of these injuries.
Depending on severity, some sports injuries, particularly ligament tears, will require surgical treatment. Many sports injuries can be surgically treated through minimally invasive, arthroscopic techniques.

4) Question: What are some common conditions that require hand, wrist, or arm surgery?

Answer: Providing rotation and precise dexterity, the hand and wrist are complex joints with several components that work in coordination. Common causes for surgery to the hand and wrist include: carpal tunnel syndrome; traumatic injury, such as a fall, severe cut, or sports injury; and severe arthritis. Patients who suffer from chronic pain in the fingers, hand, wrist, or arm, should consult an orthopedic surgeon who specializes in upper extremity treatment.

5) Question: What is computer-assisted surgery?

Answer: A recent advance in joint replacement techniques, computer-assisted surgery utilizes computer technology to increase the precision of a surgical procedure. Before the surgical procedure, information from medical imaging technology, such as MRIs, CT Scans, or ultrasounds are utilized to generate a computer model of the affected joint. This model is then used to create precise measurement guides that increase the surgeon's ability to accurately align the joint implant.
A more exact placement of the joint implant provides the patient with several potential benefits, such as increased implant life and greater joint stability and function. Likewise, it reduces the risk of needing a revision surgery.

6) Question: How long do artificial joints last?

Answer: On average, artificial joints have a lifespan of 10 to 20 years. If you are in your 40s or 50s when you have joint replacement surgery, especially if you are very active, you are likely to need another joint replacement surgery later in life.


7) Question: What happens during rotator cuff surgery?

Answer: Shoulder surgery for rotator cuff problems usually involves one or more of the following procedures: debridement, subacromial decompression, rotator cuff repair.Debridement clears damaged tissue out of the shoulder joint.

1) Question: What are the rates of trauma deaths in the country?

Answer: Trauma kills more people between the ages of 1 and 44 than any other disease or illness. Nearly 100,000 people of all ages in the United States die from trauma each years, roughly half of them in automobile crashes. But it is our children and young adults who feel the greatest impact of trauma. According to the national Center for Heath Statistics, trauma (unintentional injuries + homicides) causes: 43% of all deaths from age 1 to 4 48% of all deaths in ages 5 to 14 62% of all deaths in ages 15 to 24
Trauma can strike at any time of the day. Each year, eight to nine million individuals suffer disabling injuries in the United States, with more than 3000,000 of the suffering permanent disabilities.

2) Question: What happens when someone is brought to the Trauma Center?

Answer: When a patient arrives at the UGTS Emergency Department, emergency nurses and doctors begin assessing and treating injuries.  The UGTS Trauma physicians and nurses are also present and quickly check the patient's condition.  If life-threatening injuries are present, the patient is treated right away.
All the facilities within the UGTS Trauma Bay are state-of-the-art, including X-ray equipment and CT scan.  Our operating rooms are also equipped with the latest technology.

3) Question: What is the anticipated time of recovery?

Answer: With all injuries, especially those suffered from a trauma related incident, recovery time will vary.  It is our goal that all patients get well enough to no longer need hospital care.  Some patients will be discharged home with instructions to return to the outpatient clinic for a check-up.  This is where the health team makes sure injuries are healing properly, as well as checking that the patient is adapting to life after the injury. The nurses and doctors will discuss, in detail, the amount of time you might need for recovery and physical therapy.

4) Question: What is Trauma?

Answer: Trauma is defined as a bodily injury, wound or shock.  Trauma affects more people than heart disease and cancer combined and is the leading cause of death among Americans under age 40.  However death does not have to be the end result of a major trauma injury.  Since the beginning of Trauma Centers, like the one here at University General & Trauma Surgery, P.C., the numbers of deaths and long term disabilities have decreased.

5) Question: Who is a trauma patient?

Answer: The Ohio Revised Code (ORC) 4765.01 defines a trauma patients as someone with a significant risk of loss of life, limb, significant permanent disfigurement or disability caused by blunt or penetrating injury.

6) Question:What is a trauma system?

Answer: A trauma system is a geographically organized system of care for the injured that is fully integrated into the emergency medical service (EMS) system and strives to meet the needs of all injured patients requiring an acute care facility, regardless of severity of injury, geographic location, or population density.

7) Question: What is a Trauma Center?

Answer: A Trauma Center is a healthcare facility that has established an organized operational structure that facilitates and improves care of the injured patient.

9) Question: Who decides which hospitals are Trauma Centers?

Answer: The American College of Surgeons Committee on Trauma (ACSCOT) sets the standards for verification and site visits. Any hospital interested and willing to invest the time, effort, staffing and money is eligible.

10) Question: What are the types of traumatic events?

Answer:

• Type I trauma includes single, one-time events such as rape, accidents, natural disasters, or witnessing the death of a loved one (Terr, 1991).
• Type II trauma involves multiple, prolonged, or chronic events, such as child abuse or captivity (Terr, 1991). There are several types of events that can be traumatic.
• Natural disasters, so-called “acts of God,” that typically affect entire groups of people, e.g., hurricanes, earthquakes, tsunamis, fires.
• Stressful events that do not typically lead to trauma-related disorders in most people, but may do so in some individuals, e.g., childbirth, death of a loved one.
• Unintentional accidents caused by human error, e.g., many car accidents, building collapse, fire, a child playing with a gun and accidentally shooting a playmate.
• Acts of gross negligence, e.g., accidents caused by drunk drivers; collapse of building due to inferior construction; neglect of a child leading to a serious accident.
• Intentional interpersonal violence, e.g., arson, assault, domestic violence, child abuse, rape, war, genocide, torture.

11) Question: What is emotional trauma?

Answer: Put very simply, emotional trauma is psychological distress and pain, caused by experiences or situations that overwhelm a person's resilience-- the natural capacity to adapt, survive and "bounce back" after stress or life's challenges.

12) Question: Isn't it rare for someone to experience emotional trauma?

Answer: Unfortunately not. It was once thought that trauma only occurred as a response to circumstances that were "beyond the realm of normal human experience"-- things like war, natural disaster, or being the victim of violent crime (or a witness to violence), for instance. Now we know that trauma can arise from any event or circumstance that overwhelms a person's ability to adapt and cope. This can be a singular event, or a series of events and situations. Trauma may even result from the cumulative effects of small but repeated incidents over a long period of time.

13) Question: Why can an event be traumatic for one person, but not traumatic for another?

Answer: Remember, it's not the event that causes trauma. It's the perception of the event. This is true whether a person is courageous or strong, or more vulnerable (though feeling vulnerable and helpless is a risk factor that may increase a person's risk of trauma). People are different: every individual has his/her own unique beliefs, coping techniques, perspectives, personal histories (which may include previous traumas), and so on. Another variable is the overall meaning that each person assigns to an event; what it means to them, and/or about them. All these things affect whether or not a person suffers trauma from a particular experience. So something that is very traumatic for one person may be unremarkable for another, while a third person experiencing the same event may feel emotional distress but recover from it within a few weeks, without assistance. Because there are so many variables, most of which are unique to each individual, it's often very difficult to predict who might be traumatized by a particular situation or event.

14) Question: What's the difference between stress and trauma?

Answer: Stress and trauma are somewhat similar, in that both cause disruptions in the nervous system. However, when a person is under stress, it's typically somewhat time-constrained. Within a relatively short period of time-- days or weeks, usually-- the stress passes, the person recovers, and the nervous system returns to balance. When there is trauma, the person may seem to become "stuck" or frozen in that realm of emotional intensity. They often become upset very quickly, and frequently too. Their emotions may seem very intense and raw, as though the event were happening all over again, right now, rather than being in the past. When a person has suffered trauma, episodes of emotional turmoil may also be prolonged, with sustained intensity.  And once they become upset, it may take a while for the traumatized person to calm down. This pattern of intensity may continue for months or even years, during which time the nervous system does not regain balance and regulation.   

15) Question: Can the onset of trauma symptoms ever be delayed?

Answer: Yes, sometimes trauma symptoms may not appear until weeks, months or even years after the traumatic event. For instance, a woman who experiences a traumatic childbirth may not exhibit trauma symptoms until AFTER she weans her breastfed baby. In some cases, this may be a year or more after the child's birth. Another woman with a traumatic experience of giving birth may not exhibit symptoms of trauma until she is pregnant or even in labor with a subsequent child. In some cases, the symptoms of trauma may have been present prior to these "trigger" events, without being recognized. In other cases, there are no apparent symptoms until the person experiences a triggering event or situation which is similar in some way to the original trauma.

16) Question: Does emotional trauma ever heal on its own?

Answer: Yes. Symptoms of emotional trauma do usually subside over time, even without treatment. That said, chronic fear and anxiety can result in long-term consequences for a person's physical health and well-being. Those who suffer from unresolved traumas will often find that their symptoms affect their mental and emotional health, their professional and personal lives, their families, and more. If you've experienced emotional trauma, please seek assistance and relief... if not through EFT, then through traditional counseling, EMDR (Eye Movement De-Sensitization and Reprocessing), Somatic Therapy, or whatever mode best suits your unique needs and your strengths and preferences as an individual.

1) Question: Who is a candidate for limb reconstructive surgery?

Answer: A large percentage of patients are candidates for limb reconstruction. Surgery candidates include patients who have undergone surgery to remove a tumor, patients with a failed healing of a fracture and patients who have suffered an injury to an extremity from trauma or war.

2) Question: When would someone not be a candidate for bone reconstructive surgery?

Answer: If there are multiple tumors in the bones, surgery may not be the best option. In this case the decision to have surgery is made between the patient and surgeon, and is based on the type of cancer, where it has spread in the bones and the patient's own functional status. If patients do not qualify for surgery they may be offered treatment with radiation therapy, chemotherapy, both of these in combination (chemoradiation), another drug regimen or participation in a clinical trial investigating a new treatment.

3) Question: What materials are used to reconstruct the bone?

Answer: Orthopedic surgeons at Virginia Mason use modular bone and joint replacements, metal plates and screws, thin metal rods, bone cement and bone transplant tissue. The surgeon may use a patient's own tissue, harvested from another site in the body, or tissue from a donor to reconstruct the bone. The type and size of materials used will depend on the surgery being performed and the amount of reconstruction required.

4) Question: When is limb reconstructive surgery performed?

Answer: In patients with cancer, limb reconstructive surgery is performed at the same time as surgery to remove the tumor. Surgery may occur before or after a course of chemotherapy or radiation therapy. Limb reconstruction also is indicated when a fracture has not healed properly and in patients with traumatic injury to an extremity.

5) Question:  How is limb reconstructive surgery performed?

Answer: In patients with cancer, the orthopedic surgeon will remove the tumor and a margin of normal tissue surrounding it, then reconstruct the bone and/or joint using the patient's own bone, a bone transplant from a donor and, if necessary, a specialized modular joint replacement. The bone is stabilized using metal plates, rods and screws.
The specialized team performing surgery includes a vascular surgeon to help rebuild the circulatory system and a plastic surgeon that specializes in microvascular surgery and muscle transfer.
Your surgeon will discuss the reconstructive surgery you are having in detail with you.

6) Question: How long is limb reconstructive surgery?

Answer:The duration of limb reconstructive surgery will depend on the surgery being performed and the amount of reconstruction required. Surgery can last anywhere from two to eight hours.

7) Question: What are the risks of limb reconstructive surgery?

Answer: All precautions to ensure patient safety are taken prior to every operation at Virginia Mason. However, as with any surgery, some risks remain. There are risks of infection, excessive blood loss and the development of blood clots. The incidence of these risks occurring in patients is very small.
Over time, some joint replacements, metal plates, screws or rods can loosen and require revision. This risk occurs infrequently because of better patient selection, surgical techniques and improved implanted materials.

8) Question: What is the rehabilitation time after limb reconstructive surgery?

Answer: Rehabilitation time will depend on the type of surgery performed and the patient's own functional status. Normally rehabilitation after limb reconstructive surgery can take anywhere from six weeks to six months. Most patients will regain full function and a normal lifestyle.