Evaluation of a young patient presenting with hip pain begins with a series of X-rays to assess the hip joint and boney morphology of the acetabulum and femur. Here, we see an example of combined-type femoroacetabular impingement (FAI), meaning that both the acetabulum/pelvis and femur are involved in the disease process. The first X-ray is a false profile view of the hip and shows a huge subspine impingement spur arising from the anterior inferior iliac spine (AIIS). The second X-ray is a Dunn lateral view and shows a typical cam lesion at the femoral head-neck junction, resulting in decreased offset. These bone spurs will be resected arthroscopically during surgery to re-create normal anatomy of the hip joint, resolving the impingement and disease process.
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#femoroacetabularimpingement #fai #hipimpingement #cam #pincer #mixed #subspineimpingement #aiis #hipjoint #hippain #hiparthroscopy #impingement #impingementsyndrome #femur #acetabulum #anatomy #hipsurgery #sportsmedicine #drdold @dr.dold.md @ Star Orthopedics and Sports Medicine
Here’s a quick arthroscopy video showing what an acute ACL rupture looks like. The torn, remnant ACL is bundled up within the anterior intercondylar notch, blocking terminal knee extension. Following ACL reconstruction, we show the new ACL graft using a bone-patella tendon-bone (BTB) autograft.
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#sportsmedicine #kneesurgery #acl #anteriorcruciateligament #acltear #aclrupture #aclinjury #aclreconstruction #btb #bonepatellartendonbonegraft #bonetendonbone #autograft #aclrecon #aclsurgery #arthroscopy #arthroscopysurgery #orthopedics #orthopedicsurgery #orthopedicsurgeon #knee #anatomy #pcl #medialmeniscus #cyclops #cyclopslesion #cruciateligament #surgery #aclrehab #drdold @dr.dold.md
Treatment of AVN of the hip - Part 2:
Following “core decompression” of the femoral head, the bone void is replaced with a bone substitute (calcium sulfate, calcium phosphate, and demineralized bone matrix) that is mixed with the patient’s own bone marrow aspirate concentrate, a rich source of mesenchymal stem cells. The applicator is directly into the femoral head and slowly withdrawn as this bone graft is injected under fluoroscopy. The patient is touch weight bearing with crutches following the procedure. Procedure performed by Dr. Andrew Dold, MD.
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#avn #avascularnecrosis #hippain #osteonecrosis #hipavn #bonemarrowstemcells #bonemarrowaspirateconcentrate #avascularnecrosisofthehips #coredecompression #bonegrafting #bonemarrowaspirate #bma #bmac #msc #mesenchymalstemcells #stemcelltherapy #stemcelltransplant #stemcells #hipsurgery #ficat #orthopedics #orthopedicsurgery #sportsmedicine #drdold @dr.dold.md
Treatment of AVN of the hip - Part 1:
This video shows us performing core decompression of the femoral head using an expandable reamer system. The reamer is introducing through a small incision in the lateral thigh and directed into the femoral head. Sequential reamings are performed as the device is slowly expanded to fill the femoral head, removing the necrotic (dead) bone from the femoral head. This bone void will next be replaced by our bone graft material and stem cells (see next video!).
Dr. Andrew Dold, MD.
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#avn #avascularnecrosis #osteonecrosis #hipavn #avascularnecrosisofthehips #coredecompression #bonegrafting #bonemarrowaspirate #bma #bmac #msc #mesenchymalstemcells #stemcelltherapy #stemcelltransplant #stemcells #hipsurgery #ficat #orthopedics #orthopedicsurgery #ortho #sportsmedicine #drdold @dr.dold.md
Swipe right to see an example of all arthroscopic repair of a massive rotator cuff tear. The rotator cuff is a group of 4 muscles that come together to make a surrounding cuff of tendon. This gives us the strength to move our shoulder in different directions. When torn like we see here it causes pain and weakness. Dr. Ghattas is able to repair these tears all through 3 poke hole incisions in the shoulder using sutures and anchors in the bone to bring the tendon back to it’s normal anatomic position. #rotatorcuff #arthroscopy #shoulderspecialist #recovery #sportsmedicine @ Coppell, Texas
Here’s another example of FAI. However, this patient has NOT yet progressed to osteoarthritis of the hip joint. Rather, their joint space is well maintained. As you can see on this Dunn lateral radiograph, they have a large cam deformity at the femoral head-neck junction with a large anterolateral labral tear shown on MRI. This patient is a great candidate for hip arthroscopy to repair the labral tear and shave down the bone responsible for the impingement. It’s important to start with a plain X-ray for every patient presenting with hip pain as the findings will direct your care. #fai #hippain #labraltear #hiparthroscopy #hipjoint #femoroacetabularimpingement #hipimpingement #cam #pincer #labrum #drdold @dr.dold.md
Not the X-ray you hope to see in a 40 year old with hip and groin pain. This is what an arthritic hip looks like. In this case, we think that this is the end result of femoroacetabular impingement (FAI), which causes an abnormal articulation between the femoral head and acetabulum (ball and socket, respectively) leading to cartilage wear and progressive OA. This patient needs a hip replacement.
#arthritis #hiparthritis #osteoarthritis #arthritissucks #totalhipreplacement #tha #arthroplasty #hiparthroplasty #hippain #drdold
Star Orthopedics’ Andrew Dold, MD discussing Dallas Cowboys’ Dak Prescott’s recent ankle injury on NBC Channel 5 News...
NBCDFW.COM
Orthopedic Surgeons Weigh In on Dak Prescott Injury
Since it is Masters Sunday, here’s a recent study looking at return to golf after a total knee replacement (TKA). Both regular and competitive golfers are always concerned about their ability to recover their previous activity and “game” after total knee arthroplasty. This study shows promising results: golfers returned to 18 holes an average of 3.7 months after surgery, with a slightly better handicap, increased level of golf activity, and better golfing comfort while playing following surgery. This doesn’t mean that a knee replacement is your recipe for the senior PGA or LPGA Tour! #masters #kneesurgery #tka #totalkneereplacement #arthroplasty #joa #journalofarthroplasty #golf #returntogolf #orthopedicsurgery #kneereplacement #drdold @dr.dold.md
Here’s a more atypical sports injury: a displaced medial epicondyle fracture of the elbow in a (skeletally mature) high school football player. We performed ORIF with a partially-threaded cannulated screw and washer for added compression and purchase of the fracture fragment. Post-op XRay on slide 2. Back to football in 4-6 weeks.
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#medialepicondyle #xray #orif #elbow #elbowinjury #fracture #flexormass #orthopedicsurgery #drdold @dr.dold.md
Golfers make up a large cohort of my practice. This includes players from the PGA Tour, Korn Ferry Tour, amateur circuits, and the typical “weekend warrior.” I found the title of this article interesting: “Is golf a contact sport?” In the literal sense, the answer is easy: No.
......But, when considering the effect the sport has on our bodies (especially when bad habits and poor function are combined with the thousands (read: millions) of reps required to reach perfection (read: mediocrity)), I think golf IS a “contact” sport? What do you think?
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(With that said, sending positive vibes to the man @jordanspieth today. Make it happen buddy!!)
#golf #pgatour #kornferrytour #wastemanagementopen #sportsmedicine @golfchannel @wmphoenixopen @golfdigest @golf_com @maridoegolfclub @dr.dold.md
Honored to be voted as one of the best doctors in Dallas by D Magazine! #orthopedics #surgery #sportsmedicine #drdold @dr.dold.md
Normalcy is within sight, everyone! Today was a good day. I am thankful for science (and proud to call myself a scientist). Wear a mask, stay distanced, and GET THE VACCINE! We can do this. #science #vaccine #gettheshot #covid_19 @dr.dold.md
Platelet-rich plasma (PRP) is the process of concentrating the platelets from whole blood and using these platelets to treat pathology. The PRP is injected into the area of concern to accelerate healing. #science #prp #biologics #plateletrichplasma #drdold #sportsmedicine #platelets #evidencebasedpractice @dr.dold.md
Cheers to our buddy @georgesniang for the jersey!Looking forward to seeing this beauty back in action soon!
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#sportsmedicine #nba #prp @utahjazz @nba @dr.dold.md
