Orthopedic surgeon - pickleball injury

Beyond Surgery: How to Partner with an Orthopedic Surgeon to Be Active in Your Health

Eager to get out and Be Active this summer? Between spring showers and the lingering impacts of a full year of quarantine life, many people are more excited than ever to get back to sports, fitness and other activities that move them. But if a bone or joint issue has been holding you back, now may be the perfect time to partner with an orthopedic surgeon to get ready for an active summer.

Partnering with an orthopedic surgeon doesn’t mean signing up for surgery. Sports medicine specialists and orthopedic surgeons provide expertise and treatment options that help everyone – from weekend warriors to competitive athletes – get back in the game while minimizing the risk of injury.

The most advanced orthopedic surgeons offer a holistic approach to your health including services such as physical therapy, sports medicine and sports injury prevention, non-surgical treatments and advanced and complex surgeries.

By taking a multidisciplinary approach to each patient’s treatment, providing one-on-one personalized care, and using hands-on, evidenced-based techniques, orthopedic surgeons help patients to enhance activity, wellness and performance throughout life.

Here are just a few of the ways you can partner with your orthopedic surgeon.

Physical Therapy   

Once an injury has been assessed, a Doctor of Physical Therapy and their team take a hands-on approach to treatment. They provide detailed examinations and education regarding the source and cause of pain, how to relieve it and prevent a recurrence.

Each individualized treatment plan includes progressions and reevaluations that work with your needs, strengths and goals. By using evidence-based medicine that includes manual and manipulative therapy, exercises designed for specific injuries or damage, and the latest technology such as Trigger Point Dry Needling, physical therapy can help to reduce pain, rebuild strength, reduce inflammation, and improve range of motion, and is a great non-surgical method to achieve lasting effective pain relief.

Sports Medicine and Sports Injury Prevention

Regardless of age, if you’re injured, you should stop playing sports until you can be treated. Continued play or exercise can increase the damage and, in some cases, can cause serious additional injury.

By simply giving our bodies the rest they need, many people can recover from injuries with basic treatment such as the RICE (Rest, Ice, Compression and Elevation) method to relieve pain, reduce swelling and speed healing. Anti-inflammatory pain relievers, knowns as NSAIDs (think Advil or Aleve) can also provide pain relief and reduce swelling as you heal. But be careful not to use any kind of pain reliever to mask the pain of an injury as a way to keep playing.

Sports medicine specialists have specific expertise in sports-related injuries and a variety of procedures and therapies to both help prevent injury and aid in recovery and rehabilitation.

This includes techniques such as strength training of the injured or surrounding tendons and muscles to project a vulnerable joint, working on proper stretching, warm-up and cool-down methods, managing and maintaining a healthy and appropriate diet for the athlete’s age, condition and individual needs, and more. While surgery is sometimes required, other non-surgical options are typically explored first.

Bone Health

Often called the “silent disease,” osteoporosis typically shows no symptoms in its early stages. But your risk of breaking a bone increases as the disease progresses, as does the risk of losing height or having back pain due to compression or fractures in the spine.

While 1 in 2 women, and 1 in 4 men over the age of 50 will break a bone due to osteoporosis, you don’t need to take these stats sitting down. Osteoporosis is preventable and treatable! If you have had a broken bone as an adult or have other risk factors for osteoporosis, it’s important to partner with an orthopedic surgeon who is also a bone health specialist. They work with each patient to assess the risk of osteoporosis and can conduct a bone scan called a DXA. DXA scans are recommended every two years for the following populations:

  • Women over the age of 65, or younger with risk factors
  • Men over the age of 70, or younger with risk factors
  • Anyone over the age of 50 with a broken bone
  • Anyone with 1½ inches of height loss
  • Anyone with back pain due to a possible break in your spine

If you have low bone density, measures can be taken to help prevent falls and broken bones, and medications may be helpful to prevent future fractures to allow you to continue your active lifestyle.

What if I Really do Need Surgery

If a surgical solution is the best option for your needs, it’s important to partner closely with your orthopedic surgeon to ensure you have the best experience from introduction to recovery. A diligent and caring surgeon will work with you to carefully evaluate all options for your circumstances and ensure that you have a shared and realistic understanding of your post-surgery goals.

Your surgeon, along with their expert team, will help you navigate every step of the process to maximize your recovery potential and ensure you are an active participant every step along the way.

About Advanced Orthopedics and Sports Medicine Specialists

Ready to partner with an orthopedic surgeon to be active again? With 15 Board Certified Orthopedic Surgeons, two Board Certified Podiatric Surgeons, and one Board Certified Interventional Physiatrist, there’s sure to be a specialist that’s just the right fit.

Advanced Orthopedic is comprised of surgeons who specialize in sports injuries, upper extremity, spine disorders, total joint replacements, carticel implantation, podiatry abnormalities, musculoskeletal disorders, and surgical and non-operative treatment of the neck and spine.

We have three locations to serve your needs. Our Denver/Lowry Office is located in central Denver, our Parker/Lincoln office is located in south Metro Denver, and our Aurora/Southlands Office is in southeast Aurora in the Southlands Shopping District. We offer state-of-the-art digital imaging at all of our facilities. For more information, call (303) 344-9090 or request an appointment.

torn ACL

Does a torn ACL always require surgery?

Torn ACLs are a common result of active lifestyles. Nationally, hundreds of thousands of ACL tears occur each year. The vast majority of ACL injuries – experienced more frequently by athletes and females – are often the result of sudden movements such as a pivot on the soccer field or a sharp turn on the ski slope.

ACL tears typically present with pain, swelling, discomfort and loss of knee stability. But the severity and symptoms can vary from patient to patient. So how should an ACL tear be treated? Is surgery always required? The answer starts with a proper medical assessment of the knee injury and each patient’s circumstances.

The knee is a complex joint, so a thorough medical evaluation is needed to determine the full extent of the knee injury, confirm if it is, in fact, an ACL tear, and provide a prognosis to inform possible treatment options. X-rays are used to reveal fractures, and MRIs can assess the extent of damage to knee ligaments and cartilage. Even if you don’t think you tore your ACL, it’s important to be diagnosed to mitigate the risk of subsequent secondary injury that could lead to additional instability.

Many, but not all, ACL tears require surgery. The severity of the tear, the loss of mobility and each patient’s activity level are key considerations for treatment options. Given the role that the ACL plays in the knee’s normal rotation and movement, full ACL tears are complex injuries that typically include additional cartilage or ligament damage. Full ACL tears generally require surgery to restore stability and function.

ACL Surgery

ACL reconstruction surgery is recommended in patients whose knees give way on repeated occasions, and it’s a good option for active people who aren’t able to recapture enough stability after therapy and want to continue to participate in activities that involving cutting, pivoting, and turning motions like skiing, basketball or tennis.

However, for patients with limited damage and stability loss, nonsurgical options can also lead to positive outcomes. Nonsurgical treatments are usually most favorable for patients that have maintained stability, have isolated damage, or patients with open growth plates, or light activity levels. Non-surgical or delayed treatment may be an option for adolescent ACL injuries that present a risk of growth plate injury.

Nonsurgical physical therapy recovery regimens can include activity limitations, progressively challenging rehabilitation exercises that increase stability, and the use of protective devices such as knee braces to support subsequent low impact activities. Your doctor can review the benefits and risk of all potential treatments.

A comprehensive plan of prescribed exercises is designed to reduce tissue inflammation, aid in the healing process and improve knee function. A medical professional will closely monitor changes in knee strength, range of motion, balance and stability. These multi-month rehabilitation regimens chart the successful progress of restored knee function and provide key measurements to assess what, if any, additional treatment is needed to achieve a positive outcome.

The goal of a non-surgical rehabilitation program is to foster improved knee functionality and stability that protects the region and reduces the likelihood of recurrence. All treatment plans consider the potential for recurrence, the long-term health of your knee, and potential for joint damage or disease.

The team of knee specialists at Advanced Orthopedic can help assess your condition and provide you with the information you need to choose the best treatment option for your ACL tear.

Best Knee & ACL Surgeons

Mark Failinger

Dr. Mark Failinger


James Ferrari, MD

Dr. James Ferrari


Wayne Gersoff, MD

Dr. Wayne Gersoff


dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz


Dr Newman

Dr. Justin Newman


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


Knee Replacement Surgery

What to expect from knee replacement surgery

When people consider knee replacement surgery, it’s typically because they’ve exhausted other non-surgical treatments, but are still living with pain or mobility issues that are impacting day-to-day life. If this sounds like you, there are a number of key questions to ask before having knee replacement surgery.

There are several types of knee replacement surgery – which one is right for me?

Your orthopedic specialist will help you determine which, if any, of the four main types of knee replacement surgery are right for your situation. It depends on the type and extent of the damage to your knee, and other personal factors. Your surgeon will also evaluate your existing range of motion, stability and your overall strength.

• The most common and comprehensive is total knee replacement, also known as total knee arthroplasty. In this procedure, your surgeon removes the damaged femur and tibia bone and cartilage surfaces and replaces them with artificial material. This procedure may be recommended for patients who have extensive damage or disease throughout the knee joint and are limited in their day-to-day activities by pain and lack of mobility.

• Partial knee replacement – also called “unicompartmental” knee replacement is an option for patients whose injury or damage is affecting only part of the knee joint, and the remaining joint areas are not significantly affected. Our experienced knee replacement surgeons use state-of-the-art technologies including computer-assisted surgeries that allow the procedure to be less invasive and more precise. MAKOplasty, which was first performed in Colorado by Harold Hunt, is one such procedure, which allows the surgeon to resurface only the diseased portion of your knee and ensure that your implants are optimally positioned.

• Revision knee replacement is a special type of total knee replacement that is performed when a previous knee replacement has worn out, is not thriving or performing as hoped, or has loosened in the bone. It’s a more complex procedure because there is less bone to attach new total knee. Although more complex to perform, many patients have good results with this procedure.

• Kneecap replacement (aka patellofemoral replacement) is another partial knee replacement. in this case the undersurface of the kneecap and the groove in the femur are replaced. It typically involves a smaller incision, less disruption to other nearby tissue and thus tends to have the fastest recovery time.

How do I prepare for knee replacement?

Preparation for knee replacement involves physical, mental and organizational aspects of your life.  Physically, it always helps to be in the best shape and health that you can be. Your doctor will want to know if you have any serious health conditions like diabetes or heart disease and will encourage exercise and a healthy diet. The good news is you can impact your physical health in a relatively short amount of time and may need to improve your diet and work on leg strength – particularly your quadriceps – before having surgery.

Mental preparation includes a personal commitment to pre and post-surgical care from pre-op exercise to post-op physical therapy. By committing to do the work every day, being patient and realistic with your recovery timeframe and outcomes, you will be better positioned for a positive experience.

Lastly, being prepared means having plans and equipment for post-operative care and rehabilitation. This includes help from family and friends, ice packs, perhaps a walker and help getting around in the first few weeks after knee replacement. Patients should prepare their home to be as accommodating as possible. Depending on your home set up, this may include moving your sleeping area to the main floor, removing any obstacles or clutter that could make it difficult to navigate your space and setting aside an area that is safe and comfortable to spend time in while you recover. 

What is the recovery time for total knee replacement surgery? For partial?

Even for a full knee replacement, your doctor will likely have you up and moving as soon as possible after surgery, within a few hours of the procedure. It’s essential to get the joint moving and begin the rehabilitation process to minimize scar tissue and maximize long-term range of motion.

Within a few weeks – as soon as 2 weeks for partial, and three-six weeks for total knee replacement – most people are able to return to many daily activities including driving, as long as you are not taking pain killers, and have the range of motion and muscle control to safely operate a vehicle. At this point many low-impact activities are in play too, but it typically takes more time to be active in sports like running, skiing and tennis. Your orthopedic team will work closely with you to map out a recovery plan that includes therapy and exercise.

What does a “full recovery” look like? Will I be able to return to the activities I love?

Regardless of the type of surgery, knee replacement is intended to improve mobility and reduce pain, ultimately allowing for more independence and better quality of life. It’s important to remember that outcomes are unique to each individual. A successful outcome can mean many different things depending on the amount, type and source of damage pre-surgery; your physical fitness level, overall health and age, and your personal goals among other things.

It’s important to understand the range of likely outcomes for your personal situation before you say yes to surgery of any kind, so that you can ensure that the time and effort will result in your best outcome.

The bottom line

Talk with your doctor to ensure you understand the potential risks and rewards of knee replacement surgery, and if there are any non-surgical treatments that might provide relief. Do your homework on your surgeon, the type of surgery that’s been recommended and your role in a successful outcome. Have questions about knee replacement? Talk to one of our specialists.

Best Knee Replacement Surgeons

dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


Denver MCL Specialists Help Skiers in Colorado

Denver MCL Specialists Diagnose MCL Injuries to Keep Coloradans Active

Denver MCL specialists continue to see a high volume of MCL injuries. The medial collateral ligament (MCL for short) is in fact the most frequently injured ligament of the knee – accounting for as many as 40% of knee ligament injuries. And because minor MCL injuries often go undiagnosed, this number is likely low. But with proper diagnosis and individualized treatment, MCL patients typically have a solid path to recovery.

What is an MCL injury?

Let’s start with what the MCL does and where it’s located. The MCL is tissue connects your thigh bone (femur) to the top of your tibia, (your shin bone), on the inside of your knee. It stabilizes your knee to keep it from bowing too far inward.

Anyone can damage their MCL, but it’s also more common among men and athletes – even recreational athletes. Direct content is the most common cause, so it’s no surprise that Denver MCL specialists see a higher incidence of MCL injuries in patients who participate in contact sports, such has rugby, football, soccer and ice hockey. 

But here in Colorado, skiing is one non-contact sport where MCL injuries also tend to occur. This is typically the result of sudden twisting or stress on the knee that is common with frequent ski turns, starts and stops.

If any of these types of situations have resulted in knee pain that doesn’t improve with a bit of rest and ice, it’s probably time to see a doctor. MCL diagnosis involves a physical evaluation which includes checking for swelling, bruising and evaluating range of motion. An MRI or X-ray may also be needed. Our Denver MCL specialists help patients classify MCL injuries into grade I, II or III and determine the best course of treatment.

  • Grade I (Mild) injuries can be addressed at home (with ice, rest and mild pain reliever like Advil) and improve in just a couple of weeks
  • Grade II (moderate) may require the use of a brace to stabilize the knee. Your doctor may also ask you to minimize weight bearing activities for a few weeks.  
  • Grade III (Severe) injuries may require surgery, especially if other parts of the knee are also injured (such as your ACL, which occur with an MCL injury about 95% of the time, when there is more than one injury), or at a minimum require patients to brace the leg and limit weight-bearing activity for at least 6 weeks

Knee pain can also be the result of conditions other than MCL tears, so it’s important to recognize the signs and symptoms of MCL injuries. Patients typically have pain and lack of mobility around the knee joint and many report hearing a “pop” at the time of the injury.

Advanced Orthopedics’ Denver MCL specialist team frequently performs MCL repair or reconstruction – a procedure where the damaged ligament is either repaired or removed and replaced with tissue harvested from the hamstring or patellar tendon. The replacement tissue – called a graft – restores knee stabilization while aiding the growth of new tissue.

As with all MCL strains, physical therapy plays a vital role in the restoration of long-term strength and range of motion. Although individual recovery time varies, many MCL patients who opt for surgery return to their sports in six to nine months.

Have questions? Advanced Ortho’s team of Denver MCL specialists are available to answer your questions.

Best Knee Surgeons

Mark Failinger

Dr. Mark Failinger


James Ferrari, MD

Dr. James Ferrari


Wayne Gersoff, MD

Dr. Wayne Gersoff


dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz


Dr Newman

Dr. Justin Newman


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann


knee replacement

5 Signs You May Be Ready for Total Knee Replacement Surgery

“You’ll know when the time is right.” That’s what some doctors tell patients with persistent knee pain, when they ask whether they should have total knee replacement (TKR) surgery.

Of course, it’s not always that easy to tell. Yes, you may have arthritis and may suffer from joint pain when you bend your knee, but you may not think it’s serious enough to consider surgery.

There may be advantages to waiting – total knee replacement is a major surgery with possible complications, you’ll need time off from work and physical therapy to recover, and there are less involved measures that may offer some relief. But there may also be advantages to acting sooner — you may enjoy better results if the joint hasn’t deteriorated too much, you may not be a good candidate for surgery if you wait until you’re older and in poorer health, and you may want to get back as soon as possible to an active lifestyle.

Women, especially, tend to delay the decision to undergo total knee replacement reportedly because they have a higher tolerance for pain and inconvenience than men. In a study that compared men and women who were about to undergo knee surgery, females’ knees were in far worse shape than the mens’, even after controlling for other factors.

“Women are far more likely to suffer from knee pain due to osteoarthritis than men,” says Dr. Harold Hunt, Advanced Orthopedic surgeon and total knee replacement specialist. “And while studies like this show that they’re also more likely to tolerate pain and periods of low mobility before finally deciding on surgery, we don’t like to see anyone prolonging their discomfort for an extended period of time.”

Dr. Hunt and his total joint colleagues recommend you consider these five signals that you may be ready for a total knee replacement.

1. The pain is impairing your ability to function. If your osteoarthritis is advanced enough, it will have worn away some or all of the cartilage that protects your bones from rubbing against each other at the knee. You’ll be able to see that bone-on-bone contact in x-rays. You may even see the problem with the naked eye, as severe deterioration can sometimes deform your leg and make it bow.

As a result of the friction and pressure from loss of the cartilage cushion, it may hurt to perform everyday actions like walking, sitting, and climbing stairs. If your knee pain results in lost sleep, missed work, or stiffness and pain in your other leg from overcompensating, it may be time to consider TKR.

2. You’ve exhausted other options. While TKR is an increasingly common procedure, it’s still a major surgery. And even if the operation goes smoothly, you will still have a visible scar (though this will diminish with time), and you’ll need several weeks of physical therapy to recover most of the function in your knee.

There are other, less invasive ways for osteoarthritis patients to combat knee pain, although they may offer only temporary relief. Some patients treat their symptoms effectively with over-the-counter pain relievers such as aspirin, acetaminophen, ibuprofen, and naproxen. Physical therapy can help, and so can weight loss which reduces pressure on the knee. An injection of cortisone (to reduce inflammation) or synthetic fluid (to replace natural lubricant lost to osteoarthritis) can relieve knee pain for up to six months. You may also get the support you need from a knee brace. There are also less invasive surgeries – arthroscopic surgery to remove torn cartilage fragments, partial joint replacement surgeries, or partial bone reconstruction procedures like MAKOplasty – for patients with less advanced forms of arthritis.

Your doctor may suggest you try some or all of these therapies before you move on to a total knee replacement. But if you have tried them and they’ve stopped being effective, it may be time to go ahead with a total knee replacement.

3. You are the right patient for the surgery. The best outcomes after total knee replacement surgery occur in patients whose knees look the most arthritic on x-ray. A patient with bone-on-bone arthritis on x-ray should expect dramatic improvement in pain and function. To the same effect, a patient without much joint space loss on x-ray may want to consider more aggressive nonsurgical treatment options prior to knee replacement surgery. Age is also an important variable to consider. Most knee replacement surgeries occur in patients aged between 50 and 80, but there are individual situations where having the procedure at a younger or older age is appropriate. However, it is not always “the sooner, the better” when discussing timing of knee replacement surgery. Why? “A knee implant – which may be made of titanium, plastic, ceramic, or a combination of these – can last up to 20 years, so if you get one when you’re younger, you may need a revision later in life,”says Presley Swann, a revision specialist.

4. You’re physically prepared. The surgery is most effective and least risky for patients who are in decent physical This relates to patients who are not only non-diabetic or not prone to heart disease, but also those who keep fit through proper diet and exercise. Fortunately, you can prepare in the months leading up to surgery by improving your diet, losing weight, and especially building up your quadriceps. “Having stronger thigh muscles makes the recovery process easier because your quadriceps play such an important role in stabilizing the knee area,” says Dr. Jared Michalson, a fellowship-training total joint specialists at Advanced Orthopedic. So work those quads!

Being prepared also means having the proper equipment for your rehabilitation. As you recuperate, you may need a walker on every floor of your house. You may also need an ice-pack or cold therapy machine of the sort you can attach to your leg and wear for 20 minutes at a time to reduce pain and swelling in your knee. Aside from equipment, you’ll probably need the assistance of other people for a few weeks to drive you around or to perform strenuous tasks.

5. You’re mentally prepared. Many patients find the prospect of total knee replacement daunting since they know that recuperation can be painful and challenging. Therefore, it’s important for patients considering a total knee replacement to be in the right frame of mind.

First, you have to be committed to having the best outcome. That means being ready to be compliant, to do whatever the physical therapist instructs you to do, and to exercise as directed between your therapy sessions. After all, you will probably be seeing a physical therapist twice a week for about two months to increase the strength and flexibility of your new knee.

For the most effective rehabilitation, you need to commit to do the work every day, which means you shouldn’t expect to be able to go back to your job or your favorite sports for up to several weeks or longer. Even after the initial therapy, you may need up to a year of milder exercise before your implant feels normal.

Second, you should have realistic expectations. Your knee will probably never have the full functionality – the complete range of motion or freedom from pain – that you enjoyed before it became arthritic. For example, many total knee replacement patients report feeling pain when they kneel on hard surfaces.

Other than that, however, patients tend to feel vast improvements almost immediately. “Depending on the specifics of your surgery, you may be in the hospital for a couple days but your doctor and therapist will likely have you walking and climbing stairs before you go home,” says Dr. Scott Resig. And once you’re rehabilitated, you’ll typically be able to walk as much as you like and to engage in low-impact sports, such as hiking, biking, golfing, swimming, or ballroom dancing.

That’s another reason why it’s important for patients to be fit before undergoing total knee replacement surgery. If you didn’t get around much before knee pain, a new knee won’t have you running marathons. But you should be able to enjoy an active lifestyle again. Indeed, many patients, after waiting some time before deciding to have the surgery, wonder why they didn’t have it done sooner.

Do you think you may be ready for total knee replacement? Schedule an appointment with one of our knee specialists to discuss the best treatment options for your arthritis pain.

Best Knee Replacement Surgeons

dr harold hunt denver co

Dr. Harold Hunt


Jared Michalson, MD

Dr. Jared Michalson


H. Andrew Motz, MD

Dr. H. Andrew Motz


John Papilion, MD

Dr. John Papilion


Scott Resig, MD

Dr. Scott Resig


R. Presley Swann, MD

Dr. R. Presley Swann