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

Rotator Cuff PT Exercises Video

Rotator Cuff PT Exercises

For patients recovering from an injury of the rotator cuff PT exercise are key. PT – or physical therapy – supports the healing of rotator cuff injuries – whether post-surgery, or for someone working to stabilize and strengthen their rotator cuff.

Your doctor or orthopedic surgeon may prescribe rotator cuff PT exercises that you do in a clinic with a specialist, and they may also recommend exercises you can do at home. Physical therapist Carole Reda helps rotator cuff patients on the road to recovery every day. She walked us through three common rotator cuff PT exercises that can be done at home with just a few simple and affordable resistance bands and light weights. Both can be found at most sporting goods stores, or online.

Each exercise is described below and is often done in two “sets” of 10 each, but check with your doctor for your specific needs, and be sure to watch Carole’s demonstration in the video to follow the correct form:

Rotator Cuff PT Exercise #1: The Row
This exercise is excellent for shoulder stability.
1. First, loop the band through a sturdy item like a handrail or door handle and center the band so there are equal amounts of band on each side. [Important safety tip: always avoid looping the band through furniture or any other item that could tip and fall when pulled.]
2. Stand away from the anchor point so that the band is loose in your hands when your upper arms are straight at your side and your elbows are at a 90-degree angle.
3. Then, keeping your shoulders down, slowly pull the band toward you, extending your elbows back and squeezing your shoulder blades together.
4. Keep your motions slow and controlled.

Rotator Cuff PT Exercise #2: Shoulder External Rotation
1. Stand sideways so that the anchor point of your band is on one side of your body. Position the shoulder you want to exercise furthest from the anchor point.
2. Hold the band in your hand, keeping your elbow tight against your body and position your forearm in front of your stomach.
3. Rotate your forearm out and away from your stomach, keeping your upper arm and elbow against your body.

Rotator Cuff PT Exercise #3: “Is, Ys and Ts”
1. I’s: Stand with small weights (or no weight as recommended by your doctor) in each hand. Keep your arms straight and start with your hands by your sides. Raise your arms in front of you until they are even with your shoulder.
2. Y’s: Start in the same position with the weights, but this time raise your arms out at a 45-degree angle from your body, to create a “Y” shape with your arms.
3. T’s: Again, start with your arms at your sides. Raise both arms straight out from each side to shoulder height to make a “T” shape with your body, and then lower them back to your sides.

So, now you know three new rotator cuff PT exercises that can help support your treatment plan. As You can find all of these and more info about physical therapy on our website.

Denver Back Pain

Denver Back Specialist

As our Denver back specialists will tell you, the majority of adults will suffer from back pain at some point in their lives. Pain in the lower back is a common concern, affecting up to 80% of Americans at some point in their lifetime.

So, if you’re like many of us who are trying to navigate our way back into a workout routine, or simply get out of the house to get moving again, be thoughtful in your approach to avoid injury, including back pain.

Whether you’re ramping up your formal exercise program after several months of down time (Netflix anyone?), or you’ve taken on new independent sports as a way to stay fit and be physically distant, there are several tips our Denver back specialists offer to protect your back and keep you moving.

1) Just get going again. We’ve all had to adapt our lifestyles in recent months. First and foremost, we must still do our best to keep our families safe and manage our changing, and often challenging, work situations and demands at home. On top of all that, we have had less access to fitness and recreational facilities. All of this might have you feeling stiff and fitness may feel impossible. Or maybe you’re not quite sure how to get back in a rhythm again. “Most back pain comes from the strains and stresses of everyday life, but movement can be extremely therapeutic,” says Dr. Michael Shen, Denver back specialist and orthopedic spine specialist. “Start by getting out for a 10-15 min walk, taking an online yoga class or simply stretching.”

2) Start cross training and HIIT workouts slowly. As gyms and fitness studios begin to reopen, it’s understandable if you want to jump back into your pre-COVID routine (while complying with all local requirements, of course). Cross training and HIIT (High Intensity Interval Training) workouts are popular, and can be great for fitness, but remember to start slowly to minimize the chance of an injury, especially if you haven’t been moving at the same level of intensity for a while. Although it will be hard to take it easy and built back the level of intensity, it is important do so to avoid injury.

3) Good habits and good form go hand in hand. From golf, to running, cycling and standup paddle boarding – even that new gardening habit you’ve picked up – poor form or ergonomics is a recipe for pain. Our Denver back specialists have talked to many people who have taken up running, biking, golf or stand up paddle boarding for the first time.These independent activities can be a great socially distanced alternative to a crowded gym or other group fitness activity. But learning proper form is key. Here are a few tips for each of these independent activities:

Running: Always wear supportive running shoes and be sure to replace them once they begin to wear out. Try to run on trails and softer surfaces, avoiding concrete when you can.

Be sure to warm up before hitting your peak pace and always stretch when you’re done – especially your hamstrings. When running, keep your shoulders relaxed – down and back and keep your hands loose.

SUP: if your new to SUP – stand up paddle boarding that is – there’s lots to learn. REI has a great guide for beginners. If you’ve been getting out on the water regularly, you may be feeling the strain from all those hours of paddling. But poor form could also be the culprit. Proper paddling form relies on using your legs and core (abdominals), not your back. Keep your knees softly bent and rotate your core and hips with each gentle motion. If you’re feeling fatigued, keep each session to an hour or less.

Cycling: whether you’re on a spin bike at home, or on a road or mountain bike outside, ensuring proper fit and good posture will minimize strain on your back. Try to avoid rounding your back or bunching your shoulders together. A bike seat should be adjusted to allow you to maintain a 90-degree angle at your knee when the peddle comes to the top of each rotation. This helps ease the strain on your lower back and your hips. As always, stretching after each ride is key.

4) Take rest days. Maybe you haven’t taken on a new sport but instead have significantly increased the frequency of your favorite activity. Doing so can strain your muscles or injur yourself from overuse. A common example of this is golfers who used to play 3-4 times per month and are now playing 3-4 times per week. All that extra time on the golf course is causing lower back pains and strains – when your body doesn’t have time to rest or is suffering from overuse. Good form applies here too. Talk to a teaching pro about your swing and try to keep your motion steady and relaxed.

Denver back pain specialists understand how complex and individual back pain can be. That’s why proper diagnosis and treatment requires a skilled specialist.

Some types of acute back pain may improve with time and rest. A back specialist may suggest hot or cold packs or over-the-counter medicines such as acetaminophen or ibuprofen to help with discomfort, and then monitor your progress over time. They may also recommend physical therapy or home exercises to strengthen your core.

It’s a great time to get moving, and individual exercise is the first choice for many people. If you’re already enjoying Colorado’s great outdoors, be safe, get rest and watch your form! If you’re just getting started, go easy, have fun and build intensity and frequency.

If you need to see on of Denver’s back pain specialists, we’re here for you! We have convenient locations in Denver, Parker and Southlands:

Lowry Medical Center
8101 E. Lowry Blvd
Suite 230
Denver, CO 80230

Tel: (303) 344-9090

Directions to Lowry Location

Lincoln Medical Center
11960 E. Lioness Way
Suite 260
Parker, CO 80134

Tel: (303) 344-9090

Southlands Office
6235 S. Main Street
Suite 101
Aurora, CO 80016

Tel: (303) 344-9090


Denver orthopedic surgeons

Choosing a Denver orthopedic surgeon? Four considerations for finding the right fit.

If you’re trying to choose a Denver orthopedic surgeon, there are several important things to consider so that you can find the right fit for your needs. Here are four to get you started.

A good Denver orthopedic surgeon wants it to be all about you

First, it’s important to think through your personal situation and preferences so you can find the right fit. Every person is different, and your lifestyle, goals and nature of your injury will all impact your needs.

For example, competitive and recreational athletes often want to see an orthopedist who specializes in sports injuries and recovery plans. These sports medicine specialists use the latest technological advancements, working closely with athletes to minimize recovery time while being careful to prevent re-injury. They use a team of experts – often all under one roof – to give athletes the best treatment protocol available. This starts with imaging and other advanced diagnostic tools, and also includes an expert treatment team, from physicians’ assistants to physical therapists.

Many patients also prefer to try non-surgical solutions first before making the decision to have surgery. If this sounds like you, look for a specialist who is experienced in non-surgical solutions, such as a physiatrist, physical therapy, or a surgeon who has a focus on minimally invasive techniques that get you back to your routine without major surgery. If non-surgical options are a viable alternative, they’ll help you look at all the options and determine the best treatment plan.

Whatever your preferences or circumstances, the best Denver orthopedic surgeons want to know you as a whole person so they can provide recommendations that meet your needs.

Look for Denver orthopedic surgeons that are experts in their specialty

Orthopedic surgeons that specialize in specific areas and techniques can become experts in their field. Some of these areas of expertise include:

Denver is also home to some of the top orthopedic surgeons that specialize in areas such as MAKOplasty, the anterior approach to hip surgery, non-invasive treatments like injections or strength and conditioning treatments.

As active leaders in their area of specialization, many top orthopedic surgeons are board certified, and are active leading industry organizations, participating in research and advocating for development of new and innovative treatments. They also volunteer their time and services to communities in need.

This level of commitment and specialization gives surgeons the depth of expertise to diagnose and treat even the most complicated orthopedic conditions.

When orthopedic specialists take a team approach, you win

Many of the top Denver orthopedic surgeons are part of a group of doctors, physician assistants, medical assistants, x-ray technicians, and others, who work as an integrated team. And within each practice, there is a wide variety of physicians who have each received specialized training in orthopedic surgery and in specific subspecialty areas, so you’re sure to get access to the right types of expertise all in one place.

When orthopedic surgeons use a multidisciplinary approach, it can also provide patients with a better, more streamlined experience. In this set up, your care team works together to treat you, sharing your goals, progress and treatment plan in a way that improves your diagnosis, surgical and recovery experiences.

Consider referrals, reviews and awards

When a patient receives great care, it shows. That’s why many of the top Denver orthopedic surgeons are routinely nominated for prestigious positions or awards, or sit on national boards for their specialty. Likewise, patients from all walks of life share inspiring success stories regarding their injury, treatment and recovery, so that patients with similar situations can get a feel for the type of orthopedic surgeon that can be a good fit.

There are many great choices in Denver. Orthopedic surgeons who are experts in their specialty, committed to their patients’ success, and dedicated to continuously advancing their field are available across the front range.

The team at Advanced Orthopedics and Sports Medicine is just a call or click away to help you find the specialist that best fits your needs.

Should I still schedule a telehealth appointment?

Social Distancing Restrictions Are Easing. Should I still schedule a telehealth appointment?

Even as stay-at-home restrictions begin to ease, we understand that Coloradans want to stay safe and healthy, and it will take time until visits in our office are back to “normal.” Until then, we have options to enable patients to meet with their doctor and continue to make progress with treatment plans and recovery.

One way to stay at home and get orthopedic treatment is through a telehealth appointment, which is a little bit like a one-on-one Zoom conference or a FaceTime session with your doctor.

More people are using telehealth than ever. In fact, three in four Americans say they’re comfortable with telemedicine, which is up 10 points over pre-pandemic times. If you’ve never had a telehealth appointment before, you probably have questions about how it works and if you should invest the time to schedule one.

The short answer is yes! Telehealth is still a great way to see your doctor and keep your treatment moving! To make it as easy as possible, our team of orthopedic specialists came together to answer the most common questions about telehealth.

1) How does it work?

Telehealth uses an app to enable a face to face conversation where your doctor can perform a directed examination, and work with you to formulate a treatment plan.

Making and attending an appointment is easy. Start by visiting our website or calling our office to schedule an appointment time. Then, from our website, click the link to download the app to your computer or smart phone. At your appointment time, login and click the button to indicate that you are ready to meet.  When your provider is ready, he or app will enable a two-way video call where you can see and hear one another.

Your provider will be able to discuss your current situation, ask questions, view your injured joint and evaluate range of motion and pain levels. He or she can also recommend exercises, and arrange for physical therapy, tele-PT and more. If your provider determines you need imaging or other treatment, he or she will discuss the next steps with you.

2) What do I need to do to prepare?

Be sure to download the app after you’ve set an appointment and well in advance of your scheduled appointment time, and test your audio and video functions on your phone, laptop or tablet prior to the appointment. On the day of the appointment, plan to be in an area with strong internet connection or wifi signal. Finally choose a location where you have the level of privacy and quiet that you prefer, and good bright lighting.

Because the appointment is a video chat and your doctor will likely want to observe your joint, wear clothing that is suitable and comfortable and ensure you can expose the body part being evaluated, if practical.

3) What happens at the time of my appointment?

Log in to the app at your appointment time and wait for your doctor to join. Only your doctor can open the video connection. If your provider does not join right away, please be patient, we are working hard to accommodate every patient’s needs and delays can occur from time to time.

4) What about my xrays or MRI?

If you’ve already had an imaging appointment and the information is in or system, your doctor will be able to assess them remotely and review with you on your call. If you have then on a disk – you can mail or deliver them to our office so that they can be uploaded. If new x-rays are needed – we can make arrangements for you to come in, while maintaining social distancing protocols.

5) Is my information secure?

Yes, HippoHealth is a HIPAA-compliant app that allows us to take all reasonable precautions.

6) What do I pay? Will my insurance cover this?

Some insurance companies have temporarily waived copays, but you should expect your appointment to be billed similar to a normal office visit. Be sure to check with your insurance company to confirm what’s covered under your plan and any associated costs.

7) How long does it take?

Telehealth appoint times are similar to what you’d expect at a regular visit. Each provider will take the time needed.

8) When can I actually see my doctor?

Colorado announced the easing of restrictions for doctors’ offices beginning April 27. This means we will begin to see patients in our office at that time, while continuing to follow state guidelines for social distancing. This will include providers and patients wearing masks and waiting room arrangements that maximize social distance.

However, we are continuing to provide telehealth appointments even after our office reopens to give our patients options that work for their preferences and risk level.  If you prefer to meet via telehealth, we’re more than happy to do so.

Call our office at 303-344-9090 or use our online appointment form.

Advanced Ortho explains the best way to work from home.

Learning how to work from home? A survival guide for staying healthy and sane.

Whether you are used to a work from home environment or it’s totally new to you, there are many things you can do you keep yourself in good health both mentally and physically. And while these tips apply any time, they are especially relevant right now. Consider these tips to keep yourself and anyone you live with happier and healthier while you work from home.

1) Create and maintain a schedule.

This is key for you, and anyone you live with. You may have people who work from home, others who are remote learning from home, and still others who are trying to run a household under totally new circumstances. A good schedule includes setting aside time to work, play, eat, socialize and exercise (more on that later). It can also help you allocate household resources in a way that works for everyone – including computer and television time, sharing space in a home office or rec room, and giving everyone a little space when they need quiet time. Here, communication is key, but so is flexibility.

2) Set up a proper workspace and maintain good posture

Start with identifying a dedicated space to work that is as free from distractions as possible. This may mean making some compromises with housemates or family, or trading time in a dedicated space. From there, maintaining good posture is all about straight lines and 90-degree angles.

If you’re using a computer (and let’s be honest, who isn’t), the top of your monitor should be at eye level, allowing you to look straight ahead and avoiding a tilt or strain on your neck. When it comes to your seated position, your forearms and thighs should be parallel to the floor, putting your elbows and knees at a 90-degree angle. Likewise, your feet should be flat on the floor and your back straight to protect your spine. 

As you pay attention to good sitting posture, you may realize it’s harder than you expected! Engaging your core muscles to maintain good posture is takes practice, and breaks!

3) Schedule movement time

When that perfect posture has driven you to exhaustion, it’s time for a break. As we’ve mentioned before, sitting for 5+ hours has been shown to be the health equivalent of smoking more than a pack of cigarettes! If that’s not enough to get you moving, here are two more good reasons: Harvard reminds us that exercise actually changes the brain in ways that protect memory and thinking skills! And, if you live with children, it’s especially important for them to be moving, for everyone’s sanity. They are probably bouncing off the walls already, so embrace it!

If you spend a lot of time at your desk when you work from home, plan to get up every hour and at least walk around or stretch a little bit. Regardless of what your work or family schedule is, try to also block 30 minutes to an hour of each day to do something active. Run around in the yard with kids, walk around the block (while maintaining social distancing recommendations), walk up and down stairs in your house or whatever works in your environment. Many gyms including Orange Theory Fitness are offering free online workouts to help everyone stay active.

4) Take advantage of new (and existing) online resources

Many things we’re used to doing in person can now be done online, so take advantage of these handy resources. From purchasing office supplies to outfit your new work from home environment, buying groceries online for pickup or scheduling a telehealth appointment with your orthopedic doctor, many businesses are adapting to current circumstances with technology.

We’re all learning to work from home (even our doctors and staff are doing it too!), and if you are new to it, give yourself some time to adjust. Adopting a healthy mindset and healthy practices up front will make the transition easier and support your whole health in the long run. 

Pickleball Ruptured Achilles

Are you at risk for a ruptured Achilles? How to reduce your risk.

A ruptured Achilles is a the most common tendon rupture that can occur in your legs. The Achilles tendon connects your calf muscles to your heel bone. While it is a strong tendon, it can partially or fully tear, or rupture, if over extended.  

Certain demographic and lifestyle factors can increase your risk for a ruptured Achilles. While gender and age are two key risk factors that none of us can influence – the majority of ruptured Achilles tendon injuries happen to men between the ages of 30-50 – there are several other risk factors that may be managed or minimized by lifestyle choices:

Maintain a healthy body weight: Excess weight puts additional strain on the Achilles tendon, thus making ruptures more likely. By maintaining a health body weight, or BMI (Body Mass Index), people of all ages and genders can reduce their risk of a ruptured Achilles.

Take a smart approach high-impact exercise: Especially with certain activities or when increasing intensity suddenly. Any sport that emphasizes running, jumping, quick pivots or change in direction tends to see a higher-than-average occurrence of Achilles tendon ruptures. Common examples include tennis, high-intensity cross training, soccer, and basketball. Similarly, any dramatic increase in your level of intensity can put you a higher risk for a tear.

Warm up well, weekend warriors: If you don’t get much activity during the week, but like to go “all-out” on weekends, be sure to really emphasize a good warmup, ease into your activity, and always remember to stretch. Keeping your body limber and staying warm throughout your activities can help to minimize the risk of a ruptured Achilles or other injury.

Know the potential risks of some antibiotics: Certain antibiotics, known as fluoroquinolones, may increase the risk of a ruptured Achilles tendon by causing damage to the tendon. While this type of antibiotic may also damage other tendons, the majority of cases are associated with weight-bearing tendons, and the Achilles, in particular. Doctors typically only prescribe such drugs under specific circumstances when the benefit of the antibiotic outweighs the risk of an Achilles tear. However, patients should be sure to review and understand the risks and benefits before taking any medication.

Understand that steroid injections also have a cost-benefit trade off: Steroids can reduce inflammation and joint pain but can also weaken tendons, including the Achilles when injected nearby.

Ruptured Achilles Prevention

In addition to knowing the risks there are a few things you can do to minimize your chances of an Achilles tendon rupture, including:

Keep your workouts diverse: Especially if you already have any of the other risk factors, be mindful of how frequently you participate in activities that demand a lot of running and jumping. This could include alternating between running and biking or swimming and taking rest days between court or field time.

Don’t go from zero to 60: If you’re starting a new routine or are thinking about rounding up the team for some glory-days court time, be smart and conservative. Don’t go from couch potato to working out 5 days a week; and try to resist getting overly competitive in a pickup game if you haven’t touched a ball in years. A good rule of thumb for increasing your effort is to do so no more than 10 percent per week. When you do exercise or compete, always warm up slowly and stretch before you really get going. Gently stretch key muscle groups, in particular your calves. Never bounce while stretching – instead make slow gradual motions.

Listen to your body: If you’re feeling sore or feel like an exercise or a move is too much, don’t ignore the warning your body might be giving you. Back off your intensity when you need to. This could mean alternating walking with running or replacing a hopping motion with a stepping motion in an intense exercise class.

How to tell if you’ve ruptured your Achilles and what to do next

Many people report feeling sudden, intense pain and hearing a snap or popping sound when their Achilles tears. Most also notice an immediate limit in their ability to walk normally. If you think you’ve ruptured your Achilles, you should seek prompt medical attention from an orthopedic specialist. They will be able to confirm the nature and severity of the tear and recommend the best treatment plan to get you back on your feet and active.

Whether you’ve partially or fully torn the Achilles, surgery is often the best solution to repair the damaged tendon. A foot and ankle specialist will reattach a fully ruptured Achilles or repair a partial tear. Patients must typically be off their foot or the foot and ankle may be immobilized for at least several weeks to allow the tendon to begin to heal. In some cases, immobilization without surgery is an option.

Full recovery from ruptured Achilles surgery takes time – around 6 months to get back to normal activities, if you’re following a good physical therapy plan.

Advanced Orthopedics & Sports Medicine Specialists has several foot and ankle surgeons who use the latest surgical and open repair techniques that minimize the incision size and provide the best patient outcomes.  Get in touch for more information or to schedule an appointment with one of our foot and ankle specialists.

Best Foot & Ankle Surgeons

Keith Jacobson, DPM

Dr. Keith Jacobson

Alan Ng, DPM

Dr. Alan Ng

Scott Resig, MD

Dr. Scott Resig

Shoulder Replacement - How to choose the right doctor

What to consider when choosing a shoulder replacement doctor

If you’ve been coping with chronic pain and low range of motion in your shoulder and have exhausted other treatment options, it might be time to look for a shoulder replacement doctor. According to the American Academy of Orthopedic Surgeons (AAOS), more than 50,000 people in the US have shoulder replacement surgery each year, and while it’s not as common as hip or knee replacements, it’s just as effective in improving joint pain for many patients. But having shoulder replacement surgery is still a serious decision, so take time to find the right surgeon for your needs. In addition to reviewing the credentials of a prospective shoulder replacement doctor, you should be sure you’re working with a surgeon who will:

  1. Exhaust non-surgical options first
  2. Evaluate the cause of your shoulder condition
  3. Recommend the right type of surgery for your condition
  4. Thoroughly explain the procedure risks, benefits, process, timeline and recovery
  5. Serve as your health partner following the procedure, monitoring your rehab, recovery and addressing any complications or concerns.


  1. Choosing a shoulder replacement doctor: Exhaust non-surgical options first: Before pursuing surgery, an experienced shoulder replacement doctor will first work with you to ensure that you are a good candidate for surgery and determine if other options, such as rest, physical therapy and injections, can give you the relief and activity level you’re seeking. Once those options have been exhausted, surgery may be the most appropriate recommendation.
  1. Choosing a shoulder replacement doctor: Evaluate the cause of your shoulder condition: A shoulder replacement doctor will also want to know the cause of your shoulder damage, which can include a wide range of conditions. These may include various types of arthritis, such as osteoarthritis or rheumatoid arthritis, which cause degeneration of the joints, or less common conditions like Osteonecrosis, in which the blood supply to the joint is limited. Injuries are another major cause of shoulder damage either as a direct result of a fracture or over time due to post-traumatic arthritis.
  1. Choosing a shoulder replacement doctor: Recommend the right type of surgery for your condition: Your surgeon should have experience with and can recommend the type of procedure that is most appropriate for your condition. Depending on the severity and type of injury you have, you may be looking at any of the following types of shoulder replacement surgery.
  • Reverse shoulder replacement surgery is often the best procedure when the rotator cuff or other shoulder tendons have sustained major damage especially if you have arthritis in the shoulder joint.
  • If your damage is isolated to the ball of the humerous (the upper arm bone), your shoulder replacement doctor may recommend partial shoulder replacement.
  • And total shoulder replacementsurgery is often recommended when arthritis has damaged ball and socket.
  1. Choosing a shoulder replacement doctor: Thoroughly explain the procedure risks, benefits, process, timeline and recovery: Look for a shoulder replacement doctor that takes time to explain the procedure to you, including risk and expected outcomes, any pre-surgery preparations and requirements, what to expect on the day of surgery, the anticipated hospital stay, and – perhaps most importantly, the plan for recovery.
  2. Choosing a shoulder replacement doctor: Serve as your health partner following the procedure, monitoring your recovery and addressing any complications or concerns.: While recovery can be lengthy (up to several months), the reward can be significant, with many patients enjoying major improvements in pain and motion after successful surgery and rehabilitation. But a good shoulder replacement doctor will ensure that you understand the commitment and effort required for a successful rehabilitation too, so that you can get back to being active and pain free. They will also check in following surgery to check for complications and see you for office visits as you progress.

There are three shoulder replacement doctors within Advanced Orthopedics, all of who are board certified surgeons who specialize in shoulder replacement and repair of other shoulder conditions.

James Ferrari, MD

Dr. James Ferrari

H. Andrew Motz, MD

Dr. H. Andrew Motz

John Papilion, MD

Dr. John Papilion

If shoulder pain is severely limiting your daily activities or range of motion, and any of these descriptions apply, it might be time to raise your hand for shoulder replacement surgery. Contact our office to set an appointment.

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

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. Justin Newman

John Papilion, MD

Dr. John Papilion

Scott Resig, MD

Dr. Scott Resig

R. Presley Swann, MD

Dr. R. Presley Swann

Nerve Pain in Your Hand

Nerve Pain in Your Hands? Common Causes and Treatments

Nerve Pain in Your Hands? Common Causes and Treatments

Nerve pain in your hands can keep you from many important daily tasks. From texting and typing, to eating, grooming and sometimes even writing (yes, with a pen – people still do it!), healthy hands are, at once, remarkably efficient and incredibly vulnerable. 

The hands’ complex structure is the root of both of these traits. Your hands are a collection of bones, joints nerves and tendons that, when functioning properly, put the world at your fingertips. However, when nerve pain in hands interrupts their remarkable efficiency, it can turn your life upside down. If you have frequent pain or numbness in your hands you already know this all too well.

There are numerous factors that can cause numbness, tingling or nerve pain in hands or fingers including various autoimmune diseases, diabetes, or inflammation but one of the most common sources is a pinched nerve. Frequently, nerve pain in the hand or wrist is a result of overuse or trauma. Falls, car accidents and work injuries are common causes of hand and wrist nerve injuries. When a nerve receives too much pressure from the adjoining tissue (i.e. bones, muscles, tendons), pain, tingling or numbness ensues.

Who’s at risk for nerve pain in the hands?

Gender, weight, overuse and motion repetition are among the factors that increase the risk of nerve pain in your hands or wrists. Women have smaller carpal tunnels and are more susceptible to carpal tunnel syndrome. Both excess weight and overuse can lead to increased risk of pinched nerves.

What are the symptoms of nerve pain in hands?

Your hands can perform a complex range of motions. When that motion is impaired or one of those actions – such as flexing your wrist, thumb or finger – is lost, the culprit may well be nerves in your hand or wrist. Numbness, tingling, weakness and pain are other indicators that nerve function is being impaired and it’s time to see a specialist.

Identifying the cause of the loss of motion or source of pain is best revealed through a physical exam and potential tests such as an x-ray, MRI, ultrasound or CT scan. Your orthopedic specialist will determine the best diagnostic tools after a physical exam.

What are my hand nerve pain treatment options?

Just as the origins of hand pain are diverse, so too are treatments for the wide range of conditions. For many, conservative treatments such as rest and ice may offer relief within days or weeks. Often, lifestyle changes like adjusting typing posture, taking breaks or limiting the frequency of specific activities can have a significant impact. When conservative solutions aren’t enough, medications or physical therapy can help. More severe nerve injuries or symptoms may require surgery.

Nerve pain in the hands can have a major impact on your day-to-day life, including the ability to work, exercise and take care of family so don’t ignore symptoms. Early diagnosis of hand and finger numbness provides more opportunity for positive outcomes with both surgical non-surgical solutions. Schedule an appointment with one of our hand and wrist specialists today.

Best Hand & Wrist Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani

Davis Hurley, MD

Dr. Davis Hurley

Dr. Micah Worrell

Dr. Micah Worrell