• Clavicle fracture – fix it or no?

    As a cyclist, a clavicle fracture is an injury I think about personally.  Those of us out on the roads are more likely than most to end up at some point actually ON the road, or in the dirt.  The decision of whether to treat a clavicle fracture operatively or nonoperatively is an individual one.  […]

  • Knee pain

    It’s probably no surprise that I see a lot of people complaining about knee pain. There are tons of reasons for a knee to hurt.  A meniscus tear or ACL tear from an injury, pain from arthritis, pain from overuse, or just a general ache that seems to come on for no reason at all. […]

  • A follow up on stem cell injections

    As a follow up to my last post on stem cell and PRP injections, I recently came across an article in the New York Times about 12 people who were hospitalized with severe infections after stem cell injections. Read the article here This is an example of what can happen when an exciting new technology […]

  • Cutting Edge Technologies

    I’m not an early adopter of new technologies, though I am interested in them. I like to see a lot of evidence before I offer a new treatment to my patients.  I get asked a lot about these in the office, so here is some information.   Orthobiologics – treatments using biological components that come […]

  • Controversies in Treatment of Achilles Tendon Ruptures

    Achilles tendon ruptures are very common sports injuries.   Many years ago, these were treated without surgery, but muscular weakness and a high risk of re-rupture were common problems.  Over the past 10-15 years, the majority of orthopedists have advocated repair.  Repair clearly decreases the risk of re-rupture, but muscular weakness remains an issue, and there are […]

  • Operation Rainbow

    Last week I was priveleged to join Operation Rainbow on an orthopedic mission to Guatemala.  I’ve been familiar with their work for a number of years, as some of my San Francisco colleagues have been on trips with them.  This inspiring group does great work taking care of patients and educating doctors in developing countries.  Last week […]

  • There’s No Place Like Home

    As this recent article from the New York Times points out, the rehab facility (or hospital) is not the best place to recover from joint replacement surgery.  You want to get out of the hospital as soon as you are stable and get home where (1) you won’t be exposed to a lot of sick people and (2) […]

  • Relieving Post Surgical Pain Without Narcotics?

    Orthopedic surgery is painful.  There’s just no getting around the basic fact.  A lot of my patients, when they learn they need surgery, are more concerned about the pain, than the details of the actual surgery.  And almost no one really wants to be on narcotics.  Fortunately with multi-modal pain management (using smaller amounts of several […]

  • Shoulder Dislocation and Re-Dislocation

    Anterior shoulder dislocation is a common injury, and one that I see frequently in athletes of all ages.  Risks of repeat dislocation depends on many factors, including particularly the injured person’s age, whether the dislocation caused any bony defects, and the size of those defects.  Decision making regarding surgery/no surgery can be difficult in some […]

  • Barefoot Running

    Some years after the surge in popularity of barefoot running or running in minimalist shoes, there is enough data for an orthopaedic review article.  The verdict?  A decrease in anterior knee pain (runner’s knee) and a decrease in chronic exertional compartment syndrome.  But, an increase in risk of repetitive stress injuries to the foot and […]