Tulane Medical Center - April 21, 2021

The spirit of “Fit & Forty” is alive and well – as it should be. Many who have hit the Big 40 understand the value of being active, exercising and working to stay in shape. That said, once we near or hit the fourth decade, changes start happening to our bones, joints, tendons and muscles. We begin losing bone mass faster than we can rebuild it. Our cartilage, ligaments and tendons start to dry out, becoming brittle and less supple, and our coordination and balance may not be as sharp as it was previously.

“We're encouraged when we see people with good lifestyle habits, exercising, eating right, maintaining a healthy weight and cutting our smoking and excessive drinking,” says Mary Mulcahey, MD, director of the Tulane Women's Sports Medicine Program.

“Those things count and have a tremendous impact on orthopedic health. The more you foster your own bone and joint health through healthy habits as you age, the more successful we can be with treatments for injuries.”

The orthopedic experts at Tulane Health System consider it their calling to keep their patients active regardless of age. Not surprisingly, they see lots of age-related chronic pain, ailments, injuries and other orthopedic issues.

Neck and spine

The majority of neck and spine conditions that plague us as we get older result from the normal wear and tear on the spine from aging, says neurosurgeon, Christopher Maulucci, MD.

Chronic age-related problems include disc degeneration, osteoarthritis and osteoporosis compression fractures. Then you have injuries from falls, work- or sports-related accidents and poor lifting technique. These set the stage for a host of specific neck and spine ailments, which necessitate a personalized approach to patient care.

“The main thing we offer is an exhaustive evaluation with appropriate individualization,” he says. “It's important to know there's not just one surgery, one device or one approach. Every patient is different.”

Back

Back pain, especially low back pain, is one of the most common reasons for doctor visits. About 80 percent of adults experience low back pain at some point in their lives. Causes can range from sitting too much and excess weight, to wear and tear on the spine, congenital conditions or previous surgeries, says Mathew Cyriac, MD, an orthopedic surgeon who specializes in surgery for chronic back pain. Most back pain is muscle-related and will get better by itself or with self-treatment. If back pain doesn't subside within a few weeks, it's time to visit the doctor.

Spine and back care are offered through multiple specialty areas – orthopedics, neurosurgery, sports medicine and pain management – depending on patient need. Our treatments encompass physical therapy, innovative non-surgical pain interventions and the latest surgical procedures.

Shoulder and elbow

Damage to the rotator cuff (muscles, tendons and ligaments holding the joint together) is increasingly common as people age, says orthopedic surgeon Felix Savoie, MD. Rotator cuff tears are associated with degenerative changes that occur with aging and can impact both active and non-active adults.

“Keeping shoulders strong and staying fit are the best ways to avoid problems,” says Dr. Savoie. “This can be achieved through exercises. And while I certainly believe a strong shoulder is a happy shoulder, I caution patients to avoid overdoing it and to stay away from exercises that cause significant shoulder pain.”

With an eye toward returning patients to an active lifestyle, Tulane Health System specialists leverage treatment options including physical therapy, cortisone injections and arthroscopic surgery for rotator cuff repair and other conditions. We also offer advanced therapies such as platelet-rich plasma injections and bio-inductive collagen implants. Both of these technologies are designed to promote a patient's own healing capacity in repairing rotator cuff tears.

Hand and wrist

As we age, our tissues, tendons and supportive structures become less elastic. And our years of using our hands takes a toll. Conditions like tendonitis, arthritis, trigger finger and carpal tunnel syndrome crop up and hamper our dexterity, says Gleb Medvedev, MD, and hand surgeon at Tulane Health System. One piece of advice he offers:

“If you have an injury or condition and the surgeon recommends a procedure, don't put it off, thinking it will be fine. It's not going to get better on its own,” Dr. Medvedev says. “If you delay too long, the results won't be what you hoped and sometimes we will be unable to treat the issue at all.”

Our orthopedic program offers comprehensive care for hands and wrists, including access to surgeons with fellowship training in hand surgery. The program also offers endoscopic carpal tunnel repair, which results in quicker recovery, less post-op pain and fewer complications.

Hip

Hips are built to take a good bit of wear and tear over the years, but eventually age, repetitive motion and overuse catch up, leaving nearly one in four adults over age 60 with hip pain of some type.

“The prevalence of osteoarthritis (OA) increases with age such that 30 to 50 percent of adults over the age of 65 years suffer from this condition, which can cause inflammation and cartilage breakdown,” says orthopedic surgeon Fernando Sanchez, MD.

“In addition to hip OA, patients of all ages can have other conditions that can cause hip pain. These include femoroacetabular impingement (FAI), labral tears, ligament injuries, and tears of muscles and tendons. Some of these can be treated conservatively or with hip arthroscopy, a minimally invasive surgery that can address these conditions.”

Tulane Health System orthopedic specialists are committed to devising individualized treatment plans to reduce hip pain and restore mobility. Patients with suspected hip fractures now receive a faster diagnosis and surgery through our Hip Attack programs. When hip replacement is a patient's best option, we offer the most advanced joint replacement methods including the minimally-invasive anterior approach and robotic-arm-assisted surgery.

Knee

Our knees are consistently placed under incredible pressure and tension during sports activities. Additionally, over time, cartilage in the knee joint can wear away and the knee can become stiff and painful. Not surprisingly, knee pain and injuries are among the top reasons patients visit Tulane Health System orthopedic specialists each year.

“There have been tremendous advances in knee care, specifically partial and total knee replacement,” says orthopedic specialist, Charles Billings, MD.

“Patients who undergo knee replacement can expect to be much more active and mobile after surgery, and with our advanced techniques, generally experience a very quick recovery, with many being able to walk the day of or the day after the surgery.”

Our specialists offer some of the area's most advanced treatments for knee pain, repair and replacement including:

  • A procedure that repairs cartilage using a patient's own cells
  • 3D printed knee replacement implants that are customized to closely match a patient's anatomy and provide a better fit and feel

Robotics-assisted partial and total knee replacements for improved accuracy and fit, leading to a quicker recovery and less down time

Take a Hip & Knee Assessment

Foot and ankle

Our feet take a beating as we age. Common chronic foot/ankle problems that crop up a little later in life include tendonitis, achilles tendinopathy, plantar fasciitis and issues with toes such as arthritis or hammer toes, says foot and ankle specialists, Ramon Rodriguez, MD, a foot and ankle specialist. Additionally, as we age, our ankles tend to be less tolerant of going up and down inclines, making hilly walks more problematic, and the onset of osteoporosis can turn a simple misstep into a fracture in the foot.

Make no bones about it

Whether it’s aging’s normal wear and tear on our bodies, acute injury in the adult athlete, or the fall of an elderly loved one, our experienced team of orthopedic, sports medicine and rehabilitation specialists are committed to providing advanced care with the best patient outcomes.

Find an Orthopedic Specialist