Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
One of our favorite doctors, doctor Daniel Whitmer, or meeting
surgeon extraordinaire. He joined us now on the set here
right outside the rehab center. He just came out of surgery,
and doctor Dan tell us about the surgery he just
came out of.
Speaker 2 (00:16):
So I just did a hip replacement. Actually helped one
of my partners do it, and it was a guy
who'd been suffering from hip arthriatus for many years. He
was an ex football player, so like me, he was
a big guy. And so my partner just needed an
extra hand. So I scrubbed in and I was the muscle.
All right.
Speaker 3 (00:35):
Describe having to take out a hip. What do you
gotta do?
Speaker 2 (00:38):
So for most modern hip surgery, we try to do
it through as small of an incision as possible. But
like I tell folks, you know, a five foot one
female is different than say my surgery. I'm six foot eight,
you know, so my incision would be larger. So we
make the incision and then we have to dislocate the hip.
And to dislocate it, we have to twist the hip
around and push down and pop it out of the socket.
Speaker 3 (01:00):
Cannot be easy.
Speaker 2 (01:01):
It's not easy to do in a bigger leg. You know,
if you if somebody who's relatively thin, it can be
pretty easy and simple. But especially in guys who are bigger,
they tend to have a lot more muscular tissue and
their leg is just big, and so the leg itself
might weigh one hundred pounds, you know, or almost up
up to that, and so it's just more physically challenging
(01:21):
to do the operation. We have special retractors here at
bon and Joint for folks who are larger, and we
take care of a lot of those folks. They do
great with surgery. Their outcomes are are just as good,
if not better, you know, than everybody else. But sometimes
the retractors we use have to have special bends or
be deeper in order to access the hip joint. The
(01:43):
hip joint is way down deep in the pelvis. So
a lot of people when they put their hand on
the side of their hip, that's actually not your hip joint.
Your hip joint is you know, six or eight inches
in inwards, you know, and that's where we're actually working.
So so yeah, sometimes it can be a bit of
a physical operation to get a hip out, say, compared
to a knee replacement.
Speaker 4 (02:04):
So to explain this, Kurt says, he needs more Doctor Dan,
and I have to show the people or explain to
the people how big this man is. Well, he reached
out all the way around to grab his microphone.
Speaker 3 (02:16):
How's that, Kurt, how's that good?
Speaker 2 (02:19):
Yeah?
Speaker 5 (02:19):
Sorry, no, it's great. And you got to be a
big dude man.
Speaker 4 (02:22):
They get Yeah, we've met a lot of these hip
surgeons and they're not the smallest people in the world.
But the technology is getting better, and you're telling us
about three D printing robots. This is not the future.
This is the now.
Speaker 3 (02:36):
Right here at the better.
Speaker 2 (02:36):
Joint, we're doing that stuff now. So when you put
a hip or a knee replacement in the the early
success is about sort of how well and how efficient
the surgery is done. But the later success, I'm talking
twenty twenty five thirty years after, is how well it's
fixed to the bone, you know, because you're gonna walk,
you know, a million steps plus on this thing. And
(02:59):
so more modern bearing materials. We're using materials that are
three D printed on the undersurface, and that allows the
pores of the metal to actually be larger in ways
that modern manufacturing techniques really can't get to with just machines,
and three D printing is really the only way to
make porous metal that has larger pores in it, and
(03:21):
so that porous metal allows the bone to ingrow much better,
and that we're hoping that that leads to better long
term outcomes. We do a lot of research here at BJI.
We keep track of our patients over the years, and
so we're looking into this. You know, what we put
in now, We're not going to obviously have ten or
fifteen out year outcomes for a while, but we try
(03:42):
to keep a close eye on things and compared to
what we've done in the past.
Speaker 1 (03:46):
I know we've talked about this, we're talking to doctor
Daniel Whitmer.
Speaker 3 (03:49):
And old stuff that you've seen.
Speaker 1 (03:53):
How often do you come across a replacement knee or
replacement hip or even I mean shoulders, and I think
ankles are now replaceable items.
Speaker 3 (04:03):
And you've seen worn.
Speaker 1 (04:05):
Out parts, and I'm sure a lot of your research
is about people are living longer. We don't want to
have to see them in the next twenty thirty years.
How much of this is taking out the old stuff
and hopefully this new stuff will last for a long
long time.
Speaker 2 (04:19):
So about I do about six hundred, six hundred and
fifty operations a year, and about twenty percent of them
at this point. Our revision surgeries, so redoing something that's
either loosened or worn out or broken in some way.
We keep track of those patients. We do research for
them too to try to improve things. Revision surgery is
(04:39):
actually expected to increase three hundred percent in the next
fifteen years, and that's actually a major problem for our
healthcare system. We're putting in so many hip and knee
replacements now at some point they're going to wear out,
you know, and we're putting in maybe three, four or
five times more than we did even ten or fifteen
years ago, and so that's something that we are thinking
(05:00):
about in the future. But we're hoping that these more
modern bearing materials will bring that number down so we
don't have to revise as many of them.
Speaker 4 (05:06):
Well, what about the ages that you're doing these now?
Has that gotten younger?
Speaker 2 (05:11):
It's it's actually expanded both ways. It's gotten younger and
older folks who were very young. Let's say, and I'm
a joint surgeon, so I would call very young somebody
in their forties for a total joint replacement. Those folks,
you know, people used to say, you know, just live
with the pain. You know, get injections, deal with it
(05:31):
until you're quote unquote old enough to have a joint replacement.
But nowadays, given that the materials are so good and
they're lasting for so long, we can offer these these
younger patients joint replacements so that they can have a
better quality of life and go do things that they
just can't do with an arthritic hip or knee, like
ski or hike or things like that.
Speaker 3 (05:49):
All right, let's talk about pickleball players. It's all the
rage you've got it. It seems to be a lot
of older people like playing it.
Speaker 1 (05:56):
You don't have to do a lot of movement things
like that, but you're getting a lot of pickleball injury.
Speaker 3 (06:00):
You have described that you guys chuck a little bit
and a little bit. Surgeons go like.
Speaker 2 (06:06):
A little bit. So our favorite you know, we we
we take care of some, you know, a small a
very small number of high level athletes. The majority of
the athletes that we take care of our weekend warrior types.
And these folks they love pickleball. It's a great sport.
Anybody can play it even, you know, unto your later years.
But the issue is is that a lot of people
(06:27):
who haven't been athletic in a while they go out
and start to play pickleball, and they forget things like stretching,
proper footwear, you know, things that prevent slips and falls
on the court. And then sometimes they get a little competitive,
maybe more so than they've been in a long time,
and they might start diving for a ball or doing
something like that, and uh, there comes a point where
(06:50):
that's not a great idea to do, and where you know,
you're more brittle than maybe you used to be in
your younger years, and so things break or snap, or
they have sprains or strains. So I would say that
we see a lot more pickleball injuries nowadays than I
do with almost any other sport. And that's really been
in the past year.
Speaker 3 (07:08):
It's crazy.
Speaker 2 (07:08):
Now. Remember I'm a joint replacement surgery so the sports
medicine doctors still see all the young kids who are
getting sock injuries things like that, right, But as a
joint replacement doctor, I would say pickleball may be my
number one sport of that that I see folks that
get injured from I still love it. It's a great sport.
I encourage people to play it, but I talk to
people about proper shoe wear, stretching, proper preparation, you know,
(07:33):
making sure that you're ready to be active if you
haven't been active in a while.
Speaker 1 (07:37):
So true, like a lot of these like build up
to stuff, Well, jump right out there figuring the pickleball.
Speaker 5 (07:43):
Change jims.
Speaker 4 (07:44):
Come on, you put two paddles in our hands. We're
pointing doubles. We are going. It's all out, man, even
if we don't have any kind of experience whatsoever. I
was talking to your brother Chris about disc golf and
he's like, you ever do that?
Speaker 3 (07:57):
Man?
Speaker 4 (07:57):
I'm like, listen, bro, I do me just warn you
before you do it, stretch and warm up.
Speaker 5 (08:04):
You might go out there and think it all it's
a frisbee. I could just throw it. Same with pickleball.
Speaker 4 (08:09):
I think a lot of people are going out there think, man,
I barely even move. I'm moving like a two foot spot.
But then all of a sudden, bam, you're diving for
a ball or just reaching out of your ordinary and
then you go see doctor Daniel Whitmer.
Speaker 2 (08:21):
Yeah, the biggest thing is that again, it's interesting, but
I found it's the shoes.
Speaker 5 (08:26):
A lot of the shoes.
Speaker 2 (08:27):
So a lot of people will wear like loafers or
like sandals. Even I've seen things like that.
Speaker 4 (08:34):
It's our guy, that's how he plays pickleball. Loafers.
Speaker 2 (08:37):
They slip or they twist their ankle or what have you.
And I tell people, make sure you get a nice,
good set of sneakers, they're laced up, tight wear, proper
shoe wear.
Speaker 3 (08:45):
I gave my first pitching lesson to a kid.
Speaker 1 (08:47):
And crocs this year, my ten and I was like, Nah,
you're not getting out of my mouth in those crocs.
Speaker 3 (08:54):
Proper shoe wear. Do people wear crocks to play cross
I like crocs.
Speaker 2 (09:02):
For people that have foot pain because they're they're nicely
cushioned and supportive, but definitely not for supporting activities. I would,
you know. But I have this argument with my kids.
I have two nine year olds, twins, boy and girl,
and they love crocs. Think where I'm to school and
all that, and I just I'm trying to encourage them
to wear snakers, but it's hard because they just love
slipping into it. It's so comfortable. But yeah, if you're
(09:24):
going to play a sport or play pickleball, you need
to wear good shoes, crut crocs. I don't think fall
under that list. Unfortunately. I want to talk to you.
I got a couple of questions for you that's been
in my head. One that I teased, I guess I
got to get this one out. And now that we're
talking kids, Like in our day, we didn't have a
great place like the Bone of Joint Institute.
Speaker 5 (09:41):
We didn't have the knowledge.
Speaker 4 (09:42):
We didn't we didn't know what concussions were until a
few years ago.
Speaker 5 (09:45):
Like it has grown so.
Speaker 4 (09:47):
Exponentially and the injuries keep on increasing.
Speaker 5 (09:52):
Why is that, doc, Like, what's your theory on that?
Speaker 4 (09:55):
Why you are so much smarter than your colleagues of
fifty years ago? You have way more technology. We didn't
have three D printing, we didn't have robots like that.
We got all that stuff now, but we're getting injured
at a faster rate.
Speaker 5 (10:07):
What's your theory on that?
Speaker 2 (10:08):
So I think it's I would have to say it's
one of three things. You know, a lot of kids
are playing more in different sports than they ever were
in the past. So the number of child or teenager athletes.
Speaker 5 (10:20):
You just have more people playing.
Speaker 2 (10:22):
I would say that's one. The other the other thing
is this this drive. And I'm sure you guys have
heard it in the baseball world of specialization, which in
my opinion is not a good thing. I think obviously
you know, and I'm not an expert right on that
kind of thing, but I would tell you that just
like in baseball, a kid who's doing any one repetitive activity.
(10:43):
We even see it in golf, right with golfer's elbow
people get medial or inside of the elbow pain. It's
like having diversity in how you're moving your body, especially
as a kid, I think is important. So I think
the specialization probably contributes to it. And then kids are
honestly getting bigger, faster, strong longer than they were in
the past. And I think we see that in football.
(11:04):
You know, they're moving faster and they're bigger, and the
weightlifting aspect of it is maybe more knowledgeable than we
had when we were kids. And so kids are bigger, faster, stronger,
And I think that's also sometimes contributing.
Speaker 4 (11:16):
To those the two knee injuries that I found disturbing
in the last couple of weeks in the NFL were
not gruesome like.
Speaker 5 (11:23):
The Gino Smith one that just happened.
Speaker 4 (11:25):
I get it, Like I see the twist when Christian
McCaffrey went down for the forty nine ers, when Jonathan
Brooks just went down for the Caroline Panthers. They did
not get hit, they did not get twisted around. They
knew before anyone else knew, and they just dropped.
Speaker 5 (11:41):
Like what are they feeling that makes them know that?
Speaker 4 (11:44):
And I know both of them have had some situations
in the past, maybe they know that pain, But like,
why just drop? And how does that happen without any
kind of cut or twist from an opposite force.
Speaker 2 (11:56):
Yeah, it's a great question. So the two main ligaments
on the inside of the kneear called the cruciate ligaments.
They're called that because they form an X. They cross
on the inside and they hold your femur bone or
your thigh bone to your tibia bone. When one of
those ligaments, or if you've had it reconstructed, one of
your graphs that you've had a reconstruction on, pops, you
feel an immediate pop and you're unable to wait bear.
(12:19):
These injuries typically happen. They're what we call non contact injuries.
So it's a pivot and a shift. So it's not
a straight line run or a fall necessarily with a
bent knee that would injure your quadricep tendon or your
pittellar tendon. But a hard plant and then a pivot
with a shift is what causes those cruci your ligaments.
Speaker 4 (12:38):
That scares because it's like, didn't happen at any time
to anyone.
Speaker 2 (12:42):
We see it a lot in football, but also basketball
and soccer. I mean a number of these not we
just call them non contact injuries. They're pretty common, but
usually that's a cruciate ligament injury. It's not a meniscus
or a MCL or an LCL. It's usually one of
the cruciate ligaments.
Speaker 4 (12:59):
What's the exercises I got to do to keep that
from happening?
Speaker 2 (13:02):
Quadricep strength. So it's that crucie ligment injuries are more
common in women actually, and female basketball programs and soccer
programs that have instituted these physical therapy protocols.
Speaker 5 (13:14):
Were you kind of women's basketball fans know also.
Speaker 2 (13:19):
And actually research has shown that they've markedly decreased their
number of ACL injuries when they do that. So but
quadricep strength, or the big muscle in the front of
your knee doing leg extensions or leg kicks. That's the
muscle that really needs to be strong to prevent those
those injuries.
Speaker 3 (13:34):
So what what is still your favorite surgery?
Speaker 2 (13:37):
Though?
Speaker 1 (13:37):
What what do you if you're like, yeah.
Speaker 3 (13:41):
I can't wait to get in there.
Speaker 2 (13:42):
This might sound a little a little specific, but I'll
tell you it's a right sided knee replacement in a
thin woman. Okay, that was specific and favorite app Well,
I'm right handed, but easier number one. Number two, if
they're thin, their leg is very easy to move around.
That surgery. We have to turnick itt up for maybe
(14:04):
twenty minutes, twenty five minutes. It's quick, it's easy. They
tend to do very well, and it's it's just a
fun operation to do. There's over there's probably about one
hundred and fifty steps or so totally to a knee replacement.
And when you're in sync and the surgical tech our
surgical techs here at BJI are just amazing. When they're
(14:25):
in sync and they're just handing you things without needing
to talk about it, it's a very fun operation to do.
And you know, you know, you're helping the patient. So
it's yeah, I like right sided knee replacement.
Speaker 3 (14:38):
Right side knee replacement.
Speaker 5 (14:40):
I didn't know you were going to have a specific
answer for that, but that.
Speaker 2 (14:43):
Was it's actually a really common question that we get. Yeah,
like what surgery is your favorite right side of knee replacement.
Speaker 4 (14:49):
So it's the not one more campaign around here. We
don't want any more drunk drivers in our state. We
don't want any more.
Speaker 5 (14:56):
Trauma surgeries from drunk driving.
Speaker 4 (14:58):
There's not one more here in the bone and joint
that's been the theme of the day. Obviously, trauma is
in your world as well. You deal with knees and
you deal with hips, and this happens from drunk driving
just as much as it happens from sports injuries.
Speaker 2 (15:10):
Yes it does. Yeah, we do. Actually we do hip
replacements for hip fractures. So when you break your hip,
sometimes if you break it on the femeral neck, which
is the part right under the ball of the ball
and socket, the way that we treat that is to
do a hip replacement. And so we've seen that for
sure from drunk driving accidents and falls and how alcohol
in general is you know, a contributor to a lot
(15:33):
of orthopedic injuries. So people, you know, safely imbibing alcohol
however you're going to do it, and especially not driving
is super super important.
Speaker 1 (15:43):
As far as older people in New England and slipping
in fally, this is the season is also about footwear.
It is is there anything that older people should be
thinking about putting on their feet before they get out
there and the snow and the ice.
Speaker 2 (15:59):
Absolutely so. Slips and falls are a very common cause
of hip fractures or wrist fractures. Having proper foot wear
when you're going outside even I think what happens is
people can get totally understandably a little bit complacent. They
go to take their trash out, it's only going to
take three minutes, and they just put on their slippers
or something, and it's like, you know, if you're going
(16:19):
to go outside in New England in the winter, you
need to have shoes that have tread on it because
those kinds of things are where injuries happen. And then
the other thing I would tell folks is ladders. Be
very very careful with your ladders. Make sure that your
ladders are properly seeded into the ground and that you
have somebody that's there with you. Don't use a ladder
(16:40):
by yourself. So if you're going up to the common
thing is the ladder goes on the side of the house.
The guy climbs up to clean his gutters out, it's
icy on the ground or it's wet, and the bottom
of the ladder just starts to slip out and that
and then they fall ten or fifteen feet and you'll
survive that, but you'll break something. You'll break your arm
or your hip, and it's totally preventible.
Speaker 5 (17:00):
I just bought my stepdad.
Speaker 4 (17:02):
I hope he's not listening a ladder holder thing because
this like he has a pole barn and he's way
up there, mate, and he just puts the extender up there,
and oh god, it's it's like a circus act.
Speaker 1 (17:12):
And we're talking to doctor dan uh Whitmer and and
the rehab from a hip surgery, the re you know,
how long is it take to come back from some
of these injuries, like you said, just to slip and
fall break your hip seems like it's what six to
eight months?
Speaker 2 (17:29):
It's typically we tell folks that full recovery or back
to where you really feel one hundred percent. Normal is
up to a year. With a broken hip, six to
eight months, you're feeling pretty pretty good. At that point,
you might be back to some some sporting activities, but
really normal is a year. I tell people that it
takes three months typically to be through ninety percent of
(17:51):
surgical recovery for a hip or a knee replacement. That's
patient dependent. If you're fitter and healthier, you're going to
recover a little bit faster than if you have some
other medical problems or if you're not as physically fit.
But generally three months for ninety percent recovery is a
good guide, all.
Speaker 4 (18:07):
Right, Kurt saying, we got to go to break but
I gotta get this one in, Kurt. I mean, how
important tell our people is we got two listeners that
I know of that just had something replaced and they're
walking around it because it's faster now like when you
do a hip, especially when it's scheduled, you.
Speaker 5 (18:21):
Know it's coming. You're in and out a lot to Dona's.
Speaker 3 (18:26):
There you go.
Speaker 5 (18:26):
There's one that I was thinking of.
Speaker 4 (18:27):
My grandfather did this as well, did not do his
rehab the way he was supposed to, and the surgery
really didn't take the way it was supposed to talk
about how important that stuff is.
Speaker 2 (18:37):
So for hips, the hip is a ball and socket joint,
and to rehabilitate it you really just need to walk.
That's the number one thing. It's much more simpler. Rehabilitation
for knees is I think are sort of a different ballgame.
And if you don't do your rehab appropriately, you don't try,
or you miss your appointments, or you don't work on
it at home, you can have a worse outcome. I
(18:58):
tell people that your physical therapist is just your coach.
You only see them two times a week, maybe three
times a week. You have to be doing these exercises
on your own every day. That's very, very important.
Speaker 1 (19:09):
So yeah, you're right, doctor Dan, you are the best
life saver. We appreciate your time, of course,
One of our favorite doctors, doctor Daniel Whitmer, or meeting
surgeon extraordinaire. He joined us now on the set here
right outside the rehab center. He just came out of surgery,
and doctor Dan tell us about the surgery he just
came out of.
Speaker 2 (00:16):
So I just did a hip replacement. Actually helped one
of my partners do it, and it was a guy
who'd been suffering from hip arthriatus for many years. He
was an ex football player, so like me, he was
a big guy. And so my partner just needed an
extra hand. So I scrubbed in and I was the muscle.
All right.
Speaker 3 (00:35):
Describe having to take out a hip. What do you
gotta do?
Speaker 2 (00:38):
So for most modern hip surgery, we try to do
it through as small of an incision as possible. But
like I tell folks, you know, a five foot one
female is different than say my surgery. I'm six foot eight,
you know, so my incision would be larger. So we
make the incision and then we have to dislocate the hip.
And to dislocate it, we have to twist the hip
around and push down and pop it out of the socket.
Speaker 3 (01:00):
Cannot be easy.
Speaker 2 (01:01):
It's not easy to do in a bigger leg. You know,
if you if somebody who's relatively thin, it can be
pretty easy and simple. But especially in guys who are bigger,
they tend to have a lot more muscular tissue and
their leg is just big, and so the leg itself
might weigh one hundred pounds, you know, or almost up
up to that, and so it's just more physically challenging
(01:21):
to do the operation. We have special retractors here at
bon and Joint for folks who are larger, and we
take care of a lot of those folks. They do
great with surgery. Their outcomes are are just as good,
if not better, you know, than everybody else. But sometimes
the retractors we use have to have special bends or
be deeper in order to access the hip joint. The
(01:43):
hip joint is way down deep in the pelvis. So
a lot of people when they put their hand on
the side of their hip, that's actually not your hip joint.
Your hip joint is you know, six or eight inches
in inwards, you know, and that's where we're actually working.
So so yeah, sometimes it can be a bit of
a physical operation to get a hip out, say, compared
to a knee replacement.
Speaker 4 (02:04):
So to explain this, Kurt says, he needs more Doctor Dan,
and I have to show the people or explain to
the people how big this man is. Well, he reached
out all the way around to grab his microphone.
Speaker 3 (02:16):
How's that, Kurt, how's that good?
Speaker 2 (02:19):
Yeah?
Speaker 5 (02:19):
Sorry, no, it's great. And you got to be a
big dude man.
Speaker 4 (02:22):
They get Yeah, we've met a lot of these hip
surgeons and they're not the smallest people in the world.
But the technology is getting better, and you're telling us
about three D printing robots. This is not the future.
This is the now.
Speaker 3 (02:36):
Right here at the better.
Speaker 2 (02:36):
Joint, we're doing that stuff now. So when you put
a hip or a knee replacement in the the early
success is about sort of how well and how efficient
the surgery is done. But the later success, I'm talking
twenty twenty five thirty years after, is how well it's
fixed to the bone, you know, because you're gonna walk,
you know, a million steps plus on this thing. And
(02:59):
so more modern bearing materials. We're using materials that are
three D printed on the undersurface, and that allows the
pores of the metal to actually be larger in ways
that modern manufacturing techniques really can't get to with just machines,
and three D printing is really the only way to
make porous metal that has larger pores in it, and
(03:21):
so that porous metal allows the bone to ingrow much better,
and that we're hoping that that leads to better long
term outcomes. We do a lot of research here at BJI.
We keep track of our patients over the years, and
so we're looking into this. You know, what we put
in now, We're not going to obviously have ten or
fifteen out year outcomes for a while, but we try
(03:42):
to keep a close eye on things and compared to
what we've done in the past.
Speaker 1 (03:46):
I know we've talked about this, we're talking to doctor
Daniel Whitmer.
Speaker 3 (03:49):
And old stuff that you've seen.
Speaker 1 (03:53):
How often do you come across a replacement knee or
replacement hip or even I mean shoulders, and I think
ankles are now replaceable items.
Speaker 3 (04:03):
And you've seen worn.
Speaker 1 (04:05):
Out parts, and I'm sure a lot of your research
is about people are living longer. We don't want to
have to see them in the next twenty thirty years.
How much of this is taking out the old stuff
and hopefully this new stuff will last for a long
long time.
Speaker 2 (04:19):
So about I do about six hundred, six hundred and
fifty operations a year, and about twenty percent of them
at this point. Our revision surgeries, so redoing something that's
either loosened or worn out or broken in some way.
We keep track of those patients. We do research for
them too to try to improve things. Revision surgery is
(04:39):
actually expected to increase three hundred percent in the next
fifteen years, and that's actually a major problem for our
healthcare system. We're putting in so many hip and knee
replacements now at some point they're going to wear out,
you know, and we're putting in maybe three, four or
five times more than we did even ten or fifteen
years ago, and so that's something that we are thinking
(05:00):
about in the future. But we're hoping that these more
modern bearing materials will bring that number down so we
don't have to revise as many of them.
Speaker 4 (05:06):
Well, what about the ages that you're doing these now?
Has that gotten younger?
Speaker 2 (05:11):
It's it's actually expanded both ways. It's gotten younger and
older folks who were very young. Let's say, and I'm
a joint surgeon, so I would call very young somebody
in their forties for a total joint replacement. Those folks,
you know, people used to say, you know, just live
with the pain. You know, get injections, deal with it
(05:31):
until you're quote unquote old enough to have a joint replacement.
But nowadays, given that the materials are so good and
they're lasting for so long, we can offer these these
younger patients joint replacements so that they can have a
better quality of life and go do things that they
just can't do with an arthritic hip or knee, like
ski or hike or things like that.
Speaker 3 (05:49):
All right, let's talk about pickleball players. It's all the
rage you've got it. It seems to be a lot
of older people like playing it.
Speaker 1 (05:56):
You don't have to do a lot of movement things
like that, but you're getting a lot of pickleball injury.
Speaker 3 (06:00):
You have described that you guys chuck a little bit
and a little bit. Surgeons go like.
Speaker 2 (06:06):
A little bit. So our favorite you know, we we
we take care of some, you know, a small a
very small number of high level athletes. The majority of
the athletes that we take care of our weekend warrior types.
And these folks they love pickleball. It's a great sport.
Anybody can play it even, you know, unto your later years.
But the issue is is that a lot of people
(06:27):
who haven't been athletic in a while they go out
and start to play pickleball, and they forget things like stretching,
proper footwear, you know, things that prevent slips and falls
on the court. And then sometimes they get a little competitive,
maybe more so than they've been in a long time,
and they might start diving for a ball or doing
something like that, and uh, there comes a point where
(06:50):
that's not a great idea to do, and where you know,
you're more brittle than maybe you used to be in
your younger years, and so things break or snap, or
they have sprains or strains. So I would say that
we see a lot more pickleball injuries nowadays than I
do with almost any other sport. And that's really been
in the past year.
Speaker 3 (07:08):
It's crazy.
Speaker 2 (07:08):
Now. Remember I'm a joint replacement surgery so the sports
medicine doctors still see all the young kids who are
getting sock injuries things like that, right, But as a
joint replacement doctor, I would say pickleball may be my
number one sport of that that I see folks that
get injured from I still love it. It's a great sport.
I encourage people to play it, but I talk to
people about proper shoe wear, stretching, proper preparation, you know,
(07:33):
making sure that you're ready to be active if you
haven't been active in a while.
Speaker 1 (07:37):
So true, like a lot of these like build up
to stuff, Well, jump right out there figuring the pickleball.
Speaker 5 (07:43):
Change jims.
Speaker 4 (07:44):
Come on, you put two paddles in our hands. We're
pointing doubles. We are going. It's all out, man, even
if we don't have any kind of experience whatsoever. I
was talking to your brother Chris about disc golf and
he's like, you ever do that?
Speaker 3 (07:57):
Man?
Speaker 4 (07:57):
I'm like, listen, bro, I do me just warn you
before you do it, stretch and warm up.
Speaker 5 (08:04):
You might go out there and think it all it's
a frisbee. I could just throw it. Same with pickleball.
Speaker 4 (08:09):
I think a lot of people are going out there think, man,
I barely even move. I'm moving like a two foot spot.
But then all of a sudden, bam, you're diving for
a ball or just reaching out of your ordinary and
then you go see doctor Daniel Whitmer.
Speaker 2 (08:21):
Yeah, the biggest thing is that again, it's interesting, but
I found it's the shoes.
Speaker 5 (08:26):
A lot of the shoes.
Speaker 2 (08:27):
So a lot of people will wear like loafers or
like sandals. Even I've seen things like that.
Speaker 4 (08:34):
It's our guy, that's how he plays pickleball. Loafers.
Speaker 2 (08:37):
They slip or they twist their ankle or what have you.
And I tell people, make sure you get a nice,
good set of sneakers, they're laced up, tight wear, proper
shoe wear.
Speaker 3 (08:45):
I gave my first pitching lesson to a kid.
Speaker 1 (08:47):
And crocs this year, my ten and I was like, Nah,
you're not getting out of my mouth in those crocs.
Speaker 3 (08:54):
Proper shoe wear. Do people wear crocks to play cross
I like crocs.
Speaker 2 (09:02):
For people that have foot pain because they're they're nicely
cushioned and supportive, but definitely not for supporting activities. I would,
you know. But I have this argument with my kids.
I have two nine year olds, twins, boy and girl,
and they love crocs. Think where I'm to school and
all that, and I just I'm trying to encourage them
to wear snakers, but it's hard because they just love
slipping into it. It's so comfortable. But yeah, if you're
(09:24):
going to play a sport or play pickleball, you need
to wear good shoes, crut crocs. I don't think fall
under that list. Unfortunately. I want to talk to you.
I got a couple of questions for you that's been
in my head. One that I teased, I guess I
got to get this one out. And now that we're
talking kids, Like in our day, we didn't have a
great place like the Bone of Joint Institute.
Speaker 5 (09:41):
We didn't have the knowledge.
Speaker 4 (09:42):
We didn't we didn't know what concussions were until a
few years ago.
Speaker 5 (09:45):
Like it has grown so.
Speaker 4 (09:47):
Exponentially and the injuries keep on increasing.
Speaker 5 (09:52):
Why is that, doc, Like, what's your theory on that?
Speaker 4 (09:55):
Why you are so much smarter than your colleagues of
fifty years ago? You have way more technology. We didn't
have three D printing, we didn't have robots like that.
We got all that stuff now, but we're getting injured
at a faster rate.
Speaker 5 (10:07):
What's your theory on that?
Speaker 2 (10:08):
So I think it's I would have to say it's
one of three things. You know, a lot of kids
are playing more in different sports than they ever were
in the past. So the number of child or teenager athletes.
Speaker 5 (10:20):
You just have more people playing.
Speaker 2 (10:22):
I would say that's one. The other the other thing
is this this drive. And I'm sure you guys have
heard it in the baseball world of specialization, which in
my opinion is not a good thing. I think obviously
you know, and I'm not an expert right on that
kind of thing, but I would tell you that just
like in baseball, a kid who's doing any one repetitive activity.
(10:43):
We even see it in golf, right with golfer's elbow
people get medial or inside of the elbow pain. It's
like having diversity in how you're moving your body, especially
as a kid, I think is important. So I think
the specialization probably contributes to it. And then kids are
honestly getting bigger, faster, strong longer than they were in
the past. And I think we see that in football.
(11:04):
You know, they're moving faster and they're bigger, and the
weightlifting aspect of it is maybe more knowledgeable than we
had when we were kids. And so kids are bigger, faster, stronger,
And I think that's also sometimes contributing.
Speaker 4 (11:16):
To those the two knee injuries that I found disturbing
in the last couple of weeks in the NFL were
not gruesome like.
Speaker 5 (11:23):
The Gino Smith one that just happened.
Speaker 4 (11:25):
I get it, Like I see the twist when Christian
McCaffrey went down for the forty nine ers, when Jonathan
Brooks just went down for the Caroline Panthers. They did
not get hit, they did not get twisted around. They
knew before anyone else knew, and they just dropped.
Speaker 5 (11:41):
Like what are they feeling that makes them know that?
Speaker 4 (11:44):
And I know both of them have had some situations
in the past, maybe they know that pain, But like,
why just drop? And how does that happen without any
kind of cut or twist from an opposite force.
Speaker 2 (11:56):
Yeah, it's a great question. So the two main ligaments
on the inside of the kneear called the cruciate ligaments.
They're called that because they form an X. They cross
on the inside and they hold your femur bone or
your thigh bone to your tibia bone. When one of
those ligaments, or if you've had it reconstructed, one of
your graphs that you've had a reconstruction on, pops, you
feel an immediate pop and you're unable to wait bear.
(12:19):
These injuries typically happen. They're what we call non contact injuries.
So it's a pivot and a shift. So it's not
a straight line run or a fall necessarily with a
bent knee that would injure your quadricep tendon or your
pittellar tendon. But a hard plant and then a pivot
with a shift is what causes those cruci your ligaments.
Speaker 4 (12:38):
That scares because it's like, didn't happen at any time
to anyone.
Speaker 2 (12:42):
We see it a lot in football, but also basketball
and soccer. I mean a number of these not we
just call them non contact injuries. They're pretty common, but
usually that's a cruciate ligament injury. It's not a meniscus
or a MCL or an LCL. It's usually one of
the cruciate ligaments.
Speaker 4 (12:59):
What's the exercises I got to do to keep that
from happening?
Speaker 2 (13:02):
Quadricep strength. So it's that crucie ligment injuries are more
common in women actually, and female basketball programs and soccer
programs that have instituted these physical therapy protocols.
Speaker 5 (13:14):
Were you kind of women's basketball fans know also.
Speaker 2 (13:19):
And actually research has shown that they've markedly decreased their
number of ACL injuries when they do that. So but
quadricep strength, or the big muscle in the front of
your knee doing leg extensions or leg kicks. That's the
muscle that really needs to be strong to prevent those
those injuries.
Speaker 3 (13:34):
So what what is still your favorite surgery?
Speaker 2 (13:37):
Though?
Speaker 1 (13:37):
What what do you if you're like, yeah.
Speaker 3 (13:41):
I can't wait to get in there.
Speaker 2 (13:42):
This might sound a little a little specific, but I'll
tell you it's a right sided knee replacement in a
thin woman. Okay, that was specific and favorite app Well,
I'm right handed, but easier number one. Number two, if
they're thin, their leg is very easy to move around.
That surgery. We have to turnick itt up for maybe
(14:04):
twenty minutes, twenty five minutes. It's quick, it's easy. They
tend to do very well, and it's it's just a
fun operation to do. There's over there's probably about one
hundred and fifty steps or so totally to a knee replacement.
And when you're in sync and the surgical tech our
surgical techs here at BJI are just amazing. When they're
(14:25):
in sync and they're just handing you things without needing
to talk about it, it's a very fun operation to do.
And you know, you know, you're helping the patient. So
it's yeah, I like right sided knee replacement.
Speaker 3 (14:38):
Right side knee replacement.
Speaker 5 (14:40):
I didn't know you were going to have a specific
answer for that, but that.
Speaker 2 (14:43):
Was it's actually a really common question that we get. Yeah,
like what surgery is your favorite right side of knee replacement.
Speaker 4 (14:49):
So it's the not one more campaign around here. We
don't want any more drunk drivers in our state. We
don't want any more.
Speaker 5 (14:56):
Trauma surgeries from drunk driving.
Speaker 4 (14:58):
There's not one more here in the bone and joint
that's been the theme of the day. Obviously, trauma is
in your world as well. You deal with knees and
you deal with hips, and this happens from drunk driving
just as much as it happens from sports injuries.
Speaker 2 (15:10):
Yes it does. Yeah, we do. Actually we do hip
replacements for hip fractures. So when you break your hip,
sometimes if you break it on the femeral neck, which
is the part right under the ball of the ball
and socket, the way that we treat that is to
do a hip replacement. And so we've seen that for
sure from drunk driving accidents and falls and how alcohol
in general is you know, a contributor to a lot
(15:33):
of orthopedic injuries. So people, you know, safely imbibing alcohol
however you're going to do it, and especially not driving
is super super important.
Speaker 1 (15:43):
As far as older people in New England and slipping
in fally, this is the season is also about footwear.
It is is there anything that older people should be
thinking about putting on their feet before they get out
there and the snow and the ice.
Speaker 2 (15:59):
Absolutely so. Slips and falls are a very common cause
of hip fractures or wrist fractures. Having proper foot wear
when you're going outside even I think what happens is
people can get totally understandably a little bit complacent. They
go to take their trash out, it's only going to
take three minutes, and they just put on their slippers
or something, and it's like, you know, if you're going
(16:19):
to go outside in New England in the winter, you
need to have shoes that have tread on it because
those kinds of things are where injuries happen. And then
the other thing I would tell folks is ladders. Be
very very careful with your ladders. Make sure that your
ladders are properly seeded into the ground and that you
have somebody that's there with you. Don't use a ladder
(16:40):
by yourself. So if you're going up to the common
thing is the ladder goes on the side of the house.
The guy climbs up to clean his gutters out, it's
icy on the ground or it's wet, and the bottom
of the ladder just starts to slip out and that
and then they fall ten or fifteen feet and you'll
survive that, but you'll break something. You'll break your arm
or your hip, and it's totally preventible.
Speaker 5 (17:00):
I just bought my stepdad.
Speaker 4 (17:02):
I hope he's not listening a ladder holder thing because
this like he has a pole barn and he's way
up there, mate, and he just puts the extender up there,
and oh god, it's it's like a circus act.
Speaker 1 (17:12):
And we're talking to doctor dan uh Whitmer and and
the rehab from a hip surgery, the re you know,
how long is it take to come back from some
of these injuries, like you said, just to slip and
fall break your hip seems like it's what six to
eight months?
Speaker 2 (17:29):
It's typically we tell folks that full recovery or back
to where you really feel one hundred percent. Normal is
up to a year. With a broken hip, six to
eight months, you're feeling pretty pretty good. At that point,
you might be back to some some sporting activities, but
really normal is a year. I tell people that it
takes three months typically to be through ninety percent of
(17:51):
surgical recovery for a hip or a knee replacement. That's
patient dependent. If you're fitter and healthier, you're going to
recover a little bit faster than if you have some
other medical problems or if you're not as physically fit.
But generally three months for ninety percent recovery is a
good guide, all.
Speaker 4 (18:07):
Right, Kurt saying, we got to go to break but
I gotta get this one in, Kurt. I mean, how
important tell our people is we got two listeners that
I know of that just had something replaced and they're
walking around it because it's faster now like when you
do a hip, especially when it's scheduled, you.
Speaker 5 (18:21):
Know it's coming. You're in and out a lot to Dona's.
Speaker 3 (18:26):
There you go.
Speaker 5 (18:26):
There's one that I was thinking of.
Speaker 4 (18:27):
My grandfather did this as well, did not do his
rehab the way he was supposed to, and the surgery
really didn't take the way it was supposed to talk
about how important that stuff is.
Speaker 2 (18:37):
So for hips, the hip is a ball and socket joint,
and to rehabilitate it you really just need to walk.
That's the number one thing. It's much more simpler. Rehabilitation
for knees is I think are sort of a different ballgame.
And if you don't do your rehab appropriately, you don't try,
or you miss your appointments, or you don't work on
it at home, you can have a worse outcome. I
(18:58):
tell people that your physical therapist is just your coach.
You only see them two times a week, maybe three
times a week. You have to be doing these exercises
on your own every day. That's very, very important.
Speaker 1 (19:09):
So yeah, you're right, doctor Dan, you are the best
life saver. We appreciate your time, of course,
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