Hip Surgery Boston


A painful hip can interfere with everyday tasks and keep you uncomfortable. Hip problems impact everyone, regardless of age, and result from a range of causes, including arthritis, fractures, injury, and compressed nerves. If your hip pain does not respond well to non-surgical options, your doctor may suggest hip surgery.

Signs You May Require Hip Surgery

Persistent pain around the hip or groin that gets worse over time may indicate the need for surgery. The pain may radiate down to the knee and worsen with activity. Some patients also have difficulty sleeping due to debilitating hip pain. Other symptoms include:

  • Difficulty moving
  • Reduced ability to do routine tasks
  • Tests reveal advanced joint damage
  • Stiffness
  • Mental distress
  • Inflammation or swelling

If conservative treatments don’t relieve your hip pain, surgery may be an option. Other patients become frustrated with medication or cortisone injections that only relieve hip pain for a few months. If you are worried about the side effects of pain medications and other treatments, consider alternative treatments like prolotherapy.

Surgical Options

The various types of hip surgeries include the following.

Hip Arthroscopy

Hip arthroscopy diagnoses a range of hip problems via an arthroscope, a flexible tube with a camera. An orthopedic surgeon inserts this device into your hip joint via small incisions at the side of the hip. Thus, the surgeon avoids making a large cut through the soft tissues to examine the hip joint.

The camera on the arthroscope transmits pictures to the surgeon’s monitor, which allows the doctor to diagnose and even treat some conditions. For example, the surgeon can remove loose fragments of cartilage or repair a labral tear. Hip arthroscopy causes little trauma and has a short recovery time.

Hip Replacement

Hip replacement surgery replaces a diseased or impaired hip joint with an artificial joint. The artificial implant is typically made of ceramic, metal, or plastic. You can either get a partial or full hip replacement, depending on the extent of the joint damage.

The two approaches to hip replacement are the posterior approach and the anterior approach. In the anterior approach, the surgeon makes the incision on the upper thigh’s front part. The incision is made along the outer bottom during posterior hip surgery.

Hip replacement may be an option if your hip pain interrupts daily activities or conservative treatments are no longer effective. Advanced arthritis is often the reason to get hip replacement surgery.

Revision Hip Surgery

Depending on your daily use, an artificial hip joint undergoes wear and tear, and it may no longer be effective. Revision surgery will be needed to repair or replace the worn-out implant. Artificial hip implants also get dislocated, infected, or inflamed. Revision hip surgery reduces pain, restores mobility, and improves the range of motion.

Prolotherapy: An Alternative to Hip Surgery

While hip surgery effectively reduces pain and improves the hip’s stability, it carries many risks. Some possible complications include infection, blood clots, dislocation, and loosening of implants.

Prolotherapy is an effective non-surgical treatment for hip pain, stiffness, inflammation, and reduced range of motion. During the treatment, an irritant solution is injected into the hip joint to encourage the healing of the tendons and ligaments. Prolotherapy stimulates the body’s natural healing process to treat arthritis, unstable joints, and strains.

Prolotherapy eliminates the need for hip surgery by treating the root cause of your discomfort. Contact Boston Prolotherapy & Orthopedics today to learn about what prolotherapy can do for you.

Hip Issues in Boston
Hip Pain in Boston

Hip Pain Boston

A fully-functional hipbone enables you to move about and perform your daily activities. Mild or chronic hip pain can interfere with routine tasks like getting out of the car and walking down the stairs. Keep reading to discover the causes of hip pain.

Anatomy of the Hip Joint

The hip joint consists of two bones: the pelvis and thighbone or femur. It is a ball and socket joint, as the head of the femur sits in a socket area (acetabulum) inside the pelvis.

The hip articular cartilage reduces friction between the bones, while the synovial membrane provides fluid for lubrication. There are ligaments surrounding the hip joint that link the femur to the pelvis. Other parts of the joint include muscles, tendons, bursae, arteries, and veins.

Since the hip joint bears a lot of weight, it is vulnerable to wear and tear. With age, the muscles, tendons, and cartilage can become damaged, or bones can break from injury.

Causes of Hip Pain

Some conditions that cause hip pain include:

Osteoarthritis

Osteoarthritis describes age-related cartilage breakdown that is common in weight-bearing joints. The pain may be dull or intense. It often improves with rest and worsens with movement. In addition to pain, osteoarthritis leads to stiffness and reduced range of motion. You may struggle to complete simple tasks like tying your shoe.

Bursitis

Bursae are liquid-filled sacs that reduce friction when bones, tendons, and muscles rub together. Inflammation of the bursae causes pain that occurs even as you rest. Repetitive activities that irritate the hip joint are the major cause of bursitis. This is more common in women.

Hip Fracture

Osteoporosis, cancer, and other conditions make the hip bone brittle and weak. People with brittle bones are more likely to break a hip after a fall or direct blow. Stress fracture is another risk factor, especially among female athletes with bone weakening, menstrual irregularities, and eating disorders. Hip fractures cause severe hip pain and may result in complications like a blood clot in the leg.

Tendinitis

When the tendons attaching bones to muscles become irritated or inflamed, pain and swelling occur. Tendons lose elasticity with age, but tendinitis also results from overuse, lack of stretching, or injury.

Hip Labral Tear

The hip labrum is a ring of flexible cartilage that follows the outside rim of the hip socket. It maintains alignment between the ball and socket and promotes the hip’s range of motion. Hip labral tears are common among athletes who perform twisting movements.

Symptoms

Hip pain may come suddenly, or you may feel a day-to-day dull ache. Often, hip pain is accompanied by a reduced range of motion or limping. The pain may get worse with activity, or it may persist as you rest. You may also feel discomfort in your groin, buttocks, or thigh.

Diagnosis

Your health practitioner will ask about the movements that worsen the pain and observe you in motion. Describe how the hip pain started and how it interferes with daily activities. Imaging tests like MRI scans, X-rays, and CT scans will show the problems with the soft tissues in the hip.

How Prolotherapy Can Help

Consider prolotherapy if your hip does not get better with rest, ice and heat therapy, and medications. Prolotherapy describes the injection of an irritant solution that causes an inflammatory response to stimulate healing. The treatment strengthens worn ligaments and tendons, reduces pain, and promotes joint stability.

Hip pain is mainly caused by degenerative conditions like labral tears, arthritis, and bursitis. Prolotherapy is effective in treating hip pain because it addresses ligament laxity and hip instability.

Hip Surgery in Boston
Hip Issues in Boston

Knee Surgery in Boston


The tendons, ligaments, muscles, and bones surrounding the knee are susceptible to injury and structural damage. If conservative treatments fail to treat your knee pain, you can explore various surgical options. Chronic knee pain can make your life more stressful, which is why some patients opt for knee surgery.

Signs That You Require Knee Surgery

In most cases, knee injury and damage respond well to conservative treatments like medications, cortisone injections, prolotherapy, and physical therapy. However, look out for the symptoms below that indicate the need for additional medical intervention.

Intense and Frequent Pain

It is not normal to feel intense, disabling, and frequent knee pain. See a doctor if the pain lasts for weeks or keeps you awake at night. If you need pain medication to go through your day, it may be time for knee surgery. Sometimes, your knee pain may get worse in cold or humid weather.

Limited Mobility

You may be a candidate for knee surgery if you have trouble walking the stairs, walking, or standing up from a chair. Chronic pain makes it challenging to complete the activities you could previously perform with ease, such as climbing out of the bathtub or picking up your kids.

Worsening Arthritis

Many people with chronic knee pain have osteoarthritis or rheumatoid arthritis, which causes loss of motion, pain, and loss of cartilage. You may need knee surgery to replace the damaged structures.

Ineffectiveness of Non-Surgical Options

Home remedies like an ice pack and hot baths may relieve mild knee pain. If the pain persists, your physician may recommend medication, weight loss, cortisone injections, and other interventions that provide relief. However, if your mobility continues to decline, it may be time for knee surgery.

Types of Knee Surgery

Arthroscopic surgery is the most common knee surgery, where a surgeon uses tiny instruments to repair cartilage and remove loose fragments. This minimally invasive surgery remedies many kinds of knee problems.

If the joint cartilage has severely degenerated, your surgeon may recommend a knee replacement operation. During the procedure, the surgeon replaces the degenerated areas of the knee joint with metal, plastic, and ceramic parts.

Prolotherapy: An Alternative to Knee Surgery

Prolotherapy is an effective treatment for knee pain caused by worn-out cartilage. The treatment involves injecting irritants into tendons, ligaments, and joints to stimulate a natural healing process that repairs damaged tissues. The result is reduced pain and stiffness and increased flexibility.

Prolotherapy also enhances the mobility and function of the knee joint. By stimulating the body’s natural healing process, you can hopefully avoid invasive knee surgery. Contact Boston Prolotherapy & Orthopedics to learn more about how prolotherapy can treat your knee pain.

Knee Pain in Boston
Knee Issues in Boston

Knee Issues in Boston

The knee joint is vulnerable as it absorbs stress from everyday activities like walking, lifting, and running. You are more susceptible to knee problems if you make many repetitive motions or engage in high-impact activities like aerobics. Many knee issues also arise from the aging process and gradual degeneration from medical conditions like arthritis. Explore some common knee problems below.

Knee Sprains and Strains

The knee joint has multiple ligaments that provide stability and alignment. Sudden movements and direct blows to the knee can stretch and tear these ligaments and cause pain and swelling. Similarly, knee strains occur when injuries stretch the muscles and tendons surrounding the knee. Strained muscles can cause difficulty in walking, stiffness, and bruising.

Torn Cartilage

Cartilage tears are common among athletes who perform sudden knee twists. The knee joint has two C-shaped shock absorbers on either side called menisci. Meniscus tears manifest as pain or tenderness, crunching noises when walking, locking of the joint, inability to strengthen the knee, and tightness of the knee joint. You can experience these symptoms after the injury, or the cartilage damage can happen over time. Small cartilage tears resolve on their own, while others respond to home remedies and medication. However, you may need arthroscopic knee surgery for severe meniscus tears.

Arthritis of the Knee

Different kinds of arthritis can affect the knee joint and cause pain. The most common types of knee arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis wears out the joint cartilage, exposes the bone, and causes swelling. Then, everyday activities become painful due to the knee joints rubbing together.

Rheumatoid arthritis triggers inflammation in the joint and leaves the knee feeling stiff, warm, and swollen. Gout, psoriatic arthritis, and post-traumatic arthritis also cause knee pain and reduced mobility.

Patellar Tendonitis

Patellar tendonitis results from the inflammation of the tendon patella, which links the kneecap to the shinbone. It is also called jumper’s knee and is common among athletes whose activities include a lot of jumping. However, any repetitive motions can stress and tear the tendon patella and cause pain, swelling, and tenderness.

Treatment Options for Knee Issues

Your treatment options depend on the injury’s specifics and the medical conditions causing the knee problems. For example, elevation, ice packs, and rest can facilitate the healing of simple strains. If you have knee arthritis, your physician may recommend medication to manage the inflammation and pain. Other interventions include prolotherapy, cortisone injections and physical therapy.

If your knee pain results from worn-out cartilage, you will benefit from prolotherapy. The treatment involves injecting an irritant to the knee joint to boost blood flow and encourage healing in the damaged tissues. Contact Boston Prolotherapy & Orthopedics today for natural relief from knee pain without surgery.

Knee Pain in Boston

Knee Surgery in Boston

Shoulder Pain in Boston

Your shoulders are among the body’s most flexible joints. They allow you to brush your hair, reach for things, pull your kid’s wagon, and drive to work. Acute shoulder pain can make these simple tasks seem momentous.

Causes of Shoulder Pain

The shoulder has a complex anatomical structure that includes tendons, muscles, ligaments, bones, and nerves. Any of these parts may be responsible for your pain.

For example, rotator cuff tendons become inflamed when they get trapped in the bony area of your shoulder blade. Your rotator cuff consists of tendons and muscles that connect the upper arm bone to the shoulder blade.

Tiny tears in the rotator cuff can be caused by injury, repetitive motion, aging, and more. Some indicators that you might have such an issue include weakness and popping sounds when you move your arm and pain that interferes with your ability sleep.

Osteoarthritis is another common cause of shoulder pain. This occurs when the cartilage that covers the shoulder joint wears out over time. The cartilage is the smooth, flexible tissue that enhances the movement of the shoulder joint. Osteoarthritis can result from injuries, inflammation of the joint lining,
and chronic wear and tear.

Other causes of shoulder pain include:

  • Frozen shoulder
  • Calcific tendonitis
  • Bursitis
  • Dislocation
  • Broken bones
  • Tendon rupture
  • Impingement
  • Sprains
  • Bone spurs

Diagnosis of Shoulder Pain

As demonstrated above, there are numerous causes of shoulder pain. Your physician will first perform physical elimination to identify the possible causes of your discomfort. This may include pressing on different parts of your shoulder to check for tenderness and abnormality and test your range of motion.You might also require imaging tests like ultrasounds, X-Rays, and MRIs. Imaging tests display any damage in the shoulder’s cartilage, ligaments, bones, and tendons.

Treatment

The cause and severity of the shoulder pain will inform your treatment options. For some people, the pain responds to at-home interventions like rest, ice, heat, and over-the-counter or prescription nonsteroidal anti-inflammatory medications (NSAIDs).

Your physician may also recommend prolotherapy, physical therapy, or cortisone injections. If none of these suffice, surgery may be the only remaining option.

Prolotherapy for Shoulder Pain

Prolotherapy, also called regenerative injection therapy, is a way of injecting an irritant solution into a tendon or ligament in order to cause a reparative inflammatory reaction to help repair the tendon and relieve pain. Prolotherapy addresses the root cause of shoulder pain caused by rotator cuff tears, AC separation, arthritis, and shoulder instability. In addition to reduced pain, you can look forward to an increased range of motion and enhanced strength.

Shoulder Issues in Boston

Shoulder Surgery in Boston

Shoulder Surgery in Boston

The shoulder and upper arms are some of the most used parts of the body, and injuries can interfere with everyday tasks such as driving, carrying groceries, and picking up your children and grandchildren. If you suffer from shoulder arthritis, you are likely trying to find quick relief, especially if the pain is progressing in intensity.

There are multiple remedies and treatments for shoulder injuries, including rest, physical therapy, cortisone injections, as well as surgery. Prolotherapy has emerged as a very effective treatment for injured joints and ligaments – as well as arthritis. This treatment has fewer complications than surgery, resulting in reduced shoulder pain and improved range of motion. Another major benefit is that of not having to miss work. Prolotherapy also strengthens partially torn ligaments and tendons. And it improves the overall function of the joint.

What is Prolotherapy

Prolotherapy, also called regenerative injection therapy, uses injectable solutions to trigger the body’s natural healing mechanism. The solution contains irritants – typically dextrose, although other additives might be used by some practitioners.

How It Works

To understand how prolotherapy works we first need to understand the structure of the shoulder. What most people think of the shoulder is actually a complex series of muscles, ligaments, and tendons that provide an impressive range of motion. The tendons and muscles maintain the arm in a “ball and socket” joint, enabling you to perform a wide range of tasks – from throwing a ball to swimming.

Most shoulder issues involve the soft tissues of the muscles, tendons, and ligaments. Repeated trauma and injuries, such as rotator cuff tears, damage the connective tissue, thereby reducing the shoulder’s strength and mobility leading to an increase in pain.

The treatment options for most shoulder injuries include physical therapy, cortisone injections, rest, and anti-inflammatories. While these interventions will reduce pain, they will not address the root cause of the problem. Once normal activities are resumed, the tearing of the tendon will continue and result in more pain.

Prolotherapy acts as a regenerative treatment that triggers the growth of new and stronger fibers in the affected tissue.

When injected, prolotherapy solutions trigger a healing response and the growth of fibrous tissue. This treatment reinforces the fibers in the ligament or tendon where the tendon attaches to the bone. It also repairs mid-substance tears or injuries as well.

Prolotherapy is often recommended for patients who would like an alternative to shoulder surgery. The following are some of the risks and complications associated with surgery: failure of the procedure, infection, nerve damage, blood clots, loss of time from work, and the expense of rehabilitation.

What Shoulder Issues Can Prolotherapy Address?

Dr. Albert Franchi commonly uses prolotherapy to treat injured ligaments and tendons in the neck, shoulders, back, arms, legs, elbows, wrists, hips, knees, feet, and ankles.

Prolotherapy is also very effective in treating arthritis of the above mentioned joints. Treatments typically relieve shoulder pain, weakness, instability, and stiffness caused by trauma – as well as bad posture.

Prolotherapy is also an effective course of treatment for joint instability that can be caused by ehlers thandanls syndrome (EDS).

Prolotherapy is especially effective for tendon tears caused by overuse of the shoulder. Rotator cuff tendon tears are among the most common triggers of chronic shoulder pain, and prolotherapy is a definite alternative to rotator cuff surgery. Prolotherapy can also relieve other common shoulder conditions, including:

  • Osteoarthritis
  • Instability of the shoulder
  • AC separation
  • Partial tear of the bicep ligament

Preparation

The first step to administering Prolotherapy injections is a diagnosis, and Dr. Franchi will begin by reviewing your personal medical history. The next step is a physical exam involving the palpation of the affected shoulder. Dr. Franchi will determine if there are any weakened tissues in the ligament or tendon.

Imaging studies might also be needed to determine the extent of shoulder problems. Ultimately in consultation with Dr. Franchi, together you will decide if you are a good candidate for prolotherapy. Depending on the nature of your problem, it is possible that Dr. Franchi will recommend other interventions, such as rehabilitative exercises.

What to Expect

The injection takes only a few seconds to perform and will involve some moderate amount of pain which is tolerable. You may have some residual pain for the following day.

The protocol is for one injection per week for a total of five weeks for each affected body part. After the five weeks of treatment there is an eight-week follow-up consultation for all patients by phone.

Shoulder Pain in Boston

Shoulder Issues in Boston

Am I A Candidate For Prolotherapy?

I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

How Prolotherapy Works?

I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

Prolotherapy For Arthritis

There are many people in their 30’s, 40’s and 50’s that are starting to develop early arthritis. These patients come in with mild pain. This is due to the fact that their cartilage is starting to deteriorate and has small defects and microfractures of the cartilage. Prolotherapy helps to produce fibroblasts that fill in these areas to smoothen out the cartilage – in the same way you would put asphalt in the road to make your ride smoother. This helps to relieve the pain of arthritis significantly. Even patients with severe arthritis can get relief as well.

Knee Pain Boston


Prolotherapy treatment for knees is the number one condition we treat. It is a very effective treatment for cases of arthritis and knee instability that are the result of tendon and ligament damage. Prolotherapy for these type of knee conditions is effective 85% of the time. However, it is not effective for a torn meniscus, unless it is a peripheral tear.

Knee pain is a common symptom among people of all ages. There are many causes of knee pain, and your soreness may not be a sign of anything serious. However, consult a doctor if the pain gets worse over time.

Symptoms

The severity of knee pain varies, from a dull ache to sharp and disabling pain. The pain’s location also varies, and you can feel it in one location, or the whole knee may be swollen. Other signs that accompany knee pain include:

  • Stiffness and swelling
  • Instability or weakness
  • Popping sound
  • Inability to bend or extend the knee
  • Limping because of the discomfort
  • Redness and warmth

Causes of Knee Pain

Injuries to the ligaments, tendons, and bones surrounding the knee cause knee pain. For instance, basketball and soccer athletes are prone to ACL injuries due to sudden changes in directions. Fractures occur when a bone that surrounds the knee breaks and interferes with the knee’s functioning. The knee joint can also be dislocated during a car accident, in which case you require urgent medical attention.

Arthritis also causes knee pain, including osteoarthritis, rheumatoid arthritis, lupus, and gout. Other conditions that trigger knee pain include:

  • Bursitis
  • Osgood-Schlatter disease
  • Patellar tendinitis
  • Patellofemoral pain syndrome
  • Tendonitis
  • Baker cyst

Diagnosing Knee Pain

Every possible cause of knee pain needs different diagnostic tests. First, the medical practitioner inspects your knee for tenderness, pain, swelling, or visible bruising. The physician may urge you to move your leg as they push the joint to determine the integrity of the knee’s ligaments, tendons, and muscles. The doctor may also suggest imaging tests such as CT scans and MRI, and lab tests to detect inflammation or infections.

Knee Pain Treatment

The cause of knee pain determines the treatment path. Your doctor may recommend pain-relieving drugs or medication to treat the medical conditions causing your pain, such as gout and osteoarthritis. In other cases, you may get relief from injection medications like corticosteroids and lubricants.

Mild knee pain can respond well to home remedies like rest, ice, elevation, and heat. If you have severe knee injuries, your doctor may recommend surgery.

Prolotherapy for Knee Pain

Prolotherapy is an effective treatment for knee pain caused by tendon and ligament damage. The goal of the treatment is to inject an irritant solution into the knee joint and increase inflammation. In turn, the inflammatory response enhances blood flow and healing in the damaged tissues. Prolotherapy reduces pain and stiffness and improves the joint’s mobility and strength.

Is knee pain interfering with your ability to complete your daily tasks? Contact us at Boston Prolotherapy & Orthopedics for non-invasive treatment.

Knee Issues in Boston

Knee Surgery in Boston