© 2019 by Randolph Health Orthopedics & Sports Medicine / 503 N. Fayetteville Street, Asheboro, NC 27203 / P 336-626-2688  F 336-626-4100

Jeffrey J. Yaste, MD

Sports Medicine, Shoulder/Knee Arthroscopy and Shoulder/Knee Reconstruction

 

 

Lance T. Sisco, MD

Sports Medicine and Orthopedic Surgery

 

 

Rotator Cuff Repairs

Arthroscopic Knee

If you’re considering a knee arthroscopy due to an ACL tear or a meniscus tear, come see the doctors at Randolph Health Orthopedics & Sports Medicine. Our doctors can evaluate your condition and determine if surgery is necessary.

A knee arthroscopy is a minimally invasive surgical procedure. Through small incisions, the surgeon inserts an arthroscope into the knee to perform the surgery. This allows the doctor to see the interior structures of the knee on a video monitor as opposed to previous methods of knee surgery.

The surgeon will then remove or repair:

  • A torn meniscus

  • Torn articular cartilage

  • A torn anterior cruciate ligament (ACL)

  • Loose pieces of bone or cartilage


Our team treats a wide range of sports injuries and other orthopedic conditions. In addition to arthroscopy of the knee and conservative treatments, we also offer shoulder surgery, joint replacement, ACL reconstruction, and more.

Contact us today to schedule a consultation with one of our doctors or to learn more about a knee arthroscopy or our other treatments for knee injuries. We proudly serve patients in Randolph County, Asheboro, Greensboro, Burlington, High Point, and abroad.

Arthroscopic Hip

Arthroscopic Rotator Cuff Repair (Shoulder)

Arthroscopic Rotator Cuff Repair is a surgical technique for repairing a rotator cuff tear. Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). During arthroscopy, a small camera is inserted into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions, rather than the larger incision needed for standard, open surgery.

Benefits of arthroscopic rotator cuff repair:

 

  • Smaller surgical incisions leading to decreased pain.

  • Typically an outpatient procedure.

  • The least invasive method to repair a torn rotator cuff.


Risk Factors
Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk. People who do repetitive lifting or overhead activities are also at risk for rotator cuff tears. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. Painters, carpenters, and others who do overhead work also have a greater chance for tears.

Seeking Treatment
If you have a rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time. Chronic shoulder and arm pain are good reasons to see your doctor. Early treatment can prevent your symptoms from getting worse. The goal of any treatment is to reduce pain and restore function.

Tennis Elbow

Carpal Tunnel

Sprains and Strains

Fracture Care

Did you know that a broken bone of any kind is called a fracture? There are different types of fractures and each of them requires a specific treatment. Common fracture types are:

 

  • Greenstick fracture – often seen in children, a greenstick fracture is an incomplete fracture where the bone is bent.

  • Open or Compound fracture – this is a fracture where the broken bone is exposed. This can be dangerous because of the increased chances of infection

  • Complete fracture – a fracture where the two pieces of the bone completely separate from each other

  • Stress Fracture – is a common fracture caused by overuse. It is most often seen in athletes who run and jump on hard surfaces such as runners and basketball players

  • Compression fracture – a compression fracture is a closed fracture that occurs when two or more bones are forced against each other. It most often occurs in the bones of the spine and may be caused by falling or as a result of osteoporosis.


Common Symptoms that you may need fracture care:

 

  • Swelling, bruising or bleeding

  • Intense pain

  • A visibly out-of-place or misshapen limb or joint

  • Broken skin with a bone protruding

  • Limited mobility or inability to move a limb


The physicians at Randolph Health Orthopedics & Sports Medicine are able to meet all of your fracture needs, regardless of the type. There are non-surgical approaches to fracture care which involve casting. The cast will immobilize the limb until the bones heal. After treatment, a patient will often benefit from physical therapy to help regain range of motion and then strength in order to get back to pre-injury function as quickly as possible. Another type of non surgical treatment is splinting. Splints are most often used in the early phases of a fracture to allow for swelling and frequent checks. A special shoe or boot can also be placed if the injury is to the lower leg or foot. Both of these options will help to immobilize the injured bone while it heals.

Often times surgery is required to best fix a fracture. Your surgeon may recommend fixing the broken bone with special hardware such as a rod, or plates and screws that will hold the fracture together while your body heals.

Athletic Training Services

Concussions

What is a Concussion?

According to the Center for Disease Control (CDC), a concussion is a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes your head and brain to move rapidly back and forth. This sudden movement can literally cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain.

What you might not know is that these chemical changes make the brain more vulnerable to further injury. During this window of vulnerability the brain is more sensitive to any increased stress or injury, until it fully recovers.

Unlike a broken arm, or other injuries that you can feel with your hands or see on an x-ray, you can’t see a concussion. It is a disruption of how the brain works. It is not a “bruise to the brain.” That is why brain CAT scans and MRIs are normal with most concussions.

Causes of Concussion

 

  • A knock to the head from a fall

  • A jolt to the torso from a collision

  • A hit to the head from a stick or ball


A concussion can occur from any type of contact such as colliding with a player, a goalpost, the ground, or another obstacle.

The CDC wants you to know:

 

  • All concussions are serious.

  • Concussions can happen in any sport or recreational activity.

  • Recognizing and responding properly to concussions when they first occur can help prevent further injury or even death.

  • Most concussions occur without loss of consciousness.

  • Athletes who have, at any point in their lives, had a concussion have an increased risk for another concussion.

  • Young children and teens are more likely to get a concussion and take longer to recover than adults.


 Don’t be fooled! Even what may seem like a mild bump to the head can actually be serious!

Parents, for more information on concussions read this fact sheet from the CDC.

The ImPact Test
Area high schools and middle schools have implemented an innovative program for student-athletes. This program will assist team physicians and athletic trainers in evaluating and treating head injuries (e.g., concussions). In order to better manage suspected concussions sustained by student-athletes, we have acquired a software tool called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing). ImPACT is a computerized exam utilized in many professional, collegiate, and high school sports programs across the country to successfully diagnose and manage concussions. If an athlete is believed to have suffered a head injury during competition, ImPACT is used to help determine the severity of head injury and when the injury has fully healed.

The computerized exam is given to athletes before beginning contact sport practice or competition. This non-invasive test is set up in “video-game” type format and takes about 20-30 minutes to complete. It is simple, and actually many athletes enjoy the challenge of taking the test. Essentially, the ImPACT test is a preseason physical for the brain. It tracks information such as memory, reaction time, speed, and concentration. It, however, is not an IQ test.

If a concussion is suspected, the athlete will be required to re-take the test until his post-injury scores return to baseline. Both the preseason and post-injury test data is used by Randolph Health Orthopedics & Sports Medicine to help evaluate the injury. The information gathered can also be shared with your family doctor. The test data will enable these health professionals to determine when return-to-play is appropriate and safe for the injured athlete. If an injury of this nature occurs to your child, you will be promptly contacted with all the details.

The ImPACT testing procedures are non-invasive, and they pose no risks to the student-athlete. The Human Motion Institute is excited to implement this program given that it provides us the best available information for managing concussions and preventing potential brain damage that can occur with multiple concussions. The Randolph Health Human Motion Institute and the student-athlete’s school administration and coaching staffs are striving to keep your child’s health and safety at the forefront of the student athletic experience. We also appreciate the Carolina Panthers Foundation who provided the grant money to make this program possible.

When a Student-Athlete has a Suspected Concussion

 

  • Before ImPact Test results are known, the student-athlete should have no exertion (no return to play and rest except for school).

  • The athlete is normally within 72 hours of the suspected concussion.

  • Test results can be shared with the athlete’s physician.

  • The athlete is tested a controlled, quiet environment with no interruptions.

  • Test results make take 24-36 hours to be returned.  For this reason, post-injury tests should be done two days prior to game day.

  • Randolph Health Orthopedics & Sports Medicine is pleased to discuss test results with a parent of a student-athlete or the student-athlete’s physician.


For more information about the ImPact Testing program in the Randolph County area, call the Human Motion Institute at 336-629-8818.

Sports Medicine

For years we have diagnosed, treated, and prevented sports-related injuries for the Asheboro community. Some of the most common sports injuries we encounter include cartilage tears, ligament ruptures in the knee, and shoulder or knee pain. If you have an existing injury we can examine a wide range of treatment options to determine which one is right for you. Our physical therapists can also help you prevent future injuries by working with you on strength and flexibility exercises.

Anatomic ACL Reconstruction

Anatomic ACL reconstruction is an innovative and unique technique for replacing a damaged anterior cruciate ligament. The procedure itself involves placing the new ligament in the identical anatomic position as the original one. The two different variations are a “single-bundle” or a “double-bundle” reconstruction. That terminology simply refers to the quantity of grafts that will be used to recreate the ACL.

Benefits of anatomic ACL reconstruction:

 

  • The new ACL will perform and function much like the ligament with which the patient was born. The patient will have more regular biomechanical knee function.

  • There will be much less chance of a recurring injury to the same knee.


The Outcome
An anatomic ACL reconstruction is able to duplicate the native movement of the knee much better than a typical, non-anatomic, single-bundle reconstruction. The native anterior cruciate ligament controls both the flexion and extension of the knee. An anatomic reconstruction surgery has been proven throughout biomechanical studies as being far superior in stabilizing knee flexion and extension. Theoretically, the increased control will decrease the risk of further injury or degeneration of that knee.

What is used to construct the new ACL?
Typically, tissue from that patient will be used, and it will normally be tissue from the hamstring or the patella tendon. The decision concerning what to use will be based on an examination and the patient’s medical history.

Is there any difference in the rehab from this type of surgery?
No. Rehabilitation will be handled in much the same manner, and many aspects may actually be easier after an anatomic ACL reconstruction.

Is there a downside to this procedure?
The procedure is technically more demanding, but can be overcome by choosing a surgeon with extensive experience with this particular technique, so he can properly identify the origin of the native ACL, and therefore, know where the insertion sites will need to be.

Meniscal Root Tear Repair

Knee injuries are one of the more serious concerns to athletes regardless of their sports focus. The knee is composed of four bones connected by ligaments for stability, tendons that connect the bones to muscles allowing for movement, and cartilage between the bones, behind the knee cap, providing a kind of cushion for shock absorption. This means that to properly understand the nature of a knee injury it is necessary to consult a physician to determine the best course of treatment. One particular type of knee injury is getting special attention of late: meniscal root tears.

Meniscal Root Tears
The lateral meniscus and medial meniscus are c-shaped pieces of cartilage that sit atop the tibia or shin bone. The menisci are the cartilage pieces providing the cushion and shock absorption between the tibia and the femur or thigh bone. When the knee is twisted or suffers some form of trauma. Meniscal root tears tend to occur in conjunction with other ligament tears as a result of the trauma sustained causing the injury.

Meniscal Root Repair
When it comes to repairing a meniscal root tear, surgery is the method of treatment, and can be done as a stand-alone procedure or in conjunction with surgery to address other ligament and tendon tears. Meniscal root repair in an arthroscopic procedure designed to be minimally invasive making the smallest incision possible and using specialized equipment to stitch together or bind the cartilage in place to allow the body to heal.

Recovery and Rehabilitation
As with all knee surgery there is to be expected approximately six weeks or so of recovery time. Recovery time may vary depending on other factors, which your physician can better account for during follow up exams. Physical therapy following surgery is important for the rehabilitation process to build strength and regain mobility at appropriate intervals.

At Randolph Health Orthopedics & Sports Medicine we employ skilled physicians with the experience and training to address your sports related knee injuries through conventional and surgical treatments including meniscal root repair performed by Dr. Yaste. We also offer comprehensive individualized rehabilitation for our patients. Call us at 336-626-2688 for more information.

Procedures performed by: