At Princeton Orthopaedic Associates, we offer our patients the Three Ts on an extraordinary level. What are the Three Ts? They are extraordinary talent, extraordinary tools, and extraordinary techniques we use to serve Central New Jersey with world-class, world-recognized, and award-winning orthopaedic care.
The Three Ts are the cornerstones of the exceptional, personalized care we provide to every one of our patients. We are honored to serve you!
Extraordinary Talent
Our doctors at Princeton Orthopaedic Associates are fellowship-trained and board-certified. That means they’ve spent an additional year receiving the best training in their particular field of practice. Our doctors are focused on one particular area of practice, which means they see and treat the same types of injuries every day. That means they have knowledge, expertise, and skills beyond doctors who take a more general approach to orthopaedics.
We value training and continuing education for our doctors, team members, and physical therapists at POA. Our board-certified orthopaedists keep up with the latest literature and evidence-based treatments. If there are newer, better ways to treat your injury or illness, we want to know about it! The more we know, the better we can treat you, and your comfort and satisfaction are our ultimate goals.
Extraordinary Tools
At Princeton Orthopaedic Associates, we believe in providing state-of-the-art tools in-house for our patients, so they can get the best care possible without having to go from one place to another to do it. We offer advanced x-ray and imaging services, physical therapy tools, and treatment tools. We also have the ability to 3D print new joints, so we can customize new joints for each patient right in our offices.
Orthopaedics isn’t a stagnant field. There are new tools for treatment, surgery, or physical therapy frequently. We don’t use experimental tools that might not achieve the goals you want for your treatment or recovery, but we will adopt new, proven tools quickly once they are shown to benefit our patients.
Extraordinary Techniques
Doctors and physical therapists at POA believe in keeping up with the latest techniques to benefit our patients. We are among the first to adopt proven, effective, innovative techniques to benefit our patients. However, we don’t use new techniques until we have proof they benefit our patients. We want to provide our patients with extraordinary care without hampering their recovery with techniques that may not provide the maximum benefit.
Our patients demand excellence, and we’re committed to providing that excellence. We do that by knowing and utilizing the best techniques and the most innovative steps in their care. Their goals are our goals — to get them back to an active, pain-free lifestyle.
Visit our offices at Princeton Orthopaedic Associates and see how the Three Ts can change your life!
Princeton Orthopaedic Associates is a community of extraordinary care. We say that because we are proud and honored to bring extraordinary talent, tools, and techniques to you. We serve Central New Jersey with world-class, world-recognized, and award-winning orthopaedic care.
POA has some of the most talented and recognized orthopaedic physicians in the world. We work in a collaborative community to serve Central New Jersey communities. We are an outcome-focused orthopaedic practice that combines world-class talent with compassionate service.
Unique Patients, Personalized Care
We don’t see patients as just an injury. We don’t see every problem as a nail and every solution as a hammer. In other words, we don’t treat every injury the same because injuries aren’t the same. We don’t believe that every orthopaedic issue requires surgery.
We believe the best solutions focus on patient-desired outcomes. If those outcomes are achievable without surgery, we do everything in our power to use non-invasive techniques.
To do this, we take time to get to know our patients. We want to know your goals, your dreams for the future, and how you want to achieve those goals and dreams.
If surgery is necessary, you can rest assured that you will get exceptional care from our extraordinary team of experts. We invest heavily in the latest, evidence-based technologies. We have the right technology for even the most complicated procedures. We use the latest imaging equipment, and we can even custom-print your new joint, allowing for more precise procedures and better outcomes.
You have unique needs. We meet those needs with exceptional, extraordinary, personalized care.
Come See the Difference!
We know that we serve people - actual humans - not random orthopaedic conditions. That drives us to compassionate care. We genuinely believe our teams, doctors, and therapists are an exceptional group dedicated to all we do. That’s why we call ourselves “A Community of Exceptional Care.” We provide the communities we love, live in, and serve with exceptional care.
Our goal is to be Central New Jersey’s community orthopaedic center. More importantly, we want to be your orthopaedic center. Contact us today to see what we can do for you.
At Princeton Orthopaedic Associates, we refer to ourselves as a “Community of Extraordinary Care.” That means that we support the community we live in and love with exceptional care. It also means that we are a community of doctors, teams, and physical therapists who work together to provide the best diagnosis, treatment, and recovery care possible for each and every patient.
The Meaning Behind ‘Community of Extraordinary Care’
So what do we mean when we say we are a “Community of Extraordinary Care?” It means we provide extraordinary care that puts patients over profits and personalized care over rubber-stamp treatment. We know that patient-first care creates better outcomes.
We get to know our patients and develop long-term relationships that help us to provide personalized care. We exist to provide world-class care to our community, the surrounding region, and the greater northeastern United States in a highly collaborative, patient-centered environment.
We continue to draw patients from across the country - and we love that and will continue to serve patients worldwide - but our hearts are in our community. That is where our greatest commitment lies — the people we see in the grocery store and on the soccer field. We want to get to know you, and we want you to get to know us. Why? Because we know the more comfortable you feel with us, the better the communication, and the better we can help you.
Orthopaedic care is about so much more than surgery or physical therapy. It’s about changing or improving habits to eliminate pain. It’s about finding solutions that fit your lifestyle. It’s about discovering your goals and dreams and striving to achieve those with exceptional teams, tools, and techniques.
Extraordinary Orthopaedic Care In Central New Jersey
Whether you need urgent care today or long-term physical therapy, we can provide extraordinary care to get you back on the field, in the gym, or just on your feet again. Getting started with us is easy. Visit our website or contact us for an appointment by calling or texting us today.
Does your shoulder “lock” when you move it? Is it sore and difficult to move? Does it seem unstable? If so, these are the symptoms of a labrum tear. The labrum is the curved cartilage that sits in the shoulder’s ball-and-socket joint. When it is torn, it can cause pain and instability in the shoulder.
What Is the Labrum?
The labrum is cartilage that sits against the glenoid, which is the rounded socket of the shoulder. It cushions the glenoid from the head of the humerus or upper arm bone. The labrum is vital because the ligaments of the shoulder attach to it, providing stability for the shoulder. The labrum also supports the muscles and the tendons of the rotator cuff, which is made up of the tendons that surround the shoulder and help keep it in place. With all these critical functions, damage to the labrum can cause significant issues for the shoulder.
A labrum tear can cause your shoulder to become dislocated. In other words, the humerus head can pop out of the joint, rendering the shoulder difficult to move or completely immobile. That’s why it’s essential to diagnose and treat a labrum tear as soon as possible before further damage takes place.
There are two main types of labrum tears: a SLAP tear and a Bankart tear.
A SLAP tear stands for a tear from the “superior labrum from anterior to posterior.” That means the tear runs from the front of the upper arm back toward the glenoid, where the tendon holding the bicep connects to the shoulder. This type of tear is common in athletes, particularly those who snap their shoulders, such as baseball pitchers.
A Bankart tear occurs when a patient dislocates their shoulder and the material around the joint pulls on the lower part of the labrum, tearing it. This is common in younger patients who dislocate their shoulders. The tear can cause the shoulder to dislocate repeatedly or more efficiently.
Treatment for Labrum Tears
A labrum tear can be treated in minor cases by resting the shoulder and taking anti-inflammatory painkillers. In some cases, corticosteroid injections may be necessary. You will need physical therapy to help strengthen the shoulder and prevent further dislocation.
If physical therapy doesn’t improve the shoulder, surgery may be necessary to repair the labrum. Surgery usually can be done arthroscopically, which allows for shorter recovery times. Still, recovery will include physical therapy to regain mobility and strength in the shoulder. Full recovery can take six months to a year, depending on the severity of the injury.
People with persistent or severe shoulder pain may have a separated shoulder condition. This happens when the ligaments that connect the collarbone to the shoulder blade are stretched or torn. The injury can be mild, requiring mainly painkillers and some TLC, or severe, requiring surgery. The shoulder experts at Princeton Orthopaedic Associates can diagnose your shoulder separation and recommend the best treatment.
Separated Shoulder 101
A separated shoulder isn’t necessarily what it sounds like. Some people might imagine the humerus (upper arm bone) separating from the shoulder joint, but that isn’t the case. It involves the clavicle, the long bone at the top of the shoulder. Also, the bone doesn’t have to be separated entirely from the shoulder to be considered a “separated shoulder.”
The clavicle is connected to the shoulder blade with a series of ligaments. If the shoulder is injured, you could stretch those ligaments. In more severe cases, the ligaments are torn, causing the clavicle to pop up and creating a bump at the top of the shoulder.
Symptoms of a separated shoulder include pain, swelling, a bump on the shoulder, arm weakness, and limited mobility of the shoulder or arm.
Treatments for Separated Shoulder
Treatment for a separated shoulder depends on the severity of the injury. If only the ligaments around the clavicle are involved, and if they are just stretched, treatment may be as simple as using over-the-counter painkillers and anti-inflammatories, such as ibuprofen, and resting and icing the shoulder regularly. You may need physical therapy once the shoulder is healed to bring full mobility back.
In cases where the ligaments are torn, or other injuries are involved, such as a torn rotator cuff, surgery may be necessary to repair the shoulder and restore proper movement. During the surgery, the surgeon makes an incision and repairs the ligaments. Often, this can be done arthroscopically, which allows for faster healing. In more severe cases, a larger incision might be needed to install a plate to stabilize the shoulder and allow it to heal correctly. The plate is usually removed once the shoulder is healed.
You will require physical therapy to return full mobility to the shoulder. The patient will wear a sling for about four weeks before beginning lower arm exercises. Shoulder exercises could start as soon as six weeks after surgery. Full recovery can take up to six months.
One of the biggest tools for recovery from orthopaedic issues is physical therapy. Whether to treat an injury or disorder, or whether to speed recovery after surgery, physical therapy can greatly improve healing for patients. At Princeton Orthopaedic Associates, we have a team of physical therapists who focus on particular parts of the body, so you get the best care possible.
Physical therapists can utilize several tools to help a patient to heal, from manual therapy to ultrasonic waves. Let’s take a look at some of the tools and techniques our physical therapists can use to alleviate your pain.
1. Manual Therapy
This is one of the most common forms of physical therapy and one of the best tools we have — the therapist’s hands. The therapist can use massage, mobilization, manipulation of the muscles or joints, and strengthening exercises and movements to help the patient. Physical therapists are trained in various techniques to improve blood flow, strengthen muscles and ligaments, and ease pain.
2. Exercise
Just as physical therapists are trained in certain manual techniques, they are also trained in certain exercise techniques designed to target specific muscles and joints and help them recover from injury or surgery. Specific movements are needed to strengthen joints, tendons, ligaments, and muscles during recovery, and physical therapists know these movements and can teach patients to utilize them for recovery.
3. Ultrasound Waves
Physical therapists can use wand devices to apply ultrasound waves to certain parts of the body. These waves create heat deep within the tissue where massage or outside heat packs may not be as effective. This deep heat improves blood flow and stimulates healing. This technique is especially good for the healing of ligaments. Ultrasound waves can also be used to enhance the reaction of topical medications, such as cortisone.
4. Hot or Cold Therapy
Physical therapists are trained to use heat or cold to speed the healing of muscles and joints. Therapists know the best methods to use ice to reduce swelling and inflammation in soft tissue injuries because the cold causes the blood vessels to shrink. Therapists use heat for the opposite effect — to open the blood vessels and allow more blood to flow to the injured area. This reduces tightness and pain and allows for more mobility. It allows the therapist to stretch the muscles, ligaments, and tendons better to improve mobility faster.
5. Traction
Traction isn’t necessarily what you might think. Most people get the idea of a patient in a hospital bed with their legs in casts dangling in the air by a sling. Instead, it’s a form of decompression therapy used mainly on patients with spinal injuries or spinal disorders. Traction is used to reduce pressure on the spine and alleviate pain. It is used for conditions such as degenerative discs, pinched nerves, and herniated discs. Reducing pressure on these conditions through traction can ease the pain for patients and allow faster healing.
These are just a few of the tools physical therapists are trained to use to improve the lives of patients. If you believe physical therapy might help you, contact Princeton Orthopaedic Associates for an evaluation. Let us help you get back to a pain-free, active lifestyle.
A sore shoulder, a sore elbow, a sore knee — they all could have a common ailment. It’s called tendonitis, and it can affect the overused or injured joints of patients of any age. It’s most common in athletes and those with active lifestyles — those who use these joints often and with great effort.
The good news is, tendonitis is very treatable, often at home. However, it’s essential to diagnose and treat tendonitis quickly and adequately so it doesn’t lead to long-term damage. Princeton Orthopaedic Associates can use x-rays and digital imaging to determine whether your joint pain is caused by tendonitis or something more serious.
What Is Tendonitis?
Tendonitis is the inflammation of the tissue that connects muscle to bone. It tends to happen around joints in the body, particularly those most used, such as the shoulder, knee, and elbow. Patients with tendonitis experience pain, tenderness, and mild swelling in the area of the damaged tendon.
Tendonitis can be caused by injury, but the leading cause is repetitive or excessive motion that puts strain on the tendon. Awkward positions, forceful exertion, or frequent overhead reaches can also cause tendonitis.
Diagnosis and Treatment
Diagnosis of tendonitis usually can be done by a physical examination alone. However, your doctor may request x-rays or other digital imaging to confirm the diagnosis. The imaging can also ensure there aren’t other issues causing your pain, such as a tear to a tendon or ligament, a bone spur, or other injuries.
The good news is, you can often treat tendonitis at home. Mild cases can be treated simply by resting the joint, using over-the-counter anti-inflammatory medications, and icing the joint regularly. If these methods don’t work, corticosteroid injections can reduce the inflammation and alleviate the pain while the joint rests.
Some patients may benefit from physical therapy as well. A physical therapist can provide movements and exercises to strengthen the tendon while providing alternative movement that reduces stress on the tissue.
Your doctor may use outpatient treatments to reduce inflammation and alleviate pain in more severe cases. One such method is dry-needling, where a needle creates small holes in the tendon and encourages healing.
In chronic tendonitis cases, scar tissue may build up in and around the tendon. Ultrasonic treatment may be used to combat this. A small incision is made, and a device is inserted to remove scar tissue using ultrasonic waves.
Surgery usually isn’t necessary unless there is severe damage to the tendon, such as a tear in the tendon or if the tendon has torn away from the bone. Surgery types will depend on the location of the tendonitis. Recovery can take several weeks to several months and likely will require physical therapy.
You may have heard the term “bowlegged” or “bowlegs,” but what does it mean? Bowlegs are a deformity mainly in the knees that causes the legs to bow outward. It’s common in infants because of their positioning in the womb, but as they grow, develop, and begin to walk, their legs should straighten naturally. For those whose legs don’t straighten, you may need treatment or surgery to correct a bowlegged deformity.
What Are Bowlegs?
Infants are born with their legs in a bowed shape because of how they are positioned in the womb. Their bones develop and harden in the first three years of their lives, and the legs usually straighten as the knees move into proper position. However, if the legs are not straight by age three, that’s when a child may be diagnosed as bowlegged.
Bowleg deformity is more than an issue of appearance. It can also cause knee and hip pain; limited mobility, particularly in the hips; difficulty walking or running; or instability in the knees. The symptoms may get worse as the patient grows. Knee arthritis is common in adults with bowleg deformities.
Several diseases or factors can cause bowlegs; these include:
Bone dysplasia or abnormal growth
Paget’s Disease, a metabolic disease
Blount’s Disease, which damages growth plates in the knees
Badly healed fractures
Rickets, a vitamin D deficiency disorder
Achondroplasia (dwarfism)
Poisoning by lead or fluoride
Treatment of Bowlegs
If treatment is begun early while the bones are still developing, it is possible to treat without surgery. Braces may be used to straighten the legs and allow them to develop straighter. Physical therapy may also help the bones straighten out on their own.
As the patient ages, surgery may become more necessary, particularly for teenagers and adults whose bones have fully hardened and are no longer growing and developing as those of children. In this case, an osteotomy is performed to straighten the leg. Usually, an osteotomy involves correcting the tibia (shin bone) just below the knee. Still, it sometimes can affect the femur (thigh bone) instead of a combination of both bones if the deformity is severe.
During surgery, an incision is made on the side of the knee. A notch is cut in the upper part of the tibia near the knee joint, and the tibia is spread until it is appropriately aligned with the knee. Bone grafts are put in the notch, so the bone fuses with them and stays in its proper position. A plate is screwed into the tibia to hold the bone in proper alignment. In more severe cases, a surgeon may insert pins to screw into an external fixator, which sits on the outside of the knee and stabilizes the bone as it heals.
Most patients will begin physical therapy after about six weeks. Recovery from an osteotomy can take anywhere from 3-6 months, depending on the severity of the deformity and the complexity of the surgery to repair it.
Hip bursitis is a painful condition caused by inflammation of the small sacs that cushion the hip joint. It can be painful enough to limit mobility, including walking upstairs or getting out of a deep chair. The good news is, there are several treatment options available for hip bursitis. The experts at Princeton Orthopaedic Associates can find the right treatment plan for your pain.
What Is Hip Bursitis?
Hip bursitis, also known as trochanteric bursitis, is an inflammation of the bursa, tiny fluid-filled sacs near the hip joint called the greater trochanter. This joint is the area where the head of the femur (thigh bone) meets the long part of the bone. This area has a bursa that cushions the femur and its joint with the pelvis (hip bone).
There are several possible causes of hip bursitis:
Hip injury due to a fall or impact
Bad posture
Overuse from climbing stairs or standing for too long
Bone spurs on the hip
Poor joint positioning leading to soft tissue damage
Previous surgery
Chronic ailments such as arthritis or gout
Symptoms can include pain or stiffness, particularly when climbing stairs or standing from a deep chair or cushion. The pain tends to be on the side of the hip but can radiate around to the outside of the buttock or the hip.
Treatment of Hip Bursitis
Treatment of hip bursitis can vary depending on the severity of the pain and inflammation. That’s why it’s essential to assess your pain level before deciding on the best course of treatment. That treatment can range from over-the-counter pain medications to surgery.
Treatment begins with nonsteroid anti-inflammatory drugs (NSAIDs) such as ibuprofen. It also may require rest of the joint, which means not standing for long periods or not climbing stairs.
The next step is corticosteroid injections, which quickly reduce inflammation and pain. Relief can last several weeks to a few months.
Physical therapy can build up strength in the joint, straighten the joint, improve posture, and reduce pain and inflammation. We can also use physical therapy sessions to recover from bursitis and help prevent it from recurring.
If these methods fail to alleviate or eliminate the pain, surgery may be necessary. During surgery, the surgeon removes the bursa causing the problem. The surgery can be performed arthroscopically using only small incisions, which means faster healing for the patient.
Surgery for hip bursitis is rare and is only done in extreme cases. In most cases, other treatment methods bring sufficient relief.
Have you ever stepped out of bed and started to walk, only to feel pain and stiffness in your heel or ankle? If so, you may have a condition called plantar fasciitis, which is an inflammation of the band of tissue that connects your ankle to the arch of your foot. It is a painful condition, but one that can be corrected with a variety of treatments, from a simple change in footwear to surgery for extreme cases.
Let’s take a look at what plantar fasciitis is, what causes it, how to prevent it, and how to treat it.
What Is Plantar Fasciitis?
To understand plantar fasciitis, you need to know a little about foot and ankle anatomy. The heel bone, called the calcaneus, is connected to the bones in the upper part of the foot by a thick band of tissue. This tissue is called the plantar fascia. It provides support for the foot and arch.
Plantar fasciitis is when the plantar fascia becomes inflamed. This can happen for a variety of reasons, including:
Obesity
High arch
Repetitive motion
Tight calf muscles that reduce or prevent foot flexing motion
New activity
Increased activity
Performing new or increased activity without proper foot support from footwear can also contribute to plantar fasciitis.
Over time, the plantar fascia becomes stiff. If left untreated, that stiffness can become inflammation, which can be painful with every step. It can even lead to tearing in the tissue. Symptoms include pain on the bottom of the heel, particularly in the morning or after a long period of inactivity, stiffness, and greater pain during exercise or heavy activity.
Treating Plantar Fasciitis
Mild cases of plantar fasciitis usually can be treated without surgery. Often, minor changes and treatments can treat and prevent plantar fasciitis. Most patients improve in less than a year without surgery.
Patients may be asked to simply rest the foot and heel to reduce pain by stopping the activity causing the inflammation, such as running or stepping exercises. Patients will also be instructed to ice the foot and heal for about 20 minutes at a time, 3-4 times a day. Ideally, this can be done by rolling the foot over a frozen bottle of water. The motion helps massage the plantar fascia while spreading the cold over the length of the tissue.
Doctors may also recommend a regimen of nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naproxen. Doctors may also recommend special exercises or physical therapy such as calf or feet stretching exercises, which loosens the muscles tightening the plantar fascia. They can also recommend special orthotics to help with the pain, from over-the-counter heel pads to custom-fit orthotics to support the foot properly and reduce or eliminate pain.
If these solutions don’t work, your doctor may recommend more intense treatments, including cortisone injections for the pain, night splints to hold the foot in a certain position at night, physical therapy to loosen the muscles tightening the plantar fascia, or even extracorporeal shockwave therapy (ESWT), which uses shockwave impulses to stimulate healing of the tissue.
If none of these methods work, surgery may be necessary to relieve pain.
Surgery for Plantar Fasciitis
If there is little to no improvement after a year of treatment, surgery may be necessary to alleviate the pain. There are two options for plantar fasciitis: gastrocnemius recession and plantar fascia release.
With gastrocnemius recession, one of the muscles of the calf is lengthened to increase the ankle’s motion. The procedure can be performed as a traditional open surgery or with a small incision and an endoscope. The procedure gives the patient more motion when flexing their feet, which reduces stress on the plantar fascia.
Plantar fasciitis release is for those who still have a normal range of motion in the ankle, but the heel pain has not subsided. In this surgery, the plantar fascia is cut partially to relieve the tension. If there is a large bone spur on the heel (a portion of bone jutting out from the surface), that may be removed. While this surgery can be done endoscopically, it’s easier to do with an open incision, particularly if the surgeon must remove a bone spur.
