Blog Archive

Offering a clinical trial for rotator cuff repair surgery May 18th, 2019

We are proud to announce that we have been selected as a collection site for a new clinical trial involving rotator cuff repair surgery. This study will evaluate if pulsed electromagnetic field technology (PEMF) improves healing rates and outcomes for patients who have a rotator cuff tear repair.  Dr. Carofino...

Are you a candidate for a surgery center outpatient shoulder replacement? Oct 31st, 2018

  Recently I have been performing outpatient shoulder replacements at the Princess Anne Surgery Center. Currently, this is the only surgery center in the Virginia Beach, Norfolk & Chesapeake region offering this procedure, and Dr. Chad Manke and myself, are the only surgeons performing them. Over the past few weeks,...

Shoulder Arthroplasty Experience (Aug '18-Sep'19) Oct 26th, 2018

Up to date Shoulder replacement data and complication rate Each year I make an effort to analyze my surgical cases and publish our shoulder replacement data. I think this is important for several reasons. First, it is an opportunity to analyze our complication rate to see how our team is...

Warning Signs of Elbow Arthritis Oct 18th, 2018

Warning Signs of Elbow Arthritis Your elbow is intrinsic to most daily activities — washing dishes, carrying a briefcase, typing on a computer, playing sports like tennis, or lifting weights. You may not even realize how much you rely on the ability to extend and bend your elbow until it...

Innovations in Shoulder & Elbow Arthroplasty Course. Oct 15th, 2018

I recently participated as faculty in the "Innovations in Shoulder & Elbow Arthroplasty" course which was hosted by DJO in Miami. It was an honor to be asked to instruct other surgeons on the newest techniques in Shoulder surgery. As always, I learned as much as I taught. Course participants...

Computer navigated shoulder replacement Oct 11th, 2018

Computer Navigation for Shoulder Replacement Total Shoulder Replacement Expert. Virginia Beach & Chesapeake, Virginia Computer navigation has been used for hip and knee replacements for over a decade, but it has just recently made its way into the shoulder replacement world and I am happy to have this tool to offer my...

Little leaguers need to rest their arms......just like the pros do Sep 22nd, 2018

What do professional baseball players do at the end of their season? Your little leaguer should pay attention. As team physician for the Norfolk Tides, I do exit physicals at the end of every season. Some of the Tides players move up to the Orioles as a "September call up". This...

Sports with the Highest Risk of Shoulder Injury Sep 14th, 2018

Injuries to the shoulder often involve the soft tissue of the joint, including the tendons, ligaments, and muscles, rather than the bones located there. Often, shoulder injuries develop gradually with repetitive overhead movements or with constant swinging or throwing actions. Read on to learn which sports put you at the...

Would you travel 2,000 miles to Virginia for a shoulder replacement? Sep 14th, 2018

Would you travel 2,000 miles to Virginia for a shoulder replacement?Over the past few years I have had patients travel to Virginia for shoulder replacements and rotator cuff repairs from Illinois, Pennsylvania, Florida, Maryland, West Virginia, New York, New Jersey and even Arizona. The notion of traveling far away for an...

How Your Sleeping Positions Affect Your Shoulders Aug 15th, 2018

How Your Sleeping Positions Affect Your ShouldersYou open your eyes in the morning as the light comes through your windows. Then it hits you: pain in your shoulders. You quickly scan your memory and can’t come up with any reason for your stiff, sore shoulders. Could the way you sleep...

Cortisone Injections for shoulder problems: Think twice Jul 28th, 2018

Cortisone injections may be a bad idea for some types of shoulder pain Virginia Beach & Chesapeake, Shoulder Specialist.  Cortisone injections are often used to treat common shoulder problems such as bursitis and rotator cuff tears. These injections provide many patients with pain relief and studies have shown reduced pain for an...

"The Surgeon put a balloon in my shoulder!" A new treatment for massive rotator cuff tears Jul 24th, 2018

Balloon Procedure for Rotator Cuff TearsVirginia Beach, Rotator Cuff SurgeryThere may be a new treatment option for rotator cuff tears and it’s not what you might expect. It's a balloon. Clinical trials are underway at a few academic centers throughout the U.S to test the InSpace biodegradable balloon, which is...

Why You Shouldn't Procrastinate Treating Carpal Tunnel Syndrome Jul 10th, 2018

It may be tempting to try to ignore the pain, tingling, and numbness in your hand and arm resulting from carpal tunnel syndrome, but it’s not wise. This pain is a sign from your body that the major nerve to your hand — called the median nerve — is being...

10 Tips for Preventing Tennis Elbow Jun 19th, 2018

Whether it’s from playing tennis or golf, or your job as a painter or carpenter, if you’ve experienced the pain and burning that comes with tennis elbow — also known as lateral epicondylitis — you might want to prevent another occurrence. Tennis elbow results from a tear in the extensor...

The hospital billed my patient $40,000 dollars for his shoulder replacement! May 28th, 2018

The Forty Thousand Dollar Shoulder Replacement!!!!Atlantic Orthopaedic Specialist Shoulder Replacement Program (Virginia Beach & Chesapeake, Virginia)I recently had a patient travel to Virginia Beach from out of state for a "Ream and Run" Shoulder Replacement. He recieved a nasty surprise while back home recovering......THE HOSPITAL BILL. My patient received his...

Short stem and stemless shoulder replacements. Do they really make a difference? May 24th, 2018

Long Stem, Short Stem......Stemless Shoulder replacementsAtlantic Orthopaedics Shoulder Replacement Program (Virginia Beach & Chesapeake, Virginia)Over the past ten years shoulder replacement designs have significantly changed on the humeral side. In a traditional shoulder replacement design the humeral implant is held in place by a "stem" which goes down the center...

What Causes Trigger Finger? May 18th, 2018

Have you ever had a finger or fingers get stuck in a bent position? If so, you may have trigger finger. It may be accompanied by pain, swelling, and a clicking sensation in the finger. Once stuck, your finger may just snap back into a straight position on its own...

How long do shoulder replacements last? May 3rd, 2018

How Long Will My Shoulder Replacement last?This is by far the most common question that patients ask me when discussing a potential shoulder replacement. The answer is actually pretty straightforward. The failure rate for shoulder replacements is approximately 1% per year. This means that 10% will fail within 10 years,...

Why You Should Still Exercise if You HAve Arthritis Apr 20th, 2018

When your joints are achy and painful, the thought of joining an aerobics class or even walking around the block may seem like an impossibility. But if you want to improve your arthritis and reduce pain, exercise may be exactly what you need. Regular physical activity improves joint health and...

Tommy John surgery. Non operative management may be a better option for some players. Apr 14th, 2018

Many observers of baseball think that Tommy John surgery is a miracle operation that returns players to the MLB. In fact, many youth players are under the impression that they will actually throw harder after a Tommy John surgery and that it will improve their performance. I always counsel patients that...

Shoulder replacement in a surgery center offers big advantages Apr 7th, 2018

Want to save money on your shoulder replacement? Consider a surgery center Now offering outpatient surgery center shoulder replacement for Virginia Beach , Chesapeake and Norfolk, Virginia patients. In the past, all surgeries were done in a hospital. In the 1970’s even a simple carpal tunnel release required a trip to the...

Five Post Shoulder Surgery Exercise Tips Mar 29th, 2018

Because no two people are alike in terms of degree of injury, recovery and rehab from shoulder surgery is always individualized. Your doctor at Atlantic Orthopedic Specialists lets you know what you can expect in your particular situation. It’s a good idea to find out before the surgery just what...

Don’t let your son play baseball year round… Feb 28th, 2018

For many young athletes baseball has become a year round sport. There is fall ball, winter training, and the spring season that extends into the summer with travel tournaments. When I was growing up we played during the spring /summer and then moved on to other sports for the fall...

What is the problem with nonprofit hospitals? Feb 28th, 2018

The obvious problem is that they don’t pay taxes. This is not a trivial point. In 2002 the tax exemptions for nonprofit hospitals was approximately 12 billion dollars, and in that same year the estimated cost of providing medical care to the entire uninsured population was 60 billion. That means...

Bundled Payments for Joint Replacements: How it will limit patient access. Feb 28th, 2018

Medicare is trying to change the way it pays for total joint replacements, particularly hip and knee replacements. Currently, Medicare pays a bill for each individual aspect of a patient’s care. It’s kind of luck shopping a la carte. They pay the surgeon, the hospital, the anesthesiologist, the rehab facility...

Advice to Parents of Youth Athletes/Baseball Players Feb 28th, 2018

Injuries among youth baseball players are dramatically rising. In particular, the number of Tommy John elbow reconstructions being performed on adolescent baseball players has greatly increased over the past decade. In the past this was an injury only seen in professionals and now it is common in thirteen and fifteen...

Hope Solo “Ream and Run” Arthroplasty! Feb 28th, 2018

This past week Hope Solo underwent a “Ream & Run” shoulder replacement with Dr. Rick Matsen at UW in Seattle.I was fortunate to train under Dr. Matsen during my shoulder fellowship. These pictures of Dr. Matsen and Hope bring back memories of morning rounds at UW. Dr. Matsen is showing...

Stem Cell Therapy…are we there yet?! Feb 28th, 2018

As pointed out in this post, there is currently minimal scientific evidence to support the use of stem cell therapies for orthopedic conditions. This may to prove to be the future BUT currently we do not have any proof that stem cell therapies are very effective.Furthermore, these treatments are not...

Do I need antibiotics before dental work? Feb 28th, 2018

Patients who have had a shoulder replacement often ask if they should be taking antibiotics before dental work. In some cases, their dentist had recommended it. As pointed out in this article, there is no evidence to support the routine use of antibiotics before dental procedures in patients who have...

I am honored to be a CoVA Gold Physician! Feb 28th, 2018

This year Atlantic Orthopaedic Specialists won Gold for Best Orthopaedic Group along with 5 of our physicians! I am proud to be part of one of these physicians as well as this fantastic practice! Please check out the link below for the full scoop!http://www.atlanticortho.com/cova-gold-top-docs-mean-top-care-aos-patients-five-years-running-aos-celebrates-top-docs-cova-gold/

How patients pay for healthcare is changing… Feb 28th, 2018

Over the past few years we have seen a significant increase in high deductible insurance plans because of the ACA health exchanges. In these plans patients are often responsible for paying a large portion of the bill before the insurance kicks-in, sometimes the patient can be responsible for upwards of...

Shoulder Replacement Recall… Feb 28th, 2018

There was a recall of the Zimmer-Biomet reverse total shoulder. I am happy to say that I have never used this replacement and none of my patients need to be concerned about this. As you can see the lawyers are getting excited so be ready for the TV commercials.https://www.gblawyers.com/zimmer-biomet-reverse-shoulder-lawsuits/?utm_source=facebook&utm_medium=post+ad&utm_content=post+ad+001&utm_campaign=reverse+shoulder+jjs

How long will a reverse shoulder replacement last? Feb 28th, 2018

A new study published in JBJS helps to address this question. “Long Term Outcomes of Reverse Total Shoulder Arthroplasty” was published this month by surgeons in France.They reported that over 90% of reverse shoulder replacements lasted at least ten years. Furthermore, shoulder replacements that did fail and required revision were...

Hospitals are overpriced for MRIs and we have reached a tipping point Feb 28th, 2018

This week Anthem Insurance announced that in select states it would no longer be paying for MRIs to be performed in hospital facilities. Why would they do that? The answer is simple. Hospitals charge (some would say over charge) a lot more than freestanding imaging facilities do for MRIs and...

One Year After a Rotator Cuff Surgery Feb 28th, 2018

How should my shoulder feel one year after rotator cuff surgery?Patient education is one of the most important ingredients in a successful surgery. It is important that patients understand what to expect immediately after an operation and also years later.Arthroscopic Rotator cuff repair is a great operation that can decrease...

Are online doctor ratings accurate? Feb 28th, 2018

It is hard to pick a doctor. Everyone would like to feel that they are entrusting their medical care to someone who is truly excellent. But how can you find the best doctor for your particular problem? Recently, online doctor rating websites have emerged to fill this gap in the...

Stay awake during your shoulder surgery Feb 28th, 2018

Have you ever talked to your surgeon during your surgery? It’s definitely a different experience and it is becoming more common. Today, I performed a full day of surgeries and most of my patients remained awake during surgery. Typically, they don’t say much. Sometimes they ask how things are going,...

Weight lifting advice for patients that have had shoulder surgery Feb 28th, 2018

After patients recover from shoulder surgery they often ask about returning to a workout regimen that involves weight lifting. Strength training is a great form of exercise for staying fit and preserving bone density, but if you have had a prior shoulder operation it is important that you avoid certain...

How much does a shoulder replacement cost? Feb 28th, 2018

Patients often ask, “How much will my surgery cost?” You would think that should be an easy question to answer. Unfortunately, it is not and that is one of the biggest problems with our current healthcare system.Let’s take a shoulder replacement surgery as an example. When a patient has surgery...

Injury Epidemic Amongst Baseball Pitchers Feb 28th, 2018

Injury Epidemic Amongst Baseball PitchersThere continues to be an injury epidemic amongst baseball pitchers at the highest level (MLB) and youth recreational players. There is an obsession with throwing hard and lighting up the radar gun, and for good reason. MPH is a recruitable stat for scholarship seekers. However, new...

“I gained weight after my rotator cuff repair!” Feb 28th, 2018

A recent study published in the Journal of Shoulder & Elbow Surgery found that on average patients will add five pounds of water weight during an arthroscopic rotator cuff repair shoulder surgery. During shoulder arthroscopy, fluid is pumped into the shoulder joint. This fluid spreads into the surrounding tissues which...

MLB Pitcher Suffers Rare Latissimus Dorsi Injury Feb 28th, 2018

Noah Syndergaard, MLB pitcher,  was recently diagnosed with a partial tear injury of his Latissimus Dorsi muscle (aka ’the lat’). As team physician for the Norfolk Tides, I wanted to provide some insight into this uncommon injury and what to do about it.Many people do not realize that the latissimus, the...

What is your surgeon’s complication rate? Here’s mine. Feb 28th, 2018

If you are going to have a surgery two questions you should ask your surgeon are: “What are the most common complications of this surgery?” and “What is your complication rate with this operation?”Unfortunately, many patients do not ask these questions. I feel that some patients are hesitant to ask...

100+ shoulder replacements in 2016 Feb 28th, 2018

Shoulder surgery is a team sport, and thankfully I have a great team. In 2016 we performed over one hundred shoulder replacements which is the most in Hampton Roads and among the highest in Virginia and North Carolina.Why does this matter? Simply put, the more you do something the better...

A new technique makes rotator cuff surgery less painful! Feb 28th, 2018

Rotator Cuff Repair surgeries are notoriously painful! Many patients say it is the worst pain they have ever experienced. To make matters worse, you are bound up in a sling after surgery and can’t move the arm to try to “find a comfortable spot”. Most people are unable to lie...

Does Glucosamine Work? Feb 28th, 2018

Glucosamine and Chondroitin are common over the counter supplements that are marketed as a treatment for arthritis and joint pains. These can be purchased in pill form in nearly every pharmacy. They are also the active ingredients in the drink “Joint Juice”. These supplements are often marketed as being able...

Is it possible to do an elbow replacement? Feb 28th, 2018

Most people are familiar with knee and hip replacements. However, many patients are not aware that elbow replacements are possible.Below are a set of x-rays from a recent patient of mine who underwent a revision elbow replacement. Most often I do this surgery for elbow arthritis or very bad elbow...

Understanding the levels of minor league baseball Feb 28th, 2018

Over the past three seasons as the Orthopedic Surgeon for the Norfolk Tides I have spent a lot of time around minor league baseball. During this time I have learned a tremendous amount about shoulder & elbow injuries in professional baseball players, but some of the most interesting things I...

How fast does your pitch spin? Feb 28th, 2018

Last summer I first learned about the new baseball metric of spin rate. Like many MLB teams the Orioles had started tracking the spin rate of their minor league pitchers, and had installed doppler hardware at Harbor Park to measure how fast the baseball was spinning on each pitch thrown...

What every little leaguer can learn from professional pitchers Feb 9th, 2018

I often see youth baseball players with elbow and shoulder injuries due to overuse. Most often these are minor issues that resolve with rest, but in some cases they can be serious injuries with life long consequences. Typically, these injuries are caused by repetitive injury and inadequate rest. Many youth...

How long does a shoulder replacement last? Feb 9th, 2018

“How long will a shoulder replacement last?”This is one of the first questions asked by patients who are considering a shoulder replacement, and for good reason. Nobody wants to undergo a surgery that will need to be redone in a short period of time. A standard shoulder replacement involves replacing...

Will my rotator cuff tear get worse if I don’t have surgery? Feb 9th, 2018

Will my rotator cuff tear get worse if I don’t have surgery for it? The short answer to this question is “Maybe”, but there is some new research out that gives us clarity on this topic. Rotator cuff tears are generally degenerative in nature, meaning that the tear occurs over time from...

Reverse shoulder replacements: When things go bad Feb 9th, 2018

Reverse shoulder replacements are generally a very successful operation. However, as with all surgeries things can go wrong. In my practice, I see a number of referrals for shoulder replacements that have failed and require a revision surgery. Over the past month, I have had the opportunity to revise three...

Who deserves the blame when surgery does not turn out the way you expected? Feb 5th, 2018

I follow a Facebook support group for “ream and run” shoulder replacement patients. I have found some of my patients benefit by talking to others who have been through a similar operation and recovery process. Generally, the support group encourages its members to push themselves in physical therapy, and do...