J. Craig Morrison, MD

Products And Services

• Knee Replacement

  Patients that are experiencing chronic knee pain that affects quality of life and daily function may be suffering from knee arthritis. Generally speaking, arthritis is a condition in which the cartilage surface that protects and cushions the ends of the bone in the knee joint is damaged and worn thin. This can be from wear and tear (osteoarthritis), trauma, or diseases that cause severe inflammation in the joint (e.g. rheumatoid and psoriatic arthritis). If your pain has not decreased with medication, injections, weight loss, and/or acceptable activity changes, you may be a candidate for partial or total knee replacement. What is knee replacement surgery? Total knee replacement A total knee replacement entails resurfacing the damaged parts of the joint with metal and polyethylene (a hard plastic) generally removing only a few millimeters of bone. The primary ligamentous structures and soft tissues remain intact. Partial knee replacement A partial knee replacement involves the removal of only the damaged part of your knee joint and replacing it with an artificial device. The healthy parts of the knee are maintained. This can be considered if only one compartment of the knee is involved. What happens during knee replacement surgery? Your treatment begins with a pre-surgical evaluation to plan for the best size and position of your artificial joint utilizing computer templated digital x-rays and occasionally CT scans. During your knee replacement surgery, Dr. Morrison uses instruments that help measure the knee and prepare the surfaces. The guides allow for precise removal of damaged bone and resurfacing with implants. Only the minimal amount of bone is removed to allow for a well-balanced and mobile knee. Dr. Morrison utilizes computer navigation and robotic assisted technologies to assist in the procedure. What is the recovery time? Everyone heals from his or her surgery at a different pace. In most cases, however, you will be restricted to using a walker and/or cane for two to six weeks after your operation. Your physical therapist will guide you through this progression. You will gradually return to normal function without any assistive devices. Most patients begin aerobic exercise around week six. Although your knee will be improving quickly at this point, it is still common to have pain and be more tired than normal earlier in the day. By three months you should have normal energy and only mild knee discomfort at times. Your new joint and surrounding tissues will continue to heal even up to a year after your procedure. Can I sleep on my side? You may sleep on your non-operative side whenever you feel comfortable. Avoid sleeping on your stomach for two weeks How long do I need to keep a bandage on my incision? Waterproof bandage should be worn for 7 days after your surgical procedure. Remove the waterproof bandage after 7 days post-op. Do not remove steri-strips at this time. Continue to shower as normal with steri-strips in place. Within a week these steri-strips will begin to roll up along the edges. You may then remove the steri-strips. If desired, you may continue to wear a bandage to protect the incision from irritation. When can I shower (get the incision wet)? You may shower as soon as returning home as long as the waterproof bandage is in place for the first 7 days. After waterproof bandage is removed, continue to shower as normal. When can I immerse my knee in water (e.g., bath, swimming pool, ocean, hot tub)? Typically, you should not swim or get in a hot tub or bath tub for six weeks. However, in some circumstances we will allow patients to do so after four weeks if there is no drainage. Check with your therapist and surgeon. How long will I be on pain medication? You will likely require some form of pain medication including Tylenol and an anti-inflammatory medication (e.g. Meloxicam or Celebres) for 6 weeks. Some patients also require a stronger pain medication (narcotic or opioid) for a shorter time period after surgery. Ice, rest, and elevation also play an important part in managing pain and swelling. Do I need a physical therapist? Yes! The physical therapist plays a very important role in recovery. You will see a physical therapist the day of your surgery. If you are unable to go home the day of surgery, the physical therapist will see you during your hospital stay. Over 95% of patients start outpatient physical therapy within 2-3 days of going home. Therapy is typically 2-3 times weekly for 6 weeks. The therapist should follow the protocol that has been issued to you on your pre-op visit and/or discharge from the hospital. Your therapist will keep your surgeon informed of your progress.

  Link: Knee Replacement

• Hip Replacement

  Hip pain from arthritis or other conditions that damage the surface of the joint can lead to life altering pain. When one’s quality of life and daily function are affected despite conservative treatments like over the counter medications and activity changes, hip replacement surgery can provide long lasting pain relief and a return to an active lifestyle. Why does Osteoarthritis cause pain? Osteoarthritis is the most common reason for needing hip replacement surgery. This particular type of arthritis results from gradual wear-and-tear that can happen over many years and can even have a strong genetic component. The articular cartilage is a healthy and slippery protective coating that protects the bone ends. As this protective coating wears thinner, the exposed bone beneath can rub together leading to inflammation and pain. As the cartilage continues to get thinner and disappear, the joint damage increases, the pain worsens, and the joint stiffens. This often leads to what is called bone-on-bone arthritis. Because your hips are supporting at least some of your weight all the time, these large joints get very little rest. If you develop osteoarthritis in your hips, anything that requires hip movement – including standing, walking, and dressing – becomes increasingly challenging. This pain is most often in the groin area, but can also be felt in the buttock and down the thigh into the knee. While conservative treatments like physical therapy, medication, and injectables can help for a while, eventually, the joint deterioration is so great that the only way to find relief from your symptoms is with hip replacement surgery. What techniques are used in hip replacement surgery? There are several different ways of performing hip replacement surgery: Posterior approach The posterior approach is where your surgeon makes an incision through the muscles in your buttock to reach your hip joint. This is a very common approach with a proven track record of excellent results on both primary and revision hip replacements. Anterolateral approach The anterolateral approach is where your surgeon accesses your hip through the side of your body. This approach avoids the dissection of posterior structures. It can be used for primary and revision hip replacements. Anterior approach Using the anterior approach, Dr. Morrison accesses your hip through the front of your leg. Often a special table is used to facilitate the procedure and live x-ray and computer navigation are used to ensure appropriate component size and position. The surgical approach goes between muscles rather than through muscles. Dr. Morrison will evaluate which approach best suits your needs to optimize your results. The anterior approach is his preferred technique in over 95% of patients. Same-day or outpatient surgery is standard for patients who have hip replacement surgery, and the team offers multimodal pain management to keep you comfortable and help you get moving again. What is the recovery time? Everyone heals from his or her surgery at a different pace. In most cases, however, you will be restricted to using a walker and/or cane for two to four weeks after your operation. Your physical therapist will guide you through this progression. You will gradually return to normal function without any assistive devices. In four to six weeks you will begin low impact aerobic exercise and should be very functional in day to day activities. It is common to feel tired earlier in the day for up to three months after surgery. At this time, a patient can engage in more strenuous physical exercise including weight lifting with the operative leg. Your new joint and surrounding tissues will continue to heal even up to a year after your procedure. What are the dislocation precautions for my hip (positions I should avoid)? Anterior Hip Precautions for 6 weeks No attempting lunge position. (Hip extension with weight bearing). Posterior Hip Precautions for 6 weeks You should avoid flexing (bending) at the hip more than 90 degrees. Avoid low chairs and furniture because they require too much bending at the hip in order to get up. If you must reach to the floor when seated, always reach between your legs, not to the outside. Use an elevated toilet seat to avoid excessive bending of the hip. If possible, use a chair with arms. The arms provide leverage to push you up to the standing position. When sitting, position your legs so that you can see your inner thigh, calf and foot (not the outside). If your physician orders different precautions, you will be instructed on them by your physical therapist. Can I sleep on my side? For patients with an anterior (front) incision You may sleep on your operative side whenever you feel comfortable. For patient with a posterior (back) approach you should wait two weeks to sleep on your operative side.

  Link: Hip Replacement

• Shoulder Replacement

  Patients that are experiencing chronic shoulder pain that affects quality of life and daily function may be suffering from shoulder arthritis. Generally speaking, arthritis is a condition in which the cartilage surface that protects and cushions the ends of the bone in the knee joint is damaged and worn thin. This can be from wear and tear (osteoarthritis), trauma, or diseases that cause severe inflammation in the joint (e.g. rheumatoid and psoriatic arthritis). If your pain has not decreased with medication, injections, and/or acceptable activity changes, you may be a candidate for shoulder replacement. What is shoulder replacement surgery? Anatomic total shoulder replacement An anatomic total shoulder replacement entails resurfacing the damaged parts of the joint with metal and polyethylene (a hard plastic) generally removing only a few millimeters of bone. If the surrounding rotator cuff is healthy and the bone loss is not too severe then replacing the shoulder surface anatomically is the best option Reverse total shoulder replacement In a reverse total shoulder replacement the ball and socket of the shoulder joint are still resurfaced, but in reverse. Specifically, the socket is covered with a metal ball and the ball that is removed is replaced with a plastic socket. A reverse shoulder replacement is indicated in a patient with arthritis and no functioning rotator cuff or arthritis with severe bone loss on the socket side of the joint. Rehabilitation and recovery are similar to an anatomic total shoulder replacement, but functional outcomes may be different depending on the severity of your rotator cuff damage. What happens during shouldr replacement surgery? Your treatment begins with a pre-surgical evaluation to plan for the best size and position of your artificial joint utilizing computer templated digital x-rays and CT scans. During your shoulder replacement surgery, Dr. Morrison uses instruments, guides, and computer navigation. These tools allow for precise removal of damaged bone and resurfacing with implants in the optimal position. What is the recovery time? Everyone heals from his or her surgery at a different pace. In most cases, however, you will be restricted in some of your shoulder movements for 6 weeks. You will wear a sling for 4-6 weeks when not engaged in exercises. Your physical therapist will guide you through this progression. You will gradually return to normal function without any sling. Most patients have functional range of motion by week six and can begin lifting heavier weight at week twelve. Your new joint and surrounding tissues will continue to heal even up to a year after your procedure. Can I sleep on my side? You may sleep on your non-operative side whenever you feel comfortable and your operative side at 6 weeks. How long do I need to keep a bandage on my incision? Waterproof bandage should be worn for 7 days after your surgical procedure. Remove the waterproof bandage after 7 days post-op. Continue to shower as normally after that without a bandage. If desired, you may continue to wear a bandage to protect the incision from irritation. When can I shower (get the incision wet)? You may shower as soon as returning home as long as the waterproof bandage is in place for the first 7 days. After waterproof bandage is removed, continue to shower as normal. When can I immerse my shoulder in water (e.g., bath, swimming pool, ocean, hot tub)? Typically, you should not swim or get in a hot tub or bath tub for six weeks. However, in some circumstances we will allow patients to do so after four weeks if there is no drainage. Check with your therapist and surgeon. How long will I be on pain medication? You will likely require some form of pain medication including Tylenol and an anti-inflammatory medication (e.g. Meloxicam or Celebres) for 6 weeks. Some patients also require a stronger pain medication (narcotic or opioid) for a shorter time period after surgery. Ice, rest, and elevation also play an important part in managing pain and swelling. Do I need a physical therapist? Yes! The physical therapist plays a very important role in recovery. You will see a physical therapist the day of your surgery. If you are unable to go home the day of surgery, the physical therapist will see you during your hospital stay. Over 95% of patients start outpatient physical therapy within 2-3 days of going home. Therapy is typically 2-3 times weekly for 6 weeks. The therapist should follow the protocol that has been issued to you on your pre-op visit and/or discharge from the hospital. Your therapist will keep your surgeon informed of your progress. When can I drive? Once you are out of your sling during the day, have the ability to raise your arm to the top of the steering wheel, and are completely off narcotic medication you can drive. This is typically 3-4 weeks after surgery.

  Link: Shoulder Replacement