General Topics

Why Women Get More Arthritis Than Men? | Orthopaedics

Overview of arthritis

But not so many, perhaps, know about the unique challenges women face regarding arthritis. Not only do women get more arthritis than men, but women also often experience worse pain –ache in different joints and are far more vulnerable to rheumatoid arthritis, one of the most debilitating forms of the condition.

These tend to move different joints in women than in men. Men have more in the hip joints, women on their hands and knees. For one thing, women’s tendons move more because they are more elastic and are also more prone to injury. Additionally, women’s wider hips affect knee alignment in a way that leaves them more vulnerable to certain types of injuries, resulting in more arthritis in the future.

Hormones also play a role. Estrogen helps keep inflammation under control, which is why younger women have less arthritis than men, but when levels plummet with menopause, it often follows. Investigators are currently trying to unravel other complicated findings of how hormones shape arthritis risk, with apparent connections between puberty, childbearing, and the use of hormone spare therapy.

Excess weight means more arthritis. Obesity is more in women than in men. Excess weight puts pressure on the knee joints, erodes cartilage, and therefore increases the risk. One pound of body weight translates to three additional pounds of pressure on each knee joint.

Rheumatoid arthritis is increasing among women

According to all, after 40 years of decline, the incidence (frequency of occurrence) and prevalence (total number of cases in a given population) of rheumatoid arthritis among women is increasing. From 1995 to 2005, the occurrence of rheumatoid arthritis among women was 54 per 100,000 compared to 36 per 100,000 during the previous 10 years.

For men, the occurrence was stable at 29 per 100,000. The researchers concluded that an environmental factor could explain the reverse trend for women.

Why is arthritis more common in women?

It is more common in females than in men. Find out why women are more susceptible to arthritic conditions.

Nearly 27 million Americans with osteoarthritis, about 60 per cent of them are women and the risk factors change with age. Up to 55 years, more men are affected, but after 55, the number of women with the condition exceeds the number of men. Gender also determines which joints tend to be pretentious. It is more common for men to experience in the hips. In women, It inclines to affect the hands or knees.

Thumb arthritis is more communal in women and can be very disabling. Women are more susceptible than men for several reasons:

  • Genetics. Osteoarthritis appears to run in families, and researchers have found specific genetic links amongst women for osteoarthritis of the hand and knee.
  • Hormones Research proposes that female hormones have an effect on the shock-absorbing cartilage found between the bones of the joints to allow smooth joint movement. Although the female hormone estrogen defends cartilage from inflammation, women lose that protection after menopause when estrogen levels drop.
  • Joint stability. Women’s joints are looser than men’s the bones move more and are less stable within the joint. When joints are less stable, they are more prone to injury, and injuries can lead to this disease.

When the bones move toward the ends of the joint, they go beyond the point where the joint should move. This damages the cartilage and can trigger the development of this disease.

Some people cope with this pain for years because they don’t realize there are treatments that can help. It is important to talk to your doctor about your level of pain and how often you experience it. It progresses over time, but we have treatments that can make this development less painful for patients.

When to seek treatment

It doesn’t have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. They work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, fellowship-trained orthopaedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options.


What Is A Bone Graft? | Orthopaedics

Overview of bone graft

Bone grafting is a surgical procedure that uses the transplanted bone to repair and rebuild diseased or damaged bones. A bone graft is a choice for repairing bones almost anywhere in your body. Your surgeon might take bone from your hips, legs, or ribs to perform the graft. Sometimes, surgeons also use bone tissue donated from cadavers to perform bone grafting.

Surgeons often perform bone grafts as part of some other medical procedure. For example, if you have a severe femur fracture, your healthcare provider might perform a bone graft as part of other needed repairs to your bone. Your healthcare provider may make an incision in your hip to remove a small part of your hip bone and use it for the graft. In some cases, artificial material is used similarly, but this is not a bone graft in the traditional sense. You will usually be put to sleep under general anaesthesia for the procedure.

Alternative names for bone graft

  • Autograft – bone
  • Allograft – bone
  • Fracture
  • Autologous

Types of bone grafts

The two most communal types of bone grafts are:

  • Allograft, which uses bone from a departed donor or a cadaver that has been gutted and stored in a tissue bank.
  • Autograft, which comes from a bone within your body, such as your ribs, hips, pelvis, or wrist

The type of graft used to be contingent on the type of injury your surgeon is repairing.

Allografts are usually used in hip, knee, or long bone rebuilding. Long bones include arms and legs. The advantage is that no additional surgery is needed to acquire the bone. It also reduces the risk of infection, as no additional incisions or surgery are required.

Allograft bone transplantation involves bone that does not have living cells, so the risk of rejection is minimal compared to organ transplants, in which there are living cells. Since the transplanted bone does not contain living marrow, it is not necessary to compare the blood types between donor and recipient.

Why might you need a bone graft?

You may need a bone graft to promote bone healing and growth for various medical reasons. Some specific conditions may include:

  • An initial fracture that your healthcare provider suspects will not heal without a graft.
  • A fracture that you had not previously treated with graft and that did not heal well.
  • Bone diseases, such as osteonecrosis or cancer.
  • Spinal fusion surgery (which you may need if you have an unstable spine).
  • Dental implant surgery (which you may need if you want to replace missing teeth).
  • Surgically implanted devices, as in total knee replacement, to help promote bone growth around the frame.

These can provide a framework for the growth of new and living bone. The hips, knees, and spine are common sites for a bone graft, but you may need a bone graft for not the same bone in your body.

The procedure of bone grafts

Typically, a person will be under general anaesthesia during a bone graft procedure. A surgeon will cut and then place the bone substitute in the damaged area. They may use additional tools and supports to hold the graft in place, including:

  • Thumbscrew
  • Wires
  • Cables
  • Dishes
  • Legs

The surgeon will close the wound with stitches. Doctors will monitor a person for several hours after the procedure. Before the person is discharged, they will also give instructions on how to help prevent infection.

Before the bone graft procedure

Tell your surgeon what medications you are taking. This includes medicines, supplements, or herbs that you bought without a prescription. Follow the instructions on how to stop taking blood thinners, such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), or NSAIDs such as aspirin. These can cause increased bleeding during surgery.

On the day of surgery

  • Follow the instructions about not eating or drinking anything before surgery.
  • Take the medicines your provider has ordered with a small sip of water.
  • If you go to the hospital from home, make sure you arrive at the scheduled time.

After the procedure

Recovery time rests on the injury or defect being treated and the size of the bone graft. Your recovery can take from 2 weeks to 3 months. It will take up to 3 months or more to heal. You may be told to evade extreme exercise for up to 6 months. Ask your provider or nurse what you can and cannot do safely. It will essential to keep the area clean and dry. Follow the instructions on how to shower.

Smoking slows or prevents bone healing. If you smoke, the graft is more possible to fail. Be aware that nicotine patches delay healing.

Risks factors

Risks of a bone graft procedure include:

  • Nerve injury
  • Infection
  • Bleeding
  • Decreased mobility
  • Cosmetic defects
  • Chronic pain
  • Failure of the graft to achieve its goal
General Topics

What Are Hearing Problems In Children? | ENT Specialist

Hearing problems in children

Most children with hearing loss are born to parents with normal hearing. That means the entire family may have a lot to learn about living with the condition.

You may find out your child has hearing loss when they’re born, or might be diagnosed later in childhood. Either way, the most important thing to do is to get the right treatment as early as possible. If you understand more about the condition, you can get your child the help they need so they can learn, play, and keep up with other kids their age.

Types of hearing problems in children

Sensorineural hearing loss can occur when the sensitive inner ear (cochlea) has damage or a structural problem, although in rare cases it can be caused by problems with the auditory cortex, the part of the brain accountable for hearing.

Cochlear hearing loss, the most common type, can affect a specific part of the cochlea, such as the inner hair cells, the outer hair cells, or both. It usually exists at birth and can be inherited or come from other medical problems, although the cause is sometimes unknown. This type of hearing loss is usually permanent.

The degree of sensorineural hearing loss can be:

  • Mild (a person cannot hear certain sounds)
  • Moderate (a person cannot hear many sounds)
  • Severe (a person cannot hear most sounds)
  • Deep (a person cannot hear any sound)

Sometimes the loss is progressive (gets worse over time) and sometimes unilateral (only in one ear). Because hearing loss can get worse over time, audiological tests should be repeated later. Although medicine and surgery cannot cure this type of hearing loss, hearing aids can help children hear better. Mixed hearing loss occurs when a being has both conductive and sensorineural hearing loss.

Dominant hearing loss occurs when the cochlea is working properly, but other parts of the brain are not. This odder type of hearing loss is more difficult to treat.

Auditory Dispensation Disorder (APD) is a condition in which the ears and brain cannot fully coordinate. People with APD generally hear well when there is silence, but cannot hear well when there is noise. In most cases, speech and language therapy can help children with APD.

Causes of temporary hearing problems in children

Some of the causes of impermanent deafness in children include:

  • The buildup of wax in the ear canal.
  • A foreign object (such as a bead or the tip of a cotton swab) stuck in the ear canal.
  • Excess mucus in the eustachian tube, caused by a cold.
  • Otitis media (infection of the middle ear).

Causes of permanent hearing problems in children

Hearing problems in children, some of the conditions and events that can cause permanent hearing loss in children include:

  • Inherited conditions that cause the inner ear to develop abnormally.
  • Some genetic disorders, such as osteogenesis imperfecta and trisomy.
  • Exposure of the fetus to diseases: Rubella (German measles) is one of the diseases that can affect the developing ears of the fetus.
  • Loud noises, such as fireworks, rock concerts, or personal stereos.
  • Injuries, such as a concussion or skull fracture.
  • Certain diseases, such as meningitis and mumps.

Signs and symptoms of hearing loss in babies

Hospitals routinely perform newborn hearing exams in the first few days after birth. If a newborn shows signs of infant hearing loss, a second screening is usually scheduled a few weeks later. However, sometimes newborns who pass both hearing tests can show signs of hearing loss as they age. If you think your child is having a hard time hearing you, visit your paediatrician right away.

Babies and infants

From birth to four months, your baby should:

  • Startled by loud sounds.
  • Wakes up or shakes with loud noises.
  • Respond to your voice by smiling or cooing.
  • Calm down with a familiar voice

From four months to nine months, your baby should:

  • Smile when they talk to you
  • Observe the toys that make sounds.
  • Turn your head toward familiar sounds
  • Make babbling noises
  • Understand the movements of the hands as the goodbye greeting

At nine to 15 months, your baby should:

  • Make various babbling sounds
  • Repeat some simple sounds
  • Understand basic requests
  • Use her voice to get your attention
  • Reply to name

At 15 to 24 months, your toddler should:

  • Use a lot of simple words
  • Point to parts of the body when asking
  • Name common objects
  • Listen to songs, rhymes, and stories with interest.
  • Follow the basic commands
  • Signs of hearing loss in tots and school-age children

Older children sometimes develop a hearing loss that was not present before. Here are some things to look for if you think your toddler or preschooler might have hearing loss:

  • Has difficulty understanding what people are saying.
  • Responds inappropriately to questions (misunderstandings).
  • Turn up the volume on the TV incredibly high or sit too close to the TV to listen.
  • You have academic problems, especially if they weren’t present before.
  • You have speech or language delays or trouble articulating things.
  • Observe others imitate their actions, at home or at school.
  • Complaints of earaches, or noise.
  • Cannot understand on the phone or frequently changes ears while talking on the phone.

Diagnosis of hearing problems in children

Hearing screening can tell if a child might have hearing loss. Hearing screening is easy and is not painful. In fact, babies are often asleep while being screened. It takes a very short time usually only a few minutes.


All babies should have a hearing screening no later than 1 month of age. Most babies have their hearing screened while still in the hospital. If a baby does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible, but no later than 3 months of age.


Children should have a hearing test before entering school or at any time there is a concern about the child’s hearing. Children who fail the hearing test should have a full hearing test as soon as possible.

Treatment for hearing problems in children

No single treatment or intervention is the answer for every person or family. Good treatment plans will include close monitoring, follow-ups and any changes needed along the way. There are many different types of communication options for children with hearing loss and for their families. Some of these options include:

  • Learning other ways to communicate, such as sign language.
  • Technology to help with communication, such as hearing aids and cochlear implants.
  • Medicine and surgery to correct some types of hearing loss.

Risk factors of hearing problems in children

Risk factors for hearing loss in children contain:

  • Otitis media (ear contaminations, the most common cause of hearing loss in young children).
  • Craniofacial abnormalities (the head, face, or ears are shaped differently).
  • Family history of hearing loss.
  • Exposure to infections in the uterus.
  • Ototoxic drugs (harmful to the auditory system).
  • Syndromes associated with hearing loss, such as Down syndrome or Usher syndrome.
  • Being in the neonatal intensive care unit for more than 5 days.
  • Certain illnesses, such as syphilis, rubella, and microbial meningitis.
  • Head trauma (injury).

Prevent hearing loss in your child

Hearing problems in children, maintain a healthy lifestyle during pregnancy, including routine prenatal care. Make sure your child receives all regular childhood immunizations.

Keep your child away from loud noises. Noise-induced (acquired) hearing loss is permanent and can always be prevented. It is caused by prolonged or repeated exposure to any loud noise greater than 85 decibels, which is the volume of sound measured in units called decibels (dB). Common sounds that exceed 85 dB include lawnmowers, music concerts, emergency vehicle sirens, planes taking off, fireworks, and lawnmowers.

Create a peaceful home. Here are some recommendations:

  • Set the volume on your TV or video game to the lowest volume, but you can still hear it clearly.
  • If you live in a noisy place, keep doors and windows closed to minimize potentially harmful outside noise.
  • Use soft interior furniture, more curtains, cushions, and rugs that will absorb more sound.

Encourage children to wear earplugs or earmuffs if they are likely to be exposed to potentially harmful sounds.


Overview of Rhinology | ENT Specialist

What is rhinology?

Rhinology is a subdivision of otorhinolaryngology (ear, nose, and throat) that focuses exclusively on disorders of the nose, sinuses, and skull base (the area between the sinuses and the brain).

What are the diagnosis done by rhinology?

We use the latest technological advances in the diagnosis of sinusitis. All initial evaluations through our sinus program are dedicated to providing an accurate diagnosis and making the patient aware of sinus treatment options. After reviewing the patient’s medical history and physically examining the nose, the doctor will often examine the sinuses using the fiber optic range. This procedure, called nasal endoscopy or rhinoscopy, is done in the exam room. To further aid in the diagnosis, a CT scan may be taken.

Treatment of nasal and sinus disorders requires medical and / or surgical intervention. Medical options include topical nasal sprays, antibiotics, and frequent allergy evaluations. The approach to these disorders specializes in multidisciplinary, allergy/immunology, pulmonology, and other subtypes, including maxillofacial surgery.

Sinus surgery options are described in detail, our team is dedicated to bringing technological advancements. Minimally invasive, computer-assisted surgical procedures are available for patients with refractory or complicated diseases of the nose and sinuses. Additionally, as a leading sinus care practice in the region, we have become a referral destination for patients who have previously failed sinus surgery.

Common Sinus Procedures:

  • Computer Image-Guided Breast Surgery
  • Endoscopic sinus surgery
  • Review of endoscopic sinus surgery
  • Septoplasty
  • Turbinate surgery

Treatment of rhinological conditions

Our program treats all types of nasal, and sinus disorders, including:

  • Allergic rhinitis
  • Acute aspirin respiratory disease (AERD)
  • Cerebrospinal fluid (CSF) leaks
  • Sinusitis
  • Skull base tumors
  • Facial injury
  • Nasal polyps
  • Pituitary tumors
  • Nasal septum
  • Inverted papillomas
  • Head and neck osteoma
  • Juvenile Nasongiofibroma (JNA)
  • Sinus mucosa
  • Paranasal sinus tumors
  • Nasal obstructions: Obstruction of the nasal passage in general, since the mucous membranes of the nose become inflamed due to the inflamed blood vessels.

Nasal valve collapse: A breathing disorder that causes severe nasal congestion, snoring, and breathing through the mouth.

Tear duct obstruction: Tears usually do not flow, leaving you with a watery and irritated eye. This condition is caused by a partial or total blockage of the tear drainage system.

Treatments and procedures of rhinology

In rhinology, our specialists are recognized locally and nationally in the treatment of complex and chronic nasal and sinus disorders. Many patients seeking treatment do not have access to the combination of treatments that we offer that can effectively treat their chronic sinus condition. For example, In more complex cases, both medical treatments combined with surgery may be the best approach to successfully managing and treating chronic sinus conditions.

Leaders in the treatment of surgical rhinology

Rhino specialists have guided major surgical techniques to restore nasal function to previously unsuccessful treatments. They perform high volumes of these minimally invasive procedures using the latest surgical instruments, including image-guided navigation to provide accurate and safe care.

Advanced sinus surgery procedures for chronic rhinosinusitis:

Functional Endoscopic Sinus Surgery (FESS)

The least invasive surgical technique used to open the nostrils and improve drainage. FESS is usually done to correct sinus problems that don’t respond well to other treatments.

Sinus revision surgery

We specialize in complex breast revision surgeries for critically treated cases. Many of our patients seek sinus revision surgery when their previous surgery at another medical facility is unsuccessful. Due to the proximity of the sinuses to complex structures, including the eyes and the brain, these areas of the sinuses often become inactive and diseased. Because we have specialized experience and a leading surgical team, we can safely work on these challenging sinus areas.

Rhinology surgery conditions

Nasal and sinus conditions we treat include acute and chronic sinusitis, nasal polyps, nasal obstructions, and nasal congestion (epistaxis). Starting with your initial visit, we will help you make a complete and accurate diagnosis of your symptoms, medical history, and concerns and develop an accurate treatment plan tailored to your lifestyle.

Rhinology and sinus surgery services

We focus on improving the medical management of difficult-to-treat sinusitis cases when we use surgery as a last resort. One of the novel treatments we offer is the use of soluble steroid (propel) implants in patients with acute chronic sinusitis and polyps disease. Currently, this treatment is available to hospitalized patients as an adjunct to sinus surgery. In contrast to traditional therapies such as steroid irrigation, the benefits are direct delivery of steroid therapy to the sinus cavity, while reducing the level of systemic steroid absorption.

For cases that require surgery, we use less invasive techniques to effectively treat sinus disease while reducing recovery time. In patients with severe frontal sinusitis where multiple preoperative surgeries have failed, for example, we use a minimally invasive method called the DRAF III frontal sinus procedure, which uses endoscopic techniques to increase the opening of the frontal sinuses and their communication with the nasal cavity. This allows the frontal sinus to provide effective topical irrigation treatment and easy office access. It is a successful option for patients who have failed open frontal sinus surgery.