Ask the Doctors: Knee & Shoulder Pain

TOC is known for all things orthopaedic — however, have you ever wanted to just sit down and ask the doctors specific questions about certain issues?

We were able to do so with Dr. Patrick Boyett, Dr. Eric Stanford, & Dr. Bill Lawrence — all with years of experience and numerous joint replacement procedures. They talked us through two common joint pains many of our patients experience: knees and shoulders.

Dr. Patrick Boyett, Dr. Eric Stanford & Dr. Bill Lawrence are all considered joint replacement specialists. Any type of specialist, whether it be knee or shoulder, is a board-certified surgeon who has specialized training in complex disease and injury. Board certification is a standard that the surgeon has met a mastery level in the diagnosis and treatment of the problems. We loved having the opportunity to learn more and want to share with you.

What are common causes of Knee Pain?

Knee pain is associated with many disease processes that range from osteoarthritis to inflammatory arthritis to systemic diseases to trauma and injury. The most common cause of knee pain that is seen in the orthopaedic surgeon’s office is arthritis related. It can be broken down into two categories: pediatric and adult knee pain. Both have traumatic and just overuse injuries.

What is arthroscopy?

Arthroscopy is the diagnostic and therapeutic treatment of the knee utilizing a scope about the size of a pencil that uses the latest 4K technology to project the image of the inside of the knee onto a screen so that the surgeon can diagnose and treat many of the problems that cause knee pain. Originally, arthroscopy was used mainly for planning standard open surgery. As new tools and advanced surgical methods are developed, many conditions can also be treated using an arthroscope. The procedure does require a general anesthetic and 2-3 small incisions over the joint being surgically treated. Arthroscopy can be used in many joints nowadays including shoulder, elbow, wrist, hip, knee, and ankle. The scope allows the surgeon to inflate the knee with saline so that the surgeon can evaluate and treat the knee without creating any new injury. It allows for direct visualization of the joint and a quicker recovery.

What is Knee Replacement?

Knee replacement has evolved rapidly over the years.  A knee replacement, sometimes called knee arthroplasty, is the resurfacing of the bones around the knee. It’s commonly performed due to arthritis or a traumatic event. The goal is to maintain as much of your normal anatomy as possible such as ligaments and bone. The procedure can be done as an inpatient procedure, or, with advancements in techniques, as an outpatient procedure for select patients. Sometimes a robot or computer assisted technology can be used to help guide the surgeon to the most appropriate alignment for better and quicker recovery. Patients can get up and walk within 2 hours of surgery and in some cases, safely discharge to home in about 6 hours.

What kind of precautions should be taken to avoid knee arthritis?

Knee arthritis is a disease that has multi-factored causes. These range from activity and trauma to systemic disease that affects the joint. Genetics, body weight, injury history and systemic disease all contribute to arthritis progression.  Arthritis occurs when the “cushion” or “padding” in the joint is destroyed.  Knee arthritis can also develop from autoimmune diseases such as rheumatoid arthritis, or more commonly what we know of as degenerative arthritis. This is the most common form as it develops slowly over time and a multitude of factors are to blame when that occurs. Some things to help avoid having arthritis or to help decrease the progression would be to exercise, maintain proper diet, and mobility. Low impact exercises are great, such as treadmills, swimming and yoga.

Switching from all things knee related, another common joint issue is shoulder pain.

What is a frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. After a period of worsening symptoms, frozen shoulders tend to get better, although full recovery may take up to 3 years. Physical therapy, with a focus on shoulder flexibility, is the primary treatment recommendation for frozen shoulder. Some will require manipulation if the range of motion doesn’t improve with other non-surgical modalities. Frozen shoulder most commonly affects people between the ages of 40 and 60 and occurs in women more often than men. In addition, people with diabetes are at an increased risk for developing frozen shoulders. It can occur without warning or injury and is usually treated with injections, medications and most importantly physiotherapy.

What is the treatment for rotator cuff injury?

Rotator cuff tears are more common than one would expect.  The rotator cuff is a group of tendons that allow the shoulder to move.  When the cuff tears, the result is weakness and pain.  For the strength to be restored the torn tissue must be repaired. Rotator cuff treatment depends on the severity of the injury. If someone has just a partial tear, tendonitis, or tendinosis then the first line of treatment would be NSAIDs, exercises or PT, and possible steroid injections. If the injury is a full rotator cuff tear the options are: non-surgery but over time the injury will worsen, and this is not recommended unless medically, the patient can’t have the tear repaired; surgical repair with arthroscopic or open surgery – given the advancements in technology with surgery, open repair is rarely done. If someone has a chronic rotator cuff tear that’s not amendable to a repair then options still exist with a superior capsule reconstruction, balloon spacer and even a reverse total shoulder arthroplasty.

Tell me about shoulder joint replacement?

Shoulder replacement is reserved for patients who have either fractured the joint beyond acceptable healing or where arthritis has deteriorated the joint beyond repair.  There are different types of replacements, and your surgeon will have to evaluate your shoulder to determine which type is appropriate.


Regardless of which joint is giving you trouble, TOC has skilled and compassionate doctors that can assess your problems and determine what is the best treatment plan for you. If surgery is necessary, you can be sure that it will be performed in a way that will maximize your recovery time.

TOC is the place to go for joint replacements because of its world-class surgeons and cutting-edge equipment. Make an appointment right away to start the process of continuing to live an active life.

Schedule an appointment today!