What is Collagen Augmented Rotator Cuff Repair?

Rotator cuff injuries are one of the most common causes of shoulder pain, affecting more than 2 million Americans each year. If you have a partially torn rotator cuff that hasn’t responded to non-surgical treatment like physical therapy and cortisone injections, you may be a candidate for a procedure called Collagen Augmented Rotator Cuff Repair, performed by our shoulder specialist Dr. Noerdlinger.

What is the rotator cuff?
Shoulders are not singular joints, but rather a complex arrangement of bones, cartilage, ligaments, muscles, and tendons. The rotator cuff is made up of four muscles, connected by tendons, that originate from the shoulder blade (scapula) and attach to the upper arm bone (humerus) to form a cover, or “cuff.” The rotator cuff provides stability to the shoulder joint and helps the arm lift and rotate.

What causes a rotator cuff tear?
A rotator cuff tear happens when the tendons pull away from the bone. With a partial tear, the tendon remains attached to the bone and with a full tear it separates from the bone completely. Tears most commonly happen as a result of normal wear and tear due to aging, with people over 40 at greatest risk. A tear can also be caused by an acute injury like a fall, from repetitive shoulder movement from jobs like carpentry or painting, or from sports like tennis or rowing. Untreated, a rotator cuff tear can worsen over time and may lead to chronic shoulder pain and limited range of motion.

How do I know if I have a rotator cuff tear?
The most common symptom of a rotator cuff tear is pain. A tear can also cause weakness in the arm and shoulder, difficulty raising your arm or lifting something, and a clicking or popping sensation in the shoulder. You may also experience swelling or tenderness in the shoulder joint. If you think you have a rotator cuff tear, a doctor will need to perform a physical exam and may confirm your diagnosis with an x-ray, MRI, or ultrasound.

What is Collagen Augmented Rotator Cuff Repair?
Collagen augmented rotator cuff repair is a surgical technique that uses a collagen implant to reinforce the rotator cuff repair. The implant is made of a biologically derived material similar to the collagen found in human tissue. It’s designed to provide additional strength and support to the healing tendon, reducing the risk of re-tear. The postage-size collagen patches are absorbed by the body within about 6 months, and patients generally experience shorter recovery times than with conventional rotator cuff surgery.

We recently sat down with shoulder specialist Dr. Noerdlinger and asked him a few questions about this procedure.

Q: How does this procedure benefit your patients?
A: Collagen implants can lead to quicker recoveries. Adding collagen facilitates the biologic healing of torn tendons in certain situations. They are used in two situations:

To repair a partially torn rotator cuff tendon. In this scenario, the collagen is laid on top of the partially torn tendon. The implant blends in with the thinned rotator cuff tendon, thickens it and allows it to heal. Patients, with partial tears, do not need to wear a sling after surgery.
To augment a repaired shredded tendon that may not heal on its own, particularly in the setting of a revision rotator cuff tear when the tendon did not heal after the first surgery.

Q: Who is a good candidate for the Collagen Augmented Rotator Cuff Repair Procedure?
A: Not everyone is a candidate for this procedure. Patients with irreparable rotator tears would not qualify for this procedure. Also, patients with good tissue may not need to augment their repairs.

Q: Where do you perform the Collagen Augmented Rotator Cuff Repair procedure?
A: The procedure requires anesthesia and is performed arthroscopically at NECOS and York Hospital.

Q: Can you tell us about a success story?
A: I recently saw a 56 year old female with worsening constant shoulder pain since April 2022. I performed a Partial Rotator Cuff Repair with collagen implant in January of 2023. She was seen in early March of 2023 and reported to be doing well with minimal complaints of pain.

NOTE: Shoulder surgery has a long recovery and often people take 4-6 months before they feel great. Having an expert shoulder surgeon like Dr. Noerdlinger may help speed up recovery.

Torn ACL? Get Educated About BEAR

Atlantic Orthopaedics & Sports Medicine now offers patients an alternative to surgical reconstruction – a less invasive procedure called Bridge Enhanced ACL Restoration, or BEAR. Clinically tested and FDA-approved, this promising new procedure has been adopted by our own Dr. Tyler Welch, who performed the first BEAR surgery in the state of Maine! Dr. Welch is an orthopedic surgeon and partner at Atlantic Orthopaedics who specializes in Sports Medicine, with a focus on the knee, shoulder, and hip. His mission is to restore his patient’s function through compassionate, evidence-based care.

Anterior cruciate ligament, or ACL, tears are one of the most common knee injuries, affecting more than 100,000 Americans each year. The ACL is a band of tissue that connects the thigh bone (femur) to the shinbone (tibia) inside the knee joint. It is one of the two cruciate ligaments, along with the medial collateral ligament (MCL), that stabilize the knee joint and prevent the tibia from sliding forward. ACL injuries most often occur when playing sports that involve sudden changes in direction, like:

Basketball
Soccer
Gymnastics
Downhill skiing

Pivoting with your foot firmly planted in place, landing awkwardly from a fall or jump, stopping suddenly, or getting a blow to the knee, along with wearing shoes that don’t fit properly or using ski bindings that aren’t correctly adjusted, can all increase your risk. ACL tears are also more common among women than men. Signs that you’ve torn the ligament, either partially or fully, include severe pain, a popping sensation, rapid swelling, and a feeling of the knee “giving way” when you put weight on it.

If you think you’ve torn your ACL it’s important to be evaluated by an orthopedic doctor as soon as possible. It is possible that the ligament has been stretched or only partially torn, and in those cases the injury may respond to non-surgical treatments like ice, rest, elevation, or physical therapy. Unfortunately, a complete ACL tear can’t heal on its own. This is because the synovial fluid in the knee that keeps the bones from rubbing together also prevents the formation of blood clots needed for healing. Until recently, the only fix for a complete tear has been surgical reconstruction, where a tendon is taken from another part of the patient’s body, or from donor tissue, to reconstruct the torn ligament.

We recently sat down with Dr. Welch to ask him a few questions about the new BEAR procedure.

Q: Tell us Dr. Welch, how does this new procedure benefit your patients?

A: This procedure can benefit patients because it is less invasive than a typical ACL reconstruction. Unlike typical ACL reconstruction, the patient does not need a “graft” to replace the ACL with the BEAR technique. As a result, the procedure may lead to less pain and swelling in the post-surgery period.

What makes BEAR unique is that it doesn’t require patient or donor tissue, instead using an implant made from collagen to bridge the gap between the torn ends of the ACL ligament. The implant is secured via suture, and the patient’s own blood is injected into it during the surgery to form a clot that surrounds the device. This facilitates cell proliferation and enables the body to heal itself. Within about eight weeks of surgery, the implant is absorbed, and replaced by the patient’s own tissue, which will continue to strengthen over time.

Q: Who is a good candidate for a BEAR Procedure?

A: Anyone with an ACL tear is a candidate. Based on recent research, individuals over the age of 20 are the best candidates.

Q: Anything else you’d like patients to know about this new procedure?

A: This is an exciting time in the world of ACL surgery. The BEAR procedure may be a game-changer, but the jury is still out. It is important for patients to know that we do not have any long-term clinical data regarding the BEAR technique. We do not yet know if the re-tear rates (failure rates) are higher in patients who have a BEAR compared to those who have a typical ACL reconstruction over the long term (more than five years). However, current research (two year outcomes) has revealed similar success rates when comparing the BEAR technique to traditional ACL reconstruction. This is encouraging data that suggests that the BEAR technique is reliable.

Candidates for the BEAR procedure must have a complete rupture of the ACL. Eligible patients must also have a stump still attached to the tibia to allow for repair. Dr. Welch currently performs this procedure at York Hospital in York, ME and the BEAR procedure should be available soon at AOSM’s state-of-the-art orthopaedic ambulatory surgery center, NECOS in Portsmouth, NH.

If you think you may be a good fit for the BEAR procedure, schedule an appointment for an evaluation with Dr. Welch. To learn more, click HERE.

NH Magazine Announces 2023 Top Docs

Each year, over 3,000 licensed New Hampshire physicians nominate their peers for the opportunity to receive the honor of ‘Top Doctor.’ Those named Top Doctors received the greatest number of recommendations within 55+ specialties, and the results are in! We think all of our docs are top, but this year, eight of our physicians were voted ‘Top Doctor,’ including:

Glen Crawford, MD – Top Doctor for Orthopaedic Surgery
Robert Eberhart, MD* – Top Doctor for Hand Surgery
Andrew McMahon, DO – Top Doctor for Sports Medicine
Mayo Noerdlinger, MD – Top Doctor for Orthopaedic Surgery
H. Matthew Quitkin, MD – Top Doctor for Hand Surgery
Akhilesh Sastry, MD – Top Doctor for Orthopaedic Surgery
William Sutherland, MD – Top Doctor for Orthopaedic Surgery
Tyler Welch, MD – Top Doctor for Orthopaedic Surgery

Congratulations to all the 2023 Top Doctors!

Learn more about our providers in Portsmouth, NH and York, ME HERE. Or click HERE to make an appointment with our orthopaedic and sports medicine team.

*As of January 1, 2023 Dr. Robert Eberhart officially retired.

Dr. Welch Becomes First Surgeon in Maine to Perform a BEAR Procedure

ACL tears are one of the most common knee injuries, affecting more than 100,000 Americans each year. Until now, the only way to repair the torn ligament was with invasive surgical reconstruction using tendons from other parts of the body or from donor tissue.

We’re excited to announce that there’s now a simpler, less invasive treatment available called Bridge Enhanced ACL Restoration (BEAR), pioneered by our own Dr. Welch, who recently performed the first BEAR procedure in the state of Maine. The surgery uses an implant to ‘bridge’ the torn gaps of the ACL without the need for donor tissue but instead, using patient’s own blood encourages the body rebuild the tissue, typically within 8 weeks.

Congratulations Dr. Welch on this outstanding achievement!

If you’re suffering from knee pain, and would like to discuss your options with one of our knee specialists, please contact us today.

*Other resources on BEAR Procedure can be found here.

Dr. Robert Eberhart Retires After 36 Years at AOSM

Atlantic Orthopaedics & Sports Medicine has officially announced the retirement of Dr. Eberhart, after thirty-six years as an orthopedic hand surgeon in the New Hampshire Seacoast community. As one of the original founders of Atlantic Orthopaedics & Sports Medicine, and its leader for over 35 years, Dr. Eberhart’s impact on the practice cannot be overstated.

“We would not be one of the premiere medical providers in the Seacoast without him. Dr. Eberhart’s leadership and example will continue to inspire us even after his departure,” said Matt Lane, Executive Director at Atlantic Orthopaedics & Sports Medicine.

Dr. H. Matthew Quitkin, a board certified, fellowship trained hand surgeon, who joined the practice in 2019, is available to treat current and new patients facing a variety of hand and wrist ailments ranging from arthritis and fractures to tendonitis and nerve issues such as carpal tunnel syndrome. The entire staff at AOSM will be available to help patients during this transition.

In a letter to his patients, Dr. Eberhart said, “I have enjoyed my career tremendously. I have taken great pride and have received great joy in doing my best to help all of my patients. I also have been fortunate to work with a group of outstanding healthcare professionals to build Atlantic Orthopaedics & Sports Medicine into the excellent orthopedic practice that it is today. Thank you for your trust and loyalty for all these years. It has been a great honor and a privilege to be an orthopedic provider on the Seacoast.”

The practice recently held a holiday event at The Outlook in Berwick, Maine during which they honored and paid tribute to Dr. Eberhart with speeches and a farewell video with messages from current and past staff, colleagues, and patients. His impact on all those he worked with and cared for was evident through the laughter and the tears of this special farewell. Dr. Eberhart is an avid athlete and boating enthusiast and has many plans to keep moving and doing what he loves.

Dr. Robert Eberhart with Marc Shepcaro of Rye during a follow-up visit at Atlantic Orthopaedics & Sports Medicine’s new location at 1900 Lafayette Road in Portsmouth. Suzanne Laurent photo. Taken in 2016.

Advances in Hip and Knee Replacement: ‘All About Robotic Surgery’ – An In Person Event with Dr. Morwood

Is hip or knee pain keeping you from the activities you love?
Take the first step towards recovery and learn how robotic assisted joint replacement surgery can improve your quality of life. Attend this FREE educational event with Dr. Michael Morwood!

Advances in Hip and Knee Replacement: ‘All About Robotic Surgery’
Thursday, July 14th, 2022 | 5:30pm – 7:30pm
Sheraton Portland at Sable Oaks
200 Sable Oaks Dr. South Portland, ME 04106
Light refreshments will be provided.

REGISTER NOW!
Scan the QR Code below or click HERE to get your tickets!

2022 Top Docs

Each year, over 3,000 licensed New Hampshire physicians nominate their peers for the opportunity to receive the honor of ‘Top Doctor.’ Those named Top Doctors received the greatest number of recommendations within 55+ specialties, and the results are in! We think all of our docs are top, but this year, seven of our physicians were voted ‘Top Doctor,’ including:
(Pictured below from left to right)

Glen Crawford, MD – Top Doctor for Orthopaedic Surgery
Robert Eberhart, MD – Top Doctor for Hand Surgery
Andy McMahon, DO – Top Doctor for Sports Medicine
Mayo Noerdlinger, MD – Top Doctor for Orthopaedic Surgery
H. Matthew Quitkin, MD – Top Doctor for Hand Surgery
Akhilesh Sastry, MD – Top Doctor for Orthopaedic Surgery
William Sutherland, MD – Top Doctor for Orthopaedic Surgery

Congratulations to all the 2022 Top Doctors!

Learn more about our providers in Portsmouth, NH and York, ME HERE. Or click HERE to make an appointment with our orthopaedic and sports medicine team.

What IS Pain Management?

Pain management providers see patients who are experiencing pain in the lower back, knee, head, hip, or neck, and who could be suffering from common conditions such as arthritis, fibromyalgia, migraines, sciatica, and much more. But what exactly is “pain management”?

We sat down with our board-certified interventional pain management provider, Dr. Andrew Lehn to ask him a few questions about his specialty: pain management.

Q. What is the most common reason patients come to see you?

A. I treat pain from head to toe but low back pain is the most common complaint. It is estimated that up to 80% of people will have significant low back pain at some point in their lives!

Q. What is pain management, in your professional opinion?

A. Pain management is restoration. Pain means something is not functioning correctly. My goal is to try and figure out the source of pain and direct treatment to that location. Some conditions require surgery to correct but many things can improve by decreasing inflammation and facilitating healing. My goal is to restore someone back to how they felt before the pain started.

Q. What advice would you give a friend or a loved one if they are experiencing back or joint pain?

A. Exercise! Most painful conditions will improve with time. The goal is to strengthen the muscles and joints around a painful area so hopefully the pain does not increase. I tell people to think about joint pain like you would think about your heart. Imagine what your cardiologist would tell you: exercise, lose weight, eat healthy, decrease stress, prioritize good sleep. All these things will help your pain as well.

Q. Can you share a patient success story?

A. Recently, I had an elderly patient who was experiencing significant low back and buttock pain. She was frustrated because she was having difficulty doing her exercises and could not participate in physical therapy. Her Lumbar MRI had some degenerative issues and spinal narrowing but nothing too specific for the pain she was experiencing. She had pain around her Sacroiliac joint and her pain worsened with manipulation of the joint. I decided to inject her SI joint and she came back with significant relief. While her pain was not entirely gone, she felt that she could now do her exercises and return to physical therapy. Ultimately, that is the goal! I work alongside my patients to help get them going again and then they are better able to rehabilitate their injury and get back to functioning again.

Pain management works best when the patient and doctor work together for the best solutions.

If you’re experiencing pain of any kind, talk to Dr. Lehn today to see how he can help you overcome your pain issues and get back to living a fuller, pain-free life.

Schedule a consultation HERE or give us a call, 603-431-1121.

New Ambulatory Surgery Center Coming to AOSM!

New England Center for Orthopaedic Surgery Will Open Spring 2021

Atlantic Orthopaedics and Sports Medicine broke ground last week on a new ambulatory surgery center, New England Center for Orthopaedic Surgery.

The new, single-story ambulatory surgery center, affiliated with Portsmouth Regional Hospital and jointly owned with HCA Healthcare, will provide high-quality outpatient care for orthopedic patients.

The project encompasses 11,000 square feet of space for patients and visitors, and the building is located at 1900 Lafayette Road, Suite E, Portsmouth, New Hampshire 03801.

New England Center for Orthopaedic Surgery will feature:

Three operating rooms specially designed for orthopedic procedures
Private registration area for patients
Modern, comfortable waiting area with welcoming atmosphere
Operating rooms with the most up-to-date technology

The new, state-of-the-art facility will be highly specialized as a single-specialty center offering only orthopedic procedures for patients. It is set to be complete in the spring of 2021.

“Patients in Portsmouth will have a safe, convenient and cost-effective environment for receiving orthopedic outpatient care at New England Center for Orthopaedic Surgery,” said Michael Morwood, MD, orthopedic surgeon at New England Center for Orthopaedic Surgery. “Our modern ambulatory surgery center will be thoughtfully designed to ensure patients will feel comfortable and at ease while receiving excellent healthcare.”

About The HCA Healthcare Ambulatory Surgery Division

The HCA Healthcare Ambulatory Surgery Division operates and jointly owns with physicians, 144 ambulatory surgery centers throughout the United States. Located in 16 states with more than 3,200 physician partners, the HCA Healthcare Ambulatory Surgery Division is focused on collaborating with physicians to advance healthcare in our communities. Each year, the HCA Healthcare Ambulatory Surgery Division cares for more than 786,000 patients. HCA Healthcare ambulatory surgery centers are built on a foundation of quality care and a commitment to providing patients with healthier tomorrows.

Dr. Michael Morwood Published in the Journal of Arthroplasty

Dr. Morwood was recently published in the Journal of Arthroplasty. Dr. Morwood, who specializes in knee replacements says, “One of the main causes of total knee replacement failure is micromotion of the implants. This study was performed to see if the addition of a short stem extension onto the tibial component in a total knee replacement limits the motion of the implant. We were able to show the addition of a short stem provides a significant reduction in micromotion during cyclic loading of a cementless tibial baseplate in a synthetic foam bone model, similar to a cemented implant. The findings of this study may help lower the rate of tibial component loosening in total knee replacement.”

To read the entire study, please click HERE.

First In Maine!

Dr. Mayo Noerdlinger, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, recently became the first surgeon in Maine to perform a computer navigated stemless total shoulder replacement using ExactechGPS-guided technology, an innovative new procedure for shoulder replacement. Already one of the top shoulder surgeons in the Northeast.

Dr. Noerdlinger and his patients continue to benefit from this new technology, a major advancement in shoulder replacement. Dr. Noerdlinger also performed the first GPS-guided total shoulder surgery at York Hospital, the first hospital in the Northeast to purchase ExactechGPS.

ExactechGPS shoulder replacement, also called ExactechGPS Shoulder Application, improves the precision and predictability of shoulder surgery from preoperative planning to real-time execution. This new technology helps the surgeon better understand his or her patient’s anatomy before entering the operating room, and during surgery ExactechGPS provides a real-time view of the implant placement process and guides the surgeon toward any necessary adjustments.

“The shoulder replacement technology keeps getting better, allowing the surgeon to reproduce the patient’s anatomy in a more minimally invasive and bone sparing manner,” said Noerdlinger. “By replicating the patient’s anatomy, we anticipate the functional outcomes will improve and the recovery times will shorten. As life expectancies increase, the longevity of joint replacements becomes more and more of an important issue. Shoulder replacements are thought to last 15-20 years before patients might develop pain needing revision surgery. With the stemless design, there is less metal going into the bone, which will make future surgeries easier to perform. This new design is a particularly attractive option for younger patients undergoing shoulder replacement surgery.”

Mayo Noerdlinger, MD, FAAOS, CIME, specializes in orthopedic, reconstructive and arthroscopic surgery; shoulder surgery and replacement; reverse shoulder replacement; treatment of torn tendons and ligaments; sports medicine and others. He is also the physician behind Seacoast Shoulder, which offers patients the latest in state-of-the-art treatment for shoulder ailments of all kinds. Visit www.atlanticorthopaedics.org for more information, or call 603.431.1121.

Atlantic Orthopaedics & Sports Medicine is a group of Board-Certified physicians who utilize the latest concepts in orthopaedics and sports medicine, coupled with preventive and surgical techniques. For more information, visit www.atlanticorthopaedics.org, or call the Portsmouth clinic at 603.431.1121.

York Hospital‘s surgery center mixes advanced technology with personalized care in a comfortable, and caring environment. The center is equipped with five surgical suites staffed by a dedicated and highly trained team of specialists that care for patients preoperatively, during surgery and in recovery. Our center is well-equipped with the latest advances in technology and instrumentation for the more than 6,500 surgical procedures annually. For more information, visit yorkhospital.com or call 207-351-2385.

Special Event – Innovations in Robotic Joint Replacement Surgery with Dr. Sastry

Join York Hospital and Dr. Akhilesh Sastry to learn about the exciting innovations in joint replacement surgery. Offering robot-assisted partial knee replacements since 2016; Dr. Sastry will present information about this minimally invasive treatment option for adults living with early to mid-stage osteoarthritis that has not yet progressed to all three compartments of the knee.

Wednesday, November 20th at 6:00pm
University of Southern Maine’s Abromson Community Education Center
88 Bedford Street
Portland, ME 04104

Dr. Sastry will explain how using robot-assisted surgery for partial knee procedures, patients may experience the following benefits:

– Reduced pain
– Minimal hospitalization
– Faster recovery
– Less implant wear and loosening
– Smaller scar
– Better motion and a more natural feeling knee

Dr. Sastry will appear at the University of Southern Maine’s Abromson Community Education Center at 88 Bedford Street in Portland, ME 04104 on Wednesday, November 20th at 6pm. A light dinner and refreshments will be served during the presentation; Q&A will follow.

This event is complimentary but RSVPs are required. Please call 207-351-2385, email [email protected] or register HERE.