New Hampshire Orthopaedic Surgery

is Manchester's oldest and most established orthopaedic practice. Having served our community for over 40 years, we provide the highest level of patient care with an emphasis on sub-specialty care in each specialty area of orthopaedics. This includes: Hand, Spine, Sports Medicine, Foot, Ankle and Total Joint Replacement

We are committed to the philosophy that, in a field that is rapidly changing and developing, subspecialists are best able to stay up to date on all new developments in their field and are best able to provide patients with the most efficient and effective care.

Recent News & Articles

Knee Pain - By Gregory W. Soghikian, M.D.

Do your knees ache after running? Do they feel stiff after sitting or driving for prolonged periods? Clicking as you go up stairs? If that achiness is in the front area of the knee and does not cause swelling it is likely patellar (kneecap) irritation. This is a problem that can be hard to eliminate, but one that rarely needs surgery.

Most patellar pain can be treated by reducing activity especially impact exercise, stairs and hills; Icing the knee after activity, a week or so of anti-inflammatory medication and then a gradual return to impact exercise. Exercises that strengthen the thigh muscles but avoid bending the knees too far can also help prevent recurrences of the pain.

Knee pain that comes on more suddenly, frequently while bending and turning on the knee, with swelling that comes on over the next few hours and takes a few days to resolve may often be a cartilage or meniscus tear. There are two kinds of cartilage in the knee - the articular cartilage that lines the bones and the meniscal cartilage that acts like a shock absorbing cushion along the edges of the joint. When people suffer from a cartilage tear they are usually talking about a meniscus tear. Many tears only bother people with impact activities or when turning on or bending down on the knee. Since most meniscus tears do not heal themselves, the ones that cause enough discomfort or activity limitation require surgery. The surgery is relatively straight-forward with fairly rapid recovery.

More severe injuries to the knee frequently from twisting, skiing falls, or soccer and football can cause a combination of meniscal injury as well as ligament ruptures. When this causes a knee to become unstable it requires more complex surgery with longer, more intense postoperative rehabilitation. The good news is that with the right surgery and rehabilitation the vast majority of patients are able to get back to all of their usual sport activities.

Shoulder Pain - By Gregory W. Soghikian, M.D.

Does throwing hurt? How about raking or shoveling snow? In New England summer time shoulder pain from throwing activities can occur with fall or winter activities too. Usually, it is mild rotator cuff irritation. The rotator cuff is a series of muscles and tendons that control shoulder motion that if overused cause pain in the front of the shoulder, sometimes with an ache that radiates half way down the outer side of the arm. In its early stages, rotator cuff bursitis (inflammation of the bursal layer) or tendinitis (inflammation of the tendon) can be treated by rest, ice and a short of course of up to two weeks of an anti-inflammatory medication.

Keeping the shoulder in good shape by making sure that you maintain its full range of motion, include a series of rotational exercises along with your usual upper body work out, and by gradually working into new activities including throwing, raking, or shoveling snow (or hiring a plow service) can help prevent this problem from the beginning.

If the problem gets worse, persists, or if you start to have trouble moving your hand up to scratch your back, it is time to see your physician.

While the vast majority of shoulder and rotator cuff problems get better with conservative treatment, including sometimes physical therapy or cortisone injections, some do eventually come to surgery. The more severe rotator cuff tears that result in the loss of power or motion come to reconstruction earlier.

While rotator cuff problems can occur at almost any adult age, the more severe tears are more common as we get older. Surgery for rotator cuff problems has evolved tremendously in the last 10 to 20 years. In the past, shoulder reconstructions required long hospital stays and were associated with multiple complications. Current advances in anesthesia, arthroscopic and minimally invasive techniques have drastically reduced the surgical times, exposures and early postoperative recovery process. This allows the vast majority of shoulder surgeries to be done as an outpatient. Advances in repair techniques by shoulder specialists have also reduced the incidence of complications and has accelerated the rehabilitation process. So while surgery is rarely the first step in treatment, if it does become necessary it has a high chance of success.