Back to Work in a Few Weeks with MAKOplasty


Ron Bakalar, aged 79, can’t remember when he first started having trouble with his left knee. But his now-late doctor, who originally diagnosed the loose cartilage, told Ron he wasn’t a candidate for knee replacement. Ron had been uncomfortable ever since, but knew since it wasn’t a bone on bone injury, he was going to have to live with it.

Then he happened to see a newspaper article about a seminar that Dr. Krebs was putting on for MAKOplasty Partial Knee Resurfacing and decided to go learn more.

The procedure allows a surgeon to target only the damaged portion of a patient’s knee. Robotic technology assists in both the design and implant of the partial replacement for optimal alignment, security and movement.  UH Elyria Medical Center is the only hospital in the area with Mako technology.

The MAKOplasty procedure is an FDA-approved treatment for patients who suffer from osteoarthritis in the inner, or medial, part of the knee.

MAKOplasty patients tend to fall into two groups:

  • Younger, active patients who find they can no longer run, play tennis and do the things they enjoy because of their knee arthritis.  
  • Older patients with arthritis. MAKOplasty is much less invasive than a total knee replacement. It’s an operation done through a very small incision—only two to three inches vs. eight inches for a total knee replacement—and it involves only an overnight hospital stay.

After the seminary, Ron thought: I could be a candidate for this. “I talked to Dr. Krebs and he agreed. I had the surgery this past November 30th.”

It went better than Ron could have ever anticipated. He especially appreciated the hospital therapist, Sharon Hill, affectionately known as “Sarge.”

“She did an outstanding job with me in the hospital. Then when I got back to my condo, the therapist came twice a week and that went really well too.”

Ron was able to start driving again after the staples were removed and was back to work shortly thereafter at his part-time job as a home inspector for First Federal. “Everything was handled so professionally. I was very impressed.”

So impressed that he would definitely recommend this procedure to others: “If you are uncomfortable and don’t have bone on bone issues, than absolutely. You should consider Makoplasty.”  And, he adds, “Dr. Krebs deserves an A+ for the surgery. I have had no problems. No pain. And I don’t need a cane to walk. I’m glad I saw that notice in the paper.”

Add comment Posted in  Surgeries ,Testimonials March 1, 2017

Lower Back Pain Basics


Lower back pain episodes, that resolve within 2 weeks, are typically caused by muscle strain or spasm. Even though this doesn’t sound serious, the pain can be severe. Strains, muscle spasms and other issues in the lumbar portion of the back are common because this area bears much of the body’s weight during walking, lifting, and other activities.

Problems arise when any part of the complex, interconnected network of muscles, nerves, discs and tendons become inflamed or injured. Sources of low back pain include strained or spasming muscles; irritated nerves; damaged bones, ligaments or joints; or issues involving disc degeneration.

Emergency Treatment

If you experience these symptoms, in conjunction with lower back pain, you should seek immediate treatment.

  • Fever
  • Abdominal pain
  • Bowel or bladder incontinence
  • Severe pain in legs or inability to bear weight on leg(s)

At Home Treatment

If pain is inconvenient, but not debilitating, most people start pain management and treatment at home. Most muscle inflammation and strain issues will resolve within 2 weeks of at home care. If you try these treatments and they fail to improve pain and mobility after 2 weeks, it may be time to consult a doctor.   

  • One or two days of rest for your back to minimize stress on the area.  
  • Application of ice and heat. Generally speaking, ice reduces inflammation and heat increases blood flow and relaxes muscles. Ice is typically recommended within the first 48 hours with heat used thereafter.
  • Over the counter pain relief medication ibuprofen, naproxen, aspirin or acetaminophen. Please consult your doctor about which is best and to confirm that they are safe for you to take.
  • Adjust sitting and posture to take stress off the lower back.
  • After brief period of rest, resume light exercise if possible such as walking short distances, gentle stretching and yoga or water activity.

Doctor Treatment

If lower back pain does not start to subside within one to two weeks, and continues to interfere with mobility and daily activities, consider seeking medical attention. Physicians can identify the source of pain and determine the best course of treatment.  Common treatments include, massage or physical therapy, prescription medications, steroid injections, and other pain management techniques. Surgical treatment is rare, but may be indicated for issues involving bone and disc degeneration.

If you have been suffering from chronic lower back pain for some time, consider a consultation with Dr. Berkowitz and his team at Center for Orthopedics. Call 440-329-2800.

Add comment Posted in  Back and Spine February 15, 2017

Caring for Senior Athletes

Senior athletes have spent their whole lives pushing themselves out of their comfort zones.  Unfortunately, aging bodies don’t respond the same to “toughing it out.” There are declines in muscle mass, bone mass and weakening of ligaments, tendons and cartilage to consider. Yet senior athletes are also minimizing some of this weakening by staying active, so it’s not a black and white issue. Senior athletes should not be benched, (or couched), but they also can’t ignore new limitations.

There are two important distinctions to consider when you are an orthopedic patient and also a senior athlete.

Approach to Limitations

National Institutes of Health says, “Most injuries in older athletes are chronic and overuse injuries that result in diminished flexibility and endurance. In addition, many aging athletes have medical and musculoskeletal problems that mandate tailoring athletic activity to the patient’s general health and functional requirements.”

Common overuse injuries, often aggravated by lumbar disc disease and osteoarthritis, include but are not limited to muscle strains, tendinopathy, meniscal tears and fractures. It’s also important for senior athletes to consider changes in heart, lung and blood flow capacity, which can affect reaction time (which helps prevent injury), muscle regeneration, and also general workout recovery.

Aging should not stop a senior athlete from doing what they love, but there is a difference between young and young at heart. It’s good to remember that the zone between discomfort and injury gets smaller as we age.  

Approach to Injuries

In sports medicine, it is common to treat athlete’s injuries not just with rest but also with corresponding strength training to improve future mobility, flexibility and strength. Sedentary seniors with injuries are often told to rest and avoid using the injured area. Seniors athletes, however, should not always be given total downtime recommendations just because they are seniors.

While total downtime may be the right course of action, it’s important for senior athletes to let their physicians know about active (or pre-injury active) lifestyles so that this can be taken into consideration during rest and rehab. They may need total rest, but they may also benefit from a physician with sports medicine experience who can recommend activity modification to help heal and restore functionality to injury areas.

Approach to surgical treatment may also be different for senior athletes. It’s important to let your orthopedic physician know what types of activities you want to continue to engage in after surgery. Some may be possible while others may have to be given up.

While some active seniors may be better candidates for certain surgeries, others may not. Senior athletes have different rates of aging and decline and different corresponding health issues and assets — BMI, strength, coordination, etc.  So, a squash partner’s shoulder surgery and recovery may look nothing like your own.   

If you are a senior athlete experiencing chronic pain or an injury, consider the sports medicine specialists and physicians at The Center for Orthopedics. Give us a call at 440.329.2800.


Add comment Posted in  Back and Spine ,Conditions ,Sports Medicine January 26, 2017

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