New Hampshire Orthopaedic Center

provides the most comprehensive orthopeadic care in southern New Hampshire. Our Board-certified and fellowship trained physicians and staff specialize in the surgical and non-surgical treatment of the spine, hand, shoulder & upper extremity, hip & knee, including reconstruction in total joint replacement, foot & ankle, trauma & fracture care, arthroscopic surgery, sports medicine and pediatric orthopedics.

Recent News & Articles

In Praise of Bones - By William P. Rix MD

Did you know that bone is the only tissue in the body that heals with itself? If you cut your skin, it heals with scar tissue. If you lacerate your liver, brain, kidney, lung, it heals with scar tissue. If you fracture a bone, it heals with bone. It makes sense, doesn`t it? If the skeleton healed a broken bone with scar, an inferior tissue compared with the original, then it would be at risk for re-fracture at that site, even as we went about our normal activities. Early man would never have survived, for obvious reasons.

This illustrates one of bone`s important functions: Support. Bones support our frame whether we`re sitting, walking, lifting, or running the hundred yard dash. The bones are our scaffolding to which our muscles attach, propelling us along, flexing and extending at our joints. Muscles plus bones constitute our Musculoskeletal System. Orthopedic Surgeons specialize in the care and treatment of problems of this system.

Another bone function is Protection. The skull protects our brain, our rib cage protects our heart and lungs and our bony spine protects our fragile spinal cord.

A third function, one you might not realize, is Storage. Our skeleton is a veritable bank of calcium. Calcium is a critical regulator of many functions in our body. Some of the more important ones are muscle contraction, blood clotting, and intra cellular health. Our blood calcium levels are tightly regulated. When the body needs to increase its blood level of this mineral, it can`t wait until you have a glass of milk, or a cup of yogurt. When it needs calcium, it needs it now. One of the key ways it does this is to signal the bones to release calcium through a complicated mechanism involving PTH (parathyroid hormone). But, just like a bank that expects you to pay back the money you borrow, the bones expect you to replenish what you`ve borrowed by taking in an adequate amount of calcium in your diet. If the calcium is not replaced, the skeleton runs a deficit, and if this continues, you have a diminished Bone Mineral Density (BMD), which eventually leads to Osteoporosis. Osteoporosis is worrisome, and we will talk about this condition at some length in a future column.

The last major function of bone is Synthesis. Bone marrow is a semi liquid substance that resides in the center of our bigger bones, especially the flat bones like the pelvis and sternum. The bone marrow manufactures a variety of cells: red blood cells, which carry oxygen, white blood cells, which are important for immunity, and platelets, essential for blood clotting. In addition, bone marrow is a storehouse of pleuripotential mesenchymal stem cells. These stem cells, under the appropriate stimulus, have the capacity to turn into bone, cartilage, or muscle forming cells.

As essential as marrow is to life, there are several diseases, such as myeloma and leukemia, which target bone marrow. In such cases, bone marrow transplantation, along with radiation and/or chemotherapy, can be life saving.

Your skeleton is an amazing organ, and a few of its major functions are outlined above. In future columns we`ll talk about proper care of and common problems that affect this remarkable structure.

Wireless Internet Access

For your convenience, we now offer wireless access while you are in our office. If you’d like to take advantage of this access, please see one of our staff members for a security passcode.

ACL Injuries - By Gregory W. Soghikian, M.D.

ACL (anterior cruciate ligament) injury is the most common knee ligament problem that comes to surgery. Made famous by professional football players like Jerry Rice and skiers including Picabo Street, they are even more common now with the increasing popularity of sports, especially indoor and outdoor soccer.

The ACL is one of the knees’ central ligaments and helps to keep the top half of the knee from shifting out off the bottom half. If you are moving straight forward it doesn’t get used much, but as you turn or shift direction quickly it comes in to play to keep the knee stable. While some ACL injured knees do not act very unstable for day-to-day activities, most won’t put up with sports that require side-to-side motion and many may progress to cartilage injuries and arthritis over time.

While in the past ACL injuries and reconstruction were seen as career ending and life changing events, they are now viewed as just one more hurdle to cross by high level athletes. (Picabo Street has had 3). For the non-elite athlete ACL reconstruction was frequently reserved only for the very young or very active patient, and many were encouraged to just live with it. Advances in surgical techniques have significantly expanded the number of patients eligible for reconstruction.

ACL reconstruction surgery has evolved from something to be avoided unless absolutely necessary to a fine-tuned procedure with many technical options, relatively low risks and a high percentage of good and excellent outcomes. From a surgery that required a 5-7 day hospital stay and 6 weeks in a long leg cast, it has evolved to an outpatient procedure with early motion, rapid weight bearing and accelerated therapy with time away from work as short as a week. The range of patients who have reconstructions goes from teenagers to baby-boomers, from elite athletes to weekend warriors and occasionally couch potatoes. One of the largest increases in reconstruction procedures has been in middle-aged patients with ACL injuries that may have occurred 10 or more years ago. Don’t misunderstand the surgical complexity of a reconstruction or underestimate the amount of time and effort patients go through to fully and successfully rehabilitate an ACL, but also don’t be turned off by outdated information or age limits. If you’ve had a recent or an old ACL injury it should be carefully evaluated.

The details, choices and risks of both operative and non-operative treatment should be discussed with an orthopaedic surgeon who routinely does reconstructions, then the decision is yours.

Dr. Gregory Soghikian is an Orthopaedic Surgeon with New Hampshire Orthopaedic Surgery who specializes in Sports Medicine. A Magna Cum Laude graduate of Harvard University, he received his general surgical training at Massachusetts General Hospital and completed his Orthopaedic residency at George Washington University. He trained for an additional fellowship year in California concentrating on knee and shoulder reconstruction. Dr. Soghikian is a physician consultant to the World Professional Ski Tour and the New Hampshire Inter-Scholastic Athletic Association Sports Medicine Council. He was named by New Hampshire Magazine as one of the two best Sports Medicine surgeons in New Hampshire.