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Dr. Rachel Yvonne Goldstein, MD, MPH is a pediatric orthopedist in Boston, MA specializing in pediatric orthopedics/orthopedic surgery. She graduated from Mount Sinai School of Medicine. Dr. Rachel Yvonne Goldstein, MD, MPH is affiliated with Providence, Children's Hospital Los Angeles and CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC.
Debridement (Removal of Unhealthy Tissue)
Debridement is a procedure that removes damaged skin to help the body heal a chronic wound, acute injury, or burn. Several layers of skin surrounding a chronic wound can include foreign debris, dead (necrotic) tissue, infected tissue, and calloused (hyperkeratotic) skin. If left untreated, these damaged skin layers can spread infection to other parts of the body and may aggravate the wound and delay its healing.
Debriding (removing) this damaged and diseased skin encourages the growth of healthy new tissue, impeding infection by triggering the body's natural cycle of tissue renewal. For this reason, debridement functions both as a wound treatment and as a preventative measure against more complex consequences of infected skin, such as sepsis and amputation. In some circumstances, debridement provides additional aesthetic benefits such as decreased scarring. Debridement also permits doctors to retrieve tissue samples for testing, such as to determine whether patients need antibiotic treatment.
Wounds that frequently require debridement include:
Debridement can be performed either surgically or nonsurgically; some methods are less invasive than others. Doctors select the appropriate debridement technique by considering the location, cause, and size of a patient's wound and may also weigh the patient's overall wellbeing, age, and risk of infection.
Surgical debridement is performed by cutting away dead, infected, and hyperkeratotic skin with a surgical scalpel. For deep wounds that tear away the skin and go into the muscle, skin from another region of a patient's body may be grafted onto the wound, which may then be periodically assessed and rebandaged until fully healed.
Non-surgical debridement is achieved with water or a dissolvent gel. Water softens the damaged skin and affected tissue, allowing doctors to remove it with wet-to-dry dressing. When wet tissue dries, it adheres to the dry dressing or bandage and comes off when the dressing is pulled away. In contrast, dissolvent gel deconstructs tissue, which can be cleaned off of the wound. Nonsurgical debridement is less invasive than surgical techniques; however, it can entail repeat treatments, slowing wound recovery.
While the prospect of stripping away skin may seem jarring, debridement can be critical to the treatment and healing of wounds which cannot not heal independently.
Hip Replacement
Hip replacement is a surgical procedure to replace parts of the hip joint that are damaged by disease or injury. It is most often done to treat arthritis, a common condition that causes stiffness and pain in the joints. Surgery is used only after other, less invasive treatments have failed to work.
The type of hip replacement patients receive is based on their age and the extent of damage to their hip. The hip joint has two parts: the femoral head, or hip ball, and the acetabulum, or hip socket. The hip ball is located on the upper end of the femur (thigh bone), and the hip socket is part of the pelvis. Depending on whether one or both parts require replacement, patients may need one of the following procedures:
During hip replacement surgery, an incision is made along the side of the hip. The surgeon may access the joint directly through this incision, or by using small tools and a lighted tube called an arthroscope to see and treat the joint. The diseased tissue is removed, and the bones are smoothed out and fitted with metal ends. The metal pieces may be cemented in place, or they may have a porous structure that encourages bone to grow into them and hold them securely. A smooth plastic cushion is placed between the two bones to replace the cartilage and allow the joint to move freely.
Hip replacement surgery takes one to two hours, and afterwards patients may stay in the hospital for several days. When patients go home, they will have to use a cane, walker, or crutches at first. Patients will likely have physical therapy to improve their ability to move with their new hip. After the first few weeks, light exercise such as bike riding or swimming will help them heal, but certain actions, such as climbing stairs or bending over at the waist, may be difficult at first. It will take several weeks before they can drive or return to work. Full recovery may take six to 12 months.
Shoulder Arthritis
Shoulder arthritis is a very common condition that causes pain, stiffness, or a grinding sensation in the shoulder. Some patients may hear a clicking or popping noise, and all symptoms are more noticeable when moving. Arthritis occurs when the cartilage that cushions joints becomes damaged.
Normally, when two bones come together inside a joint, they are separated by a layer of tough, smooth cartilage. The cartilage allows the bones to glide across each other, which makes movement easier. Cartilage can be damaged by an injury, by an illness such as rheumatoid arthritis, or by simple wear and tear (osteoarthritis). In the shoulder, the two joints most commonly affected are the AC joint (where the shoulder blade and collarbone connect at the outside edge of the shoulder), and the glenohumeral joint (where the arm bone meets the shoulder blade).
Treatment for shoulder arthritis may include:
Surgical treatments include the removal of inflamed tissue and joint reconstruction. The type of arthritis and severity of the damage will determine which treatment is most appropriate.
Dr. Rachel Yvonne Goldstein, MD, MPH graduated from Mount Sinai School of Medicine. She completed residency at NYU Hospital for Joint Diseases. She is certified by the American Board of Orthopaedic Surgery, Orthopaedic Surgery and has a state license in Massachusetts.
Medical School: Mount Sinai School of Medicine
Residency: NYU Hospital for Joint Diseases
Board Certification: American Board of Orthopaedic Surgery, Orthopaedic Surgery
Licensed In: Massachusetts
Dr. Rachel Yvonne Goldstein, MD, MPH is associated with these hospitals and organizations:
Dr. Rachel Yvonne Goldstein, MD, MPH appears to accept the following insurance providers: Anthem Blue Cross HMO, Health Net HMO, Aetna HMO, CIGNA HMO, Anthem, Blue Shield of California and United Healthcare HMO.
According to our sources, Dr. Rachel Yvonne Goldstein, MD, MPH accepts the following insurance providers:
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These charts describe general payments received by Dr. Rachel Yvonne Goldstein, MD, MPH. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.
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$3,105
Sports Med Hip $33 |
Pico $24 |
$3,048 |
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$459
$459 |
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$330
PICO 7 Single Use Negative Pressure Wound Therapy $127 |
Q-FIX $118 |
Taylor Spatial Frame $85 |
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$196
MENTOR MemoryGel Resterilizable Gel Sizer $196 |
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$172
BSBHT - SPINE $172 |
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$433
PRECICE $163 |
Exparel $105 |
Pedi-Nail $70 |
ZYVOX $21 |
Hip Arthroscopy Access & Instrumentation Set $21 |
Other $52 |
| $3,000 | |
| $913 | |
| $286 | |
| $240 | |
| $172 | |
| $85 |
Dr. Rachel Goldstein practices orthopedics/orthopedic surgery. She is affiliated with Children's Hospital Los Angeles. Dr. Goldstein obtained her medical school training at Mount Sinai School of Medicine and performed her residency at NYU Hospital for Joint Diseases.
