News Archive (2011)

Joint Replacement Treatment Options with The CORE Institute
Steven L. Myerthall, MD

What are the signs and symptoms a patient would experience that would require a hip or knee replacement at The CORE Institute?

Patients may consider hip replacement surgery if their joints are causing severe hip pain and loss of function. The decision to have surgery depends on several factors including age, health, activity level, and the degree of pain you are experiencing.

Joint paint can be managed with medicine, exercise, physical therapy, and in some cases, weight loss. If these treatments do not relieve pain, other options include joint injections and arthroscopic surgery. In the most severe cases, surgery to replace the joint is an option. Most people have joint replacement only when they can no longer control the pain in their hip with medicine and other treatments and the pain is significantly interfering with their everyday life.

Can you talk about the difference between traditional hip replacement and the Direct Anterior Approach?

During your surgery, your orthopedic surgeon will remove the damaged cartilage and bone, then position new metal, plastic or ceramic joint surfaces to restore the alignment and function of your hip.

Many different types of designs and materials are currently used in artificial hip joints. All of them consist of two basic components: the ball component (made of a highly polished strong metal or ceramic material) and the socket component (a durable cup of plastic, ceramic or metal, which may have an outer metal shell). Special surgical cement may be used to fill the gap between the prosthesis and remaining natural bone to secure the artificial joint.

The CORE Institute offers two alternatives for patients who are looking for a hip replacement. The first approach is the minimally invasive total hip replacement, where an incision is made on the side of the hip; the muscles are split and detached from the hip. A second, newer option called the "direct anterior approach," makes total hip surgery a more viable option with an easier and less painful recovery for patients. In addition, it provides patients a more rapid recovery for a total hip replacement using an innovative surgical table.

First, the direct anterior total hip arthroplasty is the only surgical approach that allows the procedure to be performed without having to cut any of the muscles or tendons that are so critical for hip function. Simply put, it is the most tissue-preserving approach to total hip arthroplasty. Secondly, in order to perform direct anterior hip surgery, patients lie on their back in the supine position and the leg is extended and rotated. This prevents the damaging of important hip muscles because only the portion of the hip being replaced is exposed.

The results are incredible. Most patients are discharged two to three days after surgery. Patients have had a variety of experiences in the post-operative period. Most notably is a swift recovery, which enables patients in many cases to walk without a walker or even unaided within one to two weeks following surgery. In fact, many return for their first post-operative follow-up visit to The CORE Institute with a cane or without any assistive devices at all. We hear from many of our patients that they experience less pain and walk without limp only days after surgery. When considering hip replacement, the greatest advantages of the direct anterior approach include a faster recovery in the early post-operative period, tissue preserving surgery with minimal muscle trauma and less post-operative restrictions on hip motion.

Perhaps most importantly, CORE patients are amazed by their results.

What should a patient's expectation be after they receive a hip or knee replacement?
An important factor in deciding whether to have hip/knee replacement surgery is understanding what the procedure can and can't do. Most people who undergo hip/knee replacement surgery experience a dramatic reduction of hip/knee pain and a significant improvement in their ability to perform the common activities of daily living. However, hip/knee replacement surgery will not enable you to do more than you could before your hip/knee problem developed.

Following surgery, you will be advised to avoid certain activities, including jogging and high-impact sports, for the rest of your life. You may be asked to avoid specific positions of the joint that could lead to dislocation. Even with normal use and activities, an artificial joint (prosthesis) develops some wear over time. If you participate in high-impact activities or are overweight, this wear may accelerate and cause the prosthesis to loosen and become painful.

Dr. John Thompson receives honorable mention by Banner Boswell 

Each year, Banner Boswell staff members nominate physicians for the Top Doc award to honor the care provided to patients and families at the nonprofit hospital. Nominations are based on how the physicians collaborate with the health care team, communicate effectively with patients and their families, and the overall impact they have on the patient experience at Banner Boswell.

Charney [this year's winner] has been a member of Banner Boswell’s medical staff since 1993, specializing in interventional and diagnostic radiology. In addition to Charney’s top honor, three physicians were awarded honorable mentions: John Thompson, orthopedic surgeon with The CORE Institute; Patrick Quinn, cardiologist with Cardiac Solutions; and Arlene Conte, a family medicine and geriatric physician with Banner Medical Group and Banner Boswell’s 2010 Top Doc winner.

Get help for back pain with The CORE Institute

· Did you know that it is normal to have an extra vertebra in the lower back? 
· By the age of 60, most people will experience at least one episode of significant back pain at some point of their life. 
· Degenerative disc disease can be hereditary.

Q & A

Q: What are the treatment options for a herniated disc in the neck?
A: Cervical disc herniations can be caused by something as complex as trauma or as simple as a sneeze. Symptoms may be numbness, tingling or pain down one or both of the arms. More severe cases can be associated with weakness as well. These symptoms are called radiculopathy and are consistent with pressure on the nerve root. However, if the herniation is exerting significant pressure on the spinal cord itself, it can lead to clumsiness in the hands, difficulty with balance or even weakness in the lower extremities. These symptoms are called myelopathy and need to be addressed immediately. The goal of treatment is to preserve function and help ease the patients’ pain.

In cases of radiculopathy, unless the patient has profound weakness, the initial treatment consists of physical therapy and medications. Narcotic medication is usually not very effective. Anti-inflammatory medications such as Ibuprofen and muscle relaxants usually work well. If the patients’ symptoms do not get better with the above, the next step is usually epidural steroid injections, similar to those that a pregnant patient is given at time of delivery. These injections are usually done under x-ray guidance by a specially trained physician, such as a pain management or interventional spine specialist. If the patient fails conservative treatment and continues to have significant symptoms, then surgery may be considered. There are a number of surgical options such as a fusion, disc herniation removal or artificial disc replacement. Cervical Myelopathy is commonly treated with surgery.

Cervical disc herniations can be a very serious condition. Please consult a physician if you suspect this condition or have concerns about the symptoms described in this article.

Read more: http://www.abc15.com/dpp/lifestyle/sonoran_living/sl_sponsors/get-help-for-back-pain-with-the-core-institute#ixzz1eNTprPAP


The CORE Institute Foundation Launches in the Phoenix Community

The CORE Institute has announced the launch of their new 501c3 charitable organization called The CORE Institute Foundation. The Foundation will support three state-of-the-art research labs located in Sun City West, Arizona. The labs are dedicated to advancing orthopedic research. Integral to its mission, the Foundation will give back to the community by providing education, community events and outreach to the community. Dr. Jacofsky, Chairman and CEO of The CORE Institute, states “The CORE Institute has served the community for almost seven years. We felt it was time for the company to create its own foundation to benefit the people f our communities and to further orthopedic research causes.”

From a research perspective, the Foundation was formed to conduct scientific research related to various orthopedic issues for the purpose of providing continuing education to doctors, health care professionals and the general public, regarding the prevention and treatment of orthopedic issues. If an orthopedic of problem arises, The Foundation develops a protocol, obtains funding for research, conducts the research and then publishes the results in a peer review journal. Additionally, The CORE Institute Foundation plans to utilize its research labs to assist private industry by providing services to act as an independent research lab. Finally, the labs will support smaller start-up companies develop their orthopedic products by helping them go to market faster through fair market research and development.

Through their fundraising activities, the Foundation will support charitable causes related to orthopedics by providing orthopedic care to less fortunate patients suffering from congenital or life altering orthopedic conditions. The Foundation will use the money raised to help pay and care for less fortunate patients in need of orthopedic treatment that cannot pay on their own.

Additionally, The CORE Institute Foundation will create awareness regarding orthopedics issues through community events and educational programming.

About The CORE Institute Foundation

The Center of Orthopedic Research and Education, The CORE Institute Foundation was founded by The CORE Institute in 2007 in order to dedicate its use to the area of orthopedics. The Foundation’s headquarters are located in Phoenix, Arizona and is a non-profit, 501c3 organization. The Foundation was established with a vision to provide education, research and outreach in orthopedics. The CORE Institute Foundation was formed to conduct scientific research related to various orthopedic issues for the purpose of providing continuing education to physicians, healthcare professionals, patients and the general public regarding the prevention and treatment of orthopedic issues.

Marc Jacofsky: CORE Values

by Don Ketchum, ASU Magazine
Retreived from http://graduate.asu.edu/node/3067

The world of orthopedic research and treatment continues its evolutionary spin second by second, minute by minute and day by day. One man who puts all of his energy into keeping things moving is Marc Jacofsky, who obtained his master’s and Ph.D. degrees from ASU in physical anthropology and continues his connection to the university by working as an adjunct faculty member at ASU in the School of Human Evolution and Social Change.

Jacofsky, 34, grew up in New York and came to Arizona in 1999. He helped form The CORE Institute (Center for Orthopedic Research and Education) in 2005 with his brother, David, an orthopedic surgeon. At the start, there were three surgeons, three employees and one location. Today, Jacofsky says, there are 30 providers (doctors/treatment personnel), 300 employees and affiliations with six hospitals around the state, five in Maricopa County and one in Prescott.

He is the institute’s vice president of research and development, involved in the research aspect as director of the BSHRI-CORE Research Labs in Sun City. The organization concentrates on three primary areas of study – gait and motion analysis, biomechanical testing, and clinical research. He also has dealt with intellectual property development, having applied for five or six patents over the last three years.

“We want to provide the best care we can, to be out front through research and innovative technologies,’’ Jacofsky said. “We are primarily looking at joint replacement and fractures.’’ One of the organization’s most promising projects is called Secure Tracks, a support device that helps patients walk after surgery such as hip or knee replacements. The device slides along tracks in the ceiling. It helps the patient walk faster and with a more normal gait.

“It is relatively impossible to fall. You don’t have to lean over as you would with a walker,’’ he said.

Although his relationship with the university has changed since his days as a graduate student, he still keeps in touch with his ASU colleagues.

“My time there (at ASU) was good. We still have some collaborative research efforts,’’ he said. “In our department, we had a good sense of communication without a great sense of competition (with each other). The success of any one individual was and is good for the university. That is the same type of approach we have tried to take at CORE.’’

Reprinted from the article “Young alumni build on early success” in ASU Magazine, May 2011, Vol. 14, No. 4.