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.

Read more: http://www.abc15.com/dpp/lifestyle/sonoran_living/sl_sponsors/hip-joint-replacement-treatment-options-#ixzz1jNQQMgmW

Energy drinks' sugar, caffeine raise concerns

By Gannett News Service

Sales of energy drinks and shots are soaring, even as health concerns grow about the high-caffeine drinks.

"Energy drinks … can be beneficial to those using them as directed and for their designed purpose. But some people are using them with alcohol, a misuse that puts you at risk. People have died because of this combination.

"I don't recommend consuming energy drinks on a daily basis. This craze began with beverages chock full of sugar and carbs, which add a lot of extra calories. But worse than that, the excessive sugar intake can possibly lead to … insulin resistance and diabetes. Most of the popular brands have introduced lower-sugar and sugar-free drinks as a better option for health-conscious consumers. Still, the acid in some can cause tooth erosion. I recommend using a straw so the liquid avoids coming in contact with your teeth and rinsing your mouth with water after drinking any acidic beverages."

A.J. Jarrell, owner of Total Pro Personal Training, located at Independence Gym, Scottsdale (totalpropersonaltraining@yahoo.com)

"These drinks contain mainly sugar, caffeine and other additives whose safety or efficacy has not been established. Being sweet, it is very easy to consume large quantities of these beverages, resulting in even higher intake of caffeine and other stimulants. A much better way to get an energy boost is … drinking plenty of water, eating healthy, being physically active and getting enough sleep."

Registered dietitian Punam Ohri-Vachaspati, associate professor, Arizona State University School of Nutrition and Health Promotion

"There is some merit to the idea that extremely high levels of caffeine (or any other stimulant) could place young athletes at risk of dying from arrhythmias, a group of conditions where the electrical circuitry of the heart can be disturbed, especially if there is any underlying predisposition to this. However, this has not been very well studied and is very hard to prove … because of the relatively low prevalence of these underlying conditions in children and adolescents."

Physician John Kearney, sports-medicine specialist with the CORE Institute (Center for Orthopedic Research and Education), six Arizona locations

The dollar value of energy-drink sales rose 13.3 percent last year, thanks in part to a "significant boost" from energy-shot sales at convenience stores, according to a report from the market-research firm SymphonyIRI Group.

"Most of the (health) risk is among children, adolescents and young adults, especially those with medical conditions, such as attention-deficit disorder and if they're taking medications," registered dietitian Punam Ohri-Vachaspati said.

Yet young people are the primary marketing targets for the energy drinks, says Ohri-Vachaspati, an associate professor in the Arizona State University School of Nutrition and Health Promotion.

Adults, too, face adverse effects, especially if they mix high caffeine consumption with alcohol or drugs, she says.

American Beverage Association science chief Maureen Storey says energy drinks are no worse than coffee. A 16-ounce cup of Starbucks' Pike Place coffee, for instance, has 330 milligrams of caffeine. A 16-ounce latte has 150 mg, compared with 160 mg in a 16-ounce can of Monster Energy.

But people typically don't "gulp" coffee the way they do energy drinks and shots, says Barbara Crouch, head of Utah's poison-control center. This causes them to accumulate higher concentrations of caffeine quickly, which can result in anxiousness, palpitations and "more significant heart-rhythm disturbances," she says.

The federal Food and Drug Administration limits caffeine in soft drinks to 71 mg for 12 ounces but doesn't regulate the caffeine in energy drinks, coffee or tea.

The anti-doping agency that regulates performance-enhancing drugs for the International Olympic Committee includes caffeine in its rules, says Dr. John Kearney, a Valley sports-medicine specialist. To "legally compete" in the Olympics, athletes cannot have more than the equivalent of six cups of coffee in their system. Caffeine "does improve mental focus and lowers levels of perceived exertion in many endurance athletes, " he said.

But they and others find that as with any "habit-forming drugs, they eventually require more and more caffeine to achieve the same positive effects," Kearney said. "Most would agree that we should try to avoid exposing … children and adolescents to this phenomenon if possible."

Arizona Republic reporter Connie Midey contributed to this article.

Retrieved from http://www.usatoday.com/USCP/PNI/FEATURES/2011-11-25-PNI1111liv-prevent-energy-drinksPNIBrd_ST_U.htm

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.

Read more: http://www.yourwestvalley.com/topstory/article_afdce800-114b-11e1-9036-001cc4c002e0.html#.TswI52Mk6dA

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


Banner Del E. Webb Medical Center and The CORE Institute partner to form the Banner CORE Center for Orthopedics.  Watch the interview with Sonoran Living to learn more.