Knee Patient Pays it Forward

“Just do it!” is Dennis Kimbrough’s advice to those considering knee replacement surgery. “The longer you wait, the longer you’ll hurt.”

The 63-year-old Kimbrough had endured knee pain for decades after injuring his knee playing sandlot football in college. Although he had his knee operated on back in 1975 and had been active for decades, in recent years Kimbrough’s knee pain returned.

“It really started hurting,” says Kimbrough. “Some mornings the bottom of my knee would move and the top would stay in place. It was enough to drive you nuts!”

Kimbrough consulted with Orthopedic Surgeon Dr. Michael Casey at Fort Sanders Regional.

“Dr. Casey told me I had two choices,” remembers Kimbrough. “I could keep doing cortisone shots and wear a knee brace, or get it fixed. I chose to get it fixed!”

Dr. Casey performed a total knee replacement on Kimbrough at the Joint Center at Fort Sanders Regional. Kimbrough is thrilled with the results.

“He went in and he did it! I’ve got a whole new knee. I can walk farther, with less pain than I’ve had in years,” says Kimbrough. “I can’t do cartwheels anymore, but it’s great to be able to walk around now without worrying my knee may pop out of place.”

Choosing Fort Sanders for his knee replacement was a perfect fit for Kimbrough. He was already familiar with the Fort Sanders Joint Center program from serving as a volunteer surgery patient coach at the hospital.

“It was great because I already knew the nurses and therapists. My experience with “Dr. C”, the nurses and physical therapists at Fort Sanders was totally positive!”

Kimbrough continues to coach and encourage Joint Center patients at Fort Sanders.

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Tennessee Orthopaedic Clinics is TSSAA’s 2011 Contributor of the Year

Tennessee Orthopaedic Clinics is TSSAA’s 2011 Contributor of the Year

Tennessee Orthopaedic Clinics is TSSAA’s 2011 Contributor of the Year

Their commitment to high school athletics was recognized when Tennessee Orthopaedic Clinics was honored as the recipient of the TSSAA AF Bridges Award for the 2011 Contributor of the Year at a special ceremony held at Central High School on November 7, 2011.

The award is named for A. Foster Bridges, the first full time executive secretary of the TSSAA, who exemplified the importance of fairness, integrity and ethics in athletics.

On hand to receive the award were Board Member and orthopaedic surgeon Randall Robbins and Earl Anderson, Tennessee Orthopaedic Executive Director, who had this to say about the recognition, “It’s an honor to be recognized for this prestigious award, but it’s equally an honor to serve local high school student athletes.  Since our clinic began, our physicians, athletic trainers and staff have been dedicated to providing athletes with accessible, quality care.  We are grateful to the TSSAA and to the schools we serve.”

TOC’s Sports Medicine Program supports local high school athletic programs with both physicians and athletic trainers who work closely with high school teams, Saturday Morning Sports Clinics that allow injured athletes the opportunity to see an orthopedic physician for evaluation and sponsorship of the Loudon County, Anderson County and Sevier County jamborees.

Bernard Childress, Executive Director of the TSSAA stated, “Being recognized for one of these awards as a school or individual should be seen as one of the highest honors in high school athletics in our state.  Those who receive the awards truly reflect what high school athletics should be about, and that’s good sportsmanship and good citizenship.” 

Tennessee Orthopaedic Clinics have nine locations and 24 board-certified and board-eligible physicians on staff to serve the East Tennessee area.

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Dr. Paul Brady Invents ‘Dog-Bone’ Implant

Device twice as strong as any other shoulder repair.

Paul Brady is a down-to-earth guy, practical and enterprising. He’s also a board-certified orthopedic surgeon at Parkwest Medical Center who has invented a shoulder implant that is twice as strong as any other repair technique in existence for the Acromio-Clavicular (AC) joint. He’s pretty low-key about that, too.

Close up of Dog Bone Implant

Close up of Dog Bone Implant

“Want to see one?” Brady asked, fishing his car keys from a pants pocket. The quarter-inch-long metal implant dangles from a string to his key fob, and by virtue of its shape is called the “Dog-Bone.”

A sports fan, Brady graduated with honors from Wake Forest University School of Medicine. During his residency at Wake Forest Baptist Medical Center, he was assistant team physician for the Wake Forest Demon Deacons football team. His sports medicine background inspired the Dog Bone when Brady learned of the AC joint injury suffered by Oklahoma Sooners quarterback and Heisman Trophy winner Sam Bradford in 2009. AC joint dislocation is a relatively common injury in football and hockey players. Similar injuries have affected NFL quarterback Eli Manning and Michigan’s quarterback Tate Forcier. “Conventional repair to this type of injury involves drilling 4- to 6-millimeter holes in the clavicle (collarbone), which weakens the bone, involves persistent pain during recovery and has a mediocre success rate. I knew there had to be a better way,” Brady said. So he headed to Home Depot.

Dr. Paul Brady with Dog-Bone Implant

Parkwest orthopedic surgeon Paul Brady uses a medical model of the human shoulder to show where Dog Bone implant would be placed.

Brady purchased several metal washers at the home supply retailer and went to work in his garage, milling a prototype which would become the Dog Bone. Then, he tested the Dog Bone on fake shoulder bones, and results were outstanding. The concept was pitched to Arthrex, a company that specializes in orthopedic products and education. With input from Brady, Arthrex engineers tweaked the design, which now has been perfected and is in the process of being patented. The first Dog Bone implant was released in April 2010 on a limited basis. Brady expects wide distribution within coming months.

“There are a couple of major benefits of using the Dog Bone,” Brady explained. “First, it’s an arthroscopic procedure that involves three 1/4-inch incisions which is a significantly decreased risk from open surgery. The holes that are drilled into the bone are so much smaller than conventional repair that four times less bone is removed.”

Brady said that with shoulder or AC separations, the joint between the collarbone and shoulder blade is injured. The ligaments and capsule connecting the bones can be injured to variable degrees depending upon the severity of the injury. It is commonly caused by a fall directly on the “point” of the shoulder. This type of injury can cause significant pain and tenderness at the front of the shoulder joint, especially when an athlete attempts overhead movements such as throwing. Diagnosis is made with a physical exam and x-rays.

“Sometimes, the patient will notice something sticking up in his or her shoulder,” Brady said. “The Dog Bone implant is a type of washer that will secure the clavicle back down to its the body’s torn ligaments to heal.”

“With surgery and this implant, patients will experience improved function, improved, if not eliminated, pain and get back to sport within six months,” Brady said. Brady performed the first Dog Bone implant in July. The patient is recovering well.

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How Our Weight Can Affect Knee Pain

Harold E. Cates, Jr. M.D.

Harold E. Cates, Jr. M.D.

Have you ever wanted to lose some weight? Perhaps your motivation to shed those extra pounds was an upcoming vacation, wedding or class reunion.

Well, if you experience knee pain associated with osteoarthritis, now there is another great reason to lose that weight. Studies show that people can significantly decrease knee pain by losing as little as 10 pounds.

Let me explain how this works. Our knees are designed to work perfectly under the proper conditions. If we start adding on extra weight, we increase the force we put on our knees which results in those joints literally wearing out. As that cartilage wears away our knee pain increases. Additionally, as our pain increases, our activity levels tend to decrease which can lead to more weight gain! This is a serious cycle that needs to be broken.

So let’s get started losing those pounds! Begin with low impact cardiovascular activities like walking, biking, or swimming at least 3 times per week. These exercises not only help us shed those pounds, they also help strengthen the muscles in our knees.

As you lose those pounds and strengthen those muscles, you can begin to add in more weight bearing exercises and increase your cardiovascular activities as well.

Stay focused! Stay active! Stay informed! Always consult with your physician before starting any new exercise or diet regimen.

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Motion is Lotion for the Joints

A Physical Therapist Discusses Osteoarthritis

Tennessee Orthopaedic ClinicsI’ve been a physical therapist at TOC since 2005 and I’ve seen many patients looking for ways to minimize the discomfort of osteoarthritis.

With OA, the main complaints are pain, stiffness or even a change in the way a joint functions. For instance, you may feel your knee giving away or you start experiencing limited motion. These are all signs and symptoms of OA.

And yes, there are exercises that can help improve the discomfort and pain! From a physical therapy standpoint, I recommend low intensity and low impact exercise.

There is a saying in orthopaedics that motion is lotion for the joints. As we get older, we don’t develop as much synovial fluid (lubrication) for our joints. And what little fluid we do develop isn’t absorbed as well by the articular cartilage. To help minimize these joint changes, it is important to gradually increase activity and perform lower impact exercises such as water aerobics, bike, and treadmill activities. My experience has shown that even making small changes in your daily activities results in major improvements in your overall health.

Strength training exercises are immensely effective as well. Patients should begin with basic isometric exercises. These exercises, which do not increase the force on the load-bearing joint, are a good way to start building your muscle tone.

As your muscle tone improves, you should work on closed chain exercises (where your foot is in contact with the ground) to build strength in your quadriceps. These exercises include small step- ups and ‘sit and stands’ that are performed on an elevated surface such as a tall chair. Strengthening the quadriceps is very beneficial as they have the ability to cushion the knee by absorbing forces.

Rob Seahorn earned his BS PT (Physical Therapy) 1994 from UT Memphis and is also a CSCS (Certified Strength and Conditioning Specialist). He can be reached at 865-633-0259.

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Surgical & Non-Surgical Treatment of Back Pain Presentation & Discussion

P. Merrill White III, MD

P. Merrill White III, MD

Jeffrey A. Uzzle, MD

Jeffrey A. Uzzle, MD

Please join us Monday, September 19, 2011 from 6:00 P.M. – 7:00 P.M. at the Parkwest Physicians Plaza as Tennessee Orthopaedic Clinics, P. Merrill White and Jeffrey A. Uzzle, discuss the diagnosis and treatment of back pain.

Refreshments will be served.

Please RSVP by Friday, September 16, 2011
Email hottopics@tocdocs.com or call (865) 694-0062, ext. 241, list event, your name, organization, phone number & number attending.

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Osteoarthritis

It happens to all of us – getting up in the morning and feeling those aches and creaks in our joints. That’s Osteroarthritis and it’s the most common joint disorder in folks 50 and older.

Basically, OA is caused by natural wear and tear on a joint. The joint cartilage that cushions our bones breaks down. When it wears away, all that’s left are bones rubbing together. Ouch!

The causes of OA are usually unknown, however if you are over the age of 50, overweight, have a family history or have had a fracture or break in a bone, you will probably experience OA symptoms in your lifetime.

Those symptoms include pain and swelling of the joint, difficulty moving, loss of range of motion and a crackling noise when you move the joint.

If you exercise on a regular basis, you may notice pain and inflammation during your exercise, but that it diminishes when you are resting. Occasionally, you may even experience joint pain at night when you are asleep.

Harold E. Cates, Jr. M.D.

Harold E. Cates, Jr. M.D.

Sadly, there is no cure for any type of arthritis, although there are ways to control the symptoms and reduce the discomfort. Over-the-counter medications such as ibuprofen and NSAIDS are helpful in controlling pain. Steroid injections are also an option and of course, surgery for those whose quality of life has been seriously affected by OA.

Many folks find comfort in massage therapy, physical therapy and by taking daily doses of the dietary supplements chondroitin and glucosamine. Mostly, we simply have to find the right mix of these symptom-controlling measures to determine what works best for us individually.

Overall, the best way to avoid OA is to eat a healthy diet, maintain a healthy weight, exercise regularly, and to know your own body’s limitations.

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Heat Related Illnesses in Young Athletes

E. Brantley Burns, M.D.

E. Brantley Burns, M.D.

There is no doubt about it! It’s HOT!  In these are the dog days of summer, many young athletes are gearing up for school and team sports so parents and coaches need to know the signs of heat related illnesses.

Heat cramps. These can be painful with muscle spasms and cramps in the legs, abdomen and arms.  Make sure your athlete is well hydrated before, after, and during practice.  If there is a very strenuous or intense session coming up, start hydrating the day before.  If cramps do occur, stop, rest, and drink water and/or electrolyte replacement products.  Products that contain caffeine should be avoided as they can contribute to dehydration.

Heat Exhaustion. This occurs when the body becomes overheated. Symptoms include heavy sweating, muscle cramps, overwhelming tiredness, weakness, dizziness, fainting, headaches, nausea and/or vomiting. If any of these symptoms occur, the athlete must stop physical activity and immediately get to a cool place and drink water or electrolyte replacement products.

Heat Stroke. This is the most serious and possibly life threatening heat illness.  Heat Stroke occurs when the body temperature increases too quickly and the body is unable to cool itself off.  Body temperatures can rise as high as 106 degrees in just 10-15 minutes. Get immediate medical attention for your athlete if they become confused, dizzy and/or nauseous, start to vomit, have red, hot or dry skin, lose consciousness, or have an unusually rapid, strong pulse or throbbing headache.

If you have any questions about symptoms related to a heat related illness, or if you are experiencing a heat related illness, you should consult with your physician.

The CDC offers a free course for parents and coaches to understand heat related illnesses.

http://www.cdc.gov/nceh/hsb/extreme/Heat_Illness

 

E. Brantley Burns, MD

Dr. Burns is an avid runner, and also writes articles for the Knoxville Track Club.

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Surgical and Medical Management of Knee and Hip Arthritis Seminar

SAVE THE DATE
MONDAY, AUGUST 15th 2011 @ 6:30PM
For an exclusive Rush member and guest seminar presented by The RUSH and Tennessee Orthopaedic Clinic.

Surgical and Medical Management of Knee and Hip Arthritis
Presented by Dr. Edkin

Brian S. Edkin, MD

Brian S. Edkin, MD

Dr. Edkin and his family moved to Knoxville from Redding, California where Edkin was both a partner at the Northern Bone and Joint Center and Chief of Staff at Mercy Medical Center.  A graduate of Case Western Reserve University School of Medicine in Cleveland, Ohio, Dr. Edkin completed both his internship and residency at Vanderbilt University Medical Center. Although his Fellowship training moved him back to California, Edkin knew, if given the chance, he would move back to Tennessee to continue his practice.  He specializes in Adult Reconstructive Surgery, primarily of knees and hips.

Please RSVP early as space will be limited! The seminar will be held at The RUSH -Oak Ridge, 302 South Illinois Ave., Oak Ridge, TN 37830. RSVP through email or telephone: FM7878@therush247.com or (865)276-3488.

 

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Arthritis: Let’s Start with the Basics

Harold E. Cates, Jr. M.D.

Harold E. Cates, Jr. M.D.

What is Arthritis?

Arthritis is a disease that affects over 46 million adults and children. But it’s not just one disease. It is actually a term used to describe over 100 medical conditions. Each of us should educate ourselves about arthritis simply because it affects such a large portion of our population.

Basically, arthritis attacks our musculoskeletal system, specifically our joints. It causes pain, stiffness, inflammation and even joint cartilage damage. Most of us treat our own aches and pains with ibuprofen or other pain killers and can continue on with our day-to-day activities.

However, there are a growing number of people where arthritis causes such extreme weakness and stiffness that they can no longer perform common tasks such as getting dressed or making a pot of coffee. Just imagine how this is taking a toll on the individual, their family and even our country’s economy.

As we age, as our population continues to live longer, arthritis is becoming a very important part of millions of people’s lives. It is imperative that we educate ourselves on this complex disease and find ways to support research that will ultimately cure this un-curable condition.

That’s why we have produced a series of articles that examine and discuss the many forms of arthritis. We hope you enjoy or weekly blogs. Please give us feedback on this series and let us know if there are other topics you’d like to discuss.

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