Community Education: “Current State of Hip and Knee Replacements”

GordonAllan-rounded-wb copyRecent innovation and changes to techniques used for hip and knee surgery have reduced post-operative pain and recovery time dramatically. Join Dr. Gordan Allan to learn how pre-operative patient optimization can reduce complications and improve outcomes.

Wednesday, February 3rd  6:00-7:00 p.m.

Location: Dove Conference Center at St. John’s Hospital
619 E. Mason Street

Reserve your seat today! Call (217)814-4308

OCIF to Award $5,000 Scholarship for Health Care Studies

2015 Scholarship Recipient, Brittany Bentley, with Dr. Rodney Herrin

2015 Scholarship Recipient, Brittany Bentley, with Dr. Rodney Herrin

The Orthopedic Center of Illinois Foundation (OCIF) is now accepting applications for the $5,000 OCIF Scholarship. The scholarship will recognize a graduating high school senior in Sangamon County who is beginning college in the fall and majoring in a health-related field.  The scholarship is renewable up to four years ($1,250 per year) if the student is in good academic standing.

“The need for employees in health care continues to grow. Through this scholarship, we want to encourage students who are passionate about health care and who might need a little financial help to join the field and contribute in a meaningful way,” said OCIF Board President Ron Romanelli, M.D. “We also find it incredibly important to give back to a community that has supported us for more than 40 years.”

For more information about this opportunity or to download an application, please visit the OCIF website: www.ocif.net.  The deadline to apply is March 25, 2016, and the winner will be announced May 6, 2016.

The Orthopedic Center of Illinois Foundation supports projects promoting patient education, continuing medical education and regional charitable organizations. Since incorporation in 2005, OCIF has contributed more than $270,000 in scholarships and grants to Springfield area communities.

Staying Active in your Golden Years

By Amy Blanford, PT, DPT
Midwest Rehab

what_your_gym_can_do_for_you_now_116356255-300x169So how are the Golden Years treating you? Many people say that their golden years aren’t so golden! So what can you do to help keep that shine of youth as you age? We can’t stop time but the right amount of physical activity can help maintain strength, flexibility and energy levels as well as help prevent falls.

According to a survey performed by the American Physical Therapy Association, the majority of Americans plan to live independently into their 80’s but also expect to lose strength and flexibility over time. If you have started to notice some decline in function, it’s not too late! Research shows that with an appropriate exercise program, it’s possible to gain strength and improve physical function in your 60’s, 70’s and 80’s.

So what’s a person to do? Stay active and participate in regular exercise. An exercise program should include both aerobic activities like walking, swimming or dancing and resistive exercises using resistance bands, hand weights or weight machines. The right amount of resistance for your body can be a little tricky to determine. This may require the assistance of a physical therapist to get you started on an appropriate regimen.

Remember that regular exercise is a commitment in time and energy but it pays off in the long run. Exercise can lower your risk of diabetes and heart disease. It helps maintain bone density to prevent or reduce the risk of osteoporosis. Research has even shown that people who stay active are less likely to develop memory problems or Alzheimer’s. To stay committed to your exercise program, choose things that you enjoy doing and find a friend to keep you accountable!

It’s critical as you get started with a program to make exercise a regular part of the daily routine. Keep in mind that it’s better to start slow and not overdo. Going slow prevents muscle soreness and makes it easier to be consistent. As our bodies age, they are slower to adapt to change in activity levels. This means that longer warm up and cool down periods (5-10 minutes) are important. Warm up and cool down should include stretching as tendons and ligaments tend to be stiffer and take longer to be ready for exercise. Stretches need to be held for a long, slow stretch of 60 seconds each for best results.

If your Golden years are feeling a bit tarnished, try some exercise to help shine things up for the future. If you have questions or need help getting started ask your doctor to refer you to Midwest Rehabilitation’s physical therapists to get you on the right track.

Arthritis of the Wrist

By Christopher Maender, M.D.
Board Certified Orthopedic Surgeon
Orthopedic Center of Illinois

The wrist is an amazing joint. It is made up of the radius, ulna and 8 little wrist bones. All of these bones must work together for our wrists to work normally. They are held together tightly by many ligaments. A ligament holds two bones together. There is a great deal of motion through the wrist. This motion is possible because of the complex interaction between all of these bones. This motion positions our fingers to do our daily activities like open a jar, throw a ball, play darts, swim, brush your teeth, swing a hammer, among many other activities. Unfortunately, the wrist (like all joints) can wear out. This “wearing out” is called arthritis. As the joint wears out, the motion becomes limited, it gets inflamed and many times it hurts.

What is Arthritis?
Simply defined, arthritis is inflammation of one or more joints. “Arthro-“ means joint and “-itis” means inflammation. A joint is where two or more bones join together. At the ends of these bones there is a smooth cap covering over them. This cap is made up of cartilage. The cartilage of our joints is more smooth and more friction free than any substance we can manufacture. It’s pretty amazing! It’s like a thin coating of non-stick teflon that moves against another thin coating of non-stick teflon on the other side of the joint. Our joints are used everyday and see a lot of wear and tear through the years. Falls, sprains and direct blows to the wrist can cause damage to the joint as well. Unfortunately, our body is not able to repair this cartilage after we damage it. After injuries, this protective coating gets damaged and is no longer smooth and pristine. Just like our non-stick pans, when the coating gets scratched things start to stick and it doesn’t work like it once did. This damage leads to wearing down of the cartilage and inflammation of the joint, i.e. arthritis.

Causes
Even though there are hundreds of causes of arthritis, almost all arthritis of the wrist is only caused by three types: osteoarthritis, traumatic arthritis and rheumatoid arthritis. Osteoarthritis is wear and tear arthritis where the cartilage wears down with time. Traumatic arthritis is caused by injuries in the past where the joint was damaged. Rheumatoid arthritis is an autoimmune disease where your body sees the joint lining as foreign and tries to remove the joint similar to your body’s reaction to an infection.

Symptoms
Arthritis of the wrist causes swelling, pain, limited motion and weakness. It is worsened by lifting, gripping and twisting activities.

Treatment
Initial treatment begins with non-surgical care. Modifying your activities is the first step in relieving symptoms. Braces for a short period of time can be very helpful at relieving symptoms and can delay and even eliminate the need for surgery. There are many braces available from rigid to soft with varying amounts of support. The more rigid the splint, obviously the more support it gives the joint, but a more rigid splint can be more difficult to wear and use throughout the day. Each patient will have to find how much support they require for pain relief. Anti-inflammatory medicines can also be very helpful at controlling symptoms. They will not reverse the arthritis, but it will decrease the inflammation and pain, hence their name. After these measures fail, an intra-articular cortisone injection is frequently tried and can help alleviate an acute exacerbation of pain. Cortisone is a powerful anti-inflammatory medicine.

Patients who fail these conservative measures are candidates for surgical reconstruction. The goal of surgery is to provide a pain-free, stable and functional wrist. Most options will sacrifice motion for pain relief. Nobody wants to give up motion, but in the wrist it is often necessary to obtain pain relief. This is usually well tolerated but does take time to adjust. Surgical options include: removing the arthritic bones, fusions, and joint replacements.

Surgical Treatments
Remember the wrist is a complex joint made up of the radius, ulna and 8 wrist bones that all have to work together. If there is arthritis between only a few of them, then it can be an option to remove those bones. In this procedure, three of the bones are removed which eliminates the worn out portion. As a trade off, this will limit your motion. Studies have shown typical results of 80% of strength and 50% of motion compared to the opposite side.

PRC

Another option is partial fusions. A fusion is where two or more bones are made to fuse together and become one larger bone. This eliminates the worn out portions of the wrist, but again will limit motion. In order to fuse bones together, they have to be prepared and then held together with pins, screws or plates until it heals. This means that you will need a cast and then a brace to protect the wrist until it fully heals. Studies have shown typical results, similar to the removal of bones, with 80% strength and 50% motion. In this procedure the bones need to heal together and there is a 10% chance that they do not heal together and the surgery needs to be redone.

4 corner fusion  If the arthritis is more severe and involves more of the bones, then a complete wrist fusion is necessary. This involves removing all of the motion at the wrist for pain relief. All up and down and side to side motion will be eliminated, but forearm rotation will be preserved. Grip strength is expected to be 70% of normal. It typically takes 6 months to adjust to the wrist fusion.

A final option is wrist joint replacement. This involves removing the damaged joint and replacing it with an artificial device. This has had several variations through the years and is still being perfected. You could expect 40-50% motion and good pain relief. The downside of the wrist replacement is that it can loosen and wear out with time. It is placed into the small wrist bones and does not have the support like a knee or hip replacement. The typical replacement will last for 10 years.

Total arthrodesis

The biggest limitation is with lifting or weight bearing and it is not recommended to lift more than 10-20 pounds with the arm. Too much activity or lifting will lead to loosening and breakage of the implant.

Summary
The wrist is a complex joint and the most common reason it wears out is a prior injury. When the wrist is arthritic and painful, try non-surgical treatments first: activity modification, a wrist brace, anti-inflammatories, and steroid injections. When those fail, then surgical options are very successful at alleviating the pain.