Dr. Lederman’s Findings Featured in “Orthopedics Today”

TOCA’s Dr. Evan Lederman, MD, regularly educates, lectures, and participates in groundbreaking research to further the field of orthopedics. His expertise in arthroscopic surgery of the shoulder and knee has earned him the honor of being one of only two Arizona surgeons to be accepted into the American Shoulder and Elbow Surgeons (ASES) as an associate member.

Orthopedics Today recently highlighted the results of one of Dr. Lederman’s studies comparing functional outcome scores and revision rates between different surgical techniques in total shoulder arthroplasty. Dr. Lederman presented the results of the study at the American Shoulder and Elbow Surgeons Annual Meeting, which was held in Chicago this past fall.

Read more about Dr. Lederman’s impressive study HERE.

Stress Fracture Symptoms and Treatment Tips from TOCA’s Orthopedic Experts

“You have a stress fracture” is a diagnosis shared all too often by orthopedic specialists, especially when treating athletes. Athletes are most at risk due to repetitive activity and overuse of their feet and legs. Overuse causes the lower extremities to continually absorb these forces and potentially causing tiny cracks in the bones.

If athletic activity is too frequent, it diminishes the body’s ability to repair and replace bone. And the likelihood of sustaining a stress fracture increases. That’s why runners, dancers, soccer players, and basketball players are particularly vulnerable to stress fractures.

And, according to The Orthopedic Clinic Association (TOCA) orthopedic and sports medicine care expert, Dr. Gerald Yacobucci, MD, “If they are already experiencing consistent pain, the more these athletes train and compete, the more they may be placing themselves at greater risk for injury – and time away – from the sport or activity they enjoy.”

Here’s what Dr. Yacobucci and the TOCA team want ALL athletes, parents, and coaches to know in order to recognize stress fracture symptoms, help prevent stress fractures from occurring, and remain injury-free.

Stress Fracture Symptoms

What are some of the signs of stress fracture to watch out for? Rather than the sharp pain resulting from an acute fracture, stress fractures are typically accompanied by a dull pain that increases gradually. Often, the pain subsides during rest and intensifies during activity. Swelling around the site may be present as well as some tenderness and bruising. As mentioned above, stress fractures can be caused by overuse of lower extremities, common in athletes, but they can also arise from a sudden upsurge in physical activity. Osteoporosis can also increase the chance of a stress fracture.

It’s important to remember that, if dull pain persists, it’s time to seek help from an orthopedic specialist!

Treatment of Stress Fractures

Immediately after injury or stress fracture symptoms occur, patients are encouraged to follow the RICE (Rest, Ice, Compression, Elevation) method. Once you consult with you orthopedic specialist, he/she will examine the “pain point” and X-rays will likely be taken. If the stress fracture is not visible via X-ray, but your doctor still suspects that you have a stress fracture, he/she may recommend that you get an MRI.

Nonsurgical treatment options for stress fractures include keeping weight off of the area (perhaps wearing a boot or using crutches), and modified activity for a period of up to 8 weeks. In some, more severe, cases, surgery may be necessary to allow the stress fracture to heal properly. This typically entails using a pin, screw, or plate to “fasten” the bones together in order to promote healing. The key to recovery is to allow ample time for rest, healing, and rehabilitation. Taking time off ensures that you can eventually get back to the activities you enjoy safely and without placing yourself at risk for additional injury.

Stress Fracture Prevention

According to Dr. Yacobucci, “One of the most important pieces of advice I share with patients, especially athletes, is to monitor and be mindful of your activity and pain level. If you find that you’re consistently experiencing pain during training or workouts, then it’s time to listen to your body’s signals. Refrain from activity until you seek further treatment from an orthopedic expert.”

Additional stress fracture prevention tips from Dr. Yacobucci and TOCA experts include:

  • Wearing footwear with good support.
  • Strength training and cross-training to avoid overuse of certain muscle sets and strain on bones.
  • Good nutrition, including plenty of calcium and Vitamin D for optimal bone strength.
  • And good common sense. Listen to your body’s signals and seek help if pain persists after adequate rest.

To schedule a consult with Dr. Yacobucci, or one of TOCA’s knowledgeable and highly trained orthopedics specialists, please contact us at 602.277.6211.

Dr. Blazuk and colleagues study the Validity of Indirect Ultrasound Findings…

Title: Validy of Indirect Ultrasound Findings in Acute Anterior Cruciate Ligament Ruptures

Ken Mautner, MD, Walter I. Sussman, DO, Katie Nanos, MD, Joseph Blazuk, MD, Carmen Brigham, ATC, Emily Sarros, ATC

Objectives: Ultrasound (US) is increasingly being used as an extension of the physical examination on the sidelines, in training rooms, and in clinics. Anterior cruciate ligament (ACL) injury in sport is common, but the literature on US findings after acute ACL rupture is limited. Three indirect US findings of ACL rupture have been described, and this study assessed the validity of these indirect signs.

American Institute of Ultrasound in Medicine /  J Ultrasound Med 2018; 9999:1-8 / 0278-4297

Click here for full article!

 

Dr. Lederman and colleagues present a study comparing new techniques for rotator cuff repair!

Title: Triple-Loaded Suture Anchors Versus a Knotless Rip Stop Construct in a Single-Row Rotator Cuff Repair Model

Matthew Noyes, MD, Christopher Adams MD, Evan S. Lederman MD, Patrick Denard MD

Purpose

To compare the biomechanical properties of single-row repair with triple-loaded (TL) anchor repair versus a knotless rip stop (KRS) repair in a rotator cuff repair model.

Full article link below.

The Journal of Arthroscopy and Related Research: 2018 Feb 15. pii: S0749-8063(18)30029-X. doi: 10.1016/j.arthro.2017.12.024. [Epub ahead of print]

https://www.arthroscopyjournal.org/article/S0749-8063(18)30029-X/fulltext

Dr. Evan Lederman and colleagues review how bone reacts to shoulder replacements and propose a classification system for critical review of implant/bone interaction

Title: Stress shielding of the humerus in press-fit anatomic shoulder arthroplasty: review and recommendations for evaluation

Patrick Denard MD, Patric Raiss MD, Reuben Gobezie MD, T. Bradley Edwards MD, Evan S. Lederman MD

Introduction

Uncemented press-fit humeral stems were developed with the goal of decreasing operative time, preserving bone stock, and easing revision. In recent years, short stems and stemless humeral implants have also become available. These press-fit humeral implants have varying designs that can lead to changes in stress distribution in the proximal humerus. Such stress shielding manifests as bony adaptations and may affect long-term functional outcome and the ability to perform revision. However, current studies of humeral fixation during total shoulder arthroplasty are complicated because a variety of classification systems have been used to report findings.

Full article link below.

Journal of Shoulder and Elbow Surgery E-pub February 6, 2018

https://doi.org/10.1016/j.jse.2017.12.020

Dr. Lederman and colleagues discuss the outcome and safety of a short stem shoulder replacement

Title: Short-term clinical outcome of an anatomic short-stem humeral component in total shoulder arthroplasty

Anthony A. Romeo MD, Robert J Thorness MD, Shelby A Sumner MPH, Reuben Gobezie MD, Evan S Lederman MD, Patrick J Denard MD

Background

Short-stem press-fit humeral components have recently been developed in an effort to preserve bone in total shoulder arthroplasty (TSA), but few studies have reported outcomes of these devices. The purpose of this study was to evaluate the short-term clinical outcomes of an anatomic short-stem humeral component in TSA. We hypothesized that the implant would lead to significant functional improvement with low rates of radiographic loosening.

Full Article: https://doi.org/10.1016/j.jse.2017.05.026

The Journal of Shoulder and Elbow Surgery

Volume 27, Issue 1, January 2018, Pages 70-74

Dr. Lederman and Dr. Harmsen compare different techniques for shoulder replacement*

Title: Glenohumeral osteoarthritis in young patients: Stemless total shoulder arthroplasty trumps resurfacing arthroplasty—Opposes

Samuel Harmsen MD and Evan S Lederman MD

Abstract

When considering shoulder arthroplasty in a younger patient the surgeon can choose between stemmed, stemless or resurfacing implants for humeral reconstruction. Resurfacing arthroplasty can reproduce humeral anatomy independent of the humeral shaft, minimize bone resection and offer potential easier revision surgery. The resurfacing implant has been in use for over 30 years and has favorable long-term outcome.

Seminars in Arthroplasty

Volume 28, Issue 3, September 2017, Pages 121-123
*This is based on a lecture/Debate by Dr. Lederman with Dr. Sumant Krishnan at the 2017 Current Concepts in Shoulder Arthroplasty Conference in Las Vegas, NV.

Dr. Justin Roberts joining TOCA September 3, 2018

Dr. Roberts, MD is excited to be joining the outstanding physicians at The Orthopedic Clinic Association.

Dr. Justin Roberts is an orthopaedic surgeon who is fellowship trained in surgery of the foot and ankle. He specializes in comprehensive care of both simple and complex foot and ankle conditions including sports injuries, fractures, arthritis, and deformity. He has special interests in ankle replacement, flat foot correction, bunion correction, arthroscopy, traumatic and post-traumatic reconstruction.

Dr. Roberts was born and raised in Bakersfield, California. He received his undergraduate degree at the University of California, Santa Barbara, then attended medical school at the University of California, San Diego. Dr. Roberts came to Phoenix for orthopaedic residency at Banner University Medical Center, then completed fellowship training at the Orthopaedics Associates of Michigan in Grand Rapids, MI. During fellowship, he received comprehensive training in complex surgical reconstruction of the foot and ankle.

Dr. Roberts promotes a relaxed atmosphere where open and honest communication is encouraged. Patient education is a critical part of his practice, and he will take the time to explain your condition and all treatment options. He emphasizes exhausting non-operative measures prior to recommending surgical intervention. Dr. Roberts understands that foot and ankle problems can be very disabling and recovery can be extensive. He is dedicated to working with you through every step to get you back to the quality of life you desire.

When not working, Dr. Roberts enjoys rugby, fishing, golf and spending time with his family.

 

Dr. Padley has a long tradition of providing care for sports teams.

Dr. Padley returned to the Dominican Republic in April with the Cincinnati Reds for the annual opening of their Dominican complex. The trip included evaluations of 40+ Dominican athletes hoping to advance their way up the Cincinnati Reds baseball system. This marks the beginning of the baseball season for the Dominican teams. Most major league baseball teams have affiliates in the Dominican in search of that next great player! Dr. Padley is an orthopedic consultant and provider to the Cincinnati Reds for major league baseball spring training and throughout the year for their minor league and rookie league teams. In additional to this health care relationship, he is also a consultant to Japanese professional baseball for the Saitama Seibu Lions. With his expertise in hip disorders and injuries, Ballet Arizona benefits from his service as a consultant. He was a team physician for the WNBA’s Phoenix Mercury for four years including the 2014 championship season. Dr. Padley proudly serves as the team physician for Benedictine University in Mesa as well as Millennium and Verrado High Schools in Goodyear.

For more information on Dr. Padley, Click HERE

 

Congratulations to Dr. Evan Lederman, Top Doc!

[vc_row][vc_column][vc_column_text]Congratulations to TOCA Physician and Orthopedic Surgeon Dr. Evan Lederman, who was named as a Top Orthopedic Surgeon 2017 in the Phoenix Magazine Top Doc’s 2018 publication.

The TOCA Physicians and Orthopedic Surgeons have been ranked in Phoenix Magazine’s Top Docs consecutively since 2004!

Dr. Lederman is board certified in orthopedic surgery and subspecialty board certified in orthopedic sports medicine. Dr. Lederman has been practicing in Phoenix, Arizona since 1996. He has years of experience with specialty training in sports medicine, minimally invasive arthroscopic surgery of the shoulder and knee and complex reconstructive surgery. His practice encourages non-operative care when possible and considers surgery only when necessary. Dr. Lederman specializes in all disorders of the shoulder including advanced techniques for rotator cuff repair, shoulder instability repair, acromioclavicular joint repair and primary and revision shoulder replacement including reversed shoulder replacement and also specializes in knee arthroscopy and ACL reconstruction.

Dr. Lederman’s work has earned him acceptance as an associate member of the American Shoulder and Elbow Surgeons (ASES) and is only the second surgeon in Arizona to receive this prestigious honor. He has been awarded the distinction of Phoenix Magazine’s Top Doc and Phoenix SuperDoctors. He has been named one of the “20 of the Top North American Shoulder Surgeons: 2015″ by Orthopedics This Week.

To schedule an appointment with one of TOCA’s physicians call 602-277-6211 today!

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