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

 

Celebrate National PA (Physician Assistant) Week October 6 – 12th!

Each year from October 6-12, we celebrate National PA Week, which recognizes the PA profession and its contributions to the nation’s health.

This week is also an opportunity to raise awareness and visibility of the profession. Before it was a weeklong event, National PA Day was first celebrated on October 6, 1987, in honor of the 20th anniversary of the first graduating class of PAs from the Duke University PA program. October 6th is also the birthday of the profession’s founder, Eugene A. Stead, Jr., MD. Now the profession is 50 years strong!

History of the PA Profession

The PA profession was created to improve and expand healthcare.

In the mid-1960s, physicians and educators recognized there was a shortage of primary care physicians.

To help remedy this, Eugene A. Stead Jr., MD, of the Duke University Medical Center, put together the first class of PAs in 1965. He selected four Navy Hospital Corpsmen who had received considerable medical training during their military service. Stead based the curriculum of the PA program on his knowledge of the fast-track training of doctors during World War II.

The first PA class graduated from the Duke University PA program on Oct. 6, 1967.

The PA concept was lauded early on and gained federal acceptance and backing as early as the 1970s as a creative solution to physician shortages. The medical community helped support the new profession and spurred the setting of accreditation standards, establishment of a national certification process and standardized examination, and development of continuing medical education requirements.

What is a PA? (American Academy of PAs)

What is a PA?

A physician assistant (or PA) is a nationally certified and state-licensed medical professional. There are currently more than 100,000 clinically practicing PA’s in the United States! PA’s practice medicine on health care teams with physicians and other providers. They also prescribe medication in all 50 states.

 

What does a PA do? Well, at the most basic level, a PA is a medical practitioner who works under the supervision of a physician.

Physician assistants (PAs) work closely with doctors and handle duties that range from taking medical histories to setting simple fractures. They are allowed to prescribe medications in some states. Many PAs specialize in a particular area of medicine, such as pediatrics. A master’s degree is required, and all states require that PAs be licensed. Licensing requires passing a multiple-choice exam and completing continuing education courses to keep knowledge current.

Beyond the basic definition, however, the PA profession represents an essential part of the health care infrastructure in a number of important ways.

Physician assistants examine, diagnose and treat patients under the supervision of licensed physician. PAs can prepare casts or splints, suture small wounds and interpret medical tests. According to the American Academy of Physician Assistants (AAPA), these medically-trained professionals can also prescribe medications (www.aapa.org).

Some PAs specialize in a particular area of medicine, such as emergency care or geriatrics, and can assist doctors in advanced medical techniques and procedures. Physician assistants are often the first line of medical care in rural and underserved areas. In some cases, a physician assistant will refer the patient to a medical doctor or make arrangements for transferring the patient to a hospital or clinic.

During this week, TOCA is excited to honor our amazing PAs and to say a big thank you. We appreciate your dedication to patient care, and we recognize the impact that you make in the lives of those patients every day.

To read more about the dedicated Physician Assistant staff at TOCA Click Here

To learn more about TOCA or to schedule an appointment call 602-277-6211

 

#Recovery #Results #Relief #TOCA #TOCAMD #PA #PAWeek #ThankAPA #Patientcare #PhysicianAssistant #PADay #MyOrthoDoc

Total Elbow Replacement: What you need to know

Total Elbow Replacement

The elbow is a necessary joint for normal functioning in daily life, yet it is susceptible to various degenerative conditions and traumatic lesions or posttraumatic sequelae.  Although a total elbow replacement is much less common than knee or hip replacement, it is just as successful in relieving joint pain and returning people to activities they enjoy.

Elbow replacement surgery is a complicated procedure partly because the elbow has several moving parts that balance each other with great precision to control the movements of your forearm.

Your elbow can be damaged by problems ranging from rheumatoid arthritis to traumatic fractures. In some cases, the damage can be surgically repaired. But if the damage is extensive, your doctor might recommend elbow replacement surgery. Pain is the most common reason people choose to have elbow replacement surgery.

Over 3,000 people in the U.S. have elbow replacement surgery annually, according to the Agency for Healthcare Research and Quality.

Whether you have just started exploring treatment options or have  decided to have an elbow replacement surgery, this article will help you understand more about this valuable procedure.

Anatomy

The elbow is a hinge joint which is made up of three bones:

  • The humerus (upper arm bone)
  • The ulna (forearm bone on the pinky finger side)
  • The radius (forearm bone on the thumb side)

The surfaces of the bones where they meet to form the elbow joint are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily. A thin, smooth tissue called synovial membrane covers all remaining surfaces inside the elbow joint. In a healthy elbow, this membrane makes a small amount of fluid that lubricates the cartilage and eliminates almost any friction as you bend and rotate your arm.

 

Muscles, ligaments, and tendons hold the elbow joint together.

 

(The main structures of the elbow when viewed from the side.)

Types of elbow replacement

In some cases, you may need a replacement of just one portion of the joint. For example, if only the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head.

If the entire joint needs to be replaced, the ends of the bones that come together in the elbow will be removed. Bones are hard tubes that contain a soft center. The long, slender ends of the artificial joint are inserted into the softer central part of the bones.

There are two main types of prosthetic devices available:

  • Linked. This type of prosthesis acts somewhat like a loose hinge because all the parts of the replacement joint are connected. This provides good joint stability, but the stresses of movement can sometimes result in the prosthesis working itself loose from where it’s inserted into the arm bones.
  • Unlinked. This type of device comes in two separate pieces that aren’t connected to each other. This design depends on the surrounding ligaments to help hold the joint together, which can make it more prone to dislocation.

Description

In total elbow replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components. The artificial elbow joint is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone called the canal.

(Total elbow replacement components.)

There are different types of elbow replacements, and components come in different sizes. There are also partial elbow replacements, which may be used in very specific situations. A discussion with your doctor will help to determine what type of elbow replacement is best for you.

 

Causes

Several conditions can cause elbow pain and disability, and lead patients and their doctors to consider elbow joint replacement surgery.

Rheumatoid Arthritis

This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness.

Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”

Osteoarthritis (Degenerative Joint Disease)

Osteoarthritis is an age-related, “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the elbow softens and wears away. The bones then rub against one another. Over time, the elbow joint becomes stiff and painful.

Rheumatoid arthritis and osteoarthritis cause cartilage damage that can result in severe pain and disability.

Post-traumatic Arthritis

This type of arthritis can follow a serious elbow injury. Fractures of the bones that make up the elbow, or tears of the surrounding tendons and ligaments may cause damage to the articular cartilage over time. This causes pain and limits elbow function.

Severe Fractures

A severe fracture of one or more bones that make up the elbow is another common reason people have elbow replacements. If the elbow is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. In this type of case, a surgeon may recommend an elbow replacement. Older patients with osteoporosis (fragile bone) are most at risk for severe elbow fractures.

In addition, some fractures do not heal well and may require an elbow replacement to address continuing problems.

Instability

Instability occurs when the ligaments that hold the elbow joint together are damaged and do not work well. The elbow is prone to dislocation. Chronic instability is most often caused by an injury.

 

Teamwork

TOCA’s treatment teams include specialists in orthopedic surgery and in physical medicine and rehabilitation. These experts work together with the goal of restoring strength and range of motion in your elbow.

 

Diagnostic and surgical innovation

TOCA’s physicians  have developed several diagnostic examinations and surgical techniques to help make elbow replacement a highly effective treatment option.

Table. Treatment Options for Elbow-Related Problems

Affected joint(s) Options Plain radiographs
Radial head Radial head replacement Figure 1
Ulna Total elbow arthroplasty Figure 2
Humeroradial Radial head replacement Figure 1
Unicompartmental replacement Figure 3
Humeroulnar Total elbow arthroplasty Figure 2
Humerus Hemiarthroplasty Figure 4
Radioulnar Radial head replacement Figure 1
Radial head resection

Preparing for Surgery

Medical Evaluation

If you decide to have elbow replacement surgery, your orthopaedic surgeon at TOCA may ask you to schedule a complete physical examination with your family physician several weeks before surgery. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process.

Many patients with chronic medical conditions, like heart disease, must also be evaluated by a specialist, such a cardiologist, before the surgery.

Medications

Be sure to talk to your orthopaedic surgeon and TOCA medical team about the medications you take. Some medications may need to be stopped before surgery. For example, the following over-the-counter medicines may cause excessive bleeding and should be stopped 2 weeks before surgery:

  • Non-steroidal anti-inflammatory medications, such as aspirin, ibuprofen, and naproxen sodium
  • Most arthritis medications

If you take blood thinners, either your primary care doctor or cardiologist will advise you about stopping these medications before surgery.

Home Planning

Making simple changes in your home before surgery can make your recovery period easier.

For the first several weeks after your surgery, it will be hard to reach high shelves and cupboards. Before your surgery, be sure to go through your home and place any items you may need afterwards on low shelves.

When you come home from the hospital, you will need help for a few weeks with some daily tasks like dressing, bathing, cooking, and laundry. If you will not have any support at home immediately after surgery, you may need a short stay in a rehabilitation facility until you become more independent.

 

Your Surgery

Before Your Operation

You will most likely be admitted to the hospital on the day of your surgery. After admission, you will be taken to the preoperative preparation area and will meet a doctor from the anesthesia department.

You, your anesthesiologist, and your surgeon will discuss the type of anesthesia to be used. In most total elbow replacement surgeries, a general anesthetic that puts you to sleep for the entire operation is used.

Surgical Procedure

To reach the elbow joint, your surgeon will make an incision (cut), usually at the back of the elbow. After making the incision, your surgeon will gently move muscles aside to get access to the bone. After removing scar tissue and spurs around the joint, your surgeon will prepare the humerus to fit the metallic piece that will replace that side of the joint. The same preparation is done for the ulna.

The replacement stems are placed into the humerus and ulna bones, and kept in place with a bone cement. The two stems are connected by a hinge pin. After the wound is closed, a padded dressing is then placed to protect the incision while it heals.

Some surgeons will place a temporary tube in the joint to drain the surgical fluid. This tube can be easily removed in your hospital room within the first few days after surgery.

 

Implants

The metal replacement parts are made of chrome-cobalt alloy or titanium and there is a liner made of polyethylene (plastic). The bone cement is made of polymethylmethacrylate (acrylic, a type of plastic).

Recovery

Your medical team will give you several doses of antibiotics to prevent infection. Most patients are able to eat solid food and get out of bed the day after surgery. You will most likely stay at the hospital 2 to 4 days after your surgery.

Pain Management

After surgery, you will feel some pain, but your surgeon and nurses will provide medication to make you feel as comfortable as possible. Talk with your surgeon if postoperative pain becomes a problem.

Rehabilitation

A careful, well-planned rehabilitation program is critical to the success of an elbow replacement. You will be taught some exercises for your hand and wrist to avoid stiffness and help to control swelling. You will do gentle elbow range-of-motion exercises as the incision heals. Your doctor may prescribe therapy or may teach you how to do the exercises yourself.

You will most likely not be allowed to put any weight on your arm or push against resistance with your hand until about 6 weeks after your surgery.

Long-Term Outcomes

The majority of patients have experienced an improved quality of life after total elbow replacement surgery. They experience less pain, improved motion and strength, and better function.

You should expect to do all basic activities of daily living, such as getting a plate out of a cabinet, cooking dinner, lifting a milk jug, styling your hair, basic hygiene, and dressing. Talk to your doctor about activities you may want to avoid, such as contact sports and activities with a major risk of falling (such as horseback riding or climbing ladders), as well as heavy lifting. These things increase the risk of the metal parts loosening or breaking, or the bone breaking.

When traveling on airplanes, be prepared for extra security screening. There is a chance that your metal implant will set off the metal detector during the security check-in.

To make the check-in go more smoothly, tell the security officer beforehand that you have an elbow replacement and carry a medical identification card. Although this does not change the screening requirements, it will help the security officer confirm the nature of the alarm. Be prepared for the security officer to use a wand scanner, and perhaps examine your arm in a private area in order to see the scar. The new body scanners can identify joint replacements, making further individual screening unnecessary.

 

If you are experiencing pain from an elbow injury or chronic condition schedule an appointment with an Orthopedic Specialist at TOCA by calling 602-277-6211!

 

#Recovery #Results #Relief #MyOrthoDoc #ElbowSurgery #ElbowPain #TOCA #TOCAMD

TOCA is proud to be a sponsor for the Arizona Sports Radio KTAR 98.7 Holiday Heroes Benefiting the 100 Club for the 4th year in a row!

TOCA is proud to be a sponsor for the Arizona Sports Radio KTAR 98.7 Holiday Heroes Benefiting the 100 Club for the 4th year in a row! Listen live today starting at 10:00 am to 6:00 pm!

Join TOCA and Arizona Sports 98.7FM for the Holiday Heroes event on Wednesday, December 7th, 2016, at ASU Karsten Golf Course (1125 E Rio Salado Pkwy, Tempe, AZ 85281) from 10am-6pm, benefiting the 100 Club of Arizona.

Holiday Heroes is an annual fundraiser and golf tournament put on by Arizona Sports 98.7FM! This event provides financial assistance to families of public safety officers and firefighters who are seriously injured or killed in the line-of-duty.

We encourage you to help by making a donation now! On December 7th, you will also be able to text in, make a donation and will be entered to win great prizes like autographed jerseys, helmets, footballs and more from the Just Sports Jersey Wall, or join us on-site and purchase raffle tickets for some fabulous prizes.

Help us help those that keep us safe on a day-to-day basis by contributing to Holiday Heroes!

#Recovery #Results #Relief #100Club #TOCA

Workplace Safety!

Workplace Safety: Everyone has a part to play in keeping the workplace safe and free from unnecessary dangers and risks. By keeping these tips in mind and sharing them with others, you will be doing your part in keeping injuries, and possibly deaths, from happening on the job.
 
Tips for Avoiding Slips and Falls –
 
Falls are the leading cause of injury in the workplace. Keep these tips in mind to avoid an injury:
 
* As you walk, keep an eye on the floor in front of you for spills.
If you see a spill, never just walk by it. Always clean it up or call someone to clean it up.
 
* Wear nonskid shoes when you work in kitchens, outdoors, or any other place where you will commonly be walking on slippery surfaces.
 
* Never climb on shelving units or storage units to get things. Use only approved ladders.
 
* Never lean on railings, even if they look solid. They could be improperly secured, and you could fall.
 
* Always use safety harnesses when working at heights.
 
Tips for Lifting Properly –
 
You may work with patients who need help getting around or at a factory where you’re lifting boxes on a continual basis. No matter who or what you may be lifting, there are some key points to consider:
 
* If you are approaching a box and don’t know what’s in it, try moving it a little with your foot first to see how easily it moves. This will help you gauge how heavy the box is.
 
* Always wear nonskid shoes when you are lifting often or lifting potentially heavy objects.
 
* Never bend at the waist and lift the box up with your back. Keep your upper body straight and parallel with your lower legs. Grab the item and push up with your legs, not with your back.
Never jerk your body around when lifting. You may feel fine after doing this once, but repeated occurrences can easily lead to injury in even the healthiest workers.
 
Fire Safety Tips –
 
Some jobs carry an increased risk of fire, but understanding fire safety is important for any occupation. Keep these tips in mind:
 
* Have a fire plan in place for your worksite, and make sure your employees understand it fully. Having a fire drill every now and then is a good way for employees to keep escape routes, meeting spots, and procedures in mind.
 
* Avoid the use of so-called “power strips” whenever possible. They are often prone to overuse and can start a fire if too many appliances are plugged into them.
 
* Keep cleaning chemicals and other work chemicals in a well-ventilated room. Many chemicals emit vapors that are highly flammable and which can be set off with something as small as a spark from a faulty wire.
 
* Know where all the fire extinguishers are throughout your work-site and know how to use them.
 
* Remember that grease fires cannot be fought by dousing them with water. Oil is hydrophobic and also is the fuel source in grease fires. Water will simply splash the oil around and spread the fire even further.
 
Planning for a Safe Workplace –
 
Falls, lifting injuries, and fires are dangerous and common in the workplace, but that’s just the beginning. There are many possible safety issues that can occur at your office or factory. Sometimes the best workplace safety arises out of simple good planning and smart thinking.
 
Every single workplace should have a safety committee and safety plan in place. If you don’t have safety committees at your workplace, then propose one. If you work at home, you are the safety committee. Working at home or for a very small business isn’t a reason to get out of safety planning.
 
If you don’t have a safety plan in place yet, follow these steps when you recognize a workplace safety issue:
 
Make sure that everyone else in your workplace is aware of the problem.
 
Notify your supervisor –
 
File any reports or documents about the problem.
Follow up. Telling someone there’s a problem is not a guarantee that the problem will be resolved satisfactorily. Report it and later follow up to make sure the problem was addressed.
 
#Recovery #Results #Relief #workplacesaftey #injury preventsion

Workers’ Compensation Injury

Workers’ Compensation Injury: Workers’ compensation is a form of employer insurance that’s meant to provide injured employees with an efficient and quick way to receive medical care for work-related injuries.

TOCA takes your comfort and time seriously. Whether your daily routine involves manual labor or you spend most of your time sitting a desk, we understand that pain is a very real issue in the working world, and we go out of our way to keep it from interfering with the job you love.

As such, TOCA would like to express our sincerest appreciation for the industrial communities that support our services. We understand that time is valuable and schedules are tight, so we’ve implemented a new system that helps you make appointments for industrial patients with the utmost ease. Our dedicated team of Industrial Support Specialists will be your primary contact for setting up industrial appointments with all of our physicians….this means you won’t have to juggle your calendar simply to book a consultation.

Just make one call to 602-512-8409, and our dedicated team of Industrial Support Specialists will help you with all the details of your care.

You can also read more at: https://tocamd.com/services/workers-compensation-injuries/