InsideOI Doc Talk:
Dr. Langhorst on non-operative spine conditions
Work Comp:
Dr. Gudeman discusses the latest in work comp
Expanding Our Care OrthoIndy now offers two walk-in clinics
Volume 5: Issue 2
2010
Also in this issue
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Q u a rt e r ly P u b l i c at i o n
Editor’s Note: Everyone in the OrthoIndy and Indiana Orthopaedic Hospital (IOH ) community is dedicated to providing the highest quality care for patients and their families. We will continue to offer our services to those who matter most in our practice: the patients. ®
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In this issue you will have the opportunity to learn more about non-operative spine conditions, work comp injuries and OrthoIndy’s Walk-in Clinics. As a member of our team, please let us know if you have any suggestions on how we can improve our relationship by contacting us at suggestions@orthoindy.com or by contacting one of our staff directly (please see staff contact information on the next page). We appreciate your feedback. Thank you for choosing OrthoIndy and IOH for all of your orthopaedic needs. Sincerely,
ON THE COVER OrthoIndy physicians provide care for the Indianapolis Roller Girls. Read about one of the Roller Girls, Sin Lizzie and her injury and treatment on page 9. Photo Credit: ©2010 NRG/Marc Lebryk
Kasey Prickel Editor Public Relations Manager
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Doc Talk
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Dr. Meredith Langhorst discusses non-operative spine conditions
Walk-in Clinic
OrthoIndy offers two walk-in clinics
Rave Review
Naptown Roller Girl receives care at OrthoIndy
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Work Comp Doc
Dr. Gudeman discusses the latest in work comp
[Inside OI Staff] Referring Physician Representatives North/East Territories Jennifer Nair jnair@orthoindy.com (317) 802-2074 South Territory Amy Klesk aklesk@orthoindy.com (317) 884-5228 West Territory Kelly Keirns kkeirns@orthoindy.com (317) 268-3197 Work Comp Representative John Orr jorr@orthoindy.com (317) 802-2131 Contributing Writers Kasey Prickel Lindsay McClure Dr. Scott Gudeman Dr. Meredith Langhorst Editor Kasey Prickel Graphic Design Kim Connett
Learn more about OrthoIndy chat with us at:
Marketing Director Jennifer Fox
(800) 223-3381 or (317) 802-2000 or visit us on:
email us at suggestions@orthoindy.com
2nd Quarter 2010
OrthoIndy
8450 Northwest Boulevard Indianapolis, IN 46278
Indiana Orthopaedic Hospital (IOH) 8400 Northwest Boulevard Indianapolis, IN 46278
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Doc Talk
this quarter’s Physician:
Meredith langhorst, MD
What is Spondylosis?
Spondylosis is osteoarthritis that affects that spine. Spondylosis is a degenerative spinal disorder, meaning that it’s part of aging. As we get older, our bodies tend to wear out—no surprise there. Years of use and overuse can cause parts of the spine, especially the joints, ligaments, and intervertebral discs, to change and not work as well. Even before one experiences the symptoms of spondylosis, pain and stiffness, the joints and other spine structures are degenerating. However, aging is an individual process. Just as some people go gray earlier, some people will feel the ef3
fects (mostly pain) of their aging spine earlier. In fact, some people may not have much pain ever. It all depends on how the parts of the spine are changing and if those changes are affecting the spinal cord or spinal nerves. Spondylosis can affect all regions of the spine, another factor determining what symptoms an individual may have. The patient can have spondylosis in your neck (cervical spine), mid-back (thoracic spine) or low back (lumbar spine). Inside OI
The patient’s symptoms depend on where the spine is affected by spondylosis. These symptoms can range from mild to severe and may become chronic or even disabling. They may include pain that comes and goes, morning stiffness or limited range of motion after getting out of bed, weakness in the muscles and radiating symptoms in the arms or legs. One should think of the causes of spondylosis as a “cause and effect” scenario. The main cause is aging, but the way aging affects the spine can lead to other changes and problems. Spondylosis is a cascade: one anatomical change occurs, which leads to more degeneration and changes in the spine’s structures. These changes combine to cause spondylosis and its symptoms. Generally, the first part of the spine to wear out are the intervertebral discs. For this reason, patients with
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time with the facet joints. They help stabilize the spine, and if the disc loses height, the way the facet joints move changes. Then the cartilage that protects the facets begins to wear away, perhaps causing irritation and inflammation of spinal nerve roots. Without the cartilage, the facet joints start to move too much: they “override” and become overly mobile. This hypermobility causes another change in your spine. It tries to stop the movement with the growth of small bony elements called bone spurs (osteophytes). Unfortunately, the bone spurs sometimes pinch nerve structures and cause pain. The bone spurs can narrow the space for the spinal cord and nerves—that disorder is called spinal stenosis. Degenerative disc disease won’t cause spinal stenosis in everyone. The patient’s genes can also cause spondylosis. You may be pre-disposed to excessive joint and disc wear and tear, so if there is a family history of spondylosis,
Spondylosis is a cascade: one anatomical change occurs, which leads to more degeneration and changes in your spine’s structures.
spondylosis often also have degenerative disc disease (DDD). The effects of these two spinal conditions are very related. The changes begin in the discs, but eventually the process of aging will affect the other motion segments of the vertebrae. (The discs and the facet joints are considered the motion segments, which means that they help one move.) Over time, the collagen (protein) structure of the annulus fibrosus (that’s the outer portion of the intervertebral disc) changes. Additionally, water-attracting molecules—and hence water—in the disc decreases. Both of these changes reduce the disc’s ability to handle back movement. Through degeneration, the disc will become less spongy and much thinner. A thinner disc means that the space between the vertebra above and below the disc gets smaller, which causes a new problem, this 2nd Quarter 2010
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the patient may also develop back or neck pain related to spondylosis. Finally, the way one lives could lead to spondylosis. Smoking, for example, adversely affects the discs and can cause them to degenerate faster. Smoking actually decreases the amount of water in your discs, and water is part of what helps the discs absorb movement. With less water content, the intervertebral discs can wear out sooner. It isn’t always easy to identify spondylosis as the cause of spinal pain. Because it can develop as the result of aging, it comes on gradually and can have many related conditions—degenerative disc disease (DDD), for example. To figure out if a patient has spondylosis, a physician will need to do some exams and tests. 4
If back or neck pain that comes on suddenly is present, or if the pain persists, call a spine specialist, who will try to find the cause of the pain so that he or she can develop an accurate treatment plan for the patient—a way to manage the pain and other symptoms of spondylosis and to help the patient recover. Physical and Neurological Exams The spine specialist will also perform physical and neurological exams. In the physical exam, the doctor will observe posture, range of motion and physical condition, noting any movement that causes pain. The doctor will feel the spine, note its curvature and alignment, and feel for muscle spasms and areas of tenderness. The doctor may also check other joints to rule out those as the source of back pain. He or she may examine the knees, hip joints and/or sacroiliac joints.
During the neurological exam, the spine specialist will test reflexes, muscle strength, other nerve changes and pain spread. This evaluation also checks out other symptoms, such as numbness, tingling or bowel and/or bladder problems. The neurological exam is especially important in spondylosis because the condition can affect the nerves or even the spinal cord. Imaging Tests The spine specialist may have some imaging tests done, such as X-rays, a CT scan, bone scan or MRI. If the doctor thinks there is nerve damage, an electromyography (EMG) may be necessary. That will measure the integrity and efficiency of the nerves—how well they’re working. Then, to make the final diagnosis, the doctor will compare what he/she found in the physical and neurological exams with the imaging test results. With that information and a diagnosis of spondylosis, the doctor can develop a treatment plan. Treatment Spondylosis can be painful, so the last thing the patient may want to do is exercise. However, medical professionals do recommend that an individual keep the spine mobile by exercising and stretching on a regular basis. It should help in the long-run, even if it doesn’t feel good now. It will help by reducing joint pain and stiffness, and it should help increase muscle strength and endurance. If the muscles around the spine are working hard at supporting the spine, then the patient should have less pain. Before beginning any exercise program, the patient should talk it over with their doctor, who will be able to refer the patient to a physical therapist. The PT can help the patient develop an appropriate exercise program. This will include range of motion exericses. These exercises will help keep the joints moving properly. Range of motion exercises can also help relieve stiffness and maintain or even increase your flexibility. It will also include strength work and cardio. Strength work will work on strengthening the muscles that support the spine and the cardio will work for aerobic conditioning. There’s also an added benefit of exercise: it can help the patient lose weight or maintain their ideal weight. Extra weight can put extra pressure on the already-painful joints, Inside OI
and exercise—along with eating right—is an effective way to control your weight. Acupuncture is a popular treatment used to help alleviate back and neck pain. Tiny needles, about the size of a human hair, are inserted into specific points on the body. Each needle may be twirled, electrically stimulated, or warmed to enhance the effect of the treatment. It is believed that acupuncture works (in part) by prompting the body to produce chemicals that help to reduce pain. Severe cases of spondylosis may require bed rest for no more than one to three days. Long-term bed rest is avoided as it puts patient at risk for deep vein thrombosis (DVT, blood clots in the legs). Temporary bracing (one week) may help relieve symptoms, but long-term use is discouraged. Braces worn long-term weaken the spinal muscles and can increase pain if not constantly worn. Physical therapy is more beneficial as it strengthens the muscles. In most cases, spinal traction is rarely needed or used to alleviate symptoms associated with spondylosis. Intermittent traction therapy may be included with the use of a brace. Periodic cervical traction incorporates the use of a halter-type device worn about the head and neck that is attached to a weight. The weight causes distraction and gently pulls to help relieve nerve compression and pain. Chiropractors believe that a healthy nervous system is synonymous with a healthy body. A subluxation, or the misalignment of a vertebra, may distress the nervous system and lead to a disorder causing back and neck pain. Chiropractors do not prescribe drugs or use surgery. Their practice includes ice/heat, ultrasound, massage, lifestyle modification and spinal adjustments -- also called spinal manipulation. Losing weight and maintaining a healthy weight, eating nutritious foods, regular exercise and not smoking are important ‘healthy habits’ to help spine function at any age. Sometimes medications such as antiinflammatories, muscle relaxers are
pain medicines are used for symptomatic relief. There are many types of spinal injections including epidural steroid injections and facet joint injections. These injections combine a local anesthetic and steroid medication to reduce inflamed nerve tissues and thereby often help to reduce pain. Radiofrequency neurotomy can provide longer periods of pain relief in certain patients. Very few patients with spondylosis require surgery. When surgery is necessary, seldom is it an emergency. Non-operative therapy is tried first. The physician may determine that combining two or more therapies may benefit the patient to quickly resolve their symptoms. In most cases, non-surgical treatments work. Conclusion Patients with chronic back pain are urged to seek the advice of a spine specialist. The all-important first step to relieve back and neck pain is to obtain a proper diagnosis. You cannot stop your body from growing older, but you can do a lot to improve the health of your spine.
Meredith Langhorst, MD
Non-Operative Spine Physician
To schedule an appointment, please call: (317) 802-2879 Specialities: Non-Operative Spine and Interventional Pain Management Location: OrthoIndy Fishers 2nd Quarter 2010
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OrthoIndy Walk-in Clinics OrthoIndy has opened two walk-in clinics at its Northwest and West facilites. The walk-in clinics provides residents with immediate access to bone, joint, spine and muscle treatment.
• Patients on gurneys or requiring transport due to inability to walk • Major joint dislocations (requiring anesthesia) • Burns
“The orthopaedic walk-in clinic at OrthoIndy provides the community with immediate access to physicians specialized in treating acute injuries of muscles, bones and joints,” said Dr. Chris Bales, an orthopaedic surgeon at OrthoIndy and the Indiana Orthopaedic Hospital (IOH). “It provides quick and efficient access to high quality specialized orthopaedic care allowing patients to avoid the longer waits seen at emergency rooms.”
The OrthoIndy Walk-in Clinic does not only benefit patients, but the community as well. “The clinic is cost effective for patients as it avoids being seen at the emergency room and then being referred to the orthopaedic doctor for definitive treatment,” said Dr. Bales. “This not only benefits the patients but the community and healthcare system in general by avoiding expensive ER visits and decreasing ER volume, which allows ER physicians to focus on more critical patients.”
The walk-in clinics, will accept the following injuries: • Acute Pain • Injury from an Accident • Muscle Sprains/Strains • Closed Fractures • Tendonitis/Bursitis • Finger/Toe Dislocations • Back Pain • Lacerations • Work Comp Injury (if employer authorized)
OrthoIndy Walk-in Clinic - Northwest Located at 8450 Northwest Blvd. Indianapolis, IN.
Residents seeking care for the following injuries should call ahead to the clinic to determine if the injury needs treatment in an emergency room: • Chronic Problems (problems lasting longer than two weeks) • Patient with previously scheduled appointment for same injury • Open Fractures
The clinic is open Monday through Friday from 8:30 am to 4:30 pm. Call (317) 802-2000. OrthoIndy Walk-in Clinic - West We are located on Dan Jones south of CR 300 N in Brownsburg, Indiana. The clinic is open Monday through Friday from 8 am to 8 pm and Saturday from 9 am to noon. Call (317) 268-3600.
©2010 NRG/Marc Lebryk
Many people may not know that Indianapolis has a roller derby team. The Naptown Roller Girls (NRG) is a league that was formed to bring flat track roller derby to Indianapolis. In 2006 the Tornado Sirens was created and is one of more than 400 flat and banked track roller derby leagues around the country. The NRG is a member of the Women’s Flat Track Derby Association (WFTDA), which is the national governing body for women’s amateur flat-track roller derby in the United States. 2nd Quarter 2010
Roller derby is considered an aggressive, full contact sport, which requires protective gear. The girls are required to wear a skate helmet, wrist, elbow and mouth guards along with knee pads to help prevent injuries. It is recommended that they wear tailbone and hip pads as well. They practice several times a week to keep their bodies trained for the grueling workout they encounter during a “bout” (60 minutes of actual playing time). Some common injuries that occur are pulled muscles, sprains, strains, bruises, and/or broken bones, so every precaution is taken. 8
Stacy Elliott aka Sin Lizzie has been an NRG since February 2007. She became intrigued with roller derby after watching a show on A&E about the Texas Rollergirls in 2002 and at that time Indianapolis did not have a team. Being part of the NRG involves not only practices and bouts but also attending public community events and fundraising. The NRG is a do-it-yourself league that is owned and run by the girls in the league. “Derby is one of the most important things in my life,” said Stacy. “The women on the team have become my family. The sport we play makes any injury seem bothersome and the only thing you want to do is heal and skate.” Stacy has a long list of injuries, including: concussions, sprained ankles, bruised ribs, torn back muscles, facial/nasal fractures and her knee, which she finally had surgery on in 2009. Stacy had both her surgeries done at the Indiana Orthopaedic Hospital (IOH), where she works as a first assistant in surgery. Dr. Sanford Kunkel performed her knee scope, “Dr. Baele referred me to Dr. Kunkel for the surgery and he was amazing,” said Stacy. While injured, Stacy still attended every practice and kept in shape by doing core and arm strengthening exercises and helping the coaches. After her surgery, her knee pain was gone and she could land without having excruciating pain. She recently underwent surgery in January 2010 for exertional compartment syndrome in her lower leg, which occured when she fell at a scrimmage practice. Exertional compartment syndrome occurs when pressure within the muscles builds to dangerous levels. The pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. Stacy didn’t want her injury to keep her from playing her sport. She wanted to be able to skate for her next bout. Dr. Joseph Baele performed her fasciotomies for her exertional compartment syndrome to release the pressure. The fasciotomy involves making an incision and cutting open the skin and fascia, which is the tough membrane that covers the tissues in the arms and legs. “Dr. Baele has been great,” said Stacy. “He hears my pains about derby almost every time I see him. He knew that I was pushing for time between the surgery and our upcoming bout and how important it was to me to be skating this season. He performed the surgery in January and then I did my part to heal.” 9
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Dr. Baele has been great. He hears my pains about derby almost every time I see him. He knew that I was pushing for time between the surgery and our upcoming bout and how important it was to me to be skating this season.
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After surgery, Stacy was able to return to the derby only eight days later. After playing in the February 6th bout, Stacy encountered a few more injuries including a brachial plexus injury and a subluxed bicep tendon when she landed on her shoulder. The brachial plexus controls muscle movements and sensation in the shoulder, arm and hand. A brachial plexus injury is caused by damage to the nerves in the brachial plexus network. Since sustaining these injuries, Stacy has decided to retire from the derby. Her brachial plexus injury has started to make her lose function in her right arm. “It’s hard to retire,” said Stacy. “Derby is who I am and what I do, so much of me revolved entirely around it. When I announced my retirement, the fans on facebook were amazing--people who do not even know my real name were so supportive over the last four seasons and were so upset and saddened about my retirement along with me. Reading the posts were heartfelt and I never realized the amount of people you touch just by doing something like this.”
include attending the bouts with Dr. Baele to provide onsite medical management. “The sport is very physical and the skaters need a lot of medical support,” says Dr. Trammell. “If one of the girls gets injured we help them obtain timely and necessary orthopaedic care. If the injury requires immediate care we assist with “packaging” the patient for transport to the hospital and have a physician to physician call to expedite care.” Most of the injuries they treat are knee related; however, they are all mainly musculoskeletal. As far as being prepared to avoid injury Dr. Baele says, “They wear pads but the pads only help to a certain degree. Hits come unexpectedly. The potential for injury is high. These ladies are in great shape. I’ve watched most all of them build muscle year after year. I can only think practice and good strength keep them from getting injured more than they do.” NRG Tornado Sirens play at the Pepsi Coliseum at the State Fairgrounds. For more information about the Naptown Roller Girls visit their website at www. naptownrollergirls.com.
©2010 NRG/Marc Lebryk
OrthoIndy physicians, Drs. Joseph Baele and Terry Trammell, are the NRG team physicians. As a team physician, Dr. Trammell says his responsibilities
2nd Quarter 2010
Dr. Trammell, Sin Lizzie and Dr. Baele at a bout. 6
Avoiding Work Related Disability
An Orthopaedic Surgeon’s Perspective
As a fellowship trained, sports medicine orthopaedist, who specializes in shoulder and knee problems, I am intrigued with the similarities between the two groups of patients I primarily treat: the injured athlete and worker. Both groups may have high expectations of themselves and their post-op results. The injured athlete and worker also may have elevated demands placed on them by their coaches or supervisors. The physician’s approach to treating the injured worker also has a sports theme. If a team approach attitude is used and the members of that team know and understand their roles, a very satisfying result for the patient can occur. An orthopaedic surgeon who recognizes that he or she is just one member of this treatment team and allows other “teammates” to actively participate, usually proves to be successful in getting the injured worker
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back to work. These teammates include, but are not limited to the following: • Case managers • Physician extenders, such as certified Physician Assistants or Nurse Practitioners • Physical/Occupational Therapist and certified Athletic Trainers • Insurance adjustors • Employers • Occupational Health Physicians • Workers’ Comp department personnel within an orthopaedic surgeon’s practice • Physiatrists • Psychologists or Psychiatrists The aforementioned team approach message was the focus of an article I wrote for this same journal two years ago. This current article serves as a follow up
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An orthopaedic surgeon who recognizes that he or she is just one member of this treatment team and allows other “teammates” to actively participate, usually proves to be successful in getting the injured worker back to work.
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Inside OI
and update to the role of the orthopaedic surgeon who treats work-related injuries. The specific steps for the physician seeking to help patients avoid work-related disability include: 1. Do not commit to a diagnosis that the injury is work-related without reasonable certainty. 2. Do evaluate the physical and emotional components of each patient individually. 3. Do inform the patient of the diagnosis with care. 4. Do put reasonable limits on rest and physical therapy. 5. Do avoid and limit addictive medications. 6. Do treat physical problems with reasonable and structured activities, giving plenty of reassurance and encouragement. 7. Do encourage early return to safe work when reasonable. 8. Do take a positive role in getting the patient back to work and to use rehabilitation specialists and/or case managers. Physicians should discourage patients from prolonging disability beyond medical necessity, as this has been shown to have a negative impact on the patient’s total health. 9. Do intercept the patient on the way to permanent compensation. 10. Do remember that emotional illness cannot be cured by surgery and often can be made worse. 11. Do support legislative changes to reward the injured worker for getting well and back on the job, rather than the current system, which encourages disability. 12. Do continue to be the patient’s advocate. As patient advocates and in the best interest of society, physicians should encourage rehabilitation, not disability.
Scott D. Gudeman, MD
Specialities: Shoulder, Knee and Sports Medicine Location: OrthoIndy South To schedule an appointment, please call: (317) 884-5161
Physicians who provide care to those with work related injuries are often not prepared to deal with the biosocial issues - including motivation, social factors, psychological overlays, economic incentives and legal complications - that influence the outcomes of treatment. According to Dr. Mark Melhorn, an authority on occupational orthopaedic medicine, if physicians elect to treat patients seeking Workers’ Compensation, they need to do it right and be prepared to deal with critical issues. Physicians should address all of the critical issues: age, gender, genetics, workplace and nonworkplace environment, biosocial issues, work status, impairment, disability and handicaps. Learning this art of medicine will improve the physician’s skills for all patients and make him or her a better all-round physician. References: 1. Melhorn, J. Mark: Workers’ Compensation: Avoiding WorkRelated Disability. J. Bone Joint Surg Am. 2000;82: 1490. 2. Millender, LH, Conlon, M.: An Approach to Work-Related Disorders of the Upper Extremity. Journal of the American Academy of Orthopaedic Surgeons 1996: 4(3): 134-142
Orthopaedic Research Foundation OI Seeks Patients for Research Studies
The Orthopaedic Research Foundation, Inc. (ORF) supports various research and educational interests of the physicians at OrthoIndy. Founded in 1986, its mission is “to advance the scientific body of knowledge associated with musculoskeletal disorders, for the scientific and public communities, through research and education.”
Study Title
Participating Physicians
Brief Description Criteria
Enrollment Contact Deadline or Person Enrollment Goal
Contact
A Multicenter, Randomized, Pivotal Study to Evaluate the Safety and Efficacy of the Cartilage Autograft Implantation System (CAIS) for the Surgical Treatment of Articular Cartilage Lesion of the Knee
Dr. J. Farr
Articular Cartilage Defects of the Knee Visit www.clinicaltrials.gov for inclusion and exclusion criteria.
Open
Vicki Snodgrass CCRC
vsnodgrass@ orthoindy. com
Evaluation of the Composit of Cancellous and Demineralized Bone Plug(CR PLUG) for Repair of Focal Cartilage Lesions of the Femoral Condyle
Dr. J. Farr
Articular Cartilage Defects of the Knee Visit www.clinicaltrials.gov for inclusion and exclusion criteria.
After 10 patients enrolled
Vicki Snodgrass CCRC
vsnodgrass@ orthoindy. com
A Post Market Study of the ABS OrthoGlide Arthroplasty Device for OsteoArthritis of the Knee
Dr. J. Farr
Osteoarthritis of the knee
Vicki Snodgrass CCRC
vsnodgrass@ orthoindy. com
A Post Market Study of Articular Cartilage Defects of the Knee Treated with Denovo NT, Natural Tissue Graft
Dr. J. Farr
Articular Cartilage Defects of the Knee Visit www.clinicaltrials.gov for inclusion and exclusion criteria.
After 10 patients enrolled
Vicki Snodgrass CCRC
vsnodgrass@ orthoindy. com
Rgeneration Technologies, Inc. Registry of Biocleanse Meniscus Transplants
Dr. J. Farr
Meniscal Transplantation Candidates Visit www.clincialtrials.gov for inclusion and exclusion criteria
After 10 patients enrolled
Vicki Snodgrass CCRC
vsnodgrass@ orthoindy. com
Vicki Snodgrass CCRC or Nenette Jessup
vsnodgrass@ orthoindy. com or Njessup@ orthoindy. com
Collection of Specimens from Joint Replace- Drs. J. Farr, ment Surgery for In-Vitro Osteoarthritis Kolisek, and Research Monesmith
Total Knee Replacement Candidates
Trial to Evaluate Ultrasound in the Treatment of Tibial Fractures (TRUST)
Dr. Maar
Study of low-intensity pulsed ultrasound treatment vs. placebo treatment in IM nailed tibial fracture healing.
After 15 patients enrolled
Dana Musapatika
(317) 9174117
Reamed Irrigation Aspirator (RIA) for Bone Graft Harvest for Segmental Defect
Dr. Weber
A study focused on the use of reamed irrigation of the tibia or femur as a technique for bone graft harvesting.
After 15 patients enrolled
Dana Musapatika
(317) 9174117
Musculoskeletal Injuries Associated with Moped and Motorized Scooter Accidents
Dr. Jelen
A study of the factors involved in moped and motorized scooter accidents and the treatment methods utilized.
After 15 patients enrolled
Dana Musapatika
(317) 9174117
Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH)
Dr. Baele
A trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures.
After 15 patients enrolled
Dana Musapatika
(317) 9174117
Post-operative Knee Rehabilitation: Comparing the Conventional Approach to the Use of a Music Rehab Video
Drs. Fisher, Hellman, Kunkel, Randolph,
This is a randomized controlled blind study to determine whether patients who use a music exercise video for their physical therapy after knee replacement surgery have outcomes and satisfaction scores equivalent to patients who undergo a conventional physical therapy protocol.
April, 2010
Deborah Robinson, PA-C
drobinson@ orthoindy. com
5 – Year Prospective,Post-Market Pilot Study of Biolox Delta 36 mm and Larger Femoral Heads with Trident X3 Polyethylene Inserts
Dr. Kolisek
A single center study evaluating patients with Biolox delta femoral head with an X3 polyethylene insert hip implants for wear rate, clinical results, radiographic stability and quality of life.
18-month period
Nenette Jessup
(317) 8845232 njessup@ orthoindy. com
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Inside OI
Study Title
Participating Physicians
Brief Description Criteria
10 - Year Retrospective/Prospective Radiographic Analysis of Secur-Fit Hip Stem
Dr. Kolisek
A single center study comparing radiographic remodeling of the Secur-Fit stem to the Omnifit HA stem through 10 years and evaluating the group for quality of life and clinical results.
Osteocel® Plus in Anterior Lumbar Fusion (ALIF): Evaluation fo Radiographic and Patient Outcomes
Drs. Schwartz, Riina, Trammell, Dietz, Huler
One or two level lumbar fusion using Osteocel® Plus as a bone graft substitute.
A Prospective, Randomized, Controlled Pivotal Clinical Investigation of DIAM™ Spinal Stabilization System in Patients with Lumbar Degenerative Disc Disease
Drs. Riina, Schwartz, Trammell, Dietz
A comparison of INSORB™ staples and traditional wound closure in posterior spinal surgery.
Enrollment Contact Deadline or Person Enrollment Goal
Contact
Nenette Jessup
(317) 8845232 njessup@ orthoindy. com
July 2010
Kim Fitzpatrick
spineresearch@ orthoindy. com
Mild to moderate degenerative disc disease from L1-L5. Randomized study into either DIAM (surgical) or conservative care group.
September 2009
Kim Fitzpatrick
spineresearch@ orthoindy. com
Dr. Trammell
Randomized study comparing use of staples versus sutures on surgical incision.
July 2010
Kathy Flint
spineresearch@ orthoindy. com
Linkage analysis and gene mapping of familial spinal disorders (scoliosis, Scheuermann’s kyphosis, spondylolisthesis, lumbar disc disease, osteoporosis).
Drs. Schwartz, Riina, Trammell, Dietz, Huler, Coscia
DNA (saliva) testing of patients with scoliosis.
N/A
Kathy Flint
spineresearch@ orthoindy. com
Epidemiology, Process, and Outcomes of Spine Trauma
Drs. Schwartz, Riina, Dietz, Coscia, Huler, Trammell
Any spinal cord trauma patients
N/A
Kathy Flint
spineresearch@ orthoindy. com
Surgical Treatment for Acute Spinal Cord Injury Study
Drs. Schwartz, Riina, Dietz, Coscia, Huler, Trammell
Any spinal cord trauma patients
N/A
Kathy Flint
spineresearch@ orthoindy. com
Management of Type II Odontoid Fractures
Drs. Schwartz, Riina, Dietz, Coscia, Huler, Trammell
Cervical spine trauma patients
N/A
Kathy Flint
spineresearch@ orthoindy. com
Incidence of Dysphagia after Anterior Cervical Fusion Procedure with Various Types of Anterior Cervical Plates: A Short and Long Term Follow-up Study
Drs. Joesph Riina, Michael Coscia, John Dietz, Robert Huler, Gabriel Jackson, David Schwartz, Terry Trammell
Patients (>18 years of age) who undergo anterior cervical surgery with plating
N/A
Kathy Flint
spineresearch@ orthoindy. com
Magnetic Resonance Imaging and the Posterior Ligamentous Complex
Drs. Riina, Dr. Schwartz, Dietz, Huler
Spine trauma patients
N/A
Kathy Flint
spineresearch@ orthoindy. com
A Comparison of INSORB Staples and Dr. Fisher Metal Staples in Bilateral Knee Replacement
Patients 18 years of age or older who present wiith the need for a bilateral knee replacement will be considered for participation. Those patients who fulfill the inclusion criteria and do not meet any of the exclusion criteria will be evaluated. Patients being able to provide a written personal signature on the consent/authorization form for enrollment in the study.
Open
Mary Burgess
(317) 8022853
A prospective, comparative, ramdomized, double blind, multi-center study of the Uniglide Mobile Bearing Unicondylor Kne System vs. Uniglide Fixed Bearing Unicondylar Knee System
Patients 40-75 years of age who have osteoarthritis with the need for a Unicondylar knee replacement. Those patients who fulfill the inclusion criteria and do not meet any of the exclusion criteria will be evaluated. Patients being able to provide a written personal signature on the consent/authorization form for enrollment in the study.
Open
Mary Burgess
(317) 8022853
2nd Quarter 2010
Dr Fisher
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8450 Northwest Blvd. Indianapolis, IN 46278