CORE Ink - Fall 2016

INK

FALL 2016

A P U B L I C A T I O N O F T H E C O R E I N S T I T U T E

®

HIT THE TRAILS

Thanks to The CORE Institute, Hip Replacement Patient is Back Hiking and Pain Free

Tackling Head Trauma The CORE Institute Doctors Share Philosophy for Better Outcomes

You cannot diagnose what you cannot see!

2D Mammogram

3D Mammogram

Up to 1 in 3 cancers are not visible on 2D Mammography!

3D mammography finds significantly more cancers!

3D mammography finds more of the invasive, harmful breast cancers, and saves many women the unnecessary anxiety and costs of a return for additional imaging for what turns out to be a false alarm.

29% increase in the detection

of all breast cancers*

44% increase in invasive

cancer detected with 3D mammography†

16% decrease in recall rate from screening mammography†

Call today 602-730-3315 to schedule your mammogram † AJR 2014 Jun 13 [Epub ahead of print] *JAMA. 2014;311(24):2499-2507. doi:10.1001/jama.2014.6095.

Connect with us

@simonmedimaging

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Setting a New Standard SECURE®-C Cervical Artificial Disc SECURE®-C patients treated in the IDE clinical trial exhibited a mean range of motion of 9.3° in flexion-extension and sagittal translation of 1.2mm at 24 months.*

SECURE®-C Cervical Artificial Disc is a motion sparing technology echnology designed as an alternative to fusion to achieve motion similar imilar to the natural cervical spine. Overall success results for IDE clinical study patients at 24 months demonstrated that patients treated with SECURE®-C are statistically superior to ACDF patients. ts.

MOTION PRESERVATION Selectively constrained for rotation and sagittal plane translation.

OPTIMAL FIT Available in multiple sagittal profiles, footprints and heights.

STREAMLINED TECHNIQUE Device placement in three basic steps: Trial-Chisel-Insert.

To learn more about SECURE®-C Cervical Artificial Disc or other Globus Medical products, contact your healthcare professional or visit www.globusmedical.com. *PMA P100003 SECURE®-C Summary of Safety and Effectiveness Data Life moves us is a registered trademark of Globus Medical, Inc.

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WELCOME VOLUME 7, ISSUE 2 – FALL 2016

FROM THE CHAIRMAN

Focusing on healthy bones...and a healthier you Did you know there are over 2.1 million bone fractures in the U.S. annually as a result of osteoporosis? If bone healthcare is not provided after age 50, one in two women and over one in five men will experience fragility fractures. Nearly 80% of people in the U.S. are not identified for osteoporosis screening or treated appropriately following a fragility fracture. The CORE Institute in Arizona intends to narrow that gap in care with the launch of our new Bone Health program.

Our new program includes specialized physicians, nurse practitioners, licensed physician assistants, physical therapists, and researchers working together to offer the resources needed for comprehensive care. The program engages the Physical Therapy Department for exercise, strengthening, and home/environmental safety to increase strength and balance to prevent future falls and fractures. You can learn more about our new program on our website.

In this edition of CORE Ink, we discuss what it means to “keep life in motion” from our physicians’ perspectives. We also share a patient story about his experience with bilateral hip replacements, new technologies available in joint replacement, and what active research studies are underway to support brain health in athletes. In addition, you will learn about seven super foods for building healthy bones. We welcome new providers in both the Arizona and Michigan markets. Each of these doctors comes to us as masters of different orthopedic specialties, and we are honored to have them joining our incredible team.

The unique comprehensive programs we offer at The CORE Institute are are evidence-based solutions for problems, both common and complex. It is you…our treasured patients…that continues to drive to be better. We will never stop improving and we will continue to deliver best-in-class patient care for you, your family, and our community.

Keep Life in Motion!®

David J. Jacofsky, MD Chairman & CEO

A P U B L I C A T I O N O F T H E C O R E I N S T I T U T E

CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING FOR THE CORE INSTITUTE

General Manager: Cami Kaiser/ cami.kaiser@pni.com Creative Development Director: Isaac Moya/ imoya@republicmedia.com

®

Editor: Jim Williams/JLWilliams@republicmedia.com Project Manager: Nick Kostenko/nkostenko@republicmedia.com Design: Rachel Tullio Advertising Coordinator: Dominick Galluzzo/dgalluzzo@republicmedia.com

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Contents

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FEATURES Keeping Life in Motion®!

COVER STORY: The CORE Institute Doctors Share Philosophy for Better Outcomes. See page 14.

PATI E NT C A RE

Tackling Head Trauma

Hit the Trails

Thanks to The CORE Institute, Hip Replacement Patient is Back Hiking and Pain Free. See page 16.

Gaining insights into youth football players and head impact.

See page 10.

D E PART ME N TS

20 connect with us 1.866.974.2673

What’s New?

Nutrition

9 The CORE Institute is pleased to introduce new physicians to the CORE team.

21 Eating right can help build a foundation for overall health.

Trends

22 Employees at The CORE Institute are “Keeping Life in Motion.”

20 Youth sports injuries rise as more children participate in competitive sports.

CORE Candid

www.thecoreinstitute.com

7

A Trusted Name in Musculoskeletal & Sports Medicine Imaging for over 50 years.

Our Neuroradiologists Patrick Fredenberg, MD

Brian Frohna, MD

Aaron Greeley, DO

Sri Preethi Gunnala, MD

Stanley Wehn, MD

Our Musculoskeletal Radiologists Mohammad Khan, MD

Andrew Kwak, MD

John Lin, MD

Schedule your appointment online at valleyradiologists.com or contact Central Scheduling at 623.847.2000

Jimmy Saade, MD

WHAT’S NEW NEW PROVIDERS

The CORE Institute is pleased to announce these additions to our provider team.

ARIZONA MARK ALLEN, DO Dr. Allen is a fellowship-trained orthopedic surgeon, specializing in primary and revision joint replacement of the hip and knee.

RUSSELL MELDRUM, MD Dr. Meldrum is a board certified and fellowship-trained orthopedic surgeon, specializing in adult reconstruction with special interest in hip and knee replacement surgery and arthritis.

JASON A. LOWE, MD Dr. Lowe is a board certified and fellowship-trained orthopedic surgeon, specializing in orthopedic trauma care.

MICHIGAN ERIK BELTRAN, MD Dr. Beltran is a Sports Neurologist, specializing in sports concussion management and treatment, as well as management of common neurological disorders in athletes for The Sports Neurology Clinic at The CORE Institute®.

MATTHEW MCCARTHY, MD Dr. McCarthy is a Sports Neurologist, specializing in sports concussion management and treatment, as well as management of common neurological disorders in athletes for The Sports Neurology Clinic at The CORE Institute®.

ANTHONY SAVINO, MD Dr. Savino is a Sports Neurologist, specializing in sports concussion management and treatment, as well as management of common neurological disorders in athletes for The Sports Neurology Clinic at The CORE Institute®.

DISCOVER INSPIRED SOLUTIONS TO GET YOUR PATIENTS BACK TO MOVING FORWARD. DePuy Synthes Spine is continuously improving clinical and economic value across all spinal pathologies through a procedural solutions approach.

We define solutions differently – solutions are not confined to the surgical suite at the time of surgery, but encompass a comprehensive product portfolio, world class education, evidence generation and support of research initiatives that are driven by a greater understanding of spinal care. .

www.depuysynthes.com ©DePuy Synthes Spine, a division of DOI 2014. All rights reserved.

DSUS/SPN/0314/0063a

FEATURE

TACKLING HEAD TRAUMA Gaining Insights into Youth Football Players and Head Impacts B Y D AV I D M . B R O W N

This fall, youth football players are providing insights about head impacts.

The young players in Brighton, Michigan, are playing to win but also to learn more about the potential lifetime results of head trauma through the use of helmets equipped with the Riddell InSite Impact Response System.

RESEARCHING THE BRAIN For the multi-year study, Longitudinal Brain Health in Youth Tackle Football, The Sports Neurology Clinic at The CORE Institute® Brighton, Michigan, is partnering with the MORE Foundation and the athletics department of Brighton High School in the city just outside Detroit.

The Clinic, a division The CORE Institute, Novi, Michigan, is focused on research.

The study is supported by ElMindA (Herzliya, Israel) and Riddell (Rosemont, Illinois).

“This study is being done to determine the effect of repetitive head impacts on brain function,” said Dr. Sean Rose,

10

Director of Clinical Research at The Sports Neurology Clinic, who specializes in sports-concussion evaluation and treatment and the management of neurological disorders in athletes.

The participating football players, 9−19, are members of the Brighton Bulldogs Football and Cheer JV League and the high school’s varsity team, led by Head Coach Brian Lemons.

HARD KNOCKS The players are wearing a football helmet fitted with an InSite sensor array that communicates wirelessly with a sideline alert monitor. The helmets and head impact monitoring system have been donated by Riddell.

InSite is a helmet-based impactmonitoring technology, designed to alert coaches and staff on the sideline of on-field head impacts sustained during a football game or practice, explained Thad Ide, Senior Vice President of Research and Product Development for Riddell.

“InSite equipped helmets feature a fivezone sensor pad in the liner of the Riddell helmet that measures impact severity, emitting an alert to the sideline staff when an impact or sequence of impacts exceeds a research based head impact threshold,” he said.

RESEARCH TOOL Riddell InSite has been used by youth, high school and college teams since the fall of 2013. This year, the technology is being used in 600-plus programs, with close to 17,000 players participating.

Approximately 50 college teams are using it, including Division I University of Texas, Iowa and Wyoming.

www.thecoreinstitute.com

Network Activation (BNA™) provided by ElMindA, measures the networks formed in the brain during different tasks.

SUDDEN IMPACT When an impact occurs, the InSite player unit quantifies the impact and evaluates whether the hit is above a threshold. If an impact or sequence of impacts exceeds this threshold, the player unit sends an alert to the alert monitor, a handheld device on the sideline. This notifies the team staff of the impact by player name and number, Ide explained.

“I am alerted of an atypical hit, which

“Players have an option to participate in the research study and wear the sensors during practice and games,” Dr. Rose explained, noting that most of the players are participating. Twice a year players will visit The Sports Neurology Clinicfor extensive brain function testing, once before contact practices and again in the winter. One of the tests, Brain

allows us to examine the player who took the hit,” said Patrick Seremet, coach of the Brighton Bulldogs Football and Cheer JV White team and 2016 league president. The JV age group comprises 70 fifth- and sixth-graders, including his son Jackson, who is participating in the study.

As with all study participants, he will complete a neuro exam before the season and after. A total of 134 young people are participating in the study this year. The recruitment and study will last four years.

LEARNING FROM HISTORY The InSite version being used by the The Sports Neurology Clinic for

the Brighton research initiative features expanded alert and monitoring functionality and a dashboard view via the player management software, Ide said.

This summarizes on-field alert history and identifies training opportunities for athletes based on their history of head impacts.

“We believe the research will provide important insights about the brain health of young football players, while also helping us better understand the types of impacts players see on the football field from youth to high school competition,” he continued.

“Conducting high-quality research studies is needed in the field of brain health and concussion,” Dr. Rose said.

“Medical recommendations for concussion, especially regarding retirement decisions, are all over the place simply because research data is lacking.

“Most current research assesses athletes years and decades after contact exposure. There is a need to evaluate players real-time; focusing research efforts in this direction is a major step toward determining the true risks of repetitive head impacts in contact sport athletes.”

For more information about The Sports Neurology Clinic, visit thesportsneurologyclinic.com.

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Medication Guide XIAFLEX® (Zī a flex) (collagenase clostridium histolyticum) For injection, for intralesional use Read this Medication Guide before you receive XIAFLEX for the treatment of Dupuytren’s contracture and each time you get an injection. There may be new information. This Medication Guide does not take the place of talking with your healthcare provider about your medical condition or treatment.

What is the most important information I should know about XIAFLEX for the treatment of Dupuytren’s contracture?

XIAFLEX can cause serious side effects, including: 1. Tendon rupture or ligament damage. Receiving an injection of XIAFLEX may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit.

2. Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit.

3. Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX, because it contains foreign proteins.

Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX: • hives, swollen face, breathing trouble, chest pain, low blood pressure, dizziness or fainting What is XIAFLEX? XIAFLEX is a prescription medicine used to treat adults with Dupuytren’s contracture when a “cord” can be felt. It is not known if XIAFLEX is safe and effective in children under the age of 18.

Who should not receive XIAFLEX? Do not receive XIAFLEX if you: • are allergic to collagenase clostridium histolyticum, or any of the ingredients in XIAFLEX, or to any other collagenase product. See the end of this Medication Guide for a complete list of ingredients in XIAFLEX. Talk to your healthcare provider before receiving this medicine if you have any of these conditions.

What should I tell my healthcare provider before receiving XIAFLEX? Before receiving XIAFLEX, tell your healthcare provider if you: • have had an allergic reaction to a XIAFLEX injection in the past, have a bleeding problem, have received XIAFLEX to treat another condition, have any other medical conditions, are pregnant or plan to become pregnant. It is not known if XIAFLEX will harm your unborn baby.

• are breastfeeding or plan to breastfeed. It is not known if XIAFLEX passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you receive XIAFLEX. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Using XIAFLEX with certain other medicines can cause serious side effects.

Especially tell your healthcare provider if you take: • medicines to thin your blood (anticoagulants). If you are told to stop taking a blood thinner before your XIAFLEX injection, your healthcare provider should tell you when to restart the blood thinner.

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

How will I receive XIAFLEX? • XIAFLEX should be injected into a cord by a healthcare provider who is experienced in injection procedures of the hand and treating people with Dupuytren’s contracture. If you have more than 1 contracture, your healthcare provider may give you 2 injections in 1 of your hands during your visit.

• Your healthcare provider will inject XIAFLEX into the cord that is causing your finger to bend.

• After an injection of XIAFLEX, your affected hand will be wrapped with a bandage. You should limit moving and using the treated finger after the injection.

AR-0008607520-01

• •

•

•

• •

— Do not bend or straighten the fingers of the injected hand until your healthcare provider says it is okay. This will help to keep the medicine from leaking out of the cord.

— Do not try to straighten the treated finger yourself.

Keep the injected hand elevated until bedtime.

Call your healthcare provider right away if you have: — signs of infection after your injection, such as fever, chills, increased redness, or swelling, numbness or tingling in the treated finger, trouble bending the injected finger after the swelling goes down Return to your healthcare provider’s office as directed 1 to 3 days after your injection.

During this first follow-up visit, if you still have the cord, your healthcare provider may try to extend the treated finger to “break” the cord and try to straighten your finger.

Your healthcare provider will provide you with a splint to wear on the treated finger. Wear the splint as instructed by your healthcare provider at bedtime to keep your finger straight.

Do finger exercises each day, as instructed by your healthcare provider.

Follow your healthcare provider’s instructions about when you can start doing your normal activities with the injected hand.

What are the possible side effects of XIAFLEX? XIAFLEX may cause serious side effects, including: • See “What is the most important information I should know about XIAFLEX?” • increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX may not be right for you.

The most common side effects with XIAFLEX for the treatment of Dupuytren’s contracture include: • swelling of the injection site or the hand, bruising or bleeding at the injection site, pain or tenderness of the injection site or the hand, swelling of the lymph nodes (glands) in the elbow or armpit (axilla), itching, breaks in the skin, redness or warmth of the skin, pain in the armpit Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all of the possible side effects with XIAFLEX. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

General information about the safe and effective use of XIAFLEX. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide.

This Medication Guide summarizes the most important information about XIAFLEX. If you would like more information, talk to your healthcare provider. You can ask your healthcare provider or pharmacist for information about XIAFLEX that is written for health professionals.

For more information, go to www.XIAFLEX.com or call 1-877-663-0412.

What are the ingredients in XIAFLEX? Active ingredient: collagenase clostridium histolyticum Inactive ingredients: hydrochloric acid, sucrose, and tromethamine. The diluent contains: calcium chloride dihydrate in 0.9% sodium chloride This Medication Guide has been approved by the U.S. Food and Drug Administration.

Manufactured and distributed by: Auxilium Pharmaceuticals, LLC. Malvern, PA 19355 US License No. 1816 US Patent Nos. 7,811,560 and RE39,941 PL-1109-001.h Approved: 08/2016

XD-03924d

For adults with Dupuytren’s contracture when a “cord” can be felt

XIAFLEX® is the only FDA-approved nonsurgical treatment Injection of XIAFLEX® and the finger extension procedure can be performed:

Since 2010, it is estimated that more than

80,000 patients

have been treated with XIAFLEX® through June 2016

• In your healthcare professional’s (HCPs) office • By a hand specialist with training specifically for XIAFLEX® • With no general anesthesia required

I can’t straighten my fingers because I have Dupuytren’s contracture.

THERE’S A NONSURGICAL TREATMENT OPTION THAT COULD HELP ADULTS WITH A DUPUYTREN’S “CORD” THAT CAN BE FELT

What is XIAFLEX®?

XIAFLEX is a prescription medicine used to treat adults with Dupuytren’s contracture when a “cord” can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18. ®

Important Safety Information for XIAFLEX®

Do not receive XIAFLEX® if you are allergic to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product.

XIAFLEX® can cause serious side effects including tendon rupture (break) or ligament damage which could require surgery, nerve injury or other serious injury of the hand, allergic reaction or hypersensitivity reactions, including anaphylaxis and increased chance of bleeding.

Call your healthcare provider right away if you have trouble bending your injected finger after the swelling goes down, problems using your treated hand, pain, tingling, numbness, increased pain, or tears in the skin (laceration) in your treated hand.

Call your healthcare provider right away if you get hives, swollen face, breathing trouble, chest pain, low blood pressure, dizziness or

fainting. It’s important to tell your doctor if you have had a previous allergic reaction to XIAFLEX®.

Bleeding or bruising at the injection site is common in people who receive XIAFLEX®. It’s important to tell your doctor if you have a bleeding problem or use a blood thinner.

XIAFLEX® may not be right for you.

Other common side effects include swelling, pain or tenderness at injection site or hand, swelling of glands in the elbow or armpit, itching, breaks or redness or warmth in the skin, and pain in the armpit.

Tell your doctor if you have any other medical conditions and about all the medications you take. XIAFLEX® should be injected into the cord by a healthcare provider who is experienced in injection procedures of the hand and treating people with Dupuytren’s contracture.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see the Medication Guide on the adjacent page.

Visit XIAFLEX.com/core to find specialists nearest you.

Rx Only XIAFLEX® is a registered trademark of Endo International plc or one of its affiliates. © 2016 Endo Pharmaceuticals Inc. All rights reserved. Malvern, PA 19355 XD-04667/July 2016 www.xiaflex.com 1-800-462-ENDO (3636)

COVER STORY

BY ELISE RILEY

K

G N I P EE

E F I L M IN

N O I T O

®

Doctors share how The CORE Institute’s philosophy helps achieve better outcomes

14

www.thecoreinstitute.com

When a patient comes to The CORE Institute, they benefit from the philosophy “Keep Life in Motion®.”

Through a multi-disciplinary approach to healthcare, patients receive cutting-edge treatment in orthopedic, neurologic and spine health. Beyond traditional medical care, patients benefit from not only the care of physicians who employ cutting-edge research, but also state-of-the-art laboratories and facilities.

PERSONAL APPROACH One of the central aspects of their philosophy is the personal consultation patients receive with their doctors. Patientfocused care means more informed patients and more successful outcomes.

“I take into account what is ultimately going to most improve my patients’ quality of life — the answer is not always surgery,” said Dr. Sean Bak, an orthopedic surgeon specializing in shoulder reconstruction and sports medicine.

“We look at everyone’s individual circumstances and come up with a plan of care to improve the long-term health of the patient. When surgery is required, minimally invasive techniques and cutting-edge techDr. Sean Bak niques are applied to ensure success.”

By investigating treatments that address a patient’s long-term health, Dr. Bak is ensuring his patients stay “in motion” for years to come.

“Not every patient ultimately will see a quality of life improvement from surgery or a positive impact on their long-term health,” he said. “This is not an approach that is necessarily common in orthopedics and by using it, we maximize our patients’ satisfaction.”

FINDING A DIFFERENT PATH Many of The CORE Institute’s physicians grew up playing sports. They understand how important it is to stay active after an injury. Dr. David Jackson was an athletic child, and also was fascinated by mechanics. It’s no surprise that he became a spinal surgeon.

But unlike other spinal surgeons, Dr. Jackson endeavors to find the underlying cause for a patient’s issue, and searches for non-invasive solutions. Instead of simply sending a patient for an X-ray or MRI and then deciding on a treatment plan, he uses techniques such as therapy or injections first.

“I stress the importance of Dr. David Jackson determining the underlying cause of my patients’ pain and dysfunction,” he said. “It allows me to design a treatment that hones in on a patient’s primary issue in the most minimally invasive way. I am often able to help my patients avoid large, high-risk surgeries. This affords my patients the best chance to return to activities they enjoy.”

g yout n i p p sto the mos ing s i t a “Wh getting e’re mak fromof life? W of life by out most outients to ivity, the wing pat sical act allotinue phyizing painhat conle minim stacles tin whi other ob ise get and ld otherw wour way.” thei

ALTERNATIVES TO SURGERY The doctors agree — it’s not common for a surgeon to suggest treatment outside of the operating room first. But Dr. Jackson and Dr. Bak have seen their patients enjoy better long-term outcomes by trying alternatives first.

Patients who visit The CORE Institute can have open discussions with their doctors. By talking about what makes someone happy — doing yoga, running, hiking, playing a sport — a doctor can understand someone’s priorities. If a patient has children and wants to stay active, the treatment plan should help achieve those goals.

Those discussions with patients help Dr. Jackson determine a plan.

“What is stopping you from getting the most out of life?” he asks. “We’re making the most out of life by allowing patients to continue physical activity, while minimizing pain and other obstacles that would otherwise get in their way.”

If you’ve experienced an injury, or are dealing with chronic pain, Dr. Bak recommends writing down what your personal goals are. Whether it’s eliminating the pain, or restoring range of motion, explaining your priorities to your doctor can help you achieve a positive result.

Ultimately, that’s what physicians at The CORE Institute look at when they measure success.

“We don’t simply look at number of surgeries or technical success,” Dr. Bak said. “While our technical capabilities are on par with the best in the country, we are even more interested in quality of care, efficiency and patient experience.”

—DR. DAVID JACKSON, ORTHOPEDIC SPINE SURGEON, THE CORE INSTITUTE 15

PATIENT CARE

BACK ON TRACK AND PAIN FREE “My only regret is that I didn’t get them both done sooner,” said Donald Lee, 74, of his left and right total hip replacement surgery by Dr. David Markel of The CORE Institute. “I had no reservations going into the surgery because I talked to people who had this procedure and they all told me to do it and not to wait. Now, I have zero pain and no problems with either of my hips. I don’t even notice the implants are there.”

Although Lee says he was well informed before the procedure about what to expect, he was still amazed at being up and walking the same day as the surgery with the previous pain gone. And, he found himself going up and down steps in a few more days He was walking normally in a few weeks and said he was determined to get the most out of his twice-a-week

physical therapy, doing the exercises each day that he learned during the rehab sessions. An experienced hunter, Lee quickly reached his goal of being able to handle the grueling critter trails of locales such as the Montana mountains.

RAPID REHAB Dr. Markel pointed out that the rapid rehab protocol Lee experienced was not the norm just two decades ago when the physician began his orthopedic surgery career. He explains that recovery procedures advanced as

Hip replacement returns patient to outdoor trails XXX

BY JOAN WESTLAKE

16

www.thecoreinstitute.com

PATIENT CARE

“REFLECTING OUR MISSION TO CONTINUALLY DEFINE THE STANDARD OF PATIENT CARE THROUGH A COMMITMENT TO EXCELLENCE, INNOVATION AND LEARNING, PATIENTS ARE PUT ON INDIVIDUALIZED AND PROVEN CARE PATHWAYS.” — Dr. David Markel, Orthopedic Surgeon, The CORE Institute

17

PATIENT CARE

attitudes changed from treating patients as sick and elderly to viewing them as healthy, active people who simply have had a joint failure.

The CORE Institute’s foundation of strong, evidence-based protocols and teams of medical specialists who are at the top of their fields mean that each patient receives leading-edge treatments as well as the best surgical and rehab approaches.

CARE PATHWAYS “Reflecting our mission to continually define the standard of patient care through a commitment to excellence, innovation and learning, patients are put on individualized and proven care pathways,” said Dr. Markel. “This means we are assured everyone is on the right path

to recovery, we can easily monitor every aspect of their care and we are not diverted from what we knows works best.”

“Reflecting our mission to continually define the standard of patient care through a commitment to excellence, innovation and learning, patients are put on individualized and proven care path-

18

ways,” said Dr. Markel. “This means we are assured everyone is on the right path to recovery, we can easily monitor every aspect of their care and we are not diverted from what we knows works best.”

“Patients who come to The CORE Institute with hip issues trust that we will pick the best surgical options for them,”

said Dr. Markel. “This generation of implants we have today is excellent with new materials that mean bearings will be working well two, three and more decades from now. Hip replacement is one of the most common, life changing surgeries we do and with overwhelming patient satisfaction.”

www.thecoreinstitute.com

REAL PATIENTS. REAL EXPERIENCES. Watch Chuck talk about his journey with Mobi-C® Cervical Disc replacement.

“This totally changed my life because I was back to how I was before any of this happened. I could move around anyway I wanted.”

- Chuck, two-level Mobi-C patient April 2006

Visit cervicaldisc.com/ real-experiences to watch Chuck’s story The opinions expressed are solely those of the individual patient and are unique to his experience. This information is for educational purposes only and should not take the place of discussions with your health care provider.

For complete risk information, visit cervicaldisc.com/aboutyourneck.

T R EN DS

Bucking the Trend Youth sports injuries climb as more kids crave competition

By Brian Sodoma

 

20

It’s a boost to any parent’s ego when, at a young age, a child excels in sports. Thoughts of college scholarships and other opportunities come to mind and the next steps usually involve years of weekends and weeknights packed with practices and tournaments.

In today’s society, kids are pushing themselves harder than ever to compete and, unfortunately for some, it’s also

an early introduction to injuries.

Some 38 million children play sports in the U.S. in any given year. According to the Centers for Disease Control and Prevention (CDC), more than 2.6 million children between the ages of 0-19 visit emergency rooms annually for sports-related injuries and even more head to their primary care physicians for injuries as well.

Here, two CORE medical experts offer some insights into why the injury trend is growing and how parents can keep their kids safe in competitive environments.

PHYSICALS Doctors often recommend an annual sports physical for athletes. Some states, like Arizona, mandate all high school athletes undergo a physical prior to participating in a program.

Nina Patel-Hinkle, DO, a Non-Operative Sports Medicine Physician in the Arizona Market, says the sports physical is similar to an annual check-up.

Immunization status is checked, health and nutrition is discussed and a general medical exam complete with cardiac screening and musculoskeletal tests is performed. “It ends up being more about overall health and

general wellness for a child,” she added.

Strained muscles and sprained ligaments are the most common youth sports injuries Dr. Patel-Hinkle sees.

The physician also talks to adolescent athletes about muscular imbalance and muscle tightness, which can sometimes evolve into an injury. However, she also chalks up some aches and pains to children simply growing. “Someone might say their knee hurts, but then we learn they’ve grown two inches in the last six months,” she added.

SPECIALIZATION Some children choose to focus on one sport early on, but physicians say this could lead to injuries and burnout.

“More data is now saying specialization makes you better up until the age of 15; but the kids who flourish past 15 usually have played multiple sports ... It’s like you take bits and pieces from each sport you play,” added John Kearney, MD, an Non-Operative Sports Medicine Physician in the Arizona Market and Medical Director of the Arizona Sports Medicine Society.

Dr. Kearney encourages kids to sample many sports up until the age of 12. Then, if a child specializes, he or she should still sample “some” other sports and avoid exclusively committing to one until after the age of 15.

“When you see someone more than eight or nine months of the year playing one sport and if weekly training tops 15 hours a week — any combination of those two — you might start to see overuse injuries,” he added.

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NUTRITION

Super Foods for Strong Bones Eating right can help body strength, overall health

By Michelle Jacoby As children, we were always reminded to drink our milk. “It builds strong bones,” knowing adults would say.

While milk and other dairy products continue to be a great source of calcium, other foods that pack a calcium punch give people an opportunity to expand dietary horizons while providing this important nutrient necessary to keep bones healthy and strong.

“Dairy products — such as milk and yogurt — are the best source of calcium because they’re highly absorbable,” says Corrie Whisner, Ph.D., assistant professor at the Arizona State University School of Nutrition and Health Promotion.

“However, not everyone can digest dairy due to such conditions as lactose intolerance and other digestive conditions. Fortunately, there are other calcium-rich foods you can incorporate in your diet.”

REDUCING RISK OF OSTEOPOROSIS Dark, leafy vegetables — such as kale, collard greens and turnip greens — are a great example. In fact, one cup of cooked turnip greens has about 200 milligrams of calcium, making up 20 percent of your daily goal. Dark greens also contain vitamin K, which

can help reduce the risk of osteoporosis.

“The greener or darker, the better,” Whisner says. “Any time you introduce a new color to your diet, there will be polyphenols that help absorb calcium.”

Fish is another good source of calcium, especially fatty fish like salmon and tuna. They contain vitamin D that helps your body absorb calcium, and omega-3 fatty acids, which may help improve bone strength.

Calcium is also prevalent in sweet potatoes, which contain vitamin D and potassium; and figs, which are high in calcium, magnesium and potassium.

Recent studies also show dried plums (or prunes) can increase bone density.

According to Whisner, one animal study showed significant increase in bone mass from eating 12 dried plums a day.

While adding more calcium-rich foods to your diet is a good way to strengthen and maintain healthy bones, supplements are also ideal, especially for older adults.

“As you get older, you lose the ability to produce stomach acids, which help absorb calcium,” Whisner says. “Supplements help

you meet your daily requirements. Generally speaking, a supplement with calcium carbonate is good, but a calcium citrate is best for postmenopausal women.”

BUILDING A FOUNDATION Whisner also says to choose a supplement with vitamin D, which not only helps the body absorb calcium, “it can also

signal to the kidneys whether we’ve taken too much and excrete it from the body.”

Whisner equates building healthy bone to building a skyscraper, with the bones being the scaffolding and the main beams, and the proteins, minerals and calcium securing and boosting the building’s strength.

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CORE CANDID What Does ‘Keeping Life in Motion’ Mean to You

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