CORE Ink-Fall 2013-Arizona

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SUMMER/FALL 2013

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

Chart a Course for Excellence The CORE Institute, Banner Health Partner Together for Orthopedics

Patient Back in the Water Thanks to The CORE Institute

Detroit Surgeon Gives Back to High School Athletes

The CORE Institute Performing Groundbreaking Research

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WELCOME VOLUME 4, ISSUE 3 SUMMER/FALL 2013

FROM THE CHAIRMAN

Execute. Transform. Succeed.

In the last CORE Ink, we brought you news about a recent expansion into the Michigan market, partnering with the Porretta Center for Orthopedic Surgery, now “The CORE Institute at Porretta”. This edition, we bring you an announcement that The CORE Institute, Cleveland Clinic, OrthoCarolina and Rothman Institute have formed the first-of-its-kind clinically integrated Orthopedic PHO (Physician Hospital Organization).

Operating as the National Orthopaedic & Spine Alliance, LLC (NOSA), and this national orthopedic powerhouse will improve the delivery of orthopedic and spine care across the nation and establish industry benchmarks for quality and value. As the future health care environment evolves, employers are becoming the largest consumers of health care and continue to search for ways to best spend their health care dollars. Employers have asked for solutions to difficult questions and we believe this network will provide them their answer.

The nationwide network brings the best practices of four leading orthopedic and spine programs together to benefit three main groups: Patients by providing them access to a network of top-tier programs, which are geographically dispersed across the country Employers by allowing them to provide a consistent level of quality care with proven value for employees through alignment with a network of physicians who are focused on quality care and cost control.

Participating Providers through the scaling of our quality standards to ensure quality improvement and benchmarking through national data sharing, in an area where few quality benchmarks exist today.

We believe this PHO and its founders will help define the way in which top orthopedic groups are able to share data and improve quality in a more comprehensive, automated, and integrated way and will redefine the way in which employers can access medical care for employees based on outcomes data.

Moving forward, CORE Ink will transition into a national publication, providing our readers perspectives from all of our markets. In your respective market, you will not only continue to hear from me, but your local Market President as well, with updates and exciting news to share.

On behalf of all of our physicians, providers, and staff in all markets, The CORE Institute appreciates your continued support.

Keep Life in Motion®!

FROM THE MARKET PRESIDENT 14 New Physicians, Four New Physician Assistants, One New Physical Therapy Location and the Future Headquarters.

In this issue, we feature a patient who was predicted to be in a wheelchair by the age of 50. Through the use of cutting edge orthopedic technology and surgical expertise, she is now defeating the odds and is back keeping her life in motion. In addition, we showcase our community involvement through high school sports partnerships, research initiatives in collaboration with The MORE Foundation and we introduce our new providers.

In 2011 we brought you news of a joint venture between The CORE Institute and Banner Health.

We are pleased to announce that the Banner Core Center for Orthopedics is not only at Banner Del E. Webb, Desert, and Thunderbird Medical Centers, but has now expanded its services to an additional location at Banner Estrella Medical Center.

Thus far in 2013, The CORE Institute has acquired two local orthopedic practices, hired 14 new physicians, four new physician assistants, and added one new physical therapy location. In December, we will relocate 188 of The CORE Institute’s 400+ employees working at current facilities in North Phoenix, Central Phoenix, Administration, Physical Therapy, and Research Lab and combine them all into one larger destination. Combining the clinical expertise will allow us to create a Center of Excellence, helping us achieve our future vision of continued growth and to better serve those in need of our orthopedic services. We will hold an open house to showcase the facility and look forward to seeing you there. Please visit our website for details regarding the event.

As we continue to break national orthopedic news, lead industry developments, and grow our comprehensive services, CORE Ink will keep you on the brink of innovation right along with us. Our advances in medicine are now your advances in health. ®

Keep Life in Motion !

David J. Jacofsky, MD Chairman & CEO

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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

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

John A. Brown, MD Market President, Arizona

Editor: Jim Williams/JLWilliams@republicmedia.com Sr. Managing Art Director: Tracey Phalen/tphalen@republicmedia.com Design: Rachel Tullio Photography: Mark Lipczynski (cover), Dan Vermillion

Contents COVER STORY

Partnership Charts New Course

14 FEAT U R E

Back in the Water

Thanks to medical experts at the Banner CORE Center for Orthopedics, patient gets relief from crippling pain and gets back to living an active life. See page 18.

The CORE Institute and Banner Health, two leaders in healthcare, have joined forces in a co-management partnership that redefines excellence in orthopedics.

Read more on page 14.

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D EPART ME N TS What’s New?

18 connect with us 1.866.974.2673

www.thecoreinstitute.com

8 T he CORE Institute is pleased to announce the addition of five new physicians to the team.

Research

Specialty Spotlight

CORE Candid

10 T he CORE Institute Sports Medicine Surgeon gives back to Detroit-area high school athletes.

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

Ask the Expert

22 The CORE Institute donated more than $4,300 to local high schools in 2013.

12 Dr. Nathan Jeppesen offers advice on how kids can avoid foot and ankle injuries.

13 The CORE Institute is leading the country in one-of-a-kind research.

Community Relations

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WHAT’S NEW NEW PROVIDERS

TYLER COLLINS, MD is a fellowshiptrained orthopedic sports medicine surgeon specializing in arthroscopic and reconstructive surgery of the shoulder, hip, elbow and knee.

MARK KAYANJA, MD, PhD is a fellowship-trained orthopedic spine surgeon, specializing in minimally invasive surgery, deformity correction and cervical, thoracic and lumbar spine surgery.

JEFFREY E. MCALISTER, DPM is a fellowship-trained foot and ankle surgeon specializing in advanced foot and ankle reconstruction, total ankle replacements, trauma and limb salvage.

CHRISTOPHER ROBINSON, DO, MS is a fellowship-trained specialist in nonsurgical, rehabilitative, and the medical aspects of sports medicine. He is highly skilled in non-operative treatment options and rehabilitative principles for most musculoskeletal problems and injuries.

MITCHELL WAGNER, MD is a board certified and fellowshiptrained orthopedic traumatology surgeon.

He has extensive training is primary and revision joint replacement surgery.

SPECIALTY SPOTLIGHT

Ultimate Team Player

The CORE Institute Sports Medicine Surgeon Gives Back to High School Athletes in Detroit

By Gremlyn Bradley-Waddell While there’s no contractual agreement and he’s not paid for providing his medical services, Dr. Jefferey Michaelson views his role as team doctor for one of the Detroit area’s biggest high schools as an important responsibility to both his profession and his community. And, frankly, he enjoys the experience.

“It’s the right thing to do,” says Dr. Michaelson, an Orthopedic Sports Medicine Surgeon at The CORE Institute’s offices in Novi and Southfield, Mich. “I like that I’m identified as a team physician and I have been able to get to know the kids, their parents and their grandparents.”

BRINGING UNIQUE EXPERTISE Michaelson’s frequent presence on the sidelines of Detroit Catholic Central High School’s home and away football games, combined with his off-the-field accessibility, also means multitudes of young athletes benefit from high-quality care and having a consistent point of contact when it comes to medical care. He’s not diminishing the education or experience of athletic trainers on hand at games, but says there simply are times when his expertise makes a big difference.

“One of the most important things I can do is care for a catastrophically injured

JEFFEREY MICHAELSON, MD

“I like that I’m identified as a team physician and I have been able to get to know the kids, their parents and their grandparents.”

— Dr. Jefferey Michaelson

Jefferey Michaelson, MD, specializes in orthopedic surgery. His special area of interest is in arthroscopic surgery of the shoulder, knee and ankle, which compliments his interest in Sports Medicine.

TEAMWORK Did you know some of The CORE Institute’s providers serve as team doctors or orthopedic consultants for high schools in Arizona and Michigan? They include: ARIZONA • Centennial High School • Peoria High School • Willow Canyon High School • Valley Vista High School • Shadow Ridge High School • Desert Edge High School • San Tan Foothills High School

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MICHIGAN • Catholic Central High School • Hartland High School • Novi High School • Walled Lake Western High School

patient, or someone who’s suffered a cardiac event or been knocked out,” says Michaelson, a fellowship-trained physician who’s practiced for 12 years and is also an orthopedic consultant to the Detroit Tigers.

He says even though an ambulance may be on site at a high school game, it may not be staffed with a paramedic, and that can result in a “scoop and run” approach to an emergency. His presence, however, means emergency care can begin immediately; it also means there will be clear communication with hospital staff as well as continuity of care.

“The patient’s outcome significantly improves when you have a physician on site,” he says, adding that Catholic Central’s hockey games, and often lacrosse games, also are attended by either a CORE physician or physician’s assistant.

MAKING THE RIGHT CALL In less serious scenarios, like when a player’s been bumped and bruised during a game and a trainer’s not sure whether to let him continue playing, Michaelson’s sports medicine experience means he can quickly make that call. In addition, it means he’s mindful of team timelines, the length of sports seasons and the importance of returning to play.

“Not everyone needs to be pulled from the game,” he says. “Maybe we just have to hold them out for a few plays or a period. There have been multiple times when I’ve had to stitch someone up in the back room of a gym and, if it’s reasonable to do so, you can let -them continue to play.”

“I think knowing I’m a phone call away makes the athletes and their parents happy,” he says. “They know something can happen fast, and we can take care of it quickly to keep life in motion.”

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ASK THE EXPERT

Foot and Ankle Injuries Keeping Active Kids Pain Free

By Nathan Jeppesen, DPM

Q: With the new school year and extracurricular sports seasons underway, how can I help my kids avoid foot and ankle injuries?

A : Children are pretty resilient to foot and ankle injuries, nevertheless, about 30 percent of my patients are ages 7 to 16. The most common kids’ injury I treat is an ankle sprain, which often occurs when the muscles become fatigued and fail to support the ligaments. The ligaments can tear, or partially tear, and a patient will have throbbing pain and swelling at the site of the injury. Sprains typically happen when a young person is exercising or playing sports. He

may land “wrong” on his feet or when running can move rapidly and change directions and twist or turn his ankle in the process. Children who play sports should do a full-body stretch, focusing on the calf and hamstring muscles, before and after any exercise and they should also have proper, well-fitting gear and apparel.

Children who play sports should do a full-body stretch, focusing on the calf and hamstring muscles, before and after any exercise and they should also have proper, well-fitting gear and apparel.

NATHAN JEPPESEN, DPM

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Nathan Jeppesen, DPM is a podiatric foot and ankle surgeon, specializing in diabetic limb salvage and reconstruction, forefoot reconstruction, pediatric deformities, sports medicine, lower extremity biomechanics, primary podiatric medicine, with special training emphasis on foot and ankle deformity reconstruction and trauma.

Another reason kids may end up in a physicians office is due to the genetic condition called flat feet, characterized by having little or no arches. This condition can cause cramping and foot and leg pain, but many pediatric patients with flat feet have no pain. They’re brought in by their parents who think their children’s feet look odd and that something must be wrong. In those cases, all that’s needed is education. For those with pain, I recommend a stability or motion-control running shoe and custom or over-thecounter orthotics. The shoe should be sturdy, have a lace and a supportive heel cup and should not be able to twist; the toe should be the only flexible part.

Wearing the proper athletic shoes would eliminate many of the foot and ankle problems I see in the clinic.

FOR MORE INFORMATION about foot and ankle conditions, please email us at contactus@thecoreinstitute.com or call 1.866.974.2673.

www.thecoreinstitute.com

RESEARCH

Results That Change Lives The CORE Institute is Leading the Country in One-of-a-Kind Research

By Dolores Tropiano A shoulder injury can turn such simple tasks as tucking in a shirt or buttoning a blouse into a burden. A severe impairment can even put eating out of reach, limiting the ability to lift a spoon or fork to the mouth.

The CORE Institute is leading the country in research that is helping people with shoulder injuries to lead productive, pain-free lives.

BIOMECHANICS LAB The research takes place in The MORE Foundation’s Biomechanics Lab. Inside the lab, a state-of-the-art robotic Shoulder Controller tests implants and other orthopedic devices used to treat shoulder problems caused by arthritis, osteoarthritis or rotator cuff tears. The results of their research benefit both The CORE Institute patients and shoulder implant manufacturers.

“It is the only one of its kind in the country,” said Dr. Marc MARC JACOFSKY, PhD Jacofsky, Executive Vice President of Research and Development at The CORE Institute and the Research Director for The MORE Foundation, a Musculoskeletal-Orthopedic Research and Education Foundation. “There are other machines that purport to be similar, but are not as advanced.”

The Shoulder Controller is capable of simulating the muscles in the shoulder through lifelike movements. It records and tests the strength of implants and

FOR MORE INFORMATION Information about The MORE Foundation, please visit www.more-foundation.org the range of motion they can provide patients. Studies have found that individuals who undergo total shoulder arthroplasties experience an 83 percent reduction in moderate to extreme pain over a 12-year period.

“We put the implant in the cadaver, put the cadaver into the robot and attach all the muscles to the motors and it moves the way the shoulder would move if a living person had received that implant,” explained Jacofsky. “Our robot pulls on different cables with motors in the same way a puppeteer moves a marionette.”

SIMULATING MOVEMENT The research has helped enhance surgical planning and given the medical community a clearer understanding of the effectiveness of an implant.

“Our robotic shoulder testing machine can simulate the way a shoulder implant can perform when in the body in a way no other machine can simulate,” continued Jacofsky. “Will a patient be able to tuck their shirt in? Will they be able to comb

their hair? We can get after activities of daily living and really simulate that in a robotic environment.”

The technology has put The MORE Foundation in demand with implant manufacturers throughout the country. The Foundation has performed five different studies for two different manufacturers, examining such things as range of motion and contact between implant and bone and modifying the implant to improve muscle function.

“The companies are now coming to us and asking us to test their design before it goes to market or the human shoulder,” said Jacofsky.

More importantly, The CORE Institute’s patients are benefiting from the medical center’s advanced technology.

“We can diagnose problems with implants much earlier than if we put the implants in a living person and then have to wait years for problems to develop,” Jacofsky said. “Our physicians are at the leading edge of the best practices and best implants available for our patients.”

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Chart a Course for Excellence

MARK LIPCZYNSKI

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www.thecoreinstitute.com

COVER STORY

The CORE Institute Extends Reach with Banner CORE Center for Orthopedics

By Kristine Burnett

TODAY’S EVER-CHANGING HEALTHCARE CLIMATE DEMANDS INNOVATION, COLLABORATION and an unwavering commitment to clinical excellence. The CORE Institute and Banner Health, two healthcare leaders recognized for such attributes, have joined forces in a co-management partnership that redefines excellence in orthopedics.

The The Banner CORE Center for Orthopedics, first launched in May 2011 at Banner Del E. Webb Medical Center in Sun City West, Ariz., is a collaboration rooted in evidence-based practices. By streamlining and standardizing the care process, the initiative has improved outcomes and created a more efficient hospital experience for patients. It also has charted a new course for orthopedic care management at Banner Health with expansion of the The The Banner CORE Center for Orthopedics to include Banner Desert Medical Center in Mesa, Banner Estrella Medical Center in Phoenix and Banner Thunderbird Medical Center in Glendale and Banner Good Samaritan Medical Center in 2014.

GROUNDBREAKING COLLABORATION As Robert Gould, CEO of Banner Desert said, “It is a partnership centered on improving quality that brings together hospital leaders and physician partners to collaboratively review data, identify opportunities for improvement and institute changes that net better outcomes.”

Gould identifies improvements in collaborating with the hospital’s orthopedic

surgeons about more efficient and effective processes as well as better communication with and between doctors as the most notable changes brought about by the spring 2013 implementation of The Banner CORE Center for Orthopedics on the Banner Desert campus.

Those sentiments were echoed

by Steve Myerthall, MD, East Valley Site Chief of The CORE Institute who was instrumental in creating the The Banner CORE Center for Orthopedics.

Myerthall, who routinely operates at Banner Desert, cited evidence-based medicine as one of the biggest benefits for patients.

“The Banner CORE Center is driven by data, which means doctors practice in ways that are supported by research and years of clinical findings rather than doing things empirically without evidence to serve as the basis for their actions,” he said. “While care decisions are still tailored to each patient, the standardization that comes with a partnership of this nature means there are fewer variables and, in turn, fewer opportunities for error.”

CONSISTENCY AND CONTINUITY As with any partnership, economics also are at play. The consistency and continuity of the The Banner CORE Center model is more economical for the hospital, the physicians and, ultimately, the patients. From narrowing the list of medical and orthopedic devices used, to minimizing variation in pre and post-operative care procedures, efficiencies are improved across the board. Thanks to a program known as the Independence Expedition , those efficiencies begin ®

even before patients undergo surgery.

A key element of the The Banner CORE Center model, the Independence Expedition is a preoperative class designed specifically for orthopedic patients. Led by a Nurse Navigator, such as Heather Taylor, RN at Banner Desert, the program helps prepare patients for their surgery by outlining expectations and proactively addressing medication, safety and equipment needs.

“We discuss ways patients can prepare their bodies for surgery by building strength, review post-surgical medication and equipment needs, and help make sure potential safety hazards in the home environment are addressed prior to surgery,” Taylor said.

As a complement to the Independence Expedition , Taylor also manages the hospital’s Optimization Clinic, which screens patients for potential infections, confirms their blood type and even makes certain the blood bank is well stocked for their blood needs. But the Nurse Navigator’s job isn’t limited to pre-surgical procedures. In fact, Taylor works closely with caregivers to ensure patients’ pain is being managed, serves as a liaison between different departments and aids in creating a smooth transition from the hospital to home.

“Overall, we have improved processes related to communication and how patients flow through the system,” noted Gould. “The Independence Expedition is a prime example. Every patient knows exactly what to expect throughout the care continuum and that definitely makes for a better patient experience.” ®

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A week prior to my scheduled surgery I went to a class designed to give information and answer patients’ questions. We talked about what to expect, including post-surgery physical therapy and occupational therapy, and they gave us a Patient Passport® describing my particular procedure as well as a tool that guided me through each step of the way.”

— Carl Naisant, Patient, Banner CORE Center for Orthopedics

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COVER STORY Patient Carl Naisant and Dr. Steve Myerthall discuss treatment options using the ceiling-mounted Secure Tracks system.

HIGHEST LEVEL OF CARE AND TECHNOLOGY In addition to clear and consistent communication, The Banner CORE Center for Orthopedics delivers the highest level of care utilizing the latest medical techniques, technologies and equipment.

Rather than rely on the traditional walker for post-operative inpatient rehabilitation, The Banner CORE Center for Orthopedics uses the Secure Tracks support system.

This ceiling-mounted mobility device, which is proven to expedite recovery, enables patients undergoing rehabilitation to stand upright and walk with a more natural stride without the fear of falling.

“With a walker, patients generally put most of their weight on their upper body, but the Secure Tracks system allows them to maintain a normal posture and put more weight on their new joints,” explained Taylor. “The device can be fitted to each patient and since they are strapped in, there is no risk of falling. Patients love it!”

Carl Naisant, 56, a Tempe resident who in June underwent a hip replacement through the The Banner CORE Center for Orthopedics at Banner Desert, can testify to the fact that the Secure Tracks boosts patients’ confidence and comfort level.

“They had me in the apparatus within four hours of my surgery,” he said. “It has arms that come down from the ceiling and wrap around your back to support your weight. It then slides across the ceiling while you walk. Being able to do that right away let me really feel how things were going to be with the new hip.”

Following suit with The Banner CORE Center protocols that have all patients up and out of bed the day of surgery and discharged one to two days after, Naisant was using a walker the evening of his surgery. He went home the following day.

PREPARED FOR THE JOUNEY Despite the hip replacement being his first major surgery, Naisant says the meetings, consultations and classes leading up to it left him feeling well prepared for the journey.

“A week prior to my scheduled surgery

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FOR MORE INFORMATION For more information, visit www.BannerCoreCenter.com.

I went to a class designed to give information and answer patients’ questions,” he recalled. “We talked about what to expect, including post-surgery physical therapy and occupational therapy, and they gave us a Patient Passport® describing my particular procedure as well as a tool that guided me through each step of the way.”

Since organization is essential to delivering excellent patient care, Noelle Diesfeld, RN, Business Development Director at The Banner CORE Center for Orthopedics, works to ensure open communication and collaboration throughout the hospital.

“From admitting and nursing to dietary services, rehabilitation and more, The Banner CORE Center touches virtually all departments,” she said. “It’s our job to create and implement the program efficiencies that result in a highly-engineered, evidence-based experience for patients.

Almost any hospital can do orthopedic surgery, but it’s a different entity that can deliver the full experience.”

WAVE OF THE FUTURE Complimenting Banner Health for its willingness to join forces, resources and processes to deliver the best in orthopedic care, Myerthall describes The Banner CORE Center for Orthopedics as a new operating model that he believes will gain momentum and be replicated by others in the industry.

“The partnering of physicians and hospitals is definitely the wave of the future,” he commented. “The fact that Banner Health embraced the concept at this point in time speaks to the organization’s foresight.”

The Banner CORE Center for Orthopedics treats injuries and disorders affecting the bones, joints, muscles, ligaments, tendons and cartilage. From total and partial joint replacements, to sports injuries, congenital conditions, arthritic and degenerative disorders, fractures and spine conditions, The Banner CORE Center physicians have the experience and expertise to treat virtually any orthopedic injury or ailment.

www.thecoreinstitute.com

Bridget Nielsen, holding up her sculling ores at Tempe Town Lake, is back doing activities she loves thanks to The CORE Institute.

Back in the

Water Banner CORE Center for Orthopedics relieves patient’s crippling pain

By Kristine Burnet

WHEN BRIDGET NIELSEN WALKED INTO HER PEDIATRICIAN’S OFFICE AT AGE 10, HER doctor made a seemingly unbelievable declaration. Based on the condition of her knees, he predicted she would be in a wheelchair by the age of 50. Now 44, Nielsen is well on her way to proving him wrong thanks to the medical expertise of a surgeon at The CORE Institute.

“When I was young, there was this audible grinding sound in my knees that people could hear when I would squat or go up and down stairs,” Nielsen said. “It didn’t hurt, but my mom took me to the doctor to see what it was.

He thought it might have been juvenile arthritis, but we later discovered that my kneecaps had never tracked correctly.”

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FEATURE STORY

TALE OF PAIN, REHABILITATION Grinding cartilage and eventually bone, 10-year-old Nielsen had the knees of a 50-year-old. Since pain wasn’t a factor and she was so young, they decided to avoid surgical intervention. But six years later, the pain had set in and it was time to explore treatment options.

Nielsen underwent surgery at the close of her junior-year basketball season and took part in extensive rehabilitation over the summer so she could be back on the court as a starter her senior year.

While she did get to play basketball during her final year of high school, Nielsen’s days of knee pain weren’t over. As a college freshman, extreme pain landed her back in the operating room for an experimental procedure that entailed a tendon transfer and creating a second kneecap using donated bone from a bone bank.

The procedure left Nielsen with two kneecaps. But when she slipped on ice the following winter, her pain and problems started all over again. “The bone dislodged and the screw came out,” she said. “You could see it through my skin.”

DAN VERMILLION

LIVING NIGHTMARE When an outpatient procedure to fix the issue showed that Nielsen’s body was rejecting the donor bone and that she lacked the cartilage necessary to keep her own bones from rubbing and grinding, the supplemental kneecap was removed. Not yet 20 with three knee surgeries under her belt, Nielsen vowed to never have another surgery. By her late 30s, constant knee pain was interfering with virtually every aspect of her life.

“I couldn’t even squat to help my kids tie their shoes and giving them baths was just so hard.”

With physical therapy and steroid injections doing little to ease the near constant pain, Nielsen finally conceded and had a partial knee replacement on her left knee in 2010. Shortly thereafter, she injured the same knee while on vacation. Since x-rays failed to show signs of damage, she tried to work through the pain, even moving forward with a partial knee replacement on her right knee in 2011.

Despite having two partially new knees, the pain would not cease.

“I started waking up in the middle of the night in excruciating pain to find the prosthetic off to the side because it was floating around freely.”

PATIENT TURNS TO THE CORE INSTITUTE Frustrated and unsure of what to do, Nielsen was ready to throw in the towel. She turned to The CORE Institute where it was discovered that the implant from her previous surgery had in fact loosened from the kneecap.

In what Nielsen describes as her longest and most thorough surgery, her CORE physician performed a revision to her patella femoral joint.

This uncommon procedure was done in October 2012 at Banner Thunderbird Medical Center in Glendale, Ariz through the Banner CORE Center for Orthopedics.

“Neither of us knew if I would wake up from surgery with my kneecap,” said Nielsen. “It looked like rubble on the x-ray and my chances were not

good. He removed all the pieces of cement and bone fragments and noticed two larger pieces of my patella that he was able to reconstruct to create a functioning kneecap.”

LIVE WITHOUT PAIN Up and using a walker within hours of surgery, Nielsen is now enjoying life without knee pain, something she hasn’t experienced for decades.

“I’ll never be able to jog and run marathons like my friends, but I’m able to be active again and I love it.”

Along with skiing, Nielsen enjoys rowing. “I do it when I can and I know what my hobby will be when my kids are older and I’m not working,” she commented.

Total knee replacement of both knees is in Nielsen’s future, but until then she is staying active.

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CORE CANDID

The CORE Institute Keeping Life in Motion!

What Does ‘Keeping Life in Motion’ Mean to You JEFFREY MCALISTER, DPM I love to live the competitive life of an athlete by participating in local and national triathlons, including Ironman events. Triathlon keeps me active on many levels and allows for multiple options for daily workout routines. The most important part, of any high endurance sport is nutrition and watching your daily caloric and sugar intake is key to keeping my life in motion.

CORE CANDID

BETHANY LARSEN, Research Coordinator I keep my life in motion by engaging in a collection of activities ...coaching, research, philosophy, walking with the broken hearted, swimming, triathlon, horses, friends, travel... that feed my mind, body, and spirit. For it is in the balance of these that I experience the deeper richness of life.

ERIC BAILEY, Online Marketing Manager On July 13, 2013, I rode my bicycle 204 miles from Seattle, WA to Portland, OR as part of the Seattle to Portland Bicycle Classic. This is my fifth time riding in the event, but my first time riding it in one day! After over 12 hours of pedaling, the feeling of coming across the finish line into the arms of my wife and kids, was nothing short of exhilarating!

SCOTT BLEAZEY, DPM I keep life in motion by playing hockey. It’s a great way to have fun while exercising.

CORE CANDID

COMMUNITY

Giving Back Donated More Than $4,300 to Local High Schools In late the spring, The CORE Institute hosted its annual physical exams, which supported local high school athletes and their athletic programs. The exams cost $25 and 100 percent goes back to each respective athletic program.

The CORE Institute raised and donated more than $4,300 to local high schools in the Peoria and Dysart School Districts.

Sports medicine providers at The CORE Institute completed over 170 enhanced school physicals during this annual event.

“Participation in team sports is a significant part of High School for students that builds character, teaches teamwork, and improves one’s physical fitness,” said John Kearney, Jr., MD of The CORE Institute. “Our providers and staff are

Volleyball teams visited the CORE Booth to take fun team pictures

engrained in the community and enjoy giving back, we raise families in this community and we all work with studentathletes already — this is just one way that we can continue to give back.”

In addition, The CORE Institute provided on-site medical coverage to the 6,000 youth female volleyball players from across the United State that descended on the Phoenix Convention Center for the 2013 Volleyball Festival June 23-28.

“The festival is a massive undertaking with the Phoenix Convention Center transformed to create 107 courts to accommodate more than 500 teams from across North America,” said Arizona Market President, John Brown, MD. “A strong supporter of athletics, The CORE Institute is proud to play our role in providing medical assistance to the young athletes and event attendees.”

FOR MORE INFORMATION or if you have an event you would like us to participate in, please contact us at communityrelations@thecoreinstitute.com