Articles Posted in Orthopedics & Sports Medicine

knees-300x81Although grandma and grandpa and even older ancestors before them didn’t live as long nor usually as well as many of us do, they still can provide valuable insights into how modern Americans can avoid painful debilitation that now leads to some of the most commonly performed surgeries on seniors.

Want to avoid an inconvenient, costly knee or hip replacement?

Keep your weight down and keep moving—two steps that researchers say may have helped reduce the prevalence of the joint rheumatoid arthritis (RA) that pushes tens of thousands of baby boomers each year to seek medical treatment, up to and including knee and hip procedures that cost taxpayers billions of dollars through the Medicare and Medicaid health programs.

kessler-203x300Even as congressional Republicans advance their counter-factual campaign to strip patients who have been harmed while seeking medical services of their rights to seek legal redress, another state appeals court has rejected key GOP arguments about medical malpractice lawsuits.

An appellate court in Wisconsin has declared unconstitutional that state’s $750,000 cap on non-economic damages, reinstating a jury’s decision that a Milwaukee woman and her husband should be paid $16.5 million for their pain and suffering after emergency doctors failed to inform her fully about the severity of a strep infection she had and that led to the amputation of her arms and legs.

The jury assessed total damages against the doctors and their insurers of $25.3 million, including $8 million for the medical and other care the 57-year-old mother of four will require for the rest of her life. But the defendants appealed the total, arguing the couple, under Wisconsin law, should get no more than $750,000 for non-economic harms like pain and suffering.

softball-300x197Although fans may fret when pros like the Nationals’ Bryce Harper get hit by a pitcher—and brawls ensue—some amateur athletes are the most likely to be struck and hurt: Ball-contact injuries are highest among female softball players, followed by women who play field hockey.

That’s according to new research on thousands of college athletes that found that less than half of the female athletes’ injuries when hit by balls caused them to lose playing time. Most suffered bruises (30.5 percent) and sprains (23.1 percent). But concussions were among the most commonly recorded serious injuries, occurring in 16.1 percent of cases, with finger fractures an issue, too.

When injuries were compared between men and women in baseball-softball, basketball, and soccer, female athletes had a larger proportion of ball-contact injuries diagnosed as concussions than did men, researchers found.

Knee-300x166Hip and knee replacements, especially among seniors, have become so prevalent that almost 7 million Americans by 2010 had undergone the surgeries. With the cost to Medicare of knee replacements running between $16,500 and $33,000, and with roughly half of the procedures’ expense occurring post-operatively, there’s some good news for patients on saving money—and staying safer too.

Patients may want to get themselves out of the hospital and stay out of in-patient rehab centers in favor of well-planned, careful recuperation at home, studies show. The research focused on single adults living alone, and whether they fared better over the short- and long-term by rehabbing from total knee and hip replacements at skilled nursing facilities or at home, particularly if their home care was well considered and followed through.

They did at least as well and were happier recuperating at home, researchers found, adding that they also may have been safer: That’s because a third of patients in rehab facilities suffered adverse events in their care, a rate comparable to unacceptably high hospital harms and those in skilled nursing facilities.

QCBFL_-_Snow_Game_2011_Vander_Veer_Park_Davenport_Iowa-300x200Get up. Move. Pace. Walk around the block. Swim some laps at the Y. Hit the greens over the weekend, go dancing on Friday night, or jump into Saturday or Sunday games of touch football or pickup basketball. Exercise needn’t be strenuous to benefit your health and well-being in many ways, research continues to confirm. With a new year under way and lots going on for so many of us, activity also can play a significant role in diminishing the harms of stress.

The New York Times has put out pertinent stories on how:

  • Exercise, even a gentle walk around the block — yes, with a two- or four-footed eager companion — can improve people’s moods, making them happier.

knee-replacement-300x240Uncle Sam is struggling to figure how best to ensure the safety, quality, and accessibility of a major surgery for a sharply rising number of seniors who need it and want the government, through Medicare, to pay for it. Baby boomers, after decades of running, dancing, aerobics, football, basketball, zoomba, and all manner of joint-stressing activity, are lining up for knee replacements. Where should these procedures occur and how should they be paid for and evaluated?

The New York Times has reported that surgeons, some in hospitals and some in free-standing surgical centers, are riven by proposed rule changes that would allow patients 65 and older with Medicare to undergo complex, extensive knee replacement operations on an outpatient basis.

The surgeons who now do these operations in hospitals say this is a risky move for patients, who now typically spend several days hospitalized in recovery. The “hospital” docs say knee replacement is a complex procedure, with high risk of infection and post-operative complications, because, for example, patients receive powerful clot-busting drugs and potent painkillers as part of the surgical regimen.

fda hipThe pain and suffering that a flawed medical device can cause can last a long time. A Dallas jury provided a timely reminder of that, deciding six California plaintiffs should be paid more than $1 billion for the harm they suffered because of metal-on-metal hip replacement hardware made by Johnson & Johnson’s DePuy Orthopedics unit.

The Californians proved to jurors that they suffered tissue death, bone erosion, and other at times excruciating injury due to the faulty Pinnacle hip replacement product, which they said had been promoted as longer lasting and less risky than other alternatives. Jurors also heard that DePuy knew the products were defective and failed to warn patients.

Johnson & Johnson said it had acted appropriately and believed the verdict, which came in one of more than 8,000 Pinnacle-related lawsuits in Texas alone, would be overturned on appeal due to what the company said were errors by the presiding judge.

braintraumaIt may sound macabre. But advocates say a critical step to address important gender disparities in the care and research on concussions’ harms may rest in convincing more women to donate their brains to science. This has already  helped to prove the debilitating and deadly effects of head trauma among men in pro sports.

In contrast to the many and growing number of male athletes (especially pro football players) and their families who have allowed post-mortem brain studies, far fewer elite female players have agreed to similar research. Stat, the online health information site, says soccer stars Brandi Chastain, Abby Wambach, and Megan Rapinoe are among the public few.

Autopsies are often the only way, for now, for experts to definitively diagnose debilitating conditions like chronic traumatic encephalopathy (CTE) that result from repeated head trauma (concussions).

d magazineJust how difficult can it be to stop a highly credentialed but dangerous doctor from hop-scotching around a metropolitan area to perform brutal spinal surgeries in different hospitals, including a respected academic medical center? Just ask crippled patients, neurosurgeons, medical licensing officials, and prosecutors in Dallas what it took to derail Dr. Christopher Duntsch.

As detailed well in the latest edition of the upscale city magazine D, Duntsch was a high-flying physician who moved from Tennessee to Texas, carrying with him an excellent reputation, which later would be challenged, as a medical scientist. Although established as a cancer stem cell-researcher, the neurosurgeon also morphed himself into a spinal surgeon based on training earlier in his career.  He eventually won privileges to operate at three Dallas area hospitals, including the well-regarded Baylor Regional Medical Center at Plano, Texas.

He was a loner and boastful, though colleagues liked him at first. They  quickly were horrified by his surgeries. Among the damages he is criminally accused of inflicting: amputating a patient’s spinal nerve, causing paralysis; cutting another patient’s vertebral artery and ignoring the major bleeding that occurred; installing a too-long screw so that it punctured a big vein, causing extensive bleeding and nerve damage; slashing a patient’s esophagus and a neck artery, leaving the man struggling to eat, breathe, and with blood loss to the brain.

SouthDakota-StateSeal.svgSouth Dakotans will need their state lawmakers’ help now to pry open physicians’ iron grip on secret decisions about which doctors get to practice in hospitals and why. That’s because the state’s Supreme Court ruled this vital information must be kept confidential, even if releasing it would serve a wider good of disclosing possible criminal or fraudulent conduct.

The high court ducked its potential role in helping more than 30 patients who claim they were mangled in excruciating, needless surgeries performed by Allen Sossan, an osteopath with an easily discovered criminal past and a checkered medical practice record in the area around Yankton, S.D. I’ve written about this case before.

Several South Dakota hospitals gave Sossan practice privileges after his credentials were reviewed by physician committees, which, since have fought mightily to keep secret what they knew and when they knew it about him. Sossan since has been indicted for providing false information to medical licensing authorities. The convicted burglar and check kiter apparently has fled the country and may be back in his native Iran.

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