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Platelet-Rich Plasma (PRP) Therapy

Many active individuals, ranging from weekend warrior types who enjoy exercise and recreational sports in their spare time to professional athletes to those with osteoarthritis, suffer pain and injuries that keep them from performing at their best and sometimes from performing at all.

Surgery to treat joint, tendon and ligament injuries like tendonitis and MCL or ACL tears can keep athletes out of the game for weeks at a time due to long recovery times and possible complications such as infection from the procedure.

Platelet-rich plasma therapy procedures are an alternative option to surgery that are minimally invasive, affordable, quick and can greatly reduce pain and recovery time for athletes.

Typically, when a person is injured, the body sends blood to the site to begin the healing process. Blood platelets are full of proteins and other elements that help mend injuries. However, in some more ligamentous locations like the knee, shoulder and elbow, blood doesn’t usually travel to that area as much when injury occurs.

Platelet-rich plasma procedures mimic the body’s response to injuries by creating a catalyst for a person’s natural healing response and helps rebuild tendons and cartilage. It works by taking blood from the injured athlete, filtering it in a centrifuge that spins at high speeds to separate red blood cells from platelets and injecting that blood into the injured area.

This method of healing is perceived to be most effective for mild injuries to the everyday active individual but has also decreased rehabilitation and recovery time for professional athletes like Hines Ward and Troy Polamalu, both Pittsburgh Steelers football players, who each had platelet-rich plasma procedure therapy that reduced their combined injury times by weeks.

Using the athlete’s own blood is speedy and safe. In total, platelet-rich plasma procedures take about an hour and virtually eliminate the possibility for infection or allergic reaction. They are cheaper than traditional surgical treatment and have the potential to do away with several types of surgery that can be costly and invasive.

Whether it’s a sports related injury or pain due to arthritis, platelet-rich procedures are promising and should be considered by patients for non-surgical treatment.

Valley athletes doing on-field exercises during ACL Injury Prevention Clinic

Student-athletes from around the Valley got a chance to step on the Arizona Rattlers football field during the fourth annual ACL Injury Prevention Clinic at Talking Stick Resort Arena.

The clinic is a mixture of a classroom style lecture and on-field exercises put on by OrthoArizona, Spooner Physical Therapy and the Rattlers.

Check out some of the exercises the Spooner Physical Therapy team put the student-athletes through during their portion of the presentation.

4th Annual ACL Injury Prevention Clinic draws student-athletes from around Arizona

Student-athletes got a lesson in ACL injuries and how to prevent it from happening to them at the Talking Stick Resort Arena in Phoenix.

They were attending the fourth annual ACL Injury Prevention Clinic put on by OrthoArizona, Spooner Physical Therapy and the Arizona Rattlers.

Dr. Shelden Martin, who is with OrthoArizona and head team physician for the Rattlers, led a 30 minute presentation discussing causes, treatments and techniques to prevent ACL injuries.

The student-athletes also got a chance to hang out on the Rattlers football field. They were put through a series of exercises by the Spooner Physical Therapy team.

Once the clinic was completed, the athletes got a chance to tour the arena and then watch the Rattlers in action.

If you’re a coach interested in bringing this ACL Injury Prevention Clinic to your school or club organization, contact Dr. Martin.

Arizona man back to his active lifestyle

“I’m able to walk around this entire place,” Patrick Hutchins said. “I’m able to go hiking again.”

Something Hutchins wasn’t able to do without being in pain. The active life he was use to got out on hold after hurting his left knee walking in between college classes two years ago.

“I just kind of stumbled and finally fell, did a roll, as that was the safest route to take at that time,” Hutchins said. “Did not realize that when I hit the ground [my left] leg kind of whipped over and kind of slammed and hit the ground.”

Hutchins actually didn’t realize how bad his knee was until a few days later.

“I had a torn meniscus and then later on I discovered I had gauged a lot of cartilage out of my knee,” Hutchins said.

Hutchins was referred to OrthoArizona sports medicine specialist Dr. Shelden Martin.

He took a look at the injury and determined Hutchins was a good candidate for a cartilage transplant.

“I was actually in my [fellowship] training in 2010 at OrthoCarolina and we were one of the test centers for this [cartilage procedure],” Martin said. “It’s [also] recently been FDA approved in the last few years.”

When cartilage is damaged, whether through a sports injury or how Hutchins hurt his knee, the body has a hard time healing this type of tissue on its own.

This particular procedure called DeNovo Cartilage Transplant is something that if [patients] failed non-operative treatments and they’re a good candidate for the procedure, you have to get them scheduled because it’s based on donors,” Martin said.

The healthy donors cartilage, which is from someone 12 years of age or younger, is harvested and when done it’s ready to be transplanted into the patient to help regenerate new tissue.

“Typically [I] start with an arthroscopic procedure and then convert to an open procedure depending on how big the lesion is and where it’s in the knee,” Martin said. “It then involves removing some of the processing fluid on these cartilage wafers and then mixing it up with a fiber glue substance and over 15 minutes that fiber glue will become a hard type substance.”

“You can actual pack that into the area of the lesion that you’re going to be transplanting the cartilage into,” Martin continued.

Martin had to repair Hutchins’ torn meniscus first and after months of recovery, he performed the cartilage transplant in December 2015.

“[The doctor] had my leg in a brace and it was immobilized for a couple months,” Hutchins said. “Once that took place and he took the brace off, unfortunately my tendons started to shorten up and I had to go back in for another procedure.

“He then scoped [my knee] to clean everything up,” Hutchins continued.

Hutchins went through rehab and was back to his active life, pain free last September.

“We’re still learning the best candidates for this procedure, but certainly our numbers are growing as we find more patients that are good candidates,” Martin said. “It’s technically an easier procedure then some of the prior cartilage transplants procedures.”

“To be part of this and for the results to turn out like they have, I’m ecstatic about it,” Hutchins said.

High school students in Chandler learning about the medical profession

OrthoArizona Dr. Shelden Martin sat down with students at Hamilton High School in Chandler to discuss his journey to becoming an orthopedic surgeon.

Martin talked about why it’s important to get good grades, applying to medical school and getting a job.

Check out the ‘Career Day’ presentation —

A new procedure on the horizon for ACL injuries?

When an athlete hears the words they have a torn ACL, there is a lot of uncertainty that runs through their mind. How soon can it be fixed? When can I get back to my sport?

These are just a few of the questions I’m asked when treating this injury.

Every year more than 200,000 ACL injuries are reported. The majority of injuries happen playing soccer, basketball and football.

Surgery and rehab are involved with recovery time lasting anywhere from six months to a year. While every patient is different when it comes to getting better, understanding that this type of injury takes time to heal is important.

The traditional surgery usually involves replacing the injured ligament with a graft or replacement tissue to restore the patient’s normal anatomy. 

There is a new study being looked at that might change the way ACL tears are treated.

I found a story on The Undefeated (http://theundefeated.com/features/new-acl-surgery-could-cut-rehab-and-recovery-time-in-half/) talking about a new procedure using a bridge to help the ACL ends heal back together without doing a reconstruction.

According to the story, the first human trial looked at 10 patients getting the traditional ACL reconstruction surgery and another 10 receiving what is called the Murray’s bridge-Enhanced ACL Repair (BEAR) procedure.

The procedure, created by Dr. Martha Murray, found that three months after surgery, the BEAR participants in the study all had ACLs that were healing and the flexibility was close to their healthy knee.

I think the Murray’s bridge-Enhanced ACL Repair (BEAR) procedure is an interesting concept.  While more studies will be needed to validate this treatment, there is a lot of potential.

Our goal as doctors is to help get athletes back to their sport safely. If there is a potential new treatment that could speed the return to high-level athletics sooner than is currently possible after traditional ACL reconstruction surgery, I’m definitely interested in seeing what this procedure can do long term.

The study will be published in the Orthopaedic Journal of Sports Medicine next month.

For more information on ACL injuries and prevention please contact me at http://www.orthopedicarizona.com/contact-us/

Student Athletes Get Pro-Level Care

ABC15 came out to talk to OrthoArizona Dr. Shelden Martin about the new sports medicine program in the Chandler Unified School District.

The program will give student-athletes services that they would see playing at the collegiate level and tools to decrease injuries by providing education and prevention methods.

Outpatient shoulder replacement surgery seen as safe as inpatient surgery

BOSTON — Shoulder replacement performed in the outpatient setting is as safe as it is performed in the inpatient setting, according to results presented at the American Shoulder and Elbow Surgeons Annual Meeting.

“[I]nitial data suggest that it is safe in comparison to inpatient to perform these surgeries as an outpatient, but we need to refine the indications. Larger cohorts are required and longer time follow-up [is needed] to document efficacy and safety, and we need our payers to accept this,” Nikhil N. Verma, MD, said in his presentation.

Using the American College of Surgeons National Surgical Quality Improvement Program database between 2005 and 2014, Verma and colleagues identified patients who underwent either inpatient or outpatient primary shoulder replacement.

“We defined the outpatient cohort as length of stay of 0 days with discharge in the same calendar day,” Verma said. Of more than 7,000 patients identified, 173 patients underwent outpatient surgery.

“You can see they tended to be younger patients. They tended to be males, were healthier, had a lower BMI and generally underwent general anesthetic,” Verma said.

He noted a 2.3% rate of overall adverse events and a 1.7% rate of readmission in the outpatient group compared with 7.9% and 2.9%, respectively, in the inpatient group.

“When we performed a multivariate analysis, we found there was a trend toward decreased adverse events in the outpatient group — although it did not quite reach statistical significance — and there was no difference in readmissions between the two groups,” Verma said. “Overall, there was no difference in the rates of adverse events between the outpatient and inpatient setting and we believe that ultimately in the appropriately selected patient that outpatient total shoulder arthroplasty is at least as safe as in the inpatient environment.” – by Casey Tingle, as originally appeared here.

Arizona Woman Back in Action Thanks to her Reverse Total Shoulder Replacement Procedure

Charlene Linsalata loves being active. This includes doing things around the house and playing golf, but that wasn’t the case nearly two years ago.

“I was running and I didn’t clear the step,” Linsalata said. “I landed on the floor, on my shoulder, but I got right up because it didn’t really hurt.”

Linsalata quickly realized her left shoulder was in bad shape when she couldn’t lift her arm the next day. She headed to OrthoArizona where she met Dr. Shelden Martin.

“In comes this young man, I was scared to death and he said what he felt needed to be done,” Linsalata said.

She fractured her shoulder and Martin suggested she have a reverse total shoulder replacement. Candidates for this procedure are usually elderly patients.

“With this newer technology in the reverse shoulder, it’s still somewhat newer technology since it was FDA approved in 2004,” Martin said. “We’re initially doing it for arthritis type problems with bad rotator cuffs and we’re now expanding the indications for this procedure to include fractures.”

A reverse total shoulder replacement differs from a traditional replacement by switching the ball and socket.

The procedure works by screwing a smooth metal bone into the socket bone, a long metal stem is placed down the humerus and then a plastic socket is secured on top of the stem.

This allows for the deltoid muscle to raise the arm instead of the rotator cuff.

“In a fracture setting like Charlene had, we will try to reconstruct the boney tuberosity pieces around the upper portion of that stem and try to heal those components to the stem itself,” Martin said.

A patient will typically stay in the hospital one night, wear a sling for six weeks and then start physical therapy focusing on range of motion and strength.

“By three months, most patients have made major improvements and are probably 80 percent of the way, although they will still make improvements up to six months or even a year after surgery,” Martin said.

Linsalata credits her successful recovery to doing what Martin and her physical therapist told her to do to get the left shoulder working again.

“You have to do it the right way, the whole way,” Linsalata said. “I’m active and in a way, I’ve had no restrictions.”

“It’s probably one of the most game changing procedures we have in shoulder surgeries for decades and so for the right patient, it’s a great procedure,” Martin said.

A reverse total shoulder replacement can also be used to treat patients who have had previous rotator cuff surgeries and shoulder replacement surgeries that were not successful.

To see if you’re a candidate for this procedure, visit www.orthopedicarizona.com

Students learning how to treat injured athletes on the high school sports field

“We’re bringing together the student athletic trainers, the head school athletic trainers, Dignity Health athletic trainers, team physicians and emergency medical technicians, who would potentially take care of a high school athlete that is injured on the field of play,” said Dr. Matt Hansen, OrthoArizona sports medicine specialist.

All of these medical professionals and students are taking part in the second annual Field to Emergency Room event at Hamilton High School in Chandler.

They’re running through drills on how to work together when a student-athlete has injured his or her spine or other emergency situations on the sports field in the Gilbert Public Schools and the Chandler Unified School District.

“You could potentially take someone who has a bad injury and make it worse if we don’t treat them correctly,” Hansen said.

Hansen is the medical director of the sports medicine program in both school districts.

The program kicked off in Gilbert first and now Chandler this fall.

“Our sports medicine program between Dignity Health and OrthoArizona began about three years ago,” Hansen said. “We wanted to raise the level of care to something similar that you would have at a collegiate level.”

OrthoArizona physicians and Dignity Health athletic trainers work with the high school medical staff to make sure each student-athlete is given the best possible care. This includes hosting educational events like this one, providing sports physicals, being on the field during games and holding special office hours for student-athletes.

“It’s good for them to get hands on, so they understand the demands that we’re under when caring for that athlete,” Gary Cohen said. Cohen is with Dignity Health and is the head athletic trainer at Casteel High School in Chandler.

He likes the partnership with the orthopedic physicians and working with the student-athletes.

“They love having us on the sidelines and being able to identify things that might not be an injury necessarily, but we’re identifying that predisposed risk,” Cohen said.

“We’re getting an athletic trainer that is trained in all the latest techniques and protocols and putting them into the schools, so that all of these athletes at these schools have access to that trainer and those trainers are directing the athletes who are injured into our offices,” said Dr. Shelden Martin, OrthoArizona sports medicine specialist.

Martin is overseeing the Chandler sports medicine program. He believes the sports program they have put in place does much more than treat student-athletes’ injuries.

“Our job goes beyond fixing their injury surgically,” Martin said. “It’s counseling and coaching them, so to speak, and really setting their expectations and what to expect. You develop a bond in that relationship and that’s what it’s all about for us as the orthopedic surgeons.”