Tuesday, February 9, 2016

Arthritis of the Foot and Ankle

Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle. There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.
Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.
The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:
* Pain with motion
* Pain that flares up with vigorous activity
* Tenderness when pressure is applied to the joint
* Joint swelling, warmth, and redness
* Increased pain and swelling in the morning, or after sitting or resting
* Difficulty in walking due to any of the above symptoms
Nonsurgical Treatment -
Initial treatment of arthritis of the foot and ankle is usually nonsurgical. Your doctor may recommend a range of treatment options.
* Physical therapy
* Assistive devices (such as wearing a brace or using a cane)
* Medications including non-steroidal anti-inflammatory medications
Surgical Treatment -
Your doctor may recommend surgery if your pain causes disability and is not relieved with nonsurgical treatment. The type of surgery will depend on the type and location of the arthritis and the impact of the disease on your joints. In some cases, your doctor may recommend more than one type of surgery.
* Arthroscopic debridement
* Arthrodesis (fusion)
* Total ankle replacement (arthroplasty)
In most cases, surgery relieves the pain of arthritis and makes it easier to perform daily activities. Full recovery can take from 4 to 9 months, depending on the severity of your condition before surgery and the complexity of your procedure.
If you you are experiencing arthritis of your foot or ankle, contact TOCA to schedule an appointment with one of our expert orthopedic physicians.

Monday, October 26, 2015

Monday, October 19, 2015

Monday Meet the TOCA Team: Samuel M. Harmsen, MD!

Dr. Samuel Harmsen is thrilled to be joining the outstanding physicians at The Orthopedic Clinic Association. He is fellowship trained in shoulder and elbow surgery with advanced training in complex shoulder and elbow reconstruction. Dr. Harmsen specializes in the treatment of all shoulder and elbow conditions including sports related, reconstructive, and traumatic injury. He performs arthroscopic and open surgical techniques and is uniquely skilled with reverse shoulder replacement and revision shoulder surgery. He also treats general orthopaedic trauma of the upper and lower extremities.
Dr. Harmsen was born and raised in Salt Lake City, Utah. He attended the University of Utah majoring in Japanese and Asian Studies, interrupting his studies to serve a two-year mission for his church in Japan. Prior to medical school he enjoyed several years of ski instructing at one of his favorite ski resorts, Deer Valley, UT.
Dr. Harmsen has had the opportunity to train under some of the world’s most renowned leaders in shoulder and elbow surgery. Following orthopaedic residency, he completed a complex shoulder and elbow fellowship at the San Francisco Shoulder, Elbow and Hand Clinic under Drs. Tom Norris and James Kelly. After fellowship, he extended his training by spending time with Dr. Laurent LaFosse in Annecy, France, and Dr. Pascal Boileau in Nice, France. This specialty training has helped him gain unique skills in advanced shoulder and elbow arthroscopy and reconstruction that are not widely available in Arizona.
Dr. Harmsen is very active in orthopedic research, having published and presented at a number of local, national, and international meetings. His primary area of interest is shoulder surgery, particularly in clinical results with shoulder arthroplasty. Dr. Harmsen plans to establish the Arizona Shoulder and Elbow Institute and, together with TOCA, develop a center of excellence within Arizona for shoulder and elbow research, education, and patient care.
Dr. Harmsen likes to create a professional but relaxed clinical atmosphere where everyone feels comfortable and able to ask questions freely. He wants you to leave each visit confident and encouraged. His clinical approach is centered around each patient’s individual concerns and goals. He believes that clear communication, patient education, and patient participation are vital to the success of any treatment, whether operative or non-operative.
To schedule an appointment with Dr. Harmsen please call 602-277-6211. To learn more visit: www.tocamd.com


Tuesday, October 13, 2015

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

One of the more troublesome issues surrounding breast cancer surgery and lymph node dissection is the development of lymphedema in the arm. Traditionally these patients have been warned against having blood pressures taken, IV’s placed and surgery performed on the same side as lymph node dissection. However, recent research suggests that surgery is safe in patients who have previously had mastectomy and lymph node dissection.
A 2007 article studied 25 women who previously had mastectomy and lymph node dissection. Four of these women had a history of lymphedema. All of these patients underwent hand surgery on the same side as their lymph node dissection. There was no increased risk of infection in this group. Only 2 had a temporary worsening of their lymphedema. Of the women who never experienced lymphedema in the past, none of them developed it after hand surgery.
Another study in 1995 studied 15 women who had lymph node dissection and hand surgery. Seven of these women had a history of lymphedema. All of these women had hand surgery and none of them developed any symptoms of lymphedema after surgery.
While there is a perception, mainly among breast care nurses and breast surgeons, that hand surgery should not be performed after lymph node dissection, literature supports that it is safe. These articles suggest that hand surgery after lymph node dissection does not increase risk of developing lymphedema after surgery. Hand surgery is safe for women who have had mastectomy and lymph node dissection.
My hands helping your hands.
Josh C. Vella, M.D.

Breast J. Hershko: Safety of Elective Hand Surgery following axillary Lymph node Dissection. 2007;13(3):287-90
Ann Surg Onc. Dawson:Elective Hand Surgery in Breast Cancer patient with prior ipsilateral axillary dissection. 1995; Mar;2(2): 132-7
Ann R Coll Surg Eng: Fulford: Hand Surgery after Axillary Lymph Node clearance. 2010; Oct:92(7):573-



Monday, September 28, 2015

Men vs. Women and Musculoskeletal health:

Men vs. Women and Musculoskeletal health: differences between males and femalse extend to their bone and joint conditions.
Women in general have a higher incidence of osteoporosis-related hip fractures yet, they have a lower rate of mortality than men with the same fracture, according to a study in the June 2015 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). In addition, doctors don’t always recognize or treat osteoporosis in men as often as inwomen.
“Male and Female Differences Matter in Musculoskeletal Disease” details the differences between how common musculoskeletal disorders manifest themselves in males versus females. The paper also underscores how important it is, for healthcare professionals to understand those differences and recognize how multiple factors can contribute to musculoskeletal conditions and injuries.
There are differences between how males and females develop several common musculoskeletal disorders:
Anterior cruciate ligament (ACL) injuries are 2-8 times more common in females.
Females are 5-8 times more likely than males to suffer an ACL injury in high-intensity sports like soccer and basketball that require sudden changes of motion.
Ankle sprains are twice as common in females.
Osteoarthritis of the knee is more common in females.
Metacarpal and phalangeal (finger) fractures are more common in males.
Recognition of these differences can contribute to better care of individual patients, and to a higher index of suspicion for injury for certain diagnoses such as ACL tears.



Wednesday, September 23, 2015

Listen to the Sports Medicine Radio interview - "Dox n Jox" with Dr. Dan and Dr. Haber of TOCA!

Way to Go Dr. Joseph Haber - Orthopedic Surgeon of the Hand and Wrist at TOCA! Listen to the Sports Medicine Radio interview - "Dox n Jox" with Dr. Dan and Dr. Haber of TOCA! Click the button below to listen!

You can also learn more and listen by visiting http://www.doxnjox.com/ orhttp://www.doxnjox.com/individual-guests.html.



Congratulations to Dr. Harmsen!

Congratulations to Dr. Harmsen who has had two papers accepted for podium presentation at the 2016 AAOS annual meeting in Orlando Florida!