Thursday, June 27, 2013

TOCA is proud to announce that Dr. Carter performed the first meniscal allograft in South Africa.

(View of Cape Town from the the top of the famous Table Mountain)

Dr. Tom Carter was the visiting professor at Sports Science Institute of South Africa this month in Cape Town. TOCA is proud to announce that Dr. Carter performed the first meniscal allograft in South Africa.


Wednesday, June 26, 2013

Congratulations Dr. Anikar Chhabra for this outstanding recognition!

Congratulations Dr. Anikar Chhabra 
for this outstanding recognition!

TOCA is proud to announce that Dr. Anikar Chhabra was awarded faculty of the year from the Banner Good Sam Orthopaedic Residency program. This award is voted on by the residents in the program for outstanding contribution to their education. 


Monday, June 24, 2013

Dr. Kostas Economopoulos: Final Thoughts on Australia

“I have spent the last 6 months learning about hip arthroscopy and hip injuries in athletes.  It has been an amazing experience in many ways.  I have had the honor of working with one of the true pioneers in hip arthroscopy, Dr. John O’Donnell in Melbourne, Australia.  In addition to performing over 250 hip arthroscopies during my time here, I have learned how to deal with many complicated hip issues including femoroacetabular impingement (FAI).  In addition, my family and I have had a wonderful experience learning about Australian culture.  We have been fortunate enough to travel to many wonderful places in Australia including the Great Barrier Reef and Sydney.  Although I have loved my time in Australia, I look forward to returning to my family and friends and using the skills and knowledge I have gained when I start with TOCA in Phoenix.”

Dr. Economopoulos will begin seeing patients in Mesa, Phoenix & Scottsdale August 1st, 2013.


Wednesday, June 19, 2013

Dr. Carter invited to speak in South Africa

(Cape Town, South Africa)

Dr. Carter was invited to be a guest speaker and surgeon for South Africa Orthopedic/ Sports Medicine Society in Cape Town, South Africa. Great Job Dr. Carter!


Wednesday, June 12, 2013

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a term that is well known. Unfortunately, given this widespread familiarity, people often attribute any discomfort or pain in the hand or wrist to carpal tunnel syndrome. Carpal tunnel syndrome is quite common, affecting 4-10 million Americans, and usually very treatable. However, there are many other conditions which can cause similar complaints. It is important to know the difference.

Fast Facts:

• The main symptom of carpal tunnel syndrome is numbness of the fingers.
• Carpal tunnel syndrome may interfere with hand strength and sensation, and cause a decrease in hand function.
• Carpal tunnel syndrome can be treated effectively with medications, splinting, steroid injections in the wrist and/or surgery.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is pain, tingling, and other problems in your hand because of pressure on the median nerve in your wrist.

The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers (not your little finger).

What causes Carpal Tunnel Syndrome?

Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller. Things that can lead to carpal tunnel syndrome include:
• Illnesses such as hypothyroidism, rheumatoid arthritis, and diabetes.
• Pregnancy.
• Obesity.
• Making the same hand movements over and over, especially if the wrist is bent down (your hands lower than your wrists), or making the same wrist movements over and over.
• Wrist injuries and bone spurs.
• Smoking, because it can reduce blood flow to the median nerve.

How is Carpal Tunnel Syndrome diagnosed?

The diagnosis of carpal tunnel syndrome often is made by the physician based on an accurate description of the symptoms. During physical examination, testing may identify weakness of the muscles supplied by the median nerve in the hand, including some thumb muscles affected by the syndrome. There may be decreased sensation in the hand to pin prick or light touch. Bending the wrist to 90 degrees for one minute may cause symptoms to appear in the hand (Phalen test) or tapping on the wrist with a reflex hammer may cause an electric shock-like sensation (Tinel Sign). Late in the disease, there may be thinning of the muscles or muscle atrophy at the base of the thumb.

Your doctor may suggest tests, such as:
• Blood tests to see if any health problems might be causing your symptoms.
• Nerve testing to find out if the median nerve is working as it should.


Friday, June 7, 2013

TOCA Physician Gives Back: Flying Doctors of Mercy

Dr. Kraig Burgess and his Physician Assistant, Lisa Babel traveled to the state of Sinaloa Mexico with LIGA International this April to serve the communities of San Blas and El Fuerte on a medical mission’s trip.  Dr. Burgess and Lisa are members of LIGA International, “Flying Doctors of Mercy”, an organization providing medical and surgical care to the under-served communities of rural Mexico since 1934.  LIGA mission trips occur the first weekend of each month from October through June.  On average 15-20 pilots donate their time and 4-6 passenger planes to transport the Doctors and other health care providers with donated medical equipment to a remote single runway airfield in El Fuerte.

The April trip provided Dr. Burgess a unique opportunity to care for patients in his area of expertise, hand and upper extremity surgery.  The trip includes screening surgical candidates and treating nonsurgical patients in a clinic setting.  Once screened, the remaining time is spent performing the surgical reconstructions. “I was immediately overwhelmed by the need these people have for health care.  Many of the patient conditions have progressed to levels you would never see here in the States where treatment would have been performed much earlier,” said Dr. Burgess. 

This particular trip over 340 patients were treated, including surgeries performed in general, orthopedic hand, podiatry, ophthalmology, OB/GYN, and cardiology.  Dr. Burgess and Lisa were able to see dozens of clinic patients and treat conditions varying from pediatric congenital abnormalities, traumatic injuries, tumors, tendinitis, arthritis and nerve injuries.  These surgeries included a 19 month old boy with a condition called syndactyly, which presents with a webbed hand appearance.  They also cared for a young girl who had been badly burned and developed an infection, resulting in a partial amputation and scar contractures to her hand.  Another gentleman had been injured by a machete, resulting in multiple tendon lacerations and permanent nerve deficits.  Dr. Burgess recalls, “You have to get pretty creative and be willing to adapt to the supply limitations in order to get things done.  It’s pretty much self-service when it comes to finding equipment, prepping the rooms and setting up for surgery.  I could not have imagined accomplishing what we did without my PA, Lisa’s help.”

As they recall the trip, what stood out more than anything was how grateful the patients were and how accommodating the local people were to the volunteers.   “Patients traveled for hours, many by bus, to sit and wait for hours just for hope, hope that something could be done to help them.  It was heartbreaking to not have the equipment and time to help everyone,” Dr. Burgess said.  Through the generosity of companies Dr. Burgess works with; he has been able to obtain supplies which will allow him to care for some of these patients on his next trip.  Dr. Burgess and Lisa are planning their next trip for this fall.  To learn more about this incredible organization, “Flying Doctors of Mercy”  go to  

Lisa Babel, PA-C

Dr. Burgess

Dr. Burgess scrubbing up

Dr. Burgess & Lisa Babel, PA-C operating 

“Patients traveled for hours, many by bus, to sit and wait for hours just for hope, hope that something could be done to help them...,” - - Dr. Burgess


Thursday, June 6, 2013

Hip Arthroscopy - Dr. Kostas Economopoulos

Hip Arthroscopy
Dr. Kostas Economopoulos

“Hip arthroscopy is a minimally invasive surgical procedure used to treat several disorders by placing a small camera into the hip and using instruments the size of a pen.  The procedure can be performed through 2 or 3 poke holes in the skin rather than making a large incision.  The surgery can be done on an outpatient basis and due to its minimally invasive nature, allows patients to return to sport and other activities quickly. Hip arthroscopy is a relatively new procedure and only a few people in Arizona are performing the surgery.  Currently, I am the only orthopaedic surgeon in Arizona to have completed a concentrated fellowship in hip arthroscopy.

The most common disorders treated with hip arthroscopy are femoroacetabular impingement (FAI) and tears of the hip labrum.  FAI is a condition where the hip is misshaped which can lead to injuries inside the hip and possibly early arthritis.  The labrum acts like an “O” ring around the hip socket and can be injured or torn due to FAI or other traumatic events to the hip.  Tears of the labrum may lead to disabling groin pain in athletes.

FAI is a common issue in young athletes causing them to miss playing time.  There is a high prevalence of FAI in athletes participating in sports such as soccer, football, hockey and rugby.  Other activities such as running and ballet can also lead to injuries inside the hip such as labral tears which can be treated with hip arthroscopy.  Due to the minimal invasive nature of hip arthroscopy, athletes can return to action earlier than if they were treated with open surgery.

My interest in hip arthroscopy stems from my background in general surgery, sports hernias and groin injuries in athletes.  Groin pain in athletes is becoming a more common problem, and to be an effective sports medicine surgeon, I felt I needed to be able to treat FAI appropriately.  I have spent the past 6 months in a fellowship focusing on hip arthroscopy and FAI.  I look forward to returning to Phoenix and focusing on sports hip injuries in addition to other aspects of sports medicine.”