Guest: Jack Morgan

What are the latest trends in surgical treatment options available for patients suffering from recurrent heel pain, and how have podiatrists evolved in practice to manage the myriad of heel problems? Dr. Jack Morgan, attending staff member at the Los Angeles USC Medical Center and fellow of the American College of Foot and Ankle Surgeons, outlines the most common causes of heel pain, their respective modern treatment strategies, and upcoming advances in joint biomechanics. Dr. Michael Kotzen hosts.

Guest: Nicola Maffulli

Dr. Nicola Maffulli, professor and chair of trauma and orthopaedic surgery at the Keele University School of Medicine in Staffordshire, England, joins host Dr. Sherwin Ho to discuss pediatric sports injuries. Their discussion includes the causes and treatments for the most common sports injuries, including stress fractures, extreme hyper extension, back injuries, bone edema, and wrist and elbow injuries. 

Guest: Anthony Miniaci

Early arthritis of the knee is a frustrating and painful condition, especially for our more active patients. Some will begrudgingly accept the end of their adult sports league careers, others will be less inclined to hang up their sneakers. In this case, depending on the severity of the condition, there could be several procedural options, including a new arthroscopic resurfacing technique for those with less severe arthritis: could this be the quickest route back to the playing field? Dr. Anthony Miniaci, executive director of Cleveland Clinic Sports Health and one of the developers of this new procedure, explains why this procedure could be the answer for patients who have failed all biologic procedures, but are not yet ready for a total knee replacement. Which of your patients might be a candidate? Dr. Mark Nolan Hill hosts.

Guest: Selene Parekh

Ankle injuries extend from the common sprain, to the complex arthritis case that could warrant total joint replacement surgery. With respect to the basic sprain, why do we see so many of these injuries in our practices: are our ankles not strong enough, are we wearing the wrong shoes or are we simply more active than we used to be? What are the keys to a good clinical evaluation for these ankle injuries and what can you counsel your patients to anticipate following a more serious ankle injury? Dr. Selene Parekh, head of the foot and ankle division of the department of orthopaedic surgery at the University of North Carolina School of Medicine, assesses a range of ankle injuries in this conversation with host Dr. Mark Nolan Hill.

This article is from the issue dated October 14, 2010.  Modeling studies show that increased expression of nerve growth factor is associated with increased pain. This study tested the safety and efficacy of the monoclonal antibody tanezumab — which targets nerve growth factor — for the treatment of knee pain in patients with osteoarthritis.

Guest: Scott Levin

Trauma patients with injury to one or more limb often have additional systemic injuries that need to be considered during treatment. One approach to limb salvage is the ortho-plastic technique, which involves integrated soft tissue and bone. This conversation covers some of the latest advances in limb salvage techniques that might benefit trauma patients, as well as those with diabetes or peripheral vascular disease. Dr. Scott Levin, professor and chair of orthopaedic surgery and professor of plastic surgery at Penn Medicine, discusses strategies for avoiding amputation. Dr. Lee Freedman hosts.

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Guest: Scott Rodeo

What are the latest research and treatment modalities orthopedic surgeons use for meniscus-deficient patients? Dr. Scott Rodeo, professor of orthopedic surgery at Weill Cornell Medical College in New York and co-chief of the Sports Medicine and Shoulder Service at the Hospital for Special Surgery, discusses synthetic meniscal replacement in the knee joint with host Dr. Mary Leuchars.

Guest: Riley J. Williams III

The latest cartilage repair strategies can restore cartilage in the knees of athletes who one time would have had their career ended by their injuries. Dr. Riley Williams, associate professor of orthopedic surgery at Weill Medical College and director of the Institute for Cartilage Repair at the Hospital for Special Surgery, both in New York, talks with host Dr. Sherwin Ho about different techniques for repairing cartilage. What are the trade-offs between procedures that use the patient's own tissue, donor tissue, or biologics? Find out how today's autologous chondrocyle implantation procedure provides better results than its predecessors, and discover what the future holds for tissue repair.

Recent case reports and series have identified a subgroup of atypical femoral-shaft fractures associated with bisphosphonate use. This study analyzed data from three large, randomized bisphosphonate trials. Subtrochanteric or diaphyseal femur fractures were very rare, even among women who had been treated with bisphosphonates for as long as 10 years. In patients with osteoporosis, proven benefits for fracture reduction appear to outweigh the possible risk of femoral-shaft fractures.

There is an accompanying Editorial.

Guest: Ronald Lepow

Most of us will have walked the equivilent of three times around the world in our lifetimes. Taking into account that 75% of the population suffers foot problems at least once, the importance of taking care of our feet and ankles cannot be overstated. Dr. Ronald Lepow, past president of the American Podiatric Medical Association and the only American to ever serve as the President of the Federation Internationale des Podologues (FIP), joins host Dr. Michael Kotzen to discuss the evolution of podiatric medicine and surgery.

This article is from the issue dated February 11, 2010. Osteogenesis imperfecta is a heritable disorder that causes bone fragility. The authors describe two siblings with a mutation in the peptidyl-prolyl isomerase B gene (PPIB), resulting in the absence of cyclophilin B. Collagen folding and prolyl 3-hydroxylation in the proband were normal.

Guest: Joseph Iannotti

Are your patients with shoulder pain unable to enjoy their quality of life?

Shoulder pain can interfere with your patients' ability to enjoy life. Chronic shoulder pain is a debilitating presence in the lives of the people who suffer from it, making it difficult to sleep, eat, work, rest, accomplish everyday tasks, and in general, to live one's life to the fullest.

How can you help relieve their pain?

Listen to Dr. Iannotti's advice on the diagnosis and treatment options for shoulder pain conditions. Get tips on screening and management of your patients with shoulder pain. Dr. Iannotti discusses how best to partner with orthopaedic specialists and optimize patient outcomes through insightful discussions with Dr. Freedman.

Learn more at MovingBeyondJointPain.com

Be sure to also visit www.movingbeyondjointpain.com to access information geared to primary care for clear, general-information on shoulder ailments. From identifying the root cause of a patient's pain, to exploring treatment options and overseeing patient management or making referrals to specialists, physicians will find this website to be a helpful guide.

View an interactive learning center to understand how patients with common chronic co-morbid conditions such as diabetes and obesity, are at a higher risk for shoulder pain by visiting www.movingbeyondjointpain.com/edetail.

If you are one of the first 1,000 users to completely view the information in the Shoulder Pain Learning Center and register, you will be eligible to receive a free shoulder model.
Go to www.movingbeyondjointpain.com to learn more.

Cleveland Clinic Orthopaedic and Rheumatologic outcomes book for 2008

Guest: Lawrence Hurst

Dupuytren's disease can cause severe joint contracture in the hands, and surgery is often recommended for these patients most affected by the condition. But Dr. Lawrence Hurst, professor, chairman and chief of the division of hand surgery in the department of orthopaedics at Stony Brook School of Medicine Health Sciences Center, tells us about another new, non-surgical option that may soon be available for treating Dupuytren's contracture, using injectable collagenase. What types of patients are most susceptible to developing this condition? Dr. Lee Freedman hosts.

Guest: Nicola Maffulli

How can you help your patients with overused tendons and tendinopathies, like Achilles tendon problems and tennis elbow? Dr. Nicolas Maffulli, professor and chair of trauma and orthopaedic surgery at Keele University School of Medicine in Staffordshire, England, clinically specializes is tendinopathy. He says that we often misconceive tendinopathy as a degenerated tendon, when the problem is an actually injured tendon that cannot heal. Studies show that genetics as well as overuse may play a role in tendinopathy. Join us to learn about the latest research, treatment options and when the best solution may be surgery. Dr. Sherwin Ho hosts.

Guest: Richard Lackman

What needs to be conveyed to the patient presenting with metastasis to the bone, and in which cases is the prognosis more favorable? Dr. Richard Lackman, chair of orthopaedic surgery and director of the Sarcoma Center of Excellence at the Abramson Cancer Center within the University of Pennsylvania Health System, discusses bone cancer with host Dr. Lee Freedman. Their conversation covers the approach to blastic versus lytic lesions, impending fracture indicators, and surgical solutions for the patient.

Guest: Samir Mehta

Dr. Samir Mehta, chief of orthopedic trauma at the Hospital of the University of Pennsylvania, discusses the role of the orthopedic traumatologist. What does this designation mean?  What kind of special care or expertise do these specialists bring to the care of the patient?  In what situations might an orthopedic traumatologist be called in for consultation?  If you were in an accident, wouldn't you want this specialist called in to assist in your care? Dr. Lee Freedman hosts.

Guest: David Felson

A patient in your office describes the knee pain they have been feeling for an extended period of time. The MRI that you order on their knee reveals meniscal damage. New research is telling us that meniscal tears may be more common than we realize, and further, raises questions as to whether the meniscal tear is really the source of your patient's knee pain. Dr. David Felson, professor of medicine at the Boston University (BU) School of Medicine and professor of epidemiology at the BU School of Public Health, explains that damaged meniscal cartilage may not be directly linked to knee pain. Dr. Mark Nolan Hill hosts.

Guest: Brian Kelly

Recent advancements in hip arthroscopy and magnetic resonance imaging have elucidated several sources of non-arthritic hip abnormalities which, if left untreated, could result in chronic disabling symptoms. What are the current indications for hip arthroscopy, and what management issues should clinicians be made aware? Host Dr. Mary Leuchars examines these questions with Dr. Brian Kelly, assistant professor of orthopedic surgery at the Weill Medical College of Cornell University and attending physician at the Hospital for Special Surgery in New York.

Guest: Louis Soslowsky

Dr. Soslowsky discusses how new understandings of the pathophysiology of tendon-to-bone repair are leading to a new therapeutic approach to rotator cuff tears.

Guest: Richard Lackman

When a patient presents with a palpable mass, how can we ensure a proper diagnosis? Is pain often a false gauge of severity? Host Dr. Lee Freedman speaks with Dr. Richard Lackman, professor and chair of orthopaedic surgery and director of the Sarcoma Center of Excellence at the Abramson Cancer Center within the University of Pennsylvania Health System, about treatment modalities for a variety of palpable masses. When should patients be referred to a specialist?

Guest: Col. Jim Ficke

Many of the extremity injuries suffered in Iraq and Afghanistan are similar to those seen in previous conflicts. But according to Dr. Jim Ficke, chief of orthopaedic surgery at Brooke Army Medical Center in San Antonio, and an orthopaedic consultant to the United States Army Surgeon General, the wounds are occurring at a notably higher rate. How are we keeping up with these injuries? Dr. Ficke credits new debridement and external fixation techniques as key advances. Learn more with host Dr. John Armstrong.

Guest: John Kennedy

Commonly perceived as a minor injury, ankle sprains are dismissed by many athletes, in particular, who are encouraged to shake it off, play through pain, and pursue some simple rehab as their game and practice schedule allows. Yet there is more to simple ankle sprains than we may realize, including diminished proprioception and balance that may leave our patients more vulnerable to chronic injury. Why is this loss of proprioception specific to the ankle? Are we approaching our treatment of these injuries in the proper manner? Dr. John Kennedy, assistant professor of orthopaedic surgery at Weill Medical College of Cornell University and an orthopaedic surgeon at the Hospital for Special Surgery in New York, details effective diagnostic and treatment strategies with host Dr. Jordan Metzl. Dr. Kennedy urges us not to underestimate what may be perceived as a simple ankle sprain.

Guest: Spero Karas

What is the latest thinking in anterior cruciate ligament (ACL) injury and repair? Should techniques differ for men and women? Join orthopaedic Surgeon Dr. Spero Karas in a discussion about ACL injury and repair with host Dr. Mark Nolan Hill.

Guest: Spero Karas

The reported rates of failure after arthroscopic rotator cuff repair are widely varied. Dr. Spero Karas, director of the Emory Orthopaedic Sports Medicine Fellowship Program, talks host Dr. Mark Nolan Hill through the double-row rotator cuff repair procedure, a newer and more successful repair technique. Which patient populations will do best with this procedure and how do the results differ when compared with a more traditional repair?

Guest: Clifford Tribus

Back pain is often a complaint from patients. Spinal stenosis is often a cause of back pain, especially in the elderly. In this segment, Dr. Clifford Tribus talks with host Dr. Mark Nolan Hill about the process of identifying the source of back pain: spinal stenosis, degenerative disk disease, and beyond. He also discusses the difference between vascular and neurogenic claudication in spinal stenosis.

Guest: Paul Lux

Join Dr. Mark Hill interview Dr. Paul Lux, orthopedic surgeon on the topic of knee replacements. Which patients are the best candidate for total replacement? What is involved in a total knee replacement? Find out in this segment.

Guest: Craig Israelite

Dr. Craig Israelite, assistant professor of orthopedic surgery at the University of Pennsylvania School of Medicine, discusses a series of approaches to knee osteoarthritis. A brief review of non-surgical treatment is followed by a discussion of image-guided surgery, minimally invasive surgery, partial knee replacements and the post-operative use of multi-modal pain strategies. Dr. Lee Freedman hosts.

Guest: William Hozack

As America ages, hip replacement will be a more common surgery than it already is. Has anything changed in hip replacement surgery? What do you need to be able to tell your patient? Join host, Dr. Mark Nolan Hill in an update on hip replacement with guest Dr. Bill Hozack.

Guest: Paul Lux

What causes arthritis? Is it wear and tear or genetics? What are the best solutions for arthritis of the knee, hip and shoulder? Join Dr. Mark Hill interview Dr. Paul Lux, orthopedic surgeon and expert on joint replacement on the topic of arthritis.

Guest: Craig Israelite

Dr. Israelite intially reviews some basic concepts in the approach to osteoarthritis. He then outlines recent surgical advances in the treatment of osteoarthritis of the hip that have led to better outcomes for our patients. These include minimally invasive surgery, progress in postoperative rehabilitation and the development of new bearing surfaces that both improve range of motion and extend the life of the hip prosthesis.

Guest: William Hozack

Host Dr. Mark Nolan Hill interviews orthopedic surgeon, Dr. Bill Hozack, of Thomas Jefferson University Hospital in Philadelphia, about hip resurfacing, a newer alternative to the hip replacement procedure. What are the benefits of hip resurfacing? Is it here to stay? Find out if your patients should consider hip resurfacing.

Guest: Clifford Tribus

X-Stop, a ruuner up in the 2007 Wall Street Journal Technology Awards for best medical devices is an innovative implantable device to relieve pain in patients with spinal stenosis. In this segment Dr. Cliff Tribus shares his experience implanting the X-Stop. He discusses which patients benefit most from X-Stop and how it helps them. He also speaks about the concept of stenosis being a threshold disease and considers the role of a physician in helping to manage the pain threshold.

Guest: Paul Lux

Many physicians have ideas about better drugs or better medical devices. How do you take these ideas a step further? Join Dr. Mark Hill interview orthopedic surgeon and inventor Paul Lux, MD to learn about his experiences.

Guest: Louis Soslowsky

Dr. Louis Soslowsky, from the University of Pennsylvania Health System, outlines how newer understanding of the mechanism of injury in overuse syndromes is leading to new approaches in treatment. Dr. Soslowsky shares his expertise in biomedical engineering to help doctors fine tune their approach to rotator cuff tendinosis, epicondylitis and other common clinical problems caused by overused tendons.

Guest: Paul Lux

In this segment, Dr. Mark Nolan Hill interviews orthopedic surgeon, Dr. Paul Lux about what is new in the area of hip replacement.

Guest: Myron Genel

In this segment Dr. Genel, who served as an ad-hoc member of the US Olympic Medical Committee, narrates a historical perspective of gender verification for Olympic Athletes. Dr. Genel explores the gender testing process and its flaws, and explains some of the genetic disorders that may have caused certain athletes to fail the gender tests.

Guest: Antonia Baum

Sports Psychiatrist, Antonia Baum shares the most common psychiatric illness found in athletes and explains its impact on the game.

Guest: Martin Lanoff

Dr. Marty Lanoff, a physical medicine and rehabilitation specialist joins Dr. Larry Kaskel to discuss the meaning of Physiatry and exactly what being a physiatrist entails.

Guest: Mark Neault

Dr. Mark Neault discusses the different diagnoses related to knee injuries and focuses on diagnosis, treatment and rehabilitation of knee injuries. He then explains effective ways in which to prevent knee injuries.