Meet. Brent Adams. For more information or to schedule an appointment please call Written by Board Certified Pediatrician

Size: px

Start display at page:

Download "Meet. Brent Adams. For more information or to schedule an appointment please call Written by Board Certified Pediatrician"

Basil Scot Lambert
5 years ago
Views:

I think that a lot of orthopedic problems can be solved with medication, physical therapy, chiropractic care, injection, and other non-surgical treatment.

1 I think that a lot of orthopedic problems can be solved with medication, physical therapy, chiropractic care, injection, and other non-surgical treatment. Meet Brent Adams Written by Board Certified Pediatrician Board David Certified W. Withrow, Orthopedic MD, FAAP Surgeon Talk about the moment you felt called to practice medicine. From the time I was young and making rounds with my dad, I have always had a desire to be a physician. I enjoy interaction with patients and the most satisfying thing is to help them with a difficult health problem. What made you chose your specialty? I got drawn to orthopedics in college when I worked in a biomechanics lab at the Mayo Clinic for the summer. I was an electrical engineering major in college and interestingly, the mechanisms taught in engineering apply well to orthopedics. Do you have a personal philosophy of patient care? As a surgeon, I try to have a conservative philosophy to care. I think that a lot of orthopedic problems can be solved with medication, physical therapy, chiropractic care, injection, and other non-surgical treatment. What is your specialty? I am an orthopedic surgeon and have done a spine surgery fellowship. I spent five years at the University of Kansas after medical school studying general orthopedics. I then spent one year of studying just spine surgery at the Twin Cities Spine Center in Minneapolis, Minnesota. I have been practicing four years and am a fully board-certified orthopedic spine surgeon. What would be your advice for helping patients communicate better or feel more confident in receiving care? We try to get as much information from our patients by having them fill out a packet of information before they arrive to the clinic. I also think the Internet can be a useful resource to gather information about a condition prior to an appointment at the doctor s office. We also have the Patient Portal available at the Yankton Medical Clinic and this is being used more and more. When should a patient see a specialist and what does an orthopedist take care of? We will see most patients largely based on the recommendation of your primary care physician once conservative measures have been exhausted. I will see patients for a variety of problems; I perform general orthopedic procedures such as joint replacements, knee arthroscopy, ACL reconstruction, rotator cuff repair and fracture care in addition to spine surgery. Why did you come to practice in Yankton? My wife and I returned to Yankton because we have three small children and are both from the area. My wife, Coreen, is from Hartington, Nebraska and I am originally from Yankton. Yankton was a great place to grow up and IS a great place to raise a family. Tell us about yourself, your interests, hobbies, family. I have been married for 14 years to my wife Coreen. We have three children, Braxton who is 7 years old, Remington who is 5 years, and Ashton 4 years. I enjoy spending time with them and often take them with me to play golf, waterski, or hunt pheasants. We also have three Labrador retrievers, Wyatt, Daisey and Thunder. For more information or to schedule an appointment please call

2 For more information or to schedule an appointment please call Arthroscopic Rotator Cuff Repair Written by Board Certified Orthopedic Surgeon Brent Adams, MD, ABOS Rotator cuff tears are a very common injury seen in any orthopedic practice. They occur commonly between the ages of 35 and 60, secondary only to decreased blood supply, arthritis and chronic wear and tear injuries. In patients younger than 40 years old, trauma is usually the cause of rotator cuff tear. The rotator cuff is a complex of four muscles around the shoulder girdle that allow elevation of the upper extremity so that the hand can be placed in space to perform overhead tasks. The muscles start at the shoulder blade and insert into the humerus, the large bone of the upper arm. Without a functional rotator cuff, it is difficult if not impossible to perform simple duties such as putting on a shirt or getting objects out of a cupboard. Common symptoms of a rotator cuff injury are pain and dysfunction. Frequently, patients are unable to cite a specific time when an injury occurred. Patients often complain of having difficulty performing overhead tasks and feeling weak when doing so. Night pain is also a frequent symptom that occurs when the rotator cuff has been injured. Pain is typically present in the upper part of the arm and can be accompanied by radiating pain down the arm and pain and numbness into the hand. Treatment for rotator cuff injuries is dictated by the chronicity and the size of the tear. The initial treatment of most injuries consists of focused physical therapy on regaining range of motion and strength in the shoulder. Physical therapy is often coupled with antiinflammatory medication or injections to get optimum results. Rotator cuff tears are not repaired with physical therapy but it does strengthen the muscles around the shoulder so that the patient can compensate for the injury. Small tears do tend to become larger with time, however treatment is focused toward symptoms and not just the size of the tear. If conservative treatment fails and pain and dysfunction persist, then surgery is a viable and effective option. The goal of surgery is to fix the rotator cuff tendon back to the humerus so that the patient s shoulder can regain normal function. There are several techniques that have been used for surgical fixation. Traditionally, open techniques were used. But over the last decade, newer, lessinvasive arthroscopic techniques have become the standard of care. Arthroscopic repair has several advantages over open repair. The first is that typically only a few small stab incisions are needed to perform a successful repair. This results in less surgical trauma and post-operative scarring and the recovery time is shorter. Another advantage of arthroscopic repair is that a full direct arthroscopic examination of the shoulder can be done at the time of surgery. Other structures such as the labrum, biceps tendon, distal clavicle, acromion, etc. are all inspected during surgery and repaired if necessary. Although pre-operative radiographic studies such as MRI examinations are excellent diagnostic tools, they do have limitations and direct inspection of all structures within the shoulder helps with these shortcomings. Often with open repair all of the anatomy of the shoulder is not directly inspected and thus other damage to the shoulder can be missed and not addressed at the time of surgery. Following surgery, physical therapy is a key part of the treatment process. Therapy protocols are geared toward the size of the repair that was required. Typically, the entire recovery process takes weeks but again is dependent on the size of the initial tear. The surgeon and the therapist need to work closely together to get an optimal result for the patient. Rotator cuff injuries are common but often patients have excellent recovery with appropriate management. Arthroscopic techniques have become the standard of care over the last decade and are being performed locally in Yankton.

The disk between each of these bones is made of a thick outer lining, which contains the softer central core of the disk.

3 What exactly is a herniated disk? Written by Board Certified Orthopedic Surgeon Brent Adams, MD, ABOS What is a cervical disk herniation? The musculoskeletal structure of the neck is made up of a series of bones with shock-absorbing disks in between. There are seven of these bones, called cervical vertebrae. The disk between each of these bones is made of a thick outer lining, which contains the softer central core of the disk. A disk herniation occurs when one of the disks gets a tear in the thicker outer lining and the center portion of the disk protrudes out, or herniates. What are the causes? Most of the time, a patient will not be able to recall a specific event or injury that caused the herniation. The most common presentation is a patient waking up in the morning with new onset of neck and/or arm pain. What are the symptoms? Symptoms usually include a combination of neck and/or arm pain. The arm pain is typically down just one of the arms, but can be in both. The pain may only be in the shoulder, but can often extend down into the forearm and hand. Weakness may also accompany the arm pain. For this reason, a thorough physical examination is necessary. Neck and shoulder problems can often mimic one another depending on which disk in the neck is affected. Again, a thorough examination and imaging tests, such as an X-ray and MRI, can be used to assist with the diagnosis. What is the treatment? As with any orthopedic condition, conservative treatment is typically the first option. This course can include physical therapy, traction, medications, and injections. If no response is seen after 3-4 weeks of conservative care, operative intervention can be considered. However, surgery may be more urgent if weakness is discovered at first examination. Weakness typically indicates a severely compressed nerve in the neck. If weakness is allowed to persist, it can be difficult to resolve. In such cases, surgery may be preferable. What kind of surgery is performed? Typically, cervical disk herniations are addressed with an operation from the front of the neck. The typical operation is called an anterior cervical diskectomy and fusion (ACDF). This operation has been performed for over twenty-five years with 90-95%

4 What exactly is a herniated disk? Written by Board Certified Orthopedic Surgeon Brent Adams, MD, ABOS good-to-excellent results. More recently, disk replacement surgery has become available. Disk replacement surgery is essentially the same operation as an ACDF, however, the disk space is not fused. Instead of placing a piece of bone in the disk space, as with an ACDF, the surgeon places a prosthesis that allows motion to occur. There are ongoing studies examining whether a disk replacement is beneficial over an ACDF. What is the recovery time following surgery, and what activities will I be able to do? Surgery typically involves an overnight hospital stay. Arm pain usually recovers within days of surgery, and patients can typically get back to work in days to weeks. Full recovery is typically four to six weeks. With an ACDF, patients typically do not notice any loss of motion or function. If you feel you have a cervical disk herniation, we would be happy to see you and alleviate your pain. For more information or to schedule an appointment please call

5 Breaking down ACL reconstruction Written by Board Certified Orthopedic Surgeons Brent Adams, MD, ABOS and Jeremy Kudera, MD, ABOS What is the ACL? The ACL or anterior cruciate ligament is one of four major ligaments in the knee that allows for stabilization. The other three ligaments are the medial collateral ligament (MCL), lateral collateral ligament (LCL), and the posterior cruciate ligament (PCL). The specific function of these four ligaments is to provide stability for the knee in all planes of movement. The specific function of the ACL is to provide stability against anterior or forward translation of the tibia on the femur. This is a vitally important function for any higher level stress to the knee such as running or twisting on the knee. How do injuries to the ACL typically occur? Injuries to this ligament typically occur when there is a twisting maneuver and/ or a lateral blow to the knee. Examples being a football player who has another player fall on the outside to their knee or someone who slips on the ice and twists their knee. What are the symptoms of a patient who has injured their ACL? Typically there is an acute, traumatic event and there may be the sensation of a pop in the knee. The knee will swell significantly, which in turn causes significant pain. If the swelling is allowed to dissipate over several days the pain will subside; however, the knee will be unstable and may give out. What are treatment options for an ACL tear? Treatment depends on the patient and the physical demands of the patient. If an individual is an athlete or has a physically demanding occupation, the recommendation is generally surgical reconstruction. If the patient has lower daily demands and does not experience giving way of the knee, non-operative strategies can be pursued. How is an ACL reconstructed? Once the ACL is torn, the native ligament cannot be directly repaired. Other ligamentous tissue either from another ligament in the injured patient or from a cadaver is harvested to replace the damaged ACL. This is done arthroscopically and typically takes approximately 90 minutes of operative time. What is the rehabilitation process following surgery and when can activities be resumed? As orthopedic surgeons we work in close contact with a physical therapist following surgery. Initial exercises are focused on regaining motion to the knee; once motion is obtained strengthening exercises can begin. Range of motion is regained anywhere from 2-6 weeks and strength regained from 4-12 weeks post

6 Breaking down ACL reconstruction Written by Board Certified Orthopedic Surgeons Brent Adams, MD, ABOS and Jeremy Kudera, MD, ABOS operatively, depending on the patient. Competitive athletics is deferred for at least 6-9 months following surgery, which is dictated by the new ligament that has been placed, properly incorporating and obtaining the appropriate blood supply to withstand the stress that is required to compete in athletics. Early return to athletics can lead to rupture of the same ligament and failure of the healing process. Is a brace required following ACL reconstruction? The risk of re-rupturing a healed properly, reconstructed and rehabilitated ACL is as likely as rupturing the ACL initially. Braces have not been shown to prevent a rerupture in the orthopedic literature. What are the long-term consequences of an ACL tear? This is largely unknown in the medical literature. However, the consequences of leaving an ACL unrepaired and having an unstable knee will likely lead to early osteoarthritis and joint replacement. Who should I see? You should be seen by a Board Certified Orthopedic Surgeon for evaluation and treatment. Both Orthopedic Surgeons at Yankton Medical Clinic, P.C. are Board Certified and specialize in sports injuries. For more information or to schedule an appointment, please call

Meet. Brent Adams. For more information or to schedule an appointment please call Written by Board Certified Pediatrician

Meet. Brent Adams. For more information or to schedule an appointment please call Written by Board Certified Pediatrician I think that a lot of orthopedic problems can be solved with medication, physical therapy, chiropractic care, injection, and other non-surgical treatment. Meet Brent Adams Written by Board Certified Pediatrician