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Kirkland WA
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News & Events

Radio Frequency Ablation vs. Hyaluronic Acid

October 23rd, 2020

Radio frequency ablation compared with a single injection of hyaluronic acid for chronic knee pain. Reported in the Journal of Bone and Joint Surgery September 2020 There are many potential approaches to alleviating the pain associated with osteoarthritis. The most common approach is suppressing the inflammatory response to cartilage breakdown. This would include icing, oral anti-inflammatory medication, Injectable anti-inflammatory medication like steroids. Activity modification, weight loss, and physical therapy can also mitigate some of the symptoms of arthritis. Injection of platelet rich plasma which provides growth factors for cartilage regeneration has been shown to be effective in early arthritis theoretically improving or repairing the cartilage through the delivery of growth factors. There are also injectable medications that rehydrate the remaining cartilage in an arthritic joint, and lubricate the joint, by incorporating into the articular cartilage. Examples of this would be Synvisc or Euflexxa. (  hyaluronic acid ). Another approach is simply to try to suppress the pain and stay active despite the arthritis. Examples of this would be Tylenol, Narcotics, or nerve ablation. Nerve ablation is an attempt at decreasing the nerve stimulation Signal coming from the arthritic joint to the brain. Prior studies of radio frequency ablation have demonstrated […]

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What to Expect After a Meniscectomy

April 10th, 2020

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in total knee arthroplasty, total hip arthroplasty, exercise and health, and more. When it comes to meniscal injuries, many patients have little knowledge about the types of treatment options available and their outcomes.  The meniscus, a significant cushion or shock absorber in your knee, is a c-shaped disc of soft cartilage that sits between the femur and the tibia.  When the knee meniscus tears, the cushioning effect diminishes and can cause knee pain and arthritis, eventually requiring treatment. One option is a meniscectomy, a surgical removal of all or part of a torn knee meniscus. A survey conducted by Brophy et al of 253 patients evaluated for meniscal pathology found 62 percent rated their knowledge of the meniscus as “little or none,” and another 28 percent had no idea that meniscectomy procedure–and not a meniscal repair–is the most common surgical treatment for surgical repair. Did you know that? Since many meniscal tears can require surgical intervention, there’s a clear need to educate patients on options and postoperative considerations: overall outcomes, the risk of needing a subsequent surgery, the ability to return to sport (RTS), the postoperative risk of developing osteoarthritis (OA), […]

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Diabetes and the Heightened Risk of Periprosthetic Joint Infection

February 26th, 2020

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in joint replacement, sports medicine, and more. Diabetes is prevalent not just in the U.S., it affects millions of people worldwide and is one of the leading causes of disability. Its direct effects on postoperative care can impact both the patient and an already strained healthcare system. In the world of orthopedic surgery specifically, little has been documented about a diabetic patient’s incidence of infection after undergoing total knee or total hip arthroplasty. A recent investigation by researchers at the University of Utah looked at data of type-1 and type-2 diabetes mellitus patients and the incidence of periprosthetic joint infection. By looking at historical, statewide data of more than 75,000 patients undergoing knee or hip arthroplasty between 1996 and 2013, researchers were able to identify 1,668 patients with type-1 diabetes and another 18,186 patients with type-2 diabetes, providing a strong sample size. The researchers hypothesized that arthroplasty patients with type-1 diabetes were at greater risk for infection than those with type-2 diabetes. While age and sex were found to be insignificant factors contributing to infection rates, the study did find that the frequency of periprosthetic joint infection in non-diabetic patients was 2.6% compared with […]

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Chronic Prescription Opioid Use Before and After Total Joint Arthroplasty: Overall Promising News

January 21st, 2020

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in total knee arthroplasty, total hip arthroplasty, exercise and health, and more. An April 2019 study in the Journal of Arthroplasty explored the chronic prescription opioid use of patients under the age of 65 before and after having total knee arthroplasty or total hip arthroplasty. Looking at three years of MarketScan data between 2009 and 2012, patient opioid use was measured three months before and 12 months after their respective surgeries. With a large sample of more than 125,000 patients, a multicenter scope, and inclusion of both TKA and THA patients, the study lays out a strong and promising snapshot. The goal of total joint arthroplasty is to reduce or eliminate the painful symptoms of a degenerative joint disease. Due to the addictive property of opioid medications, some patients may develop a pattern of chronic use after surgery. Others can develop chronic opioid use in managing their pain prior to surgery. “Chronic” was defined in the analysis as having two or more opioid prescriptions filled within a six-week period.  Of the 24,127 patients (under 65) who were chronic opioid users before surgery, 72% were no longer chronic users 12 months post- […]

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Hamstring Injuries

December 30th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in sports medicine, hamstring injuries, exercise and health, and more. Hamstring injuries are a common, and often frustratingly persistent, source of limitation for both elite athletes and weekend warriors. These injuries can involve either the muscle belly or the tendinous attachment of the muscle to bone. The hamstring is one of the longest muscle bellies in the body as it stretches from the pelvis to the tibia spanning the hip and the knee. Hamstring tears, knee muscle tears and related injuries make up nearly 30% of all lower extremity muscle tendon injuries. These injuries are commonly sustained while running particularly with running uphill. They are very common in soccer, football and all sports associated with acceleration or kicking. Hamstring injuries also are common in weightlifting, skating, or water-skiing. This can be the result of a rapid uncontrolled Hip Flexion with knee extension. If the injury is associated with a loud pop that often signifies a tendon avulsion. In that case, the tendon has pulled off of bone. On the other hand, if there is acute muscular tearing pain followed by bruising and a palpable defect in the muscle, this typically signifies an intermuscular tear. […]

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Should There Be Strict BMI Cutoffs for TKA and THA?

November 19th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in total knee arthroplasty, total hip arthroplasty, exercise and health, and more. Recently we posted a blog about candidacy for and outcomes of Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA) in morbidly obese patients who underwent pre-operative weight loss. Operating on obese patients for TKA and THA continues to be a hot button topic of risk versus reward in surgical outcomes. Two well-respected orthopedic authorities, recently faced off to have a deeper conversation about whether or not orthopedic surgeons should have strict BMI cutoffs for performing primary TKA or THA. Benjamin F. Ricciardi, MD engaged Thomas K. Fehring, MD, from OrthoCarolina and Nicholas Giori, MD and PhD, a Stanford University professor, to face off. Highlights are summarized below. Q: To what degree does the evidence support a strict BMI cutoff to determine eligibility for primary TKA and THA? Dr. Fehring noted many Americans (35%) are obese and the association between patients with a BMI above 40 and surgical complications/infection is irrefutable. He recommends looking at big data such as Medicare or Veterans Affairs, meta-analysis, and position statements by specialty medical societies. All findings to date underscore the need to […]

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Can Weight Loss Before Total Knee Arthroplasty Help?

October 14th, 2019

When obese patients undergo total knee arthroplasty (TKA), many surgeons require or request preoperative weight loss. A group of researchers sought to determine the amount of weight loss needed in this patient population, to improve TKA operative time, length of stay, discharge to a rehab facility, and functional improvement after surgery. This is the first known study to look exclusively at obese patients to understand how preoperative weight loss might improve knee surgical outcomes after TKA. Those considered morbidly obese have a body mass index (BMI) of 40 or higher. This study looked at 203 patients with a BMI of 40 or more. They were evaluated 90 days before their TKA, and again immediately preceding TKA, to assess weight loss. Of those who lost weight preoperatively, 41% had lost five or more pounds, 29% lost 10 or more pounds, and 14% lost 20 or more pounds. Losing 10 or less pounds before surgery made no difference in operative time, length of stay, the need for discharge to a rehab facility, or post-operative functional improvement. However, the preoperative loss of 20 pounds or more showed benefits: It lowered the odds of discharge to a rehab facility, and was associated with a […]

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After One Joint Wears Out, Will More Go?

September 19th, 2019

Here’s a question I’m often asked by patients: “If one of my joints has worn out, how likely are the others to go?” A recent publication from the Osteoarthritis Initiative (OAI) lends some insights into this question. The study, found in the Aug. 12, 2019 issue of Clinical Orthopaedics and Related Research, is the first of its kind. The likelihood of undergoing a 2nd Arthroplasty (Joint replacement) after hip or knee replacement had not previously been evaluated. The authors prospectively asked two questions: “What is the likelihood of second Total Knee Arthroplasty (TKA) or Total Hip Arthroplasty (THA) after primary TKA or THA?” and “What risk factors are associated with undergoing addition joint replacement. The study identified 332 patients who underwent primary TKA and another 132 who underwent THA across five OAI-participating centers in the U.S., who hadn’t previously had a THA or TKA. The patients were followed for 8 years after their primary joint replacement. The incidence of contralateral (opposite Knee) TKA after primary TKA was 40% The incidence of THA after any TKA was 13% The incidence of contralateral (opposite) THA after primary THA was 8% The incidence of any TKA after primary THA was 32% As for […]

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Less Pain, Less Opioid Use After Total Knee Arthroplasty

September 6th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is a knee expert specializing in new knee surgery procedures, total knee replacement, sports medicine, and more. Managing postsurgical pain after total knee arthroplasty (TKA) is critical to successful surgical outcomes including patient recovery, rehabilitation and overall satisfaction. Local infiltration analgesia (LIA) with anesthetic agents is shown to improve pain and reduce morphine consumption. It also shortens the length of hospital stays compared with using peripheral nerve blocks, which can hinder mobility. A randomized control PILLAR study conducted by Michael A. Mont, M.D., Walter B. Beaver, M.D., Stanley H. Dysart, M.D., John W. Barrington, M.D., and Daniel J. Gaizo, M.D. took a closer look at the efficacy of LIA with Liposomal Bupivacaine (LB) in improving patient pain scores and reducing opioid use after TKA. Here, the study team compared the effects of LIA with or without LB on pain scores, opioid consumption including opioid-free patients, time to first opioid rescue, and safety after primary unilateral total knee arthroplasty. The study involved 140 TKA patients randomized to LIA with LB to 266mg/20mL (admixed with bupivacaine HCI %0.5, 20mL) or LIA with Bupivacaine HCI %0.5, 20mL. Standardized infiltration techniques and standardized multimodal pain protocol were used. Co-primary efficacy […]

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Considering Injections for Knee Osteoarthritis

July 24th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is a knee expert specializing in new knee surgery procedures, knee reconstruction surgery, exercise and health, and more. Recently, the prevalence of knee osteoarthritis (OA) has climbed swiftly because of an increase in human life expectancy, physical activity, and obesity. With knee OA on the rise, doctors are in search of the best treatment for their patients. As a result, interest in intra-articular hyaluronic acid (HA) injections and platelet-rich plasma (PRP) knee injections has been rapidly increasing. But which treatment is the most effective, if any? A study on injections for knee OA conducted by Kuan-Yu Lin, M.D., Chia-Chi Yang, Ph.D., Chien-Jen Hsu, M.D., Ming-Long Yeh, Ph.D., and Jenn-Huei Renn, M.D., Ph.D. takes a closer look. The study’s purpose was to prospectively compare the efficacy of intra-articular injections of PRP and HA with a sham control group (using normal saline solution [NS]) for knee OA in a randomized, dose-controlled, placebo-controlled, double-blind, triple-parallel clinical trial. The clinical trial involved 53 patients with a total of 87 OA knees who were randomly assigned to one of three groups receiving three weekly injections of either 1. Leukocyte-poor PRP (31 OA knees) 2. HA (29 OA knees) or 3. NS (27 OA […]

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A New Chapter in Knee Implants

June 25th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is a knee expert specializing in new knee surgery procedures, knee reconstruction surgery, sports medicine, and more. New developments in biomedical engineering and robotics have recently opened a new chapter in high-performance knee implants with the creation of the JOURNEY II XR Active Knee System, which combines an implant designed to restore the stability and natural motion of the human knee with low-friction materials that may help extend the longevity of the implant itself. We are proud to be offering this new product to our patients. Conventional Knee ImplantsAll knee implants are faced with the challenge of mimicking the normal swing-and-rotate motion of the knee while making sure the joint remains stable and has durability after surgery. Conventional knee implants have attempted to recreate this natural, fluid motion of the knee with a rotating platform or plastic insert design that allows flex and rotation. Unfortunately, both of these options force the muscles around the patient’s joint to work harder as they adjust to the joint’s new pattern of movement. The anterior cruciate ligament and sometimes the posterior cruciate ligaments are removed with conventional knee designs. These ligaments aid in position sense or proprioception. There have […]

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Hamstring Injuries: Risks, Treatment, and Rehab

May 27th, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is a sports medicine expert specializing in hamstring injuries, pitching shoulder injuries, Swiftpath knee surgery, and more. Hamstring injuries are common among individuals with a hamstring injury risk–those living an active lifestyle, especially for athletes in sports that involve high speed running or kicking. Sports like track-and-field, soccer, dancing, football, long-distance running, and water-skiing all have a heightened risk for hamstring issues. Erratic contraction of the hamstrings while running at high speeds, quick-burst movements, and sudden trauma are believed to cause these injuries. Three muscles make up the hamstring (semitendinosus, semimembranosus, biceps femoris), starting from the bottom of the pelvis (ischial tuberosity) down to the knee joint where the muscles connect with tendons to attach to the bones. Your hamstrings allow you to bend your knee and help with hip extension, though this is primarily done by the gluteus Maximus. There are two prominent types of hamstring injuries – tears to the muscle belly (the thick part of the muscle or where muscle fibers join tendon fibers) and acute avulsions to the tendon (when the tendon completely tears away from the bone). The sciatic nerve running from the lower back down the back of the […]

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Is Physical Therapy Effective After Rotator Cuff Tear?

April 23rd, 2019

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in shoulder injury treatment, total and partial knee arthroplasty, sports medicine, and more.  Rotator cuff tears can occur from athletics such as baseball, weightlifting, competitive swimming or just over time with overuse and improper strength and flexibility. These shoulder injuries are extremely common, affecting at least 10% of people over the age of 60 in the United States – which equates to over 5.7 million individuals. Of the 5.7 million+ individuals who suffer from rotator cuff tears, fewer than 5% are treated surgically, and patients who undergo surgical repair experience a failure rate between 25 and 90%. What’s interesting though, is that patients with repair failures report satisfaction levels and outcome scores that are nearly indistinguishable from those whose repairs are intact. Because most of these surgical patients undergo postoperative physical therapy, it is logical to assume that physical therapy may be responsible for the improvements in outcome. A multicenter prospective cohort study conducted by the MOON Shoulder Group and published by Journal of Shoulder and Elbow Surgery takes a closer look. To conduct the study, 452 patients with atraumatic full-thickness shoulder rotator cuff tears provided data via questionnaire on demographics, symptom […]

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Should You Consider Partial Knee Replacement?

March 28th, 2019

A partial knee replacement, also known as unicompartmental knee arthroplasty (UKA), can be a very appealing alternative to a total knee replacement for those suffering from severe knee pain. UKA is less-invasive, more cost-effective, promises the preservation of important bone, ligaments, and knee function, and provides an enhanced postoperative recovery. But is it the right procedure for you? The Medial Unicompartmental Arthroplasty of the Knee article by Jennings, J. M., Kleeman-Forsthuber, L. T., and Bolognesi, M. P. takes a closer look. In years past, isolated anteromedial osteoarthritis or spontaneous osteonecrosis of the knee were the only primary indications for partial knee replacement. Patients needed to be under age 60, less than 180 pounds, avoiding heavy labor, and experiencing minimal baseline pain, among other restrictions, which left only 6% of patients meeting all parameters. Over the last two decades, however, studies have shown that the traditional indications for UKA can be expanded significantly with excellent results still obtained. Focused preoperative examination and imaging are needed to identify appropriate surgical candidates, but once selected, patients who undergo UKA experience faster recovery, improved kinematics, and better functional outcomes compared with total knee replacement, also known as total knee arthroplasty (TKA). What’s more, the […]

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Is Yoga Safe After Joint Replacement Surgery?

February 28th, 2019

If you’re one of the 35 million people in the US practicing yoga, you may be wondering if you can return to your practice after joint replacement surgery. Or maybe you’ve heard about the benefits of yoga and are interested in starting it up postoperatively. But is yoga safe and recommended for your new joint? Carried out with awareness of your limitations after surgery, yoga can be a very useful tool in the rehabilitation process. Physical activity, including yoga, is an important part of recovery after joint replacement surgery. It helps to restore function and mobility in your joint, ease pain and swelling, and more. Yoga, specifically, helps to strengthen the muscles surrounding your new joint, increase flexibility, reduce stress, and can help you become more aware of your body’s alignment and posture. Consult with Your Orthopedic Surgeon First. Remember, your situation is unique to you, and no one knows the condition of your new joint better than your orthopedic surgeon. Whether or not your orthopedic doctor recommends yoga can depend on how your joint replacement surgery went, how your recovery is expected to go, and what kind of restrictions you may have. For example an anterior hip replacement would […]

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Meniscectomy Biomechanics and Clinical Outcomes

January 31st, 2019

Meniscectomy

Though the knee meniscus is just a small part of the knee, it plays a very important biomechanical role in regular knee function including load bearing, shock absorption, and joint stability. Unfortunately, meniscus tears are one of the most common injuries orthopedic surgeons encounter, and thus, partial meniscectomy is one of the most common procedures performed. But not all tears require surgery. In fact, according to Biomechanics and Clinical Outcomes of Partial Meniscectomy by Freeley, Briant T., MD; Lau, Brian C. MD published in Journal of the American Academy of Orthopaedic Surgeons, an MRI study found that 61% of aging asymptomatic patients had a meniscus tear identified on imaging. Because orthopedic physicians must identify patients who will likely benefit from a partial meniscectomy, it’s vital that they understand the biomechanical implications and knee surgical outcomes of partial meniscectomy. As a patient, it’s always best to be educated on the latest research as well, so you can be an advocate for your own health. For cases that do require partial meniscectomies, there has been extensive research conducted evaluating the biomechanical consequences and knee surgical outcomes. It was found that as the portion of the meniscus that is removed increases, the greater the […]

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Can Activity Trackers Assist with Recovery After Knee or Hip Arthroplasty?

December 28th, 2018

Commercial wrist-worn activity monitors, like those by Fitbit, the Apple Watch or Garmin, have the potential to accurately assess activity levels and have been gaining popularity in the last few years. In a 2018 study published in The Journal of Arthroplasty, researchers set out to determine if feedback from activity monitors can improve activity levels after total hip arthroplasty or total knee arthroplasty. To conduct this study, 163 people undergoing primary total knee arthroplasty or total hip arthroplasty were randomized into two groups. Subjects in the study received an activity tracker with the step display obscured two weeks before surgery and completed patient-reported outcome measures. On the day after surgery, participants were randomized into either the “feedback group” or the “no feedback group”. The feedback group was able to view their daily step count and was given a daily step goal. Those in the no feedback group wore the device with the display obscured for two weeks after surgery and did not receive a formal step goal, but were also able to see their daily step count after those two weeks were up. Average steps taken by both groups were monitored at one, two, and six weeks, and again at […]

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Home Exercise vs. Outpatient Physical Therapy Following Total Knee Arthroplasty

November 26th, 2018

Dr. Jeff Stickney, a Kirkland orthopedic surgeon, can help you determine whether outpatient physical therapy or home exercise is better suited for your recovery following total knee arthroplasty. He specializes in orthopedic surgeries and health care including total knee replacement, joint replacement, sports medicine, and more. Contact doctor Stickney’s office today to learn more. Outpatient physical therapy (OPT) is the practice of visiting a healthcare facility such as a clinic or office to perform exercises to treat musculoskeletal problems. This strategic physical activity with the guidance of a physical therapist is a common means of both injury prevention and recovery from sports injuries, because it helps patients address joint pain and regain range of motion. While OPT has a long history as a fundamental part of proper treatment plans for recovery and maintenance following total knee arthroplasty (TKA), recent studies have questioned the need for OPT following total knee replacement surgery. A new study, “Home Exercises vs. Outpatient Physical Therapy After Total Knee Arthroplasty: Value and Outcomes Following a Protocol Change”, explored the “health safety, efficacy, and home economics of routine home exercises following TKA compared with OPT immediately afterward”. It compared 251 patients who were prescribed OPT following TKA, […]

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Two Habits for Orthopedic Health

October 29th, 2018

Dr. Jeff Stickney, an orthopedic surgeon in Kirkland, is an expert in orthopedic health, modern pain management like the SwiftPath method, sports medicine, and more. Make an appointment with Dr. Stickney to learn how you can return to a pain-free lifestyle. Prevention is key when it comes to joint pain, sports injuries, neck and back pain, and other complications to your orthopedic health. The best means of prevention is to consistently tend to your overall health, which is often easier said than done. However, maintaining a pain-free lifestyle may be as simple as adding these two healthy habits to your daily routine: Sleep EvenlyGetting quality sleep is arguably the most crucial aspect of any daily routine, and the most impactful to your orthopedic health. Not only is it the time when your body recovers from activity or injury during the prior days, but it can also determine how your body feels in the days to come. By developing an awareness of your sleeping habits and adapting them, you can prevent waking up with back or neck pain, and set your musculoskeletal system up for pain-free success. Sleeping on your back is ideal for pain prevention because it avoids any unnatural […]

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Computer Assisted vs Conventional Total Knee Replacement

October 5th, 2018

Osteoarthritis is one of the most common chronic joint conditions, impacting nearly 27 million Americans, with people over 60 generally having some form of the disease. Of the few surgical solutions with long-term benefits, total knee replacement (TKR) is proven to aid with advanced osteoarthritis. However, 20% of patients report continued pain or stiffness in their knees following TKR – preoperative angular deformity from wear and tear can be difficult to correct, and contributes to post-operative symptoms. Computer navigation during surgery has emerged over the past decade as a solution to correct the knee’s alignment, and the implant’s positioning, during TKR. Whether improved alignment leads to better clinical outcomes after TKR or greater implant longevity, is currently a hot topic of debate. A new study from the Journal of Bone & Joint Surgery compared computer-assisted navigated vs conventional TKR. 190 patients with inflammatory arthritis or osteoarthritis in their knees were randomly assigned to undergo computer-assisted or conventional TKR. The surgeries were performed by eight experienced surgeons, each with more than 100 conventional TKR operations and 10 computer-assisted TKRs. Computer-assisted Knee replacement requires an additional 1 inch incision in the midpart of the tibia, therefore a similar sham incision was performed […]

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The Do’s and Don’ts of Supplements and Surgery

August 28th, 2018

If you’re preparing for surgery, you want your body in the best condition for your operation. It’s natural to feel like you need to take every precaution – after all, the success of a procedure depends heavily on preparation and your state of health. Even though it’s done strategically, your tissue undergoes trauma during surgery. Bones, muscles, cartilage, tendons, and skin endure stress and may experience injury associated with surgery. To avoid complications during the operation and help your body heal, it’s useful to prepare by taking specific supplements and stopping others. Read on to learn what supplements could be beneficial and those that may be worth avoiding: What Supplements Can You Take to Promote Recovery After Surgery?Rather than loading up on supplements, the goal is to correct any deficiencies by consuming essential minerals. Consider taking these to keep your body working optimally: Vitamins D, A, and Calcium: Each aid in bone growth and collagen strength. Magnesium: This often deficient mineral ensures proper circulation and heart rate among other benefits. Vitamin C: Supports the immune system as an antioxidant and rebuilds collagen. Zinc: Helps heal wounds and keeps the immune system strong. Probiotics: Replenishes good bacteria and may stave off […]

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The Potential and Pitfalls of Stem Cell Injections

July 31st, 2018

When it comes to stem cell therapy, it’s wise to be a bit wary. While stem cells can have enormous implications for treatment of injury and disease, many facilities offering stem cell injections are simply looking to capitalize on the buzz surrounding this therapy. If you’re considering stem cell injections for injuries, it’s essential that you learn everything you can about stem cell practices so you can identify the healing potential and possible scams. This type of therapy involves repurposing self-renewing stem cells found naturally in your body by injecting them into damaged tissue. When you experience an injury, the body’s healing reaction sends undeveloped cells through the bloodstream to the injured area. When they arrive, they develop into repair cells as a response to their surroundings. The goal of stem cell injections is to expedite treatment of injury or disease by harnessing this natural capacity your body has for healing itself. The procedure begins with stem cell harvesting, where a doctor extracts cells from points within the body, like fat or bone marrow. Alternatively, cells from a donor like blood from an umbilical cord, could be used, but they must be treated first to prevent negative reactions in the […]

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Game Changers: Preventing Common Sports Injuries

June 14th, 2018

Summer 2018 has arrived and World Cup fever is in the air. While we certainly see our share of flops in these matches, many players endure legitimate injuries too. Those same injuries will be happening to people everywhere this summer as we spend more time being active outside. Reviewing these common sports injuries, their symptoms, and injury prevention tactics will ensure you know how to stay safe and keep the ball rolling. Stay on Your FeetSoccer players possess the remarkable ability to run nearly nonstop for 90 minutes. However, their effort often comes at a price, especially when warm weather factors in. Groin pulls, thigh strains, and calf cramps are among the most prevalent injuries we see, and they often result from overuse and dehydration. Make sure to stay drink plenty of water, wear the correct equipment, and listen to your body while exercising, especially in the heat. Bend ItBending your muscles, ligaments, and joints by stretching regularly will help you “bend it” like the pros. Injuries such as shin splints, ACL tears, and Achilles tendinitis aggravate when athletes don’t stretch or rush back into action too soon. Condition yourself by starting at a low-intensity level and gradually increasing to […]

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How to Avoid Summer Workout Dangers

May 29th, 2018

Staying safe during your summer sweat sessions is important, whether you’re doing laps in the pool, getting in touch with your inner yogi, or logging miles on the road. Read below for a few tips on injury prevention and how to avoid summer workout dangers. Stay Hydrated. It may seem like a no-brainer, but becoming dehydrated in the heat of summer is easier than you think. If you want to avoid the unfortunate side effects of dehydration, including light-headedness, heat exhaustion, and heat stroke, it’s crucial to properly hydrate. The National Athletic Trainers Association suggests aiming to consume 17-20 ounces of water two-three hours prior to exercise and seven-10 ounces of water every 10-20 minutes during your workout. Skip Mid-Day Outdoor Exercise. With peak sun and heat hours being from 10 a.m.- 3 p.m., it’s best to move your workout indoors during this time frame. Plan your bike rides, runs, or swims for early morning, late afternoon, or evening to keep cool and avoid exposing your skin to damaging UV rays. If it’s not possible to workout inside, look for shaded outdoor areas instead. Use the Buddy System. Heat-related illnesses, like heat exhaustion and heat stroke, can be easier to […]

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Can Patients Who Live Alone Be Sent Home Safely After Joint Replacement?

April 18th, 2018

According to a recent study published by The Journal of Bone & Joint Surgery in partnership with Wolters Kluwer, most patients who live alone can safely be discharged home from the hospital to recover after knee or hip replacement surgery. This encouraging finding questions the firmly held belief that patients who live on their own should first be sent to an inpatient rehabilitation facility after undergoing hip or knee joint replacement surgery. “Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” write Andrew N. Fleischman, MD, and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia. The study focused on 769 patients of a similar age demographic who were sent directly home after one-sided total hip or knee replacement; 138 of these patients were living alone for the first two weeks after surgery. The researchers compared complication rates and other important outcomes for patients who lived alone versus those who lived with others. The researchers did find that patients who lived alone were more likely to spend more than one night in the hospital, had higher rates of in-home nursing care and physical therapy. But otherwise, the outcomes were very similar for […]

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Middle-Aged Women Who Exercise Could Delay Dementia

March 19th, 2018

For middle-aged women, physical fitness may do more than give the heart a boost; it may also benefit the brain in a big way. Recent findings out of Sweden show that middle-aged women with a “high degree” of cardiovascular fitness are 90% less likely to develop dementia later in life than those who had just a moderate fitness level. The study, published in the journal Neurology, also discovered that if the middle-aged women who maintained a high fitness level did develop dementia, the symptoms tended to emerge 11 years later (on average) than they did for the women who had a moderate fitness level. To conduct this study, a team of researchers from the Center for Aging and Health at the University of Gothenburg studied the health data of 191 local women, ages 38-60, from 1968-2012. At the beginning of the trial, the participants were given an exercise test in which they cycled on a stationary bike until they felt exhausted. After tracking the health of the women for 44 years, the researchers found that the initial fitness test scores helped predict whether the participants would be diagnosed with dementia later in life. The results showed that 32% of the […]

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The Link Between Distance Running and Arthritis

March 9th, 2018

Although distance running is often associated with numerous health benefits, the impact on hip and knee joint health has been inconclusive up to this point. Long-distance running has been linked with an increased prevalence of arthritis in some studies, but others have shown an inverse association or no association at all. In a recent study published by Journal of Bone & Joint Surgery, authors Ponzio et al. investigate hip and knee health in active marathon runners, including the prevalence of pain, arthritis and arthroplasty (joint replacement) and associated risk factors. To conduct their research, Ponzio et al. distributed a hip and knee health survey internationally to marathon runners from 18-79 years old, divided into subgroups by age, sex BMI and physical activity level. The survey questions assessed pain, personal and family history of arthritis, surgical history, running volume, personal record time, risk factors and current running status. The results were then compared with National Center for Health Statistics’ information for a matched group of the US population who were not marathon runners. What the authors of the study found is that while age, family history and surgical history independently predicted an increased risk for hip and knee arthritis in active […]

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How to Prevent Falls in the Winter

February 8th, 2018

This time of year, outdoor walkways more closely resemble skating rinks, as they become slippery hazards obscured by leaves, rain, ice and snow. Though many falls are more embarrassing than they are painful, injuries and even deaths caused by falling are common and more prevalent in the winter months (though it’s important to be cautious of trip hazards year-round). Senior citizens, being less agile and more fragile, are especially at risk. Unfortunately, falls are the number one cause of injury to seniors, one in three of whom will fall each year and too often, the result is a debilitating fracture, loss of independence or death. So, how to avoid outdoor slips, trips, falls and their resulting injuries this winter? The New York Times offers a few tips: “Check your footwear. Shoes and boots should have slip-resistant soles (rubber or neoprene, not plastic or leather). Or equip them with external traction cleats, sold under brand names like Yaktrax. Take smaller steps, bend forward slightly, go slow and walk as flat-footed as possible when it’s icy or snowy. Check the steps and sidewalk for black ice before going out in the morning, even if only to pick up the paper or mail. […]

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Stay Active Outside this Winter

January 26th, 2018

Winter weather can make it a little too easy to ditch your outdoor exercise routine, but hibernation is not the answer even when you live in the chilly Northwest. Research shows that taking your workouts outside not only keeps your physical health in peak condition, but also helps to boost your mood and your immune system and can even play a hand in preventing long-term chronic illness. And when you’re active year round you are less prone to injuries, so think of winter exercise as a form of injury prevention. Read below for fun ways to remain active outdoors this winter. Get Walking. Or even go for a run! Don’t let the rain or snow stop you from getting your cardio in. Dress appropriately for the weather and consider doing a 5-10 minute warm-up indoors to get your heart pumping and blood flowing. That way, the cold air won’t be nearly as jarring when you open the door. Enjoy Winter Sports. Do you enjoy skiing, snowboarding or maybe ice-skating? Winter is the ideal time to perfect your favorite winter sport skills or even try your hand at a new one. Bundle up, get your heart racing and have fun while […]

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Inpatient Compared to Outpatient Joint Replacement

January 4th, 2018

With outpatient (same-day discharge) hip and knee replacement procedures becoming more common, it’s crucial to keep up with the latest research. In a recent article published by Journal of Bone & Joint Surgery, Authors Basques, Tetreault and Della Valle conduct a cohort study taking a look at patients who underwent outpatient joint replacement compared to patients who underwent inpatient joint replacement. The authors researched 177,818 patients who underwent primary elective total hip arthroplasty, total knee arthroplasty or unicompartmental knee arthroplasty from 2005-2014. They found no significant differences in overall postoperative complications or readmission between the inpatient and outpatient procedures, though the study did find that inpatients did have a higher rate of thromboembolic events (blood clots in the legs) and outpatients had a higher rate of reoperation. The researchers also noted that patients with elevated body mass index, (overweight) diabetes and an age over 85 years had an increased risk of readmission rate following outpatient surgery. In another recent study published by Journal of Bone & Joint Surgery, authors Arshi et al. take a look at the nationwide trends and risks associated with outpatient total knee replacement. The study is a retrospective review of patients who had undergone total knee […]

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How The SwiftPath Method is Changing Joint Replacement

November 21st, 2017

Joint replacement patients need surgical options that reduce pain, reduce the need for narcotics and speed recovery more than ever. Even patients with severe debilitating arthritis are often afraid of joint replacement — and what they fear most is the pain of the surgery, complications due to using narcotics and being completely out of commission after surgery. The SwiftPath Method aims to resolve all these issues.  SwiftPath is a protocol-driven company that is constantly striving to discover advanced surgical techniques in joint replacement. Their goal is to collaborate with top surgeons in driving improvements for outpatient and enhanced recovery joint replacements. Over the past two years, the SwiftPath Program has been used in thousands of knee and hip replacements performed across the country. The program is so effective, that many patients can be discharged directly to home with no use of rehabilitation centers, hotels, or other types of recovery settings. Where traditional joint replacement methods relied on large incisions, heavy doses of pain medications and months of difficult postoperative therapy, new minimally-invasive techniques have advanced joint replacement surgery for better hip and knee surgical outcomes, now allowing people to get back to their active, healthy lifestyle faster with reduced postoperative pain and stiffness and no need […]

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Is Your Job Putting You at Risk for Hip Osteoarthritis?

October 19th, 2017

Osteoarthritis of the hip, which causes the cartilage that cushions your joints to be lost, can be extremely painful and negatively affect one’s quality of life. Could your job be putting you at risk for hip osteoarthritis (HOA) and if so, what can you do about it? A new study takes a closer look. In the last decade, there has been an influx of studies searching for an association between occupational strain and the risk of developing hip osteoarthritis. The published studies conclude that there is a basic link between occupations involving physically demanding work and the development of HOA. A new study, published by Deutsches Aerzteblatt International, explores a new systematic survey of the previous literature. The goal? To identify ways of preventing occupational HOA if the link between physically demanding work and HOA was indeed present. The study takes a look at five cohort studies along with 18 case-control studies that were found suitable for inclusion. The researchers found that years of physically demanding work consisting of activities such as dealing with heavy loads, heavy manual work or prolonged walking and standing increases the risk of HOA (and eventually total hip replacement) by 150% in men and 40% […]

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Top Doctor 2017

August 29th, 2017

The list is compiled based off the results of the Professional Research Services survey company. The company asks licensed health care practitioners in King, Pierce, Kitsap, and Snohomish counties who they would recommend to a sick loved one, allowing voters to nominate and celebrate their peers.  Dr. Stickney is a Kirkland orthopedic surgeon who offers patients both a compassionate bedside manner and high-quality medical care. With more than 20 years of experience, he performs surgeries including total hip replacement, total knee replacement, and shoulder replacement surgery. If you or a loved one is suffering from pain that’s getting in the way of a health lifestyle, consult Dr. Stickney today. 

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Why Exercise Is Best Done Outside

July 25th, 2017

It’s no secret that one of the essential components of a healthy lifestyle is exercise: from lowering the risk of physical disease or the need for joint replacement to improving your emotional and mental well being, exercise is critical for longevity and a higher quality of life.  Fitness is also a great mechanism for injury prevention. However, dragging yourself to the gym isn’t always appealing, and exercise that isn’t enjoyable can become exercise that isn’t done.  A new study by the University of Innsbruck in Austria has found that the best way to exercise is by heading outdoors, whether for a vigorous walk in the woods or a casual stroll near your house. In the past, experts believed that a successful exercise regimen boiled down to two factors: intensity and duration. They figured that the secret to getting people to exercise was short, high-intensity workouts: this ensured that busy professionals weren’t strapped for time, though the intensity and effort could become off-putting.  The new study, published in PLOS One,  believes that a workout’s emphasis should instead be on duration and enjoyment. To test this, they recruited 40 volunteers from Innsbruck to complete several prolonged workouts, completing mood and anxiety tests before and after.  First, a guide took […]

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Like Exercising? Avoid Painkillers

July 7th, 2017

Over-the-counter painkillers like ibuprofen and aspirin may seem a great way to alleviate soreness and pain after a particularly vigorous run or strength training session. These nonsteroidal anti-inflammatory drugs, or NSAIDS, suppress inflammation, but recent studies published in the Emergency Medical Journal and The Proceedings of the National Academy of Sciences have found this may not be without consequence. When combined with exercise, they may overwork the kidneys and impede the muscles’ recovery.  Unfortunately, ibuprofen and similar drugs have a long relationship with athletes, especially those engaging in more strenuous activities like marathon running. Some studies have found that more than 75% of long-distance runners rely on anti-inflammatory medications (NSAIDS) as a form of pain meds to blunt the strain of training and competitions.  A team from Stanford University began investigating the true impact of NSAIDS after it was found that those that take them may still experience muscle soreness. Essentially, NSAIDS block the production of prostaglandins, a biochemical that heads to the site of an injury and begins the process that creates pain and inflammation. To increase blood flow to the area, prostaglandins also stimulate blood vessels to dilate. NSAIDS limits the amount of prostaglandins, lessening inflammation.  The Stanford researchers studied 89 participants in multi-day […]

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The Risk of Needing a Second Surgery

June 21st, 2017

  For many patients, undergoing a total hip or knee arthroplasty may seem like the solution to joint pain and the opportunity to return to a more mobile, active lifestyle. However, the possibility of facing a secondary surgery may seem frustrating or daunting. Though the number of total hip and knee arthroplasties has risen in recent years, the incidence and prevalence of secondary surgeries isn’t well understood. A new study from the National Center for Biotechnology Information sought to examine rates of incidence. First, researchers examined groups that either had total hip arthroplasty (1,933 subjects) or total knee arthroplasty (2,139 subjects) between 1969 and 2008. Following-up after an average of 12 years from initial total hip arthroplasty, the researchers found that if a patient had a hip replacement on one sider, there was a 29% chance he or she would require a hip replacement on the other side. Those who underwent primary surgery at a younger age had a significantly high incidence of a follow-up operation. For the total knee arthroplasties, the researchers followed up after an average of 11 years. They found that those who had a knee replacement on one side had a 45% chance of requiring a knee […]

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Runners May Not Hit Stride Until 50 Years Old

June 5th, 2017

  For those who always struggled with running or were never able to commit to a consistent running routine, it turns out your best running days might still be ahead of you.New research reveals that recreational runners might not peak until they’re 50, compared to elite runners, whose performance starts to decline when they hit 35. The study, summarized in the Washington Post, examined 16 years of data from the Chicago, New York, and Boston marathons. While the fastest runners, both male and female, are between 25 and 34, those who ran competitively started to lag after 35. This is partly because when we turn 35, our muscle mass, bone density, and maximal aerobic capacity starts to decrease. In turn, we are less able to sustain high-intensity exercise and the amount we spend training might start to diminish, if we trained at all.  Elite runners, however, continue at an intense rate, drawing on their reserve energy at a much faster rate. Recreational runners, however, have more endurance because they’ve never pushed themselves as hard.  The scientists view the recreational runner’s tendency to veer away from training that’s too difficult or intense as a boon. Since his or her physiological limits haven’t been tested, […]

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There’s No Place Like Home After Surgery

May 26th, 2017

Traditionally, patients and doctors have opted for in-patient postoperative rehabilitation after total hip or total knee replacement surgery, despite the high costs. However, recent studies found that after joint replacement surgery, patients who live alone are happier and fare just as well, and possibly better, when recovering at home rather than staying at a rehab facility.  The study, published by the American Academy of Orthopaedic Surgeons, examined 769 patients who had undergone primary total hip replacement (THR) or total knee replacement (TKR). About 18% lived alone, all of whom were discharged home for outpatient rehab. Of these, almost 80% had friends or family nearby that could help provide support if necessary.  Overall, there was no significant difference in complications, pain, functional outcomes, or patient satisfaction scores between people who lived alone and those who lived with others after the surgery. However, when recovering at home instead of spending an extra night at a hospital, patients saved an average of $10,776, amounting to almost $1.5 million total. Patients recovering at home were also found to avoid other complications — such as infections and blood clots — that they might experience in a rehab facility.  “We found that patients living alone were able […]

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Why Athletes Should Treat the Brain Like a Muscle

May 21st, 2017

For many people, one of the most frustrating aspects of recovering from surgery or an injury is returning to their former level of performance. To overcome these hurdles, champion athletes are honing a different muscle: their brain. By sharpening their confidence, motivation, and the mind-body connection, they’re able to surpass previous limits, and, now, research suggests this is a feasible option for amateur and casual athletes facing physical obstacles.  The Washington Post rounded up tips from former Olympic athletes, psychologists, and fitness experts about the best ways to train your brain to surpass your physical limits: 1. Stay positiveIf you’re struggling with an exercise or activity after joint replacement surgery, it can be tempting to indulge in harsh self-talk. However, this can significantly impede your progress and fuel a cycle of negativity. Sports psychologist Justin Ross instead recommends writing down how you feel while exercising, when things became difficult, and how these feelings shaped your performance. Positive affirmations can also be a productive way to end an activity, reminding yourself of how much progress you’ve made and how much your body has accomplished. 2. Practice visualizationTake time to imagine what you’re going to do, whether that’s walking up a hill or […]

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Staph Infection Heightens Risk of Surgical Complications

May 8th, 2017

Staph infection after joint replacement surgery is a terrible complication that often results in subsequent surgeries with extended morbidity and postoperative rehabilitation. The surgical risk factors of staph infection after knee or hip joint replacement depends to some degree on the patient’s immune capabilities, with the incidence ranging from 1.5 to-6% over a lifetime. One of the leading pre-operative risk factors in orthopedic patients is the presence of Staphylococcus aureus (S. aureus), or staph, on the skin or nasal cavity. Most postoperative infections after joint replacement are the result of bacteria from the patient’s skin falling into the wound during surgery. In most cases, the immune system is able to eliminate those bacteria, but staph carriers are two to ten times more likely to face infection. Pre-operative skin washing at home, skin scrubbing in the operating room, and intraoperative surgical irrigation and antibiotics help minimize this risk. Patients with staph chronically growing on their skin are at higher risk due to the aggressive nature of this bacteria and the heightened risk of wound infection. On average, 18-25% of patients will have staph on their skin chronically, and of this group, approximately 11% have a strain resistant to antibiotics. A recent study […]

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Smoking Increases Risk of Postoperative Complications

April 10th, 2017

The adverse effects of smoking upon a patient’s health have been known for decades. However, the relationship between smoking and postoperative complications for total joint arthroplasty has, until recently, been unclear. As total joint arthroplasty, a treatment for degenerative joint disease, is expected to increase in frequency in the United States, the medical community has been interested in potential risk factors, such as smoking. A recent study performed at The Rothman Institute at Thomas Jefferson University has found definitive evidence that current smokers, as well as former smokers, are at significantly higher risk of postoperative complications after joint replacement than non-smokers. This recent research, published in The Journal of Bone and Joint Surgery, Inc, studied 15,264 patients who underwent 17,394 total joint arthroplasties between 2000 and 2014. The team sought to determine if smoking impacted whether or not a patient faced readmission and/or reoperation within 90 days of the first surgery. Of the patients surveyed, 9% currently smoked, 34% had formerly smoked (on average, they had quit 22 years before), and 57% were nonsmokers. While the average age of the latter group was 63.2 years, current smokers needed surgery at an average of 57.7 years. The researchers also analyzed packs smoked per […]

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PRP Injections May Be the Answer to Osteoarthritis

March 24th, 2017

Although osteoarthritis is one of the most common chronic joint conditions, few nonsurgical options have shown long-term benefits. Impacting almost 27 million Americans, the disease causes pain, swelling, and mobility issues as the cartilage between joints wears down. Joint replacement surgery can provide relief once the disease has significantly progressed, but nonsurgical alternatives have only had short-term benefits. Now, a new study published in The Journal of Arthroscopic and Related Surgery suggests that Platelet-Rich Plasma (PRP) injections could combat pain and improve joint functioning in the knee. In the past, nonsurgical treatments have included using anti-inflammatory drugs and corticosteroid and hyaluronic acid (HA) injections. While they ease discomfort, research hasn’t found that the conditions are improved over a longer length of time, necessitating total knee replacement surgery. PRP, however, might offer a new solution. PRP is blood plasma infused with platelets and contains several different growth factors. It’s been used to help alleviate pain from damaged muscles, ligaments, tendons, and joints by healing damaged cells and promote formation of cartilage repair tissue. Until now, no tests about its efficacy have been conclusive, partly due to small sample sizes. To make a more definitive claim, researchers from The First Affiliated Hospital of Chongqing […]

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Does Timing for Total Joint Surgery Matter?

March 8th, 2017

While choosing whether or not to get total joint arthroplasty (TJA) can be a difficult and daunting decision, new research shows that delaying it may have a negative impact on postoperative outcomes. Carlos J. Lavernia, MD, who helmed a study evaluating pre- and postoperative functioning, presented his findings at the American Association of Hip and Knee Surgeons’ (AAHKS) annual meeting. Previously, Dr. Lavernia had studied TJA patients and found those with lower preoperative functioning had worse short-term self-reported outcomes after surgery than their higher preoperative functioning peers. Interested in examining the long-term impacts, Dr. Lavernia and his team looked at 105 patients from the original group and split them into those who were severely functionally impaired versus those who were functionally impaired. The demographics for both groups were very similar, though the first was 40% female and the latter was 73.8% female. The patients had an average age of 65 years and 54 had total hip arthroplasties while 51 had total knee arthroplasties. The mean follow-up period for all patients was 11.2 years, 13 had revision surgery, and 43 passed away. However, there did not seem to be significant differences in revision or mortality statistics between the severely functionally impaired […]

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Research Shows Benefits of “Weekend Warrior” Lifestyle

February 22nd, 2017

Working out may stave off premature death, but that doesn’t mean it’s easy to squeeze the recommended amount of exercise into your week. To combat this, the trend of “weekend warriors” has emerged: adults who condense physical activity into Saturday and Sunday. While opinions on how effective this is have been mixed, a recent study showed that the benefits for working out only one or two days are almost the same as spreading exercise throughout the week. The study, published in JAMA Internal Medicine, looked at over 63,000 adults from the UK over 15 years, studying how long they exercised, what their exercise consisted of, and what days they exercised. The participants were grouped into two categories: inactive (those who never exercised) and sufficiently active (those who exercised for the recommended amount). The latter was split into those who worked out for three or more days a week, and those who compressed their activity into one or two days, the preference of about one out of every three American adults. The so-called “weekend warriors” were primarily male and 90% of them participated in vigorous activities like competitive cycling or team sports one day a week. Compared to the inactive group, […]

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Running Might Be Good for Your Knees After All

February 8th, 2017

One of the most common myths around running is the toll it can take on your knees as you get older. Both runner and non-runners generally promote the claim that  exercise causes the cartilage around your joints to deteriorate, leading to arthritis and possibly necessitating treatment by an orthopedic surgeon. However, recent research has shown that it can actually be beneficial for your body and joints, warding off arthritis in the future. Researchers from Brigham Young University have found that running changes the joint’s biochemical environment so it functions better, longer.  Various studies have followed runners throughout lengthy periods of time to determine that they are less likely to develop osteoarthritis than their non-runner peers, but until now, why this is has only been conjecture. Sports medicine experts speculated this was due to a lower body mass putting less strain on the knees, but little work had been done to isolate the impacts of running on joint health. The team at BYU studied fifteen male and female volunteers, all of whom were runners, under 30, and had no history of arthritis. The researchers collected a small amount of blood and synovial fluid, a fluid that lubricates joints, from each volunteer […]

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How to Prevent Winter Injuries

January 18th, 2017

With winter comes the holidays, ski vacations, and long-awaited snow days. However, the ice and inclement weather can also lead to an increase in slips, falls, and injuries that may need treatment by an orthopedic surgeon. To make sure you can get the most out of the season, follow these tips from Dr. Alan S. Hilibrand to stay pain-free while hitting the slopes and spending time with family. An ounce of winter injury prevention can go a long way. Practice Ladder SafetyAccording to the Consumer Product Safety Commission, in 2015, nearly 566,000 Americans received a ladder-related injury and 69,000 went to the doctor or emergency room due to injuries incurred in holiday decorating. Whether you’re removing your holiday decorations or taking care of housework, prevent injury by selecting the right ladder — step stools and utility ladders for low and medium heights, extension ladders for outdoors — and never exceeding the ladder’s maximum load capacity. Make sure it doesn’t have any damage, is clean, and is set on a firm, level surface. Don’t Rush Holiday TravelUnfortunately, travel and stress can often be synonymous, and in our hurry to get to our destination or avoid lines, we might strain our backs […]

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The Link Between Gum Disease and RA

January 12th, 2017

 When your dentist reminds you to floss, they may be improving your orthopedic well being, along with your oral health. New research published in Science Translational Medicine discovered that the bacteria behind gum disease could also be the catalyst behind rheumatoid arthritis (RA). Although about 1.3 to 1.5 million Americans suffer from RA, an autoimmune condition which causes inflammation, swelling, pain, and stiffness in the joints and can necessitate joint replacement surgery, the root cause is unknown. The relationship between gum disease and RA has been explored in the past. In 2008, a German study that appeared in the Journal of Periodontology found that people with RA are eight times more likely to develop gum disease than people without RA. In 2012, researchers discovered a correlation between tooth loss and joint inflammation — the greater the tooth loss, the greater the joint inflammation. Various other studies looked at different types of bacteria, such as that responsible for periodontal disease, to try and find a connection, though this research probes further at what specific strain of bacteria could link the two issues. An international group of researchers collected blood samples from 100 people with gum disease and 100 people with healthy […]

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The Importance of Staying Active

December 29th, 2016

It’s no secret that incorporating physical activity into your lifestyle helps stave off heart disease and contributes to longevity while 11% of early deaths in the US can be attributed to physical inactivity. However, recent research from the University of Texas at Austin shows that getting exercise doesn’t alleviate health risks if you’re also sitting for long stretches of the day. The study, published in The American Journal of Physiology – Endocrinology and Metabolism, followed a group of young male volunteers and is one of the first to look at people who work out but spend prolonged periods sitting. The men were active — sitting for about eight hours every day while averaging 17,000 steps daily — for four days in a row and sedentary — sitting for 14 hours a day — for the following four days.  Earlier studies have shown how exercise — specifically, running for an hour — can offset high-fat, sugary meals by reducing triglycerides, or fats linked to heart disease that enter the bloodstream after eating. During the volunteer’s active days, the research team observed this phenomenon, although when the volunteers did the same workout during their sedentary days, running didn’t offset the high levels of triglycerides.  According […]

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Innovative Developments in Treating Knee Osteoarthritis

December 15th, 2016

Knee osteoarthritis is a progressive degenerative condition. Up until recently, all treatments have been directed at ameliorating its symptoms, with no hope of stopping disease progression. However, recent trials using Platelet-Rich Plasma (PRP) to treat the disease, rather than just the symptoms, have had encouraging results.  PRP is concentrated plasma from your own blood that has been separated to include platelets, small blood cells that are loaded with growth factors responsible for healing cells and that help form clots so your body can repair any damage.  Many of these growth factors have been shown to promote cartilage regeneration. Although PRP has been used since 1987 to help with cell regeneration, using it to stimulate cartilage renewal is fairly new. The treatment entails drawing blood and injecting the PRP into the knee.   Two recent scientific papers reported decreased pain and improved function after PRP injections. In 2011, the Journal of Arthroscopy reported on the comparative results of injecting knees with PRP versus viscosupplementation with hyaluronic acid (HA), a procedure that injects a lubricating fluid into the joint. At the six-month follow-up, the PRP group had less pain. A second study in the American Journal of Sports Medicine in 2016 reported on […]

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Running vs. Weightlifting

November 3rd, 2016

Did you know that just like the rest of your body, the brain also requires physical exercise for its healthy development and functioning? According to the findings of an exceptional study recently conducted on rats, some kinds of exercise could have a larger bulking-up impact on our brains than others. For the first time ever, researchers compared head-to-head the neurological effect of various forms of exercise: running, weight-lifting and high-intensity interval training (HIIT), with the astonishing findings suggesting that training hard may actually not be the best choice for the long-term health of our brains.

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AAOS Tips for Preventing Summer Injuries

June 20th, 2016

preventing summer injuries

As summer arrives, it is inevitable that we come out of our winter hibernation and become more active. Regrettably though, with more activity comes the increased chance of orthopedic injuries. In hospitals the summer season is also known as “trauma season” because adult injuries spike by 25-30%. Although not all of these injuries are orthopedic, the vast majority of these injuries fall into this category.

The most common types of summer orthopedic injuries come from: biking accidents, lawn mower mishaps, ladder incidents, swimming injuries, ATV calamities, trampoline trauma, and funky falls.

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Causes and Treatments of Common Shoulder Injuries

May 20th, 2016

shoulder injuries

The shoulder is a complex joint that facilitates the movement of the arm . Without this crucial joint, the most basic movements of the arm and hand would be impossible.

Think about the mobility that the shoulder affords the arm and hand. Although it is crucial for our daily activities, this movement often comes with a price as we age. Over time the shoulder joint can wear down causing increasing pain.

Due to the complexity of the joint, there are many categories that shoulder injuries fall under…

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Pediatric & Adult Hip Dysplasia

May 11th, 2016

hip dysplasia

The thigh bone’s connected to the hip bone – that’s what the song says. But sometimes that connection doesn’t work so well, which is the result of a hip socket that is too shallow – a condition known as hip dysplasia.

The hip is the largest “ball and socket” joint in the body, held together by ligaments, tendons and a joint capsule. The hip socket is designed to hold the femur tightly to prevent it from coming out of the socket while allowing enough motion to permit a wide variety of activities. Hip dysplasia simply means that the hip is in the wrong shape, most commonly, the hip socket is too shallow and not positioned to fully cover the femoral head.

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Platelet-Rich Plasma Treatment for Orthopedics

April 26th, 2016

Platelet-Rich Plasma Treatment

Invasive surgery and long recovery times for orthopedic surgery are becoming a thing of the past. After years of extensive surgeries and painful recovery times, surgeons are now looking towards new nonsurgical management of orthopedic issues. The current nonsurgical treatment that everybody is talking about is platelet-rich plasma, or PRP.

PRP is an autologous derivative of blood, which singles out high concentrations of platelets and is loaded with many growth factors and cytokines. While it is clear from the buzz that PRP can be useful for orthopedics, there is some debate as to the best use of PRP in the orthopedic world.

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How PRP Affects Soft-Tissue Injuries

April 13th, 2016

how prp affects soft-tissue injuries

The discussion about platelet-rich plasma, or PRP, treatment is becoming a more popular topic by the minute. PRP treatment is being proposed as an alternative to normal orthopedic treatments that tend to be costly for the wallet and for your time. In a previous blog we looked at PRP treatments’ ability to handle orthopedic difficulties like ACL reconstruction, fractures, and osteoarthritis. This time, let’s shift our focus to: how PRP affects soft-tissue injuries.

For the purpose of this analysis we will look at how PRP affects meniscal repair, rotator cuff repair, and tendon healing.

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Navigational and Conventional UKA: The differences

March 30th, 2016

Navigational and Conventional UKA

Arthritis is one of the top diseases that plagues the aging population; with osteoarthritis being the main assailant. Although sometimes mild, this disease can quickly turn into a painful menace that inhibits daily activities.

One type of osteoarthritis that often leads to meniscal disruption, ligament instability, or limb deformity is unicompartmental arthritis. This subset of arthritis affects only one compartment of the joint, and it usually attacks the articular cartilage in the medial or lateral part of the tibiofemoral joint.

When unicompartmental arthritis hits the advanced stages and surgery becomes necessary, patients have to choose between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty. UKA has recently become the preferred method due to its 10-year survival rate of 95%.

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Computer or No Computer for Minimally Invasive Surgery

March 9th, 2016

computer vs no computer minimally invasive knee surgery

For a long time orthopedic surgeons have turned to the medial parapatellar approach for total knee arthroplasty. In other words, the most commonly used total knee replacement is often an invasive procedure that is coupled with long hospital stays and lengthy rehabilitation. However, this methodology is changing. In today’s world where people want better results faster, surgeons are now facing pressure to perform surgery using minimally invasive techniques.

The idea behind minimally invasive surgery (MIS) for total knee arthroplasty is that there will be less recovery time, shorter hospital stays, and smaller scars. However, there is some concern about the minimal visibility that comes with this type of surgery. The more conventional parapatellar surgery involves large incisions that give the surgeon maximum visibility. In comparison …

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Three Secrets to Improving your Orthopedic Health

February 17th, 2016

orthopedic health

Thousands of people every day are starting out on a path towards a healthier lifestyle. This means that people are now more conscious about what they eat, and many people are trying out new types of exercise they would never have dreamed of before. While the goal here is to stay healthy and active, many people often forget that adding daily exercise to their lifestyle can take a toll on their body and orthopedic health.

As people become more active, the number of bone and joint injuries and chronic conditions continues to increase. This increase calls for a need to take care of our orthopedic health. Read about these few secrets that will help you improve your orthopedic health and ultimately avoid injury.

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The Risks Of CrossFit Injury

February 3rd, 2016

As CrossFit becomes more and more popular among exercise enthusiasts, many people are beginning to question the safety of the activity. Whether it is a CrossFit newbie or a seasoned veteran, everybody is beginning to wonder what their risk for injury could be.

The Orthopaedic Journal of Sports Medicine recently published an article that speaks directly about CrossFit injuries. The study was conducted based on surveys taken by CrossFit participants in Rochester, New York City, and Philadelphia. The survey asked a number of questions about CrossFit related injuries the participants had suffered over a 6-month period.

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5 Facts About Shoulder Injuries

January 13th, 2016

Most people think joint problems are limited to serious athletes or older adults. But when it comes to the shoulder, everyone is at risk. Between the ages of 18 and 88, almost everyone will experience some kind of shoulder issue, according to Gregory Nicholson, MD, an orthopedic surgeon who specializes in shoulder surgery at Rush University Medical Center. In fact, shoulders are the most commonly injured joints in the body. The unique and complex anatomy of the shoulder makes it …

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1.35 Million Youths a Year Suffer Serious Sports Injuries

December 30th, 2015

Occasional bumps and bruises are expected when kids play sports, but for more than 1.35 million children last year a sports-related injury was severe enough to send them to a hospital emergency department. Sprains and strains, fractures, contusions, abrasions and concussions top the list of sports-related ER diagnoses for kids ages 6 to 19 — at a cost of more than $935 million each year, according to a report out Tuesday from the non-profit advocacy group Safe Kids Worldwide.

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ACL Tears Are on the Rise in Kids

August 24th, 2015

ACL Tears are on the Rise in Kids

Once considered an adult injury, ACL tears are occurring more often in the legs of elementary and middle school-age children, orthopedic specialists report. The increase, which stems in part from better diagnostic tools and a dramatic increase in children playing competitive, organized sports, has created a vexing problem: What is the best way to fix it?

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Bad Knees: The Best Exercises to Prevent Further Injury

August 12th, 2015

best exercises to prevent further injury

When people have bad knees, whether they were athletes for several years, received a detrimental injury or have osteoarthritis, it can be a pain – literally. Aside from limiting your daily activity, it can also make staying in shape a lot harder. Consider these exercises to keep active with bad knees.

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Tips for Running After Hip Replacement

March 30th, 2015

Runners rely on mobility when hitting the track or trail on any given day. Running is a high-impact activity that relies not only on your legs to move, but also your hips; and according to the American College of Sports Medicine, about 500,000 hip replacement surgeries occur yearly in the United States.

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Early Signs of Osteoarthritis (OA) in the Knee

January 29th, 2015

early signs of osteoarthritis

Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. In fact, knee OA is the most common cause of disability in the United States. In the past, people were led to believe that nothing could be done for their problem. Now doctors have many ways to treat knee OA so patients have less pain, better movement, and enhanced quality of life. According to a HealthDayNews report, “Having knee pain while using the stairs may be an early sign of arthritis.” A study conducted at the University of Leeds included more than 4,600 people who were at high risk for arthritis. Researchers followed the volunteers for up to seven years. Professor Philip Conaghan, a professor of musculoskeletal medicine at the University of Leeds in England stated in a news release, “At present, we have little concept of ‘early’ osteoarthritis and often only see people when they have significant, longstanding pain and loss of function.” He goes on to say, “This research is vital to understanding early symptoms of knee osteoarthritis.” Using stairs was the first weight-bearing activity in which people […]

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Knee Problems Associated with Snowshoeing

November 18th, 2014

Enjoying the beauty of the Pacific Northwest on snowshoes is a great way to see the “country” on a beautiful winter day.

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The Throwing Arm of a Baseball Pitcher – Understanding Shoulder Pain

October 20th, 2014

shoulder injures in baseball players

Shoulder pain, particularly related to throwing sports such as baseball, involves the rotator cuff. You may have heard a variety of medical terms related to the shoulder, like rotator cuff tendinitis, rotator cuff tear, or impingement syndrome. But what does this mean to a baseball athlete?

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Knee Pain? Learn about Knee Tendinitis

September 22nd, 2014

Consider this statement, “Many people who participate in sports or fitness activities will get tendinitis at one time or another.” If you’re an avid athlete or fitness enthusiast like myself, chances are you have felt the discomfort of pain in your knees. What is tendinitis? Tendinitis is a persistent inflammation in the tendons. Typically in the knee, this involves the patella tendon between the kneecap and the tibia bone or the quadriceps tendon between the quadriceps muscle and the kneecap. The illiotibial band and the hamstring tendons can develop tendonitis as well. Injuries that do not adequately heal result in persistent inflammation and scar formation. Overuse is a common risk factor for tendinitis. When the tendon is stretched repeatedly by doing the same kind of exercise over a long period of time, the tendon can become strained and inflamed. Runners often get tendinitis for this reason. Tendinitis can also be caused by intense exercise over a short period of time.  For example, exercising all weekend to make up for the lack of physical exercise during the week. As we age our tendons become more brittle which makes our knees more vulnerable to stress and strain. Tendinitis is usually treated with therapy, […]

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Hip Replacement – Performing the Anterior Approach

September 3rd, 2014

Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA that performs this procedure. How does the anterior approach to total hip replacement differ from the traditional hip replacement surgery? For one, the anterior approach is a tissue-sparing alternative. The approach to the hip from the front does not involve cutting any major structures to get to the hip. Instead, the interval between two muscles is separated, leading to the hip capsule. I work between your muscles and tissues without detaching them from either the pelvis or thighbones – sparing the tissue from trauma. The traditional posterior approach from the back requires dividing the gluteus maximus (butt) muscle and splitting part of the ilio-tibial band on the side of the hip and then cutting several small tendons off the back of the hip. Many surgeons […]

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Dr. Jeff Stickney Recognized as 2014 Top Doctors by Seattle Met Magazine

August 20th, 2014

Congratulations Dr. Stickney for being recognized as a “Top Doctor of Seattle” by Seattle Met Magazine!   According to Seattle Met Magazine, “The panel’s criteria to select the finalists included a provider’s years of experience and competency within his or her specialty, rapport with patients, including patient satisfaction and compliance with care recommendations, and ability to work effectively with colleagues across specialties to deliver the best care for patients.” Dr. Jeff Stickney practices in Kirkland Washington. He subspecializes in sports medicine and joint reconstruction. He is board certified in orthopedic surgery and specialty board certified in sports medicine. His primary interest is in knee, hip, and shoulder problems. His joint replacement practice emphasizes minimally invasive procedures and computer guided navigation in knee replacements. He was educated at the University of South Florida and The University of Washington. Visit Dr. Stickney’s web site at www.stickneymd.com or call and schedule an appointment at 425-823-4000.  You can also email him at ProOrthoAppointment@proliancesurgeons.com.

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Common Weightlifting Injuries

August 14th, 2014

Weight training is a sport as well as part of someone’s exercise regimen.  Experienced weightlifters rarely suffer serious injuries but newcomers to the sport or exercise are more prone to musculoskeletal injuries. Distal biceps rupture: This is a rupture of the biceps tendon that attaches the biceps muscle in the arm to a bone of the upper forearm. A weightlifter can rupture this tendon at the elbow with a sudden force that extends the elbow while trying to contract the biceps. Performing a biceps curl and then losing control of the weight is an example. Surgery to reattach the tendon is usually needed. Less traumatic and sometimes requiring surgical repair, a biceps tendon tear can also occur. Choosing weights one can reasonably lift and fully control can help prevent a distal biceps rupture.  Labral tear: The labrum is a cartilage bumper in the shoulder that surrounds the glenoid (socket). With repetitive compression of the labrum or possibly an acute motion that injures the shoulder, the weightlifter can feel discomfort or a clicking sensation deep within the shoulder. An orthopedic surgeon can perform a physical exam and tests that suggest a labral tear. An MRI with contrast injected (MR arthrogram) can demonstrate a […]

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Housemaid’s Knee (Prepatellar Bursitis) – Know the Signs and Symptoms

August 4th, 2014

Housemaid’s knee is also known as prepatellar bursitis. It is caused by inflammation of the bursa (a small fluid-filled sac) in front of the kneecap. It more commonly occurs in people who spend long periods of time kneeling. Housemaid’s knee is more common in tradesmen who spend long periods of time kneeling -for example, carpet fitters, concrete finishers and roofers. In sports medicine,  this injury is common in wrestlers, who get it from their knees rubbing on the mats. Any age group can be affected by housemaid’s knee. It is generally more common in males than in females. Housemaid’s knee in children is more likely to be caused by infection. Infection is also a common cause of housemaid’s knee in people whose immune systems are not working normally; people include those receiving steroid treatment or those on chemotherapy treatment for cancer. What is bursitis? Bursitis means inflammation within a bursa. A bursa is a small sac of fluid with a thin lining. There are a number of bursae in the body. Bursae are normally found around joints and in places where ligaments and tendons pass over bones. They can also be found in other places if there has been unusual pressure or friction placed […]

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Jeff Stickney, M.D. Launches Web Site

July 2nd, 2014

Dr. Stickney is pleased to announce the launch of his web site, www.stickneymd.com. Staying true to his commitment of helping everyone stay healthy, active, fit and free of injury, Dr. Stickney hopes that by launching his site, patients and people suffering from pain and injury are able to determine their next course of action when faced with an orthopedic injury.

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ACL Prevention and Treatment

July 1st, 2014

ACL prevention and treatment

Spring is the perfect time to get outdoors to play tennis, basketball, soccer or even take up running. Being active requires our bodies to adjust to the season once again and the providers at ProOrtho want to make sure that you are not sidelined from enjoying your favorite outdoor activity this season

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Orthopedic Injuries Related to Spring and Tips to Avoid Injury

July 1st, 2014

When the rain showers subside here in the Pacific Northwest, we all love to take advantage of the great outdoors. Cleaning the rain gutters, mowing the lawn, moving furniture or gardening may present injuries. Let’s face it, when the sun comes out, we want to do everything outside

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ProOrtho Physicians Recognized as 2014 Top Doctors by Seattle Magazine

July 1st, 2014

According to Seattle Magazine, “We asked thousands of local doctors this question: To whom would you send a loved one for medical care? And more than 1,300 doctors participated, with nearly 13,000 nominations, to create this list of 437 physicians judged to be at the top in their field.” The Awards Ceremony will be held June 26, 2014

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