Reprinted with the permission of Memphis Medical News

memphismedicalnews.com

September 2011 >> $5

PhysicianSpotlight

By JANE SCHNEIDER

When the Cordova High School football team is facing an opponent, team doctor and orthopedic surgeon Chris Ferguson, MD, isn’t always watching the scoreboard. Instead, he’s making sure any injuries the players sustain during the game aren’t compromising shoulders, hips, or knees. As an orthopedic surgeon, it’s his job to make sure the players func-tion at their best.

As a young man fresh out of college, Ferguson started his career as an engineer. But what he discovered was that while he liked the science of engineering, he didn’t like sitting alone in front of a computer screen day after day. His wife, who was an occupational therapist at the time, began assisting an orthopedic group and as Fer-guson learned more about orthopedic sur-gery, he realized that his engineering skills could be put to better use.

“There were lots of the mechanical principles we study in engineering that apply to structures and machines but can also be applied to the human body,” said Ferguson. In fact, implant manufacturers often use engineers to help create knee and hip implants. Once he got to observe a few surgical procedures, he saw his fu-ture. Instead of rethinking how to replace worn out bridges, he’d replace worn out joints instead.

At age 26, Ferguson went back to school, first to gain the coursework he needed to complete a pre-med degree,

then to enter medical school. In 1998, he began his studies at the University of Mis-sissippi and graduated almost a decade later after completing the prestigious AO Fellowship – Trauma in Chur, Switzer-land.

Now, Ferguson applies his engineer-ing background as an orthopedic surgeon with Memphis Orthopaedic Group. Un-like the predictability of his old job, Fergu-son says he enjoys the variety and attention to detail that each day brings.

“We take care of fairly healthy pa-tients. Our goal is to take the injured and get them back to functioning. We see ev-erything, from kids with broken bones to elderly people with arthritic hips. There is a row of clinic doors and you never know what you’ll be seeing. So you’re constantly switching gears,” he said.

Genetics play a large role in joint health, along with the level of activity peo-ple engage in over the course of their lives. For some, joints remain strong, but for a small percentage of people, arthritis takes its toll, or knees and hips eventually wear out and need to be replaced. That is what brings patients to Ferguson’s clinic. Of course, replacement surgery is just a small portion of what he does. Ferguson spends several mornings a week performing less invasive outpatient surgeries, procedures that correct more common complaints that are sometimes tied to sports, such as a torn meniscus, rotator cuff, or ACL. Wednesday afternoons are reserved for the more complicated replacement sur-geries or joint revisions.

“The happiest patients are those with hip replace-ments,” said Fergu-son, “because they experience immedi-ate relief from the pain.” Since replace-ment joints typically only last 10 to 15 years, doctors often have patients put the surgery off until they are 60 or older, but “now, we’re doing people in their 50s. The problem can be that with getting a new joint at this age, the patient will have to get a second surgery in 20 years.” How-ever, many want to improve their quality of life now, so Ferguson arms them with the best information he can on joint re-placement, so they make an informed de-cision.

Projections show that as baby boom-ers march toward retirement, the number of knee and hip replacement surgeries will increase dramatically. Yet Ferguson said due to the decline in Medicare dollars, there’s not a lot of incentive for young doctors to go into orthopedics, despite the field’s having made significant strides over the past several decades. Unlike years ago, when knee or hip replacements were com-pleted in a hospital and required months of recovery time, incisions today are smaller, there are fewer wound problems,

and patients are up and walking almost immediately follow-ing surgery.

“Motion is life; you want to keep the joint moving. We now know that the benefits of exercise far outweigh any damage you’ll do to the joint,” he said.

Ferguson said that anesthesia is also more effective today, which helps to make the post-operative pain management

much more doable.One common problem Ferguson said

he sees is treating patients who are obese. For those who have a larger BMI, the higher the problem for wound recovery and infection. Obesity puts lots of stress on joints and brings medical complica-tions of its own, like hypertension and diabetes. When faced with having to per-form replacement surgery on someone 400 pounds or more, Ferguson often tells patients they must lose weight before he can do the procedure.

The doctor is doing his part to keep his own joints healthy. He enjoys long-distance cycling and is currently training for a 150-mile ride to benefit multiple scle-rosis. When not seeing patients or cycling, Ferguson enjoys spending time with his wife and three girls.

Chris Ferguson, MDOrthopaedic Surgeon, Memphis Orthopaedic Group

‘‘ Motion is life, you want to keep the joint moving. We now know that the benefits of exercise far outweigh any damage

you’ll do to the joint. ’’

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Q I have shoulder pain at night that is keeping me awake and pain when I reach overhead. The problem has been getting worse over several months. What could be causing this?

A Impingement syndrome is the most common cause of shoulder pain. It is the result of the rotator cuff tendons in the shoulder rubbing or “impinging” on part of the shoulder blade called the acromion. This problem can eventually lead to a rotator cuff tendon tear. The initial treatment consists of rest, nonsteroidal anti-inflammatory medications and stretching exercises. If symptoms persist, your doctor might recommend an injection of a local anesthetic and corticosteroids in the shoulder. A program of formal physical therapy is very often helpful. Finally, if nonsurgical treatment fails, surgery to create more space between the acromion and the rotator cuff may be necessary.

Dr. Ferguson is a board-certified orthopaedic surgeon with the Memphis Orthopaedic Group. He specializes in sports medicine and joint replacement surgery.

Memphis Orthopaedic Group901.381.4MOG (4664) www.memphisorthogroup.com

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Q I love to golf but my knee arthritis is limiting my ability to play. My family doctor has suggested that I see an orthopaedic surgeon for possible knee replacement surgery. Can I return to golfing after total knee replacement?

A Most orthopaedic surgeons encourage the return to low impact sports following total knee replacement. Examples of low impact sports are golf, cycling, swimming, walking, doubles tennis and bowling. The risk of early component wear, loosening and other complications increases with higher impact activities. For these reasons, higher impact sports such as singles tennis, downhill skiing, jogging, soccer and basketball are discouraged. Your orthopaedic surgeon should explain when it is safe to return to higher levels of activity after knee replacement surgery and the risks associated with doing so.

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MY ADOLESCENT DAUGHTER PLAYS SOCCER AND BASKETBALL AT SCHOOL. SEVERAL OF HER TEAMMATES HAVE HAD SERIOUS KNEE INJURIES, INCLUDING ACL RUPTURES. WHAT IS AN ACL RUPTURE, AND WHAT CAN WE DO TO HELP PREVENT A SIMILAR INJURY?

The anterior cruciate ligament, or ACL, is an important knee stabilizer that is attached to both the femur (thigh bone) and tibia (shin bone). Injuries to the ACL cause chronic knee instability and can lead to other serious problems, such as meniscal tears and arthritis.

Injuries to the ACL are commonly associated with non-contact sports such as soccer, basketball, volleyball, and skiing. As the athlete lands from a jump or suddenly decelerates, her foot remains stationary while a twisting or pivoting of the knee causes the ligament to tear. These types of injuries almost always warrant surgical reconstruction and rehabilitation, particularly in young, active patients.

Females are at a higher risk of ACL injury due to a combination of factors. For example, women have smaller ligaments and weaker hamstring muscles as compared to men, making the ACL easier to tear, as well as a wider pelvis to accommodate childbirth, causing an increased angle between the femur and tibia at the knee. Hormonal changes also impact the strength of the ACL.

Fortunately, several recent studies have shown that a pre-season sports therapy program focused on strengthening the knees, training the

athlete to land from a jump, decelerate from running, and perform side-to-side cutting maneuvers in a safer manner can lead to a dramatic decrease in ACL injuries among females. I therefore recommend that the parents of adolescent girls involved in high-risk knee injury sports discuss such a knee injury prevention program with a knowledgeable physical therapist, athletic trainer, or sports medicine doctor.

Dr. Chris Ferguson is board certified in orthopaedic surgery and subspecialty board certified in sports medicine with Memphis Orthopaedic Group. To schedule an

appointment call 901.381.4664 or visit www.Memphisorthogroup.com

HOW DO YOU PREVENT ACL INJURIES IN YOUNG FEMALE ATHLETES?

Ask Christopher Ferguson, M.D.

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Q: i’M AN AVid CYClist BUt i’Ve BeeN GettiNG NUMBNess iN tHe riNG FiNGer ANd sMAll FiNGer oF oNe oF MY HANds AFter loNG rides. wHAt’s GoiNG oN ANd How do i PreVeNt it?

A:“Handlebar(orcyclist’s)palsy”isacommonconditionsufferedbycyclists.Itresultsfromprolongedcompressionoftheulnarnerveinthehand.Theulnarnerveprovidessensationtotheringandsmallfingersandcontrolsmanyofthehandmuscles.Symptomsofcyclist’spalsyincludenumbnessandtinglingoftheringandsmallfingersand/orhandweakness.Thoughprolongedcompressioncanleadtopermanentinjuryandseverecasesmayrequiresurgery,mostcasesresolvewithrest,activitymodificationandequipmentadjustments.Icingandstretchingexerciseshelp,asdoesavoidinglong-distancecyclinguntilsymptomsresolve.Paddedcyclingglovesandhandlebars,frequenthandpositionchangeswhileriding,andaproperlyfittedbicycleareallimportantinpreventingthiscondition.

Q: i JoG seVerAl dAYs A week BUt i’Ve lAtelY deVeloPed PAiN oVer tHe oUtside oF MY kNee tHAt stArts A Few Miles iNto MY rUN. wHAt’s CAUsiNG tHis?

A:Iliotibialbandsyndrome(ITBS)isanoveruseconditioncausedbyinflammationoftheiliotibialband,athickbandoftissuethatrunsdowntheoutsideofthethighfromthehiptotheknee.Thebandoftenbecomesirritatedovertheoutsideofthekneewhereitrubsagainsttheendofthefemur(thigh)bone.Properrunningshoes,icingtheaffectedarea,andastretchingprogramcanhelpwithITBS.Anadequateperiodofrestbetweenrunsisessentialandcross-trainingwithcyclingorswimmingisoftenhelpful.Moreseverecasesmayrequireaprescriptionanti-inflammatorymedicationfromyourdoctor,acourseofphysicaltherapy,and/orcortisoneinjectionsintotheinvolvedarea.Ifallothertreatmentsfail,surgeryissometimesrequired.Fortunately,thevastmajorityofcasesrespondtoconservativetreatment.

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Dr. Ferguson is a board-certifi ed orthopaedic surgeon with the Memphis Orthopaedic Group. He specializes in sports medicine and joint replacement surgery.

8040 Wolf River Blvd, Suite 100, Germantown

3980 New Covington Pike, Suite 200, Memphis

1325 Eastmoreland, Suite 260, Memphis

4816 Riverdale Rd, Memphis

901 381 4MOG (4664)

memphisorthogroup.com

Dr. Frances A. Tylavsky is a Professor in Preventive Medicine at the University of Tennessee Health Science Center. She has obtained nutrition degrees from Pennsylvania State University, Boston University and University of North Carolina at Chapel Hill. Over the past 30 years, she has worked extensively in assessing how diet and nutrition affect bone and body composition in children and adults. Dr. Tylavsky is the principle investigator of the CANDLE study. Her particular interest is examining how nutrition during pregnancy may affect how children develop during the fi rst 3 years of life.

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CANDLE,ConditionsAffectingNeurocognitiveDevelopmentandLearninginEarlyChildhood,isastudythatenrollswomenduringtheirsecondtrimester(16-27weeks)ofpregnancy.Theyarefollowedthroughtheirpregnancyanduntilthechildis3yearsold.Theresearchersaretryingtofindwhatmostaffectsthebabyanditsabilitytolearn.Isitthemother’shomeenvironment,prenatalhabits,nutritionoracombinationofallofthese?Afterthebabyisborn,isitthechild’shomeenvironment,caregiversand/oraccesstohealthcare?TheCANDLEresearchers’aimistodiscoverthemostimportantfactors.

wHAt is tHe reseArCH ProCess?

Theresearchersdon’taskforanychangestobemade.Theyjustwanttoperiodicallycheckin,observeandlearn.TheCANDLEmomsdojustwhattheywouldnormallydo.Participantswillcompleteafewquestionnaires;attendclinicvisitsandprovideroutinelabsamplesbeforethebabyisborn.Thegoalistousetheinformationgatheredtohelpcommunityleadersindecidingwheretoputmoneyandresourcestohelpchildrendeveloptotheirpotential.

How will MY CHild ANd i BeNeFit?

Overthecourseofthestudyyoucouldreceiveupto$500ingiftcardsbyattendingstudyvisits.Yourchildwillreceivedevelopmentalevaluationsat1,2and3yearsofage.

Formoreinfo,visitcandlestudy.orgorcall901.448.8400.

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