400 Massasoit Ave Suite 200, East Providence, Rhode Island 02914 401-383-7753 401-383-8982

Sports Medicine and Orthopaedics

Compassionate Care, Education & Excellence

Health Care and "Insurance"

Money

There is an unmistakable revolution occurring in Healthcare. As a direct consequence of this, you are losing control of your health care provider and your money spent on health care insurance. You may not even be aware of this. The government and insurance companies would like you to think this problem is due to "greedy doctors." In fact the problems we are encountering are not new or unique to the United States, but are throughout the Western World. No country's solution to the problem of providing wide access to Health Care at a reasonable cost has been adequate. Canada's Health Care System has struggled in the past with care access, but has improved. Britain turned full circle from private fee for service to a purely government subsidized Health Service back to partial reinstitution of private care. This is largely due to inefficiencies in a highly bureaucratic government controlled system where cost outweighs quality, and the social and personnel impact of health problems are ignored rather than incorporating them into the complex equation. Sweden has excellent health care with a nationalized health care delivery system contributing to a large tax burden on the public. The United States is currently groping in unexplored territory with a Health Care System which most would agree is little more than a huge experiment. We also have the largest cost for treatment which is fragmented. This is clearly a result of Lobbying and monetary considerations with the added complexity of unregulated Insurance Companies.

Fracture Treatment

Fractures of bone may be minor, or a serious threat to life and limb. Severity depends on fracture location, complexity, joint involvement, and the presence of a wound at the fracture site. Simple fractures may be treated with as little as a rigid shoe, while complex fractures often require surgical fixation. This depends on patient age, general health, fracture pattern, site and stability, and functional status of the patient. Often the decisions involved in Fracture Treatment are best made with the help of both patient and family. They are influenced by patient age, mobility, and functional status as well as functional requirements. Fractures or breaks of bone are one and the same. Displacement is generally a large determinant for the need to reduce the fracture (replace the bone fragments in proper alignment). If the fracture enters a joint surface, or disturbs the competence of weight-bearing bones, this will likely enter into the decision process between surgical fixation and cast treatment. In children, a fracture which involves the growth plate may disturb or halt the growth of a long bone or disturb joint function in later life. This is often an important determinant in initial treatment and follow-up care.

Tendinitis

Tendinitis

Sports related tendon injuries often involve high repetitive loading of tendons with microscopic areas of rupture, surrounding inflammation and scar formation. In the tennis player, golfer or swimmer, this may be seen with a painful elbow or shoulder. In basketball this may be seen as patellar tendonitis of the knee, and in the runner it may be seen as Achilles tendonitis. Causes of tendonitis include repetitive or acute tendon overload, constriction of a tendon sheath with associated tendon friction, direct blow to a tendon attachment site, or systemic diseases which cause generalized soft tissue inflammation. The site of injury may be at the anchor site of tendon to bone, the midsubstance of the tendon , or at the muscle tendon junction. In tennis, lateral epicondylitis occurs at the bone-tendon origin of the wrist extensor muscles in the forearm. In golf, the medial epicondylitis is more commonly affected.

Osteoporosis

Osteoporosis

Bone Metabolism

Osteoporosis is a slow progressive loss of bone mass with age. It is a normal part of the ageing process, but may be accelerated in abnormal situations. Generally Osteoporosis develops slowly without obvious symptoms. Eventually, however, stature may decrease, and the spine may curve to create a fixed hunched alignment. The most worrisome effect of osteoporosis is the increasing risk of fracture with progression. More than 25 million Americans are affected by osteoporosis and nearly 1.3 million bone fractures occur per year as a direct consequence. These are the most serious consequences of osteoporosis, with wrist, spine and hip fractures most common. They contribute to significant pain, disability, and a large expense. The causes of Osteoporosis are not fully understood. The quantity of bone mass slowly declines with age in both men and women beginning about age 35. This bone loss is accelerated with the onset of menopause, accounting for a fracture rate in women more than double that in men.

Total Hip Replacement

After Hip Replacement

Total Hip Replacement

The arthritic hip is a significant problem for many people; it may arise as a result of wear and tear (normal or accelerated), caused by: rheumatoid arthritis, trauma, or joint collapse caused by a fault in blood supply to the femoral head (ball of the joint). The hip is a ball and socket joint which is very stable and resistant to wear. As a result of this resistance to wear, hip joint replacement is more common with advancing age. In some cases however, the joint may be subject to early or accelerated wear which necessitates earlier replacement surgery. Because the replacement has a finite life, other management strategies are employed to delay surgery, (unless this is not an option) until the patient is at least 60 years of age.