The Orthopaedic Center

TOC PHYSICIANS SPECIALIZING IN THE FOOT & ANKLE Darnell Blackmon, M.D. Lisa Mogelnicki, D.P.M. We specialize in the medical and surgical treatment of pathologies of the foot and ankle. This includes injuries, malformations, conditions and diseases in adults, children and seniors, as well as rehabilitation following trauma or surgery. The comprehensive range of conditions treated includes everything from ingrown toenails and bunions to sprains and fractures to diabetic foot care. In addition to expert treatment using the latest techniques and technologies available, we are dedicated to palliative and preventive foot care to ensure that our patients' feet remain healthy and strong throughout their lives.

TOC Physicians Specializing in the Hand & Wrist Brian Chalkin, D.O. Jeffrey Stromberg, M.D. James Bischoff, M.D. WHY IS HAND SURGERY PERFORMED? Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best. WHY WOULD SOMEONE NEED HAND SURGERY? Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma. HAND SURGERY PROCEDURES Hand surgery is usually performed under general anesthesia or local anesthesia with sedation, on an outpatient basis. The surgeon will make an incision to access the targeted area. Many hand procedures can be performed laparoscopically, allowing patients to benefit from smaller incisions, less bleeding and shorter recovery times. The actual procedure will vary depending on the type and severity of each patient’s individual condition, but may include: Carpal Tunnel Surgery – tissue that is causing pressure on the nerve is removed to relieve pressure. Rheumatoid Arthritis Surgery – damaged tissue is removed from the joint, tendons and ligaments are repositioned, or the entire joint is replaced with a prosthetic. Dupuytren’s Contracture Surgery – thickened, scar-like tissue is separated to improve range of motion and prevent nerve damage. Grafting – transfers bones, nerves or other tissue from healthy areas of the body to the damaged area, commonly performed after trauma. After the condition is treated, the incision is closed, with or without sutures, depending on each individual patient. HAND SURGERY PROCEDURES The results of hand surgery usually appear gradually, as swelling and other side effects subside. Most patients notice significant pain relief almost immediately, while cosmetic results may take several months before they are fully visible. RECOVERY FROM HAND SURGERY After hand surgery, patients may experience mild to severe pain. Your doctor will provide you with oral medication to manage pain, if needed. The hands will usually need to be immobilized for a few days as they heal. Patients usually require a course of physical therapy in order to restore full function and range of motion to the hand. WHY CHOOSE THE ORTHOPAEDIC CENTER FOR YOUR HAND SURGERY? Effective hand surgery requires the skill and precision of an experienced surgeon, in order to successfully treat the condition and restore full function to the hand. At The Orthopaedic Center, our surgeons have years of experience performing a full range of hand surgery procedures, and utilize the latest techniques while doing so. SCHEDULE YOUR APPOINTMENT TODAY! To learn more about our hand and wrist surgical procedures or to schedule an appointment, call us today at 918-582-6800 or click here to request a appointment online.

TOC PHYSICIANS SPECIALIZING IN JOINT REPLACEMENT Darnell Blackmon, M.D. (ankle & knee) Greg Holt, M.D. (hip & knee) Yogesh Mittal, M.D. (hip & knee) Chad Hanson, D.O. (hip & knee) TOTAL KNEE REPLACEMENT A knee replacement is recommended for patients with arthritis and certain knee injuries or diseases that have not responded well to conservative treatments such as anti-inflammatory medications or cortisone injections. The replacement devices are designed to relieve pain caused by cartilage damage, and usually last up to 20 years in most patients. During the knee replacement procedure, the entire joint is replaced with an artificial prosthesis. The end of the femur is replaced with a metal shell, while the end of the tibia is fitted with a plastic cup and metal stem that fit into the shell. The posterior cruciate ligament and kneecap may be replaced if needed or may be left in place. This procedure can take up to three hours to perform and usually provides immediate pain relief and a return to regular activities. Our knee replacement surgeons use computer assisted navigation and robotics which allows for precise cuts and placement of the prosthesis resulting in better outcomes for our patients. MAKO ROBOTIC-ARM ASSISTED TECHNOLOGY FOR TOTAL KNEE REPLACEMENT Mako Robotic-Arm Assisted Total Knee replacement is a treatment option for adults living with mid to late-stage osteoarthritis (OA) of the knee. Mako provides you with a personalized surgical plan based on your unique anatomy. HOW DOES MAKO TECHNOLOGY WORK? First, a CT scan of the diseased knee joint is taken. This CT scan is uploaded into the Mako System software, where a 3D model of your knee is created. This 3D model is used to pre-plan and assist your surgeon in performing your total knee replacement. Bone Preparation Graphic In the operating room, your surgeon follows your personalized surgical plan while preparing the bone for the Total Triathlon Knee implant. With over a decade of clinical history, triathlon knee replacements are different than traditional knee replacements because they are designed to work with the body to promote natural-like circular motion.1-4 The surgeon guides the robotic-arm to remove diseased bone and cartilage within the pre-defined area and the Mako System helps the surgeon stay within the planned boundaries that were defined when the personalized pre-operative plan was created. In a laboratory study, Mako Technology demonstrated accurate placement of implants to a personalized surgical plan.5 WHY CHOOSE THE ORTHOPAEDIC CENTER FOR YOUR MAKO PROCEDURE? It’s important to understand that the surgery is performed by our fellowship-trained orthopedic surgeons, who guide the robotic-arm during the surgery to position the implant in the knee joint. The robotic-arm does not perform surgery, make decisions on its own, or move without the surgeon guiding the robotic-arm. The Mako System also allows your surgeon to make adjustments to your plan during surgery as needed. IMPORTANT INFORMATION Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Mako, Stryker, Triathlon. All other trademarks are trademarks of their respected owners or holders. PARTIAL KNEE REPLACEMENT Mako partial knee replacement is a minimally invasive procedure for those suffering with painful early to mid-stage osteoarthritis of the knee. It is performed using the surgeon-controlled robotic arm system and offers more accurate resurfacing of the diseased portion of the knee, saving as much of the original knee as possible. As a partial knee surgery, Mako surgery can be performed on either the medial (inside) compartment, patellofemoral (top) compartment, or the lateral (outside) portion of the knee. It can also be performed as a bicompartmental procedure on both the medial and patellofemoral portions of the knee. In many cases, patients are permitted to walk soon after surgery, drive a car within two weeks and return to normal daily activities shortly thereafter. WHAT CAN KNEE REPLACEMENT WITH MAKO TECHNOLOGY DO? The use of this highly advanced robotic arm technology can: Enable surgeons to accurately resurface the arthritic portion of the knee and preserve healthy tissue and bone Facilitate optimal implant positioning to result in a more natural feeling knee following surgery Result in a more rapid recovery and shorter hospital stay when compared to traditional total knee replacement surgery Promote a rapid relief from pain and return to daily activities The Mako system assists the orthopedic surgeon in several ways. First, it provides patient-specific three dimensional modeling for pre-surgical planning.

TOC PHYSICIANS SPECIALIZING IN THE SHOULDER & ELBOW Brian Chalkin, D.O. Greg Holt, M.D. Victor Palomino, D.O. Athletes are not the only ones to experience elbow and shoulder problems. Many of the repetitive motions used in everyday activities can result in tennis elbow, also called lateral epicondylitis, an inflammation of the tendons that makes every move extremely painful. Hours spent typing on a computer keyboard or moving around a mouse can be as damaging as the repetitive swinging of a tennis racquet. Any profession that requires repeated hand motions, including dentistry, carpentry and house painting, can cause tennis elbow. The shoulder is also susceptible to injury from wear and tear. Aging alone can lead to shoulder arthritis, a painful inflammation of the joints, and even rotator-cuff tears. When caused by aging, rotator-cuff tears are often painless and do not require treatment. But injury to the elbow and shoulder do not always stem from overuse and getting older. Traumatic injury that is caused by a fall, car accident, heavy lifting and the like occurs frequently, and can result in a separated or dislocated shoulder, or a fractured elbow. Pain, swelling and bruising, and limited movement are all symptoms of traumatic injuries, which should always be evaluated by a medical professional as quickly as possible. TYPES OF ELBOW INJURIES Golfer’s elbow (medial epicondylitis) Tennis elbow (lateral epicondylitis) Bursitis Fracture Biceps tendon rupture TYPES OF ELBOW INJURIES Dislocated shoulder Shoulder separation Clavicle fracture Proximal-humerus fracture Acromioclavicular-joint sprain Rotator-cuff tear Rotator-cuff tendonitis Frozen shoulder (adhesive capsulitis) Bursitis Arthritis Labral and SLAP injuries Impingement Bankart lesion

BACK PAIN The spine is the main support for the human body and provides protection for the spinal cord. It is comprised of 33 vertebrae that permit you to maintain an upright position as well as bend. There are three regions of the spine: the cervical or neck area, the thoracic or chest area and the lumbar or lower back area. The sacral and coccyx areas make up the bottom of the spine. ANTERIOR CERVICAL DISCECTOMY AND FUSION SURGERY In the video below, Dr. Villamil is showing a completed Anterior Cervical Discectomy and Fusion. CAUSES OF BACK PAIN About 80% of adults will suffer significant back pain at some time in their lives due to an injury at work, at home or at play. Back pain and medical spine problems can be caused by: Mechanical difficulties when you move your spine in a specific manner Injuries such as a sprain or fracture Conditions such as arthritis or scoliosis Sacroiliac Joint Dysfunction DIAGNOSING SPINAL ISSUES Doctors generally diagnose spine problems by: Physical examination Diagnostic tests (such as x-rays, bone scan, CAT scan, MRI, arthroscopy, and biopsy) Medical History BACK PAIN TREATMENT OPTIONS IN TULSA, OK Conservative forms of treatment will generally be the first line of defense against most forms of back pain. This may include medication to reduce pain, such as aspirin and acetaminophen, or medication to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs). Physical therapy is often effective, with patients practicing exercises to improve flexibility and strength. In addition, lifestyle changes may be recommended, including those that will lead to the maintenance of a healthy body weight. If the back pain is unresponsive to conservative treatments or has been brought on by a more serious condition, surgery may be recommended. Spine surgery involves several different procedures that target affected vertebrae within the spine. These procedures are effective in treating a wide range of spinal conditions, including diseases, degeneration, injuries and more. Some of the conditions treated with spine surgery include: Degenerative disc disease Spinal stenosis Fractures Herniated disc Lower back pain Infection Scoliosis Tumors SCHEDULE A CONSULTATION For more information or to schedule an appointment with one of our physicians call us today at 918-582-6800, or you can request an appointment online by clicking here!

TOC PHYSICIANS SPECIALIZING IN SPORTS MEDICINE Darnell Blackmon, M.D. Greg Holt, M.D. Victor Palomino, D.O. Chad-Hanson, D.O. Sports medicine is a subspecialty of orthopaedics that deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate injuries so patients can quickly return to their athletic activities. Participating in sports places wear-and-tear on the body, and can lead to orthopaedic injuries. Athletes are susceptible to injuries that include stress fractures and chronic pain, as well as tearing or stretching of internal structures. Treatment for these conditions can involve surgery, orthotics, physical therapy and rest. SPECIALIZED CARE IN SPORTS MEDICINE Many physicians work together to help a patient regain maximum use of an injured limb or joint. A sports injury is typically treated by a physician, orthopaedic surgeon, rehabilitation specialist, athletic trainer and physical therapist, all of whom have specialized training in the diagnosis, treatment and prevention of sports injuries. Common injuries treated in sports medicine by our experience and talented team include: Anterior cruciate ligament (ACL) tears Compartment syndrome Fractures Heat exhaustion Muscle contusions (bruises) Muscle cramps Shin splints Sprains and strains Stress fractures Torn tendons and ligaments Sports injuries are often repairable with arthroscopy, which is a minimally invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and disease through small incisions in the skin. INJURY PREVENTION IN SPORTS MEDICINE In order to prevent sports injuries, it is important for athletes to take care of themselves before, during and after physical activity; this helps to ensure long-term athletic health. Some of the most effective injury prevention tips include the following: Staying hydrated Taking time to rest Not working out on an empty stomach Warming up before exercising Increasing activity levels only gradually Seeking proper medical care at the first sign of a sports injury is imperative because continued activity can lead to even more damage. Chad Hanson DO, Friday Night Sports Clinic Hosted at OSU Medical Center in the Emergency Dept. August 30 - November 8 from 9:30pm - 11:30pm

TOC PHYSICIANS SPECIALIZING IN TRAUMA & FRACTURES Darnell Blackmon, M.D. Brian Chalkin, D.O. Greg Holt, M.D. Yogesh Mittal, M.D. Victor Palomino, D.O. Jeffrey Stromberg, M.D. Chad Hanson, D.O. TRAUMA & FRACTURE CARE IN TULSA, OK The structures of our musculoskeletal system - the bones, joints, ligaments, tendons and other tissues - are highly susceptible to damage caused by trauma from accidents, injuries and other events. These traumatic events may include a fall, automobile accident or sports injury, and often include a direct blow or twisting on a specific area of the body, causing pain, swelling, inflammation and other sometimes serious complications. At The Orthopaedic Center, we provide comprehensive trauma care for all types of falls, accidents or injuries. Our skilled doctors are experienced in everything from performing emergency surgeries to administering physical rehabilitation programs. Treatment for accidents or injuries can vary depending on the type, severity and location of the affected area, as well as the patient's overall health. Most treatment courses usually begin with conservative methods and only consider surgery as a last resort. Physical rehabilitation is often needed in order to restore movement and function to the affected area as it heals. WHAT IS A FRACTURE? A fracture is defined as any type of break or crack in the bone. This can range from a small crack to a complete separation, and can be caused by a traumatic event or by normal activities in patients with low bone density, a condition known as osteoporosis. FRACTURE TYPES Stress fracture Compression fracture Incomplete (greenstick) fracture Comminuted fracture Fractures cause pain, swelling and bruising in the affected area, which often worsens when weight or pressure is applied. Your doctor can diagnose a fracture often just with a physical examination, although an X-ray or CT scan may be performed to confirm the diagnosis and determine the severity of the fracture. FRACTURE TREATMENT The quadriceps and patellar tendons are structures in the knee that help us straighten our knee and perform a kicking motion. Tendons are cord-like structures made of fibrous tissue that help connect muscles to bones. The quadriceps tendon connects the thigh muscle to the knee, while the patellar tendon connects the patella (kneecap) to the rest of the knee. Both of these tendons can be easily damaged as a result of a fall or other type of injury. Most patients experience quadriceps or patellar tendon damage after falling on a partially bent knee. The force of this injury is often too much for the patellar or quadriceps tendon to bear, causing tendon rupture. This condition most commonly affects middle-aged patients and recreational athletes. Treatment for tendon rupture usually begins with conservative methods such as icing and elevating the affected leg and using crutches. If the tendon is completely torn, surgery may be required to repair the tear and relieve pain. Patellar and quadriceps tendon repair is a simple surgical procedure performed in under an hour. During the procedure, the affected tendon is reattached to the kneecap using sutures and holes drilled into the bone. A cast is then applied to the area to ensure that the tendons heal properly. Patients can begin moving the knee within a few weeks and continue to increase movement until the tendon fully heals, usually within eight to 12 weeks. For more information or to schedule an appointment with one of our skilled doctors call us today at 918-582-6800, or you can request an appointment online by clicking here! PATELLAR AND QUADRICEPS TENDON REPAIR Depending on the type and severity of the fracture, treatment may include ice, rest and anti-inflammatory medication for mild fractures; casting or bracing for moderate fractures; or surgery for the most severe cases, including open fractures with wounds that need to be closed. Treatment for fractures aims to heal the bone so that it is properly aligned and able to function once again. Once proper treatment has been administered, rehabilitation may be performed as well to ensure proper healing. Your doctor will advise you on how to care for your fracture, along with helpful measures you can take to ensure a speedy and healthy recovery.

The Orthopaedic Center is proud to partner with Advantage MRI, providing high quality imaging and 3 Tulsa locations. Advantage MRI uses Northeastern Health System as their billing company, therefore your billing statement will reflect Northeastern Health System and not The Orthopaedic Center. MRI stands for Magnetic Resonance Imaging, a non-invasive, radiation-free scanning technology. It is a test that uses radio waves and magnetic fields to produce clear and detailed three-dimensional images of organs and hard and soft tissues throughout the body. REASONS FOR AN MRI The multifunctional MRI can be used to identify or locate an injury or abnormality, to scan for developing problems or analyze damage from previous trauma, and to aid in the planning of surgery. MRI produces images of any area of the body and can be an invaluable tool for detecting the following problems: Tumors, infection, and cancer Eye and inner ear disorders Chronic nervous system disorders such as multiple sclerosis, dementia, and pituitary gland disorders Back pain, spinal cord injury, herniated disk, and pinched nerves Heart and vascular disease and stroke Joint and musculoskeletal disorders: knee, shoulder, hips, wrists, and hands; tendons, ligaments, and muscles Degenerative disorders such as arthritis; deterioration of joint surfaces Major organs including the brain, heart, lungs, liver, kidney, spleen, and pancreas Problems of the male and female reproductive systems, bladder, pelvis and hips, and breast cancer THE BENEFITS OF AN MRI The MRI procedure is an effective diagnostic tool that does not involve any exposure to radiation; unlike X-Rays, radioisotopes, CT, and other methods that use radiation, MRI uses radiofrequency waves. Radio waves detect differences in water concentration and distribution in various body tissues. MRI is the only procedure to produce images of the hard and soft tissue within the body. This procedure is safe for nearly all patients and is constantly being improved so that it is more comfortable for patients with claustrophobia. THE MRI PROCEDURE During the procedure, the patient lies still on a table that slides into the MRI unit. Newer, “open” scanners do not enclose the patient and reduce anxiety for those with claustrophobia. A series of scans is then performed to obtain the image. The procedures are painless, frequently do not require contrast material, entail short examination and recovery times, and take the place of catheter angiography and exploratory surgery so there is no risk of damaging an artery. THE RISKS OF AN MRI While an MRI is considered a safe diagnostic procedure with no major risks or side effects for most patients, its use of a strong magnetic field may lead to serious complications for some. An MRI exam is not recommended for patients with certain conditions, including: Cardiac pacemaker Implantable cardioverter defibrillator Cochlear ear implant Pregnancy Breastfeeding Intrauterine device Metal implants Surgical staples PAYMENT OPTIONS The Orthopaedic Center contracts with a wide variety of insurance companies, workers' compensation carriers, employer groups and Medicare. We know that insurance information can be confusing and hard to understand. That's why, as a service to our patients,we research eligibility and directly bill insurance providers. If you have a question about our participation with a particular plan, please call us.

The Orthopaedic Center’s Osteoporosis Clinic provides comprehensive care for people who have or are at risk of having osteoporosis. Our state of the art program helps individuals learn about the risks of osteoporosis and the lifestyle changes they can make to improve their bone health. The Clinic has a comprehensive team of trained healthcare professionals to meet the needs of patients. Our team will develop a comprehensive treatment plan which may include Dexascan, nutritional counseling, weight bearing exercises, and medication if appropriate. WHAT ARE THE GOALS OF THE OSTEOPOROSIS CLINIC? To provide comprehensive multidisciplinary assessment and treatment for individuals with osteoporosis. The clinic evaluates patient’s needs and works closely with them and their family doctor to establish the best management plan for them. To provide education about osteoporosis for health care professionals, clinic patients, and the public. This is done in a variety of ways: By sponsoring and presenting continuing health professional education sessions. By educating the public about osteoporosis through lectures, television, radio or newspaper interviews, and other media. To support and initiate research about osteoporosis. To collaborate with other hospitals and organizations interested in osteoporosis prevention, support, diagnosis, and treatment. WHAT IS OSTEOPOROSIS? Osteoporosis is a condition in which there is a thinning of the bones, causing them to fracture (break) more easily. It is most commonly associated with older women, although men and younger people can also develop this disease. WHO CAN DEVELOP OSTEOPOROSIS? Chances are you or someone you know has osteoporosis. Osteoporosis affects both men and women. It’s occurrence increases with age and is more common in women after they go through menopause. One in three women and one in twelve men over the age of 50 will have an osteoporotic fracture, affecting around 28 million people and resulting in more than 1.5 million fractures of the back, wrists and hips each year. Eighty per cent of those affected are women and twenty per cent are men. HOW IS OSTEOPOROSIS DETECTED? DEXASCAN / BONE DENSITY SCANCAN OSTEOPOROSIS AFFECT YOU? The DEXA (dual energy X-ray absorptiometry) scan provides a direct measurement of bone density. It is currently the most accurate and reliable means of assessing the strength of your bones and your risk of breaking a bone. The scan is fast, accurate and painless and the dose of radiation used is extremely low. Anyone, male or female, who displays one or more of the risk factors for osteoporosis, irrespective of age, should have a DEXA scan. The earlier osteoporosis is identified, the more can be done to prevent its progress. As a result, women in their thirties should consider having a scan, for comparison purposes in later years The bone densitometry test determines the bone mineral density (BMD). Your BMD is compared to two norms – healthy young adults (your T-score) and age-matched (your Z-score). Positive T-scores indicate the bone is stronger than normal; negative Tscores indicate the bone is weaker than normal. RISK FACTORS FOR OSTEOPOROSIS There are certain risks that you should know about that can increase your chances of having Osteoporosis. These risks include: Decrease in the estrogen hormone, i.e., post-menopausal Lack of calcium and Vitamin D in diet Smoking, alcohol consumption, use of certain medicines Lack of exercise Family history of osteoporosis Female *Advanced age Abnormal absence of menstrual periods Anorexia nervosa Low testosterone levels in men IF I AM AT RISK, WHAT SHOULD I DO? Contact your physician or call our Osteoporosis Clinic hotline at (918) 301-3126. TO LEARN MORE ABOUT OUR OSTEOPOROSIS CLINIC SERVICE, PLEASE CONTACT US TODAY TO SCHEDULE AN APPOINTMENT!

TOC PHYSICIANS SPECIALIZING IN SPINE & PAIN MANAGEMENT Fernando Villamil, M.D. Marco Criscione APRN-CNP Caroline Wescott APRN-CNP Our Orthopaedic providers are still practicing in our Mid-Town Tulsa location, but our Spine & Pain Management group has moved to our new location in Jenks, OK - 512 N Franklin St. Jenks, OK 74037 An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different and more complex than acute pain. While acute pain is a normal sensation triggered in the nervous system to alert one to possible injury, chronic pain is a state in which pain persists for many months or years, beyond the normal course required by healing. The economic and personal losses associated with chronic pain can be significant, including costly medical expenses, lost income and productivity; lost mobility, anxiety or depression. The causes of chronic pain are not always clear. Past traumatic injuries, congenital conditions, cancer, arthritis or other disorders may seem to be obvious culprits, but in many cases the source of chronic pain is complex. This makes it difficult to treat, and pain management usually involves a multidisciplinary focus designed to help the patient reach the highest possible level of function and independence. Spine & Pain Management specialists are medical professionals well-trained in the diagnosis and treatment of acute, sub-acute and chronic muscle and nerve pain. Board-certified in this specialty and utilizing the most advanced treatment techniques, Spine & Pain Management physicians work one-on-one with patients who suffer from chronic pain to determine the best treatment plan to relieve symptoms and allow resumption and enjoyment of everyday activities. CAUSES OF CHRONIC PAIN Chronic pain may develop as a result of several different conditions. Back pain is an extremely common form of chronic pain and may result from many causes, including herniated discs, stenosis, scoliosis, compression fractures and sciatica. Back pain may be radicular, meaning it travels down the arms or legs. Other causes of chronic pain that may require serious Spine & Pain Management include: Headaches Injury Cancer Reflex sympathetic dystrophy (RSD) Fibromyalgia Diabetic neuropathy Trigeminal Neuralgia Osteo, psoriatic or rheumatoid arthritis Inflammatory bowel disease Depression or other psychiatric disorders Any chronic pain should be diagnosed by qualified physicians so that it can be appropriately treated. SPINE & PAIN MANAGEMENT TREATMENTS Treatments for chronic pain may focus on relieving symptoms or treating underlying conditions, and vary depending on the cause and severity of the condition, as well as the patient’s overall health and medical history. The most successful Spine & Pain Management programs are those that are specifically tailored for each individual patient so that they can remain actively involved in their own recovery. Some of the most common treatments for chronic pain include: MEDICATIONS Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) are often the first treatment utilized to relieve chronic pain. Corticosteroids and stronger prescription medications, often opioids are used when NSAIDs are ineffective. These medications include: codeine, oxycodone, percodan and morphine. Because these medications have some serious side effects, doctors usually try to minimize pharmaceutical treatment by recommending alternative pain management techniques whenever possible. INJECTIONS Injections are one of the most effective treatment options for pain management, as they block nerve signals to relieve pain and inflammation. These injections are administered directly into the affected area, along with a local anesthetic to relieve any potential discomfort, and may be composed of corticosteroids, BOTOX®, sclerosing solutions or other substances. ELECTRICAL STIMULATION Through a small battery-operated device worn on the body, transcutaneous electrical nerve stimulation can relieve pain by stimulating the nerves that target the affected area of the body. This treatment is not painful and is considered safe for most patients. SURGERY For the most severe cases that do not respond to less invasive treatments, surgery may be required to relieve pain and allow patients to resume normal functioning, although movement may be somewhat restricted. Surgery may include joint replacement, cartilage repair or denervation. MULTIDISCIPLINARY APPROACH Most patients benefit from a combination of treatments in order to achieve successful pain relief and may be treated by a number of different physicians, therapists, chiropractors and other health care providers. Spine & Pain Management specialists sometimes function as team coordinators of individualized treatment plans.

Children with orthopedic conditions require special care that takes into consideration their bones, joints and muscles for effective treatment that does not affect the growth and development process. Our doctors are specially trained in the diagnosis, treatment and prevention of pediatric orthopedic conditions, and work together with parents and children to ensure happy and healthy development for all patients. There are a variety of orthopedic conditions that specifically impact children and teens, including congenital abnormalities, childhood disease, broken bones, playground accidents, sports injuries and aches and pains associated with the growth spurts of puberty. Depending on the type of injury or disease, children with these conditions may experience abnormal muscle tone, impaired balance, weakness, poor coordination and a decrease in functional movement, in addition to pain, swelling and bruising. CONGENITAL DEFORMITIES While children are at risk for many of the same injuries and conditions as adults, they are also susceptible to certain congenital conditions that may affect their ability to walk or perform other everyday tasks by themselves. While many children grow out of these conditions naturally over a certain amount of time, some may require ongoing treatment to maintain or restore function in the affected area. Some of the most common childhood conditions include: In-toeing Bowlegs Knock knees Club foot Flat foot Our doctors will provide specialized care to correct these deformities and allow your child to experience a happy and healthy life. INJURIES Because of the fragile nature of growing bones and joints, children are often at an increased risk of experiencing injuries such as a fracture, sprain or dislocation. Children are also usually more active than adults and likely to experience injuries or accidents during physical activity. Fortunately, many of these injuries tend to heal easier in children because their bones are strong and flexible, allowing your child to quickly return to normal growth and activity with little to no long-term damage. Conservative treatment such as casting, rest and immobilization are often effective in treating these injuries. NEUROLOGICAL CONDITIONS Children with certain neurological conditions often experience muscle deformities or imbalances that require long-term care so that patients can experience a certain quality of life and degree of independence regardless of their condition. We provide treatment programs for cerebral palsy, spina bifida and muscular dystrophy, among others, to help patients gain function in affected areas. Treatment for some of these conditions may require surgery to correct structural abnormalities, as well as ongoing physical therapy programs customized for each individual patient. PEDIATRIC ORTHOPAEDIC TREATMENT OPTIONS There are many treatment options available for your child’s orthopedic condition. The best treatment for your child will depend on his or her individual condition, but may include stretching exercises, casting, orthotics, physical therapy and surgery. Your doctor will determine the most effective treatment option for your child’s individual condition after a physical exam and thorough evaluation of the patient’s age and overall health. A personal treatment plan will be developed to ensure proper healing and continued growth and development for each child. Many children can successfully overcome these conditions and may play sports and continue to grow unaffected. Parents should bring their child to see a doctor at the first sign of orthopedic problems in order to prevent the condition from causing permanent damage. PREVENTION Parents and children can work together to prevent certain orthopedic conditions from occurring and help maintain an active and healthy lifestyle for their children through special care and activities at home. It is important to take safety precautions when participating in sports activities, including wearing protective gear when necessary, staying hydrated, stretching and playing carefully with others. Seeing your doctor on a regular basis can help detect any abnormalities as soon as possible for prompt treatment and a reduced risk of permanent damage. To learn more about our Pediatric Orthopedics services, please call us today to schedule an appointment with one of our experienced doctors.

The Orthopaedic Center (TOC) is proud to partner with EXOS Sports Medicine offering the most up to date, scientific treatment available. EXOS 's on-site rehabilitative physical therapy bridges the gap between rehab and continued activity, ensuring a safe and optimal recovery. EXOS at TOC specializes in treatment for all injuries; spine, shoulder, elbow, wrist/hand, hip, knee and foot/ankle. At any time our Tulsa clinic is filled with athletes and non-athletes alike ranging in age from 10 to 85. Our physical therapists have doctoral degrees and are licensed in their respective fields. WHAT IS PHYSICAL THERAPY? Physical Therapy is both the science and art of rehabilitating your musculoskeletal and neurological systems to help you reach your maximum functional potential. Every day people experience injury to their bodies—whether it is a single traumatic injury, a progressive disease process, or just the wear and tear of life. When this occurs, physical therapy services are available to educate you on your injury, to develop a plan of care aimed at maximizing your abilities, to guide you through the rehabilitation process, and to facilitate a lifestyle of life long wellness. TREATMENTS OFFERED We use a balanced program of therapeutic exercise, proven manual techniques, functional training and education. Each patient relationship begins with testing and evaluation and we provide positive feedback throughout the patient-centered treatment process. INJURIES TREATED Orthopaedic Injuries Arthritis Carpal Tunnel Low Back Pain & Neck Sprains Shoulder Injuries Ankle & Knee Injuries Fractures Sports Injuries Work related injuries SERVICES OFFERED Orthotics Trunk Stabilization Trigger Point Dry-Needling Running Analysis Industrial Rehabilitation Closed Chain plyometric training Evaluation and treatment as a component of pain management Custom Bracing Sport Specific Bracing Sport Specific Training Outpatient Physical Therapy Myofascial Therapy Private Treatment Rooms Weight Training Plyometrics OUR COMMUNITY Through our EXOS Physical Therapy & Sports Medicine programs, we believe that athletes of any age can learn tips and techniques that can help keep them out of the emergency room. Our certified staff can provide evaluations and wellness education programs upon request. Just call us to talk about how we can help your community athletic association. OUR PHYSICAL THERAPISTS Jamie Fox, PT, DPT - Clinic Director - South Tulsa (101st & Sheridan) John Keller, PT, DPT - Clinic Director - Midtown Tulsa (13th & Utica) Kyle Stanley, PT, DPT - Clinic Director - Broken Arrow (N 9th St) Kyle Culver, PT, DPT, CSCS Bryce Eslinger, OT, CHT Alyssa Puckett, OT Buddy Blair, PT, DPT Terri Cassel, PT Jordan Simpson, PTA Thomas "Buddy" Blair, PT, DPT OUR PHYSICAL THERAPY OFFICES Orthopedics - Tulsa Location 1809 E. 13th Street Tulsa, OK 74104 Broken Arrow 1130 N 9th St., Broken Arrow, OK 74012 South Tulsa 10123 S Sheridan Rd, Tulsa, OK 74133 Owasso 9700 N Garnett Rd, Ste B Owasso, OK 74055

The Orthopaedic Center is a recognized leader in the delivery of medical imaging services. We offer a comprehensive range of radiology services using the latest technology to provide our patients and their referring physicians with superior diagnostic evaluation in a comfortable and welcoming environment. The diagnostic equipment at TOC features the latest in advanced, high-resolution digital imaging technology. SourceOne and Konica teamed together to provide our PACS and computerized radiography(CR) system, Phillips provides the C-arm technology for pain management and Toshiba our Vantage MRI system. Together the staff and technology provide you and your physician with the medical images needed to aid in your diagnosis and treatment. The PAC system links all x-ray, MRI and c-arm studies for easy review by doctor and patient, conveniently in the exam rooms by utilizing this filmless technology. GENERAL X-RAY It is the oldest and most frequently used form of medical imaging. X-ray is the fastest and easiest way for a physician to view and assess broken bones. It can also be used to diagnose and monitor the progression of degenerative diseases. Unlike most forms of radiation, x-rays can pass through body tissue, making it possible to provide images of internal structures without performing surgery. During the procedure, electromagnetic radiation passes through the body onto film. Dense structures such as bone absorb most of the radiation and appear white on developed film. Structures that are less dense appear in lighter shades of gray and black. FLUOROSCOPY Fluoroscopy is a form of diagnostic radiology that enables our physicians, with or without the aid of a contrast agent, to visualize area of concern via the x-ray. This contrast agent allows the structures in the body to be viewed clearly, in real-time, or “live” on a television monitor or screen. Fluoroscopy, also called C-Arm, ensures optimal application flexibility and customizable x-ray functionality. SERVICES MRI Osteoporosis Clinic Spine & Pain Management Pediatric Orthopaedic Care Physical Therapy Radiology Worker’s Compensation Stem Cell Therapy carecredit apply btn Click on image above to apply now! WORKERS’ COMPENSATION For information on our Workers Compensation program please call (918) 582-6800. With the proper authorization we have same day appointments.

WE GET YOU BACK ON THE JOB! The Orthopaedic Center offers a workers' compensation program which combines a commitment to timely access, communication, and cost-effective quality care all resulting in a prompt return to work. The Orthopaedic Center offers the following services: Same day Workers' Compensation appointments as requested. Physicians and staff commitment to communicating and providing requested information in a timely manner. Patient Status Report (PSR) providing significant work related information, will be completed at the end of the office visit and faxed to the involved parties. Medical records will be completed and available within 4-10 days of the office visit. Distribution of medical records will include all parties involved in the treatment and management of the injured worker with a patient signed release. Medical/legal second-opinion consultations. Independent Medical Evaluations (IME's) will be scheduled in a timely manner following receipt of request and advance payment. Coordination of Functional Capacity Evaluations (FCE's). WORKER’S COMPENSATION ADVANCED SERVICES Caring for patients from the business community is of utmost importance to The Orthopaedic Center. Over the years we have tailored many of our services to better serve this important area. In addition to our orthopaedic surgeons we also offer physical therapy, pain management, EMG and MRI to our healthcare service mix. Our single location services combined with our outstanding providers ensure an enhanced continuity of care for work injury patients. TIMELY, STREAMLINED COMMUNICATION Speedy and accurate communication is a top priority when it comes to work-related injuries. For this reason, the Work Comp team at TOC tracks patients through the treatment process, answers employer and third-party administrator questions, and communicates with all involved parties in a timely manner.

Stem Cell Therapy in Tulsa, Oklahoma Our physicians utilize stem cell therapy in treating Arthritis, Tendonitis, Knee Pain & More As an alternative to surgery, our patients can now benefit from injections of platelet - rich plasma, amniotic, bone marrow or adipose stem cells to treat chronic orthopaedic conditions. These treatments can reduce pain and provide long lasting relief from chronic tendinitis, early arthritis and cartilage damage in the joint. Our surgeons offer these fairly new treatment options; PRP, amniotic membrane stem cell, bone marrow stem cell as well as adipose stem cell injections to successfully treat patients with knee, hip or shoulder osteoarthritis, rotator cuff tendonitis, Achilles tendonitis, chronic bursitis, meniscal tears and degenerative arthritis. (For clarification, amniotic stem cells comes from the amniotic sac – not an embryo. While some people may have ethical issues with embryonic stem cell therapy, most people agree the use of amniotic tissue product raises no ethical or moral questions.) Amniotic tissue, such as the tissue we use has been used since 1910 in the US and is FDA-exempt for treating wounds and other conditions. It was first used for treating eye problems, primarily corneas and is still widely used in ophthalmology today. Immediately After Your Cell Transplant Procedure: The stem cell injection includes producing a micro-injury in the joint. As a result, expect the joint to be sore. This can be everything from minimally sore to very sore. Activity: The goal is to allow the stem cells to attach and then to protect them while they differentiate into cartilage. For this reason, you’ll be asked to keep the joint as still as possible for 30-60 minutes after the procedure. Do not take a bath for three days, but a shower 12 hours after the procedure is fine. 1st – 3rd Day: For the first day, you should limit activity on the joint. You may have post-op soreness, or have a natural limp or “antalgic” gait (your body does this to reduce pressure on the area to allow healing). If you don’t have this, then simply, naturally taking a bit of weight off this area as you walk is a good idea the first day. Avoid all contact sports as well as jogging, running, or sports that involve impact on that joint. 4th Day – 2nd Week: You can start to walk normally, no more than 30-60 minutes a day. Avoid all contact sports as well as jogging, running, or sports that involve impact on that joint. Bike riding is fine as are stationary bikes (no up/downs), elliptical machines, and swimming (no breast stroke). 3rd – 6th Week: Avoid all contact sports as well as jogging, running, or sports that involve impact on that joint. You can walk as much as you like. Bike riding is fine, as are stationary bikes, elliptical machine, and swimming.