We are pleased to announce that Thomas Jefferson University Hospitals have been designated a Blue Distinction Center for Spine Surgery and a Blue Distinction Center for Hip and Knee Replacement.

They say that laughter is the best medicine.

Jefferson family physician Richard Wender and several Jefferson med students were featured in a Philadelphia Inquirer story on the use of clowns and humor in medicine.

Dr. Wender said that he is "interested in humor as a way of communicating, of creating healing relationships. Humor is part of how both patients and clinicians cope."

Each Friday evening, a group of about a dozen Jefferson staff members try to spread cheer to hospital patients, families and medical staff, the Inquirer reported.

Read the full Philadelphia Inquirer story.

Thomas Jefferson University Hospital is the first hospital in Pennsylvania to offer an FDA-approved device that helps individuals with certain types of spinal cord injuries breathe on their own again.  Michael Weinstein, MD, assistant professor in the Department of Surgery at Jefferson, is among the first surgeons in the United States to implant the NeuRx DPS™ in patients with spinal cord injuries who lack voluntary control of their diaphragms.

The device provides electrical stimulation to muscle and nerves in the diaphragm. When the muscle is stimulated, the diaphragm contracts and creates a vacuum-like effect in the chest cavity that allows air to fill the upper and lower parts of the lungs. When this contraction eases, the air is expelled from the lungs – essentially the same as regular breathing.

"In the past, spinal cord injury patients were tethered to a respirator and did not have the freedom to taste foods, smell or breathe on their own," said Dr. Weinstein. "We are excited about being able to offer the benefits of this device at Jefferson and to offer new hope to patients living with spinal cord injury."

We are pleased to announce that Jefferson has recently received Advanced Certification from The Joint Commission in:

• Stroke (Primary Stroke Center)
• Ventricular Assist Device

And Certification in:

• Joint Replacement - Hip
• Joint Replacement - Knee

Jefferson has also received a renewal of its designation as a Chest Pain Center from The Society of Chest Pain Centers. To earn this designation, the Chest Pain Center demonstrated expertise in eight key areas:

• Emergency Department integration with the Emergency Medical System
• Emergency assessment of patients with symptoms of possible Acute Coronary Syndrome (ACS) (timely diagnosis and treatment of ACS)
• Assessment of patients with low risk for ACS and no assignable cause for their symptoms
• Process improvement
• Personnel, competencies, and training
• Organizational structure and commitment
• Functional facility design 
• Community outreach

Peter DeLuca, MD, used platelet-rich plasma (PRP) therapy to treat the elbow injury of Philadelphia Eagles long-snapper Jon Dorenbos. "Platelets are like the EMTs of the body. They are the first cells that go to any injury," Dr. DeLuca told the Inquirer. "In those platelets are growth factors, which are the chemical compounds that enhance healing or start the cascade of healing in our bodies. It only makes sense that injecting a high concentration of them into a damaged area would help enhance its healing."
 
This week's, Philadelphia Inquirer Health and Science section cover story was on the use of platelet-rich plasma (PRP) therapy. Peter DeLuca, MD, Head Team Physician and Head Orthopedic Surgeon for the Philadelphia Eagles and sports medicine specialist with the Rothman Institute at Jefferson, recently used the therapy with Philadelphia Eagles long-snapper Jon Dorenbos.
 
Another patient of Dr. DeLuca, Peter Kleiner, participated in a research study of the treatment and was treated successfully for “golfer's elbow” with PRP.
 
"It was like nothing. It seemed only 10 minutes -- drawing the blood, spinning it, injecting it back in, giving me some ice," Peter told the Inquirer about the procedure. "I had the procedure on Monday, and I was back out on the golf course on Wednesday."
 
Read the Inquirer Story

Whether you’re getting a new knee or a new hip, preparing for surgery is essentially the same. So are the actual joint replacement procedures – each of which typically takes less than an hour. Even so, there are some differences in recovery.

With the caveat that every patient and situation is different, we asked William Hozack, MD, Director of Joint Replacement for the Rothman Institute at Jefferson, to explain what patients can generally expect as they recover.

As Dr. Hozack notes, knee and hip replacement surgeries have some important differences.

“In general, pain management techniques seem to be more effective with the hip than with the knee,” Dr. Hozack says. “With a hip replacement, patients often don’t need narcotics while they’re in the hospital. They can be out of bed the same day, out of the hospital two days after surgery, and walking on a cane within a week.”

What’s more, those with a new hip don’t always need structured physical therapy. Day-to-day movement and activities typically provide for a smooth transition.

With knee replacement, Dr. Hozack says that managing pain is a greater challenge: “With patients who have had a knee replaced, we usually have to use narcotics to manage the pain,” he explains. “We also find that the patients themselves need to work harder and do more active forms of physical therapy.”

Thomas Jefferson University Hospitals has again been ranked as the top hospital in Philadelphia for orthopaedics and rehabilitation medicine by U.S.News & World Report in their 2009 Best Hospitals survey. This ranking translates into the 17th best hospital in the nation for orthopaedic surgery and the 11th best in the U.S. for rehabilitation medicine. U.S. News & World Report this year also named Thomas Jefferson University Hospitals as among the best in the nation in four other specialties – cancer; ear nose & throat; gastrointestinal (digestive) disorders; and respiratory disorders. In addition, Wills Eye, which serves as the Department of Ophthalmology for Thomas Jefferson University Hospital and Jefferson Medical College of Thomas Jefferson University, was ranked as third in the nation and the top medical center in Philadelphia for ophthalmology. Jefferson Hospitals’ President and CEO Thomas J. Lewis said Jefferson and its staff are again honored to be among a select number of medical centers of excellence in the nation. “Being recognized in this way by U.S. News & World Report reflects the extraordinary efforts of all the talented doctors, nurses, and staff, who are dedicated to providing exceptional patient care here at Jefferson every day,” said Mr. Lewis. Redefining how healthcare is delivered is at the core of Thomas Jefferson University Hospitals’ commitment to its patients, its community and the nation.

Gerald Williams, MD, is a shoulder specialist. His areas of expertise include shoulder replacement, shoulder arthroscopy, rotator cuff repair and shoulder dislocations, among other areas. He completed medical school at Temple University and a fellowship in shoulder reconstruction at the University of Texas in San Antonio. Dr. Williams is an active participant in major orthopedic societies and has held positions on the Academy of Orthopedic Surgeons Board of Directors and with the Philadelphia Orthopedic Society. His research has been published in numerous peer-reviewed publications – including the Journal of Shoulder and Elbow Surgery. Dr. Williams sees patients at the Rothman Institute at Jefferson’s Center City and King of Prussia, Pennsylvania, locations. Here, he answers a patient’s question about rotator cuff injury.

Question: I belong to a tennis club and lately, it seems that everyone complains about a rotator cuff injury. Is that commonplace?

Answer: The rotator cuff consists of tendons and muscles that work together to hold the shoulder in place. It allows you to lift your arms and reach up. The rotator cuff may be damaged from a fall or other injury to the shoulder or damage may occur slowly over time from repetitive movement or overuse of the shoulder. Rotator cuff tears are also due to aging. A rotator cuff tear is manifested by shoulder pain that is worse with overhead activity. Symptoms include recurrent pain, limited ability to move the arm, and muscle weakness.

John M. Fenlin, Jr., MD, is a graduate of Jefferson Medical College. He completed an internship and a residency in orthopedic surgery at Thomas Jefferson University Hospital. He is a member of multiple professional organizations and societies. The winner of several awards, Dr. Fenlin has authored numerous articles and book chapters and is a sought-after lecturer in the field of shoulder replacement. Here, he answers a patient’s question about whether or not to wait to have his shoulder replaced.

Question: I’m a 57-year-old male whose passion is golf. For the past year, my arthritic shoulder is so painful that I haven’t been able to play much. My doctor suggests a shoulder replacement, but I feel I should wait until retirement. What do you think?

Answer: We used to put off the surgery as long as possible, but now, we view it as a quality-of-life issue. I ask my patients, “Are you willing to live with pain for the rest of your life, or do you think you’ll consider surgery at some point?” If you know you will opt for surgery eventually, sooner is better. Have the surgery while you are in good health and will enjoy the benefit of more quality years.

Osteoarthritis, a common cause of shoulder pain and mobility loss, affects more than 16 million Americans. Arthroplasty (total shoulder replacement surgery) helps restore function to shoulders damaged by degenerative joint disease, osteoarthritis or rheumatoid arthritis. Replacing the worn-out ball and socket in the shoulder with a prosthetic device relieves pain and increases shoulder mobility.

Acupuncture is the practice of puncturing the skin with needles at certain anatomical points in the body to relieve specific symptoms associated with many diseases. The practice originated in China more than 2,500 years ago but started gaining popularity in the United States in the 1970s.

A recent study suggests that acupuncture helps relieve lower back pain – and that’s true whether or not the skin is pierced. The randomized trial – which compared acupuncture, simulated acupuncture and usual care for low back pain – is the largest research study of its kind.

A total of 638 patients with chronic mechanical low back pain were enrolled in this study funded by the National Center for Complementary and Alternative Medicine (NCCAM), part of the U.S. National Institutes of Health (NIH).

Research participants were randomized to one of four treatment groups – individualized acupuncture, standardized acupuncture, simulated acupuncture (non-penetrating) or “usual care.” Each participant was given a questionnaire to rate their symptoms and dysfunction, as well as 10 treatments by an experienced acupuncturist for seven weeks.

At eight weeks, dysfunction and symptom scores improved equally among the three acupuncture treatment groups. Also, medication use decreased immediately and over the next year.