Category: Orthopedic Surgery

Richard Lukas is happy to be back on the golf course after a superior capsular reconstruction surgery with Dr. Gruber that restored his shoulder range of motion, which he is demonstrating in this photo.

Richard Lukas is an active retiree living in Arizona and originally from New York. Golf is his passion along with pickle ball. He lives in Arizona with his wife; his daughter and four of his grandchildren also reside in Arizona.

Richard originally came to see Dr. Brian Gruber, board certified orthopedic surgeon, over a year ago to repair a torn meniscus, which went very well. Shortly after, he was playing in the pool with one of his grandkids and injured his rotator cuff. After having such a positive experience with Dr. Gruber for treatment for his torn meniscus, he decided to go back to him for the rotator cuff injury.

“Upon exam and MRI, Dr. Gruber said that I don’t have a rotator cuff anymore,” Richard shared. “He identified that I’d injured my rotator cuff 10 years earlier and slowly over the years, the tissue had eroded and the muscle had atrophied.”

My best options for restoring function and my rotator cuff were a total shoulder replacement or a newer procedure that Dr. Gruber was doing where he takes cadaver tissue and totally reconstructs the rotator cuff.

“Dr. Gruber told me that I would be the sixth person he performed this surgery on,” said Richard. “He was very honest that this was not a ‘normal rotator cuff surgery’ and it would be a longer recovery – approximately 12 to 18 months – but that the success rate was good.”

Richard decided to have the more innovative surgery called superior capsule reconstruction, which is performed in less than an hour using allograft from cadaver tissue. He is now several months into his recovery and doing very well with about 90 percent range of motion and hoping to get 100 percent by the 18-month mark.

“I did my physical therapy with Jessica Tate, PT, DPTat Integrated Orthopedics physical therapy (PT) clinicand have had a fantastic experience,” said Richard. “Jessica really knows her stuff and is very professional and caring.”

In fact, just a few weeks after his rotator cuff surgery, Richard experienced a blood clot that required immediate medical attention to address. The blood clot made PT more challenging and Richard noted that Jessica was especially delicate and caring during his PT sessions right after this happened.

“The entire team at Integrated Orthopedics is great,” noted Richard. “Dr. Gruber is extremely dedicated to his patients and their recovery, and he is meticulous in his work. Jessica is a caring and knowledgeable physical therapist and Rob Hutchinson, PAis also fantastic and has a great bedside manner.”

 

 

 

 

 

 

 

 

 

 

We aim to always offer the most innovative orthopedic therapies available to our patient community. The two primary ones we offer currently are regenerative medicine in the form of stem cells and platelet-rich plasma (PRP) therapy and iovera cold therapy for pre-surgical treatment and pain management.

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shoulder surgery

Myra Chait is a busy business owner, wife, mom and grandmother. She is originally from Rochester, NY and has lived in Arizona for 45 years. In her spare time, Myra enjoys gardening, reading and playing with her grandchildren.

She came to see Dr. Brian Gruber, board certified orthopedic surgeon when shoulder pain she was experiencing in both shoulders, which had gotten progressively worse over four years, began to significantly interfere with her daily activities. “It was hard to do simple things like carry a pot of coffee or reach for things, and I was losing range of motion,” said Myra.

Myra was referred to Dr. Gruber by her sister, who had also been his patient and had a great experience with him and his practice Integrated Orthopedics. After doing an initial consult with Dr. Gruber, Myra felt confident he was the right orthopedic doctor for her situation.

“Dr. Gruber is a great diagnostician,” said Myra. “He diagnosed both shoulders as ‘bone-on-bone’ where the cartilage has worn away and said I was a good candidate for a total shoulder replacement on both shoulders.”

Myra shared that Dr. Gruber did not pressure me at all, but just told her the diagnosis and provided treatment options. “He is very bright and definitely knows what he’s doing and has a lot of experience as an orthopedic surgeon,” shared Myra.

Being left-handed and with the left shoulder also in more pain than the right, Myra decided to have total shoulder replacement surgery on the left shoulder first, which Dr. Gruber performed in January 2018.

“I found the surgery to be pretty easy and simple. I only stayed one night in the hospital, was in very little pain and came home the next day,” said Myra. “I followed the doctor’s instructions and started physical therapy within a few days and recovered really well.”

Myra also completed her physical therapy at Integrated Orthopedics’ physical therapy clinic and her therapist was Jessica Tate, PT, DPT. She shared that she had a wonderful experience with Jessica. “I did everything Jessica told me to do and went to all of my therapy sessions,” Myra commented. “Jessica was impressed with how quickly and well I recovered.

Even though Myra’s surgery was less than 3 months ago, she was recently able to go on a Caribbean cruise pain-free in her left shoulder and had a wonderful time. “I had a great time and felt great,” said Myra.

Myra shared that Dr. Gruber has great people skills in addition to being a great diagnostician and surgeon. “Because he does so many surgeries, he is very skilled and experienced,” she noted.

“The team at Integrated Orthopedics is an all-around great team – from my therapist Jessica to the front desk staff who always greeted me warmly and knew my name,” said Myra. “They are all on the same page and have really coordinated the care and communication – everyone knows what everyone else is doing.”

Myra noted that the level of communication and care coordination at Integrated Orthopedics is rare and that few doctor’s offices operate that way. “I don’t know what Dr. Gruber’s formula is for the high level of communication and keeping everyone on the same page about a patient’s care is, but it works,” she said.

Myra is waiting to do her right shoulder, which will also eventually need a total shoulder replacement, but when she is ready she will definately have Dr. Gruber perform the surgery.

 

 

March is national athletic training month, a great time to explore the important role of Athletic Trainers in an orthopedic practice. Our team’s ATs work in our Physical Therapy clinic and help get our patients back up-and-running as quickly as possible. They are an integral part of our care team.

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Symptoms of a broken toe vary from person to person. Learn about the common signs of a broken toe.

Hammertoes is a very common condition. Learn all about it in this month’s featured infographic. Dr. David Larson, Fellowship Trained Foot & Ankle Surgeon at Integrated Orthopedics, specializes in all forms of foot and ankle injuries and surgeries, including hammertoe.

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At the start of the New Year, many people decide to start a running program. We treat a lot of runners in our orthopedic and sports medicine practice and see a lot of the more common running injuries, with both new and long-time runners.

Running is a fantastic cardio workout, but if you’ve never run before – or are getting started again after an injury or break – it’s good to be aware of the more common running injuries.

Foot Mechanics & Running

During running, the foot is active in both the landing and push-off phase. It absorbs the shock of impact when landing and controls the forces generated by running during push-off. Most running injuries can be linked to one of these two functions.

Common Running Injuries

Here are the most common injuries runners experience and tips to prevent these injuries from occurring:

Plantar Fasciitis:
This is probably the most common running injury. It is usually due to overtraining, especially hill work and speed work; and not stretching the calf muscles. The plantar fascia – a think band of tissues that stretches from the toes to the heel – is prone to tearing when overworked. This tearing results in inflammation. The slow blood supply to the fascia hinders healing and results in a chronic condition.

To prevent plantar fasciitis, follow these tips:

  • Wear the right shows with good arch support and heel cushioning
  • Stretch the Achilles tendon regularly
  • Keep at a healthy weight
  • Increase your running gradually and alternate running with other activities
  • Try to minimize going barefoot at home which puts stress on the feet

Achilles Tendinitis:
This large strong tendon runs from the heel to the calf and propels you forward while running. Overworking the Achilles tendon results in inflammation.

A couple good ways to ward off Achilles tendinitis are:

  • Tennis ball roll: Loosen your plantar fascia by rolling a tennis ball under each foot. The muscles and tendons along the bottom of your foot exert pressure from below on the Achilles. This exercise helps keeps things loose.
  • Foam roller: You can increase the flexibility in your lower legs with a foam roller, rolling it over the front and back of the lower legs. This release tightness and tension.

Stress Fracture:
The most common runners’ stress fracture is to the tibia, or shin bone. This type of fracture occurs with issues related to the landing or push-off phase of running.

Here are a few tips to prevent shin fractures:

  • Do exercises to keep calf muscles healthy – do calf raises to strengthen them and stretches the loosen these muscles
  • Avoid muscle fatigue in the legs – when muscles fatigue, weight distribution shifts and the bone takes increased weight and impact
  • Don’t shift from soft trails to hard surfaces rapidly
  • Wear shoes with good shock absorbance

Runners Knee:
When the foot is not stable and lands in an uncontrolled way, runner’s knee can develop. It can also be caused by a biomechanical issue such as the patella being larger on the outside than it is on the inside, or a patella that easily dislocates. Worn cartilage in the knee joint also reduces shock absorption. High-arched feet can be a culprit as well as flat feet.

To prevent runner’s knee, follow these tips:

  • Run on soft surfaces
  • Do not increase mileage more than 10 percent per week
  • Gradually increase hill work
  • Go to a specialty running shoe store to get fitted for the proper shoes for your foot and gait
  • Incorporate exercises that strengthen the quadriceps muscles to improve patellar tracking
  • Stretch your hamstrings and calves to prevent over-pronation (too much inward rolling of the foot)

For many, losing weight – especially those extra holiday pounds – is a New Year’s resolution. Here’s some information to consider on obesity’s impact on knee health from a recent study.

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