That’s what some Sunnybrook scientists are questioning, and now investigating in a clinical research study to enhance bone fracture repair.

The “magic pill” in this case is a daily medication already scientifically tested and well established in clinical use known as lithium carbonate.

With timed administration at very low doses, lithium carbonate has been shown to enhance bone repair, and now, orthopaedic clinical researchers are testing it in injured patients with fractures.

The Sunnybrook-led study – Lithium for Fracture Treatment (LiFT) – is a randomized controlled multi-centre clinical trial investigating if lithium can improve long bone fracture healing in healthy patients from 18 to 55 years of age, who have a shaft fracture of the femur, tibia/fibula, humerus or clavicle. Participants take the medication for just two weeks starting 14 days after the fracture or surgery.

“Fracture healing in adults typically takes several weeks to months to heal – and in up to 10 per cent of cases, it can fail to heal completely despite appropriate treatment,” says Dr. Diane Nam, an associate scientist with the Holland Bone and Joint Research Program and orthopaedic trauma surgeon at Sunnybrook.

Dr. Diane Nam, Principal Investigator on the LiFT trial.

“Sustaining a fracture significantly impacts an individual’s function, such as the ability to work, drive or physically parent young children. We’re talking not only about the long time to heal bones, but don’t forget the pain and negative impact on a patient’s quality of life and mental health. If we can show that this safe and inexpensive ($1/a day) therapy works, it can potentially have a huge impact to globally change how we manage fractures.”

Dr. Nam was involved in the scientific research from “lab bench to patient bedside”. She led the team as its principal investigator in conducting the pre-clinical work and in translating the research through to the current clinical trial.

The first few patients in the initial pilot clinical trial showed a reduction in pain with the use of lithium, with no impact on mental activity or mood. In order to keep the highest standards for clinical research, the current study is blinded, meaning that patients and the research team who will analyze the data do not know who is receiving the actual drug or a placebo pill in order to control for potential bias. 120 patients have been enrolled in the study to date.

The trial has sites at Sunnybrook, St. Michael’s Hospital, McMaster University Medical Centre, Ottawa Hospital and Royal Victoria Regional Health Centre, and is supported through Sunnybrook’s Centre for Clinical Trial Support (CCTS) and the Canadian Institutes for Health Research.

A research participant from the LiFT trial comes in for one of his check-in visits at the fracture clinic and to have x-rays taken.

The research team will analyze and compare X-ray result scores assessing for bone union where three of the four outer layers at the fracture site are bridged. They will also factor in how the research participants are functioning in their day-to-day life, including accounting for pain levels.

The research is also considering potential barriers to the acceptance of lithium therapy for the purpose of fracture healing, from both the perspective of patients and care providers. Of note, the dose of lithium being used in the study is so low (300 mg or one-quarter of the dose amount used for other applications) that it’s not detectable in blood work at 12 hours after taking it.

“This important clinical trial is one of many promising investigations that have resulted from collaborations between surgeons and scientists in the Holland Bone and Joint Program,” says Dr. Cari Whyne, senior investigator involved in the trial and the Susanne and William Holland Chair in Musculoskeletal Research at Sunnybrook Research Institute and University of Toronto. “This aligns with my research focus in clinically-translational bioengineering research aimed at maximizing function among those who develop musculoskeletal disease or disability.”

For more information about participating in the LiFT trial, contact lift@sunnybrook.ca

The post Igniting Discovery: Can we speed up bone healing? appeared first on Your Health Matters.

We asked Dr. David Wasserstein, trauma and knee reconstruction specialist in the Schatzker Joint Preservation Initiative for Active Adults and the Holland Bone & Joint Program at Sunnybrook, for some tips on how to protect your joints so you can keep doing the activities you enjoy most.

What impact can high-intensity exercises like running have on your joint health?

From a medical-evidence perspective it is currently unclear whether high-intensity exercise increases the risk of joint breakdown.  In fact, there is evidence on both sides, suggesting there may even be a protective effect in addition to concern for early breakdown. This is typically relevant to load bearing joints like the hips, knees and ankles, and in persons who are performing high levels of impact exercise like running and jumping.

Acute injuries, like sprains, strains and fractures, are more common in sports due to contact or when someone is placed into an awkward or uncontrolled position like landing from a jump.

For high-volume impact activity athletes, we are also concerned for injury around the joint.  Most commonly they experience tendon injuries including overuse and inflammation.  They may even experience stress injury to bone that results in fractures.

What are your top tips for preventing pain and injury while living an active lifestyle?

People run into to trouble when they do too much of one thing.  So, even if you are training for something specific, like running a marathon, don’t forget to vary the exercise and training.  Maintaining strong cardiovascular health that is needed for this type of high-volume exercise can be achieved in several ways in addition to just running, things like cycling, swimming, or rowing, for example. Taking an approach of cardiovascular training that ‘rests’ the usually overloaded parts of the body can be helpful.

Resistance or strength training is critical for bone, joint and tendon health. It should be incorporated into any fitness routine. Sufficient rest and adequate nutrition are also key elements of maintaining optimal health and reducing the risks of injury.

The benefits of an active lifestyle cannot be understated from the perspective of musculoskeletal health but also for every organ system, including mental health. So definitely stay active!

What should people do if they’re experiencing joint pain while exercising or participating in other high-intensity activities?

First is to rest and then consult a physician or therapist. Although we live in a world of ‘access to information,’ that information exists largely unregulated in social media spaces. Those spaces can be a good place for information but they can also be a good place for misinformation. I would exercise caution and rely only on trusted sources!

The post How to protect your joints while living an active lifestyle appeared first on Your Health Matters.

To spread the word that our Toronto-area hospital collaborations are open for business – with an approximate four-to-six week wait for patients to see a specialist for their hip or knee arthritis – we recently caught up with Dr. James (Jim) Vavougios, a family physician in East York, before an appointment with one of our mutual patients. Here’s what he had to share.

How long have you been practicing family medicine in the community?

40 years, but not yet ready to retire! I don’t want to give up all my skills, I diagnose now better than ever before. 32 years here on the Danforth, along with my colleague James; we were buddies since grade 7, and opened this practice together.

We’re here today to chat a bit about your experiences as a family doctor who refers your patients in to the Toronto Region Rapid Access Clinic for Hip and Knees – but we understand you have a unique perspective as you’ve also been a patient yourself for knee replacement and rehabilitation?

That’s correct. I’ve had lots of experience as a patient, too. I’ve had a knee replacement at Sunnybrook’s Holland Orthopaedic & Arthritic Centre. I went on to have my rotator cuff done and both shoulders repaired there. The service was great for me and for my patients, too. I like that the people there specialize in their area.

Referring patients through the centralized intake for the Rapid Access Clinic, they get a quick assessment and the process is streamlined, which is nice. The Rapid Access Clinic’s model works well, as for a lot of patients, they may just want an opinion and some of the patients aren’t ready for surgery yet. Some will go through the GLA:D exercise program, delay the progression or worsening of their arthritis symptoms for a few years, and then they’re ready for surgery. When they know their doctor had it done too, they feel more comfortable.

It’s like anything, when you believe in something yourself, you give off positivity. If you have had a negative experience, then you won’t talk about it.

Is there a situation or recollection that stands out of your experiences referring your patients for hip and knee surgery?

Sometimes it’s a surprise how the patient is going to react. I’m always a little nervous for my patients, and with new doctors on board, you ask yourself “Are they going to do a great job?” It’s always excellent. It’s satisfying when a patient comes back, you think a particular patient may have a harder time than others, but they’re like ‘No, everything is great.’

You’ve asked one of your patients if we could come in today to meet her and take a few photos. Can you give us a little background on her situation?

Georgia had her first knee done in June 2023, and then her second knee replacement in March 2024. She’s only 42, but she’s had terrible arthritis. We were pleased to see her go through the system and have both her surgeries within a nine-month period and I’m so pleased to see how well she is doing.

Dr. James Vavougios and Georgia. Photos: Kevin Van Paassen/Sunnybrook

What do you think would be helpful information to share with other primary care practitioners in the community, and their patients?

We still hear in the news of some long waits for hip or knee arthroplasty surgeries. I would encourage other primary care practitioners to look into the Toronto Region Rapid Access Clinic as their model has always been efficient and leading in the industry.

And now, with the addition of the “weekend surgery” dates over the past year, I understand they have been able to process through more than 1,000 additional surgeries that wouldn’t have been able to be completed on weekdays alone, which is part of the reason why my patients, like Georgia, have received their specialist appointments and surgery dates much sooner than we anticipated.

 To learn more or to get a referral for your patients, please visit ReduceMyHipandKneeWait.ca.

The post A primary care practitioner’s experiences with getting his patients through for hip and knee assessments/surgery smoothly and efficiently appeared first on Your Health Matters.

Margo Mingay was hard at work breaking up boxes while talking with fellow volunteers Omar and Dallas.

They were shocked to learn that, just 10 weeks ago, Margo had hip replacement surgery, as she scurried along and proceeded to push a cart stacked high with crates of produce. Little did they know, it was her second hip replacement in eight months.

A year ago, Margo was experiencing pain in her arthritic hip joints. “My legs were very sore, I couldn’t walk very far,” she says. “I’d get out of the car, and my hip would lock. I couldn’t move, I’d just stand there for a few minutes and shake my leg or hips around. Bending over was difficult; overall, life was challenging.”

Margo tried different therapies, but the pain progressed. “The pain would radiate; my lower leg was really tight. I’d go to exercise, went to physiotherapy; nothing got better.”

X-rays showed osteoarthritis in her hip joints, which went from medium to severe over only a few years’ time.

“The actual hip joint itself wasn’t so bad; it was the inability to do a lot of things,” explains Margo. “Every day was something different. But I thought ‘Oh the wait list for surgery is so long’, so I thought ‘may as well get on it’.”

It was early 2023 and there were over 4,000 patients waiting for a hip or knee arthroplasty – total joint replacement surgery – in the Toronto region. 20 per cent of those patients were considered “long waiters” – some of whom had severe and painful osteoarthritis as they waited to see an orthopaedic specialist and get a surgery date.

A solution to long wait times

Around this time, a partnership between Sunnybrook Health Sciences Centre and Michael Garron Hospital – the Toronto Regional Arthroplasty Collaborative (TRAC) – was preparing to launch the start of weekend surgeries for hip and knee replacement to increase the number of patients treated. The goal? Help tackle long waits across Ontario.

When Margo had her first consultation with orthopaedic surgeon Dr. Markku Nousiainen at Sunnybrook’s Holland Orthopaedic & Arthritic Centre in March 2023, the centre was preparing to open its operating room on the weekends for the first time. In the months that followed, Sinai Health and Unity Health joined the collaboration.

Participating orthopaedic surgeons were scheduling patients into the weekend surgery dates. Margo was offered a Saturday surgery appointment and quickly accepted. “You’re one of my first Saturday patients,” Dr. Nousiainen told her.

“I was surprised I got in so quickly,” says Margo.

On the road to recovery, Margo was adjusting to her new hip joint. After seeing Dr. Nousiainen again in early November 2023 to assess her other hip, and decide upon surgery again, she made herself available any time for her other hip replacement. “I received a call back with the option of surgery on December 19,” she says. “Despite Christmas being six days out, I jumped at the opportunity.”

“As we celebrate the one-year mark for this initiative, our current wait is less than four weeks for a patient to see a specialist from the time that their referral comes in from their primary care provider.”
– Dr. Markku Nousiainen

For her part, Margo is intent on following through on doctor’s orders to keep active, as evidenced by her weekly shift at the food bank, as well as resuming her volunteer work driving cancer patients to and from their hospital appointments. She’s also doing regular walking, going to the gym and riding her stationary bike.

“I feel great,” she says. “Bending over can be a bit tough, but 10 weeks in, no major problems, I’m getting back in to it, getting stronger. Now it’s my other joint arthritis problems that bother me!”

As of March 31, 2024, TRAC had completed 1,120 additional arthroplasty surgeries. “These are surgeries that wouldn’t have otherwise been completed in that time period, and our patients are seeing the results with more accessible and earlier surgical dates,” says Dr. Nousiainen.

Would you like to be seen for your hip or knee arthritis in under four weeks?

Learn more about the referral process at ReduceMyHipandKneeWait.ca

Photo: Kevin Van Paassen/Sunnybrook

The post How weekend surgery got patient Margo back to health faster and helping the community again appeared first on Your Health Matters.

The most common type of arthritis is osteoarthritis, a progressive disease of the whole joint that leads to the breakdown of joint cartilage and the underlying bone. When there is too much breakdown in the cartilage, it can result in bones rubbing together, which causes swelling and pain.

Andrea Nunn is a physiotherapist at Sunnybrook’s Holland Centre, where she works with patients who have osteoarthritis in the hip or knee, providing exercises and education through the GLA:D Canada program. She also helps patients rehabilitate following joint replacement surgery. Andrea shares some insights into how to reduce your risk of osteoarthritis. Read those tips below, as well as information on signs, symptoms and treatment options from GLA:D Canada and the Arthritis Society of Canada.

Signs and symptoms of osteoarthritis

While osteoarthritis can occur in any cartilage-covered joint, it is especially common in the knees, hips and lower spine because of the load these joints bear on a daily basis.

Typically, symptoms may begin with pain, either in the knee when it is bearing weight (standing, walking, climbing), or in the hip joint. In the hands, osteoarthritis is most common in the ends of the fingers and base of the thumb, leaving them feeling stiff and tender.

People with arthritis may notice that daily tasks become more challenging, such as putting on socks, getting into a car or even clenching a fist.

Symptoms may begin slowly, starting as pain with movement and, as the arthritis progresses, the pain will likely become more constant. Most people will see progression slow, sometimes even stop completely, but others will experience rapid deterioration.

If you are experiencing new pain or stiffness in your joints, or reduced mobility that is making it difficult to do daily tasks you could do before, reach out to your family physician.

Treatment

Since every patient will experience arthritis differently, doctors can’t predict how the disease will progress for an individual. It’s also why, even though a patient may get X-rays to see if there are any changes to the cartilage surrounding the joint, diagnosis is made based on symptoms because oftentimes, a patient is experiencing more severe symptoms than might be indicated in an X-ray.

There is no known cure for cartilage loss, so any treatments for arthritis are designed to reduce symptoms and improve joint function.

Exercise 

Osteoarthritis often causes pain, which can lead to people reducing their physical activity to accommodate the discomfort. According to GLA:D Canada, research has shown that reduced strength in the muscles can worsen arthritis symptoms, so maintaining consistent physical activity is important for patients with arthritis. Exercise can also improve overall health and wellness and quality of life.

People with arthritis can find benefit from improving strength, flexibility and cardiovascular fitness, but before beginning a new exercise program, speak with your family doctor.

Other treatment options

Other treatment options for arthritis can include referrals to healthcare professionals such physical therapists or occupational therapists. Medication is an option for pain management, and if arthritis becomes severe, surgery may be required. It’s important to stay in contact with your family physician who can help develop a plan of care based on Health Quality Ontario’s Quality Standards for Osteoarthritis. They can connect you with any other appropriate healthcare professionals to help manage arthritis symptoms and make a referral to a Rapid Access Clinic for assessment for surgery, if required.

Once diagnosed with osteoarthritis, you will have it for life, says Andrea, but symptoms will vary depending on the person and can be managed with treatment.

Reducing Risk

Andrea says there are several ways for people to reduce their risk of osteoarthritis.

“Preventing joint injury earlier in life can reduce your risk of developing osteoarthritis,” she says. “We’re seeing more joint injury prevention programs for young people playing sports now because there can be long-term consequences if you have traumatic injury to a joint, even as young as teenage years.”

Andrea says people who work in industries such as construction and are putting a lot of load on their joints on a daily basis should be aware of their risk of developing osteoarthritis and can take steps to reduce that likelihood.

“Trying to use ideal body mechanics is important—alignment of hip, knee and foot,” she says. “Being balanced in your whole posture and body will help too.”

Maintaining an optimal body weight can help prevent osteoarthritis. Andrea says two pounds of extra weight can increase the joint load by three to five times, which means that losing weight can improve symptoms of osteoarthritis.

Finally, Andrea says consistent movement and physical activity is important for healthy cartilage and strong muscles, both of which can reduce the risk of osteoarthritis.

“Muscles help absorb some of the load the joints would normally take,” she says. “They also help to improve stability of the joint.”

And she says cartilage needs “dynamic load” to stimulate it, so regular movement means the joints are loaded on a regular basis and that encourages cartilage to regenerate.

Living well with arthritis

Andrea emphasizes that an arthritis diagnosis doesn’t necessarily mean a lifetime of pain and discomfort. Symptoms can be managed, and with some simple adaptations (e.g. jar openers or sitting to put on socks and shoes), many patients will live healthy, active lives with arthritis.

The post Osteoarthritis: symptoms, treatment & reducing risk appeared first on Your Health Matters.

Harlan Kirshenbaum says that engaging in virtual treatment for his OCD from his home has been beneficial.

COVID-19 presented a vast challenge for medical and administrative staff at Sunnybrook: How could they deliver the programs and services their patients relied on, yet still keep everyone as safe as possible? Here are just a few examples of virtual care initiatives developed at Sunnybrook through the pandemic.

Virtual OCD treatment: A better fit for some

Harlan Kirshenbaum has battled obsessive-compulsive disorder (OCD), a chronic psychiatric illness, for most of his life. Over the years, his OCD has led to the repetition of various actions, called compulsions, which have had a dramatic impact on his life.

“At one point, I couldn’t get dressed without looking at the labels on my clothes,” Harlan explains. “In recent years, I couldn’t touch my kids or my wife because I would get bad thoughts, like I would give them cancer.”

When the COVID-19 pandemic hit, Harlan’s OCD worsened. He reached out to Sunnybrook’s Frederick W. Thompson Anxiety Disorders Centre for support through the Intensive Residential OCD Program, which had recently shifted from in-house treatment to virtual care amid the pandemic.

The six-week program includes exposure and response prevention sessions guided by a therapist through video conferencing, as well as group sessions for mindfulness and cognitive-behavioural therapy. It was an intense experience, but Harlan says that virtual treatment for his OCD was even more beneficial because he was being treated while in his home, where the majority of his triggers are.

“It’s where my OCD attacks me the hardest, and the virtual program was amazing – the most effective treatment I’ve ever had,” he says.

Dr. Peggy Richter, head of the Frederick W. Thompson Anxiety Disorders Centre and director of the Clinic for OCD and Related Disorders at Sunnybrook, says that coaching people in their home environment has, for many, been advantageous over typical live treatment on-site.

The success of the virtual program has prompted Dr. Richter and her colleagues to plan for a hybrid model of care in the future, based on the positive experience of patients like Harlan. Patients would have shorter residential stays, then migrate to a virtual environment to take advantage of coaching in their home environment.

“We see all the advantages in terms of access, what can be done and how much easier it is for patients to attend our program,” Dr. Richter says. “We don’t want to lose those wonderful improvements.”

COVIDEO: A lifeline for patients

For infectious disease physician Dr. Nisha Andany, developing a virtual care model for COVID-19 was an important part of keeping patients informed about a new and unknown disease.

“Early on, it became clear that most people with COVID-19 would not need to be admitted to hospital and could be managed at home,” Dr. Andany says. “But they might be feeling alone or uncertain in terms of what to expect, what they should do or when they should seek medical attention.”

Alongside members of the infectious diseases team at Sunnybrook, Dr. Andany developed the COVIDEO program to conduct phone and video assessments of outpatients with COVID-19.

“We [also] give patients our email address and pager number and inform them there’s a doctor on call 24 hours a day for any emergencies,” she adds. “We’re often able to reassure most patients that they can stay home and guide them in managing their symptoms.”

As the COVIDEO program was rolling out, the team also began to send out blood oxygen monitors to higher-risk patients. That way, the COVIDEO team could obtain a more objective assessment of someone’s condition from home.

“Now, patients will call us and say ‘my oxygen level is at a certain level’,” Dr. Andany says. “It allows us to more reliably determine how sick someone is. If a patient has a normal oxygen level, we will typically reassure and advise them to remain home and keep monitoring. However, for those with low oxygen levels, even if they say they feel okay, we know they actually need to come into the hospital for treatment.”

Virtual post-operative physiotherapy

For patients recovering from hip or knee replacement surgery, virtual post-operative physiotherapy offered by the Holland Centre has given patients all over the province greater choice, says Amy Wainwright, manager of the Holland Bone and Joint Program.

“For some patients, the possibility of virtual care removes some barriers to receiving care at the hospital such as arranging transportation, long travel times, paying for parking, as well as family members to accompany them,” Wainwright says.

Throughout the pandemic, physiotherapists have been hosting rehab sessions by video to safely guide patients in their post-surgical recovery.

Going forward, the Holland Bone and Joint Program will continue to offer virtual care for outpatient physiotherapy, as well as virtual options in other areas of the program such as pre-admission and post-operative follow-up clinics. Wainwright says the expansion of virtual care has been something of a silver lining among the challenges caused by COVID-19.

“We now have a virtual care model that would have taken years to get to and may have been challenging to implement if it wasn’t for the pandemic pushing us all into a new arena,” she says.

Bringing the ED to the community

When Sunnybrook physician Dr. Justin Hall saw patients avoiding the Emergency Department (ED) due to fears around contracting COVID-19, he saw the need to provide another option.

“People delayed their care and were more unwell when they eventually came in,” Dr. Hall explains. “In some cases, there was permanent or irreversible damage because of this delay.”

Along with members of ED leadership, Dr. Hall developed Sunnybrook’s Virtual ED. Focused on addressing acute but non-life-threatening issues, it launched thanks to provincial funding as a six-month pilot in December 2020, and it has since been extended with ongoing provincial and hospital support. Patients can book a same-day appointment to see a physician through video conferencing app Zoom if they’re unable to visit their regular family doctor.

“It’s not a replacement for the in-person ED,” Dr. Hall notes, as emergency departments are still open and are safe to visit. People experiencing life-threatening issues like a heart attack or stroke should still go to the hospital. But issues such as skin conditions, some mental health concerns or sprains and strains can now be assessed through a video appointment.

As with many departments at Sunnybrook, there are plans to incorporate a hybrid model of virtual and in-person care in the ED post-pandemic, says Dr. Hall, making it easier for patients to access treatment in an integrated manner.

“We estimate that 30 per cent of in-person visits could be seen virtually,” he says. “There’s an increasing recognition of the value of virtual care and that patients like it and are willing to use it.”

Learn more about the Virtual ED »

Staff members of the Virtual Emergency Department Team (from left): Toni Alevantis, patient administrative associate; Steffanye Michaelson, patient care manager; Dr. Aikta Verma, chief of emergency medicine; Dr. Justin Hall, emergency room physician and virtual emergency department lead.

The post Ushering in a new era in medicine: Sunnybrook creates virtual care programs in response to COVID-19 appeared first on Your Health Matters.

Find simple ways to move

If you have hip or knee osteoarthritis, staying active can be a challenge.

But staying active can help you manage your pain. Consider incorporating the options below in your daily routine:

• Aim for 3,000 steps a day. If you are able, you can work your way up to 6,000 steps or more! Use hiking poles or a cane to ease any pain and improve your walking pattern.
• To put less of a load on your hips or knees, biking and water-based exercises are great options.
• Mind-body exercises like Tai Chi can help to improve strength, balance and your mood.

It’s important to remember that aiming for 30 minutes of moderate exercise per day is a great way to start. “This doesn’t have to be one 30-minute chunk — you can exercise in 10-minute intervals throughout the day too,” says Patricia.

You might also consider attending a GLA:D Canada Hip and Knee Arthritis Exercise Program after consulting with your family doctor or arthritis specialist.

Get the most out of your virtual care experience

“Some aspects of your care might be a little different, so you might need to prepare a little more,” highlights Patricia when speaking of virtual care. As we continue to navigate the changes brought on by COVID-19, virtual care is a great avenue to improve your access to care while staying in the comfort of your own home.

For the best virtual consultation experience, here are a few tips:

• Dress in loose, comfortable clothing so you can move around easily.
• If your appointment will occur over the phone, think about how to best describe what your joint looks like.
• In the case that your appointment will be over a video call, make sure you are in a space where you can move comfortably and show your joints.
• Try to log in early so you can check your internet connection!

Watch Patricia’s full presentation in the archived video of September’s lecture:

For more information and resources on osteoarthritis, check out some of the resources below:

• A guide for patients having hip or knee replacement
• The Arthritis Society
• Health Quality Ontario, Quality Standards “Care for Adults With Osteoarthritis of the Knee, Hip, or Hand” Patient Reference Guide

The post Living well with hip or knee arthritis: A Speaker Series summary appeared first on Your Health Matters.

“I didn’t know anything that I could do about it,” says 55-year-old Albert. When he brought it up to his family doctor, his doctor mentioned that a knee osteotomy was an option for individuals in his age bracket. By shifting weight off of the damaged side of the joint, an osteotomy can relieve pain and improve function.

While Albert was correctly identified as being a potential candidate for an osteotomy surgery, many primary care physicians are not familiar with this type of modern joint preservation procedure. “Great advancements have been made in the field of osteotomy surgery, but many healthcare professionals and patients alike are not aware of these options,” says Dr. Sebastian Tomescu, orthopaedic surgeon at Sunnybrook.

Albert did his research on the procedure and thought it would be a good idea to proceed, especially if it could relieve the pain in his legs at nighttime.

He underwent a knee osteotomy for his right leg first, and then about a year later, he had an osteotomy of his left knee as well.

Despite the onset of the COVID-19 pandemic, Albert continued to receive care but in a new, virtual format. He explains, “My care team was available virtually in case I had any questions, but my knees just naturally had gotten better over time.”

“Within three to four weeks, I wasn’t feeling pain in my hips and I wasn’t taking any anti-inflammatory medications,” says Albert, “My knees feel like they’re back to 100 per cent and life is starting to feel like it’s returning to normal!”

For patients with cases like Albert’s, the Schatzker Joint Preservation Initiative for Active Adults at Sunnybrook can make a significant difference. For a population with early to mid-stage arthritic diseases impacting their quality of life, this initiative aims to provide advanced surgical treatment options.

With newer bone and joint procedures targeting localized osteoarthritis, the progression of arthritis in different areas can be slowed down while preserving the native joint, which functions better than an artificial one when healthy.

Albert explains, “My whole family life has improved because I can participate in these recreational activities again with my loved ones.” Having this surgical procedure at Sunnybrook meant that Albert got the opportunity to kick a soccer ball around, ride his bike and go on long hikes with his wife and kids.

“Hopefully, I’ll be able to play recreational soccer again soon!” says Albert.

The Schatzker Joint Preservation Initiative for Active Adults is named after Sunnybrook’s Professor Emeritus, Dr. Joseph Schatzker. Known for his expertise in trauma, joint preservation and fracture management, Dr. Schatzker continues to consult on patients with a variety of orthopaedic issues.

The post New generation of treatments to preserve joint health your doctor may not know about appeared first on Your Health Matters.

Here are eight common foot conditions with some treatment recommendations to help keep your feet healthy:

1. Heel Pain (Plantar Fasciitis): Also referred to as a ‘heel spur.’ Symptoms can include pain on the bottom or inside part of the heel, which is usually most painful with the first few steps in the morning or after a period of rest. Treatment can include custom foot orthotics, supportive footwear and stretching.
2. Bunion (Hallux Valgus): This is a misalignment of the big toe, often with a ‘bump’ that may be red or inflamed and can be quite painful. This can be hereditary, or can occur because of injury, arthritis or wearing shoes that are too tight. Treatment can include custom foot orthotics, wider footwear and toe separators.
3. Forefoot/Ball of Foot Pain (Metatarsalgia): Pain across the ball (metatarsal bones) of the foot and can occur because of injury, arthritis, or pressure in this area from footwear (high heels) or activity. Treatment can include custom foot orthotics and proper footwear.
4. Flat Feet (Pes Planus): Those with flat arches tend to have overly flexible feet that roll too far to the inside. Arch pain can often happen because of this and can contribute to pain in the knees, hips and back. Treatment can include custom foot orthotics, motion control footwear and physiotherapy.
5. High Arches (Pes Cavus): Those with high arches tend to have inflexible feet with excessive pressure along the outside edges of the feet. Pain can often happen because of too much weight along the outer part of the foot, as well as along the heel and/or ball of the foot. Treatment can include custom foot orthotics and cushioned footwear.
6. Ankle Pain: Ankle pain can happen because of poor foot mechanics (such as flat arches or high arches), disease (such as arthritis) or injury. Treatment can include custom foot orthotics, supportive footwear and physiotherapy.
7. Corns & Calluses: Corns are thickened areas of skin that form because of excessive pressure and friction. Corns are usually hard and round in appearance. Calluses are thickened areas of skin that form as a result of pressure, or shearing (friction). Corns and calluses form to help protect the skin and the structures beneath it from injury or damage. Treatment can include podiatry/chiropody care to remove corn and/or callus, custom foot orthotics and proper footwear.
8. Ingrown Toenails: Ingrown toenails occurs when the corner of the nail imbeds into the skin causing pain and sometime infection. It usually happens because of improper nail trimming, injury, and pressure from footwear. Treatment can include proper nail care and treatment from a Podiatrist/Chiropodist, and making sure your shoes are not too tight.

What can you do to help manage your foot pain? If you feel you need advice or help to manage your foot pain, you should speak to your family doctor about the treatment options available.

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Did you know?

Sunnybrook Centre for Independent Living (SCIL) Pedorthic Services specializes in non-surgical treatment for foot and lower extremity pain. If you would like further information about our services, please call us at 416.480.4261, email us at scil@sunnybrook.ca or visit our website.

The post Helping you walk away from foot pain appeared first on Your Health Matters.

Adjust & be creative

Some people are energized by activities that include others, like group sports or going to the gym. Knowing these outlets aren’t safe or available right now, adjusting your expectations and reward system will help. If you thrive on the social aspect, Denis says to try to build in a virtual home workout or virtual challenge with friends that changes daily or weekly. You can also share a personal fitness goal with a loved one to keep you accountable.

Keep it up

Consistency is the key to success and building healthy habits. Schedule in your time for physical fitness and make that time a priority in your day. Denis says exercise helps boost your immune system and provides many physical and mental health benefits. It can help reduce stress, anxiety and feelings of sadness that can worsen with self-isolation. She says participating in mind-body activities, such as yoga, tai chi and meditation, can also help tend to our mental health.

Explore what’s available

There are countless fitness apps and online training programs, some available at little or no cost. Denis says many fitness and mindfulness leaders have also contributed free resources to help people manage through these difficult times. If you don’t have a lot, or any fitness equipment at home, rest assured many workout options only require your body, a little space and a towel.

Easy does it

If you are starting a new fitness program, go slow and build up over time. Even if you are normally physically active, it can take your body some time to adjust to new or different movements. Ramping up moderately will help reduce the risk of injury and keep you on your game plan.

Enjoy it

Physical activity can help break the monotony of being inside, and even small bursts of elevating your heart rate can be beneficial. If you need some extra motivation, music has been shown to help boost endurance and the overall quality and enjoyment of working out. Denis says whether its dance, tai chi or another activity, this is your opportunity to try something new.

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