In-Office Ultrasound

Dougherty Sports Medicine is pleased to offer in-office ultrasound for the diagnosis of a variety of musculoskeletal conditions.

In-office ultrasound offers a two significant advantages for patients over relying solely on MRI:

1. If an ultrasound is indicated during your appointment, there's no need to make an additional appointment. The ultrasound can be performed immediately.

2. It is covered under msot insurance with no additional copay.

Not all problems can be imaged with ultrasound, so MRI may still be recommended. For patients whose conditions are captured by ultrasound, however, the procedure can save considerable time and money.

Dr. Dougherty serves as an instructor for musculoskeletal ultrasound and teaches diagnostic techniques to physicians from around the world.

A Busy Fall Already

The Northwest Arkansas Naturals made the playoffs, which was exciting. When you work with people for a whole season it's great to see them succeed.

My teaching trip to Hawaii was excellent as I was able to instruct representatives from Australia and New Zealand in performing my double bundle ACL reconstructions as well as hip arthroscopy. They are to say the least a very entertaining group. We were invited to travel to Australia over the winter to teach more surgeons the new and exciting techniques.

I also had the opportunity to be on the air with KREB 1190 AM. We discussed the difference between double bundle ACL reconstructions and a standard reconstruction. We also covered how to reduce your chances of injury and what exercises to do. You can find may of these exercises on Dougherty Sports Medicine's Physical Therapy page. In addition we talked about collarbone fractures and how treating them with a nail that I place inside the collarbone rather than a plate on the outside lets you get back to activity as quickly as possible without a large incision and pain from the plate when you get hit wearing shoulder pads. Probably the best feature of the nail over the plate is the amount and level of activity that you are able to get back to very quickly as you can often resume full activity in just a few days to weeks after nail insertion.

I traveled to Florida at the end of September to teach surgeons from Japan and Asia as well as serving as a laboratory instructor for the Arthroscopy Association of North America’s annual meeting, teaching hip arthroscopy to other surgeons.

Summer Roundup

May - Newcastle England – Newcastle is a beautiful city about three hours north of London. It took awhile to get there as the plane out of Detroit was delayed almost 5 hours. The weather was fantastic and sunny. The medieval architecture and old castle and church were breathtaking. It’s hard to comprehend sections of the city standing for over 900 years. Took in our first cricket match in Durham and it was great, even though the home team lost 136 to 137. The meeting involved teaching shoulder arthroscopy, including rotator cuff and instability repairs as well as very difficult posterior labral tears and instability of the shoulder. We also covered knee arthroscopy, including double bundle ACL reconstructions, as well as hip arthroscopy with labral repair. Representatives were present from Turkey, Ireland, North America, Lybia, Egypt, South Africa, England, Pakistan, and Saudi Arabia. The meeting was hosted by Linvatec and was a fantastic trip with the opportunity to teach new techniques to such a broad audience.

June – Visiting Surgeon in to learn about hip arthroscopy from Orlando, FL. We performed two surgeries, including a labral repair and psoas release as well as an Iliotibial band release and trochanteric bursectomy along with labral debridement.

July – Spoke at a meeting in Hawaii on anatomic ACL reconstructions. ACL tears are extremely common and debate over how to repair them (ie--single bundle or double bundle) continues. Your original ACL has two bundles but it can be very difficult to place two bundles back into the knee. Anatomic reconstruction whether it’s single bundle or double bundle simply means placing the graft in the normal anatomic position for that bundle. Surgeons came in from New Zealand and Australia, so this was a very fun meeting.

August - A busy month. I had a teaching engagement where I talked about rotator cuff repairs and prehabilitation for shoulder injuries for a physicians educational Seminar. I landed in Florida on the 6th to work on more prototype testing for my clavicle nail with the company that I am in development with and then spoke in Bella Vista at the end of the month on Arthritis and injury prevention. In between these I taught hip arthroscopy and my patent pending ACL reconstructions in Oahu, Hawaii.

MRSA - What it is, Where To Find It, How To Treat It

MRSA (Methicillan-resistant Staphylococcus aureus, pronounced “meth-eh-sill-an staff-ill-o-cock-us or-ee-us”) is a type of bacteria that can cause infections in humans that are often difficult to treat.

MRSA is a highly virulent form of staph infection that resists most treatment with antibiotics—it is thought to have evolved the ability to survive treatment due to overuse of antibiotics.

It can be found all around us, including some places you wouldn’t commonly think to look. For instance, several years ago I conducted a study concurrent with the St. Louis Rams to determine the sources of MRSA infections in our players. We both suspected it may be coming from the Astroturf, but were surprised to discover the real sources:

· Under the rails on the treatment tubs

· On the door frames outside the restrooms

No other surfaces grew it, and no cultures grew from the Astroturf.

After the study, it became clear that it was necessary to sanitize exposed surfaces in the locker rooms, restrooms and treatment areas—doorframes and rails were sanitized against staph with bleach.

As the head team orthopedic surgeon for the Northwest Arkansas Naturals, I treat all kinds of sports injuries, including MRSA and normal Staph infections. We take all wounds very seriously and treat them with topical antibiotics, such as over the counter bactroban, after thoroughly cleaning the wound with soap and water or alcohol in an effort to destroy as much bacteria as possible. Soap can break down the cell wall while the water reduces the number of bacteria on the skin by simple dilution. The alcohol also kills the bacteria. Then we closely monitor the wound to make sure it is getting better and that specific antibiotics will not be needed to treat resistant bacteria.

How Do I Know If I Have A MRSA Infection Or Normal Staph Infection?

The only way to tell if you have a MRSA infection versus a regular Staph infection is to check for response to antibiotics. Regular Staph infections, known as Methicillin-sensitive Staph aureus or MSSA, are drug-sensitive and easier to treat. Because it’s so difficult to tell which kind of infection you have, it’s important to treat any Staph infection topically as well as with the usual antibiotics. Treat the wound topically with antibacterial ointment such as bactroban or Neosporin after cleaning the wound and let your doctor look at it.

Keep in mind that if you’re commonly in areas, such as locker rooms, where Staph bacteria are prevalent, you may have it on your skin, and a small puncture can lead to an infection. It’s important to wash your hands and clean around even small scrapes sustained on the field.

Dr. Dougherty’s First-Quarter Roundup

January

Spoke on Rotator cuff repairs in Santa Barbara, California. Meeting went very well. Double row arthroscopic rotator cuff repairs are rapidly becoming the standard of care and it is gratifying to be able to teach this technique to others.

February

Returned from Florida, where I worked in the lab on new surgical procedures for Bicep repairs and minimally invasive shoulder repairs. I also worked on a new technique for ACL reconstructions that I have United States Patent pending. Very excited about bringing this to the public to restore normal kinematics in the knee.

Spoke to the Rogers Optimist club about Double Bundle ACL reconstructions where we restore the normal native bundles of a torn ACL to the knee instead of just one, which is how a reconstruction is usually performed. What is most important is understanding how two bundles are being seen to be more protective to your knee cartilage than one bundle.

Just completed our third Annual Razor Sports Medicine Symposium, in Fayetteville, AR. The meeting is designed to bring the latest in orthopedic surgery and rehabilitation to the athletic trainers, physicians and other caregivers in Northwest Arkansas. This year was no different in that we brought out information that will help keep all of the athletes of NWA on the playing field.

March

Attended the Hip arthroscopy summit in Vail, Colorado. This was a very exciting meeting where hip arthroscopy surgeons met to discuss outcome studies, and challenges in hip arthroscopy. It is refreshing to see so many publications coming out showing significant sustained improvement from baseline following hip arthroscopy for specific injuries.

Returned from the AOASM sports medicine meeting in Snowbird, Utah. Spoke there on single socket double bundle ACL reconstructions. I truly believe this procedure will be the next wave of improvement in ACL repairs. Standard double bundle can be limited by the patient’s knee, but this new technique provides a double bundle ACL (as close to your original ligament before it tore) to be placed into nearly all patients.

Spring Training With the Naturals and Royals

Spring training for the Royals/Naturals went well this year. While there we look at incoming players and perform pre-participation exams. Every test is an effort to help the player perform at his highest level without injury. I do orthopedic exams looking at their shoulders, elbows, hips, knees, ankles, wrists, and spines. It takes place in Surprise, Arizona at the Royals spring training complex. Every year the Royals organization puts the best athletes on the field and this year is no different. So far, the season has gone well—the Naturals and Royals are both winning games and the pitching looks great.

It’s great to see both teams battling for first place!

Welcome to the Dougherty Sports Medicine blog!

Dr. Dougherty and his staff will use this space in the future to announce new offerings, update conditioning and rehab regimens, issue reminders and generally keep patients and the community informed.

 

Stay tuned!