How Stem Cells Will Shape Tomorrow’s Health Care

Experts discuss stem cell treatments for cancer, neurosurgery, orthopedics, pediatrics:

The use of stem cells in medical treatments already is yielding exciting results and may yield greater medical advances in the future. At a recent event hosted by Rush University Medical Center, experts at Rush discussed the role of stem cells in neurosurgery, orthopedics, pediatrics and oncology and how their breakthrough research may dramatically improve the lives of people afflicted by disease and severe injury. An edited transcript of that discussion appears here:

Larry Goodman, MD, CEO of Rush University Medical Center and the Rush system, moderated the conversation. The panelists included Brian Cole, MD, MBA, professor in the Department of Orthopedic Surgery and section head of the Center for Cartilage Restoration at Rush; Richard G. Fessler, MD, PhD, professor in the Department of Neurological SurgeryTimothy M. Kuzel, MD, chief of the Division of Hematology, Oncology and Cell Therapy; and Anna Spagnoli, MD, the Woman’s Board Chair of the Department of Pediatrics.

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New 3D Animation on Reverse Total Shoulder Replacement

We are pleased to announce the latest addition to our 3D Animation Library on surgical procedures: Reverse Total Shoulder Replacement

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Reverse Total Shoulder Replacement is a surgery performed toimprove shoulder function and decrease pain. This procedure is performed on patients who have suffered massive rotator cuff tears, which have led to a painful condition known as rotator cuff tear arthropathy, or on those patients who have undergone previously failed shoulder surgeries. The surgery removes damaged portions of the shoulder joint, and replaces them with a prosthesis.


There are three bones that are involved in the shoulder: the humerus, the scapula, and the clavicle. The head of the humerus rests in the socket of the scapula called the glenoid cavity.

The rotator cuff is made up of a group of four tendons from muscles that surround the shoulder joint, and together with the deltoid muscle, they work to stabilize the joint and move the arm.

Reverse Total Shoulder Replacement vs. Conventional
Shoulder Replacement

There are two types of total shoulder replacement surgery: conventional shoulder replacement and reverse shoulder replacement. The determination between which surgery should be performed is based upon the strength and functionality of the rotator cuff.

For many patients, the function of the rotator cuff has been compromised through massive tears, and the muscles and tendons do not function properly. In these cases, a conventional shoulder replacement may not be effective and reverse shoulder replacement may be an option.

In a reverse shoulder replacement prosthesis, the ball is placed on the shoulder socket while a cup and stem replace the head of the humerus. This configuration relies on the deltoid muscle instead of the rotator cuff to stabilize the shoulder and provide joint mobility. Additionally, this procedure may be recommended for individuals who have undergone previously unsuccessful conventional  shoulder replacement surgery.


Depending upon your preference and that of the anesthesiologist, you will be put under general anesthesia and/or a nerve block. Your surgeon will make a single incision through the skin to access the shoulder joint.

Your arm is rotated and the head of the humerus is removed. Next, a space is created in the humerus and your surgeon will insert the stem portion of the prosthesis into the bone. The plastic cup then is fitted onto the humeral side.

Next, your surgeon will remove the damaged surface of the glenoid cavity. The first portion of the prosthesis is placed in the glenoid cavity and secured to the bone with screws.

Next, the “ball” portion of the implant is affixed to the previously placed glenoid prosthesis, and the arm is rotated to place the ball into the socket.

The incision is closed with internal sutures; and either external sutures, or staples. Finally, surgical tape or bandages will be placed over the incision.

Recovery and Results

Most patients return home within two to three days of the procedure. Any external staples or sutures that are present are usually removed in 10 days to two weeks. Scarring along your incision site is normal, but it is likely that your scars will fade
considerably over time.

Your arm will be in a sling after surgery and until your surgeon prescribes therapy. Depending upon your specific needs, your surgeon and physical therapist will develop an exercise routine to gradually increase your range of motion and strength. Your surgeon will recommend when you can return to work, daily activities, and driving; full recovery typically takes 6-8 months.

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Tips To Find A Sports Medicine Specialist

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Sports medicine specialists have specific training in working with health conditions affecting athletes and sports performance
  • Family and friends can be a very good source for recommendations on good sports medicine doctors
  • Doctor search tools from two verified medical professional organizations can be another excellent source to find a sports medicine specialist

Last week I offered some pointers in helping you figure out whether you need to see a doctor for a possibly serious knee injury. This week I’d like to expand on that a bit by offering some tips on who exactly you should see for any type of sports medicine injury or condition.

Not all health issues in athletes need to see a sports medicine specialist. For example, let’s say you have a really congested sinus that’s preventing you from training or working out. That’s a very common condition and can be quickly handled through your primary care doctor or pediatrician. However, if you have a possibly serious injury that may or may not require surgery, if you have a condition that’s ongoing and affecting athletic performance, or if you’d just prefer to see someone who “gets it” when working with athletes and competition- you may be better off with a sports medicine specialist.

Sports medicine specialists generally are trained in two different pathways. Either you’re trained as a surgeon (an Orthopedic Surgeon), or you’re trained in a non-surgical specialty such as Emergency Medicine, Family Medicine, Internal Medicine, Pediatrics, or Physical Medicine+Rehabilitaon.

If you’re really concerned that you have an injury that could need surgery then an orthopedic surgeon would be your best choice. Seeing an orthopedic surgeon doesn’t necessarily mean that we’ll always recommend surgery for a problem, in fact I’d say that at least 75% of the issues we see in our practice at Stanford will not require surgery. If you have a problem that is not something that needs surgery, such as concussion management, heat illness, asthma, diabetes, etc. you’ll be better to see a non-surgical sports medicine specialist first.

Here are some tips to help you find the right sports medicine specialist:

  • If you or your family already has a relationship with a sports doctor, start there. Even if it’s not that doctor’s specialty, their staff can usually direct you to the right person when making an initial appointment.
  • Ask around to friends and teammates. Others with your injury will be a good source to tell you about their experiences.
  • Use a “find a doctor” tool through one of our main sports medicine societies. Most orthopedic surgeon team doctors are members of the American Orthopaedic Society for Sports Medicine and you can find members here. Most non-surgical sports medicine specialists are members of the American Medical Society for Sports Medicine, and you can use their search tool here. Members of these two professional organizations have credentials and expertise in sports medicine and typically take care of professional, collegiate, and high school teams. You’ll find doctors even at HMOs through these verified sites. Be cautious about just Googling “sports medicine doctor” in your local area- there’s no telling what you’ll find.
  • Do a web search of your local professional sports team doctors, cross reference through one of the two search tools above
  • And finally… once you’ve identified the doctor or doctor’s group, call their office and check whether they are “in-network” with your insurer. Fortunately, the field of sports medicine is now so large that even if your first choice isn’t in-network, chances are strong that someone really good is.


Alternative Treatment Options for Rotator Cuff Repairs

Dr. Brian Cole’s presentation on patient satisfaction and managing expectations delivered at the 2017 Chicago Sports Medicine Symposium.

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3D Animation on Torn ACL Procedures


The anterior cruciate ligament (ACL) is one of four ligaments that are crucial to the stability of your knee. It is a strong fibrous tissue that connects the femur to the tibia. A partial or complete tear of your ACL will cause your knee to become less stable and feel as though your knee is about to give out. The following videos will describe the different options available to repair or replace your torn ACL.

Visit  our Patient Education page for the full Library of 50 specific Orthopedic Surgical Procedures in 3D Animation. Produced by an experienced team of medical writers, 3D BCMD whiteanimators, and project managers with a detailed understanding of anatomy and surgery; they take complex surgical procedures and animate the steps to tell a visually stunning story in 3D that is both educational and entertaining. Each animation is embedded with an illustrated script which can be shared, viewed or printed separately.