Jamari’s Story

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Jamari’s diagnosis

Jamari Sanders’ mother, Sharenne Shumate, didn’t worry when Jamari returned with complaints of leg pain after a day of playing basketball at his uncle’s house. The eight-year-old said he had fallen, but Sharenne didn’t see any bones that appeared to be broken. Just to be sure, she took him to the nearest emergency room where doctors confirmed no broken bones, tendon or ligament tears. But two days later, when Jamari woke in the middle of the night in tears and complaining of pain, his mom knew something was very wrong.

After returning to a local doctor for more tests, Jamari was diagnosed with osteosarcoma of the right femur, or cancer in his right thigh bone. This is the most common form of bone cancer in children. Worried about Jamari’s spirits, Sharenne focused on finding a doctor who could both heal her son and continue to treat him like the strong, outgoing, and active little boy he is.

Finding a care team

Sharenne immediately contacted experts at Midwest Orthopaedics at Rushbecause she was familiar with Rush University Medical Center’s reputation. After a long visit, the family chose the team of Dr. Matthew Colman, orthopedic oncologist; Dr. Monica Kogan, pediatric orthopedic surgeon; Patti Piasecki, N.P., and Dr. Paul Kent, pediatric hemotology-oncology specialist at Rush University Medical Center. With the medical team decision made, Jamari and his family relocated from Wisconsin to Chicago to be closer to his care team.

As part of a carefully constructed treatment plan, Jamari began chemotherapy right away at Rush University Medical Center. Within a month, his tumor had shrunk by 95%, but Drs. Colman and Kogan discussed the importance of surgery to ensure that his cancer wouldn’t return. They approached Jamari’s family with two surgical options.

The first option was a series of several surgeries to remove the tumor and parts of the surrounding bone, then replacing that section with an implant. The procedure would mean lots of time in and out of the operating room and the possibility that the implant could break as he continued to grow. The second option was a rotationplasty, a procedure in which the knee joint is removed along with the tumor from the mid-thigh. Then, the lower leg, ankle joint, and foot – all unaffected by the tumor – are reattached backwards onto the remaining thigh bone. This allows the ankle bone, now rotated, to serve as the “new” knee joint and the foot to serve as an attachment point for a prosthetic lower leg.

Rotationplasty procedures are extremely unusual, with fewer than ten performed in the U.S. each year. This is because the diseases which make rotationplasty an option are rare and the nature of the procedure is unconventional. The procedure is typically the best option for very young children who still have significant growth remaining. This is not only because their bodies are more adaptable and resilient, but because the other main option, a metallic knee replacement prosthesis, is commonly associated with multiple complications and re-operations in this age group. Rotationplasty is complex and Drs. Colman and Kogan are among a short list of surgeons with the required skills to perform a successful rotationplasty.

Jamari’s medical and surgical team provided his family with research, websites, and videos which explained both procedures in layman’s terms. They even connected Jamari and his family with other patients who had had the procedure in the past. The family took a leap of faith and decided on the rotationplasty procedure.

“I would do it all again with the same team of doctors, nurses, and social workers,” Sharenne explained. “They gave us all the resources we needed to make the best decision.”

Sharenne was confident that the doctors, her son’s strength of spirit, and the support of her family would result in a successful outcome. “Rush really accommodated Jamari and our family,” Sharenne explained. “They made sure that we had a room big enough for all of us to be together on the day of the surgery. They gave us an update through every step of the procedure. Dr. Colman spoke with us immediately after the surgery to tell us that things went well. That meant the world to us.”

Wearing a cast to stabilize his new knee joint, Jamari underwent one more round of chemotherapy and then began physical therapy to build up his strength and get accustomed to walking with his new joint and prosthetic leg.

Reflecting on Jamari’s journey

“He’s been much stronger than we have,“ Sharenne says. “He has stayed positive and worked very hard to turn a tough situation into the best possible outcome.”

When she reflects on her family’s journey, Sharenne is almost at a loss for words when she talks about the Midwest Orthopaedics at Rush medical team. “They’re just amazing. I am in awe. This whole experience made us appreciate life and the little things. It is clear to us that God touched the doctors’ hands to do such an awesome thing for Jamari.”

While he’ll need to be watched regularly for the next five years, Jamari, who’s now 10, is excited to join his friends back at school this fall and to continue being the bright, active boy that he has always been.

For more information on rotationplasty or treating bone tumors, contact Dr. Colman’s office at 877-MD-BONES.

Bone Bruise: What It Is And How It’s Managed

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

Key Points:

  • A bone is a living tissue with a blood supply, and impact to the bone can cause bruising in the bone’s interior
  • Bone bruises are diagnosed on MRI scan
  • Bone bruises will predictably heal and allow the athlete to return to play, however the time frame for return is widely variable

Many people are surprised to learn that bone has a blood supply. It’s every bit a living tissue as skin, your brain, or your heart. And like any of those other tissues with a blood supply, a bone can be bruised.

Lots of people are familiar with a bruise on the skin. If you bump the outside of the skin hard enough it will cause tiny blood vessels in the skin to break, leading to some bleeding in the skin. This causes the common black/blue/green discoloration. If you hit a bit harder the force can be transmitted deeper, to the underlying muscle. And if you hit harder still that force can go straight to the bone.

A bone bruise is an injury to the interior of the bone (the bone marrow) with enough force to disrupt the internal blood supply but not enough force to crack the outside of the bone. A bone bruise is an injury that almost broke the bone but came up just short. There are several sports scenarios that can cause bone bruises. Common ones I see are direct impact injuries such as a fall onto a hard surface, or a bone bruise to the arm in a batter hit by a pitch. We’ll see a fair number from player to player contact, and there’s also a bone bruise pattern we see on an MRI of a knee with an ACL tear.

One of the key features of a bone bruise is that it can be extremely painful immediately after the injury. Severe pain after impact typically makes an orthopedic surgeon concerned for a fracture, and if the initial x-ray shows no broken bone a common next thought would be for a bone bruise. A bone bruise is diagnosed by MRI scan, and x-rays are typically normal.

The good news about a bone bruise is that the same system that causes the bruise- the internal blood supply- is also the system that creates the environment for healing. Like the bruise in the skin, the bone bruise will typically go on to heal. What’s usually required is limiting the impact loading that caused the problem. In the upper extremity the treatment may be and arm sling or brace followed by light activity until healing. In the lower extremity crutches, a brace, or a boot may be needed.

The tough part about a bone bruise is that they can be very painful, especially in the initial healing phase. The other key consideration for the athlete is that return to play can be highly variable, taking from a couple of weeks to several months.

There are several interesting variables about bone bruises. First, the long term implications of a bone bruise are unknown. We believe that the vast majority of bone bruises will go on to heal in the near term but there isn’t yet enough data to know whether there are any long term implications. Second, the extent of the bruise on an MRI is not necessarily correlated with pain. We see severe pain with fairly minimal bone bruising, and conversely we see some severe bruises on an MRI in people with only a small amount of pain.Logo

Because of the lack of clear correlation between bruising on the MRI, pain, and function, we will usually not repeat an MRI to assess healing but instead rely on how the injured athlete feels and how they are functioning. When pain is resolved and the function is restored we’ll usually allow the athlete to return to play.

Segment 102.1: Athletico’s Overhead Athlete Program

Matt Gauthier, PT, DPT, SCS from Athletico Physical Therapy talks with Steve and Dr. Cole about the unique characteristics of the Overhead Athlete, types of overhead throwing injuries: causes, prevention and treatment.


There’s more to throwing than just the motion of your arm.  There’s actually a whole science dedicated to it-and Athletico offers a comprehensive approach. Our team of physical therapists, occupational therapists, certified athletic trainers, and physical therapy assistants combine their expertise in throwing analysis with slow-motion video analysis to enhance performance and help prevent injuries.

Whether you are returning from an injury or simply working to refine mechanics, Athletico has skilled professionals to assist you in optimizing your form and preparing your body for the field of competition, bringing you one step closer to making your goals a reality.

Matt Gauthier specializes in the treatment of high-level athletes, and is the most passionate about treating shoulder and knee injuries. He is the head of Athletico’s Overhead Athlete Program,  and is a member of the USOC physical therapy volunteer program. As a sports specialist, he has experience treating athletic injuries at the youth, high school, college, professional, and Olympic levels.

Matthew’s Story

Matthew Lee, 22, of Oak Park, discovered his passion for playing lacrosse at a youngmatthew lee age. Although he also excelled in baseball and tennis, it was the ‘brotherhood’ of lacrosse that drew him into the sport.  Playing lacrosse gave him a supportive foundation throughout his years at Oak Park River Forest High School and when it was time to make college decisions, his love of lacrosse played a big part. He enrolled at Beloit College in Beloit, WI and joined its NCAA Division III lacrosse team.

College life and lacrosse were going very well for Matthew until his spring break trip to Washington, DC his sophomore year. This was a special time during which the team had an opportunity to scrimmage against the U.S. Naval Academy. While attempting a shot on goal, Matthew fell on his hand and wrist. He immediately felt a ‘pop’ followed by intense pain and swelling. To his disappointment, the team’s trainer had to sideline him for the rest of the trip.


After returning to Wisconsin, he was evaluated at a local hospital where he was diagnosed with a fracture to the scaphoid bone, one of several small bones in the wrist. He was casted for six months and then underwent occupational therapy. It was tough time, but he looked forward to returning to lacrosse.

A Second Opinion

Unfortunately, after the cast was removed, he still felt pain and an unusual grinding sensation in his wrist. Matthew felt something was still wrong and his mother insisted they get a second opinion. After researching several specialists, they chose Dr. John Fernandez, a hand, wrist, and elbow specialist at Midwest Orthopaedics at Rush. They liked Dr. Fernandez’s reputation for treating high level athletes and for performing particularly challenging cases.  Coincidentally, Dr. Fernandez also has three sons who play lacrosse and is a big fan of the sport himself. He immediately connected with Matthew and understood his frustration.

Dr. Fernandez carefully assessed Matthew’s wrist.  He used simple measures like examining the normal side which no one had done previously.  He also used high-tech techniques including examining his wrist under a live video xray to see what the wrist was doing in real time and under stress. This led to the discovery that Matthew hadn’t suffered a wrist fracture at all.  Instead, he had torn a very important ligament in the wrist.

This ligament is a crucial connection between the carpal bones in the wrist. Without it healing, Matthew would likely have continued problems, including long term arthritis and disability.  This would make it hard for him to use his hand for simple tasks, much less playing lacrosse. He explained that Matthew needed surgery to repair the torn ligament and restore function. This was devastating news because it meant more time away from lacrosse.

“Even though it was tough to hear that the casting period was a waste of time, Dr. Fernandez and his amazing physician assistants were so helpful throughout the whole process.”

Dr. Fernandez recommended a technically demanding and unusual surgery to reconstruct the scapholunate ligament of the wrist. This required transplanting one of Matthew’s tendons to replace the ligament he had lost.  Stainless steel pins would be used across the bones to maintain alignment during the recovery process. This cutting-edge technique was designed for higher demand individuals with and a better success rate.

Complicating matters further, before his surgery Matthew fell and injured his other wrist. This time he truly did fracture his scaphoid bone.  But, instead of casting it, Dr. Fernandez suggested a method of repairing the bone internally with a screw. This would then act as an internal cast and decrease healing time.

Now, the stakes were higher. Matthew required a staged surgical approach so that he could use one of wrists during the healing process, but not compromise the outcome. Several surgeries and nine months of recovery were needed to make this work.  Dr. Fernandez and Matthew confidently agreed to take this plan head on. As hoped, the surgeries were successful and Matthew’s recovery was smooth.  Finally, eighteen months after his initial injury, Matthew was functioning well and pain free. He finally scored his ‘goal’ — with Dr. Fernandez making the assist.

Back on the Field

Dr. John Fernandez

Dr. John Fernandez

After a long time away from lacrosse, Matthew was able to join his teammates back on the field during his senior year. “I was able to score over 25 points this season and could not be more thankful to Dr. Fernandez, his PAs, and MOR for making my senior year a great one to remember,” he says.

During this process, Matthew received a unique look into the practice of orthopedics and expressed an interest in a career as a physician assistant. Dr. Fernandez admits that he has seen this happen before and encouraged Matthew to follow his passion. He hopes that one day Matthew will be able to pay it forward by performing a surgical assist of his own to help someone else score their goals.

To schedule an appointment with Dr. John Fernandez, call 877-MD-BONES.