Save the Dates for 2011

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Don't miss these FREE educational programs to help plan your care. Download the flyer below.
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Bone and Joint Health Series Event Planned for May 1, 2010

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The American Academy of Orthopaedic Surgeons released an information statement reinforcing the need to take prophylactic antibiotics when having dental work or other invasive procedures.  This recommendation comes from the fact that deep infections of total joint replacements are very costly, both financially and emotionally for the patient due to the need for extensive revision surgery and staged treatment. Patients often do not have normal use of the infected joint until the revision process and surgery is completed, which can be 3-6 months and in some cases longer.  Revision surgery due to infection affects both the patient's quality of life as well as can be a significant financial burden due to time off work.  

Due to the disastrous consequences of infection in a total joint replacement, it is highly recommended to take prophylactic antibiotics.  "It is likely that bacteremia associated with acute infections in the oral cavity, skin, respiratory, gastrointestinal, and urogenital systems and/or other sites can and do cause late implant infections.  Patients with total joint replacements who are having invasive procedures are at an increased risk of hematogenous seeding of their prosthesis."  Therefore, the American Academy of Orthopaedic Surgeons recommends that clinicians consider antibiotic prophylaxis for all total joint replacement patients prior to any invasive procedure that may cause bacteremia.  Invasive procedures include dental cleaning, Orthopaedic, vascular, gastrointestinal, head and neck, obstetric and gynecological, and genitourinary procedures.  The first dose must be given at least 60 minutes before the procedure so that an effective dose is present in the tissues before the procedure begins.  Antibiotic prophylaxis is recommended in most patients, but must be examined on a case-by-case basis.

February 2009 American Academy of Orthopaedic Surgeons Information Statement.  http://www.aaos.org/
A population-based case-control study performed revealed that family history of dvt is a risk factor for a first dvt.  Blood samples and information about family history and environmental triggers were collected from 1,605 patients with a first dvt and 2,159 control subjects, 31.5% of patients and 17.3% of the controls reported having one or more first-degree relatives with a history of dvt.  A positive family history increased the risk of dvt more than 2-fold, and up to 4-fold when one or more relatives was affected.  

The risk also increased when a family history of dvt was also present with other genetic or environmental risk factors.  For those with a family history, a genetic, and an environmental risk factor, the risk of dvt was increased 64- fold compared to those without risk factors or a family history.  Overall, it is important to pay attention to a patient's family history of dvt, as it may be beneficial in risk assessment for patients who are undergoing surgery.  Patients who have a family of dvt and are in a hypercoaguable state from surgery, may benefit from extra prophylaxis in the prevention of dvt.

Bezemer, I et al.  "The Value of Family History as a Risk Indicator for Venous Thrombosis."  Archives of Internal Medicine 169 (2009): 610-615.


Check Out This Patient Video on YouTube!

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Another Special Letter from Dr. Tony DiGioia

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December 2009

  

Dear Patients, Family and Friends,

I'm back!

Thank you for your patience and understanding during the recovery from my bicycling accident.  I have returned to my surgical and clinic schedule this past Monday, November 30, 2009.

My family and I appreciate all of your prayers, get well cards and gifts.  We are truly blessed by all of our wonderful patients and friends.

From my family to yours, we wish you a healthy and happy holiday season.


As always, best wishes,

Dr. Tony DiGioia

A Special Letter from Dr. Tony DiGioia

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Dear Patients, Family Members and Friends,

 

As you may have heard, I was hit by a car on Sunday morning, November 15th while taking a bicycle ride.

 

I have been told to take some time off to recover and rest at home.  However, I assure you that I will be back and at full capacity - it's only a matter of time and short time at that.   Although I am sore, there is no permanent damage and I will be back to operating and seeing patients in the office as soon as I am cleared by my doctors.  Day by day, I am feeling much better.

 

Thanks to everyone for your words of concern, get well wishes and prayers.  I would also like to extend my sincerest thanks to you and your families for understanding if the accident affected your scheduled surgery or an office visit.  My staff and I are doing everything we can to ensure that your care and road to recovery also gets back on track.

   

Accidents involving bicycles and cars are never good for the bike rider and considering what could have happened, I am very lucky and thankful.  In no time at all, I will back in the office seeing patients and operating again.  So if you know other patients and families, please pass on the word since we have had many calls of concern from the community.

 

Many, many thanks for your support and understanding from Renaissance Orthopaedics, The Orthopaedic Program at Magee and, especially, Cathy and me.

 

As always, best wishes,

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Did you know that October is PFCC Awareness Month?

 

Patient and Family Centered Care (PFCC) Awareness Month is an international awareness-building campaign that occurs every October to commemorate the progress that has been made toward making PFCC a reality and to build momentum for further progress through education and collaboration.

 

Hospitals and health care organizations around the world are encouraged to celebrate by empowering patients, strengthening their patient and family centered care practices, and publicly proclaiming to their patients and communities their commitments to PFCC.

 

The staff at Renaissance Orthopaedics and The Orthopaedic Program at Magee-Womens Hospital of UPMC, under the leadership of Dr. Tony DiGioia, have implemented many PFCC measures for patients needing orthopaedic care.  Dr. DiGioia designed the PFCC Orthopaedic Program to make the surgical process as easy and pain-free as possible for patients and their families.  The orthopaedic staff understand patients' and families' needs from the beginning of the process to the end.  They use a team approach with the patient (and the patient's chosen coach) as team members.  This builds a sense of community and allows the team to focus on the patient's wellness.  PFCC methods start with the initial appointment through pre-op testing and teaching to pre-surgery discharge planning, surgery, pain management, physical therapy and discharge. 

 

The in-patient hospital unit was designed to promote a healing environment.  PFCC hospitals are organized, not cluttered.  The unit is clean and quiet.  It provides comfort to patients and families in a friendly, open, welcoming environment.  Most patients in The Orthopaedic Program at Magee are able to stay in private rooms with wireless internet access.  CafĂ©-style room service is available 24 hours each day.  There is even a state-of-the-art gym and fitness area on the unit floor.  Family and friends are able to visit with patients in the Family Room.  The Family Room is a combination kitchen/living room with rocking chairs, couches, a big screen TV, a fully stocked refrigerator, internet kiosk and a massage chair.

 

The results show that PFCC works!  Renaissance Orthopaedics and The Orthopaedic Program's patients stay in the hospital one to three days (with an average of approximately two and a third days).  Ninety-five percent of patients are discharged directly to their homes.  Press Ganey scores place Dr. Digioia's group in the 99th percentile nationally.  These are the highest Press Ganey scores in the region!  Patients agree:  After a month, 90 percent reported decreased pain from pre-op, 90 percent resumed "normal" activity, 90 percent reported good to excellent outcomes, and 99 percent would recommend The PFCC Orthopaedic Program to friends and family!

 

Dr. DiGioia also chairs workshops to teach PFCC methods to other health care providers.  In partnership with the Innovation Center at Magee-Womens Hospital of UPMC, the AMD3 Foundation sponsors the PFCC Workshop Series, which is geared toward all caregivers from support staff, nurses, doctors, and, in fact, any person who has the potential to impact a patient's care experience.

 

The next PFCC Workshop Series event will be the VisionQuest Workshop, A Journey to Transform the Patient and Family Experience Begins Here...One Step at a Time, which will be held on Friday, Nov. 13.  To find out more information about this workshop or to register, please visit www.patientandfamilycenteredcare.org.

 

To learn more about the PFCC methodology, please visit www.patientandfamilycenteredcare.org.

Operation Walk Pittsburgh Update #8: Friday, August 28, 2009

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Our trip to Guatemala is coming to a close.  Tonight we had a goodbye dinner for the staff at the Santo Hermano Pedro Hospital.  Padre gave each of us a certificate to commemorate our stay here.

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Santo Hermano Pedro hospital staff

 

Although we could not help everyone, we have accomplished much this week.  We would like to leave you with a patient's story.

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Julio's Story

Julio was diagnosed with leukemia at age 14.  He had a bone marrow transplant and was treated with high doses of steroids.  He is now 24 and cancer-free.  The side effects of his cancer treatment affected his knee joints as the steroids destroyed the cartilage between his knee bones. He has been in pain for the last eight years with increasing limits in his activity.

Julio told us that his family could not afford the joint replacement operation and that even if they could, he thought he would die in the hospital.  His neighbor had a knee replacement at Santo Hermano Pedro Hospital.  She showed Julio's family her new knee and told them about "the best doctors in the world" who have come here to operate.

Julio told us his story in the hospital:

I was so scared the day of surgery.  My heart just went beat, beat, beat, beat.  Dr. Tony talked to me that morning and made me calm, and my heart started to beat normally again.  I told the anesthesia doctor to give me something so I would not have to see the surgery, and the next thing I knew, I was awake with my new knee.

Because I can speak English and most of the others here cannot, I would like to thank all of you for helping me and my people.  I'm sorry, this makes me cry, but I have so much thanks in my heart for all of you.

Soon I will be able to play soccer with my friends and dance with the girls.

Gracias!!!!

  

And as you can see from the photo of Julio, he is quite the ladies' man!


Operation Walk Pittsburgh Update #7: Thursday, August 27, 2009

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Today was discharge day for the first of our patients.  The morning started with breakfast, dressing changes and physical therapy.  This afternoon four of our patients were discharged with their families.  The patients going home visited all of the other people in the same ward to say goodbye and to offer words of encouragement.  In the women's ward, there was clapping as Blanca left the ward with her husband and four children to return home.  There were many hugs and gracias and a few tears as patients and their families sought out the staff to thank them before leaving.

 

It is amazing that people who were in so much pain walking into the hospital on screening day are now making the long walk out of the hospital with smiles on their faces and tears in their eyes.  Several of the patients stopped at the chapel on the way out of the hospital to say a prayer before getting into the car that would take them back to their homes.

 

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The first patient leaving the hospital

 

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Blanca and her family going home

 

Another project the Operation Walk volunteers undertook was to restore the basketball hoop to playing condition.  It was mostly rust when the Operation Walk team arrived - no net or basketballs to use.  It took several days to sand the rust, make some welding repairs and paint, but today it looked as good as new and there were several games played with residents of the hospital, their families and staff.

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Angel sanding