Robert Hubbs III, an elite basketball talentwith a bright future in the sport, injuredhis right knee during an AAU game in

Minnesota before his junior season at Dyer CountyHigh School. “I tried to make a quick move, and my knee

just kind of popped,” Hubbs said.At 6 feet, 5 inches, Hubbs is one of the highest-

rated basketball recruits in the country and one ofthe top shooting guards among high school ath-letes. He didn’t know it at the time, but he had atorn meniscus, and he would need surgery. The night of the injury, doctors in the Min-

nesota emergency room told him to take it easy fora couple of days, and the knee should heal. Hubbswanted to get back on the court as soon as possible,but when his father, Robert “Coach” Hubbs Jr.,noticed that he wasn’t playing to his full potential,they looked for the best doctor they could find.“I said your health is more important than just

one game,” Coach Hubbs said.Their clinic in Dyersburg recommended Dr.

Jason Hutchison at West Tennessee Bone & JointClinic. Dr. Hutchison diagnosed the injury and ex-plained that a meniscus tear was like a rip in a sheetof paper, Coach Hubbs said. It wouldn’t mendwithout surgery, and further activity could causemore tissue damage.Coach Hubbs said Dr. Hutchison was very

thorough and made them feel comfortable aboutthe procedure. “He took time to explain what hewas going to do,” Hubbs said.Though the prospect of surgery was scary, Hubbs

said he wanted to get back on the court. He was confi-dent his knee would get better. “I really wasn’t worriedabout it. I put a lot of trust in Dr. Hutchison.”Dr. Hutchison performed the surgery in September

2011, and Hubbs underwent several weeks of physicaltherapy. The rehabilitation progressed, and he was backon the court in time for the start of his junior seasonwith Dyer County.

“He basically gave me a brand-new knee,” he said.Today, Hubbs is finishing his senior year of high

school. He will play basketball for the University ofTennessee this fall, and analysts say he could make animmediate impact. A rare talent, his potential for a ca-reer in professional basketball is strong. Coach Hubbs said the injury hasn’t set his son back

at all. His knee is back to 100 percent, and he continuesto develop his skills. “It’s like it never happened,” CoachHubbs said. “They’ve done a great job.”

Keeping you...

ActiveActive

Keeping you...Active Active … is a quarterly

newsletter fromWest TennesseeBone & Joint Clinic. The clinic’s 11 physicians specializein sports medicine,hand injuries anddisorders, and or-thopedic diseasesand musculoskeletalinjuries. For copiesof this newsletter,contact Adam Kelley, MarketingDirector, at731.661.9825.

Congratulations toDr. David Johnson

and Dr. David Pearcefor being selected as Jackson SunReaders’ Choice

Favorite OrthopedicSurgeons!

Like us on Facebook!

Successful surgery allows star athlete toplay for Tennessee and then possibly NBA

Robert Hubbs, a star player for Dyer County High School, willbe playing for the University of Tennessee at Knoxville next year.(Photo courtesy of Dyersburg State Gazette.)

731.661.9825 n 888.661.9825 n www.wtbjc.com

Spring 2013 Sports Medicine • Orthopedic Excellence

Slowed down by joint pain?Not all solutions lead to joint-replacement surgery

Total joint replacement is a so-lution for patients with lim-ited function and chronic pain, and for many, it’s given them

the ability to walk again and return to work.But it’s a major surgery with a long recovery, and it’s not the only

route to consider when a joint disorder such as osteoarthritis becomes aproblem. At West Tennessee Bone & Joint Clinic, we assess patients in-dividually to find the best course of treatment for their condition andthe lifestyle they want to achieve.

Much of the decision dependson how the joint problem has lim-ited the patient’s activity and af-fected daily life. A lot depends onhow much function a patient wants.Some non-surgical options are …

n Medications:Treating pain isa big part of battling osteoarthritis,and over-the-counter or prescriptiondrugs may be all a patient needs.

n Cortisone: A cortisone injec-tion up to three or four times a yearmay be enough to relieve the symp-toms and keep a patient ambulatory.Cortisone shots, however, lose theireffectiveness if they are overused.

n Viscosupplementation: An-other treatment for pain caused byosteoarthritis is viscosupplementa-tion, which is a hyaluronic acid in-jection that acts as a lubricant andshock absorber. It’s a substance simi-lar to the natural fluid found in

joints. It is delivered through three injections during the course of threeweeks. (See box, below, for more information.)

The use of an ultrasound helps make the viscosupplementation in-jection and other injections more effective. It improves the accuracy ofthe injection, and it’s less painful. An ultrasound is often used for injec-tions of the knee, but is also used for injections of the shoulders, hands,feet and ankles.

n Activity: Another treatment for joint disorders is exercise, such aswalking or swimming, which helpsincrease range of motion while im-proving function and reducing pain.Physical therapy can be very benefi-cial for a select group of patientswith arthritis.

n Other options: Sometimes,braces or shoe inserts are all a pa-tient needs. Changing somethingvery minor could decrease the painenough.

The solution is different for eachpatient because each has differentlevels of pain and functionality, aswell as different objectives. Somejust want to be able to get aroundthe house. Others want to get backto work and travel.

While total joint replacementcan be an effective solution for pa-tients with joint disorders, it’s notthe only one. Many patients havefound success with a much less in-vasive treatment plan.Dr. Doug Haltom examines a patient’s knee joint.

By Doug Haltom, M.D.

A few facts about viscosupplementation

Viscosupplementation is a procedure that involves the injec-tion of a gel-like substance of hyaluronic acid into the kneejoint.

Hyaluronic acid is a natural sub-stance normally found in the synovialfluid of a joint. It acts as a joint lubri-cant and cushion to reduce frictionand enable bones to move smoothly over each other. People with os-teoarthritis have less hyaluronic acid in the synovial fluid. As a re-sult, the joint surfaces don’t get lubricated and are more likely to getinjured from daily stress and strain on the joint. Two preparations of hyaluronic acid are available for viscosup-

plementaion. One is extracted from rooster combs (the crown offeathers on a rooster’s head), and the other is manufactured frombacterial cultures in the laboratory. Patients who have allergies to eggs or chickens should not receive

the rooster-comb injection.

When is viscosupplementation advised?Viscosupplementaion is usually reserved until other treat-

ment options have been tried to relieve pain. These include exercise,physical therapy, weight loss, use of heat or cold, use of a cane orwalker, pain relievers or steroid injections.

Who is a candidate for viscosupplementaion?Candidates for viscosupplementation include elderly pa-

tients across the osteoarthritis spectrum, younger patients with mildto moderate osteoarthritis and patients with late-stage osteoarthritis.Patients who are too young for total knee replacement, cannot takenonsteroidal anti-inflammatory drugs or have multiple comorbidi-ties may be considered for viscosupplementation.

How long will the benefits of viscosupplementation last?Studies show that viscosupplementation can provide pain re-

lief from osteoarthritis of the knee for up to six months.

By Cheryl Murray,

Physical Therapist,

Certified MDT

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Hayden McCuan, an 11-year-old at Trinity Christian

Academy, was playing basketballduring recess this past Januarywhen he tripped and injured hisright hand. It was painful, and hewas scared.“It was swollen immediately,”

said his mom, Barbie McCuan. The family went to a doctor

the day of the injury, but they leftwithout getting a full diagnosis.They didn’t know if the knuckleswere broken, and they were wor-ried that if they were, Haydenwould need surgery, Barbie said.“You just don’t hear about peoplebreaking their knuckles.”They called West Tennessee

Bone & Joint Clinic to see ifthey could get an appointmentthe next day, and Dr. MichaelCobb agreed to seethem. “Hayden was

up all night,”Barbie said.“We wereso excited

to have an appointment.”Dr. Cobb diagnosed the injury

right away, and X-rays confirmedmultiple finger fractures. Haydenwould not need surgery, Dr. Cobbtold them. Instead, he would weara cast until his hand healed.Throughout his recovery, Hay-

den and his mom made regularvisits to West Tennessee Bone &Joint so Dr. Cobb could monitorhis progress. Barbie said the doc-tors and staff told jokes to makeHayden laugh, complimented hisbravery and worked hard to makehim comfortable. “I just don’tthink he’d get treated like that

everywhere,” she said.Hayden said his treat-ment at West TennesseeBone & Joint made him

feel good about hisrecovery. “Theywere just re-ally nice tome, and Ithink thatmade me feelreally com-fortable, and Iknew every-thing wasgoing to beOK,” he said.

Hayden’s hand wastreated with a splint, fol-lowed by buddy taping. Today, he’s back on the

playground playingbasketball – his fa-vorite sport. The family will

never forgettheir experi-ence atWest Ten-nesseeBone andJoint, hismom said.

We love it when our patients say nice things about usTo encourage patients to fill out the online patient satis-faction survey, West Tennessee Bone & Joint Clinic holdsdrawings to award gift baskets to those who have filledout the survey. Two recent gift-basket winners tell theirstory here. To fill out the survey, visit wtbjc.com.

Jean McKinnie’s journey with West Tennessee Bone &Joint Clinic began in 2005 with a referral from her doctorin Huntingdon.Mrs. McKinnie, now 74, had been treated for carpal tun-

nel syndrome and other aches and pains, but it was becom-ing too difficult to move around. “I was barely being able towalk with severe pain in my left hip,” she said.Her doctor, who recommended hip-replacement surgery,

put her in touch with Dr. David Johnson at West TennesseeBone & Joint. She said she couldn’t have been happier withthe result.Dr. Johnson replaced her left hip in 2005. Two years

later, he replaced both knees with a team that included Dr.Jason Hutchison. And two years after that, Dr. Johnson re-placed her right hip. “I credit him with being able to walktoday,” Mrs. McKinnie said. He’s also performed other procedures, such as repairing a

tear in her shoulder and an irritated tendon in her thumb. As a result, Mrs. McKinnie has spent a lot of time with

Dr. Johnson and the staff at the clinic. “They almost feel likefamily now,” Mrs. McKinnie said.Mrs. McKinnie is now retired after a career in the legal

profession. She said she’s spending her time tending to herhouse, and she enjoys the freedom of being able to do what-ever comes up – with much less pain. “I don’t want to sitaround and hurt. I want to keep going.”Because of her experience, Mrs. McKinnie recommended

West Tennessee Bone & Joint to her daughter, Kim Moss,when she tore her shoulder. And, she always mentions theclinic and Dr. Johnson when one of her friends develops ajoint problem. “I’ve recommended him and West Ten-

nessee Bone &Joint to a lot ofmy friends,”Mrs. McKin-nie said.“I con-sider himexcellentin hisfield.”

‘They were just really nice to me’

‘I credit him (Dr. Johnson) withbeing able to walk today’

Are there any side effects of visco-supplementaion?

Some commonly reported side effects as-sociated with viscosupplementation are tem-porary injection-site pain, swelling, heat orredness, rash and itching, bruising aroundthe joint and fluid accumulation in the in-jected knee. These reactions are usually mildand normally clear up in one to two days.

Will viscosupplementation curemy osteoarthritic knee?

Viscosupplementation will not cure os-teoarthritis of the knee. The procedure im-proves the lubricating properties of thesynovial fluid, reduces or stops the pain fromknee arthritis, improves mobility, and pro-vides a more comfortable level of activity.

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From left, Dr. David Johnson, Jean McKinnie, Amber Cox, S.T., and Anne Hudson, R.N.

Hayden McCuan andDr. Michael

Cobb

Lowell Stonecipher, M.D.

Michael Cobb, M.D.

David Johnson, M.D.

KellyPucek, M.D.

HaroldAntwine III, M.D.

DavidPearce, M.D.

JasonHutchison, M.D.

AdamSmith, M.D.

J. DouglasHaltom, M.D.

JohnEverett, M.D.

MichaelDolan, M.D.

Donna Klutts, CMPEPractice Administrator

Keeping You ActiveThe physicians at West Tennessee Bone & Joint

Clinic, P.C. specialize in comprehensive

orthopedic care for adults and children. This

includes sports medicine, hand injuries and dis-

orders, orthopedic diseases and musculoskeletal

injuries. Our physicians are Board Certified.

They see patients in …Jackson • Brownsville • Selmer Lexington • Parsons • Dyersburg Union City • Bolivar • Ripley

24 Physicians Drive, Jackson n 731.661.9825 n 888.661.9825 n www.wtbjc.com

Patient back to her activities after two knee surgeries

Elizabeth Gist found herselfin the emergency room twoyears ago when the pain in

her left knee was too much to bear.“It got to the point where I justcould not walk,” said Gist, who isin her 60s. Gist, the wife of Jackson Mayor

Jerry Gist, had a torn meniscus anddecided to have Dr. Adam Smith atWest Tennessee Bone & JointClinic do surgery. She didn’t knowit at the time, but it was the begin-ning of a long road to recovery. “I was slow coming back, and

they were so patient with me,” Gistsaid. “Dr. Smith had the patienceof Job.”After knee surgery in 2010, Gist began physical therapy. She

needed crutches as her left knee healed itself, and before long, herright knee began to hurt. It was another torn meniscus, an injuryfrom repeatedly using her right leg for support to walk withcrutches. She would need a second surgery.

“I said ‘oh no.’ I was looking for-ward to being back to normal, and Iwas anxious to get out of there.” With each surgery, Dr. Smith

asked her about her expectationsand what she wanted to achieve. Gist said she was an avid gar-

dener and regularly went on two-mile walks. She also enjoyedwalking in Jackson’s Christmas pa-rade. “I felt like he gave me his undi-

vided attention when I was there,”Gist said. “I don’t know how Icould have had a better experience.” Dr. Smith recommended the

surgeries so she could maintain heractive lifestyle. The plan was suc-

cessful. Gist is walking in the Christmas parade again. She alsotravels with her husband, and she continues to garden and walkregularly. “I wanted to get back to doing that, and I am back to doing

that,” Gist said. “I’m pretty much back to normal.”

Elizabeth Gist and her husband, Jackson Mayor Jerry Gist