Total Hip Replacement: Relieving Pain and Restoring Function Bradley Ashman, MD, David Cruikshank, MD, Michael Moran, FRCSC
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Is lesion location random, November 2016; 58: 9 and does it matter? Pages 489–540 The scoop on supplements for disease prevention BC doctors reduce unnecessary antibiotic use Achilles tendon ruptures Billing tips: Telephone fees Division-created patient resources Fake joints, Proust: Dr Vishal Varshney real results Part 1: Hip and knee replacement bcmj.org November 2016 Volume 58 • Number 9 Pages 489–540 contents A R T I C L E S THEME ISSUE: FAKE JOINTS, REAL RESULTS, PART 1 504 Guest editorial: Hip and knee replacement Established 1959 Bas Masri, MD 505 Total hip replacement: Relieving pain and restoring function Bradley Ashman, MD, David Cruikshank, MD, Michael Moran, FRCSC 514 Total knee replacement: Understanding patient-related factors Paul Dooley, MD, Charles Secretan, MD O P I N I O N S ON THE COVER: In this first of a two-part theme issue Editorials on joint replacement, we 494 consider the most common Apply healing paint daily, David R. Richardson, MD (494) joint replacement surger- Quest for Superdoc, Jeevyn K. Chahal, MD (495) ies: hip and knee replace- ment. Dr Masri’s guest edi- torial begins these articles President’s Comment on page 504. 497 The value of social media to you and the profession Alan Ruddiman, MBBCh, Dip PEMP, FRRMS 498 Personal View Expectation of fairness, Michael A. Ross, FRCSC Pharmacy prescribing and renewal system, Jack Boxer, MD 538 Back Page Proust Questionnaire: Vishal Varshney, MD ECO-AUDIT: D E P A R T M E N T S Environmental benefits of using recycled paper Using recycled paper made with post- consumer waste and bleached without the use Premise of chlorine or chlorine compounds results in 499 measurable environmental benefits. We are Is lesion location random, and does it really matter? pleased to report the following savings. • 1399 pounds of post-consumer waste used Margo S. Clarke, MD instead of virgin fibre saves: • 8 trees • 760 pounds of solid waste BC Centre for Disease Control • 837 gallons of water 501 • 1091 kilowatt hours of electricity (equivalent: BC physicians reduce unnecessary antibiotic use—and costs 1.4 months of electric power required by the average home) David M. Patrick, MD, Laura Dale, Mark McCabe, MPH, Bin Zhao, MSc, • 1382 pounds of greenhouse gases (equivalent: Mei Chong, MSc, Edith Blondel-Hill, MD, Fawziah Marra, PharmD 1119 miles traveled in the average car) • 6 pounds of HAPs, VOCs, and AOX combined • 2 cubic yards of landfill space Environmental impact estimates were made Council on Health Promotion using the Environmental Paper Network Paper 502 Calculator Version 3.2. For more information visit The scoop on supplements for disease prevention www.papercalculator.org. Ilona Hale, MD, Kathleen Cadenhead, MD, Mary Hinchliffe, MD BC MEDICAL JOURNAL VOL. 58 NO. 9, NOVEMBER 2016 bcmj.org 491 #115–1665 West Broadway, Vancouver, BC, Canada V6J 5A4 Tel: 604 638-2815 or 604 638-2858 Fax: 604 638-2917 contents E-mail: [email protected] Web: www.bcmj.org D E P A R T M E N T S ( Continued) 520 WorkSafeBC Achilles tendon ruptures—a review for primary care Derek Smith, MD EDITOR 522 Pulsimeter David R. Richardson, MD New procedures for CL19 medical reports (522); Congratulations EDITORIAL BOARD from the BCMJ (522); Planning your family: The insurance Jeevyn Chahal, MD Ada Lo (522); (523); David B. Chapman, MBChB essentials, Practice support: 1300 docs Anne I. Clarke, MD Physicians honored with Above & Beyond Awards (523); Resource Brian Day, MB for treating obese or overweight child patients (523); Study: COPD Timothy C. Rowe, MB (523); Cynthia Verchere, MD epidemic looms New weapon for hard-to-treat bacterial Willem R. 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(Shelly) Naiman, Gershon Growe, MD, The Naiman PROOFREADER family (526) Ruth Wilson Dr Charles Edward (Ted) Reeve, Charles Reeve, Jr., PhD (527) DESIGN AND PRODUCTION Scout Creative General Practice Services Committee COVER CONCEPT 528 & ART DIRECTION Division-created patient resources: Empowering patients to make Jerry Wong Peaceful Warrior Arts healthy choices Afsaneh Moradi PRINTING Mitchell Press advertising 530 Calendar Kashmira Suraliwalla 604 638-2815 [email protected] 533 Classifieds ISSN: 0007-0556 536 Advertiser Index 539 Club MD Advertisements and enclosures carry no endorsement of Doctors of BC or BCMJ. © British Columbia Medical Journal, 2016. All rights reserved. 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The BCMJ reserves the right to refuse advertising. 492 BC MEDICAL JOURNAL VOL. 58 NO. 9, NOVEMBER 2016 bcmj.org BC MEDICAL JOURNAL VOL. 58 NO. 9, NOVEMBER 2016 bcmj.org 493 editorials Apply healing paint daily “ ake the coast road. It’s in way ing as it passed each vehicle in a long my bicycle. I remember one patient better condition and much nic- line behind some poor scared tourist stating the obvious: “Dr Richardson, Ter to drive.” a few cars ahead. There was even a have you ever considered that maybe This was the e-mail advice I re- grandma in the passenger seat gestur- you aren’t very good at this bike rid- ceived from the nice woman at the ing as only an Italian can. I’m pretty ing thing?” This is probably why I’ve hotel in Amalfi, Italy, in response to sure she wasn’t mouthing “Welcome never had the urge to get a tattoo— my query as to the best method of ar- to the coast.” I’ve been doing a pretty good job of rival by car. After spending a week that on my own. And physical scars in Tuscany and then another 10 days are one thing, but emotional scars on a bike tour across Italy, the Amalfi Like the Amalfi car, run deeper. As physicians, we often coast seemed like a perfect ending to I now have numerous deal with our patients’ mental dents. a fairytale trip. So on a beautiful Mon- scars. A privilege of general practice is that day morning we headed out on our as the physician-patient relation- 5-hour drive from southern Tuscany. ship grows through the years patients Apart from the numerous tolls and As you can deduce from the fact let down their guard and share their high-performance vehicles traveling that I penned this editorial after my stories. We are trusted with tales of around 200 km/hr on the autostrade, encounters, Grandma didn’t cause my childhood trauma, relationship fail- the trip was uneventful until I piloted death, and I sincerely hope her heaven- ure, addiction, loss, and more. It is in my little Fiat 500 onto road SS163. ly bubble wasn’t burst by a large, cor- these moments that heartfelt words of Two Fiat 500s might be able to pass nering, two-wheeling tour bus (prior support can mean so much to those one another on this ever-twisting, to my trip I wasn’t aware such a thing we care for. Therefore, I have made a walled avenue of death but not the was even possible). I did notice that commitment to acknowledge at least collection of buses, trucks, vans, peo- the walls that lined “S-cared S-… less one patient’s emotional dent each day ple, and bikes we encountered. How- 163” have numerous gouges. I also and, if possible, to apply a little heal- ever, none of the local drivers seemed noticed that the typical Amalfi vehicle ing paint. to be aware of the physical principles has dents on all four sides. I wonder how much Limoncello of space and time, and drove as if God This got me thinking about how and gelato I would have had to con- himself had blessed them with a pro- we all develop scratches along the sume to calm my nerves had I driven tective bubble. The icing on the cake way. In my 50s I have to admit that, the much more dangerous mountain was when I looked to my left to see an like the Amalfi car, I now have numer- road.