Thursday, 17 of January of 2019

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Update on the DePuy Hip Replacement Lawsuit




An Articular Surface Replacement, removed from a patient.
Photo Credit: The New York Times

Metal on metal implants for hip replacement surgery have been the subject of intense scrutiny and media attention for some time now. Bloomberg Business News and the New York Times recently reported that Johnson & Johnson has “tentatively agreed” to an estimated $4 billion settlement to settle some 7,500 lawsuits against its DePuy Articular Surface Replacement (ASR) hip implant device.

Metal-on-metal implants were initially thought to be a breakthrough product that would last longer, offer greater stability and improve bone conservation, but unfortunately that is not turned out to be the case. In January of this year, the FDA issued a safety bulletin, citing growing clinical evidence that shows a failure rate two to three times that of non-metal-on-metal devices.

In addition, the impact of metal rubbing on metal can cause tiny metal particles to flake off, causing damage to muscle and bone, as well as a high level of metal ions in the blood. Many patients have been forced to undergo hip revision surgery to remove the flawed implant and replace it with a different design.

Thousands of patients have filed lawsuits against DePuy and other manufacturers of metal implants, claiming the devices were defective and have harmed their health. When formal announcement in the DePuy ASR case is released some time this week, it is expected to be one of the largest product liability claims to be paid involving a medical device. The New York Times reports that only patients who have undergone revision surgery to replace the defective ASR implant will be included in the current settlement.

If you are dealing with chronic hip pain from osteoarthritis or are concerned about a hip replacement that you had in the past, please feel free to call our office at 239-936-6778 to schedule a consolation. For more information about joint replacement or other orthopedic-related conditions, go to

October is Physical Therapy Month



In recognition of October as Physical Therapy Month, Dr. Kagan and staff want to acknowledge the importance of physical therapy in helping patients recover from orthopedic-related injuries and thank these professionals for the excellent work  they do every day.

Physical therapists are vital members of the healthcare team. They have completed a master’s degree or doctorate degree in their field and work hand-in-hand with doctors to help patients recover after everything from sports or workplace injuries, to traumatic car or workplace accidents, joint replacement surgery and other orthopedic issues.

“No matter what area of the body ails you – neck, shoulder, back or knee, physical therapists have an established history of helping people improve their quality of life,” reports the American Physical Therapy Association.

What exactly do physical therapists do? Physical therapists have specialized training in anatomy, the musculoskeletal system and kinesiology (the study of how the body moves), which allows them to prescribe various strategies that help reduce pain; improve mobility and range of motion; and prevent injury or re-injury. Often, physical therapy is the first step in the treatment plan when a patient comes for an orthopedic consultation. Physical therapy is also recommended following orthopedic surgery to help patients recover faster.

Just how effective is physical therapy? A study published in the May 2013 New England Journal of Medicine found physical therapy was a good first choice before surgery for moderate knee osteoarthritis and mild meniscus tears in the knee.

Congratulations to the many physical therapists who have helped our patients over the years.

For more information about Dr. Kagan or treatment for orthopedic-related conditions, go to

AAOS Co-Sponsors Distracted Driving Campaign



Photo Credit: IntelFreePress/Flickr

Photo Credit: IntelFreePress/Flickr

This week, as Florida bans texting and emailing while driving, Dr. Kagan joins the American Academy of Orthopedic Surgeons in raising awareness about the dangers of driving while distracted.

For the past few years, the AAOS has co-sponsored a major national campaign titled, “Decide to Drive,” that emphasizes how easy it is to be distracted and how quickly accidents can occur.

“If you’re doing something else while you’re driving, you’re not focused on the road, and orthopedic surgeons would much rather keep bones strong them put them back together after a traumatic accident,” says an AAOS spokesperson about why the national medical organization has put so much effort into education about this important safety issue.

According to the Florida Department of Transportation, nearly 5,500 people have been killed since 2009 and an additional 448,000 injured from motor vehicle crashes related to distracted driving The National Safety Council (NCS) estimates that nearly 28 percent of crashes — about 1.6 million a year — can be attributed to cell phone talking and texting while driving.

While texting, emailing and talking on the phone are a major cause of distracted driving, they are not the only concerns.  Reaching over to adjust radios ,portable music players or navigation systems, eating and drinking, applying makeup, brushing your hair, reading a map or newspaper, and children and pets in the backseat are all potential distractions that can cause drivers to take their eyes off the road, hands off the wheel and mind off the task at hand, says the AAOS.

Here are some recommendations from the AAOS to make sure you arrive safely at your destination.

Before Starting Your Car:

  • Put on sunglasses and other accessories such as Bluetooth ear pieces
  • Adjust seats, headrests and mirrors
  • Fasten your seat belt
  • Adjust the music volume
  • Enter address in your GPS navigation system
  • While You’re Driving
  • Don’t talk on the phone, text or email
  • Don’t eat or drink, change your clothes or groom yourself
  • Pull over any time there is a major distraction such as disciplining a child, retrieving an item, or looking at printed directions

Dr. Kagan strongly supports the AAOS slogan, “Behind the wheel, there is no such thing as a small distraction.” For more than 30 years, the doctor has been serving the orthopedic needs of Southwest Florida.  For information on the practice, go to or call 239-936-6778.

National Men’s Health Week




This Sunday, June 16, Dr. Kagan and staff will join families across the country in celebrating Father’s Day and thanking Dads – or other significant men in our lives, such as grandparents, step-fathers, uncles, teachersand mentors – for all they have done and continue to do for us.

This week, June 10-16, is also National Men’s Health Week and a perfect time to remind men to adopt healthier lifestyle habits, including eating healthy, exercising more, maintaining appropriate weight, not smoking and making sure they have an annual check-up with their physician.

Early detection is the key to preventing many illnesses and even has a role to play in greater awareness about orthopedic-related issues that affect men. As boomers push the boundaries for active, healthy aging, men of all ages are enjoying exercising, staying fit and participating in sports. This is a very positive trend, but at the same time, can put men at risk for sports-related overuse injuries that strain ligaments and tendons and stress joints and damage cartilage. Remind Dad to go easy on the joints and not ignore acute or chronic pain and tenderness.

Shoulder, hip and knee arthroscopic surgery are among the top 10 successful procedures in the U.S. every year. These procedures can be life-changing in reversing mobility and improving quality of life.

For more information about bone and joint health, visit

Study Reported At AAOS Meeting Highlights Total Knee Success



shutterstock_137018378For people who suffer from the chronic, crippling pain of severe osteoarthritis in their knee, life can be a challenge. Even walking or getting out of the car can be difficult. The pain can be bad enough to be disabling, limiting patients’ ability to work or stay physically fit through biking, dancing, tennis, golf or swimming.

Over the past two decades, knee replacement has been the gold standard for relieving pain and restoring mobility. But not as much was known about how the surgery impacted younger active adults who were still working. Now a new study reported this past spring at the 2013 annual meeting of the American Academy of Orthopedic Surgeons confirms the surgery’s benefits in all arenas of life.

The study, appropriately titled, “Do Patients Return to Work after Total Knee Arthroplasty?“ surveyed 660 patients ages 18 to 60 from one to three years after their surgery. The results? Ninety-eight percent of the patients were able to return to work, ranging from sedentary office jobs to those that involved heavy physical labor.

These results are impressive, especially since the AAOS reports that “more than one in four Americans have bone or joint health problems making these medical conditions the greatest cause of lost work days in the U.S.”

“We can now confirm that knee replacement is successful in keeping patients in the workforce and in preventing the pain and suffering that leads to loss of employment,” said the lead researcher in the study. “Returning patients back to work not only gives the patient a sense of fulfillment, but also is economically beneficial to society.”

Knee replacement is one of the most frequently performed procedures for chronic osteoarthritic pain in the knee. For more information about the surgery, or to schedule an appointment, call our office at 239-936-6778 or visit 

Free seminar Dec. 15 on treatment options for joint pain

Orthopedic surgeon Dr. John C. Kagan is offering a free seminar to provide surgical and non-surgical options for treating joint pain including minimally invasive options for hip and knee replacement. The public is invited to attend the free seminar and ask questions on Saturday, Dec. 15 from 10 a.m. to noon at Gulf Coast Medical Center, 13681 Doctors Way in Fort Myers.  For reservations, call 239-936-6778 ext. 2227.  To register online and for more information, visit Space is limited.

Dr. John C. Kagan is a board-certified orthopedic surgeon specializing in joint replacement surgery including minimally invasive hip and knee surgery, sports medicine, arthroscopic surgery of the knee and shoulder, hand surgery and general orthopedics.

Kagan attended theUniversityofAlabamaon a full scholarship and was the Jimmy Moore Memorial Scholar Athlete recipient prior to attending medical school at theUniversityofSouth FloridainTampa. He completed a surgical internship at theUniversityofFlorida, and his orthopedic surgery residency at theUniversityofAlabamainBirmingham. He is board certified by the American Board of Orthopedic Surgery.

Kagan returned toFort Myersin December of 1980 to begin private practice. He is founder and director of the Athletic Orthopedic and Reconstructive Center, a comprehensive orthopedic practice with four orthopedic surgeons and three locations in Lee County.

Devoted to serving the community and its residents, Kagan and his partners are team physicians for the Minnesota Twins baseball team during spring training, the Miracle baseball team and the Florida Everblades hockey team. In addition, he is team physician for the Fort MyersHigh Schooland ClewistonHigh Schoolfootball teams.

Kagan is a member of the Lee County Medical Society, Florida Orthopedic Society, Florida Medical Association,AmericanAcademy of Orthopedic Surgeons and the American Medical Association.

For more information, visit Also, visit Dr. Kagan’s blog at and follow him online on Facebook and on Twitter.

Causes of Hip Pain

The first step in treating hip pain is to determine the cause. Your age, level of activity, gender and medical history are important clues in helping the doctor diagnose the source of persistent aches and pains. For example, someone in their 20s or 30s is more prone to certain types of medical conditions than someone in their 70s or 80s.

The four most common causes of hip pain include:

Osteoarthritis. Former president George H.W. Bush, singer Billy Joel and Olympic skater Rudy Galindo are among the millions of people who have received a hip replacement due to osteoarthritis, a painful condition that causes inflammation and breakdown of the cartilage in the hip joint.

Hip Fractures. Ninety percent of all hip fractures in the U.S. are the result of falls, says the American Academy of Orthopedic Surgery. In addition, women are two to three times more likely to have a hip fracture than men. That’s because women are more likely to develop osteoporosis, a degenerative condition that weakens the bones and makes them more brittle. It takes a lot to break a hip bone – except when it’s been damaged by osteoporosis.

Bursitis. Repetitive stress on the hip joint from sports such as running and bicycling, work that requires standing for long periods of time, and even gardening or stair climbing can irritate and inflame the bursa. The bursa is a small fluid-filled sac that cushions the muscles and the bones in the hip. If you have bursitis, the pain may be worse after you’ve been sitting for long periods of time or it may wake you up at night if you happen to lie on the affected hip.

Muscle Strains and Tendonitis. Overdoing it in sports, training errors, excessive stretching, or sudden increases in the level of activity can stress the hip tendons beyond capacity or tear the muscle fibers, causing pain and swelling and loss of strength. The AAOS offers these easy suggestions to prevent muscle strains or tendonitis: warm up before stretching, stretch slowly, wear the right shoe for the sport and participate in a conditioning program that builds muscle fitness and flexibility.

Treatment for hip pain may range from rest, ice and over-the-counter medication to surgery. For a list of painful hip conditions that require surgical intervention by an orthopedic surgeon, go to

What is Knee Resurfacing?

Knee resurfacing is a new minimally invasive procedure that is a good alternative to total knee replacement. There are many advantages to knee resurfacing, including faster healing and return to an active lifestyle in just four to eight weeks, rather than 12 weeks for joint replacement surgery.

 Other benefits include:

Short hospital stay of just one to three days

A small incision

Only the damaged or arthritic parts of the knee are treated, rather than replacing the entire knee joint

 There are two types of knee resurfacing – partial knee resurfacing and full knee resurfacing. Which type is best for you will depend on the extent of your arthritis and the damage it has done to the cartilage, the fibrous tissue that cushions the bones and prevents them from rubbing together. In early stages of arthritis, only one side or compartment of the knee may be affected. For these patients, a partial knee resurfacing is usually recommended. Cartilage that is damaged on both sides of the knee will require a full knee resurfacing.

 During resurfacing, the surgeon will trim and reshape the ends of the bones, removing jagged edges or bony spurs caused by the arthritis. Then the damaged cartilage will be replaced with an implant, which is cemented into place on the reshaped bone.

 If your doctor has suggested you may need surgery to due to knee pain from arthritis, ask if you might be a candidate for resurfacing. For more information about joint resurfacing, go to

Dr. Peter Walimire has joined our team

I am pleased to welcome Dr. Peter Walimire to my practice. A podiatrist, Walimire specializes in foot and ankle reconstructive surgery, including foot and ankle trauma, diabetic limb salvage and application of both internal and external fixation devices. Walimire joins our medical team which includes Drs. Michael Jugan, Pedro Monserrate, Peter Curcione and David Sudderth at the Athletic Orthopedic and Reconstructive Center, a full-service orthopedic medical and surgical practice with offices in Fort Myers, Cape Coral and Lehigh Acres. Walimire will treat patients in all three locations.

 Walimire is a graduate of Cornerstone University, Grand Rapids, Mich. and the Ohio College of Podiatric Medicine in Cleveland. He completed his residency in podiatric medicine and surgery at Florida Hospital East Orlando and served as chief resident. Walimire is an associate member of the American College of Foot and Ankle Surgeons and is a member of the American Podiatric Medical Association and the Florida Podiatric Medical Association. In addition, he is a volunteer with the Special Olympics of Florida Healthy Athletes Initiative’s Fit Feet division.

Our team is devoted to providing the highest level of quality care and treatment of the musculoskeletal system, which includes the bones, joints, ligaments, muscles and nerves. AORC specializes  in total joint replacement, fracture care, sports medicine, hand surgery, neurology, podiatry and general orthopedics. For more information call 239-936-6778 or visit or

What you need to know about osteoporosis

Do you or someone you care about suffer from osteoporosis? You are not alone! More than 1.5 million bone fractures occur a year due to osteoporosis. Fracture care is one of our areas of expertise at Athletic Orthopedic and Reconstructive Center. And given that today is National Osteoporosis Day, I want to recognize the impact that the disease has on patients and families and to provide some insight and tips on preventive care and treatment options.

Most people are unaware that they have osteoporosis until a fracture occurs. Osteoporosis affects everyone as they age, but the degree to which bone loss occurs can vary.

Although there is no known cure for osteoporosis, there are a number of preventative measures patients can undertake to slow down the loss of bone.

Bone is a living tissue, comprising mainly of calcium and protein. Healthy bone is always being remodeled; that is, small amounts are being absorbed in your body and small amounts are being replaced. When bone is no longer being replaced as quickly as it is removed from the body, osteoporosis occurs. If the mass of the bone is greatly reduced, the bone becomes weaker and can fracture.

There is not one specific cause of osteoporosis. In fact, there are a number of factors that come in to play, such as: aging, physical activity, reduced levels of estrogen, heredity, excessive cortisone or thyroid hormone, smoking and excessive alcohol intake. Although some of these factors can be controlled by the patient, many of them require help from an orthopedic specialist.

To help prevent osteoporosis, I recommend getting the proper amounts of calcium and vitamin D. Also, doing regular weight bearing exercises, such as; walking, jogging, or dancing, three to four hours a week can help to build strong bones and are investments in future bone health. Smoking and consuming excessive amounts of alcohol should be avoided because they increase bone loss.

Early treatment for osteoporosis is the most effective way to reduce bone loss and prevent fractures. However, treatment programs after a fracture has occurred are also valuable and will help to prevent future fractures. If you would like to check your bone density and evaluate your risk for osteoporosis, please contact our office at 239-936-6778 or visit

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