Currently browsing: Physician/Surgeon

Fun to see I am still quoted from 1979 publication

11/29/2017: It was fun to see work I published 38 years ago is still quoted in the medical literature. The original publication was: Johnson LL: Lateral capsular ligament complex: Anatomical and surgical considerations. Am J Sports Med 7:156-160, 1979 This was reference in Oper Tech Orthop by Jorge Chahla as in press 2017 Elsevier Inc. Chahla J, Moatshe G, LaPrade RF. Biomechanical Role of Lateral Structures in Controlling Anterolateral Rotatory Laxity: The Anterolateral Ligament Biomechanical Role of Lateral Structures in Controlling Anterolateral Rotatory Laxity – The Anterolateral Ligament. Available from: www.researchgate.net/publication/314031553_Biomechanical_Role_of_Lateral_Structures_in_Controlling_Anterolateral_Rotatory_Laxity_-_The_Anterolateral_Ligament [accessed Nov 29 2017].

Patent Claims Granted for Skin Wound and Potential Wrinkle Treatment

10/12/2017: I learned that my application U.S. Application No. 15/189,510  Title: “ANTIMICROBIALS AND METHODS OF USE THEREOF” resulted in successfully granted the following claims which I have proof that after cosmetic skin defoliation or dermabrasion that the wound healing will be enhanced showing rapid healing, minimal inflammation and importantly restoration of the skin collagen layer.  This has the potential for wrinkle treatment in combination with skin defoliation and/or dermabrasion. Allowed Claims 1–32. (Cancelled) A method of treating a wound to promote healing consisting essentially of administering a composition of an aqueous solution comprising 2,4,6,trihydroxybenzaldehyde (“246 THBA”) and protocatechuic acid (PCA) both of which are present at a concentration of between 10 to 200 mM, wherein the administration results in: promoting wound healing; reducing at least one microbe selected from the group consisting of L. casei, C. difficile, P. acnes, C. perfringens, L. casei, E. coli, S. aureus 6538, S. aureus 33591,, S. mutans, S. pyogenes, P. aeruginosa, K. pneumonia, and C. albicans; increasing localized IGF-1 expression; and reducing localized TGF-E and EGF expression. 34–35. (Cancelled) The method of claim 33, wherein the composition is in the form of a(n) liquid, solution, cream, ointment, salve, gel, emulsion, suspension, dispersion, or paste. The method of claim 33, wherein the wound is a burn, skin break, bone break, muscle tear, puncture, surgical incision site, microdermabrasion site, skin graft site, a wound associated with diabetes, a bed sore, a pressure sore, or a laceration. The method according to claim 33, wherein the composition is administered in ultradeformable liposomes. The method of claim 33 wherein the PCA and 246THBA are each present at a concentration between 20 to 100 mM. The method of claim 33 wherein the PCA and 246THBA are each present at a concentration between 20-50 mM. The method of claim 33 wherein the PCA and 246THBA are each present at a concentration of about 25 mM. The method of claim 33 wherein the PCA and 246THBA are each present at a concentration at about 50 mM. The method of claim 33 wherein the composition may be administered by any conventional route including, oral, topical, buccal, injection, pulmonary, intravenous, inhalant, subcutaneous, sublingual, or transdermal. The method of claim 33 wherein the treating of the wound is a cosmetic method of treating skin to enhance skin healing, wherein the composition is administered topically, orally or by intradermal or subcutaneous injection to a skin tissue, wherein the composition promotes an effect selected from the group consisting of reducing inflammation, optimizing growth hormone production, and increasing collagen stimulation. 45–52. (Cancelled) The method according to claim 33, wherein said administration further results in reduced scar formation.      

Football injuries would be reduced by rule changes

11/11/2015: Football injuries could be reduced by 3 rule changes. #1: “Spearing” or leading with the head and helmet to hit another player is technically outlawed. The institution of “targeting” or hitting with helmet to head or neck is now penalized. However the incidence of leading with the head and helmet still is prevalent. This is seen with attempts to cause a fumble. The impact on the players head and neck is still there with this fumble inducing technique. I have long proposed that the rule be more general; No hitting with the head and helmet or in the head or helmet. This should be understood by all parties. #2: No slamming to the ground outside of normal tackling technique. This occurs most often on the quarterback after he has released the pass. The result is the quarterback is forced backward into the ground with his head the last to hit the ground with great acceleration. It is almost like a whip lash injury to the neck but more importantly the potential for brain concussion of some magnitude. #3: Restore the rule on “No assisting the ball carrier”. What happens now is that the ball carrier is upright or nearly so and both teams are pushing on this rugby like scrum, which is short for scrimmage. The result is often an injured player laying on the field after all the pile is cleared. This is the source of knee and ankle injuries especially to the linemen pushing in the scrum.

Nice Award

I received the inaugural President’s Award today from the Arthroscopy Association of North America. It was given the person who, although never president of the organization, made “numerous contributions to the Association and to the advancement of Arthroscopic Education.”

Invited Speaker: AANA April 2015

12/4/2014: I was invited to give a Presidential guest lecture in April 2015 at Arthrocopy Association of North America. So I had to get recent photograph. This is the requested Bio related to the lecture. Dr. Johnson was one of the pioneers in arthroscopic surgery. He was probably the first in the USA to perform arthroscopy of the temporal mandibular joint, the shoulder, the elbow, the wrist, the hip and ankle in the 1970’s. He performed perhaps the first arthroscopic repair for shoulder instability in August 1982. He is holder of more than 60 US patents, most related to arthroscopic surgery and tissue engineering. The most notable was perhaps the motorized instrumentation for arthroscopic surgery. 4,203,444: Surgical Instrument suitable for closed surgery such as of the knee (arthroscopy) 5/20/1980 and 4,274,414: Surgical Instrument (arthroscopic shaver) 6/23/1981. He has a long interest in cartilage repair and healing. He may have been the first to promote such by arthroscopic means, the procedure known as Arthroscopic Abrasion Arthroplasty. Although he concluded his clinical practice in 1995 he continues to do research and publications in the cartilage engineering space. The following two publications are long term follow ups on what previously would not have been expected; repair of articular defects with histological evidence of hyaline cartilage and a clinical benefit. Johnson LL, Delano M, Spector M, Gottschalk A, Pittsley A. The Biological Fate of Autogenous Bone Grafting for Large Volume Osteochondral Defects of the Knee: 13020 years follow-up. Johnson LL, Delano M, Spector M, Gottschalk A, Pittsley A. Long Term Clinical Assessment following Autogenous Bone Grafting for Large Volume Three Dimensional Osteochondral Defects of the Knee. ICRS, May 2009, Miami, FL. The last several years have been devoted to R & D on phytochemicals and their biological effects. He has been issued US patent 8,263,069 Composition including anthocyanins and anthocyanidins for prevention and or treatment of articular cartilage associated conditions. September 11, 2012. His presentation will review his past experience as well as present more recent research concerning the discovery of osteoarthritic disease modifying reagents and novel broad spectrum antibiotic and wound healing promoting reagents. He believes there is a new era coming in orthopedics will be in tissue engineering and disease modification based upon phytochemicals. He predicts that this will have a greater impact on orthopedic surgery than that of arthroscopy.

Late Stage Treatment for Government Run Health Care

11/28/2014 www.msn.com/en-us/news/world/russian-doctor-rebellion-causes-headache-for-putin/ar-BBg5j9J This is an interesting read about a government further down the road than the USA on government run health care.

Prediction: Only Providers with low Infection rates will do total joint surgery

4/26/2014: Prediction. Only surgeons and hospitals with low infection rates will do total joint surgery. The incidence of operative infection will control who will do surgery of this type in the future. The reason is that a surgical infection is very costly to treat as well as the morbidity, loss of work, even mortality. Here are the numbers concerning infection and total knee replacement. The relative incidence of operative infections was reported as 2.0% and 2.4% following total knee surgery. The annual cost of infected revisions to U.S. hospitals increased from $320 million to $566 million during the study period and was projected to exceed $1.62 billion by 2020. (Kurtz SM, et al Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012 Sep; 27(8 Suppl) The average cost of the surgical revision of an infected total knee replacement was $116,383 in the years 2001 through 2007. (Kapadia BH, et al. The Economic Impact of Periprosthetic Infections Following Total Knee Arthroplasty at a Specialized Tertiary-Care Center. J Arthroplasty. 2013 Oct 17). Under the new rules for quality assurance under the affordable health care act (Obamacare) the hospital will eat this loss. Another often overlooked factor for those not on Medicare have a higher deductible under Obamacare. No patient going through the prolonged treatment for post operative infection will be able to pay their deductible. It can be $1000 to $10000. This problem already exists in Germany. This is a burden on the patient if they pay. If they do not pay then the cost is shifted to the doctor and the hospital. (Haenle M. et al. Economic impact of infected total knee arthroplasty. Scientific World Journal. 2012; 2012:1 96515). So the hospital gets the expense shifted to them. Cost shifting is major feature of government health care insurance public policy. Therefore only hospitals and surgeons with no or very low infection rates will do total joint surgery. Notice I said surgeons. The hospital will not be able to afford even a “large producer” who has infections. “Sorry Doctor SoandSo, we know you are a nice guy and a good surgeon, but we can not afford to underwrite the risk of your incidence of infection.”