Dr Bruce E Ellison MD - Orthopedic Surgery Expert Witness - Offices Near Sequoia Hospital

  Acromioclavicular (AC) separation, commonly referred to as shoulder separation, does not involve injury to the shoulder joint.   The injury instead involves various degrees of dissociation between the wingbone (acromion) and the collarbone (clavicle.)   The most common mechanism of injury involves a fall directly onto the shoulder, with injury to the ligaments that surround and stabilize the AC joint.   In the case of an extremely high energy fall, the ligaments attaching to the inferior aspect of the clavicle are torn, causing the "separation" of the clavicle and acromion.   The acromion and scapula actually moves downward from the weight of the arm, creating a "bump" or bulge above the shoulder.

A sprained ankle is a very common injury.  Approximately 25,000 people experience ankle sprains daily.  A sprained ankle can occur with athletes and non-athletes, children and adults.  Ankle sprains may occur when participating in sports and physical fitness activities, or simply stepping on an uneven surface, or step down at an angle. The ligaments of the ankle hold the ankle bones and joint in position.  These ligaments protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot.  The ligaments usually stretch within their limits, and then go back to their normal positions.  If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length.  When a ligament is forced to stretch beyond its normal range, a sprain occurs.  A severe sprain causes actual tearing of the ligament elastic fibers.  When excessive force is...

Dr Bruce E Ellison MD Knee Arthroscopy.wmv

Dr. Ellison performs workers compensation Qualified Medical Evaluations ( QME ) and Agreed Medical Evaluations ( AME ) for work compensation industrial injuries at his primary office in Redwood City and at satellite offices in San Francisco, San Mateo, Oakland, El Cerrito and Mountain View, California: 801 Brewster Avenue, Suite 240 Redwood City, California 94063 2460 Mission Street (at 20th St.) San Francisco, CA 94110 415 North San Mateo Drive, Suite 2 San Mateo, CA 94401 5032 Woodminster Lane Oakland, California 94602 425 Kearney Street El Cerrito, Calif 94530 2500 Hospital Drive, Building 9  Mountain View, Calif 94040

BEACH-CHAIR POSITION Dr. Ellison uses the beach chair position almost exclusively. Beach-chair position provides faster and easier patient positioning, reduces risk of neurapraxias because traction is not used. There is reduced distortion of intraarticular capsular anatomy, improved mobility of the patient's arm, and easier conversion to open surgery since repositioning and repreparation is not required. In the beach-chair position, either general anesthesia or interscalene block can be used. Interscalene block allows the patient to be awake and can assist in controlling the posotion of the head. The knees are flexed to provide counterpressure against the posterior thigh, which will reduce the tendency to slide off the table during surgery. Flexion also decreases tension on the posterior neurovascular structures of the legs. The affected shoulder is brought off the side of the table for access during the procedure. The head is supported in a neurosurgical headrest...

Osteoarthritis of the knee is a degenerative condition affecting millions of Americans. Though often associated with the aging, osteoarthritis involves an overproduction of degradation enzymes which attack and destroyed cartilage. Healthy joints, including the knee, are covered by a layer of articular cartilage. The cartilage acts as a cushion providing for smooth gliding surface during range of motion. The articular cartilage has no nerves, and thus there is no pain with activity. However as anyone who has broken a bone knows, there are abundant nerves and pain receptors at the bone. In the knee with osteoarthritis, the cartilage wears away and becomes roughened. If the wear becomes significant, the rubbing a one rough bony surface on another can result in debilitating pain, with resulting stiffness and swelling. Nonoperative treatment options include behavior modification, drug therapies including hyaluronic acid and steroid injections, braces and electrical stimulation. Oper...