Convenient Care For Your Urgent and Non-Life Threatening Medical Needs
Our Urgent Care facilities provide convenient care for your urgent and non-life threatening medical needs. We know that having immediate access to medical care is important, so we offer extended hours to provide quality care when you need it most. Our facilities are equipped with a full in-house lab and x-ray equipment.
Bridger Valley Urgent Care
3580 State Highway 414
Lyman, Wyoming 82937
(307) 786-2042
Evanston Urgent Care – Coming Soon!
191 Overthrust Road
Evanston, Wyoming 82930
(307) 789-0096
Box Elder Urgent Care – Coming Soon!
1950 South Hwy 89
Perry, UT 84302
Urgent Care
Urgent Care facilities are for those times when you need medical attention within 24 hours, but your situation is not emergent or life-threatening. Here are some examples of conditions that would be treated at an Urgent Care facility:
Fever
Flu-like symptoms
Sprain
Broken bones
Minor cuts
Minor burns
Sore throat or cough
Cold-like symptoms
Headaches
Vomiting
Allergic reactions (non-life-threatening)
Emergency Room (ER)
Emergency rooms are for times when your medical needs are life-threatening or “emergent”. If your life is in danger, if part of your body may be permanently damaged, or if you are in severe pain, go to the ER or call 911. Here are some examples of conditions that may be treated at an Emergency Room:
Chest pain
Severe breathing problems
Major bleeding
Seizures
Head injuries
Sudden or severe pain
Sudden loss of consciousness
Slurred or slow speech (may be a sign of stroke)
We Treat Orthopedic Injuries For All Ages
We offer world-class orthopedic care in orthopedics, knee and hip, hand, back and spine, podiatry, and physiatry. We treat orthopedic injuries for all ages. We provide care that can allow you to end chronic pain, return to work, treat sports injuries, or improve your athletic performance. Our specialists excel in every aspect of orthopedic care – from diagnosis and treatment to physical therapy and recovery. Here at Goble Medical, we have the expertise to help you heal and get back to your life.
Goble Medical
3580 State Highway 414
Lyman, Wyoming 82937
(307) 786-2042
Goble Medical
191 Overthrust Road
Evanston, Wyoming 82930
(307) 789-0096
Goble Medical
1950 South Hwy 89
Perry, Utah 84302
(435)787-8467
Over 30 years experience as an Orthopedic Surgeon, Innovator, and Entrepreneur
Recognized as one of the 125 Outstanding Knee Surgeons by Becker’s Orthopedic, Spine & Pain Management Review. Co-founder of five medical device companies. 120 US Patents
Dr. E. Marlowe Goble has specialized as a knee surgeon for 30 years. During that time he has researched and published on virtually every orthopedic procedure involving the knee. To provide the best quality care possible, Dr. Goble has concentrated his practice narrowly. It is not just specialized around disorders of the knee but further focused on the following three knee disorders: Anterior Cruciate Reconstruction (ACL), Meniscal Allograft Transplantation (MAT), & Minimally Invasive Total Knee Arthroplasty.
Dr. Goble has had a significant impact on the field of Orthopedics and knee disorders. He performed the world’s first Minimally Invasive Total Knee Arthroplasty in 1992 and has had a generous amount of experience in each of the three areas. Expand the fields below to learn more about his impact and research in each area.
Personal: European Tour (Knee Ligament Reconstruction), 2 months, 1983; Dr.Paul Maquet, Dr. Werner Muller, Dr. Paul Dejour
Board Certified: Orthopedic Surgery, July 26-27, 1984, American Board of Orthopedic Surgery
Fellowship: Slocum Clinic, 3 months, 1982, Eugene, Oregon
Residency: Orthopedic, University of Utah 1976 – 1981, Dr. Sherman S. Coleman ,Chairman
Internship: Barnes Hospital, Surgery 1976, St.Louis, Missouri
Medical Degree: Washington University, June 1976, St. Louis Missouri
Baccalaureate Degree: Chemistry/Medical Biology, June 1971, University of Utah
(2002 – present) five patents contributing to MAT method and devices.
(2009 MAT)System and method for meniscal repair through a meniscal capsular tunnel
(2009 MAT)Methods and apparatus for forming a tunnel through a proximal end of a tibia
(2007 MAT & ACL)Apparatus and method for attaching a graft ligament to a bone
(2007 MAT o& ACL)Bone fixation systems and related methods
(2002 MAT & ACL)Self-tensioning soft tissue fixation device and method
(1988 – present) 63 patents involving ACL reconstruction methods and devices:
(2007 MAT or ACL) Apparatus and method for attaching a graft ligament to a bone
(2007 MAT or ACL) Bone fixation systems and related methods
(2006 ACL) Method and apparatus for reconstructing a ligament
(2003 ACL) Apparatus and method for attaching a graft ligament to a bone
(2002 ACL) Adjustable length strap and footing for ligament mounting and method for its use
(2002 MAT or ACL) Self-tensioning soft tissue fixation device and method
(1999 ACL) Bone fixator for a ligament anchor system
(1999 ACL) Suture anchor assembly
(1999 ACL) Fixation device chemical dispensing system
(1999 ACL) Surgical site chemical dispensing system
(1998 ACL) Suture anchor assembly
(1998 ACL) Ligament fixator for a ligament anchor system
(1998 ACL) Modular drill and method for using the same
(1998 ACL) Anterior cruciate ligament tensioning device and method for its use
(1997 ACL) Ligament bone anchor and method for its use
(1997 ACL) Bone-tendon-bone drill guide
(1997 ACL) Variable angle drill guide and ligament fixation method
(1997 ACL) Chemical dispensing system
(1997 ACL) Suture anchor system and method
(1997 ACL) Soft tissue anchor and method
(1996 ACL) Suture anchor loader and driver
(1996 ACL) Orthopaedic washer
(1996 ACL) Orthopedic washer
(1996 ACL) Ligament replacement cross pinning method
(1996 ACL) Orthopedic washer
(1996 ACL) Orthopedic washer
(1996 ACL) Modular surgical drill
(1996 ACL) Method and apparatus for tensioning grafts or ligaments
(1996 ACL) Orthopaedic washer
(1995 ACL) Surgical drill guide
(1995 ACL) Cross pin and set screw femoral and tibial fixation method
(1995 ACL) Instrument with dual holding feature
(1995 ACL) Bone fixation and fusion system
(1995 ACL) Suture anchor and driver combination
(1995 ACL) Pin for securing a replacement ligament to a bone
(1995 ACL) Process of endosteal fixation of a ligament
(1995 ACL) Process for endosteal ligament mounting
(1995 ACL) Sight barrel arthroscopic instrument
(1994 ACL) Procedure for verifying isometric ligament positioning
(1994 ACL) Drill guide apparatus for installing a transverse pin
(1994 ACL) Arbor press staple and washer and method for its use
(1994 ACL) Method for securing a ligament replacement in a bone
(1994 ACL) Method for forming a tunnel intersecting a straight cruciate ligament tunnel
(1994 ACL) Channel ligament clamp
(1993 ACL MAT) Multiple guide sleeve drill guide
(1993 ACL) Ligament attachment method and apparatus
(1992 ACL) Femoral tunnel entry drill guide
(1992 ACL) Endosteal ligament fixation device
(1992 ACL) Harpoon suture anchor
(1992 ACL) Endosteal ligament retainer and process
(1991 ACL) Procedure for verifying isometric ligament positioning
(1991 ACL) Soft tissue anchor system
(1991 ACL) Endosteal fixation stud and system
(1990 ACL) Channel ligament clamp and system
(1990 ACL) Process of endosteal fixation of a ligament
(1989 ACL) Ligament anchor system
(1988 ACL) Ligament attachment method and apparatus
(1988 ACL) Suture anchor system
17 patents involving MIS TKA method and devices
(2005 MIS) Integrated infusion and aspiration system and method
(2006 MIS) Modular femoral components for knee arthroplasty
(2009 MIS) Methods for mounting a tibial condylar implant
(2009 MIS) Femoral components for knee arthroplasty
(2010 MIS) Line lock graft retention system and method
(2010 MIS) Milling system and methods for resecting a joint articulation surface
(2010 MIS) Milling system with guide paths….for resection a Joint articulating surface
(2010 MIS ) Modular bone implant, tool, and method
(2010 MIS) Tibial condylar hemiplasty tissue preparation instruments and methods
(2010 MIS) Method of Rasp for resurfacing joint articulation surface
(2010 MIS) Modular Bone Implant and method
(2010 MIS) Tibial condylar hemiplasty implants, anchor assemblies, and related methods
(2010 MIS) Modular progressive implant for a joint articulation surface
(2011 MIS) Implants and Method for Securing Implant to Surface of Knee.
(2011 MIS) Methods for mounting and using tethered joint bearing implants
(2011 MIS) Instruments and methods for preparing a joint articulation surface for an implant
11 patents involving facet methods and devices
(2002 SPINE) Prosthesis for the replacement of a posterior element of a vertebra
(2003 SPINE) Multiple facet joint replacement
(2003 SPINE) Facet joint replacement
(2006 SPINE) Facet joint replacement
(2006 SPINE) Multiple facet joint replacement
(2006 SPINE) Method and apparatus for spine joint replacement
(2008 SPINE) Method and apparatus for spine joint replacement
(2009 SPINE) Prosthesis for the replacement of a posterior element of a vertebra
(2009 SPINE) Facet joint replacement
(2009) SPINE) Multiple facet joint replacement
(2009 SPINE) Facet joint replacement
(1995- present) 11 published peer reviewed articles & chapters regarding MAT techniques, technologies and issues.
(1980 – present) 11 peer reviewed articles or chapters regarding ACL repair
Other Publications:
(1991- Present) Presentations at 36 different seminars to informing and instructing other orthopedists regarding MAT developments.
(1980 present) invited to speak at 65 international speaking / instruction seminars presented to other orthopedists regarding ACL reconstruction.
26, Goble, E.M. (1991) Soft Tissue Repair. Management of Complex Fractures / Zimmer –
Sun Valley, ID 08/91
Two presentations regarding MIS TKA technique.
Goble, E.M. (1992) The Arthroscope after TKA. 9th Annual Snowbird Arthritic Hip,
Knee and Shoulder Symposium – Snowbird, UT 1/92
Goble, E.M. (2004) Minimally invasive total knee replacement, Principles and
Technique, Orthop Clin. North AM 2004, 150(4):750-2
Dr. Goble was first introduced to MAT in 1990 when a colleague, Dr. John Garrett of Atlanta Georgia, consulted with Dr. Goble in the possible development of a standard surgical approach to replacement of a native meniscus by a donor meniscus. Conceptually, there were would be many advantages of meniscal transplantation over knee replacement – if a practical and reliable procedure could be developed. A new transplanted meniscus would rejuvenate and protect an otherwise healthy knee joint. It would provide an alternative to a total knee procedure and avoid the limitations it imposes.
To that point, Dr. Garrett had pioneered early MAT transplantation by use of fresh cadaver harvest and transplantation, within 48 hours. However, Dr. Garrett was confronted with the practical difficulty of using fresh meniscal tissue because of issues concerning supply, sizing, disease transmission, and cost.
Dr. Garret presented his early research and development to a group of knee surgeons: Doctors Wjoyts, Stone and Wolf. They accepted the challenge and began their own efforts to develop a practical MAT procedure.
Over the next 10 years, Dr. Goble implanted well over 100 Meniscal Allograft Transplantations. The surgical indications, allograft preparation, sizing, surgical technique and patient results are reported by Dr. Goble in these publications. The research and innovation performed by Doctors Goble, Wjoyts, Stone and Wolf resulted in an effective and practical MAT surgical procedure.
However, the MAT procedure is not widely offered by orthopedists who perform total knees for several reasons. First, the current Meniscal Allograft Transplantation procedure takes over 4 hours, and is very difficult for a surgeon to learn and perform. Second, it is relatively time consuming and expensive compared to alternatives. Last, insurance companies do not reimburse doctors who perform the surgery at a rate which makes the surgery cost effective for regular practice.
The MAT surgery works. For the proper patient it is a superior alternative to a total knee. Although only a few surgeons are trained to perform this procedure, it is available to the educated candidate.
Dr. Goble accepts candidates for Meniscal Allograft Transplantation after referral from a local doctor. He will also accept a candidate who is otherwise sufficiently informed about their options regarding the procedure.
IN 1977 an injured Anterior Cruciate Ligament was rarely reconstructed. Indeed, as resident in Utah Dr. Goble had no knowledge of the function or the treatment of the Anterior Cruciate Ligament, or its injury. His first substantive venture into the knee wasn’t until 1979 when he published an article with doctorial candidate Paul France, called “Simultaneous Quantitation of Knee Ligament Forces” in 1979. This landmark publication in the Journal of Biomechanics was the first quantitative analysis of the then-misunderstood function of the cruciate ligament pair.
In the years immediately thereafter, he completed a sports medicine fellowship at the Slocum Clinic (Eugene, Oregon) and a European fellowship tour in 1982 and 1983.
While studying with Werner Mueller in Basel Switzerland, Dr. Goble imagined his first medical invention. Upon his return, he developed a new devise (and accompanying arthroscopic surgical technique) for reattaching torn ligaments back to their long origins. He applied for a patent in 1984 called a ‘suture anchor’. The “Suture Anchor” has since matured into the single most important arthroscopic implant in Sports Medicine. While primarily developed for use in the knee, variations of the original idea are now used in the repair of major joints throughout the body.
In 1986 Zimmer Inc. hired Dr. Goble to develop a surgical technique for a Prosthetic (nonbiological) Anterior Cruciate Ligament. During this development period (1986-1988) they learned that artificial Anterior Cruciate Ligaments would not consistently survive within the knee for more than one year. Instead, Dr. Goble, together with other researchers, developed a Straight Tunnel Anterior Cruciate Ligament reconstruction surgical technique. This introduced arthroscopic Anterior Cruciate Ligament reconstruction. Today, this same basic technique is still used, with only minor changes, in almost all Anterior Cruciate Ligament reconstruction surgeries.
The development of the Suture Anchor and the Arthroscopic Anterior Cruciate Ligament surgery led the establishment of Medicine Lodge Inc, a sports medicine research and development company, in 1990.
This extant research enterprise has been responsible for the creation of several orthopedic companies, all located (initially) in Logan, Utah.
Alan Chervitz and Wade Fallin, two Georgia Tech engineers co-founded these companies with Dr. Goble. Working through these companies the creation of many ACL implants and surgical techniques would come about over the next 15 years. These patented systems which are currently utilized include:
Of all the above, the Cannulated Interference Screw, co-developed by David McQuire and Dr. Goble, is the most universally utilized. This rigid femoral and tibial implant is used in 65% of Anterior Cruciate Ligament surgeries worldwide.
Dr. Goble has utilized all of the above Anterior Cruciate Ligament systems over the past 30 years.
The development moves forward, on the horizon is yet another new system, called non-rigid Anterior Cruciate Ligament fixation. It is currently still in the development process. This new system, to be released in 2012, will decrease the rate of late occurring degenerative arthritis in Anterior Cruciate Ligament Reconstructed knees.
Total Knee Arthroplasty is a surgical procedure which replaces the weight-bearing surfaces of the knee joint with artificial, implanted surfaces. The surgery reduces pain and disability caused by osteoarthritis.
Minimially invasive, or less invasive arthroplasty is a less physically traumatizing surgery. It utilizes smaller incisions into the knee to place the artificial implants and therefore avoids cutting major muscular and nervous tissues.
HISTORY
In 1992, Dr. E. Marlowe Goble performed the world’s first Minimally Invasive Total Knee Arthroplasty on 79 year-old Ms. West. His novel approach used a small 3-inch lateral incision, instead of the conventional approach which relied upon a 12-15 inch incision on anterior portion of the knee. For the next decade, Dr. Goble worked together with Dr. Richard Caspari to develop a technique and accompanying devices which would allow other doctors to more easily learn the minimally invasive procedure.
The lateral approach, begun by Dr. Goble in 1993 offered the advantage of completelysparing the quadriceps, in particular, the vastus medialis obliquus, as well as branches of the saphenous nerve and the genicular artery. The Minimally Invasive Total Knee Arthroplasty combined established knowledge gained from the long-term success of conventional total knee arthroplasty with the benefits of a less invasive surgical approach.
In 2002, Zimmer, a large orthopedic device company, partnered with Dr. Goble & Doctors Thomas Coon and Alfred Tria to finish development and production of new devices and techniques that would allow other orthopedist to operate using Minimally Invasive Total Knee Arthroplasty known as The Quad Sparing Total Knee. The technique revolutionized the approach to the total knee procedure. Today, minimally invasive, or less invasive knee arthroplasty is common practice among orthopedists.
WHY MINIMALLY INVASIVE TOTAL KNEE
Today, all orthopedic surgeons use either a less invasive or the minimally invasive knee replacement procedures. With the proper technique, the minimally invasive knee surgery has several advantages.
The Quad Sparing Total Knee:
Today, many other surgeons and orthopedic device companies have developed similar techniques since Zimmer released the MIK TKA. However, the surgery and technology developed by Goble, Coon and Alfred has remained relatively unchanged.
Soon, modified implants, robotics and improved visualization systems will advance Minimally Invasive Surgery Total Knee Arthroplasty to increase accuracy of implant placement and further reduce trauma to the surrounding tissues.
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