Study
after study touts the benefits of an active lifestyle. But injuries
happen. Joints wear out. Our aching and aging bodies beg for help.
Technology to the rescue! Read on to learn about new ways to treat
orthopedic cases.
Restoring the
Knee
A torn ACL used
to derail an athlete for months, or even mark the end of a competitive
career. Surgeons would replace one ligament and sometimes remove a
portion of bone. The procedure succeeded, but arthritis was almost
sure to follow in five to 10 years.
Now, there’s a
new playbook: Doctors can replace both ligaments in the anterior
cruciate bundle and put them in their natural location.
"We’re
basically restoring the knee to its normal state," says Dr. Brian
A. McCarty, sports medicine surgeon at Midwest Orthopedic Specialty
Hospital.
The key to the
new method is smaller arthroscopic surgical instruments, developed by
McCarty. The procedure requires just a small incision near the top of
the shin bone and three "pokes" on the front of the knee.
Two "buttons" are attached to the outside of the bone to
secure the ligaments in place while they heal.
"The idea
is it will last a lifetime," McCarty says.
Hip Surgery
Relief
The next big
thing in surgery really is big — the surgical table itself.
It’s called
the hana table (pictured above), and it allows the operating room
staff to maneuver a person’s legs into position for a new type of
hip replacement surgery. What makes it all work is a set of what look
like ski boots and hinged braces to hold the patient’s feet and
legs.
"We can
rotate the leg, drop and raise the leg, turn it in any position we
need during surgery — that’s the advantage," says Dr. Bruce
Faure, joint replacement specialist at Aurora Advanced Orthopaedics.
Previously, a
patient was placed on his or her side for surgery, and muscles had to
be cut to allow access to the hip socket. With the hana table, the
patient is on his or her back. As the leg is manipulated, the muscles
separate just enough for the surgeon to reach the joint. It’s known
as the direct anterior approach.
"It’s
only a matter of 1 to 1-1/2 inches from a traditional hip approach,
but it makes all the difference in the world, because you’re going
between two major muscle planes and not through them," Faure
says.
Hospital stays
are shorter, and patients can plan on four to six weeks of recovery
— about half of the previous time. For aging baby boomers who are
expected to cause a five-fold increase in joint replacement in the
next 10 years, that’s good news.
Pain-Free
Physical Therapy
Post-surgical
pain can discourage an orthopedic patient from doing the all-important
physical therapy that’s needed after an operation.
A device called
a continuous peripheral nerve block can be the answer. It’s a way to
deliver a low dose of numbing medicine right to the nerve near the
surgical area. One version of this pain pump is the ON-Q, manufactured
by Kimberly-Clark Health Care.
During surgery,
a small tube is placed under the skin and attached to a pump and a
portable, softball-size pouch of non-narcotic medicine. Patients
adjust the amount of medicine they receive. After three days, the
patient removes the catheter and pump; it’s all disposable.
"We’re
breaking the whole pain cycle," says Dr. Mark Zimmerman,
anesthesiologist at Midwest Orthopedic Specialty Hospital, where a
study showed patients using the pumps need less pain management and
sleep better following surgery.
The newest use
of the pump involves blocking the saphenous nerve in the upper thigh
for patients having total knee replacement or ACL surgery. According
to Zimmerman, that’s better than blocking the femoral nerve (in the
groin) because it preserves strength in the quadriceps muscle.
"This is
the way to get patients up and moving after surgery," says
Zimmerman.
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On
the web
For more
on orthopedic care, go to our website mmagazinemilwaukee.com and
see how Froedtert & The Medical College of Wisconsin Sports
Medicine Center is helping athletes of all abilities with their
orthopedic problems. The center focuses on a team approach so
patients can be treated for their injuries in one location. |