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Rebuild your body
New technology allows for less recovery time and pain

By CATHY BREITENBUCHER

December 2012

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, thereís a new playbook: Doctors can replace both ligaments in the anterior cruciate bundle and put them in their natural location.

"Weíre 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 ó the surgical table itself.

Itís called the hana table (pictured above), and it allows the operating room staff to maneuver a personís 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 patientís feet and legs.

"We can rotate the leg, drop and raise the leg, turn it in any position we need during surgery ó thatís 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. Itís known as the direct anterior approach.

"Itís 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 youíre 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 ó 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, thatís good news.
 

Pain-Free Physical Therapy

Post-surgical pain can discourage an orthopedic patient from doing the all-important physical therapy thatís needed after an operation.

A device called a continuous peripheral nerve block can be the answer. Itís 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; itís all disposable.

"Weíre 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, thatís 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. 

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.







 

This story ran in the December 2012 issue of: