Orthopedics, the branch of medicine concerned with diseases, injuries, and conditions of the musculoskeletal system, is one medical discipline widely represented in the Greater New Orleans areas. Physicians and other medical specialists tend to various conditions relating to the body’s muscles and skeleton – including the joints, ligaments, tendons and nerves.
Many of New Orleans’ orthopedists are busier than ever, due to injuries sustained during the process of rebuilding. The increase in extreme physical activity has led to a number of falls, incidents using tools and other accident-related injuries.
Diagnostics, treatment and disease management in orthopedics have taken giant steps toward alleviating or successfully treating a variety of conditions. Among the greatest advances is the emergence of arthroscopic surgery, allowing an orthopedic surgeon to make a small incision in the patient’s skin, insert a pencil-sized instrument with a small lens and lighting system and then magnify and illuminate the structures inside the joint.
Total Joint Replacement
Still, many patients are undergoing procedures that replace entire joints. At East Jefferson General Hospital, (EJGH), an entire program is in place to treat individuals requiring joint replacement surgery.
“We have a program that has been a big success,” says Laurie Norman, R.N. certified in orthopedics. “We have a patient-centered focus, in which we educate the patient and family members about surgery and rehabilitation, and we try to address all questions along the way.”
The skilled nursing staff at EJGH works with and counsels patients throughout the process, and therapy continues even after the patient goes home.
“We found there was a huge need for patients who are finished with their therapy, usually after about eight weeks,” Norman says. “They were not always sure what to do in terms of exercise, so we have a new program at our wellness center, free for the first month. They can do either warm water pool exercises or land-based exercises that get them moving, meeting new people and seeing other joint patients. Our goal is to help them with strength and mobility. We are working primarily with replacement of hips and knees, although we also do some minimally invasive partial joint replacement surgery.”
As for the post-Katrina environment, Norman says there has been a high incidence of hip and other fractures. EJGH has also met the needs of those who are going to go home to trailers. Personnel work with each patient’s specific home needs, teaching patients how to use ramps, steps, bathrooms and more.
“We have a whole house built in which we teach patients how to maneuver bedrooms, kitchens and even how to get in a car,” Norman says. “We also have different types of flooring, tubs and showers the patient might have.
Norman and the staff at EJGH conduct classes for patients who will undergo joint replacement surgery. For more information, visit www.EJGH.org. On the home page, click on “Classes and Education.”
Rapid Medical Advances
The business of orthopedics has advanced at breakneck speed in recent years, according to Fernando L. Sanchez, MD, an orthopedist with Westside Orthopaedic Clinic.
“The joint replacement industry has changed a lot in the past three years,” Sanchez says. “Today we are using what are called alternative bearing surfaces, which represents new technology. In the past plastic was the limiting factor of these implants. In time, the plastic would fail or wear out. Now there are alternatives made of metal, or metal on ceramic, and a new frontier plastic called cross linking plastic.”
The main goal of the new materials, according to Sanchez, is simply to make them last longer. Initially, the focus was on design features that would help the joint move better. Today that focus has been broadened to include use of materials that will endure.
“When it comes to knee replacement, the newest technique is intra-operative pain management,” Sanchez says. “That involves using medication ‘cocktails,’ a combination of pain meds and anti-inflammatories. Before the surgery, the patient is injected with a combination that is intended to decrease pain after surgery. During the past two years, especially, our focus has been on making these procedures less painful.”
The doctors at Westside Orthopaedic Clinic, who operate at West Jefferson Medical Center, are also using a new technology called Sonocur ®. This is a medical device used to treat and relieve the pain associated with soft tissue conditions like tendonitis and heel spur. This Extracorporeal Shock Wave Therapy System has provided pain relief in up to 90 percent of the patients treated in European health centers and is now available here in New Orleans. Unlike other therapies, the low energy Sonocur treatment does not require a hospital stay or visit, invasive surgery or anesthesia.
The team at Westside Orthopaedic also includes Chris DiGrado, MD, MBA; David Kessler, MD; and Ralph P. Katz, MD. For more information, visitwww.westsideortho.com.
Pain Relief Footwear
Sometimes, relief of pain in the joints is as simple as finding the correct footwear. Enter Dr. Theodore Kurz, a Metairie-based chiropractor and New Orleans native, who has introduced Z-Coil pain relief footwear to this area.
“Z-Coil is impact reduction footwear that absorbs 50 percent of your foot shock every time your foot hits the ground,” Kurz says. “It has a full one-inch high density neoprene toe cushion. This helps reduce impact in ankles, knees and backs.”
Z-Coil started in Albuquerque, N.M., Kurz says, and went through 12 years in the design phase. “As a chiropractor who has spent 30 years treating patients, I find Z-Coil, due to its impact reduction, prevents problems I have spent all of these years treating.”
A large part of Kurz’s practice focuses on nutrition and treatment of muscular skeletal disorders.
For more information about Z-Coil pain relief footwear, visit zcoil.com.
The Conservative Approach
Dr. Alexis Waguespack is a fellowship trained spine specialist, providing treatment of cervical, thoracic and lumber spinal disorders and trauma, including herniated discs, spinal stenosis (pinched nerve), tumors and infection. She also treats adult scoliosis and osteoporotic fractures. “I try things conservatively, not operatively, but if surgery is necessary I do minimally invasive procedures,” says Waguespack. “For osteoporatic fractures, we use kyphoplasty procedures, where we inject cement into the bone, which restores height and strength and gives immediate pain relief. It also allows patients to stand and walk again.”
Waguespack is starting her own medical group, where she will continue to offer various types of injections and share space with a pain management physician. Waguespack is a board certified orthopedic surgeon and member of the North American Spine Society, Cervical Spine Research Society and the American Academy of Orthopedic Surgeons.
Waguespack maintains two offices in the metropolitan New Orleans area to serve the needs of her patients. Her East Bank Office is located on the I-10 Service Road North at the corner of Lake Villa Drive. Her West Bank office is located in the Meadowcrest Professional Building next to Ochsner Medical Center on the West Bank.
For more information, call (504) 887-7207.