No Bones About It
Our list of top orthopedists
At least we don’t have hills to climb. If we did, the stress on our skeletal systems would be even greater. But down here in the lowlands, everyday life presents body challenges too, even if it’s from giant potholes in the street. n This year, for our annual “Top Doctors” issue, we have decided to look at a specialty area, orthopedics. Many of us have had personal experiences with them, and all of us have subconsciously cheered them any time we see a Saints or Hornets player clutching an ankle. n An editorial committee, including our medical adviser, Dr. Brobson Lutz, reviewed previous “Top Doctors” lists, asked for recommendations and discussed nominations. No method is foolproof. We concede that we likely left off some worthy names, yet we feel confident that those included are among the best in their profession. We regard this list as a sampling of the top achievers rather than a definite ranking. Consistent with our policies, the selections are those of the editorial department and are not connected with advertising. As it turns out, they are an interesting bunch, as you will discover by reading the profiles. n Take a look, but please, if you read and walk, watch out for those potholes.
A Rare Specialty
Scott Wilson — Orthopedic Oncologist
Dr. Scott Wilson is the lone full-time orthopedic oncologist in the entire state of Louisiana, and his is such a rare specialty that it has taken him a decade to build a practice devoted mainly to the treatment of bone cancer.
“Fortunately, bone tumors and other types of soft-tissue neoplasms occur infrequently, so there is not as much demand for that type of expertise,” says Wilson, an assistant professor and chief of orthopedic oncology at the Tulane University School of Medicine.
About one-third of the patients who do seek Wilson’s help come from Mississippi, which has no full-time osteo-oncologist, and some travel from Mobile, Ala., and the Florida Panhandle to see him.
“Most of what I do is to evaluate people who have unusual lumps and bumps in their arms and legs,” Wilson says.
If the tumor is cancerous or is causing or risking a fracture of the bone, he operates. He often performs reconstructive surgery following the removal of a tumor, using both metal implants and structural allografts, which are segments of cadaver bone that have been donated through a system similar to an organ bank. Wilson and other orthopedic surgeons at Tulane have recently begun using a new kind of implant in some patients who require replacement of a bone segment that is connected to a joint. Called a compress device, it substitutes a spring-loaded connector for the traditional metal rod. “The initial results are very encouraging,” he says.
Born in Geneva, N.Y., Wilson is the son of two research scientists, who had second careers as apple orchard farmers in Upstate New York and Vermont. After graduating from Wake Forest University in North Carolina with degree in biology, Wilson was still unsure about the direction of his own career.
“I decided to spend a summer trying to capture a Peace Corps-type experience, and I volunteered to work in a missionary hospital in Honduras,” he says. “It was a wonderful experience. The chief doctor there, Dr. Marx, was a true inspiration. I remember vividly one night he delivered twins by Caesarian section, and the next morning he delivered a sermon in the native Miskito tongue. I said, ‘If I can find a way to become anywhere near as accomplished and needed as he is, I will have found my calling.’ So that’s what truly motivated me to pursue medicine.”
Wilson earned his medical degree from the Bowman Gray School of Medicine at Wake Forest in 1986. After 10 more years of residencies and fellowships, he landed in New Orleans, where he joined the faculty of Louisiana State University School of Medicine. In September 2000 he was named to dual posts as assistant clinical professor at LSU and a member of the faculty at Tulane.
“I bleed both green and purple,” says Wilson, who is also a surgical consultant at Veterans Administration Medical Center and Charity Hospital.
Wilson, who says his “favorite thing to do is to tell people they don’t have cancer,” sees great promise in the development of new cancer treatments derived from gene therapy, which have the potential to be much more effective than current methods.
“My great hope is that in my lifetime, I will become obsolete and just go back to setting bones,” he says. –Sonya Stinson
The Joint Chief
Chad Millet — Hip and Knee Replacement
A specialist in total joint replacement, Dr. Chad Millet has become the go-to guy for fixing an old hip or knee replacement gone wrong.
“I see a lot of patients that have had joint replacements somewhere else, and those joint replacements have failed or become loose or infected, and then I redo them. That’s really become a big part of my practice,” says Millet, who has been a member of Southern Orthopedic Specialists, one of the oldest orthopedic-practice groups in Louisiana, since 1990.
These surgical revisions are the most challenging type of surgery he does, requiring more planning and more time in the operating room than initial joint replacements. Often the patient has lost a lot of bone in the area of the prosthesis, and Millet has to replace it with allografts, or bone fragments from a cadaver. Millet says the use of allografts in orthopedic surgery is one of the biggest recent developments in the field. Another major advancement is use of minimally invasive techniques, which involves making smaller, more targeted incisions so that patients experience less blood loss, less post-op pain and a quicker recovery.
While his primary surgical practice is at Memorial Medical Center-Baptist Campus, across the street from his office at Southern Orthopedic Specialists, Millet also performs surgery at Pendleton Memorial Methodist and East Jefferson General hospitals. He operates on patients ranging in age from their teens to their 90s.
One of his most satisfying recent cases was a man of about 50 who came from Millet’s hometown of Crowley. The patient had had his hip replaced about 20 years earlier because of a congenital condition, but when the artificial joint had to be removed 10 years later, doctors told him he would never be able to get another one. “So for all those years he had been walking around with a short leg and using a cane,” Millet says. After determining that the man was a good candidate for a new hip after all, Millet put one in, and the patient is now walking without a cane and is “happy as a clam,” he says.
Born in Rayne, Millet grew up in Crowley, where he lived next door to a general surgeon who used to take him on hospital rounds and into the operating room. It was that experience that prompted Millet to go into medicine. After graduating from McNeese State University in Lake Charles, he attended Louisiana State University School of Medicine in New Orleans, receiving his medical degree in 1984. He completed the five-year orthopedic-surgery residency at LSU, then did a one-year fellowship in adult reconstruction and total joint replacement at Johns Hopkins hospital in Baltimore before returning to New Orleans.
At McNeese State, Millet was a quarterback and four-year letterman on the football team, taking the Cowboys to the 1979 Southern Conference championship. The team doctor, himself an orthopedic surgeon, was a major influence on his career.
“He was another one that kind of took me under his wing and helped me decide what I wanted to do,” Millet says. “Orthopedics is one of the only specialties in which your results are really tangible. If something’s broken, you can fix it. If there’s a bad joint, you can replace it. And I liked that.” –S.S.
Minding the Hornets
Deryk Jones — Cell Cartilage and Replacement
Dr. Deryk Jones has accomplished more at age 40 than most people accomplish in a lifetime. He earned his medical degree from Stanford University in 1991 and followed that with an internship in general surgery at Brigham and Women’s Hospital in Boston and a residency in orthopedic surgery at Harvard. Now he practices medicine at Ochsner Clinic Foundation and holds faculty appointments at Tulane at the Institute of Sports Medicine and in bioengineering. He is a pioneer in cell cartilage regeneration and is one of the few doctors in the area, if not the country, who can perform this complex procedure. Suppose a basketball player has ripped the cartilage in his knee on a really impressive hook shot and Jones is his team doctor. Instead of cutting open the knee and trying to repair the damage, Jones takes cells from healthy cartilage, lets them populate in liquid form, and then injects these new cells into the defective knee where they grow to create new cartilage.
This is no easy task. “It’s a tough thing to regenerate a normal biological process that God has created,” says Jones. For injured athletes, this process could mean the difference between being in the game or sitting on the bench for good. Appropriately, Jones is team doctor for the New Orleans Hornets, along with Dr. Matthew McQueen, which means that he gets to attend to all home games (being brilliant has its perks). He also evaluates potential draftees to determine if they can take the pounding of the usual 80 games in the NBA regular season.
Jones is an athlete himself, having played college and European soccer, as well as football and baseball. His own knee injury in 1979 inspired his interest in sports medicine, and the University of Pittsburgh gave him the exposure and opportunity to develop the professional expertise. “They were doing cutting-edge, state-of-the-art arthroscopic stuff,” says Jones. During his fellowship in Pittsburgh, he worked on professional athletes, college athletes and celebrities.
He was born in Detroit but grew up in Tallahassee, Fla., where his father made sure he received the best possible education. “My dad took me to a dark room, and this man came out of a closet and said, ‘Take this test,’ ” Jones says. As it turns out, the test was an entrance exam for a private school in Tallahassee, where he was the first black student to be admitted. “Being the first black in school was tough,” he says. “I definitely socially suffered … but it pushed me to do well and taught me to thrive in any environment,” especially the South. New Orleans is his environment now, a home deliberately chosen in part because of its proximity to Tallahassee. Putting New Orleans on the map when it comes to sports medicine keeps Jones busy. He also plans to make Ochsner a state-of-the-art facility, not only for sports medicine, but as a place for athletes to exercise and work on their game. Other than that, Jones says, he plans to spend time with his wife and three children and play golf. –Kim Belchere
Making Recovery Faster
Henry Louis Eiserloh III — Back Specialist
We have evolution to thank for our back pain. Our spines were made for walking on four legs, not two; it is as if our genes are working from an old blueprint of our distant past. Obesity, bad posture and injury are culprits, too, so evolution is not entirely to blame, but it may account for the fact that modern-day back doctors face similar problems to those that Hippocrates faced in 430 B.C. A certain amount of back pain may be the price we pay for standing on our hind legs.
Dr. Henry Louis Eiserloh III is one person we should thank for helping us get rid of the pain. A native New Orleanian and LSU alumnus, Eiserloh now practices at Southern Orthopedic Specialists. He credits his breadth of knowledge and training as a back specialist to a fellowship at the University of British Columbia. There, he received training in both neurosurgical and orthopedic spinal procedures, was able to undertake clinical research and, as he says, “do some basic science.” This training was more comprehensive than the more specialized approach common in the United States. “I felt that it was a natural fit,” Eiserloh says.
Asked to give the pros and cons of back surgery, which seems to be risky business, Eiserloh says, “Just treating low back pain with spinal surgery does not provide for an adequate outcome, and just because non-operative treatment hasn’t worked, it doesn’t mean a surgery will improve a patient.” He also says that patient selection is the most important factor in successful spinal surgery. He holds out arthroplasty surgery as a significant development. Arthroplasty is the implantation of prosthetics to replace damaged discs. Another important development is minimal-access lumbar surgery, which entails smaller incisions when fusing damaged vertebrae together. This, along with disc arthroplasty, “provides for faster patient recovery and theoretical clinical improvement.” As far as chiropractic medicine goes, “I do feel that it can provide relief for some conditions,” Eiserloh says. “It is better to work in conjunction with a chiropractor than in an antagonistic role with them.”
Having the expertise and training is, of course, critical to being a top doctor. But some things, such as kindness and compassion, just cannot be taught. These are attributes Eiserloh seems to have in abundance. His family doctors, Dr. Lawrence Boll and Dr. Sam Zurich, were his inspirations. Eiserloh has tried to emulate their kindness and compassion in his career. He says that his greatest passion is his family.
What lies ahead for Dr. Eiserloh and Southern Orthopedic Specialists? “In the future, we would like to add additional spine surgeons to our group in an attempt to develop a more multidisciplinary spine approach,” he says. Asked if he ever wanted to be anything other than a doctor, Eiserloh replies, “I can’t recall, other than maybe when I was a ‘fireman’ or ‘cowboy,’ as a child.” –K.B.