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Joint Efforts

SPECIAL ADVERTISING SECTION | New developments in orthopedics are improving care and outcomes for Minnesotans with hip, knee, and spine issues.

Mayo Clinic rendering

When Mayo Clinic moves into downtown Minneapolis next year—the largest expansion of the Rochester-based health care facility in the Twin Cities metro so far—it will not only light up the long-declining Block E, it will also change the landscape of Twin Cities orthopedic care. Newly minted as Mayo Clinic Square, the first-of-its-kind facility will feature a clinic, practice basketball courts, and a workout area connected to the Target Center that caters to Mayo’s new partners, the Minnesota Timberwolves and Minnesota Lynx.

But you don’t have to be Kevin Love or Lindsay Whalen to use the shiny new center. All services at the 20,000-square-foot facility, including sports injury treatment and rehabilitation, injury prevention, performance solution programs, and sports-specific skill programs, will be available to the public.

“We want to apply the same strategies we use for the conditioning, training, and rehabilitation of these athletes to make a difference for the 70 percent of Americans who are overweight, inactive, and suffering the ill effects of a sedentary lifestyle,” says Dr. Edward Laskowski, co-director of the Mayo Clinic Sports Medicine Center and professor in the department of physical medicine and rehabilitation at Mayo. “Whether you are a weekend warrior, an elite school-age or professional athlete, or someone just starting to think about improving their conditioning, we want to help you achieve your fitness goals.”

But just as anyone can train like an athlete, anyone can get injured like an athlete. Here, with the help of the already-robust Twin Cities orthopedic community, we look at the joints most often in need of orthopedic attention, plus new medical developments available—even if the name “Love,” “Whalen,” or “Mauer” isn’t emblazoned on your back.

Hips

According to Dr. Gary Wyard at Twin Cities Orthopedics, there are about 400,000 total hip replacements done each year for osteoarthritis, aka “wear and tear” arthritis, which affects joints such as hips and knees.

With the number of hip replacements expected to triple over the next 15 years, due in part to aging baby boomers, orthopedists are constantly working to improve treatments and recovery time for patients.

For example, hip impingements—which can cause tears due to a person having too much bone on the femur or the pelvic cup that holds the femur—can now be treated with minimally invasive hip arthroscopy. “Today, MRI scans are so good that we can see those tears,” says Dr. Jack Drogt, president of Summit Orthopedics. “In the past, imaging a tear was not possible.

“Also, correcting hip impingements previously required us to dislocate the patient’s hip in a significant, invasive procedure. With today’s technology, we have much less invasive surgical options to offer these patients.”

Another advancement comes in the way orthopedists approach total hip replacements. The direct anterior method is a muscle-sparing alternative to traditional hip replacement surgery in which the surgeon works between the patient’s muscles and tissue without detaching them from the hip or thighbones, sparing the tissue from trauma. This provides patients “the potential for more initial strength after surgery, less post-operative pain, faster recovery, and increased ease performing activities like getting out of bed, putting on socks and shoes, and going up and down stairs,” Drogt says.

Knees

Typically the result of arthritis, total knee replacement surgery involves the replacement of damaged bones and joints with metal, plastic, or ceramic components. But new, more organic materials are on the horizon. At Twin Cities Orthopedics, for example, Wyard and his team are “working with more biological versus mechanical approaches” to repairing wear and tear on the knees, such as cartilage transplants in which a person’s own cartilage is used to repair the damaged joint.

Some surgeons are even tailoring knee implants to individual patients, making for a perfect fit. For example, at HealthEast Acute Care Hospitals, “surgeons use customized knee implants designed and created using only your measurements,” says nurse Jaci Krech.

These advancements are crucial to patient recovery. But even recovery itself has been revolutionized, with greater responsibility placed on the patient. In addition to pre-op classes that teach each patient what to expect post-surgery, post-op check-ins encourage patients to stay on track and follow their exercise plans, without which recovery time would dramatically increase.

Spine

The result of new medical developments and procedures for correcting spine issues (that cannot be resolved with nonsurgical treatments) is better surgery. “[Many] are aimed at decreasing muscle disruption during surgical procedures using minimally invasive techniques,” says Dr. Glenn Buttermann of Midwest Spine Institute. “For example, one minimally invasive spine surgery involves a short incision instead of a long incision, so it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.”

One year post-op, patients who underwent muscle-sparing procedures had improved outcomes and less muscle damage compared to those who experienced a conventional procedure, according to two recently published studies Buttermann has been a part of.

Minimally invasive techniques may also be more affordable. It depends on each individual surgeon and surgery, but because these procedures call for less recovery time, and therefore a shorter hospital stay, less invasive procedures may decrease the cost of treatment.

Motion preservation technology is another recent surgical development. This procedure replaces afflicted spinal discs—pads of tissue between each vertebra—while helping a patient maintain normal spine motion. Artificial disc replacement, for example, “is a motion-preserving spine surgery used to replace a disc that has been worn, damaged, or diagnosed with a degenerative disease as a cause of back pain,” Buttermann says. “Because one of the goals of artificial discs is motion, patients often experience a faster return to activities, although at a gradual progression.”

Doctors’ Orders

Six tips to maintain musculoskeletal health—from the pros.

“Stretch before and after exercise.”
Dr. Kirk Aadalen, TRIA Orthopaedic Center

“Elderly patients need to be sure to take adequate vitamin D, especially in our climate zone.”
Dr. Glenn Buttermann, Midwest Spine Institute

“Always begin a sport with the best technique possible for that sport or activity. It is worth the time to establish good foundational technique.”
Dr. Edward Laskowski, Mayo Clinic

“Maintain a healthy weight and a nutritious diet. Staying trim reduces the force we place on our joints.”
Dr. Jack Drogt, Summit Orthopedics

“Walking for a minimum of 10 to 15 minutes is better than being stationary all day.”
Dr. Jamy Antoine, Minnesota Disc Institute

“Don’t smoke!”
Dr. Gary Wyard, Twin Cities Orthopedics



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