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Orthopedics Opener
Not to brag (too much), but our bodies are— in a word—incredible. What else can you count on to carry you around for some 80- or 90-odd years? But just like a trusted vehicle, our bodies need replacement parts and patching up every now and again. For those oops moments, orthopedic clinics are at the ready with specialists for everything from feet and hands to knees, hips, and spines.
Not Solely Surgery
Despite orthopedics’ reputation for surgery-only care, nonsurgical treatments are a first course of action for most conditions, says Dr. Robert Anderson, hand surgeon and president of Summit Orthopedics. “We have a robust regenerative medicine group of doctors who use advanced technologies and techniques, including stem cell treatments,” he says, “our goal being to make surgery one of the last options and not always the first or only option.”
Road Map for Recovery
Both avenues of orthopedic care—physician referral or straight to an ortho clinic— lead to the same destination. “Generally, if it is a more long-standing or chronic issue, checking with a primary care provider who you know and trust can be a great place to start,” says Dr. Robby Bershow, an orthopedic specialist at Allina Health.
For those slips and falls, sports injuries, and other moments when you think you might need orthopedic care, clinics have developed orthopedic urgent care.
State of Emergency
We’ve all had our fair share of midafternoon (or late-night) urgent care visits. But how do we know if we should go to orthopedic urgent care or the emergency room?
“Complex situations like fractures where the skin has been breached or there is a large soft tissue component” necessitate an emergency room visit, Anderson says. “Also, large joint dislocations, like shoulders or hips, almost always require hospital assistance.” But, if you’re playing eenie-meenie, give your ortho clinic a call and they can help point you in the right direction.
Good Sportsmanship
For soccer-induced fractures, stretch-inflicted strains, and other exercise-related injuries, we wondered, will any orthopedic specialist do? Sports medicine orthopedic surgeons still deal in the orthopedic realm (the musculoskeletal system), but for athletes instead of the general population, says Dr. Kelechi Okoroha, an orthopedic surgeon at Mayo Clinic Orthopedics and Sports Medicine. “Conditions treated usually involve injury to muscle, tendons, or ligaments, which can be subsequently repaired or reconstructed, when necessary.”
DYK?
A far majority of orthopedic care is nonsurgical.
”Most people are surprised that we advocate for conservative management of even complex problems. Surgery is rarely the only option. We pride ourselves in believing we can get to a shared decision on the best treatment options—surprisingly, it’s not surgical the majority of the time.” —Dr. Robert Anderson, Summit Orthopedics
Big Swells
Did anyone else noticed the you-size dent in the sofa becoming more pronounced over the last year? With our main hobby of staying home and the nippy winter temps discouraging any kind of movement, our bodies have become “deconditioned,” Bershow says. This is a result of not keeping up with dedicated exercise and the decrease in general daily life activity since the beginning of the pandemic.
With these factors colliding, orthopedic clinics are seeing a rise in overuse (or just use) injuries. “As [people] have started to return to activity,” Bershow says, “sometimes their bodies are not used to the loads or demands that are being placed on them, and that can be a recipe for overuse injuries. This can mean muscle strains, joint tightness, [and] tendinitis or tendinosis injuries in really any body part, as well as exacerbation of underlying osteoarthritis in the knees, hips, shoulders, and spine.”
While a jump in exercise is good, it can lead to problems from hopping in too quickly—oh, the irony. Summit’s orthopedic clinics are seeing more patients in the over-40 group, Anderson says, because of injuries from seeking healthier and more active lifestyles. “COVID has also seemed to add a few pounds here and there, and finally there has been a big push to drop those,” he says. “Unfortunately, this jump in exercise had the unwanted effect of more and more injuries. Whether it’s from a fall, sporting injury, or overtraining, this feels like the largest single group seeking our services.”
Pioneering Procedures
In the thick of the tech age, it’s only fitting that AI and robots are entering the operating room. It seems like something out of a sci-fi scene, but, Okoroha says, artificial intelligence is helping doctors predict injury patterns, evaluate patient outcomes, and interpret advanced imaging. Besides these features, he says, “there have been great strides in the realm of robotic-assisted surgery in fields of joint reconstruction and minimally invasive spine surgery.”
We’re throwing out the old adage “No pain, no gain.” Large strides in pain management and surgery methods mean, Okoroha says, that “some surgeries are able to be performed without prescription of any opioids.”
Chronic pain sufferers, this one’s for you! For conditions like tennis elbow, hip bursitis, plantar fasciitis, and knee arthritis, Bershow says, Allina is tapping regenerative medicine, sometimes called platelet-rich plasma treatment or stem cell therapy, which builds off the body’s “healing potential.” “We take some of the body’s own cells and inject them into the site of the injury to jumpstart a healing process.”
More information is needed on harnessing the treatments, but the framework is there. “Our hope is that someday we may be able to help the body repair its own injured tissue and address the root cause of pain, rather than treating the end result with surgery or pain-control medications.”
Back Basics
We’ve all had the uff da moment where we lift, bend, or just tweak, and our backs pay the price. Just like other joints, our spines are prone to injury, strain, stress, and degeneration.
Up to 90 percent of people will have an episode of severe, limiting back pain in their lives, says Dr. Todd Jackman of Midwest Spine and Brain Institute. Lucky for us, most people’s pain improves by leaps and bounds in the first six weeks with religious icing and heat, plus stretching and some mild medication. If the pain or muscle weakness continues or worsens, Jackman says, that’s the point when a spine surgery consultation is on the table.
“I am very aware that there are two frightening words in my office: spine surgery,” he says. “Knowledge and understanding are so vital to managing the concerns and embracing the hope surgery can provide.”
The goal is, of course, to have the best outcome in the safest and least invasive way. New additions like “robotic spine surgery, technological advances in imaging in the operating room, and newer, less invasive methods to treat pathologies” are helping patients recover faster and more fully, Jackman says.
This article originally appeared in the August 2021 issue of Mpls.St.Paul Magazine.
