MDNews - Mid Hudson

"We are all focused on getting patients moving and out the door as soon as possible," says Nicholas J. Renaldo, MD, orthopedic spine surgeon, Orthopedic Associates of Dutchess County. "Our goal is independence and high quality of life for all our patients. That mission is evident in everybody who cares for orthopedic patients at Vassar Brothers Medical Center." Technology at Their Fingertips The operating rooms have equipment and technology specifically geared for orthopedic surgery, an advantage that makes VBMC the right choice for Dr. Renaldo. "Vassar Brothers Medical Center offers the capability to perform hundreds of spinal surgeries a year with specialized instrumentation and tables," he says. "In the last year, we acquired the equipment to use intraoperative X-rays and microscopy to guide our procedures." Another advanced technology available for spine surgery at VBMC, the BoneScalpel uses ultrasonic waves to make precise bone cuts while sparing nearby soft tissues. The .5-millimeter blade permits exact straight or curved cuts, allowing for greater accuracy and speed. Combined with microscopic visualization of the spine, Dr. Renaldo says, this technology helps surgeons perform spinal procedures with shorter operating times and less pain. A hana surgical table offers surgeons the opportunity to position patients' legs separately during hip replacement surgery, making anterior hip replacements easier and allowing for reduced muscle trauma. Finally, technologies and procedures for infection control help ensure orthopedic patient safety at VBMC. Presurgical testing for infections, such as methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA), combined with rigorous preoperative decolonization treatment and continuous monitoring after surgery, help keep patients safe. Even the private patient rooms have a safety aspect. They help reduce the spread of infection. Care starts with a Consult V BMC o r t h o p e d ic p h y s ic i a n s suggest thoughtful, conservative management — in consultation with an orthopedic specialist when necessary — as the first line of defense against joint pain. "If the primary care provider is comfortable with his or her diagnosis, such as arthritis, and comfortable administering nonoperative treatment, including non-steroidal anti-inflammatory drugs [NSAIDs], physical therapy or injections, we welcome that," Dr. Stamer says. "If this is not something normally done, then the physician should feel free to refer patients, even those in the early stages of joint pain. In other cases, a referral makes sense if the patient has not responded to medical management and physical therapy." When it comes to spine problems, primary care providers should consider swifter referrals in certain cases, Dr. Renaldo says. "Most cases of spine pain are muscular and benign and can be treated with physical therapy or NSAIDs," he says. "But when there has been an injury, such as a fall or a car accident, the patient should be sent for evaluation and X-rays. Likewise, significant arm or leg pain associated with neck or back pain may indicate nerve involvement. That also warrants assessment for herniated disc or spinal stenosis." Whatever the diagnosis, providers caring for patients who have other conditions in addition to bone and joint problems should consider VBMC for their patients' joint replacement surgery. While most joint replacement surgeries are uneventful, VBMC offers access to a host of highly qualified specialists, including anesthesiologists, cardiologists and pulmonologists, should any emergency arise. A Circle of Care For patients scheduled to undergo joint replacement surgery and members of the public deciding whether joint replacement is a reasonable option for them, VBMC offers a preoperative class staffed by nurses, physical and occupational therapists, and case managers from the orthopedic team. These professionals have firsthand experience in caring for patients after joint replacement surgery and can answer any relevant questions. The class touches on practical topics, such as adaptive equipment, pain management, medications and side effects. Preoperative planning also takes place, nicholas J. Renaldo, mD, spine surgeon, reviews an mRi scan of a spine. MDNEWs.COM ■ MD News Mid Hudson |7

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