MDNews - Mid Hudson

Cover Feature the Orthopedic Center of Excellence team at Vassar Brothers medical Center recently achieved a Five-star Rating for total hip Replacement 2013 by healthgrades. "Patients no longer have to leave the Hudson Valley for optimal orthopedic care — it's right here in our own backyard at Vassar Brothers Medical Center." — Frank t. Lombardo, mD, orthopedic surgeon and joint replacement specialist, Orthopedic associates of Dutchess County had previous hip surgery, are not morbidly obese and are interested in faster recovery, anterior-approach hip replacement is an excellent choice, says Dr. Lombardo. "This is a newer approach that spares muscle and reduces the chance of dislocation in the hip joint," Dr. Lombardo says. "Recovery times are faster, and the patient experiences less trauma." When a patient has not had success with a hip replacement surgery — when an infection has occurred, for example — revision surgery may be necessary. In these cases, VBMC offers multiple advantages, including equipment specifically designed for revision surgeries, Dr. Lombardo says. "Vassar Brothers Medical Center has made a large investment in capital," Dr. Lombardo says. "We have a bone bank with bone stock to use during revision surgery. We also have an appropriately trained support staff. Some revision surgeries are prolonged and require ICU care afterward, so we have a team of anesthesiologists and 10 | Mid Hudson MD News ■ MDNEWs.COM other operating room staff who are familiar with revision surgery." Complicated spine surgery with Minimal Trauma Using the advanced instrumentation at VBMC, surgeons perform spinal surgeries weekly. Among the most common of these are microdiscectomy for herniated discs in the lower back that cause sciatica. This procedure may be performed emergently or on an elective basis for patients who have not benefitted from conservative management of sciatic nerve pain. During a microdiscectomy, which takes no more than an hour, the surgeon uses microscopic and X-ray guidance to visualize the lower spine. "I use tubular retractors to spare the soft tissues," Dr. Renaldo says. "The surgical incision is usually less than 1 inch in length." After removing bone spurs, disc fragments and some tissues and nerves, the surgeon repairs the small wound with buried sutures, allowing the patient to return home the same day and even shower normally. "Patients typically experience a significant amount of pain relief immediately following surgery," Dr. Renaldo says. "In spine surgery, we are moving toward more minimally invasive, motion-sparing approaches to treating herniated discs while avoiding spine fusion." The Minimal-Minimals Joint procedures need not always mean surgery. When considering referral to an orthopedic specialist, referring physicians and their patients should keep in mind that non-replacement techniques have advanced just as quickly as joint replacement during the past years. Using both common and innovative solutions, orthopedists at VBMC help the majority of joint pain patients with the least invasive measures possible. Knee arthroscopy now captures very high-resolution images that allow physicians to diagnose conditions as well as remove torn or damaged cartilage and bone fragments. Microsurgeries through arthroscopy may help people with joint damage avoid major surgery. Injectable supplements for joint fluid, such as Euflexxa, can decrease pain and increase function and mobility in people with osteoarthritis, Dr. Stamer says. "While the FDA has only approved these supplements for knees, they should work with any arthritic joint," he adds. Fortunately, whatever the orthopedic condition, VBMC offers the team, technolog y and skill necessary to provide excellent care and increase patients' mobility, independence and quality of life. For more information or to refer a patient, please visit www.health-quest.org/ortho. ■

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