MDNews - Minnesota

between living with pain or undergoing joint replacement. Today, Dr. Jewison is able to offer options that reduce joint pain and can foresta ll surger y, a llow for better surgical outcomes, or prevent surgery altogether. " U ltra sound-g uided or thobiolog ic injections are an effective adjunct to physica l therapy," Dr. Jew ison says. "These injections decrease joint pain, which allows patients to take the neces- sary actions to avoid surgery." ORTHOBIOLOGIC INJECTIONS: A CLOSER LOOK "A patient's preferences, age and a variety of other factors play into the decision- making process when we recommend a course of treatment for joint pain," Dr. Jewison says. "Depending on those factors, we can recommend orthobiologic technologies and techniques that use a patient's own blood and stem cells to help restore cartilage and other tissues that are damaged." Comprehensive Collaboration THE UNI V ER SIT Y OF MINNE SOTA HE A LTH Cartilage Restoration and Joint Preservation Program utilizes a team approach to handling patient cases. Key members include orthopedic surgeons, sports medicine physicians, physical therapists, researchers and other individuals on the clinical staff. Together, they make sure that the complexities of each patient's condition are properly considered and addressed. Members meet monthly to discuss program development, operations and individual patient cases. Physicians also review protocols with physical therapists and assess enrollment and outcomes of research studies. After patients are assessed and it is determined they are a good fit for the program, the staff works diligently to gather records, images and reports from surgeries and imaging studies that patients may have undergone prior to visiting University of Minnesota Health locations. The program makes use of EHRs and patient-provided materials that can be imported into the University of Minnesota Health system for a comprehensive record. If necessary, providers can reach out to patients' prior or current physicians for additional resources. Much of this material is acquired in advance so that patients can receive timely diagnoses and treatment plans. By accessing records and coordinating with other providers, the University of Minnesota Health team can effectively treat patients in a convenient fashion, no matter where they live. "We have a concierge component to our program that is very important," says Bradley J. Nelson, MD, University of Minnesota Health orthopedic surgeon. "Many patients come from out of state. We have an athletic trainer who serves as a concierge that can coordinate visits, postoperative care and rehabilitation with facilities nearer to patients' homes so they don't have to travel out of state as often following treatment." " People should keep their joints as long as they can. Joint replacement is such a life-changing endeavor and may require follow-up surgery once the replacement wears out. We only want people to go through joint replacement if it can't be avoided. If it can be avoided, that's even better." — JEFFREY A. MACALENA, ORTHOPEDIC SURGEON WITH UNIVERSITY OF MINNESOTA HEALTH Patients with joint injuries or cartilage wear may be candidates for orthobiologic injections. These injections can augment a patient's recovery after surgery or be used before surgery to aid with pain manage- ment and physical therapy regimens. Orthobiologic injections of stem cells or platelet-rich plasma (PRP) can help decrease inf la mmation a nd improve function. These injections are a new and evolving alternative to corticosteroid injections (cortisone) that may promote healing of damaged structures. Research is still under way to fully understand the efficacy of these therapies in repairing damaged joints. Regardless of whether or not damage is reversed, there is evidence that PR P a nd stem cell injections can decrease joint pain for patients who are pursuing physical therapy or undertaking a weight-loss pro- gram. At University of Minnesota Health, Elizabeth Niemuth, PT, DPT, OCS, and Shannon Kelly, PT, DPT, OCS, work with a patient. M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 018 0 7

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