Gateway’s orthopedists use medications, therapy, more to minimize surgery

By ALAN J. ORTBALS
    At Gateway Regional Medical Center’s Bone and Joint Center, the emphasis is on minimizing the use of surgery as a remedy.
    “There are more things you can do today to solve problems without resorting to surgery,” said Dr. Peter Anderson, M.D., who started the department 21 years ago and leads it today. “The diagnostics tests are much better than they used to be so now we can identify the problems sooner. If you have a labial tear of the hip, we can get in there, scope it and fix it maybe before you need a hip replacement. We have hyaluronic acid — not just cortisone — for injections in knees. We try to keep them mobile and going without surgery for long as we can.”
    There are four orthopedists in the practice including Anderson. Dr. James Sola, M.D. joined the group in 2000. The others are Dr. Timothy Penn, M.D. and Dr. Paul Scherer, M.D. These board-certified orthopedic surgeons from Illinois Southwest Orthopedics have more than 100 years of experience between them. Three of them trained at the Mayo Clinic. Gateway’s surgeons and nurse managers hand-selected the top nurses with the most orthopedic experience and best skills to work on the Bone and Joint team. They received special training and average 20 years of experience. And its physical therapists specialize in post-operative hip and knee replacement therapy and have an average of 15 years of experience.
    “I think that the focus of our practice, from when I started, has always been that surgery is the last option,” Sola said. “Surgery is only what is done when other options have not been successful. There are obviously certain exceptions. When patients have traumatic injuries, surgery is often the first. If you break a leg and have a bone sticking out we are not going to send you to therapy and give you some Motrin, we are going to operate.”
    Sola said that medications, therapy, braces and injections are all options for non-surgical treatment. And, people can reduce their need for even those by stretching, exercising and staying fit. But, some people put off seeing a doctor because they assume that surgery is in the cards for them.
    “I have patients walk in with arthritic knees and I say, ‘Why didn’t you come in to see me two or three years ago’,” Sola said. “Sometimes it has been bothering them for six or seven years. They say, ‘Well, I knew I was going to have to have surgery and I didn’t want to have surgery so I didn’t come in.’ They get a cortisone shot; they walk out feeling great; and wonder why they waited six or seven years.”
    While advances are being made both in treatments and in products all the time, the newest product is not always the best, according to Sola. He pointed to the Genesis knee replacement, which was touted to last for 30 years but had to be replaced in just two or three.
    “New designs are not always good,” Sola said. “So we don’t typically jump on the bandwagon of a new technology until they’ve been tried and proven. And, you might not know about a new implant product for seven to 10 years.”
    Heretofore, Sola said, replacement joints have had about a 20-year lifespan on average. But the newer, plastic liner for knee and hip replacements that are being used today are showing much better wear characteristics in lab tests. Newer sterilization techniques are also making a difference in longevity but it’s too early to tell how much better they’ll be.
    Gateway Regional has recently renovated its Bone & Joint Center to create a dedicated unit designed especially for its orthopedic patients undergoing hip or knee replacement surgery. It features six private rooms, each equipped with a special orthopedic bed and flat-panel TV. Recovery and physical therapy take place in the same unit so there’s no need to be wheeled down the hall or elevator for post-op therapy sessions. Additionally, the operating rooms are equipped with the OSI table — the only one in the area — which is specifically designed for bone and joint surgery.
    “The products get better all the time,” Anderson said. “The techniques are getting better. This all means less pain, faster recovery times and better outcomes for the patient. Things are constantly evolving and getting better.”
    GRMC was nationally recognized by The Joint Commission for the fifth year in a row for achieving excellence on performance of key quality measures. Gateway Regional Medical Center is the only hospital in Illinois to be recognized five years in a row.