Fall 2013 - OhioHealth

FALL 2013
ADVANCED TREATMENT
AWARDS AND ACCOLADES
Differentiating serious ACL injuries
OhioHealth surgeon honored
for commitment to student
athletes
As the popularity of U.S. soccer grows, so does the prevalence of knee injuries. Orthopedic surgeon with
Orthopedic One, Peter H. Edwards, Jr., MD, a member of the OhioHealth Sports Medicine Institute, has been
the team doctor for the Columbus Crew since the team’s inception and has been involved in U.S. National
Soccer for over 10 years. Serious knee injuries can be difficult to assess due to pain and swelling, but careful
history and physical exams can create a differential diagnosis list that can guide further evaluation and/or
the need for referral.
Peter H. Edwards, Jr., MD
The main differential diagnosis list of the acutely swollen post-traumatic
knee includes:
1. 2. 3. 4.
5.
6.
7.
Intra-articular ligament injury (ACL/PCL)
Patellar dislocation
Peripheral meniscal tear
Intra-articular fracture
Chondral or osteochondral injury
Synovial lining or band rupture
Patellar tendon or quadricep rupture
“When patients hear a pop during a non-contact cutting or deceleration injury and experience rapid swelling,
75 percent of the time it’s an ACL tear,” Dr. Edwards said. “Quick referral to a sports medicine specialist is crucial,
as some injuries, such as posterior lateral corner injuries, require surgery within two weeks of injury.”
Dr. Edwards practices at OhioHealth Riverside Methodist Hospital.
Refer knee injuries to a specialist when:
Patients
Examination
findings for
serious knee
injury
++
Heard or felt a pop
++
Experienced or sustained rapid swelling
++
Had an instability event; knee gave out
++
Bearing weight is painful or impossible
++
Large intra-articular effusion
++
Anterior, posterior, varus or valgus instability
++
Inability to perform straight leg raise
++
ruising and swelling in the soft tissue, especially if there
B
was no direct blow
Randall R. Wroble, MD
The Columbus Medical Association
recently bestowed its highest
honor, the 2013 Gregory I. Brooks,
DO, Memorial Award, to Sports
Medicine Grant orthopedic surgeon
Randall R. Wroble, MD. Dr. Wroble
was recognized for his career-long
commitment to student athletes.
A co-founder of OhioHealth Sports Medicine Institute,
he is also the team physician for Grove City High School,
Olentangy Liberty High School, Ohio University and U.S.A.
Wrestling. In addition, he is a member of the Ohio High
School Athletic Association State Wrestling Tournament
Medical Staff.
“I especially enjoy working with high school athletes
who deserve the same level of care afforded to
collegiate and professional athletes because many
of the injuries in younger athletes are equally as
severe,” said Dr. Wroble.
AOFAS names surgeon to post
Orthopedic surgeon with the
Orthopedic Foot and Ankle Center,
Thomas H. Lee, MD, has been named
secretary of the American Orthopaedic
Foot & Ankle Society (AOFAS). Dr.
Lee will focus his two-year term
on supporting the global mission
Thomas H. Lee, MD
of the AOFAS, whose members
specialize in the diagnosis and treatment of disorders
of the musculoskeletal system of the foot and ankle.
“I’m dedicated to advancing orthopedic foot and ankle
surgery regionally, nationally and internationally in
the areas of education, research and humanitarian
service. I’d like to get everyone talking about higher
level patient care, educational advancements and
professional innovation so we can promote the
Society’s values,” said Dr. Lee.
Dr. Lee sees patients at OhioHealth Dublin Methodist
Hospital and the Polaris Surgery Center at OhioHealth
Westerville Medical Campus.
Dr. Wroble practices at OhioHealth Grant Medical Center
and the Polaris Surgery Center at OhioHealth Westerville
Medical Campus.
make a
referral!
For more information on all of our physicians,
visit ohiohealth.com to review our directory.
OhioHealth Orthopedics
C L I N I CAL U P DATE
IN THIS ISSUE:
FOCUS ON: SHOULDERS
OhioHealth at the forefront of innovative
shoulder surgery options
ADVANCED TREATMENT
Hip resurfacing benefits young, active
AWARDS AND ACCOLADES
A FAITH-BASED, NOT-FOR-PROFIT HEALTHCARE SYSTEM
RIVERSIDE METHODIST HOSPITAL + GRANT MEDICAL CENTER + DOCTORS HOSPITAL + GRADY MEMORIAL HOSPITAL
DUBLIN METHODIST HOSPITAL + DOCTORS HOSPITAL–NELSONVILLE + HARDIN MEMORIAL HOSPITAL + MARION GENERAL HOSPITAL
WESTERVILLE MEDICAL CAMPUS + 20 HEALTH AND SURGERY CENTERS + URGENT CARE + PRIMARY AND SPECIALTY CARE
WELLNESS + HOSPICE + HOME CARE + 22,000 PHYSICIANS, ASSOCIATES AND VOLUNTEERS
© OhioHealth Inc. 2013. All rights reserved. FY14-120-2165. 12/13.
OhioHealth surgeon honored for
commitment to student athletes
FALL 2013
FOCUS ON: SHOULDERS
ADVANCED TREATMENT
OhioHealth at the forefront of
innovative shoulder surgery options
OhioHealth CME event featured
international expert
In August, OhioHealth sponsored a CME event on the Birmingham
Hip Resurfacing procedure. The event included lectures from
a panel of internationally renowned hip resurfacing surgeons
— Edwin Su, MD, from the Hospital for Special Surgery in New
York, Ryan Nunley, MD, from Washington University School of
Medicine and Peter Brooks, MD, from the Cleveland Clinic. Over 230
participants attended the event from around the country.
OhioHealth Orthopedics is once again in the national spotlight for advancing shoulder surgery options. Three
groundbreaking procedures are highlighted — central Ohio’s first outpatient total shoulder resurfacing
procedure, a Step-Cut Glenoid procedure that makes possible an anatomic total shoulder replacement for
many patients with osteoarthritis, and a new shoulder prosthesis study.
Central Ohio’s first outpatient total
shoulder resurfacing procedure
Step-Cut Glenoid procedure helps
restore shoulder joint function
Thomas J. Kovack, DO, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, is among the first surgeons in
the country to perform a less invasive,
outpatient alternative to conventional
total shoulder replacement.
The new, innovative treatment for younger
patients with advanced glenohumeral osteoarthritis is known as
Arthroscopic Biologic Total Shoulder Resurfacing. It replaces worn
cartilage in the shoulder joint with transplanted donor cartilage
and bone.
Thomas J. Kovack, DO
Dr. Kovack, who serves patients at both OhioHealth Dublin
Methodist Hospital and OhioHealth Doctors Hospital, performed
his first procedure in the spring. “My patient went home
the same day,” said Dr. Kovack. Conventional total shoulder
replacement surgery typically requires a two-to-three day
hospital stay.
The use of biologic instead of synthetic material enables an
arthroscopic replacement to be done, allowing surgeons to
access and treat the joint through the rotator interval without
violating or injuring the rotator cuff muscles. Using the biologic
material also helps to reproduce normal anatomy and function.
Unlike conventional surgery, the new procedure preserves more
healthy tissue and removes a minimal amount of bone. This
makes revision to conventional total shoulder replacement,
or arthroscopic revision with another graft, technically feasible
later if needed.
IDEAL CANDIDATES:
++ 55 years old or younger
++ Physically active
++ Relatively flexible arthritic shoulders
++ Diagnosed with glenohumeral osteoarthritis
Joseph Mileti, MD
James C. Latshaw, MD
OhioHealth Riverside Methodist Hospital
was one of the first in Ohio to have
access to a special Step-Cut Glenoid
procedure that augments the posterior
glenoid in Total Shoulder Arthroplasty
(TSA). Joseph Mileti, MD, and James C.
Latshaw, MD, orthopedic surgeons with
Orthopedic One, have been performing
this surgery at Riverside Methodist for
the last 18–24 months.
“While TSA has become increasingly
common and a very reliable surgery
for osteoarthritis pain relief, the
weak link is the glenoid component,”
said Dr. Mileti.
The glenoid component enables the pain relief, but it is
also the most common source of loosening and failure due
to the posterior glenoid wear and erosion often seen with
osteoarthritis. “This can make component placement more
difficult, higher risk for failure, or even impossible,”
Dr. Mileti said.
The novel new procedure uses a special implant and
instrumentation to allow for a more anatomic restoration of
the joint in situations when glenoid placement may not have
been otherwise possible.
IDEAL CANDIDATES:
++ End stage shoulder arthritis
++ Failed conservative treatment
++ Glenoid bone loss
OhioHealth studies innovative shoulder replacement prosthesis
Nationwide trial examines
safety and efficacy of new
investigational ‘stem-less’
implant design.
OhioHealth Grant Medical Center has
been selected to study the safety and
effectiveness of a new shoulder replacement system for adults
with degenerative shoulder joint disease. The OhioHealth
Research & Innovation Institute at Grant is participating in the
trial comparing the Arthrex Eclipse™ Shoulder Prosthesis to a
more conventional prosthesis among subjects receiving total
shoulder replacement surgery.
Nathaniel K. Long, DO
“This is a promising, new advancement, and we are
excited to be among a select group of hospitals in
the United States chosen to participate in the study,”
said Principal Investigator, Nathaniel K. Long, DO,
an orthopedic surgeon and shoulder specialist with
OhioHealth Orthopedic Surgeons. “It puts us at
the forefront of shoulder replacement innovation
and research.”
Shoulder replacement removes the damaged part of the
shoulder and replaces it with artificial components. People
with different types of arthritis and other conditions causing
pain and disability are candidates for the procedure.
The shoulder is a ball and socket joint with the top of the
upper arm shaped like a ball. Traditional surgery attaches the
new ball joint to a large metal stem inserted into the upper
arm. The new “stem-less” procedure under investigation at
Grant fixes the ball joint at the top of the upper arm with a
special screw without inserting a stem all the way through
the upper arm.
“It’s a much less invasive surgery that avoids the insertion of
a long stem,” said Dr. Long, who is the second surgeon in the
nation to implant this device. “This new system was designed
to preserve more bone in the shoulder. Saving more healthy
bone and tissue may reduce pain, make the new joint function
more naturally and maintain options in the event that future
surgical interventions are needed.”
Dr. Long may enroll up to 24 patients who will receive either
the new prosthesis or a conventional one.
The study will follow patients for two years after surgery to
assess functional impairment, radiographic success, absence
of reoperations and revisions, and the lack of device-related
adverse events.
Patients must be at least 21 years-old and have significant pain
and functional impairments of the shoulder from a diagnosis
of arthritis or avascular necrosis (death of bone tissue due to
lack of blood supply). They must have also tried at least six
months of non-surgical treatment such as anti-inflammatory
medications, physical therapy and steroid injections.
While it remains an investigational device in the United States,
the Arthrex Eclipse Shoulder Prosthesis has been approved for
use in Europe and Canada, where thousands of procedures
have been completed, Dr. Long said.
This trial is investigational and it may not be appropriate for
all patients. The safety and effectiveness of Arthrex Eclipse are
being investigated by this study and any benefit to patients
has not been determined.
Sharat K. Kusuma,
MD, MBA
A live hip resurfacing operation was
performed by event organizer and chair,
Sharat K. Kusuma, MD, MBA, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, and moderated by the surgeon
developer of the procedure, Mr. Derek
McMinn, FRCS, from the Royal Orthopaedic
Hospital in Birmingham, United Kingdom.
Dr. Kusuma is the only surgeon in the Midwest who performs this
procedure using the exact technique and instruments as developed
in Birmingham, England in 1996.
Hip resurfacing benefits young, active patients
From left to right: Mr. Derek McMinn, FRCS, Peter Brooks, MD, Edwin Su, MD,
Ray Wasielewski, MS, MD
ADVANCED TREATMENT
Streamlining total ankle
replacement
Birmingham Hip Resurfacing Surgery could be considered an
alternative to traditional hip replacement, allowing young, active
patients to relieve their hip arthritis pain without the diminished
function common to traditional hip replacement surgery.
Rather than removing the entire femoral head, as with traditional
hip replacement surgery, the surgeon simply places a metal
cap over the rough, arthritic portion of the hip. This removes
significantly less bone than hip replacement and allows patients
to return to high-level activity and even contact sports if desired;
including soccer, tennis, running and skiing.
IDEAL CANDIDATES:
++ Young and middle-aged, active patients
++ Significant hip arthritis
++ Good bone quality
++ Overall good health
To find out about upcoming OhioHealth CME events,
please visit OHCME.com or call (614) 566.4675.
Gregory Berlet, MD
Surgeons can now perform a virtual surgery
and have a visual plan that details the exact
implant placement in advance of total ankle
replacement surgery. Orthopedic surgeon with
the Orthopedic Foot and Ankle Center, Gregory
Berlet, MD, helped pioneer the procedure and
was the first to perform it in 2012.
“It enables me to accurately position the replacement
components while providing predictable implant alignment
from case-to-case,” said Dr. Berlet.
Designed for use with Inbone® Total Ankle Replacement Systems, the
Prophecy® Inbone® Pre-Operative Navigation Alignment Guides can
create custom guides for surgical placement, reduce the amount of
standard instrumentation required, streamline the surgical procedure
to cut down on the patient’s time in the operating room and improve
safety during surgery.
The technology utilizes CT scans to create custom, patient-specific
ankle alignment guides that facilitate the surgeon’s ability to
precisely size, place and align components during surgery.
This procedure is currently being performed at OhioHealth Dublin
Methodist Hospital.
OhioHealth Orthopedics | CLINICAL UPDATE
FALL 2013
FOCUS ON: SHOULDERS
ADVANCED TREATMENT
OhioHealth at the forefront of
innovative shoulder surgery options
OhioHealth CME event featured
international expert
In August, OhioHealth sponsored a CME event on the Birmingham
Hip Resurfacing procedure. The event included lectures from
a panel of internationally renowned hip resurfacing surgeons
— Edwin Su, MD, from the Hospital for Special Surgery in New
York, Ryan Nunley, MD, from Washington University School of
Medicine and Peter Brooks, MD, from the Cleveland Clinic. Over 230
participants attended the event from around the country.
OhioHealth Orthopedics is once again in the national spotlight for advancing shoulder surgery options. Three
groundbreaking procedures are highlighted — central Ohio’s first outpatient total shoulder resurfacing
procedure, a Step-Cut Glenoid procedure that makes possible an anatomic total shoulder replacement for
many patients with osteoarthritis, and a new shoulder prosthesis study.
Central Ohio’s first outpatient total
shoulder resurfacing procedure
Step-Cut Glenoid procedure helps
restore shoulder joint function
Thomas J. Kovack, DO, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, is among the first surgeons in
the country to perform a less invasive,
outpatient alternative to conventional
total shoulder replacement.
The new, innovative treatment for younger
patients with advanced glenohumeral osteoarthritis is known as
Arthroscopic Biologic Total Shoulder Resurfacing. It replaces worn
cartilage in the shoulder joint with transplanted donor cartilage
and bone.
Thomas J. Kovack, DO
Dr. Kovack, who serves patients at both OhioHealth Dublin
Methodist Hospital and OhioHealth Doctors Hospital, performed
his first procedure in the spring. “My patient went home
the same day,” said Dr. Kovack. Conventional total shoulder
replacement surgery typically requires a two-to-three day
hospital stay.
The use of biologic instead of synthetic material enables an
arthroscopic replacement to be done, allowing surgeons to
access and treat the joint through the rotator interval without
violating or injuring the rotator cuff muscles. Using the biologic
material also helps to reproduce normal anatomy and function.
Unlike conventional surgery, the new procedure preserves more
healthy tissue and removes a minimal amount of bone. This
makes revision to conventional total shoulder replacement,
or arthroscopic revision with another graft, technically feasible
later if needed.
IDEAL CANDIDATES:
++ 55 years old or younger
++ Physically active
++ Relatively flexible arthritic shoulders
++ Diagnosed with glenohumeral osteoarthritis
Joseph Mileti, MD
James C. Latshaw, MD
OhioHealth Riverside Methodist Hospital
was one of the first in Ohio to have
access to a special Step-Cut Glenoid
procedure that augments the posterior
glenoid in Total Shoulder Arthroplasty
(TSA). Joseph Mileti, MD, and James C.
Latshaw, MD, orthopedic surgeons with
Orthopedic One, have been performing
this surgery at Riverside Methodist for
the last 18–24 months.
“While TSA has become increasingly
common and a very reliable surgery
for osteoarthritis pain relief, the
weak link is the glenoid component,”
said Dr. Mileti.
The glenoid component enables the pain relief, but it is
also the most common source of loosening and failure due
to the posterior glenoid wear and erosion often seen with
osteoarthritis. “This can make component placement more
difficult, higher risk for failure, or even impossible,”
Dr. Mileti said.
The novel new procedure uses a special implant and
instrumentation to allow for a more anatomic restoration of
the joint in situations when glenoid placement may not have
been otherwise possible.
IDEAL CANDIDATES:
++ End stage shoulder arthritis
++ Failed conservative treatment
++ Glenoid bone loss
OhioHealth studies innovative shoulder replacement prosthesis
Nationwide trial examines
safety and efficacy of new
investigational ‘stem-less’
implant design.
OhioHealth Grant Medical Center has
been selected to study the safety and
effectiveness of a new shoulder replacement system for adults
with degenerative shoulder joint disease. The OhioHealth
Research & Innovation Institute at Grant is participating in the
trial comparing the Arthrex Eclipse™ Shoulder Prosthesis to a
more conventional prosthesis among subjects receiving total
shoulder replacement surgery.
Nathaniel K. Long, DO
“This is a promising, new advancement, and we are
excited to be among a select group of hospitals in
the United States chosen to participate in the study,”
said Principal Investigator, Nathaniel K. Long, DO,
an orthopedic surgeon and shoulder specialist with
OhioHealth Orthopedic Surgeons. “It puts us at
the forefront of shoulder replacement innovation
and research.”
Shoulder replacement removes the damaged part of the
shoulder and replaces it with artificial components. People
with different types of arthritis and other conditions causing
pain and disability are candidates for the procedure.
The shoulder is a ball and socket joint with the top of the
upper arm shaped like a ball. Traditional surgery attaches the
new ball joint to a large metal stem inserted into the upper
arm. The new “stem-less” procedure under investigation at
Grant fixes the ball joint at the top of the upper arm with a
special screw without inserting a stem all the way through
the upper arm.
“It’s a much less invasive surgery that avoids the insertion of
a long stem,” said Dr. Long, who is the second surgeon in the
nation to implant this device. “This new system was designed
to preserve more bone in the shoulder. Saving more healthy
bone and tissue may reduce pain, make the new joint function
more naturally and maintain options in the event that future
surgical interventions are needed.”
Dr. Long may enroll up to 24 patients who will receive either
the new prosthesis or a conventional one.
The study will follow patients for two years after surgery to
assess functional impairment, radiographic success, absence
of reoperations and revisions, and the lack of device-related
adverse events.
Patients must be at least 21 years-old and have significant pain
and functional impairments of the shoulder from a diagnosis
of arthritis or avascular necrosis (death of bone tissue due to
lack of blood supply). They must have also tried at least six
months of non-surgical treatment such as anti-inflammatory
medications, physical therapy and steroid injections.
While it remains an investigational device in the United States,
the Arthrex Eclipse Shoulder Prosthesis has been approved for
use in Europe and Canada, where thousands of procedures
have been completed, Dr. Long said.
This trial is investigational and it may not be appropriate for
all patients. The safety and effectiveness of Arthrex Eclipse are
being investigated by this study and any benefit to patients
has not been determined.
Sharat K. Kusuma,
MD, MBA
A live hip resurfacing operation was
performed by event organizer and chair,
Sharat K. Kusuma, MD, MBA, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, and moderated by the surgeon
developer of the procedure, Mr. Derek
McMinn, FRCS, from the Royal Orthopaedic
Hospital in Birmingham, United Kingdom.
Dr. Kusuma is the only surgeon in the Midwest who performs this
procedure using the exact technique and instruments as developed
in Birmingham, England in 1996.
Hip resurfacing benefits young, active patients
From left to right: Mr. Derek McMinn, FRCS, Peter Brooks, MD, Edwin Su, MD,
Ray Wasielewski, MS, MD
ADVANCED TREATMENT
Streamlining total ankle
replacement
Birmingham Hip Resurfacing Surgery could be considered an
alternative to traditional hip replacement, allowing young, active
patients to relieve their hip arthritis pain without the diminished
function common to traditional hip replacement surgery.
Rather than removing the entire femoral head, as with traditional
hip replacement surgery, the surgeon simply places a metal
cap over the rough, arthritic portion of the hip. This removes
significantly less bone than hip replacement and allows patients
to return to high-level activity and even contact sports if desired;
including soccer, tennis, running and skiing.
IDEAL CANDIDATES:
++ Young and middle-aged, active patients
++ Significant hip arthritis
++ Good bone quality
++ Overall good health
To find out about upcoming OhioHealth CME events,
please visit OHCME.com or call (614) 566.4675.
Gregory Berlet, MD
Surgeons can now perform a virtual surgery
and have a visual plan that details the exact
implant placement in advance of total ankle
replacement surgery. Orthopedic surgeon with
the Orthopedic Foot and Ankle Center, Gregory
Berlet, MD, helped pioneer the procedure and
was the first to perform it in 2012.
“It enables me to accurately position the replacement
components while providing predictable implant alignment
from case-to-case,” said Dr. Berlet.
Designed for use with Inbone® Total Ankle Replacement Systems, the
Prophecy® Inbone® Pre-Operative Navigation Alignment Guides can
create custom guides for surgical placement, reduce the amount of
standard instrumentation required, streamline the surgical procedure
to cut down on the patient’s time in the operating room and improve
safety during surgery.
The technology utilizes CT scans to create custom, patient-specific
ankle alignment guides that facilitate the surgeon’s ability to
precisely size, place and align components during surgery.
This procedure is currently being performed at OhioHealth Dublin
Methodist Hospital.
OhioHealth Orthopedics | CLINICAL UPDATE
FALL 2013
FOCUS ON: SHOULDERS
OhioHealth at the forefront of innovative shoulder surgery options
OhioHealth Orthopedics is once again in the national spotlight for advancing shoulder surgery options. Three groundbreaking procedures are highlighted — central Ohio’s first outpatient total
shoulder resurfacing procedure, a Step-Cut Glenoid procedure that makes possible an anatomic total shoulder replacement for many patients with osteoarthritis, and a new shoulder prosthesis study.
Central Ohio’s first outpatient total
shoulder resurfacing procedure
Step-Cut Glenoid procedure helps
restore shoulder joint function
Thomas J. Kovack, DO, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, is among the first surgeons in
the country to perform a less invasive,
outpatient alternative to conventional
total shoulder replacement.
The new, innovative treatment for younger
patients with advanced glenohumeral osteoarthritis is known as
Arthroscopic Biologic Total Shoulder Resurfacing. It replaces worn
cartilage in the shoulder joint with transplanted donor cartilage
and bone.
Thomas J. Kovack, DO
Dr. Kovack, who serves patients at both OhioHealth Dublin
Methodist Hospital and OhioHealth Doctors Hospital, performed
his first procedure in the spring. “My patient went home
the same day,” said Dr. Kovack. Conventional total shoulder
replacement surgery typically requires a two-to-three day
hospital stay.
The use of biologic instead of synthetic material enables an
arthroscopic replacement to be done, allowing surgeons to
access and treat the joint through the rotator interval without
violating or injuring the rotator cuff muscles. Using the biologic
material also helps to reproduce normal anatomy and function.
Unlike conventional surgery, the new procedure preserves more
healthy tissue and removes a minimal amount of bone. This
makes revision to conventional total shoulder replacement,
or arthroscopic revision with another graft, technically feasible
later if needed.
Joseph Mileti, MD
James C. Latshaw, MD
OhioHealth Riverside Methodist Hospital
was one of the first in Ohio to have access
to a special Step-Cut Glenoid procedure
that augments the posterior glenoid in
Total Shoulder Arthroplasty (TSA). Joseph
Mileti, MD, and James C. Latshaw, MD,
orthopedic surgeons with Orthopedic
One, have been performing this surgery
at Riverside Methodist for the last 18–24
months.
“While TSA has become increasingly
common and a very reliable surgery
for osteoarthritis pain relief, the weak
link is the glenoid component,” said
Dr. Mileti.
The glenoid component enables the pain relief, but it is
also the most common source of loosening and failure due
to the posterior glenoid wear and erosion often seen with
osteoarthritis. “This can make component placement more
difficult, higher risk for failure, or even impossible,” Dr. Mileti said.
The novel new procedure uses a special implant and
instrumentation to allow for a more anatomic restoration of the
joint in situations when glenoid placement may not have been
otherwise possible.
IDEAL CANDIDATES:
++ End stage shoulder arthritis
IDEAL CANDIDATES:
++ Failed conservative treatment
++ 55 years old or younger
++ Glenoid bone loss
++ Physically active
++ Relatively flexible arthritic shoulders
++ Diagnosed with glenohumeral osteoarthritis
ADVANCED TREATMENT
OhioHealth CME event featured
international expert
In August, OhioHealth sponsored a CME event on the Birmingham
Hip Resurfacing procedure. The event included lectures from
a panel of internationally renowned hip resurfacing surgeons
— Edwin Su, MD, from the Hospital for Special Surgery in New
York, Ryan Nunley, MD, from Washington University School of
Medicine and Peter Brooks, MD, from the Cleveland Clinic. Over 230
participants attended the event from around the country.
OhioHealth studies innovative shoulder replacement prosthesis
Nationwide trial examines
safety and efficacy of new
investigational ‘stem-less’
implant design.
OhioHealth Grant Medical Center has
been selected to study the safety and
effectiveness of a new shoulder replacement system for adults
with degenerative shoulder joint disease. The OhioHealth
Research & Innovation Institute at Grant is participating in the
trial comparing the Arthrex Eclipse™ Shoulder Prosthesis to a
more conventional prosthesis among subjects receiving total
shoulder replacement surgery.
Nathaniel K. Long, DO
“This is a promising, new advancement, and we are
excited to be among a select group of hospitals in
the United States chosen to participate in the study,”
said Principal Investigator, Nathaniel K. Long, DO,
an orthopedic surgeon and shoulder specialist with
OhioHealth Orthopedic Surgeons. “It puts us at
the forefront of shoulder replacement innovation
and research.”
Shoulder replacement removes the damaged part of the
shoulder and replaces it with artificial components. People
with different types of arthritis and other conditions causing
pain and disability are candidates for the procedure.
The shoulder is a ball and socket joint with the top of the
upper arm shaped like a ball. Traditional surgery attaches the
new ball joint to a large metal stem inserted into the upper
arm. The new “stem-less” procedure under investigation at
Grant fixes the ball joint at the top of the upper arm with a
special screw without inserting a stem all the way through
the upper arm.
“It’s a much less invasive surgery that avoids the insertion of
a long stem,” said Dr. Long, who is the second surgeon in the
nation to implant this device. “This new system was designed
to preserve more bone in the shoulder. Saving more healthy
bone and tissue may reduce pain, make the new joint function
more naturally and maintain options in the event that future
surgical interventions are needed.”
Dr. Long may enroll up to 24 patients who will receive either
the new prosthesis or a conventional one.
The study will follow patients for two years after surgery to
assess functional impairment, radiographic success, absence
of reoperations and revisions, and the lack of device-related
adverse events.
Patients must be at least 21 years-old and have significant pain
and functional impairments of the shoulder from a diagnosis
of arthritis or avascular necrosis (death of bone tissue due to
lack of blood supply). They must have also tried at least six
months of non-surgical treatment such as anti-inflammatory
medications, physical therapy and steroid injections.
While it remains an investigational device in the United States,
the Arthrex Eclipse Shoulder Prosthesis has been approved for
use in Europe and Canada, where thousands of procedures
have been completed, Dr. Long said.
This trial is investigational and it may not be appropriate for
all patients. The safety and effectiveness of Arthrex Eclipse are
being investigated by this study and any benefit to patients
has not been determined.
Sharat K. Kusuma,
MD, MBA
A live hip resurfacing operation was
performed by event organizer and chair,
Sharat K. Kusuma, MD, MBA, an orthopedic
surgeon with OhioHealth Orthopedic
Surgeons, and moderated by the surgeon
developer of the procedure, Mr. Derek
McMinn, FRCS, from the Royal Orthopaedic
Hospital in Birmingham, United Kingdom.
Dr. Kusuma is the only surgeon in the Midwest who performs this
procedure using the exact technique and instruments as developed
in Birmingham, England in 1996.
Hip resurfacing benefits young, active patients
From left to right: Mr. Derek McMinn, FRCS, Peter Brooks, MD, Edwin Su, MD,
Ray Wasielewski, MS, MD
ADVANCED TREATMENT
Streamlining total ankle
replacement
Birmingham Hip Resurfacing Surgery could be considered an
alternative to traditional hip replacement, allowing young, active
patients to relieve their hip arthritis pain without the diminished
function common to traditional hip replacement surgery.
Rather than removing the entire femoral head, as with traditional
hip replacement surgery, the surgeon simply places a metal
cap over the rough, arthritic portion of the hip. This removes
significantly less bone than hip replacement and allows patients
to return to high-level activity and even contact sports if desired;
including soccer, tennis, running and skiing.
IDEAL CANDIDATES:
++ Young and middle-aged, active patients
++ Significant hip arthritis
++ Good bone quality
++ Overall good health
To find out about upcoming OhioHealth CME events,
please visit OHCME.com or call (614) 566.4675.
Gregory Berlet, MD
Surgeons can now perform a virtual surgery
and have a visual plan that details the exact
implant placement in advance of total ankle
replacement surgery. Orthopedic surgeon with
the Orthopedic Foot and Ankle Center, Gregory
Berlet, MD, helped pioneer the procedure and
was the first to perform it in 2012.
“It enables me to accurately position the replacement
components while providing predictable implant alignment
from case-to-case,” said Dr. Berlet.
Designed for use with Inbone® Total Ankle Replacement Systems, the
Prophecy® Inbone® Pre-Operative Navigation Alignment Guides can
create custom guides for surgical placement, reduce the amount of
standard instrumentation required, streamline the surgical procedure
to cut down on the patient’s time in the operating room and improve
safety during surgery.
The technology utilizes CT scans to create custom, patient-specific
ankle alignment guides that facilitate the surgeon’s ability to
precisely size, place and align components during surgery.
This procedure is currently being performed at OhioHealth Dublin
Methodist Hospital.
OhioHealth Orthopedics | CLINICAL UPDATE
FALL 2013
ADVANCED TREATMENT
AWARDS AND ACCOLADES
Differentiating serious ACL injuries
OhioHealth surgeon honored
for commitment to student
athletes
As the popularity of U.S. soccer grows, so does the prevalence of knee injuries. Orthopedic surgeon with
Orthopedic One, Peter H. Edwards, Jr., MD, a member of the OhioHealth Sports Medicine Institute, has been
the team doctor for the Columbus Crew since the team’s inception and has been involved in U.S. National
Soccer for over 10 years. Serious knee injuries can be difficult to assess due to pain and swelling, but careful
history and physical exams can create a differential diagnosis list that can guide further evaluation and/or
the need for referral.
Peter H. Edwards, Jr., MD
The main differential diagnosis list of the acutely swollen post-traumatic
knee includes:
1. 2. 3. 4.
5.
6.
7.
Intra-articular ligament injury (ACL/PCL)
Patellar dislocation
Peripheral meniscal tear
Intra-articular fracture
Chondral or osteochondral injury
Synovial lining or band rupture
Patellar tendon or quadricep rupture
“When patients hear a pop during a non-contact cutting or deceleration injury and experience rapid swelling,
75 percent of the time it’s an ACL tear,” Dr. Edwards said. “Quick referral to a sports medicine specialist is crucial,
as some injuries, such as posterior lateral corner injuries, require surgery within two weeks of injury.”
Dr. Edwards practices at OhioHealth Riverside Methodist Hospital.
Refer knee injuries to a specialist when:
Patients
Examination
findings for
serious knee
injury
++
Heard or felt a pop
++
Experienced or sustained rapid swelling
++
Had an instability event; knee gave out
++
Bearing weight is painful or impossible
++
Large intra-articular effusion
++
Anterior, posterior, varus or valgus instability
++
Inability to perform straight leg raise
++
ruising and swelling in the soft tissue, especially if there
B
was no direct blow
Randall R. Wroble, MD
The Columbus Medical Association
recently bestowed its highest
honor, the 2013 Gregory I. Brooks,
DO, Memorial Award, to Sports
Medicine Grant orthopedic surgeon
Randall R. Wroble, MD. Dr. Wroble
was recognized for his career-long
commitment to student athletes.
A co-founder of OhioHealth Sports Medicine Institute,
he is also the team physician for Grove City High School,
Olentangy Liberty High School, Ohio University and U.S.A.
Wrestling. In addition, he is a member of the Ohio High
School Athletic Association State Wrestling Tournament
Medical Staff.
“I especially enjoy working with high school athletes
who deserve the same level of care afforded to
collegiate and professional athletes because many
of the injuries in younger athletes are equally as
severe,” said Dr. Wroble.
AOFAS names surgeon to post
Orthopedic surgeon with the
Orthopedic Foot and Ankle Center,
Thomas H. Lee, MD, has been named
secretary of the American Orthopaedic
Foot & Ankle Society (AOFAS). Dr.
Lee will focus his two-year term
on supporting the global mission
Thomas H. Lee, MD
of the AOFAS, whose members
specialize in the diagnosis and treatment of disorders
of the musculoskeletal system of the foot and ankle.
“I’m dedicated to advancing orthopedic foot and ankle
surgery regionally, nationally and internationally in
the areas of education, research and humanitarian
service. I’d like to get everyone talking about higher
level patient care, educational advancements and
professional innovation so we can promote the
Society’s values,” said Dr. Lee.
Dr. Lee sees patients at OhioHealth Dublin Methodist
Hospital and the Polaris Surgery Center at OhioHealth
Westerville Medical Campus.
Dr. Wroble practices at OhioHealth Grant Medical Center
and the Polaris Surgery Center at OhioHealth Westerville
Medical Campus.
make a
referral!
For more information on all of our physicians,
visit ohiohealth.com to review our directory.
OhioHealth Orthopedics
C L I N I CAL U P DATE
IN THIS ISSUE:
FOCUS ON: SHOULDERS
OhioHealth at the forefront of innovative
shoulder surgery options
ADVANCED TREATMENT
Hip resurfacing benefits young, active
AWARDS AND ACCOLADES
A FAITH-BASED, NOT-FOR-PROFIT HEALTHCARE SYSTEM
RIVERSIDE METHODIST HOSPITAL + GRANT MEDICAL CENTER + DOCTORS HOSPITAL + GRADY MEMORIAL HOSPITAL
DUBLIN METHODIST HOSPITAL + DOCTORS HOSPITAL–NELSONVILLE + HARDIN MEMORIAL HOSPITAL + MARION GENERAL HOSPITAL
WESTERVILLE MEDICAL CAMPUS + 20 HEALTH AND SURGERY CENTERS + URGENT CARE + PRIMARY AND SPECIALTY CARE
WELLNESS + HOSPICE + HOME CARE + 22,000 PHYSICIANS, ASSOCIATES AND VOLUNTEERS
© OhioHealth Inc. 2013. All rights reserved. FY14-120-2165. 12/13.
OhioHealth surgeon honored for
commitment to student athletes
FALL 2013
ADVANCED TREATMENT
AWARDS AND ACCOLADES
Differentiating serious ACL injuries
OhioHealth surgeon honored
for commitment to student
athletes
As the popularity of U.S. soccer grows, so does the prevalence of knee injuries. Orthopedic surgeon with
Orthopedic One, Peter H. Edwards, Jr., MD, a member of the OhioHealth Sports Medicine Institute, has been
the team doctor for the Columbus Crew since the team’s inception and has been involved in U.S. National
Soccer for over 10 years. Serious knee injuries can be difficult to assess due to pain and swelling, but careful
history and physical exams can create a differential diagnosis list that can guide further evaluation and/or
the need for referral.
Peter H. Edwards, Jr., MD
The main differential diagnosis list of the acutely swollen post-traumatic
knee includes:
1. 2. 3. 4.
5.
6.
7.
Intra-articular ligament injury (ACL/PCL)
Patellar dislocation
Peripheral meniscal tear
Intra-articular fracture
Chondral or osteochondral injury
Synovial lining or band rupture
Patellar tendon or quadricep rupture
“When patients hear a pop during a non-contact cutting or deceleration injury and experience rapid swelling,
75 percent of the time it’s an ACL tear,” Dr. Edwards said. “Quick referral to a sports medicine specialist is crucial,
as some injuries, such as posterior lateral corner injuries, require surgery within two weeks of injury.”
Dr. Edwards practices at OhioHealth Riverside Methodist Hospital.
Refer knee injuries to a specialist when:
Patients
Examination
findings for
serious knee
injury
++
Heard or felt a pop
++
Experienced or sustained rapid swelling
++
Had an instability event; knee gave out
++
Bearing weight is painful or impossible
++
Large intra-articular effusion
++
Anterior, posterior, varus or valgus instability
++
Inability to perform straight leg raise
++
ruising and swelling in the soft tissue, especially if there
B
was no direct blow
Randall R. Wroble, MD
The Columbus Medical Association
recently bestowed its highest
honor, the 2013 Gregory I. Brooks,
DO, Memorial Award, to Sports
Medicine Grant orthopedic surgeon
Randall R. Wroble, MD. Dr. Wroble
was recognized for his career-long
commitment to student athletes.
A co-founder of OhioHealth Sports Medicine Institute,
he is also the team physician for Grove City High School,
Olentangy Liberty High School, Ohio University and U.S.A.
Wrestling. In addition, he is a member of the Ohio High
School Athletic Association State Wrestling Tournament
Medical Staff.
“I especially enjoy working with high school athletes
who deserve the same level of care afforded to
collegiate and professional athletes because many
of the injuries in younger athletes are equally as
severe,” said Dr. Wroble.
AOFAS names surgeon to post
Orthopedic surgeon with the
Orthopedic Foot and Ankle Center,
Thomas H. Lee, MD, has been named
secretary of the American Orthopaedic
Foot & Ankle Society (AOFAS). Dr.
Lee will focus his two-year term
on supporting the global mission
Thomas H. Lee, MD
of the AOFAS, whose members
specialize in the diagnosis and treatment of disorders
of the musculoskeletal system of the foot and ankle.
“I’m dedicated to advancing orthopedic foot and ankle
surgery regionally, nationally and internationally in
the areas of education, research and humanitarian
service. I’d like to get everyone talking about higher
level patient care, educational advancements and
professional innovation so we can promote the
Society’s values,” said Dr. Lee.
Dr. Lee sees patients at OhioHealth Dublin Methodist
Hospital and the Polaris Surgery Center at OhioHealth
Westerville Medical Campus.
Dr. Wroble practices at OhioHealth Grant Medical Center
and the Polaris Surgery Center at OhioHealth Westerville
Medical Campus.
make a
referral!
For more information on all of our physicians,
visit ohiohealth.com to review our directory.
OhioHealth Orthopedics
C L I N I CAL U P DATE
IN THIS ISSUE:
FOCUS ON: SHOULDERS
OhioHealth at the forefront of innovative
shoulder surgery options
ADVANCED TREATMENT
Hip resurfacing benefits young, active
AWARDS AND ACCOLADES
A FAITH-BASED, NOT-FOR-PROFIT HEALTHCARE SYSTEM
RIVERSIDE METHODIST HOSPITAL + GRANT MEDICAL CENTER + DOCTORS HOSPITAL + GRADY MEMORIAL HOSPITAL
DUBLIN METHODIST HOSPITAL + DOCTORS HOSPITAL–NELSONVILLE + HARDIN MEMORIAL HOSPITAL + MARION GENERAL HOSPITAL
WESTERVILLE MEDICAL CAMPUS + 20 HEALTH AND SURGERY CENTERS + URGENT CARE + PRIMARY AND SPECIALTY CARE
WELLNESS + HOSPICE + HOME CARE + 22,000 PHYSICIANS, ASSOCIATES AND VOLUNTEERS
© OhioHealth Inc. 2013. All rights reserved. FY14-120-2165. 12/13.
OhioHealth surgeon honored for
commitment to student athletes