Ortho | Brain & Spine Special Section

Orthopaedics & Neurosurgery SUNDAY, AUGUST 13, 2017

A SPECIAL ADVERTISING PUBLICATION OF THE STATE MEDIA ADVERTISING DEPARTMENT AND LEXINGTON MEDICAL CENTER

FOCUSED ON GETTING YOU BETTER SOONER

From unexpected injuries to chronic pain, Lexington Medical Center’s orthopaedics and neurosurgery experts are focused on helping patients of all ages get better sooner.

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exington Medical Center has three orthopaedic surgery physician practices dedicated to treating conditions of the musculoskeletal system: Carolina Shoulder & Knee Specialists; Lexington Orthopaedics; and Southeastern Orthopaedic and Sports Medicine.

The physicians are board certified and have fellowship training in specific focus areas. From top to bottom, they treat shoulders, elbows, hands, hips, knees, ankles and feet. These doctors are experienced specialists in sports medicine, trauma, broken bones, total joint replacement and rehabilitation.

Lexington Medical Center’s network of care also includes Lexington Brain and Spine Institute, a Lexington Medical Center physician practice dedicated to treating and managing chronic painful conditions. The practice offers a wide variety of techniques with teamwork from physicians in different specialties. Interventional

INSIDE THIS ISSUE

pain management physicians work together with physiatrists, neurosurgeons and physical therapists to provide individual treatment plans for each patient.

Each of the practices is part of Lexington Medical Center’s network of care, linked together with one electronic health record that allows providers to have a patient’s full health history at their fingertips and enhance care.

This special section showcases Lexington Medical Center’s orthopaedic and neurosurgery services. It also features patient stories, answers to common questions and information on stateof-the-art technology. With a comprehensive and growing line of services, Lexington Medical Center looks forward to taking care of Midlands families’ orthopaedic and neurosurgery needs now and in the future.

Visit LexMed.com/Ortho

Man Avoids Amputation with Limb-Saving Surgery

Spine Surgery Puts New Mom Back on Track

What Is Functional Dry Needling?

Customized Knee Resurfacing Creates a Perfect Fit

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Lexington Orthopaedics Specializes in Your Care From an injured shoulder to a broken ankle, the physicians at Lexington Orthopaedics are specialists in treating a variety of conditions involving the musculoskeletal system.

Each doctor has extensive training in a particular focus area, which means they can provide patients with comprehensive care that helps them feel better sooner.

———————————————————————————— Foot and Ankle Matison L. Boyer, MD, is a fellowship-trained “Ankle and foot problems are common and orthopaedic surgeon who specializes in foot and can be very disabling. It’s a challenging ankle care. Dr. Boyer believes experience is one of area of orthopaedics, and I enjoy helping the most important factors in providing quality care, these patients.” and likes that Lexington Orthopaedics has highly trained physicians in a variety of orthopaedic specialties.

Dr. Boyer has more than 10 years of experience focusing on this area of care.

MATISON L. BOYER, MD

———————————————————————————— Traumatology Barnaby T. Dedmond, MD, is a fellowship-trained “My work allows me to meet patients orthopaedic traumatologist. His area of practice at a time of crisis, partner with them to focuses on major and minor trauma, and all aspects help their broken bones heal and help the of fracture care, including the most modern and patients regain function.” minimally invasive surgery techniques. He is one of only a small number of orthopaedic traumatologists in South Carolina.

BARNABY T. DEDMOND, MD

———————————————————————————— Sports Medicine and Knee Replacement David R. Kingery, MD, focuses on sports medicine and knee replacement. He understands the difficulties athletes have following sports injuries.

Dr. Kingery performs partial and total knee replacement. He has served as the team physician for professional, collegiate and high school teams.

“I suffered a knee injury myself while playing high school football. I know what it’s like to endure pain that limits your quality of life and prevents you from participating in activities you enjoy.”

DAVID R. KINGERY, MD

———————————————————————————— Shoulders, Elbows and Hands James C. McIntosh Jr., MD, completed an orthopaedic fellowship focused on treating the upper extremities and hands. An Irmo native, his areas of specialty include disorders of the shoulders, elbows and hands. He also has a special interest in arthroscopy, a minimally invasive surgical procedure on a joint.

“I treat a lot of patients with injuries from unexpected accidents. Fractures in their shoulder, arm or hand can limit their ability to take care of their children, go to work or enjoy life as usual. I like that I can play an important role in their recovery.”

Welcome Randy Beard, MD Lexington Orthopaedics is pleased to welcome Randy Beard, MD. He is fellowship trained in adult reconstructive surgery.

Dr. Beard has also completed training in complex hip and knee replacements and revisions.

“Joint pain can be debilitating.

A cum laude graduate of Princeton University in Princeton, New Jersey, It robs people of sleep, Dr. Beard received his medical degree playing with grandchildren from Wake Forest University in and participating in golf with Winston Salem, North Carolina. He friends. I love hearing stories completed an orthopaedic residency about how people ‘got their at Wake Forest Baptist Health and a lives back’ after a successful fellowship at New England Baptist RANDY BEARD, MD hip or knee replacement.”

Hospital in Boston.

Dr. Beard is a member of the American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Academy of Orthopaedic Surgeons, and the Orthopaedic Research and Education Foundation.

JAMES C. McINTOSH JR., MD

A Lexington Medical Center Physician Practice

Lexington Orthopaedics has three convenient locations in the Midlands.

Lexington Medical Park 2 Suite 140 146 North Hospital Drive West Columbia, SC 29169 811 West Main Street Suite 101 Lexington, SC 29072 7033 St. Andrews Road Suite 104 Columbia, SC 29212 (803) 936-7230 Lex-Ortho.com

Orthopaedics & Neurosurgery

A Special Advertising Publication of The State Media Advertising Department and Lexington Medical Center

PATIENT STORY

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Madison Kutyla at Lexington High School

Something to Shout About CHEERLEADER TUMBLES STRONG AFTER HAND INJURY Madison Kutyla can barely remember a time when competitive cheerleading wasn’t a big part of her life.

“S

tarting in second grade, I was on an all-star team and competed on weekends in a league,” the 15 year old said. “I’ve always loved cheerleading and tumbling.”

Last football season, she was thrilled to cheer with the Lexington High School varsity squad as a freshman. But during the first game of the season, a tumbling pass on uneven grass landed badly, with a hard impact on Madison’s right hand. She tried to ice her hand and shake off the pain. Injuries can be common with the intensity of the sport at a high level. But this time was different.

“I couldn’t move my hand,” she said. “It looked normal at first, but then it swelled up like a huge balloon.” At Lexington Medical Center’s Emergency department, an X-ray revealed a fracture in her right ring finger and a more serious injury to the middle finger joint.

“I cracked my middle finger knuckle in half,” Madison explained. “You could definitely see on the X-ray that it was going to be a while before I could get back to cheering.”

It wasn’t Madison’s first tumbling-related injury. Just eight

months earlier, she dislocated and broke a finger on her left hand.

David K. Lee, MD, an orthopaedic surgeon at Southeastern Orthopaedic and Sports Medicine, a Lexington Medical Center physician practice, helped her return to top form after her left hand injury. So that’s where Madison and her parents turned for expertise to treat her right hand.

Dr. Lee told Madison she would need surgery to heal completely. “I tried to remain calm, but I was definitely upset,” she said.

According to Dr. Lee, the middle finger injury was particularly challenging because the damage to the joint could lead to post-traumatic arthritis early in life.

“The spot where Madison broke it could lead to future instability of that joint. If we hadn’t fixed it, she wouldn’t have good function in that hand,” Dr. Lee said. “Between the two injuries, you would look at the finger fracture and think, ‘That’s a bad break.’ But from the standpoint of the future, the joint injury was even more important to treat carefully.”

For the hand break, Dr. Lee surgically placed two screws to hold the bone in place and allow it to heal. Because Madison wanted to get back to her squad right away, he surgically placed pins under the skin on the middle finger joint, rather than using external pins, a treatment that may have been more typical for a different patient.

“She couldn’t cheer with those pins on the outside,” Dr. Lee said.

Madison said Dr. Lee respected her priority of getting back to cheering. “I could tell he understood I wanted to be back as soon as possible,” Madison said.

“He fixed my hand so I could tumble and cheer safely, and without pain.”

“My ultimate goal in sports medicine is to get patients healthy and happy,” Dr. Lee said. “With a young athlete, I don’t want him or her to feel like he or she is compromising anything because of an injury.”

Madison’s mom Sally said Dr. Lee also worked to understand the mechanics of what Madison’s sport requires of her hands. As a “base” on the squad, she uses her hands to hold other girls’ ankles on her shoulders, performs cradle catches and does a range of tumbling moves requiring strength and agility.

“We knew he was going to do all he could to get her back,” Sally

said. “As her skill level gets higher, the risk of injury is higher; but she loves cheerleading and wants to keep returning to it. She’s in good hands with Dr. Lee.” After surgery, occupational therapy helped Madison regain strength and flexibility in her fingers.

Just over a month after her fall, Madison was cleared to tumble again. “I had practice the day I was cleared, and it was really nice to be back,” she said.

Dr. Lee says that athletic drive to achieve a high level of physical performance makes his job fun.

“I want my patients to return to what they love and have a good quality of life.”

That mindset has inspired Madison. She’s decided that she wants to study sports medicine in college and help athletes like herself one day.

DAVID K. LEE, MD

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

David K. Lee, MD (803) 936-7966 Lexington Medical Park 2 Suite 350 146 North Hospital Drive West Columbia, SC 29169 (803) 936-7966 SEOrthopaedic.com

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Orthopaedics & Neurosurgery

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Managing Chronic Pain AT LEXINGTON BRAIN AND SPINE INSTITUTE

Chronic pain can affect quality of life. Untreated, it can lead to anxiety and depression, social withdrawal, weakening of personal relationships and poor sleep. Over time, it can also worsen conditions such as high blood pressure, diabetes and heart disease.

Lexington Brain and Spine Institute, a Lexington Medical Center physician practice, offers a multidisciplinary approach with doctors in a variety of specialties to treat and manage chronic painful conditions.

Physiatry “Our goal is to properly diagnose a patient, learn how their condition affects them and work together to decide the best way to improve their function and quality of life,” said W. Randal Westerkam, MD, FAAPMR, RMSK, a physiatrist with Lexington Brain and Spine Institute.

Physiatry is a branch of medicine that works to restore optimal function to people with injuries or conditions impacting the muscles, bones, ligaments or nervous system.

“We can treat a variety of conditions including brain and spine injuries, strokes,

SCOTT B. BOYD, MD, FAANS

musculoskeletal issues affecting the knees and shoulders, carpal tunnel syndrome and tendonitis,” Dr. Westerkam said.

BRETT C. GUNTER, MD, FAANS

Interventional Pain Management Through interventional pain management, the practice incorporates non-surgical, minimally invasive options. That includes alleviating chronic pain with epidural steroid injections and nerve blocks. These treatments can provide significant benefits to patients with spine pain, residual pain after surgery, cancer pain, complex regional pain syndrome, fibromyalgia, joint pain or migraines.

“I have two goals for all of my patients: to improve their function and quality of life, and to do everything possible to prevent surgery and the need for opioid medication,” said Kamran Z. Koranloo, MD, interventional pain management physician at Lexington Brain and Spine Institute.

Erin Lawson, MD, also an interventional pain

management specialist at the practice, helps to alleviate knee and hip pain with a procedure called cooled radiofrequency.

“Knee pain can limit your ability to perform daily activities and have meaningful interaction with your family and friends. You may not be going to work or church, and you can’t exercise,” said Dr. Lawson.

With cooled radiofrequency, Dr. Lawson uses guided instruments to target the sensory nerves that cause knee and hip pain, leading to pain relief.

For back pain, one procedure with positive results is spinal cord stimulation. It’s for patients who have undergone back surgery, but still experience pain in the back and legs, despite having no structural problem that can be fixed with surgery. Their pain may be caused by scar tissue or nerve damage.

In this outpatient procedure, a battery-powered device about the size of a pocket watch and similar to a pacemaker for the heart is inserted under the skin.

A lead stimulates nerve fibers in the spinal cord to reduce pain signals. The result is that instead of pain, patients feel a sensation of vibration or buzzing.

“We’ve seen a dramatic improvement in quality of life and the ability to perform activities of daily living in these patients,” said C. Philip Toussaint, MD, FAANS, a neurosurgeon at the practice.

ERIN F. LAWSON, MD

C. PHILIP TOUSSAINT, MD, FAANS

W. RANDAL WESTERKAM, MD, FAAPMR, RMSK

Neurosurgery Sometimes, chronic pain requires surgical intervention when conservative treatments do not make the pain go away. When surgery is necessary, there are a range of options.

“I’m proud to be part of a comprehensive group of specialists and surgeons who see and manage neurorelated disease,” said Scott B. Boyd, MD, FAANS, neurosurgeon at Lexington Brain and Spine Institute.

Brett C. Gunter, MD, FAANS, is a leader in cervical disc replacement surgery. This type of surgery can fix neck, shoulder and arm pain caused by discs at the top of the spine that have worn out over time.

“As cervical discs wear out with age, the disc collapses and pushes into the spinal cord and nerves, which can be painful,” said Dr. Gunter. “This surgery allows patients to maintain range of motion and

KAMRAN Z. KORANLOO, MD

A Lexington Medical Center Physician Practice

return to their daily activities.”

From degenerative conditions to disorders of the spine and nerves, Lexington Brain and Spine Institute can provide the most effective and comprehensive treatment plan for each patient.

Lexington Medical Park 3, Ste. 200 155 North Hospital Drive Neurosurgery (803) 935-8410 Pain Management & Physiatry (803) 936-7035 Pain Management – Northeast 720 Rabon Road Columbia, SC 29203 (803) 764-1228 LexingtonBrainandSpine.com

Orthopaedics & Neurosurgery

Jimmy Oswald back at work inside the warehouse at Oswald Lumber in Batesburg-Leesville

A Special Advertising Publication of The State Media Advertising Department and Lexington Medical Center

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PATIENT STORY

Avoiding Amputation ORTHOPAEDIC TRAUMA SURGERY SAVES BATESBURG-LEESVILLE MAN’S LEG Jimmy Oswald runs a lumber company in Batesburg-Leesville. In January, he had a day at work no one there will forget. Inside the warehouse, Jimmy was standing in front of a commercial saw when a forklift a few inches away accidentally began moving and hit him. Jimmy’s right side became pinned between the 9,000-pound forklift and the saw.

T

he pain from the accident was excruciating.

It took five minutes for his employees to move the forklift away.

The 77 year old suffered compound fractures of the bones in his lower leg and a crush injury causing multiple broken bones in his ankle. If not handled with great care and expertise, that type of injury can lead to amputation.

An ambulance rushed Jimmy to Lexington Medical Center where he underwent emergency orthopaedic surgery.

and minor trauma, including simple and complex fracture care for patients of all ages, with modern and minimally invasive surgery techniques.

“In Jimmy’s case, we assessed his injuries one by one and customized the best course of treatment for him,” Dr. Dedmond said.

Describing the range of orthopaedic surgery resources as tools in a toolbox, Dr. Dedmond said there are many choices and options for surgeons in his specialty. “No fracture is

“The most rewarding part of what I do is walking the road to recovery with my patients.

I share tremendous joy when people like Jimmy are back to life again.”

—Barnaby T. Dedmond, MD

“When I woke up, the first thing I did was look to see if I still had a leg,” Jimmy said. “I had a great doctor. He fixed it for me, and I was so relieved.”

Jimmy’s doctor was Barnaby T. Dedmond, MD, an orthopaedic surgeon with Lexington Orthopaedics, a Lexington Medical Center physician practice.

A fellowship-trained orthopaedic traumatologist, Dr. Dedmond specializes in major

the same,” he said. “So I pull different tools for each case to do the best job possible for what that patient needs.”

Dr. Dedmond set Jimmy’s leg bones back in line, rebuilt his crushed ankle and concluded the pelvis fracture could heal with intensive therapy.

“A surgeon’s job doesn’t only begin at the time of surgery,” Dr. Dedmond said. “It’s important to be actively involved in all aspects

of a patient’s care — before, during and after surgery.”

The road to recovery was a long one.

Jimmy spent two months in intensive physical therapy and rehabilitation before he could walk again. Because of his pelvis injury, he couldn’t bear weight on his legs for a while.

“I’m still working on it,” he said. “But it’s worth it to be able to walk with your own legs.”

Today, Jimmy is back on the job at the lumber company, working full days and involved in the daily operations.

“The most rewarding part of what I do is walking the road to recovery with my patients,” Dr. Dedmond said. “I share tremendous joy when people like Jimmy are back to life again.”

Jimmy’s family and friends continue to encourage him, too.

“I feel I’m very fortunate to be able to walk again, and that I’m still here,” he said.

He’s thankful to be walking, working and driving now, and values the time he can spend with his five grandchildren.

“I’m going to get back close to where I was,” he said. “I have a lot of things I want to do and haven’t accomplished yet.”

“I feel I’m very fortunate to be able to walk again, and that I’m still here.”

—Jimmy Oswald

BARNABY T. DEDMOND, MD

A Lexington Medical Center Physician Practice

Lexington Medical Park 2 Suite 140 146 North Hospital Drive West Columbia, SC 29169 811 West Main Street, Suite 101 Lexington, SC 29072 7033 St. Andrews Road Suite 104 Columbia, SC 29212 (803) 936-7230 Lex-Ortho.com

Lexington Orthopaedics offers same-day appointments for broken bones. Patients must make an appointment before 9:00 a.m.

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Orthopaedics & Neurosurgery

SUNDAY, AUGUST 13, 2017

ASK THE L EX I N G TO N M ED I C A L C E N T E R C L I NI C I A N onto the shoulder. In contrast, a degenerative tear is more insidious, with symptoms worsening over a period of months or longer.

Acute traumatic rotator cuff tears often do very well with early operative management using arthroscopic surgery to repair the tendon. Degenerative rotator cuff tears may require repair if nonoperative treatments do not improve the symptoms.

What are the top three sportsrelated injuries and how are they best treated?

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Top athletic injuries vary depending upon age and interests.

In my practice, I see a wide range of sports injuries, but some of the most common issues include shoulder instability (or dislocation), tears of rotator cuff tendons in the shoulder and ligamentous injuries in the knee.

1

SHOULDER INSTABILITY (OR DISLOCATION) Treatment of shoulder instability depends largely upon the age of the patient and whether the shoulder has recurrent episodes of instability. Generally, the younger the patient, the higher the likelihood for recurrent dislocation. Recurrent instability is typically best managed with arthroscopic surgery to stabilize the support structures in the shoulder. Arthroscopic surgery

is a minimally-invasive procedure.

However, an older patient with a single dislocation in the absence of rotator cuff pathology may do well with non-operative treatment.

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TEARS OF ROTATOR CUFF TENDONS In my practice, I divide rotator cuff tears into two broad categories: acute traumatic and degenerative. A traumatic tear usually happens due to a single incident, such as a fall

LIGAMENTOUS INJURIES IN THE KNEE One of the most common ligament injuries in the knee is an anterior cruciate ligament (ACL) tear. Untreated ligament tears may result in chronic instability in the knee. This instability can limit an athlete’s ability to return to his or her sport, and may lead to further damage to the cartilage of the knee. With some exceptions, these injuries are managed with arthroscopic surgery to reconstruct the torn ligaments.

What steps can recreational and elite athletes take to avoid these injuries?

4.5 MILLION

MUSCULOSKELETAL SPORTS INJURIES

465,070 SPINAL FUSION SURGERIES

75 MILLION

ADULTS WITH NECK OR LOW BACK PAIN

JUSTIN R. KNIGHT, MD

A Lexington Medical Center Physician Practice

Working to maintain a baseline level of fitness is one of the best preventive measures. It allows the body to develop strength and stamina, and minimizes injuries

ORTHOPAEDICS & NEUROSURGERY In the United States Each Year

that occur due to fatigue. Proper technique is also critical to diminish injury risk for many sports, whether you are a recreational golfer or a professional football player. All athletes should take time to adequately stretch and warm up prior to starting any high-intensity sport. Improved flexibility and mobility during workouts can boost performance and decrease the risk of significant injury.

Lexington Medical Park 2, Suite 350 146 North Hospital Drive West Columbia, SC 29169 (803) 936-7966 SEOrthopaedic.com

BY THE NUMBERS

29,000

TOTAL SHOULDER REPLACEMENTS

15,860

PARTIAL SHOULDER REPLACEMENTS

105,000 PARTIAL HIP REPLACEMENTS

306,000 TOTAL HIP REPLACEMENTS

645,000 TOTAL KNEE REPLACEMENTS

40% PEOPLE OVER AGE 65 WITH CHRONIC JOINT PAIN

Source: American Academy of Orthopaedic Surgeons

Orthopaedics & Neurosurgery

A Special Advertising Publication of The State Media Advertising Department and Lexington Medical Center

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Oh, Baby!

SPINE SURGERY PUTS NEW MOM BACK ON TRACK Last summer, Kate Pollard was six months pregnant with her first child and started having lower back pain.

At first, the 28 year old from Forest Acres thought the discomfort might be related to her pregnancy. Then the pain got much worse.

PATIENT STORY

“I

got up quickly out of a chair and turned. That’s when I felt a horrible, shooting pain down the back of my leg,” she said. “Each time I moved, the pain started again.

Then my leg went numb.”

The debilitating back pain and numbness in her leg continued for the rest of her pregnancy and after her son Wyatt was born in the fall.

“I would carry Wyatt, and it would hurt,” Kate said. “And the

“I would carry Wyatt, and it would hurt. And the constant bending over to pick him up felt really bad.”

—Kate Pollard

constant bending over to pick him up felt really bad.”

In fact, the pain affected all areas of Kate’s life. At her job as a CPA with an accounting firm in Columbia, carrying her laptop to visit clients was uncomfortable.

Then the holidays arrived.

“My husband Matthew and I went to a Christmas party, and I was on my feet all night. The next day I could barely stand up without feeling intense pain in the heel of my foot.”

An MRI revealed Kate suffered a herniated disc in her lower back.

The spine is made up of vertebrae and discs. The discs are like shock absorbers for the spine.

A herniated disc occurs when part of the disc escapes its normal space and enters the spinal canal. It often causes direct compression of the nerves in the lower back, leading

to terrible back and leg pain.

Kate made an appointment with C. Philip Toussaint, MD, FAANS, a neurosurgeon at Lexington Brain and Spine Institute, a Lexington Medical Center physician practice.

“Kate continued to have significant pain and numbness after she gave birth,” Dr. Toussaint said. “She realized the pain and numbness affected her ability to care for her child.”

Sometimes herniated discs resolve themselves with conservative treatments such as rest, over-the-counter pain medication and steroids. But because Kate’s pain had lasted for months without reprieve, Dr. Toussaint recommended surgery.

“Surgery can be highly effective in these circumstances with a more than 90 percent success rate in pain relief and improvement of quality of life,” he said.

In January, Dr. Toussaint performed a microdiscectomy on Kate at Lexington Medical Center.

With a small incision, he removed a portion of the disc material that was putting pressure on Kate’s nerve. The surgery took less than an hour, and Kate went home later the same day.

After surgery, Dr. Toussaint prescribed physical therapy to reduce the risk of further disc herniation and educate Kate on overall spine health.

Today, Kate has no pain in her lower back or foot.

“It’s a huge weight lifted and a relief. I knew that if I didn’t try surgery, I wouldn’t get better,” Kate said. “I’m glad I did it.”

According to Dr. Toussaint, the most common age groups for herniated discs are patients in their 30s and 40s. Sometimes heavy lifting or twisting cause them; other times, they occur spontaneously.

“Surgery can be highly effective in these circumstances with a more than 90 percent success rate in pain relief and improvement of quality of life.”

—C. Philip Toussaint, MD, FAANS

Kate Pollard lifts her son Wyatt in front of their home in Forest Acres.

Today, baby Wyatt is 10 months old. Kate can lift him without pain — making the joy of motherhood even sweeter.

C. PHILIP TOUSSAINT, MD, FAANS

A Lexington Medical Center Physician Practice

Lexington Medical Park 3 Suite 200 155 North Hospital Drive Neurosurgery (803) 935-8410 Pain Management & Physiatry (803) 936-7035 Pain Management – Northeast 720 Rabon Road Columbia, SC 29203 (803) 764-1228 LexingtonBrainandSpine.com

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Orthopaedics & Neurosurgery

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PATIENT STORY

Martin Faile and his grandson Trent are ready to work in their garden in Lexington

Out of the Weeds

HIP SURGERY HELPS GRANDFATHER RETURN TO THE GARDEN Not much comes between Martin Faile and his garden. The 78 year old is dedicated to tending the rows of vegetables in his Lexington backyard daily.

B

ut last year, Martin couldn’t do the work anymore.

Arthritis in his right hip made gardening painful. “My hip just wore out,” he said. “I was having trouble just walking on it.”

His grandson Trent stepped in to help take care of the crop. “I had to have someone do it for me because I couldn’t myself.”

And Martin knew he

operation in all of medicine because it restores people’s lives,” said Dr. Lazzarini. “Surgery gets rid of the pain. We can also correct limb length discrepancies.

And once the arthritis is removed, it can never come back.”

According to Dr. Lazzarini, patients are ready for hip surgery when hip pain starts interfering with their lives.

The doctor is by his patients’ side every step of the way. Before surgery, Dr. Lazzarini scores a patient’s pain and ability to walk, sit, use stairs and do other daily activities. After surgery and recovery, he scores them again to assess their progress.

“It’s incredible. When we compare results, they have been able to resume all activities of daily living — going to the store, driving, walking significantly longer distances and sleeping — without pain,” he said. “A lot are getting back into golf or

“Hip replacement surgery has been the single most successful operation in all of medicine because it restores people’s lives. Surgery gets rid of the pain.

We can also correct limb length discrepancies. And once the arthritis is removed, it can never come back.”

—Adam M. Lazzarini, MD, FAANS

needed help for his hip. He went to Adam M. Lazzarini, MD, FAANS, orthopaedic surgeon at Southeastern Orthopaedic and Sports Medicine, a Lexington Medical Center physician practice. Dr. Lazzarini specializes in using advanced surgical techniques to perform complex total joint replacement surgery.

Dr. Lazzarini recommended total hip replacement, a surgical procedure that replaces a damaged hip with an artificial one. As Baby Boomers age, total hip replacement is becoming more common because it can dramatically relieve pain, help the hip joint work better and improve quality of life.

“Hip replacement surgery has been the single most successful

While total hip replacement is not a new procedure, the technique and materials have improved dramatically in the last 10 years. New replacement components reduce the risk of joint instability, and are less likely to become tight or limit range of motion. They last longer, too.

“Artificial joints don’t wear out like they used to anymore. In fact, 85 percent are functioning at good to excellent levels 20 years later,” Dr. Lazzarini said.

gardening. They can kneel in church again and become more active in their communities.”

“Patients are also no longer self-conscious about the need for services, such as a ride in a special vehicle or an elevator,” Dr. Lazzarini said. “That’s why I love doing what I do.”

Martin said the surgery was easier than he thought it would be.

“They had me up and walking the next day. It was amazing,” he said.

Martin went home from the

After hip surgery, Martin is back in the garden — pain free. He welcomes help from his grandson Trent, but this time only because he likes the company.

hospital walking on his new hip with minimal soreness.

Dr. Lazzarini says the typical patient is in the hospital for one to three days. About 90 percent of patients are able to go home instead of a rehabilitation facility.

They receive home nursing care and physical therapy as needed for two to three weeks. Because many patients have walked for years on a bad hip, extended outpatient therapy may be needed to learn how to strengthen muscles and correct a limp or problematic gait.

After hip surgery, Martin is back in the garden — pain free. He welcomes help from his grandson Trent, but this time only because he likes the company.

And Martin applauds Dr. Lazzarini’s work. “I’m just waiting for my left hip to go bad so that I can go see him again.”

ADAM M. LAZZARINI, MD, FAANS

Lexington Medical Park 2 Suite 350 146 North Hospital Drive West Columbia, SC 29169 (803) 936-7996 SEOrthopaedic.com

Orthopaedics & Neurosurgery

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ASK THE L EX I N G TO N M ED I C A L C E N T E R C L I NI C I A N

What is functional dry needling?

Functional dry needling uses a very thin needle, typically smaller than a hypodermic needle, to affect a change in the neuromusculokeletal system.

Physical therapists use this therapy to relieve pain from a trigger point, or muscle knot. The needle can be placed and manipulated to cause a localized twitch response, which quickly activates the muscle and causes it to relax.

Dry needling can also be used for muscular imbalances in which one group of muscles becomes stronger or weaker than an opposing group. Electrical stimulation can be applied to the needles to relax overactive muscles or to help contract muscles that the nervous system does not activate properly.

Who can benefit from FDN? Patients should talk with their therapist to see if FDN could work for them. FDN may help: • patients with chronic pain, such as fibromyalgia; • anyone suffering from pain and dysfunction due to trigger points or tight muscles; • patients with chronic headaches (tension headaches/migraines); • athletes with acute or recurring injuries; • patients with muscle imbalances.

How can physical therapy help manage chronic pain?

Chronic pain is any discomfort or unpleasant sensation that lasts longer than three months or beyond an expected healing time.

A physical therapist can provide more information about chronic pain and find solutions to improve quality of life. He or she will help to improve movement, teach pain management strategies and, in many cases, reduce pain. Because not all chronic pain is the same, your therapist will need to evaluate your clinical examination and test results, and design an individualized

treatment plan that fits you best.

Physical therapy treatments may include:

Who best benefits from these pain management treatments?

• Education to improve your understanding of chronic pain — how it occurs and what you can do about it. Your therapist will teach you how to manage your pain and help you work toward performing your normal daily activities again.

Most people with musculoskeletal pain can be helped by a physical therapist. He or she should be knowledgeable about your specific condition or surgery. There are many types of physical therapists, and you want to make sure you go to one who specializes in the treatment you need.

• Strengthening and flexibility exercises to help you move more easily with less discomfort. Your therapist will design a program of graded exercises — movements that are gradually increased according to your abilities. These exercises help you improve your coordination and movement, reducing stress and strain on your body and decreasing pain.

SCOTT R. WILBERT, PT, DPT, CCI, OMT-C, CSCS, FDN-1

• Manual therapy, which consists of specific, gentle, hands-on techniques that manipulate or mobilize tight joint structures and soft tissues. Manual therapy is used to increase range of motion, improve the quality of tissues and reduce pain.

• Posture awareness and body mechanics instruction to help improve posture and movement.

This training helps you use your body more efficiently while performing activities and when resting. Your therapist will help you adjust your movements for work, chores and recreational activities to reduce your pain and increase your ability to function.

A Lexington Medical Center Physician Practice

Lexington Medical Park 3 Suite 200 155 North Hospital Drive West Columbia, SC 29169 (803) 935-8410 720 Rabon Road Columbia, SC 29203 (803) 764-1228 LexingtonBrainandSpine.com

RUN • WALK • HONOR OUR HEROES

P RE SE N T E D BY

FRIDAY, SEPTEMBER 15, 2017 H 7:00 P.M. Register at T2TRunSC.org

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Orthopaedics & Neurosurgery

SUNDAY, AUGUST 13, 2017

From Off-the-Shelf to One-of-a-Kind CUSTOMIZED KNEE RESURFACING CREATES A PERFECT FIT

There are custom suits and drapes. But how about custom knee implants — completely designed for one specific person and guaranteed to be a perfect fit?

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technology. ConforMIS uses the scan to create or patients with severe knee arthritis, a 3-D model of the knee and develop an this option is now available at Carolina individualized implant made of titanium cobalt Shoulder & Knee Specialists, a chrome. The process takes about six weeks, Lexington Medical Center physician practice. and the implant is delivered to Lexington Knees vary in size and shape. Even a Medical Center a few days before surgery. person’s two knees are different. Traditionally, Regina Koposko Cox of Lugoff underwent knee implants come in six to 10 standard sizes. the procedure on both knees after suffering Doctors will select the one that fits the patient knee pain for three years that best during surgery. continued to get worse.

But for patients with “Before the surgery, it leg bones that are especially was difficult to walk up the wide, narrow or odddriveway,” she said. “Now I shaped, finding the perfect look forward to going up and fit can be difficult. down steps because there “It can be like wearing isn’t any pain.” your dad’s shoe. It’s a shoe, She’s completing but it might not fit you physical therapy and looks right,” said Kevin Nahigian, forward to spending time MD, of Carolina Shoulder KEVIN NAHIGIAN, MD working in her yard, pain & Knee Specialists. If a knee free. The implants help implant doesn’t fit correctly, patients meet those patients may experience goals easily. pain or a knee that doesn’t “They’re designed to feel natural. follow the shape and contour Patients who choose A Lexington Medical Center Physician Practice of each patient’s knee, customized knee resurfacing which provides an increased will have a diagnostic CT 810 Mallet Hill Road potential for a more natural scan of their knee. The Columbia, SC 29223 feeling knee,” said Dr. physician’s office sends (803) 419-6646 Nahigian. “Customized the scan to ConforMIS, LMCCarolinaShoulder.com implants also allow for the company behind the

Regina Koposko Cox inside Carolina Shoulder & Knee Specialists holding a model of a knee implant

“Before the surgery, it was difficult to walk up the driveway. Now I look forward to going up and down steps because there isn’t any pain.”

—Regina Koposko Cox

optimal bone preservation.”

Patients can bear full weight on their knee on the day of surgery and go home from the hospital the next morning.

The goal is to have patients back to enjoying an active lifestyle with the best results possible.

A S K T HE L EX I N G TO N M ED I C A L C E N T E R C L I NI C I A N What are the best treatments for plantar fasciitis?

What is plantar fasciitis?

The plantar fascia is a ligament on the bottom of the foot that attaches to the bottom of the heel. Sometimes, when this ligament gets too much stress or strain, it can develop microscopic tissue damage and subsequently become inflamed. This process is gradual and causes chronic inflammation, which is referred to as fasciosis. It can make pressing on the bottom of the heel, and sometimes out into the arch of the foot, feel very tender and may be painful.

Patients often feel more significant pain first thing in the morning and after periods of rest. Visible swelling or bruising is rare.

How do you get plantar fasciitis?

People who have hypermobile flat feet or extremely rigid, high-arched feet may excessively strain the plantar fascia. Standing for long periods, walking long distances, or high-volume weight-bearing exercises, such as longdistance running or walking, can contribute. Aging and excessive weight can also be contributing factors. The problem is usually due to one of or some combination of these factors.

PAUL R. BEARDEN, DPM

The most effective treatments for plantar fasciitis include wearing good athletic shoes with good arch support, consistent daily stretching exercises and occasional icing. Night splints, anti-inflammatory medications, cortisone shots and physical therapy are also useful conservative treatment options. A custom-molded orthotic may be the single most effective and reliable conservative tool, and some patients may benefit from using all of these treatment options.

How long does it take plantar fasciitis to heal?

A Lexington Medical Center Physician Practice

121 Park Place Court Effective treatment can improve Lexington, SC 29072 plantar fasciitis within one to four (803) 356-4712 weeks, but complete resolution often LMCLexingtonPodiatry.com takes up to six months. It is important to note that healing does not begin until you start an effective treatment plan.

Subsequently, if this treatment doesn’t seem to be working, it probably won’t work. Waiting six months may not improve the condition. You have to do something to effectively change the status quo.

What can you do to prevent plantar fasciitis?

While there are things we can do to help prevent plantar fasciitis, there is no surefire way to prevent it. Wearing good shoes with proper arch support, and staying flexible and stretching daily can help prevent this problem. Talking with an associate at a reputable running shoe store can also be helpful.

Orthopaedics & Neurosurgery

A Special Advertising Publication of The State Media Advertising Department and Lexington Medical Center

Lexington Medical Center Extended Care occupational therapist Kate Abney with Joe Cousins inside the therapy apartment kitchen

PATIENT STORY

Now We’re Cooking!

LIFE IS GOOD WITH OCCUPATIONAL THERAPY

Joe Cousins fixed lunch at the kitchen counter, did laundry and made the bed.

But he wasn’t at home. Instead, the 75-year-old Lexington man was at an occupational therapy session inside Lexington Medical Center Extended Care’s rehabilitation facility.

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oe received inpatient physical and occupational therapy there for a month.

The retired computer scientist has a neurological issue that affects his balance, and spine issues that cause pain and trouble walking. He also had knee replacement surgery earlier this year and went straight to Extended Care for inpatient therapy after surgery.

“I liked the intensity of being there full time,” Joe said. “When I arrived, I could barely move my feet. I had limited mobility and real balance problems.

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We worked hard.”

Clinicians worked with Joe six days a week for nearly a month.

“When Joe first came to us, he needed two people to help him stand and walk,” said Kate Abney, Joe’s occupational therapist at Extended Care. “And even with help, he could only walk to the door and back to the bed.”

Joe gained strength using machines in the facility’s stateof-the-art rehabilitation gym where therapists complimented his progress and applauded his milestones.

“He is a hard-working man,

for sure. His improvement was miraculous,” Kate said.

While physical therapy tends to focus on helping patients recover from injuries by using exercise and other techniques, occupational therapy focuses on a patient’s day-to-day tasks in their home or work environments.

Both are important to help patients get better and live life to the fullest.

Each day, Kate and Joe moved forward with new tasks to help ensure Joe could do activities that are part of his daily routine.

That included work in a therapy

“apartment” that offers a homelike environment where patients become comfortable performing household tasks. He enjoyed working in the kitchen there, perfecting an egg omelet with cheese, ham and vegetables.

“Sometimes you think, ‘What are they going to tell me that I don’t already know?’” Joe laughed.

“But they make you think about how you’re going to do something before you do it and demonstrate that you can do it comfortably.”

Today, Joe is back at his Lexington County home. He navigates the space without a cane or walker. He also drives daily.

“He is fully independent,” Kate said. “It’s great to see his remarkable recovery.”

For more information about rehabilitation services at Lexington Medical Center Extended Care, visit LexingtonExtendedCare.com.

ASK THE L EX I N G TO N M ED I C A L C E N T E R C L I NI C I A N

Can working in an office affect your health and, if so, what can you do to reduce the risk of injury?

Many hazards in environmentally controlled office settings can contribute to injury or illness. Two of the more common causes for injury are ergonomicrelated injuries and eye strain.

Ergonomic injuries are usually repetitive or positional injuries leading to musculoskeletal strains, or tendon or nerve injuries. Adjustable workstations help fit the workstation to the worker, such as adjustable chairs with lumbar supports that encourage neutral posture with both feet on the floor to reduce back fatigue and strain. When positioning your mouse and keyboard, try to keep your elbows at a 90° angle and align wrists neutrally with your forearms and hands to help reduce hand pain, fatigue and numbness.

Another common cause of injury is eye strain. Spending long hours using a computer often contributes to this injury. Headaches are also common with eye strain. Take a 10-minute break periodically to focus your eyes on more distant objects to rest your eyes. Dimmed florescent lights and/or desk lamps may also be more suitable for indoor lighting when working on a computer. To reduce outside glare on computer screens, use window shades and/or computer glare screens or reposition your monitor to be opposite of windows. The optimum position for a computer monitor is 20 to 26 inches from the eyes and slightly below eye level.

DANA RAWL, MD, MPH

A Lexington Medical Center Physician Practice

3799 12th Street Extension Suite 110 Cayce, SC 29033 (803) 755-3337 LMCOccHealth.com

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Orthopaedics & Neurosurgery

SUNDAY, AUGUST 13, 2017

Connor Shaw, University of South Carolina’s All-Time Winningest Quarterback

Focused on getting you better sooner.

Lex-Ortho.com

SEOrthopaedic.com

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