MOVING ON
Orthopedics Throughout
Your Life
TW Grossman, Jr., MD, FACS
Agnesian Center for Bone & Joint Health
Our Team
Thomas Grossman, Jr.,
MD, FACS
Joe Kemp, MD Steven Magoline, MD
Our Team
Michael Mannebach, MD Karl Pennau, MD Alan Roetker, MD
Our Team
Clark Searle, MD Margie Anderson, APNP Meagan Kruck, PA-C
Orthopedics - History
• 1741 Orthos = Straight
Paidon = Child
• 1780 First hospital dedicated to treatment
of children’s d...
Who Are We?
About:
• 20,400 orthopedic surgeons
• 700 “new” per year
• Three to four percent of all physicians are orthope...
Top 10 Procedure List
10. Radius and Ulna Fracture Surgery
9. Rotator Cuff Surgery
8. Hip Replacement
7. Hip Fracture Surg...
Orthopods Are Surgeons
• We are surgeons, but not everyone gets an
operation.
• In my practice about 50 percent of patient...
Children
• Children are not small
adults
• Unique anatomy of
growing bone
• Growth plate - cartilage
cells
Children’s Fractures
• Children do not get sprains
- they get fractures
• The growth plate is
“weaker” then the rest of
th...
Children’s Fractures (continued)
• Greenstick
Fracture - bone
partially breaks
Greenstick Fracture
Torus or Buckle
• One side bends but does
not break
• Resembles bending a
plastic drinking straw
Children’s Fracture (continued)
• Most treated with immobilization
• Healing time usually four to eight weeks
The ACL
• ACL = anterior cruciate
ligament
• Usually report “My knee
gave out”
• Often football, basketball,
soccer, skiin...
The ACL (continued)
ACL Anatomy
• One of two
crossing ligaments
ACL Anatomy (continued)
ACL Surgery
ACL Injury & Treatment
• Report a “pop”
• Rapid swelling
• Unsteady or trick
knee
• Men and women
are different
ACL Injury & Treatment (continued)
• The tears do not heal
• Non-operative
treatment
– Brace
– Strengthen quads and
hamstr...
Joint Replacement
• Arthroplasty - realign or
reconstruct joint to relieve
pain
• Hips, knees, shoulders,
ankles, knuckles...
Joint Replacement – When?
• When?
– Must be “old enough”
– Other measures (cane, crutches, walker,
rehabilitation, medicat...
Joint Replacement - Knee
• How?
– Open knee
– Machine thigh bone
(femur)
– Machine shin bone
(tibia)
– Glue in components
...
Joint Replacement - Hip
• How?
– Open hip (back, outboard
side, inboard side, front,
front from the outboard
side)
– Machi...
Hip Fractures
• Surgery is the conservative treatment
• Non-operative treatment - Bed rest, traction
• Non-operative treat...
Hip Fractures In the Elderly
• About two percent of falls yield a fracture
• Most commonly due to
brittle bones (osteoporo...
Hip Fractures In the Elderly
(continued)
Hip Fractures In the Elderly
• Surgery sooner rather then later
– Align the fracture
– Stabilize with an implant
– In some...
Hip Fractures In the Elderly
(continued)
Hip Fractures In the Elderly
(continued)
Hip Fractures In the Elderly
(continued)
Hip Fractures In the Elderly
(continued)
Thank You!
Questions?
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Agnesian HealthCare Know & Go Showcase: Orthopedic Services

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The doctors from the Agnesian HealthCare Center for Bone & Joint Health discuss what is going on in the world of orthopedics, including the most common diagnoses and the treatments offered to the patients.

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Agnesian HealthCare Know & Go Showcase: Orthopedic Services

  1. 1. MOVING ON Orthopedics Throughout Your Life TW Grossman, Jr., MD, FACS Agnesian Center for Bone & Joint Health
  2. 2. Our Team Thomas Grossman, Jr., MD, FACS Joe Kemp, MD Steven Magoline, MD
  3. 3. Our Team Michael Mannebach, MD Karl Pennau, MD Alan Roetker, MD
  4. 4. Our Team Clark Searle, MD Margie Anderson, APNP Meagan Kruck, PA-C
  5. 5. Orthopedics - History • 1741 Orthos = Straight Paidon = Child • 1780 First hospital dedicated to treatment of children’s deformities • 1851 Plaster of Paris invented by a Dutch military surgeon Correction of spinal and bony deformities are a cornerstone of orthopedic practice.
  6. 6. Who Are We? About: • 20,400 orthopedic surgeons • 700 “new” per year • Three to four percent of all physicians are orthopedic surgeons • 90 percent male • Average age is 55 • In Wisconsin, 9.9 orthopedic surgeons/100,000 people • 563 in Wisconsin
  7. 7. Top 10 Procedure List 10. Radius and Ulna Fracture Surgery 9. Rotator Cuff Surgery 8. Hip Replacement 7. Hip Fracture Surgery 6. Knee Replacement 5. Anterior Cruciate Ligament Reconstruction 4. Remove Plates and Screws 3. Carpal Tunnel Release 2. Shoulder Arthroscopy 1. Knee Arthroscopy and Menisectomy
  8. 8. Orthopods Are Surgeons • We are surgeons, but not everyone gets an operation. • In my practice about 50 percent of patients are treated without surgery.
  9. 9. Children • Children are not small adults • Unique anatomy of growing bone • Growth plate - cartilage cells
  10. 10. Children’s Fractures • Children do not get sprains - they get fractures • The growth plate is “weaker” then the rest of the bone and is often injured
  11. 11. Children’s Fractures (continued) • Greenstick Fracture - bone partially breaks
  12. 12. Greenstick Fracture
  13. 13. Torus or Buckle • One side bends but does not break • Resembles bending a plastic drinking straw
  14. 14. Children’s Fracture (continued) • Most treated with immobilization • Healing time usually four to eight weeks
  15. 15. The ACL • ACL = anterior cruciate ligament • Usually report “My knee gave out” • Often football, basketball, soccer, skiing or a slip and fall • Twisting knee while running or cutting
  16. 16. The ACL (continued)
  17. 17. ACL Anatomy • One of two crossing ligaments
  18. 18. ACL Anatomy (continued)
  19. 19. ACL Surgery
  20. 20. ACL Injury & Treatment • Report a “pop” • Rapid swelling • Unsteady or trick knee • Men and women are different
  21. 21. ACL Injury & Treatment (continued) • The tears do not heal • Non-operative treatment – Brace – Strengthen quads and hamstrings • Operative Treatment – Reconstruct ACL
  22. 22. Joint Replacement • Arthroplasty - realign or reconstruct joint to relieve pain • Hips, knees, shoulders, ankles, knuckles • Highly effective for pain relief • Completely elective surgery
  23. 23. Joint Replacement – When? • When? – Must be “old enough” – Other measures (cane, crutches, walker, rehabilitation, medications) no longer effective • Keep your original equipment as long as possible • Most patients say they waited too long to have it done
  24. 24. Joint Replacement - Knee • How? – Open knee – Machine thigh bone (femur) – Machine shin bone (tibia) – Glue in components – Plastic insert
  25. 25. Joint Replacement - Hip • How? – Open hip (back, outboard side, inboard side, front, front from the outboard side) – Machine the thigh (femur) – Machine the socket (acetabulum) – Impact or glue in components
  26. 26. Hip Fractures • Surgery is the conservative treatment • Non-operative treatment - Bed rest, traction • Non-operative treatment is greater risk than surgery – Pneumonia, blood clots, pressure sores, poor outcome • Risk of death following hip fracture 20 to 35 percent within one year
  27. 27. Hip Fractures In the Elderly • About two percent of falls yield a fracture • Most commonly due to brittle bones (osteoporosis) • 80 percent are women • Average age - 77 women • Average age - 72 men • 310,000 per year in the United States
  28. 28. Hip Fractures In the Elderly (continued)
  29. 29. Hip Fractures In the Elderly • Surgery sooner rather then later – Align the fracture – Stabilize with an implant – In some instances, “half replacement” (hemi arthroplasty” – Rarely hip replacement
  30. 30. Hip Fractures In the Elderly (continued)
  31. 31. Hip Fractures In the Elderly (continued)
  32. 32. Hip Fractures In the Elderly (continued)
  33. 33. Hip Fractures In the Elderly (continued)
  34. 34. Thank You! Questions?

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