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Bone, Joint Center brings motion to life by Susan Kammeraad-Campbell  Director of Publications, Marketing The MUSC Total Joint Replacement Program is about restoring the motion of life. As part of the MUSC Bone and Joint Center, the program gives patients and their families a team of professionals who are experts in caring for arthritis.  The MUSC Bone and Joint Center delivers the most comprehensive range of musculoskeletal services in the region. Highly trained specialists and staff are dedicated to helping those who experience the pain and stiffness associated with arthritis live more active lives with less discomfort. Patients of all ages are evaluated and treated with the most innovative technology available and elevated to a  level of care only  found at an academic medical center. Together, orthopaedic surgeons, rheumatologists and endocrinologists utilize services from radiology, internal medicine, anesthesiology, physical therapy and occupational therapy to maximize care. Whether exploring non-surgical options or joint replacement, the team supports patients in making the choices that will serve them best. H. Del Schutte, M.D., and Harry A. Demos, M.D., are board certified orthopaedic surgeons who are fellowship trained in joint replacement surgery. The primary focus of their work is total joint replacement, making them two of the most experienced surgeons in this field. Balancing the benefits of the most innovative techniques with the proven technology of the past, their experience and expertise result in improved outcomes and faster recovery. The team has a genuine concern for patients's well-being that extends not only through surgery and initial recovery, but for life. Having a joint replaced is a decision with life-long impact. MUSC’s approach to joint replacement begins by thoughtfully evaluating treatment options with patients and their families. The care extends well beyond the actual surgery. All patients are enrolled in a joint registry to monitor their performance for life. MUSC Bone and Joint Center continually studies and evaluates new technologies, procedures and techniques, and participates in research designed to provide patients a more active, less painful future. “As a surgeon, having the opportunity and ability to restore someone to an active lifestyle is tremendously gratifying,” said Demos. “It’s a responsibility that goes far beyond the actual operation. It begins before and continues long after surgery.” “We are committed to combining the latest advances in technology and technique with a conscientious, conservative approach to provide the best result possible,” said Schutte. “Most importantly, we, as a team, are dedicated to life-long care of our patients.” Total Joint Replacement Unit The MUSC Medical Center has dedicated a special unit, 2 West,  to the care of patients who have undergone total joint replacement surgery. The nursing staff on this unit is specially trained to help manage the particular issues associated with joint replacement surgery. This specialized unit includes a therapy gym where patients are guided through recovery by a team of physical and occupational therapists who coach patients and their families about the rehabilitation process. Each patient receives a customized plan to regain strength, mobility and a better quality of life. A continuum of care manager and social worker help our patients make the transition from hospital to home. Surgery The surgical team is made up of physicians, nurses and technicians who specialize in orthopaedic and joint replacement procedures. The team has the expertise and equipment readily available to perform primary and complex revision joint replacement procedures that are beyond the scope of what is available at most other institutions. Sophisticated technology—The operating room is equipped with some of the most advanced technologies and computerized equipment available, such as digital imaging, electronic medical records and integrated computerized technology, including computer-guided navigation. Advanced implants—Patients have access to implants manufactured with the most advanced materials available to provide the longest-lasting, highest-performing replacement. Less invasive approach—Surgeons at MUSC use the most minimal surgical approach possible, while still providing for the most accurate placement of the replacement joint. This approach results in the smallest incision and least muscle disruption, thus easing recovery.  Dedicated orthopaedic anesthesiologists—Our anesthesiologists have special training in orthopaedic anesthesia, including epidural anesthesia and regional nerve blocks. Their involvement extends throughout the hospital stay to assist the team in keeping the patient comfortable. Follow-up care and ongoing patient involvement Joint replacement patients are followed closely after surgery by the surgeons and nurses at the Bone and Joint Center, as well as therapists in the community, and receive life-long follow up care. For more information, call the Bone and Joint Center at 1-800-424-MUSC (6872) or 792-2400.   Seven weeks after getting a new knee Don Brown hit a hole in one It’s been four decades since Don Brown played as a wide receiver for Western Carolina University. But for years and years, every step he took was a reminder of that time. “For the last four or five years, I couldn’t walk without pain,” says the 57-year-old retired state trooper from Moncks Corner. “I couldn’t even sleep without the pain waking me up.” Don’s bad knee came from an injury he sustained while playing college football in which he seriously damaged the ligaments and cartilage in his knee. “At that time, they thought the way to deal with it was to take out the cartilage,” says Don in reference to the surgery he underwent in the 1960s. Cartilage is the smooth layer that covers the bone ends of a joint.  It also forms the shock absorbing meniscus that Don had removed.  Normal articular cartilage allows nearly frictionless and pain-free movement. When the cartilage is damaged or diseased by arthritis, however, joints become stiff and painful. For Don, the impact over time was there was no buffer between the bones of the joint. As a committed five-day-a-week golfer, Don was hurting badly enough that he only golfed a couple of times a week. His game was hurting as much as his knee. Don’s good friend and frequent golf companion Watson Mims had more than friendship and golf in common with him. Don’s friend also had bad knees. When Watson decided to get his knees replaced with artificial joints, he chose the MUSC Bone and Joint Center and orthopaedic surgeon Harry Demos, M.D., to do the work. This gave Don an opportunity to observe first-hand the impact of the replacement surgery on his friend. “Watson did very well,” he says. “It was impressive—he went from barely being able to walk to playing golf pain free.” Don contacted the MUSC Bone and Joint Center to arrange for Dr. Demos to do his joint replacement. “Bone rubbing on bone is extremely painful,” says MUSC orthopaedic surgeon Harry Demos, M.D. “Given the deteriorated state of Don Brown’s knee, he was an excellent candidate for joint replacement.” When a total joint is replaced, the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function. The materials used are designed to enable the joint to move just like a normal joint. Seven weeks after surgery, Don was back on the links. Like his friend, he was moving better and pain free. On his third golf outing, Don Brown pulled a six iron from his bag and lined himself up on the fifth tee of the Berkeley Country Club. The par-three hole was 165 yards from where he stood. He swung, contacted the ball and sent it arching toward the green. And it rolled right in the hole. What’s new Computer-guided surgery  Precision. When a knee or hip is replaced, alignment determines how well the joint functions over time. An experienced surgeon develops a learned touch for accurate alignment. Now, breakthrough technology, currently in use at MUSC, offers surgeons computer-assisted navigation to ensure accuracy within a fraction of a degree. MUSC orthopaedic surgeon Del Schutte, M.D., who performs hundreds of joint replacement procedures annually, is impressed with the new technology. “It uses an infrared camera and markers to continually monitor the alignment of the implant in relation to the patient’s anatomy,” said Schutte. “It’s like having a powerful surveyor’s tool in the operating room.” The navigation system provides the surgeon with a comprehensive understanding of the patient’s knee or hip mechanics. The interactive display of lines, angles and measurements gives a clear reading of what’s needed to give the patient’s replacement knee the best strength, stability and range of motion.  “This technology allows for more accurate placement, potentially resulting in decreased complications and a longer lasting implant,” Schutte said. Editor's note: The article is reprinted from Checkup, produced by MUSC Business Development and Marketing Services.    Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.