3 Surgeries that can be Performed in the OSMS Procedure Room

Hospital or outpatient surgery center. These are probably the two most common types of locations a person would think of to answer the question, “Where are you having your orthopedic surgery?”  But there is actually a third option – the OSMS procedure room. This type of treatment is often called “office-based surgery,” as the procedure is performed right in the clinic setting. The OSMS physicians can perform many hand and minor procedures in this setting, including:

  • Finger cyst removal
  • Trigger finger release
  • Carpal tunnel release
  • Nail bed repair
  • Tendon repair and transfer
  • Some lacerations from injuries at home or work

Learn more from Dr. Ben Zellner, orthopedic hand-to-shoulder surgeon, about 3 of the most common surgeries performed in the OSMS procedure room. You can also learn more about how the procedure room works by reading “The OSMS Procedure Room: A Quicker and Less-Expensive Option for Hand Surgery.”

How Orthopedics and Physical Therapy Work Together

Since October is National Physical Therapy Month, we wanted to discuss the important role physical therapy plays in the treatment and recovery of many of the injuries and conditions that we care for at OSMS. So we sat down with Andy Taber from one of our partners, Advanced Physical Therapy and Sports Medicine, to learn more about how physical therapy and orthopedics work together. Andy is a Doctor of Physical Therapy, Board Certified Orthopedic Clinical Specialist, and Board Certified Strength and Conditioning Specialist.

If you sustain an orthopedic injury like a torn meniscus or broken elbow, or you are diagnosed with a condition like arthritis, your orthopedic physician might recommend physical therapy as a starting point for treatment. Physical therapy can often be an effective nonsurgical treatment to relieve pain and restore function.

“Physical therapy can assist the body in the natural healing process,” Andy says. “Through physical therapy, we can address mechanical faults to help an injury heal. We also develop prevention strategies to reduce the risk of injury in other limbs that may try to overcompensate for the injured area during the healing process.”

For example: if a person is dealing with pain, stiffness, and inflammation from osteoarthritis, a physical therapist can help relieve symptoms by:

  • Evaluating, diagnosing, and correcting gait and posture abnormalities that may increase the breakdown of a joint or cause injury to another area of the body.
  • Improving strength, range of motion, and flexibility around an arthritic joint to reduce pain and improve overall function.
  • Implementing joint protection strategies in an effort to conserve the remaining cartilage in a joint.

When an orthopedic surgery is needed to treat an injury or condition, physical therapy continues to play an important role.

Whether it’s repairing a torn ACL or replacing a hip joint, the ultimate success of a patient’s recovery after surgery is partially dependent on the condition of the patient going into surgery.

“Doing physical therapy before an orthopedic surgery can help improve flexibility and build strength around the injured or arthritic area,” Andy says. “And as range of motion and strength increases prior to surgery, the patient is likely to have an easier time recovering these aspects of mobility and function after surgery.”

Once an orthopedic surgery is performed, physical therapy helps the recovery process in several ways, including:

  • Implementing interventions designed to reduce pain and improve comfort in the hopes of reducing the need for long-term use of pain medications.
  • Helping patients understand how to properly use assistive devices such as crutches, walkers, and canes.
  • Restoring range of motion and strength of the surgical area.

“Once the body gets through the initial post-operative inflammation, and the healing process is well established, physical therapy continues to help patients return to their previous level of function,” Andy says. “This is done through progressive, individualized retraining of motions, postures, and activities related to what a patient wants to get back to.”

3 Facts About Pediatric Fractures

At this time of year, you see skeletons all over the place…

Skeletons

But it’s important to remember that skeletons are much more than just spooky Halloween decorations. The bones that make up each of our skeletons actually play several significant roles in keeping our bodies healthy and active.

Our bones:

  • Protect vital organs
  • Store and supply calcium for the body’s cells
  • Give structure to the body, and together with muscles, allow us to move

That’s why when a bone breaks, it is important to have it properly treated so that it can heal and continue to perform these important tasks. This is especially true for children, since their bones are still growing.

Watch this video from Dr. Steven Schechinger to learn about a few of the common types of pediatric fractures and their treatments.

You have Osteoarthritis…What’s Next?

You decided to see an orthopedic doctor about your painful joint, and the physician says you have osteoarthritis. You are probably asking, “Now what do I do?”

OA Definittion

Osteoarthritis of the knee

After being diagnosed with OA, your orthopedic physician will go through several treatment options with you based on the severity of your arthritis. In most cases, they will recommend nonsurgical treatments to start.

We talked with orthopedic surgeon Dr. Walker Flannery about some of these nonsurgical methods to better understand how they help relieve the symptoms of osteoarthritis.

Medications

One of the simplest ways to try and help relieve the pain, stiffness, and swelling from arthritis is taking over-the-counter medications such as:

  • Ibuprofen – Max does of 2400 mg per day, split into three equal doses
  • Naproxen (Aleve) – Max dose of 880 mg per day, split into two equal doses
  • Acetaminophen (Tylenol) – Max dose of 3000 mg per day, split into three equal doses

(Please consult with your primary care physician before taking any of the above medications).

“These over-the-counter medications not only help relieve pain, but many will actually reduce inflammation within the joint,” says Dr. Flannery.

Lifestyle Changes

In addition to over-the-counter medications, there are many lifestyle changes that a person can make to help with joint pain. These include:

  • Staying active, but switching to lower impact activities like walking, biking, swimming, and yoga.
  • Maintaining a healthy weight to reduce the pressure put on joints like the knees and hips.
  • Using an assistive device such as a cane or walking stick.

Physical Therapy

“Physical therapy helps maintain or increase range of motion within the joint,” says Dr. Flannery. “It also builds muscle strength, which may help relieve any extra pressure being put on the joint.”

Doing physical therapy at this stage (prior to surgery) can also help with the recovery and overall outcome if a joint replacement surgery is eventually needed.

Injections

A fourth nonsurgical option for arthritis management is joint injections. This treatment method is used to deliver medication directly into the arthritic joint to reduce inflammation and relieve pain.

One type is a cortisone (steroid) injection that reduces inflammation within a joint, which can significantly reduce pain. A second type of injection uses a solution that lubricates the joint to reduce pain and improve range of motion and mobility within the joint.

“Any of these nonsurgical methods can be used for arthritis in the hips, knees, shoulders, or other joints,” says Dr. Flannery. “Our goal with recommending these options is to relieve a patient’s symptoms and see if surgery can be delayed or even prevented.”

It’s also important to note that many insurance plans require patients to try nonsurgical methods prior to having a joint replacement surgery if they are looking to have the procedure covered under insurance benefits.

Flannery-bio page

Dr. Walker Flannery is the newest orthopedic surgeon to join the OSMS team. To make an appointment with him or any of the other OSMS physicians, call 920-430-8113.

 

 

 

 

The Benefits of Yoga

Benefits of Yoga

Since September is National Yoga Month, we talked with a couple of local instructors to learn more about the many benefits of yoga.

Some of the most commonly talked about benefits are the physical ones, like improved flexibility, increased strength, and better balance. These are why many people have started to include yoga in their fitness regimens. But beyond being a good workout, yoga has other physical benefits.

“Practicing yoga can help increase respiratory capacity, improve circulation, and enhance digestion,”‘ says Jackie Schechinger, a Green Bay yoga instructor and wife of OSMS physician Dr. Steve Schechinger.

Yoga also has a positive effect on a person’s mental health.

“The increased awareness to mindfully breath helps calm the nervous system and increase oxygen flow in the blood, which causes this wonderful duality of feeling calm yet energized,” says Jen Berres, owner of and instructor at Jenstar Yoga and Dance in De Pere.

While everyone can benefit from the strengthening and stress-reducing outcomes of yoga, it can be especially beneficial for two types of OSMS patients – athletes and those living with arthritis.

Yoga and Athletes

Competitive athletes are always looking to improve athletic skills and reduce the risk of injury. Yoga can help with both!

“Athletes tend to have a ‘go hard’ mentality about training, and a yoga practice brings balance to this mindset by teaching athletes to slow down and be in the moment,” says Jen. “It also creates better body awareness, which allows athletes to gain more range of motion, fluidity of movement, strength, stamina, and coordination. It is definitely a game changer, and many of the best athletes in the world are incorporating yoga into their routines.”

Yoga can also help with injury prevention and recovery.

“The improved body mechanics, balance, stability, and flexibility that an athlete can experience from yoga all work together to reduce the risk of injury,” says Jackie. “But perhaps the most important benefit for athletes is the increased mental awareness and focus to overcome an injury and elevate training and performance to the next level.”

Yoga and Arthritis

Despite the pictures of headstands, arm balances, and intricate twists that you may see on social media, yoga can be gentle enough for people living with arthritis.

“Yoga helps those with arthritis see better overall physical functioning, in particular increased joint range of motion, flexibility, and balance,” says Jackie.

Together, these outcomes can help reduce joint stiffness and pain so that people can continue to live actively.

“Joint pain is uncomfortable, but if you stop being active it can only get worse,” says Jen. “I have seen clients with arthritis feel a world of difference after only a few yoga classes.”

Learn more about yoga and arthritis from the Arthritis Foundation.

If you are new to yoga – no matter your age or activity level – it’s important to find a style and instructor that fits your needs and allows for appropriate modifications for individual restrictions, limitations, or injuries.

3 Myths about Physician-Owned Clinics

Myths about Physician-Owned Clinics

First, let’s define what a physician-owned clinic is. You may have heard of “independent practices,” “private practices,” or “doctor-owned clinics.” All of these terms describe a healthcare organization where the physicians not only provide the care, but they are also the owners of the business.

OSMS is an example of a physician-owned clinic. OSMS doctors make up the board of directors along with the CEO, and they make the business decisions that ultimately affect the patient experience.

Many perceptions exist about the cost and quality of “independent” or “physician-owned” medical practices. We are going to show you the truth behind three of of the most common myths about this type of clinic.

Myth 1: Doctor-owned clinics are small and outdated.

The Truth: Doctor-owned clinics can vary in size and specialty. While some may only have one or a few providers, many others feature larger groups of physicians. For example, as of this September, OSMS will have 14 physicians who specialize in a variety of orthopedic and rheumatologic services, including:

  • Sports medicine
  • Joint replacements
  • Arthritis care
  • Fracture care
  • Hand-to-shoulder care
  • Foot and ankle care
  • Pediatric rheumatology
  • Adult rheumatology

See all of our physicians here.

Plus, they often provide other supporting services such as X-ray, MRI, and lab services onsite to ensure the most convenient experience for their patients.

Many doctor-owned specialty clinics also own, or partially own, freestanding surgery centers where they can perform outpatient surgeries outside of the hospital setting. These types of facilities are called ambulatory surgery centers, and they are known for their high quality, high patient satisfaction rates, and lower costs. OSMS is a a co-owner of the Bellin Orthopedic Surgery Center (BOSC), located onsite at the OSMS Green Bay clinic.

As both the care providers and the business owners, physicians at independent clinics are motivated to make business decisions that will ensure the best possible patient experience. For example, if updating the onsite MRI machine is going to provide better patient care, then the physicians have the authority to make that purchase decision.

Myth 2: Doctor-owned clinics are more expensive.

The Truth: Many times the cost of your overall care will be less expensive at a doctor-owned clinic than seeing the same type of specialist at a larger healthcare system. One reason for this is that physician-owned clinics typically focus on one or a only a few areas of medicine like orthopedics, gastroenterology, or OB/GYN. This allows for a more efficient, lower-overhead environment that can help keep overall costs down.

Another benefit that OSMS provides patients as a doctor-owned clinic is the ability to see a physician without a referral (unless required by your specific insurance). This cuts down on the number of appointments you need to get a diagnosis for an orthopedic or rheumatologic condition; ultimately, reducing the cost of your care. It also helps patients get to a diagnosis more quickly and be on the path to treatment or recovery more quickly. So patients can see cost and time savings.

Plus, if you need surgery and the physician-owned clinic has an outpatient surgery center, your surgery may actually cost less too. For example, surgeries performed at BOSC cost on average 40% less than the same procedure performed in a hospital setting.

Myth 3: Doctor-owned clinics won’t accept my insurance.

The Truth: Just like a larger health system, doctor-owned clinics can negotiate contracts with all different types of insurance plans and companies. In most cases, they will have contracts with many plans to ensure they are accessible to patients with primary care providers at multiple health systems.

OSMS accepts most insurance plans. You can see a list of the major ones here.

Understanding Anterior Hip Replacement: A Q&A with orthopedic surgeon Dr. Walker Flannery

We are proud to introduce orthopedic surgeon Dr. Walker Flannery! He’s a Wisconsin native who will be joining our physician team in September.

Flannery-bio page

One of his areas of interest is anterior hip replacement. During his residency training, Dr. Flannery worked with four different orthopedic surgeons who performed anterior hip replacement. After seeing how well patients did with this approach, it became a special interest of his. We asked Dr. Flannery a couple of questions to help explain this approach to hip replacement.

Q: How is the anterior approach different than other hip replacement methods?

A: There are several approaches for hip replacement that have been used over the last half-century with good success. While the anterior approach is relatively new compared to other methods, it has been used for hip replacement with a strong track record for over 15 years. The anterior approach is increasing in popularity for several reasons:

  • It uses an “inter-nervous plan,”allowing a path between muscle groups to insert the implants, preventing injury to the buttock muscles. This can help aid in a quicker recovery, such as earlier walking without a cane and less pain medication use. There also can be a lower risk of “limp gait” or “foot drop” in comparison to other approaches.
  • Surgeons use a specialized Hana Table that allows the patients to remain in a flat position on their back, instead of on their side. This enables the surgeon to check key criteria – like leg lengths and implant positions – using a real time X-ray machine called fluoroscopy. The table can also change positions during surgery to aid in the surgeon’s visibility.
  • Due to the nature of the anterior approach, the risk of the hip “popping out” or dislocating after the procedure is lower. Patients are allowed to go about their activities after surgery without many of the hip precautions that are typically needed, such as not bending past 90 degrees at the the hip.

Q: Who is a candidate for anterior hip replacement?

A: Many patients who need a hip replacement are good candidates for the anterior method. However, just like with any surgery, it’s important for patients to understand the risks and benefits of each approach to hip replacement and for patients and their surgeons to discuss which approach will be the best option for their individual needs.

Characteristics that could make anterior hip replacement technically challenging include:

  • Women who are short statured with a wide pelvis bone.
  • Patients who are large statured and muscular, i.e. former football lineman.
  • Patients who carry most of their weight in the abdomen with a high body mass index.
  • If the surgery is a revision surgery that would involve replacing the implant inside the upper leg bone (the femoral component).

These criteria will not exclude you from the anterior approach to hip replacement. They will be considered in the decision making process with your surgeon following a physical examination of the hip.

“Anterior hip replacement is a technically challenging procedure and requires a specific skill set for the surgeon. It is currently offered by less than 25% of orthopedic surgeons,” says Dr. Flannery. “By being proficient in the other approaches to hip replacement, I can help provide guidance on which method would be the best fit for each individual I care for.”

Learn more about Dr. Walker Flannery here.

How much will my surgery cost?

It’s a question we all ask (or at least think) when we are told we need a surgery. Unfortunately, getting an answer isn’t always that easy. Here are two reason why it’s hard to put a standard price sticker on your surgery.

Surgery Costs-

1. What you pay can depend on your individual health insurance.

One thing that makes pricing more complicated in healthcare is the role of insurance. Private insurance providers (think Blue Cross Blue Shield and United Healthcare) negotiate their coverage fees directly with individual healthcare providers and facilities. That means if a surgery costs $2,000, one insurer may cover $1,000 while another only covers $800.

Now add in all of the individual health plans that people have. Do you have a co-pay? Have you already met some – or all – of your deductible? What is your maximum out-of-pocket? Is the facility in-network or out-of-network? With all of these other factors, how much you will end up paying for a surgery is truly unique to you.

At OSMS, our patient advocates are a great resource to help people who need surgery understand how much it will cost. They look at a patient’s insurance plan and determine if any out-of-pocket costs will remain after insurance benefits are applied. They also meet with patients to help them understand their insurance coverage, the out-of-pocket expenses they will be responsible for, and any financial resources that may be available.

Ultimately, the patient advocates want to help patients put together a plan for paying for their surgery in advance so that there isn’t “sticker shock” after it’s all done.

Learn more about the OSMS patient advocates here.

2. Sometimes a physician goes into surgery to do one thing and he ends up needing to repair something else too.

Let’s say you are having a knee scope. When the surgeon is performing this procedure, he discovers that you also have a torn meniscus that wasn’t detected prior to surgery. The surgeon isn’t going to ignore this new diagnosis. He’s going to fix the torn meniscus while you are already in surgery. Doing this may change the original cost of your surgery, but it will be significantly less expensive than having a completely separate surgery to repair the torn meniscus.

If you have questions or concerns about the cost of an upcoming or past surgery, please contact the business office at 920-430-8120.