Hip Preservation: An Emerging Approach to Hip Pain

Hip Preservation is a new approach to hip pain.  If you are experiencing persistent or chronic hip pain, the emerging field of Hip Preservation may be able to provide answers – and get you back to your activities.

Michael Merz, MD, pursued a fellowship in this new field at Boston Children’s Hospital, affiliated with Harvard Medical School.  He had comprehensive training with leaders in the field in hip conditions for patients from birth through middle age that included both arthroscopy and osteotomies of the pelvis and femur.  Like all of our Orthopaedic Surgeons, Dr. Merz is trained in General Orthopaedics, and can see patients for all Orthopaedic issues.  His dual fellowship training is in Hip Preservation and Joint Replacement.  Specific conditions that he treats include: hip dysplasia (DDH), femoroacetabular impingement (FAI) or hip impingement, hip labral tears, Perthes disease, avascular necrosis (AVN) of the hip, femoral anteversion, and congenital hip dislocation.  Call (919) 220-5255 to schedule an appointment with Dr. Merz.

 

Is Outpatient Joint Replacement An Option For You?

 

OUTPATIENT JOINT REPLACEMENT

GENERAL

If you are healthy enough, outpatient joint replacement (where you have surgery and go home on the same day) may be an option for you at EmergeOrtho.  In comparison to inpatient joint replacements, much of the process remains the same but there are a few differences.  Special consideration of the medical status of the patient is the biggest factor.  Anesthesia techniques (to make you more comfortable) are modified for outpatient replacement patients.  Physical therapy at home is begun the day after surgery.  Since you won’t be at the hospital where the surgical team can check on you, an earlier follow-up appointment is scheduled.  Lastly, you’ll need a caregiver or team of caregivers present with you to assist with walking, medications, and meals.

Some of the advantages to outpatient joint replacement include:

1) cost

2) convenience/comfort

3) fewer complications

Outpatient joint replacements often offer substantial cost savings since there is no hospital stay.  Also, they can be done at “surgery centers” which typically charge significantly lower fees than typical hospitals might.  Many patients are more comfortable being at home in a familiar environment while they recover.  Patients may be more likely to avoid complications since they are likely to move around the home more than they might at the hospital.  Lastly, the chance of picking up an infection from something or someone at the hospital is lessened the shorter the amount of time spent there.

Sometimes patients scheduled for outpatient surgery may end up having to stay at the hospital (or may be sent to a hospital from a surgery center) if unforeseen complications occur.  To lessen this risk, the patient’s health is carefully screened prior to surgery.   The bottom line is your safety is our top concern.

AT THE SURGERY CENTER

The main differences between inpatient and outpatient joint replacements at the surgery center involve the type of anesthesia used.  Outpatient patients often get a shorter-acting “block” or injection to allow them to move their legs sooner.  A long-acting “local anesthetic” to numb the tissue around the incision is frequently used to help provide comfort.  Special combinations of pain and nerve medications may be prescribed.  Generally, urinary catheters are not used for patients undergoing outpatient joint replacement.

Rather than being transferred to a hospital bed (also called “the floor”) after surgery, you will have physical therapy (PT) when recovered enough in the post-anesthesia care unit (PACU). When you have proven you can walk appropriately with PT and are felt to be safe to be sent home, you will be discharged. Patients undergoing outpatient joint replacements may stay in the PACU longer than inpatient replacement patients since they need to be fully recovered before being released.

 

RECOVERING AT HOME

  • Take your medications as directed in your discharge paperwork
  • Your leg muscles may be weak for the first day or so – make sure to wear any braces sent home with you and use your walker or crutches when you move around
    • Do not stop using braces until you are advised to do so by your therapist or surgical team
    • Try to drink plenty of fluids and eat a healthy diet – you need energy to heal
    • Follow the instructions for your dressings and showering given to you at the time of discharge

 

To learn about whether outpatient joint replacement surgery would be a good fit for you, visit www.triangleortho.com or call (919) 220-5255 to schedule an appointment with one of our surgeons.

 

Article By: William Silver, MD, Orthopaedic Surgeon, Medical Director, EmergeOrtho Triangle Division

Dr. Liebelt Performs First Total Knee Replacement with New Robotic-Arm Assisted Application!

Liebelt Knee North Carolina

 

NORTH CAROLINA SPECIALTY HOSPITAL NOW OFFERING NEWEST TECHNOLOGY IN TOTAL KNEE REPLACEMENT WITH STRYKER’S MAKO ROBOTIC-ARM ASSISTED TOTAL KNEE APPLICATION

Innovative Robotic Technology Allows Surgeons to Personalize Procedures to Each Patient in North Carolina

FOR IMMEDIATE RELEASE

Durham, North Carolina – N.C. Specialty Hospital is one of the first hospitals in the Southeast to offer Stryker’s robotic-arm assisted total knee application for use with its Mako System. This latest advancement in joint replacement surgery transforms the way total knee replacements are performed.

Total knee replacements in the United States are expected to increase 673 percent by 2030,1 yet studies have shown that approximately 30 percent of patients are dissatisfied after conventional surgery.2 Mako Total Knee combines Stryker’s advanced robotic technology with its clinically proven GetAroundKnee (Triathlon Total Knee System), which enabled surgeons to have a more predictable surgical experience with increased accuracy during laboratory testing.3

“Mako is changing the way joint replacement surgeries are performed by providing each patient with a personalized surgical experience based on their specific diagnosis and anatomy,” said Dr. Ralph Liebelt of EmergeOrtho, who performed the first procedure this Spring.  “Using a virtual 3D model, the Mako System allows surgeons to create each patient’s surgical plan pre-operatively before entering the operating room. During surgery, the surgeon can validate that plan and make any necessary adjustments while guiding the robotic-arm to execute that plan. It’s exciting to be able to offer this transformative technology across the joint replacement service line to perform total knee, total hip and partial knee replacements.”

The Mako Total Knee application is a knee replacement treatment option designed to relieve the pain caused by joint degeneration due to osteoarthritis. Through CT-based 3D modeling of bone anatomy, surgeons can use the Mako System to create a personalized surgical plan and identify the implant size, orientation and alignment based on each patient’s unique anatomy. The Mako System also enables surgeons to virtually modify the surgical plan intra-operatively and assists the surgeon in executing bone resections.

“We are proud to be the first hospital in the state to offer this highly advanced robotic technology in our area,” said Randi Shults, Chief Executive Officer of NC Specialty Hospital.  “This addition to our orthopaedic service line further demonstrates our commitment to provide the community with outstanding healthcare.”

 

Welcome to Chapel Hill, Dr. Takenaga!

Chapel Hill (1)

“Dr. Takenaga was the most a personal, caring, and informative physician that I have ever encountered.”

Ryan Takenaga, MD is a General Surgeon who has been with us since  August of 2015.  We are pleased to announce that he will be seeing patients once a week at our Chapel Hill office!

A graduate of John Hopkins University School of Medicine, Dr. Takenaga completed his orthopedic surgery residency at the University of Iowa Hospitals and Clinics. During his time in residency he performed research, published articles, and presented at meetings on topics such as fragility fractures and the long term outcomes of total hip arthroplasty.

Dr. Takenaga enjoys helping patients with general orthopaedic problems and is experience in fracture care, hand surgery, joint replacement, and sports medicine.  Dr. Takenaga patients and their family members are regularly impressed with his caring nature and excellent bedside manner. Dr. Takenaga is talks with you about all of the options, invasive or non invasive. He strives to work together with patients to help them achieve their activity and quality of life aspirations.

Dr. Takenaga is married and resides in Durham with his wife, Nancy, and their son Dylan and two daughters, Sophie and Lizzy. They enjoy various youth sporting activities, camping, and golfing. Together, they have also gone on medical mission trips to Kijabe, Kenya and Santo Domingo, Dominican Republic.

Dr. Takenaga is now at two locations, Chapel Hill and Oxford.

Testimonials (2)

Emerge Stronger This Summer with 21 Counties Across NC!

Across NC!

If your Summer Vacation is taking you beyond the Triangle, we’ve still  got you covered.  As a physician-owned, state-wide practice, we offer the best in patient-centered specialty care.  With one electronic health records system, our board-certified and fellowship-trained physicians can communicate across 21 counties.  Whether your travels take you to Western North Carolina or the Beach, chances are there’s an EmergeOrtho nearby.  And when you get home, you can follow up with your local EmergeOrtho provider, who will have seamless access to your medical records.

To check locations near your travels, just go to EmergeOrtho.com

Learn more about the EmergeOrtho locations from the Mountains to the Coast:

Triangleortho.com Raleigh-Durham, Chapel Hill, Burlington, Oxford, Johnston County, Roanoke Rapids, Roxboro and Wilson, North Carolina

10 Orthopaedic Urgent Cares, and complimentary specialty care in Rehabilitation Medicine, Physical and Occupational Therapy, traditional in-house, mobile, and open MRI scanners, CT, Rheumatology, General & Bariatric Surgery, Breast Care, Neurology, Bone Health, Wound Care, and Vein therapy.

 

brbj.com Asheville, Arden, and Hendersonville

Orthopaedic Urgent Care and Walk-in Clinic Services.  Our subspecialty clinics offer complete evaluation of the joint and musculoskeletal systems, with expertise in preventative, diagnostic and therapeutic orthopedic focusing on full-motion living. Subspecialty clinics include Foot & Ankle, Hand Elbow & Shoulder, Hip & Knee, Interventional Physiatry, Sports Medicine and Spine.

 

www.carolinaortho.com Unifour Area | Hickory, Newton, Lenoir, Morganton, Valdese and Taylorsville 

Ortho Quick Care – Walk-in Orthopaedic Clinic Comprehensive Orthopaedic Care, including sports medicine, spine, hip and knee joint reconstruction and revision, hand and upper extremity, foot and ankle, trauma and PM&R (Physical Medicine and Rehabilitation). We offer a complete range of services including diagnostic testing, treatment, rehabilitation and pain management.    

 

www.orthowilmington.com New Hanover, Brunskwick, and Onslow Counties

AccessOrtho for Walk-in Care. As the regional referral center for orthopaedics, the practice offers 23 fellowship-trained and board-certified experts in a variety of subspecialties within orthopaedics, including spine, sports medicine, hip and knee joint reconstruction and revision, hand and upper extremity, foot and ankle, trauma and PM&R (physical medicine and rehabilitation).

Injury Prevention: Reduce Risk of ACL Tears in Pre-Season

Warmer weather means pre-season starts soon for many sports.  The pre-season is an impactful time for injury prevention: eight to ten weeks of proper conditioning can reduce risk of an ACL (anterior cruciate ligament) tear by 60-90%!

Shepherd Rosenblum MD recently wrote an article for a recent Healthcare Guide with The Franklin Times, “Understanding and Preventing ACL Injuries.” He shares that of the 250,000 surgical ACL repairs each year, most injuries are non-contact.  This means cutting, twisting, and landing are risks for tears – and opportunities for pre-season training.  Increasing agility, balance, strength, and core strength with neuromuscular training enables athletes to improve their alignment and protect their knees.

ACL Sports Medicine

Dr. Shepherd Rosenblum is a board certified, fellowship trained orthopaedic surgeon specializing in Sports Medicine, shoulder, hip, and knee arthroscopy and reconstruction, and

cartilage repair. He has expertise in treating a wide variety of sports-related injuries, as well as problems related to degenerative conditions such as rotator cuff tears, ligament and cartilage problems of the shoulder, elbow, hip, knee, and ankle. Dr. Rosenblum has been in practice since 1995, and has great experience in helping his patients to return to health and activities as quickly and safely as possible. He relies on a variety of techniques, emphasizing conservative management whenever possible, but Dr. Rosenblum is also able to offer the most advanced, minimally invasive surgical techniques available to his patients.

To schedule an appointment with Dr. Rosenblum or any of our Orthopaedic Surgeons, please contact us at 919-220-5255.

Read Dr. Rosenblum’s article in the 2016 Healthcare Guide of the Franklin Times (or click the image below to enlarge.)

 

Copy of Rosenblum ACL

Better Living with Arthritis Seminars

EmergeOrtho and the Arthritis Foundation are hosting our annual seminar series, Better Living with Arthritis.  All events are free and open to the public! RSVP to 919-281-1958.

Arthritis Seminar

RHEUMATOID ARTHRITIS
Tony Ning, MD, Rheumatologist
Thursday, April 6 at 6PM
Durham | 120 William Penn Plaza

ARTHRITIS OF THE HAND
Marshall Kuremsky, MD, Orthopaedic Surgeon
Wednesday, April 12 at 6PM
Raleigh | 7850 Brier Creek Parkway

HIP PRESERVATION
Michael Merz, MD, Orthopaedic Surgeon
Wednesday, April 19 at 6PM
Durham | 120 William Penn Plaza

 

EmergeOrtho PA, Krista Bartlett, PA-C, Receives National Recognition!

Physician Assistant

EmergeOrtho PA Receives National Recognition

Johns Creek, GA, Jan. 11, 2017 – Krista Kathleen Bartlett, PA-C, who is employed by EmergeOrtho, has been nationally recognized for earning a specialty credential called a Certificate of Added Qualifications (CAQ) from the National Commission on Certification of Physician Assistants (NCCPA).

Bartlett was recognized for earning a CAQ in Orthopaedic Surgery, a distinction earned by meeting licensure, education and experience requirements and then passing a national exam in this specialty area. She is one of only four Certified PAs in North Carolina to earn a CAQ in Orthopaedic Surgery since the program’s inception in 2011.

“Certified PAs are prepared and proven providers who contribute real value to the healthcare of this nation,” says Dawn Morton-Rias, Ed.D, PA-C, president and CEO of NCCPA. “They graduate from demanding masters-level programs, pass a rigorous certification exam, and maintain certification at the highest level through continuing medical education programs and retesting throughout their careers. Certified PAs increase access to care for patients in every specialty and clinical setting, including those that are historically underserved.”

CAQs are offered to certified PAs in cardiovascular and thoracic surgery, emergency medicine, hospital medicine, orthopaedic surgery, nephrology, pediatrics and psychiatry.

 About the National Commission on Certification of Physician Assistants

The National Commission on Certification of Physician Assistants (NCCPA) is the only certifying organization for physician assistants (PAs) in the United States. The PA-C credential is awarded by NCCPA to PAs who fulfill certification, certification maintenance and recertification requirements. There are more than 115,500 certified PAs in the U.S. today. For more information, visit www.PAsDoThat.net.

Free Seminar: Tommy John and Related Injuries in Baseball

Apex_Baseball_Seminar_Tommy_John

 

Dr. Kuremsky will be giving a talk on injury prevention in throwing sports on Saturday, January 21 from 9:30 – 11:30 AM.

Anyone is welcome. Parents, athletes, trainers, therapists!

“We will review injuries and treatment, then have an open discussion. The exchange of ideas last year was the best part and people stayed an extra 90 minutes to continue discussing,” said Dr. Kuremsky.

The talk will be at our Apex office at 910 West Williams Street.

The event is free but space is limited! Please RSVP by January 18 to BSherrell@triangleortho.com or 919.281.1958.

 

 

New Physician: Welcome, Dr. Michael Merz!

We are pleased to welcome Michael Merz, MD to EmergeOrtho! He will be seeing patients in our Chapel Hill and Durham (William Penn Plaza) offices, specializing in Hip and Knee Preservation and Replacement Surgery.
copy-of-merz-1

First Shoulder Replacement Performed with Custom 3D Model in Johnston County

1

Dr. Lucas Romine MD, an Orthopaedic Surgeon with EmergeOrtho, recently performed a Reverse Total Shoulder Arthroplasty with a custom guide generated from a 3-D printer. Dr. Romine utilized software from DJO surgical known as the Match Point System™ to execute the operation.  The surgery, which took place on May 24, 2016 at Johnson Health, was the first of its kind in Johnston County.

The operation required several weeks of pre-operative planning, including virtual placement of the components, 3D analysis of the patient’s severely deformed shoulder, and production of a scapular model.  The custom guide was designed, created and utilized specifically for this one procedure.

The patient, Claudious Stallings, had experienced pain in his right shoulder for twenty years, and at his first appointment with Dr. Romine, he unable to move his right arm without severe pain. According to Dr. Romine, “Mr. Stallings was clearly in need of a new shoulder, but he had a rare socket malformation that would make a standard shoulder replacement impossible to implant.”

Fortunately, Dr. Romine, who learned the latest techniques in shoulder surgery at Johns Hopkins Hospital, had experience with custom designed implants.  “Utilizing a CT based 3-D model, I was able to design a custom fit for Mr. Stallings’s shoulder. This allowed me to accurately place the implant where it would work properly, and it significantly decreased the total time of the operation. Essentially, I was able to execute the difficult aspects of the surgery on my laptop computer, weeks in advance,” Dr. Romine stated.  “This technology has only become available for shoulder replacements in the United States over the past 3-4 years, so many people are amazed with this new advancement.”

Mr. Stallings is recovering as expected and pleased with the results.  He is the organist at First Freewill Baptist Church, a vocation he returned to six weeks after surgery.  “I don’t hurt in that shoulder.  It’s amazing,” says Stallings. “I was seeking relief and a way to keep serving the Lord by playing the organ. I just kept looking, and I am so thankful I did.”

As a physician-owned practice, EmergeOrtho is committed to patient-centered care, using innovative strategies such as 3D custom modeling to optimize clinical outcomes.  There are 49 offices across the state, with two offices in Johnston County.

For more information on Dr. Romine and EmergeOrtho, please visit: www.triangleortho.com.

NC Specialty Hospital Receives 5-Star Rating from Medicare!

NCSH Durham NC 5 Stars

Medicare has released a snapshot from its Hospital Star Rating System, which rates hospitals based on 62 quality measures.  The release reveals that only 2 percent of the 4,599 hospitals in the database got five stars for the last year.  Twenty percent got four and 39 percent got three.  About 3 percent got only a single star.  North Carolina Specialty Hospital (NCSH) is in the 2 percent that got 5 stars!!

Triangle Orthopaedics jointly owns the North Carolina Specialty Hospital.  As a privately owned medical facility, it provides individualized attention to each and every patient it serves.  Conveniently located at 3916 Ben Franklin Blvd, in Durham, North Carolina, it is across the street from the Durham office of Triangle Orthopaedic Associates, P.A.  Many TOA specialties work with NCSH, including Triangle Breast Care, TOA Surgical Specialists, Bariatric Specialists of North Carolina, and Wound Care, in addition to Orthopaedics. All of our current Bundled Payment programs include NC Specialty Hospital.

Related: Wound Care Named 2015 Center of Distinction

Hand Therapy Week!

Hand Therapy Occupational Therapy

 

Here at Triangle Orthopaedics, our Occupational Therapists treat a variety of conditions and diseases.  Our Occupational Therapists are Certified Hand Therapists (CHT), and they specialize in evaluation and treatment of the upper extremities.

Individualized rehabilitation programs consist of modalities for pain relief, supervised exercise programs, custom splint fabrication, and a variety of evaluation tools to provide objective information and up-to-date progress results. Home program participation is highly emphasized. Our Certified Hand Therapists work in tandem with our Hand Surgeons providing excellent Hand and Upper extremity care in multiple locations across the greater Triangle area.

Our hand therapists utilize specialized evaluations and treatment for upper extremity acute, post-traumatic, and repetitive strain injuries for Workers’ Compensation patients injured on the job, dedicated to helping businesses and industry control the frequency and resulting costs of on-the-job injuries.

For more information please visit our website at triangleortho.com or call us at (919) 220-5255.

 

 

 

Dr. Gilmer interviewed for Hyco Lake Magazine

Gilmer Roxboro Orthopaedics Hyco Lake

 

Our Roxboro location is in the first 2016 volume of Hyco Lake Magazine!  Dr. Gilmer was interviewed on the role of Orthopaedics in all age groups.  With Dr. Gilmer and Dr. Takenaga in Roxboro, comprehensive Orthopaedic care is available for the whole family.  ”We are a general Orthopaedics practice, so we see everything,” explains Dr. Gilmer, “from children to the elderly,” describing basics for Osteoporosis prevention, rheumatoid and osteoarthritis, bunions, and other conditions treated by Triangle Orthopaedics in Person County.  Dr. Gilmer and Dr. Takenaga have years of experience in Orthopaedic Surgery and see patients in the Roxboro office.

“Most people have a fracture at some point in their lives.  At Triangle Orthopaedic Associates, we see patients promptly, do x-rays quickly, put on casts, and schedule surgery if necessary.  All of this is done in a state-of-the-art, cost-effective way by experts in the field.”

Check out the full spread in Hyco Lake Magazine or just read the article!

Join us in Welcoming Our Newest Orthopaedic Surgeon

Welcome_Freels

 

Please join us in welcoming Dr. Douglas Freels,MD, to our orthopaedic team!  He will be seeing patients at Wilson Ortho, a division of Triangle Orthopaedics.

Dr. Freels has extensive experience in orthopedic surgery and joint replacement patients having been in practice for over 18 years. This includes both primary hip, knee, and shoulder replacement patients including minimally-invasive joint replacement surgeries such as the “Oxford” partial knee replacement and the direct anterior approach for hip replacement surgery. He also has experience in the more complex joint replacement patients including infections, peri-prosthetic fractures, and revision joint replacement surgery.

To see Dr. Douglas Freels,MD, please contact us at 252-243-9629.

 

 

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