UK Orthopaedic Surgery & Sports Medicine prepares for the future



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O R T H O P A E D I C S U R G E R Y & S P O R T S M E D I C I N E Clinical Report 29

ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 2 UK Orthopaedic Surgery & Sports Medicine prepares for the future UK HealthCare will be undergoing exciting changes over the next few years, beginning with the opening of the new UK Chandler Emergency Department in July 21. The new UK Albert B. Chandler Hospital is designed to be one of the most technologically advanced and patient-friendly medical centers in the country. To prepare for anticipated growth in volumes, the new ED is more than twice the size of the current ED. In addition, the new ED has separate, dedicated areas to treat children, adults and trauma patients. The ED opening is timed to accommodate the needs of thousands of people coming to Lexington for the 21 Alltech FEI World Equestrian Games in September. The UK Orthopaedic Trauma team is a major component of the UK Chandler ED, providing comprehensive 24-hour service specializing in patients with multiple-system injuries. Inside, you ll learn more about our trauma team, orthopaedic surgeons and sports medicine specialists. Our goal is to improve the quality of life for patients who suffer from these disorders and restore injured people to a healthy level of activity.

3 ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 U K F o o t & A n k l e S e r v i c e The UK Foot & Ankle Service provides both orthopaedic and podiatric care and specializes in managing a wide array of conditions. The program receives referrals for specialized care from sources throughout the state. We perform operative services including ankle arthroscopy, subtalar and ankle joint fusions, and rheumatoid forefoot and posterior tibial tendon reconstructions. Forefoot pain and deformity can be treated with bunion or hammertoe surgeries. The majority of elective foot and ankle surgeries are performed on an outpatient basis at the Center for Advanced Surgery or with an overnight stay. 1,2 1, 8 6 4 2 Adult Foot/Ankle/Lower Leg Orthopaedic Surgery 25 26 27 28 29 Heather Whitesel, DPM, FACFAS, joins UK HealthCare After receiving her podiatric medical degree from Ohio College of Podiatric Medicine in Cleveland, Dr. Whitesel completed a three-year podiatric surgical residency followed by a one-year limb-salvage fellowship at University of Utah and Salt Lake City VA Medical Center. Prior to joining UK HealthCare, Dr. Whitesel practiced at the Western Pennsylvania Hospital in Pittsburgh and at UC Davis Medical Center in Sacramento, Calif. Dr. Whitesel treats a wide variety of surgical and nonsurgical conditions, including: Fractures and dislocations Tendon injuries and ruptures Foot and ankle deformities Foot and ankle reconstruction Sports injuries Wound care Foot and ankle pain Diabetic limb salvage Dr. Whitesel sees patients at clinics in UK Plastic Surgery, Orthopaedic Surgery and Vascular Surgery, and at UK Good Samaritan s Surgical Specialty and Wound Care clinics. Ankle arthroscopy available for diagnosis and treatment Arthroscopic surgery is preferred over more traditional open surgery to diagnose and treat certain ankle conditions. It has many advantages over traditional open ankle surgery, including excellent visualization of the joint and much smaller incisions, decreased pain and shorter recovery times for the patient. Arthroscopic procedures in the ankle can be technically challenging because of the size and configuration of the curved joint surfaces. Since ankle arthroscopy is a relatively new procedure, sports medicine and foot and ankle orthopaedic specialists are usually most experienced in this technique. In addition, not all ankle problems can be addressed with these methods, especially advanced arthritis and most ankle fractures.

ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 4 U K U p p e r E x t r e m i t y S e r v i c e The UK Hand & Upper Extremity Service provides comprehensive care for all aspects of upper-limb musculoskeletal problems, from shoulder to fingers. Our ability to perform ultrasound scans in our clinic for diagnostic and therapeutic injection purposes allows us to diagnose and begin treatment without the need for multiple hospital visits. Our program also manages complex shoulder and elbow arthroscopic and reconstructive problems. Adult Shoulder/Elbow Orthopaedic Surgery 1, 9 Adult Hand/Forearm Orthopaedic Surgery Conditions treated: Abnormal function of the shoulder, elbow, wrist and hand ACJ and SCJ instability and pain Primary and post-traumatic arthritis Frozen shoulder Instability Loss of motion Quadrangular space syndrome Previously failed surgeries including arthroscopy, joint replacements and trauma fixation Rotator cuff arthropathy, tears and impingement SLAP tears Sports injuries Tennis and golfer s elbow Traumatic fractures, dislocations and soft-tissue injuries Other upper extremity pain 7 6 5 4 3 2 1 25 26 27 28 29 8 7 6 5 4 3 2 1 25 26 27 28 29 S p i n e New minimally invasive spine procedure offered Our orthopaedic surgery specialists are now offering a new, minimally invasive spine procedure: the COUGAR LS Lateral Cage System. These implants are indicated for use in the thoracolumbar spine (T1 to L5) to replace a diseased vertebral body resected or excised for the treatment of tumors, to achieve anterior decompression of the spinal cord and neural tissues, or to restore the height of a collapsed vertebral body. This system is also indicated for treating fractures of the thoracic and lumbar spine. The system is designed to restore the biomechanical integrity of the anterior, middle and posterior spinal column even in the absence of fusion for a prolonged period. The COUGAR LS Lateral Cage System is also indicated for intervertebral body fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two contiguous levels from L2 to S1. These DDD patients may also have up to Grade 1 spondylolisthesis or retrolisthesis at the involved levels. DDD is defined as discogenic back pain with degeneration of the disc confirmed by history and radiographic studies. These patients should be skeletally mature and should have had six months of nonoperative treatment. The system may be implanted via an open or a minimally invasive lateral approach. Elective Spine Orthopaedic Surgery 1,2 1, 8 6 4 2 25 26 27 28 29

5 ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 J o i n t R e c o n s t r u c t i o n UK Good Samaritan now offering a minimally invasive joint replacement option UK Good Samaritan Hospital now offers anterior hip replacements. An anterior hip replacement allows the surgeon to operate on the hip joint from the front of the hip as opposed to the lateral or posterior approach. During a conventional hip replacement surgery, the gluteal muscles, which are important for hip function, are cut from the bone. An anterior approach requires no muscle detachment. Leaving these muscles intact reduces the recovery and healing time, allowing the patient to get back on his or her feet sooner and reducing the postoperation hospital stay. The anterior approach keeps soft tissues in those areas strong, decreasing the chance of a dislocation. In addition, the incision for an anterior hip replacement is radically smaller. Adult Elective Hip Joint Reconstruction Adult Elective Knee Joint Reconstruction 3 3 25 25 2 2 15 15 1 1 5 5 25 26 27 28 29 25 26 27 28 29 Chandler Hospital Good Samaritan Hospital Chandler Hospital Good Samaritan Hospital P e d i a t r i c O r t h o p a e d i c s In cooperation with Kentucky Children s Hospital and Shriners Hospital for Children, we are pleased to provide the region with four fellowship-trained pediatric orthopaedists. No other hospital in Kentucky can boast as many trained orthopaedists dedicated to the care of children. Many of our referrals are centered on pediatric trauma and fracture care, as we support the UK Level I Trauma Center and UK Chandler Hospital. We assist in the care of patients with a broad spectrum of diagnoses, from scoliosis to simple fractures. Our research endeavors allow us to be on the leading edge of medicine and surgery.

ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 6 S p o r t s M e d i c i n e Regardless of your sport or recreational activity, injuries can occur as a result of overuse or trauma. If that happens, our multidisciplinary team of sports medicine professionals can provide you with a physician-directed program of treatment, rehabilitation and conditioning. We offer the state s largest group of fellowship-trained sports medicine physicians. Athletic training outreach expands As the region s largest certified athletic training staff, we provide outreach athletic training services to numerous schools. We began providing coverage to Midway College and Woodford County High School in 29. Our certified athletic trainers are specially trained in the prevention, assessment, treatment and rehabilitation of all types of sports-related or physically active injuries and illnesses. Prevention, treatment and rehabilitation programs are developed based on medical, exercise and sports sciences. Our current list of contracted schools includes: Bath County Berea Independent Fayette County public high schools and middle schools Jackson County Gallatin County Kentucky State University Lincoln County Midway College Nicholas County Owen County Pendleton County Rockcastle County Woodford County Walker Terhune, MS, ATC, joins UK Sports Medicine team Walker Terhune, MS, ATC, joined the sports medicine group and provides athletic training coverage for Woodford County High School. Terhune received a bachelor s degree in kinesiology from the University of Kentucky, and he earned his master s degree in sports administration from Eastern Kentucky University. Terhune is nationally certified by the National Athletic Trainers Association Board of Certification. Prior to joining Woodford County High School in 25, he worked as the head athletic trainer for Kentucky State University. Adult Orthopaedic Knee Surgery Pediatric Orthopaedic Knee Surgery 1,2 3 1, 25 8 2 6 15 4 1 2 5 25 26 27 28 29 25 26 27 28 29 Chandler Hospital Good Samaritan Hospital Chandler Hospital Good Samaritan Hospital

7 ORTHOPAEDIC SURGERY & SPORTS MEDICINE CLINICAL REPORT 29 Tr a u m a The orthopaedic trauma service is an integral part of the UK Level I Trauma Center. Our team provides comprehensive 24-hour service specializing in patients with complex traumatic orthopaedic injuries. Our fellowship-trained surgeons also offer outpatient clinic consultations for patients with the following problems: Complex upper- and lower-extremity fractures Pelvis and acetabular fractures Periarticular fractures Nonunions Malunions Orthopaedic deformities Inpatient Discharges 1, 8 6 4 2 Adult Inpatient Orthopaedic Trauma Surgery Discharges 25 26 27 28 29 Outpatient Adult Outpatient Orthopaedic Trauma Surgery 1, 8, 6, 4, 2, 25 26 27 28 29 The orthopaedic trauma service emphasizes early stabilization of fractures and aggressive rehabilitation for victims of major trauma. Specialized surgical techniques include closed intramedullary fixation and combinations of internal and external fixation. A w a r d s Help us help others All great major academic medical centers rely on gifts of all sizes to deliver the most advanced subspecialty care of the highest quality and to enhance the healing environment. Many opportunities exist at all levels to support UK Orthopaedic Surgery & Sports Medicine and every gift is important. Our specialists are world-renowned for developing and implementing state-of-the-art techniques to diagnose, treat, research and educate patients about bone and joint disorders. With your help, we will continue building one of the nation s leading orthopaedic surgery and sports medicine programs. Mary Lloyd Ireland Best Doctors in America Darren Johnson Best Doctors in America Scott Mair Best Doctors in America To discuss the options for supporting UK HealthCare and Orthopaedic Surgery & Sports Medicine, please contact Katharine Dennis at 859-323-7955.

Physicians by specialty Foot & Ankle Steven Lawrence, MD Heather Whitesel, DPM, FACFAS Hand & Upper Extremity Srinath Kamineni, MD Joint Reconstruction Mauro Giordani, MD Daniel Primm, MD Scott Scutchfield, MD Jeffrey Selby, MD Pediatric Orthopaedics Sheila Chandran, MD Henry Iwinski, MD Todd Milbrandt, MD Vishwas Talwalkar, MD Janet Walker, MD Spine Carter Cassidy, MD Sports Medicine Robert Hosey, MD Mary Lloyd Ireland, MD James Jagger, MD Darren Johnson, MD Christian Lattermann, MD Scott Mair, MD Trauma Brandon Bruce, MD Eric Moghadamian, MD Daniel Primm, MD Jeffrey Selby, MD Ray Wright, MD To learn more about UK Orthopaedic Surgery & Sports Medicine or to schedule an appointment, please call toll free 1-8-333-8874 or visit ukhealthcare.uky.edu/ortho.