Category: Knee

Benefits of an Outpatient Hip or Knee Replacement

A hip or knee replacement is seen as a last resort that is used when non-surgical treatments have failed. But for the right patient, advances in technology have made it possible for a person to forgo an overnight stay in the hospital. Outpatient joint replacement surgeries are growing in popularity. In fact, researchers expect that over half of all joint replacement surgeries will be outpatient procedures by 2026.

Continue reading “Benefits of an Outpatient Hip or Knee Replacement”

Putting Patients First

Rana Crisostomo, Patient Advocate

Practice features full-time advocate

Because our patients are what keep us growing and succeeding, we understand the value of having a seamless line of communication between all parties. As the only orthopedic practice in Southern Nevada with a dedicated patient advocate, we at Nevada Orthopedic & Spine Center have placed emphasis on this area of our business to ensure satisfaction. With Rana Crisostomo leading the way as our Patient Advocate, we are more than certain that our patients are getting the best service possible day in and day out.

Born and raised in Guam, Rana came to Las Vegas in 2002. In 2009 she found herself working with Nevada Orthopedic & Spine Center in Medical Assisting, Front Desk Registration, and in the Diagnostic Department. As the years passed, Rana was learning every aspect of the practice from beginning to end in order to help her perfect the practice’s internal “language.” In January of 2012, Rana took over the Patient Advocate role, and hasn’t looked back since.

On a normal day, Rana says the part she enjoys the most is “making the human connection with patients in (her) attempt to help them with their care.” She typically will assist 20 or more patients per week, but volume has never been an issue. As always, Rana puts the patient first, stating “there have been certain patients that stick in my memory, but I look at every patient’s circumstance and ask myself ‘if the person was family–especially my dear grandmother–how best could I help them to a level that I would be satisfied?’”

While there are taxing parts to the job, such as explaining that there may be a substantial wait time before the next available appointment, Rana says that it’s all about learning how to resolve the issues and explain them to patients in a way they understand. “Many patients misunderstand the perceived lack of time that a doctor may spend with them during an appointment is not a personal slight, but rather the doctor’s efficiency gained through their varied experience and training,” she says. With an interest in social work and counseling, it’s no wonder that Rana has perfected the art of patient communication, and we can’t thank her enough for that!

After spending a number of years with the practice, Rana says there are a few things that people should absolutely know about her company. “We are dedicated to our patients’ care and positive outcomes,” she states. “We have treated virtually every kind of orthopedic case, and you are in the best hands possible. Nevada Orthopedic & Spine Center is truly an interdependent and interwoven practice that puts patients first.”

Thank you, Rana, for your continued dedication to our patients!

NOSC winter newsletter is here!

The winter 2016 edition of On The Move, Nevada Orthopedic & Spine Center’s newsletter, is now available and linked below. This newsletter offers referring practices updates, insights and tips to make their patients’ experiences with NOSC as stress-free and satisfying as possible.

 

https://nevadaorthopedic.com/news-events/nv_orthonews_winter2016/

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Summerlin expo a big hit

Representatives of Nevada Orthopedic & Spine Center recently attended a health and wellness expo at Downtown Summerlin. Several hundred people visited the practice’s information booth. Events such as this are just one of the many ways that the practice educates the community about the expertise and capabilities of its physicians.
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Meet Our Providers: Thomas C. Kim, M.D.

At Nevada Orthopedic & Spine Center, all of our Orthopedic Surgeons are board certified and fellowship trained in their respective specialties.  We offer quality health care you can trust.  As a patient, it is important to learn about the orthopedic surgeon that you are visiting at our office.

Join us for our new blog series, “Meet Our Providers” to learn more about our providers and their specialties.

MEET THOMAS C. KIM, M.D.

Thomas C. Kim, M.D.

Request an appointment with Thomas C. Kim, M.D. here or call 702-258-3773

Thomas Kim, M.D. joined Nevada Orthopedic & Spine Center in 2002.  Dr. Kim is fellowship trained in the surgical treatment of athletic injuries focusing on disorders of the shoulder, hip, and knee with an emphasis on arthroscopic surgery of these joints.

Dr. Thomas C. Kim received his undergraduate education at the Georgetown University College of Arts & Sciences in Washington, D.C. where he graduated magna cum laude with a Bachelor of Science Degree in Chemistry and was nominated into Sigma Xi for research in Organic Chemistry.  As an undergraduate student, Dr. Kim also received a Minor in Theology.  While attending Georgetown University, Dr. Kim was accepted via the Early Assurance Program into the Georgetown University School of Medicine where he received his Doctor of Medicine degree.

Dr. Kim completed a year of general surgical residency at the University of Virginia in Charlottesville and completed his orthopedic training with the San Francisco Orthopaedic Residency Program.  In 2000, following residency, Dr. Kim completed his Sports Medicine Fellowship at Harvard University under Lyle Micheli, M.D. in Boston, Massachusetts.  During his fellowship, he provided medical coverage to the Boston Ballet, Boston Marathon, Eastern College Athletic Conference Track Championship, Bay State Games, and several local college and high school hockey and football teams.  His fellowship also involved training at the Boston Children’s Hospital.  The

Boston Children’s Hospital division of Sports Medicine was the first facility in the nation devoted to the treatment of sports injuries in pediatric and adolescent athletes.

Thomas Kim, M.D. was raised in Los Angeles, California.

Request an appointment with Thomas C. Kim, M.D. here or call 702-258-3773.

What is Pain?

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Pain is often the trigger to seek medical care and many patients experiencing pain seek treatment with an orthopedic surgeon.   At Nevada Orthopedic & Spine Center, our board certified and fellowship trained orthopedic surgeons will identify why you are experiencing pain.  After the reason for pain and discomfort is diagnosed, our orthopedic surgeons will create an individualized treatment strategy for you.

There are two categories to describe pain, Acute and Chronic.  The American Academy of Orthopaedic Surgeons describes pain as “a sensory and emotional reaction precipitated by actual or anticipated injury; results from damage to tissue or nerves and is made worse by pressure or inflammation.” 1  In Orthopedics, you may experience acute pain, after an injury like a sprain, strain or broken bone.  You may have chronic pain is more likely when you have a condition called osteoarthritis.

Chronic vs. Acute

Chronic pain is often defined as any pain lasting more than twelve weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists, often for months or even longer.2

Your Next Step

If you are experiencing pain or injury, first seek an appointment with your primary care physician if your insurance plan requires this step.  If your insurance company does not require a referral from your primary care physician, contact Nevada Orthopedic & Spine Center to request and appointment with one of our board certified and fellowship trained orthopedic surgeons.  Our mission is to provide quality health care you can trust and Nevada Orthopedic & Spine Center is setting the standard for care in Southern Nevada.

Request an appointment with Nevada Orthopedic & Spine Center, call 702.258.3773.

Partial Knee Replacement Surgery with Ronald Hillock, MD

Ronald W. Hillock, M.D.
Ronald W. Hillock, M.D.

If you would have told me 4 years ago that I would be performing partial knee replacements (Uni) today I would have laughed.  Traditionally this was a very technically demanding surgery with widely varied outcomes.  Technical errors in cutting the bone and positioning the implant have previously been a major source of failure in Uni Knee Replacements[1].  Due to the irregularity of predictable success I had opted not to preform Uni Knee Replacements.  That was until my wife Deb opted to have partial knee replacements and had an outstanding success.

Deb had tried everything prior to surgery.  She tried injections, pills, physical therapy and braces with little or no relief in her knee pain.  She gave up hiking with our dogs.  She gave up almost every leisure activity we had enjoyed due to the pain in her knees.  The pain was so severe that she avoided going to the store for fear of having to walk in her painful knees.  Stairs were an impossible barrier under any circumstances.  Her life was being dictated by her knee pain.  Taking matters into her own hands Deb researched the options and decided to try Uni knee replacements (against my advice).

Needless to say the surgery was a complete success.  Her recovery took about 8 weeks.  Since the time of her the partial replacements Deb has been able able to resume her active lifestyle.  This lead to a serious re-evaluation of my position on the Uni Knee Replacement.

I then began to research the topic and found that advances in robotic surgery and surgical planning have dramatically reduced the chances of error and increased the probability of success in Uni Knee Replacement surgery.  I contacted the manufacturer of the latest version of the Uni Knee Replacement, Mako, and began the process of educating my self on the techniques and planning for this surgery.

Unicompartmental (Uni) Knee replacement is a surgery where only the diseased or damaged portion of the knee is replaced with metal and plastic, allowing the normal portions of the knee to be retained and removing the damaged portions.  All the ligaments are retained allowing for more natural motion, function and most importantly it feels like a normal knee.

Published medical research has shown that robotic surgery for Uni Knee Replacement leads to greater accuracy in implant position.  A study completed in the United Kingdom looked at the benefits of robotic knee surgery in the setting of Uni knee replacement[2].  They found the robot resulted in 100% accurate implant position while matched traditional methods resulted in only 40% accurate implant position.  With robotics the surgeon makes a plan and can then execute the plan with complete precision and confidence.

When considering surgery I am often amazed when patients don’t ask how many of these surgeries of the type being discussed I have completed.  I am told by the implant manufacturer that I have performed more MAKOplasty Uni Knee Replacements in Nevada than all other surgeons combined.  Experience counts, when it comes to the MAKOplasty system I have learned through practice how to deliver a partial replacement with outstanding results.

Another factor that is often taken for granted is the hospital within which a surgery is preformed.  A study published out of Sweden showed a direct relationship between quality outcomes and surgeon experience in partial/Uni Knee Replacement[3].  This study demonstrated what should have been common sense, the more partial knee replacements performed the less likely to have the need for additional surgery.  High volume surgeons had a revision rate of less than 1% over a 5-year period while surgeons that preformed less than 8 Uni knees per year had revision rate of 6%.  Stated another way, the low volume surgeon’s patients were 6 times more likely to need additional surgery within 5 years.

The Makoplasty Robot is located in Centennial Hills Hospital and Medical Center.  The staff and leadership of this facility have devoted their efforts toward delivering the highest quality care attainable.  In a recent published report by Consumer Reports showed that Centennial Hills is one of 37 facilities in the nation to achieve the highest level of safety scores for 10-key surgical care related measures.  Compared to other facilities in Nevada, Centennial Hills Hospital and Medical Center scored highest for surgical safety issues.

All factors taken together if you have arthritis and have been advised that knee replacement is indicated I would be more than happy to help you consider your options.  My team, facility and staff are truly expert at Uni knee replacement and I would be honored to help recovery your actively lifestyle.

Are you a candidate for Unicompartmental/ Partial Knee Replacement?

Schedule a visit with Ronald W. Hillock, MD at Nevada Orthopedic & Spine Center to discuss your options.

Request an appointment here!

Learn more about MAKOplasty here

References

[1] Tregonning R, Rothwell A, Hobbs T, Harnett N. Early Failure of the Oxford Phase 3 Cemented Medial Uni-Compartmental Knee Arthroplasty: An Audit of the NZ Joint Registry over Six Years. J Bone Joint Surg Br 2009

[2] Cobb, J.; Henckel, J.; Gomes, P.; Harris, S.; Jakopec, M.; Rodriguez, F.; Barrett, A.; and Davies, B.: Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 2006

[3] Robertsson O, Knutson K, Lewold S, Lidgren L. The routine of surgical management reduces failure after unicondylar knee arthroplasty. J Bone Joint Surg Br 2001

Non Operative Management of Arthritis with Dr. Ronald Hillock- Part Six

If you or a loved one has been diagnosed with OA of the knee or hip (or both) there are several non-operative medical treatment options that should be used before considering surgery. These options are weight loss, medications, exercise through physical therapy, injections, alternative medicine in the treatment of osteoarthritis, and bracing and foot wear.

Non-Operative Management Option 6: Bracing and Foot Wear

Braces

There are many different designs of braces for use in the treatment of OA of the Knee.  These devices work by providing support to the knee while shifting the load to uninvolved portions of the joint.[1] The specific brace that is right for each situation must be determined by physical exam, radiographic images and careful consideration by the prescribing healthcare professional.  Unfortunately bracing is not a realistic option of pain relief in arthritis of the hip.

Foot Wear

Many vendors produce foot wear with extra cushioning in the heel to minimize the pain of contact or ground reaction force.  Unfortunately these are usually not covered by Medicare or insurance plans.

What is my next step?

If after several months of non-operative management of hip and/or knee arthritis you or your loved one still has joint pain that is altering their quality of life and lifestyle, then you should open the conversation about joint replacement.  Total Knee Replacement and Total Hip Replacement are great surgeries with excellent success rates.  The vast majority of patients who have undergone total joint surgery would recommend the surgery to their friends or family members.

Learn more about treating arthritis and request an appointment with Dr. Hillock here

References

[1] https://www.djoglobal.com/motion-is-medicine/protocol/knee-osteoarthritis

 

 

 

 

 

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