Andrews Sports Medicine and Orthopaedic Center, which has long been known for orthopaedic surgery, is now expanding its presence in nonsurgical orthopaedics with the recruitment of more physicians who specialize in treating muscle, bone and joint conditions that don't require surgery.
"The most appropriate treatment for many orthopaedic conditions, including injuries, often doesn't require surgery," Andrews CEO Lisa Warren said. "In addition to helping young athletes recover from sports injuries, we're seeing an increasing number of patients with degenerative conditions like osteoarthritis that respond well to nonsurgical care.
"Expanding our staff of nonsurgical orthopaedists improves access for both nonsurgical and surgical patients. It frees slots on our surgeons' schedules so patients who need surgery can get an appointment sooner."
In the past two years, Andrews has expanded its staff from four nonsurgical orthopaedists to seven, with an eighth expected to join the practice in the fall. Satellite offices have been added in Gardendale and Trussville, with a Cullman office planned for the future.
Medicare and many private insurers are now requiring that patients first try conservative nonsurgical treatments before coverage for joint replacement is approved.
"Fortunately, in addition to the advances in joint replacements, we're also seeing progress in other treatments that can ease pain and possibly delay or prevent the need for surgery. Our nonsurgical orthopaedics specialists are also performing a wider range of more invasive procedures including ultrasound guided techniques," Warren said.
Jody Ortega, MD, is one of the orthopaedists on the Andrews staff who has been working with nonsurgical alternatives to help patients delay or avoid the need for surgery.
"One example is ultrasound guided injections for viscosupplementation," Ortega said. "In the right cases, this can bring patients relief and delay the need for a joint replacement. When we are dealing with progressive joint deterioration, we tend to see the best results in patients who are referred sooner rather than later. In early stages, steroid injections may be enough to bring relief. Viscosupplementation injections tend to have better outcomes before deterioration progresses too far.
"There are also situations where we can help patients who need joint replacements prepare for them so they can meet qualifying requirements and be able to expect better outcomes.
"So often in progressive conditions, people get caught in a spiral. When they hurt, they move less, which reduces their muscle strength and makes them tend to gain weight, which increases the pain. Some insurance companies, hospitals and surgeons have weight limits for total joint replacements. We can help patients break the pain spiral and get into better condition before surgery so they can look forward to a better outcome."
Nonsurgical orthopaedists may also use PRP injections for arthritis, tendonitis and similar inflammatory conditions. To boost healing in difficult areas such as torn rotator cuffs, they may gather bone marrow from the hip bone, spin it down, and inject bone marrow aspiration concentrate (BMAC).
Andrews nonsurgical physicians are also continuing to perform an increasing number of microinvasive procedures such as trigger finger release and partial plantar fascia release with topaz microdebrider
"Although people tend to associate us with sports medicine, our orthopaedists work with people of all ages and backgrounds," Ortega said. "When we do see sports injuries, from elementary and high school to college athletes and the pros, most can be treated without surgery. A broken arm would likely come straight to us. If we see surgery could improve the outcome, the workups are already done, then expedited and passed on to our surgeons. We work as a team to give our patients our best effort."