IN MOTION NEWS FROM MEDSTAR ORTHOPAEDIC INSTITUTE Winter 2020 A Life Changer for Detective Inside this issue... COUPLE UNDERGOES SAME CHEF IS PAIN-FREE AFTER A RETURN TO NORMALCY AFTER ROTATOR CUFF SURGERY DOUBLE HIP REPLACEMENT WRIST HEALS CORRECTLY IN MOTION NEWS FROM MEDSTAR ORTHOPAEDIC INSTITUTE IN MOTION, published twice yearly, shares the latest news from MedStar Orthopaedic Institute with CONTENTS our community. The Institute is made up of dozens of specialists from Visit us at MedStarOrthopaedicInstitute.org MedStar Georgetown University Hospital, features news & information MedStar Montgomery Medical Center, MedStar Southern Maryland Hospital Center, MedStar St. Mary’s Hospital, and 4 8 MedStar Washington Hospital Center. NECK & SPINE ASK A DOC Detective has Two Orthopaedic Surgeons Answer Commonly Asked Questions life-changing Sam Wiesel, MD cervical disc Chair replacement MedStar Orthopaedic Institute surgery 9 INNOVATION Kenneth A. Samet, FACHE Custom Implants Broaden Shoulder Replacement Options President and CEO MedStar Health Karen Alcorn 6 16 NEW PHYSICIANS Vice President, Marketing SHOULDER Meet MedStar Orthopaedic Institute’s Newest Physicians MedStar Health Our new MedStar Orthopaedic Institute website offers you a full range Couple with chronic and Lisa Arrington of information about almost anything related to your musculoskeletal acute injuries Regional Director, Marketing system, from explanations of conditions and new procedures, to undergo same 17 rotator cuff MEET THE TEAM MedStar Health helping you find the right doctor at the preferred location to treat you. surgery MedStar Orthopaedic Institute Physicians Norma Babington • Our design is patient-oriented, easy to navigate, and includes Managing Editor educational videos and resources to help you learn more about Tammi Bricker the musculoskeletal system—the bones, muscles, ligaments, and 20 Design & Art Direction tendons—of the body. 10 LOCATIONS ADVENTURE You’re Never Far From • Easy navigation helps you connect with the right physician for your Brother surgeons MedStar Orthopaedic Institute condition/treatment at the most convenient location. hike 180 miles over Whitney, • Our physician profiles, some with links to videos and podcasts, allow Muir, and Russell you to learn about each of our highly trained specialists online, so you mountains can find the one who meets your needs. • Patient stories bring to life first-person accounts of the MedStar Orthopaedic Institute experience. • For your convenience, we provide options for making appointments. 12 HIPS • And it’s accessible from all your devices! Chef is pain-free after double hip Get convenient and coordinated care when you need it. replacement surgery MedStarOrthopaedicInstitute.org 14 WRIST A return to normalcy after surgery to correct improperly healed wrist 2 IN MOTION MedStar Orthopaedic Institute | Winter 2020 MedStarOrthopaedicInstitute.org 855-788-6464 IN MOTION 3 SPINE & NECK “ In cervical disc arthroplasty, instead of fusing vertebrae together, we replace the disc with Cervical Disc an implant that mimics normal disc motion. It basically functions as a joint that allows normal Replacement: range of motion and reduces stress on the discs above and below. The most amazing part about this technique, other than sparing your range of A Life Changer motion, is the short recovery period.” for Detective — OLIVER O. TANNOUS, MD or Detective Michael Pavero, weakness, numbness, and “I came across Dr. Oliver Tannous,” he says. “He had fabulous A month after first meeting with Dr. Tannous, Detective Pavero pain in his neck and shoulders can be show stoppers. reviews from patients and did disc replacement surgery.” made up his mind and had the surgery. Dr. Tannous had fAssigned to the ATF Arson Task Force for Washington, Detective Pavero made an appointment with Dr. Tannous at warned Detective Pavero that fusion could still be a possibility. D.C., he is a 20-year veteran of the D.C. Metropolitan Police MedStar Orthopedic Institute at MedStar Washington Hospital “He told me he was planning to do the replacement, ‘but if I get Department, and his physical readiness is required for his Center. “Dr. Tannous told me disc replacement surgery WAS an in there and your anatomy is not what it looks like on film, I’ll have own safety, his colleagues’, and the citizens he protects. option, and I’d be a good candidate for it,” he says. to do a fusion.’” So when Detective Pavero woke one morning with upper “In cervical disc arthroplasty,” explains Dr. Tannous, “instead of Detective Pavero was in luck. “When I woke up,” the detective left arm pain, he assumed it was a temporary pulled fusing vertebrae together, we replace the disc with an implant recalls, “the first thing I did was feel for a collar, which would muscle, wrapped it in an Ace™ bandage and went that mimics normal disc motion. It basically functions as a joint have meant I’d had fusion. For a minute I wondered if I’d even about his day. But two days later, his fingers were tingling. that allows normal range of motion and reduces stress on the had surgery. But I had no pain, so I knew he was able to do the Detective Pavero, 47, was a little concerned it might discs above and below. The most amazing part about this replacement.” be something serious. Doctors at a local Emergency technique, other than sparing your range of motion, is the short Department diagnosed a pinched nerve and prescribed recovery period.” And the recovery was equally successful. Not only was he pain medication. immediately without pain and could move his neck freely, he While it sounded like a great solution to the detective, “I didn’t says, “I had a day of coughing, a day of eating soup, a day of The pinched nerve did not go away. For the next several immediately jump on board,” he says. “I wanted to try a little eating soft stuff, and by day four I had a pork chop!” months Detective Pavero ping-ponged between his primary longer with physical therapy and other things I was doing.” care physician, an orthopaedist, and a neurosurgeon, along Six weeks after surgery, Detective Pavero was cleared to return with treatments of physical therapy, steroid shots, and pain Dr. Tannous agreed. He prefers to try more conservative methods to work. Since returning, he’s had to take tests on the firing range medication. Not being 100 percent, he was either on sick first. “In fact,” he says, “if you’re experiencing neck and arm pain and in defensive tactics training. He passed with no problem. leave or desk duty at work. due to disc herniation or cervical spinal stenosis, you may not “If I’d had fusion,” he says, “it would have been six months rather need surgery at all. About 75 percent of our patients get better than six weeks before I could return to work—if I could return to An MRI found a herniated cervical disc and bone spurs, and using physical therapy, anti-inflammatory medications, or steroid work at all.” a spine surgeon told him he had two choices: live with it, or injections. It’s only after we’ve exhausted those options that we have a procedure called anterior cervical discectomy and talk about surgery.” Ever grateful to Dr. Tannous, he says, “There are a few people, fusion, or ACDF. The procedure relieves pain and numbness or events, that change your life. Meeting Dr. Tannous was one by removing the problem disc and replacing it with a piece For Detective Pavero, “some days would be ok, then I’d turn my of those for me. It was as though I was on a road, my car broke of bone, a metal plate and screws. Over time the vertebrae head the wrong way, and pain would shoot up my arm. I wasn’t down, and I had to get off. Then Dr. Tannous came along and fuses and stabilizes that part of the cervical spine. While happy. I was either on desk work or at home just moping around. put me back on the road so I could drive again.” the surgery relieves pain, the patient loses some range of I couldn’t mow the lawn or do much of anything physical.” motion. And there is a long recovery. Had Detective Pavero been retired, or in another profession, he says he may have opted for fusion. “But a physician on the police force told me that it was highly likely I would be forced to take early retirement,” he says, “because I’d have REPLACEMENT FUSION limited mobility and wouldn’t be able to perform at 100 Pros Pros percent. I knew I couldn’t survive on 15 to 20 percent • Recovery: Patients can move their necks immediately after • Has well-documented history of success over a 50-year period of my salary.” surgery and return to work within a few days, depending on • Eliminates pain, numbness, and weakness over time their jobs. For patients like Detective Pavero, it's 4 to 6 weeks One of the doctors he had seen mentioned cervical disc before returning to work. Cons replacement (arthroplasty), but said he wasn’t a candidate. • Full range of motion immediately • Must wear brace or collar for six to 12 weeks, fusion complete Yet the mere possibility of another option sent Detective • No brace or collar at 6 to 9 months Pavero to the internet looking for a second opinion. • Immediately eliminates pain, numbness, and weakness • Bone graft, usually from cadaver or pelvis Cons • Reduced range of motion Detective Michael Pavero is back investigating fires after • Because replacement surgery is only about 15 years old, • Discs above and below fused disc may degenerate faster cervical disc replacement surgery eliminated weakness, the long-term effectiveness is unknown. due to increased stress. numbness, and pain in his neck and shoulders, which could have cost him his job.