Same day surgeries restore joint mobility

September 04, 2007
It wasn't the hope of winning an Ironman triathlon or summiting Mt. Everest that led Linda Vernon to New Hanover Regional Orthopedic Center at Cape Fear Hospital.

“I just wanted to regain the ability to put my earrings on again,” said Linda, 65, who for decades had suffered the agonizing and debilitating effects of Rheumatoid arthritis (RA), a chronic disease resulting in joint pain and inflammation.

For Linda, combing her hair, brushing her teeth – even raising and closing the clasp of an earring – had become nearly impossible. When finally she experienced almost total functional loss of her right elbow and several fingers on each hand due to the disease, Linda, with help from husband Marion, began an exhaustive, nationwide search to find relief.

That search ended off Wrightsville Avenue at Cape Fear Hospital in the form of New Hanover Regional Orthopedic Center, a nationally recognized orthopedic program, and with help from Richard Bahner, MD, an orthopedic surgeon in Wilmington who specializes in joint replacements of the finger, hand, wrist, elbow and shoulder.

Long known for its expertise in inpatient procedures like spinal, hip and knee replacement surgeries, New Hanover’s orthopedic center is also home to the region’s premier provider of orthopedic outpatient, or “same day,” surgical procedures, including various knee, hand, shoulder and joint-related procedures.

“I can’t even begin to describe the relief and joy I have experienced from the results of my surgery,” said Linda, who under Dr. Bahner underwent total elbow joint arthroplasty, or replacement of the elbow joint, at Cape Fear. “It was a very positive experience, especially with an expert surgeon like Dr. Bahner and others working in a positive, nurturing environment like New Hanover’s orthopedic center.”

A unique by-product of the merger between NHRMC and Cape Fear in November 1998, New Hanover’s orthopedic outpatient program has quickly evolved to become a big hit not only with patients, but also surgeons, doctors and local physical therapists.

"The Cape Fear campus allows me to take care of complex orthopedic problems
that normally would have to go to a larger academic institution,” Dr. Bahner said.

For Doug Messina, MD, an orthopedic surgeon in Wilmington who specializes in arthroscopic and reconstructive surgery of the knees and shoulders, New Hanover’s orthopedic center represents the best in modern orthopedic care, comfort and convenience.

“We’ve worked very hard to make the orthopedic program as efficient as possible, including establishing a patient call center,” said Dr. Messina, the program’s Steering Committee Chairman. “Patients undergoing outpatient orthopedic procedures can call the night before and check on their surgery time, and we can advise them accordingly. This decreases the patient’ s waiting time on the front end.”

Teamwork, said Dr. Messina, is the bedrock of New Hanover’s orthopedic program, which in 2005 was named in the Top 5 percent nationally for Total Hip and Knee Replacement and in the Top 10 percent nationally for Orthopedic Care, according to a national ranking service.

“From patient check-in to the recovery room, everybody’s working toward the same goal of serving the patient’s needs,” he said.

For orthopedic surgeon and shoulder-knee specialist Robert Boswell, MD, New Hanover’s orthopedic center means performing cutting-edge medical procedures in a modern orthopedic environment.

“Just 10 years ago, for example, it was pretty routine for anyone having shoulder surgery to be in the hospital for two or three days,” said Dr. Boswell, who practices in Wilmington. “Today, however, with arthroscopy and advances in anesthesia and pain management, most patients having shoulder surgery at the orthopedic center at Cape Fear will be home in a matter of hours. It’s the best thing about our outpatient orthopedic care.”

Ensuring patients return home just as soon as possible with their pain well-managed is something Arlene Gurganus, RN, Cape Fear's Manager of Pre-Operative and Post-Anesthesia Care Services, knows all about.

"At Cape Fear we have the opportunity to meet the unique needs of the orthopedic outpatient," she said. "The Ambulatory Surgery Unit at Cape Fear Hospital offers highly customized care beginning with pre-admission testing and progressing to discharge, which includes a follow-up call the next day."

In addition to same day surgery care, New Hanover’s orthopedic program provides outpatient therapy services at several sites.

It's this complete continuum of care that makes it special, said David Oehler, Orthopedic Program director.

"At Cape Fear we have the benefit of staff, systems, technology and medical providers that are experts in caring for patients undergoing both inpatient and outpatient procedures on a daily basis," he said. “The result is a depth of experience and capability to handle almost any orthopedic or medical need.”

As for Linda, living pain free with full elbow mobility to comb her hair, brush her teeth and put on earrings has given new meaning to the phrase “super-human strength.”

“This procedure has allowed me to regain 1,000 percent of what I did have and more,” she said.