T he job of an orthopedic surgeon is twofold: 1) To fix the body when something goes wrong, and 2) To prevent it from going wrong in the first place. The objective of treating any orthopedic condition is to return the patient to a normal status in the most prudent manner possible. Many factors go into making such a decision, including the nature of the injury, the age and activity level of the patient, the time to recovery, risk of recurrent injury and the expected outcome of treatment.
All of these factors require a detailed discussion with the patient, addressing their specific needs and expectations.
One of the more important innovations in modern surgical principles is that of minimally invasive approaches. The fact is that surgery, itself, causes trauma. By this we mean some degree of tissue damage is created whenever an incision is made. A skilled surgeon endeavors to minimize any tissue damage during the act of surgery. Recently, advanced techniques have been developed to keep incisions and surgical trauma to a bare minimum. As a result, the pain, swelling and inflammation are much less and the patient can expect a quicker recovery. This principle is called minimally invasive surgery, or MIS.
The purpose of MIS is to create the least amount of tissue damage to address the underlying injury and the trade-off significantly favors the beneficial side of the equation. This is at the heart of the risk benefit equation. As every kid knows, the less you the scratch a wound, the quicker it heals. The amount of healing correlates to the degree of tissue damage or trauma; whether this damage is the result of external trauma, or the trauma of the surgery itself. Surgeons endeavor to create the least amount of tissue trauma. This principle is the essence of “minimally invasive surgery.” The lesser the amount of surgical insult to the tissue, the lesser healing required, and therefore the quicker the recovery.
D r. Nordt and his research team have created a novel exercise program, the object of which is to optimize joint mechanics and reduce stress concentrations by understanding and controlling stress vectors. The program is designed for patients with cartilage damage and osteoarthritis of the knee and incorporates weight-bearing exercises focused on tri-planar control of the foot and hip to promote proper alignment of the knee.
Proper alignment is continually stressed in standing, walking, occasionally running as well as transfers from sitting to standing and stair climbing. Emphasis is placed on motor control in the performance of the exercises rather than high repetition endurance training or overload strength training. Exercises are performed without footwear and in view of mirrors for visual feedback.
Kinesthetic awareness is promoted by verbal cuing and manual correction in activity performance. Concurrent clinical research using this novel exercise approach has generated outcomes of improved knee joint alignment instance, walking, and on stairs in as little as six weeks of training. Patients report “awareness of how to use the knee” as well as decreased symptoms of pain and improved function.
Dr. William Nordt is an orthopedic surgeon in Richmond, VA and a partner in OrthoVirginia since 1990. Perennially voted one of Richmond’s “Top Docs,” he has a strong commitment to excellence in all aspects of orthopedic care, ensuring that every patient is treated with courtesy and compassion. He has served as the team physician for the U.S. Olympic ski team and Olympic training camp, as well as various professional soccer, football, and hockey teams.
Dr. Nordt’s passion is restoring patients of all ages to an active and healthy lifestyle. He has devoted much of his career to the study of cartilage disease and founded the Virginia Cartilage Center. He is involved in the development of both surgical and non-surgical techniques for the treatment of cartilage damage.