Improving Joint Replacement – From Consultation to Recovery

Posted by Brigham and Women's Hospital June 4, 2014

BWH's evidence-based knee replacement process is based on research by the Care Improvement Team, led by orthopedic surgeon Dr. John Wright (center).

As a concerned friend or relative of a patient who recently had a joint replaced, you might be tempted to ask: “How was your surgery?” But research findings from our Department of Orthopedic Surgery suggest that you should be just as concerned about how they were treated before and after surgery.

Brigham and Women’s Hospital (BWH) now uses a standardized approach to total knee replacement that guides how patients should be treated from the time they arrive at the hospital for a consultation to the care they receive after being discharged. This new evidence-based approach is based on the work of the Care Improvement Team, led by orthopedic surgeon Dr. John Wright. After researching prospective changes to conventional knee replacement practices, the team tested selected changes and evaluated their effects. Changes found to have had a significant impact were incorporated into a new knee replacement process, which is now the standard protocol for all knee replacement surgeries at BWH.

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Comprehensive Spine Care: Surgical and Non-Surgical Treatment

Posted by Brigham and Women's Hospital May 6, 2014

Treating back pain can be very challenging, requiring the expertise and coordination of more than one medical specialty.

Certain spinal conditions, such as back pain, are very common. However, treating these conditions can be very challenging, requiring the expertise and coordination of more than one medical specialty, including physical medicine, pain management, and surgery.

“Back pain is a very common complaint, but a very non-specific complaint. Back pain and leg pain can be caused by many different things, including spinal stenosis, disk herniations, and instability. The procedures that we offer are really tailored to the specific patient with a specific disorder, based on imaging and exam,” says orthopedic surgeon Dr. Chrisotopher Bono, Co-Director, Brigham and Women’s Comprehensive Spine Center.

To ensure the correct diagnosis and treatment for spinal disorders, patients who are referred to the Brigham and Women’s Comprehensive Spine Center are evaluated with state-of-the-art diagnostic procedures and imaging. Often, the first step is conservative, non-operative treatment by physiatrists, pain management physicians, and other specialists.

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Helping People Step Strong after Trauma

Posted by Brigham and Women's Hospital April 21, 2014

Gillian and her family hope that the Stepping Strong Fund helps others with traumatic injuries.

Imagine a world where patients with severe limb injuries – like survivors of the Boston Marathon bombings – could hope for better recoveries, with muscle, cartilage, and bone regenerated.

That vision draws closer every day, according to Brigham and Women’s Hospital (BWH) researchers. They are hopeful that a new initiative, the Gillian Reny Stepping Strong Fund, will fuel breakthroughs for patients with traumatic, athletic, military, and disease-related injuries.

A year ago, Audrey Epstein Reny and Steven Reny were standing near the Boston Marathon finish line with their daughter Gillian, cheering on the runners and waiting for their oldest daughter Danielle to cross. When the bombs went off, the Renys were among the many innocent bystanders who were injured, Gillian critically.

The family was rushed to BWH, where clinicians worked to save Gillian’s life — and both of her legs. On that tragic day, dozens of patients were treated at BWH for similar injuries.

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Innovative Knee Replacement Process Gets Patient Back on His Feet

Posted by Brigham and Women's Hospital June 13, 2013

Knee replacement patient Rick Litavis (center) enjoys a post-surgery family stroll.

With three torn ligaments and no cartilage left in his right knee, 49-year-old Rick Litavis of Hopkinton, MA, had two options – continue to live in pain and suffer through sleepless nights, or get a knee replacement.

Rick was ready for relief.

And thanks to surgical expertise, teamwork, and an innovative approach to improving knee replacement outcomes, Rick was not only pain-free within days after his January 2013 operation, but also walking and biking within weeks.

“I was completely floored,” says Rick. “The first night after my surgery I was standing, the next day I was using a walker without pain, and I was home the day after that.”

After playing football at Northeastern University, Rick continued to play competitive, high-impact sports throughout his 20s and 30s. But such a lifestyle also comes with risks, and Rick managed to severely injure his right knee several times over the years.

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Weighing Treatment Options for Knee Pain: Surgery vs. Physical Therapy

Posted by Brigham and Women's Hospital April 24, 2013

What's the best treatment for a torn meniscus?

Many middle age and older adults have serious knee pain due to a tear in the meniscus, an important supporting structure that is often damaged in people who have osteoarthritis. In the United States, more than 450,000 arthroscopic surgeries are performed each year to treat these injuries. Now, new research from Brigham and Women’s Hospital (BWH), suggests that treatment with physical therapy, with an option for arthroscopic surgery if patients do not respond, may prove as effective as initial treatment with surgery.

“These results are extremely valuable and will enable us to work with patients and their families to identify the treatment that is best aligned with patients’ preferences,” said Dr. John Wright, an orthopedic surgeon at BWH and lead orthopedist on the study.

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Innovation Units: Helping Patients Transition Back Home

Posted by Brigham and Women's Hospital April 11, 2013

Orthopedic Surgery nurses continue to care for patients who have returned home.

These days, it’s routine for patients who have had orthopedic surgery at Brigham and Women’s Hospital (BWH) to receive a phone call from the nurses who cared for them at the hospital after they go home.

“We ask patients if they had trouble getting pain medications, how their pain is, whether the visiting nurse and physical therapist came to the house and if they know when their follow-up appointments are,” said Mary Anne Kenyon, MPH, MS, RN, ONC, Nursing Director, Department of Orthopedic Surgery.

Through the calls, BWH nurses have learned how they can ensure that patients have a smooth transition back home. This includes making sure prescriptions for pain medications are available and that patients learn how to take their medications correctly before they leave the hospital.

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Spine Surgery — When Is It Right for You?

Posted by Blog Administrator May 16, 2012


spine specialist with patient

Dr. Bono (right) and his spine surgeon team strive to ease back pain with the least amount of surgery possible.

Dr. Christopher Bono, Chief of the Department of Orthopedic Surgery’s Spine Service, has a habit of talking patients out of spine surgery. It’s not that he doesn’t want to help you – quite the contrary.

Spine surgeons in Dr. Bono’s practice end up performing surgery on less than 25 percent of the more than 800 patients that they see each year. Dr. Bono is proud of that low rate, as his team’s goal, as ironic as it may seem, is to perform the least amount of surgery possible. His rationales for this objective are that spine surgery, even in the hands of its best surgeons, is a very risky proposition, and the vast majority of patients with back pain can be treated effectively without surgery.

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