St. Joseph's Health Musculoskeletal Minute

Welcome back to St. Joseph's Health Center's Musculoskeletal Minute! This video blog features doctors from St. Joseph's Hospital Health Center in Syracuse, NY, speaking on orthopedic topics of interest. You will see a new video blog out every few weeks.

In this edition, Dr. Ryan Smart, sports medicine specialist at St. Joseph's Hospital Health Center, discusses sports knee injuries.






Dr. Ryan Smart is board certified in orthopedic surgery.

Education: MD, University of Michigan, BA, Cornell University
Residency: Yale University
Fellowship: Baptist Hospital, Boston
Areas of Expertise: Adult and pediatric sport injuries; fracture care; surgical repair of injuries of the shoulder, hip, knee, including arthoscopic shoulder and knee surgery; total shoulder and knee replacement, arthoscopic management of hip disorders, including labral tears and hip impingment.

Operation Walk Syracuse: Preparing for Panama

Operation Walk Syracuse is a group of orthopedic specialists (surgeons, medical doctors, nurses, anesthesiologists, and physical therapists) who travel to countries that lack ample access to desperately needed hip and knee replacement surgeries. The surgeries are performed at no cost and patients receive the same state of the art services that our patients receive here at home. This post highlights the “pre-trip” the group made to Panama recently, preparing for their longer trip in November 2012. Last year the group traveled to Nepal, performing more than 75 hip and knee replacements.

Thousands of miles closer, a fraction of the travel time, one hour difference in time, and the luxury of clean, running water, ample electricity, and sound building structures--this is Panama City, Panama.  We joked casually as we were chauffeured from the airport in Panama City to the modest hotel that would serve as home base during our pre-trip visit to St. Tomas Hospital.  We were preparing for our upcoming annual Operation Walk trip in November, 2012.  We (Dr. Brett Greenky, Mike O’Hara, and I) discussed the stark contrast of Panama City in comparison to Kathmandu, Nepal our 2011 Operation Walk Syracuse destination.  We speculated about the hospital, the working conditions, the medical staff, equipment challenges, and our potential patients.  A literal world of difference from the far away and exotic land of Nepal, this mission should be a virtual walk in the park from a comparative standpoint. 

Our small “scouting” team was warmly greeted by the Panamanians and hospital staff, and eagerly embraced and integrated into the Operation Walk Team visiting Panama City for their annual trip.  Operation Walk Denver, a long time established Operation Walk group, had graciously permitted us to coordinate our “pretrip” visit with their scheduled mission trip to enable us to draw from their vast experience as an established team, as well as to permit them to show us the lay of the land at St. Tomas Hospital. 

True to our beliefs, the differences were vast—a modern city with a fairly well equipped hospital rivaling many in the US in terms of the structure and facility features.  Lacking, however, was the capacity to provide the people of Panama with life altering joint replacement surgery primarily due to the supply and demand.  There simply aren’t enough joint replacement surgeons in Panama to meet the surgical needs of their people.  It is for this very reason that Operation Walk teams are warmly embraced and welcomed into this country.  The surgery missions are viewed by both government and hospital officials as a conduit for meeting the needs of their people; in essence, a salvation for them.

Our “perceived” differences between Kathmandu and Panama City rapidly dissipated as we filed into the patient screening clinic that had been assembled in anticipation of our arrival accompanying the Operation Walk Denver team.  As we wound our way through the waiting room crowded with potential patients and their families, applause erupted and cheers echoed from the walls from the hundreds of people crowding the room.  The American team offering the promise to relieve the pain and suffering for some, and restoring the ability to walk for others, had arrived.

The next six hours flew by in what seemed like mere minutes.  Grateful patients and their families were ushered into screening rooms and evaluated by teams comprised of surgeons, medical doctors, anesthesiologists, and nurses.  We encountered elderly people crippled from pain who had limbs misaligned by the long term effects of osteoarthritis.  We met young people, eyes filled with hope for a better future, who had fused hips and/or knees with little or no mobility due to advanced rheumatoid arthritis that had been left untreated due to the lack of availability of disease modifying medications which are readily accessible in the US but not available in this country.

The potential patients were all impeccably dressed in Sunday best for their appointments with the Operation Walk team, wanting to demonstrate respect and admiration for the Americans who had come to offer them hope and relief.  We quickly learned from the Denver team and from the Panama physicians that their lifestyle reality is actually dramatically different from the way they presented to us.  Many live in condition  of complete squalor and poverty, but their pride and respect for Operation Walk inspires them to present themselves immaculately coiffed and wearing what might be their only untattered garment. 

Most of the patients were candidates for bilateral hip or knee replacements, and whenever medically feasible, procedures on both sides would be performed.  For those patients only able to tolerate a single procedure, they were offered the hope of having the second surgery done when we, Operation Walk Syracuse, returns in November.  The same held true for those patients who had medical conditions such as heart disease or diabetes that had to be brought under control prior to undergoing a surgical procedure.  These patients were all considered to be in our “bullpen” and in the queue for surgery in November upon our return. 

So, back to the differences—Nepal versus Panama City—the city, the hospital, the environment couldn’t not have been more in contrast, but the differences end there.  Glance into the eyes of the people, old or young, patient or family member, and we were witness to the same basic need and hope for relief from suffering. It transcends several continents and many thousands of miles.  Once again as we embark on this new journey to Panama City, we are forever humbled by the honor and privilege of caring for those less fortunate brothers and sisters in our world. 

A patient in Panama, who will receive total knee replacement surgery. 

St. Joseph's Health Musculoskeletal Minute

Welcome back to St. Joseph's Health Center's Musculoskeletal Minute! This video blog features doctors from St. Joseph's Hospital Health Center in Syracuse, NY, speaking on orthopedic topics of interest. You will see a new video blog out every few weeks.

In this edition, Dr. Brad Raphael, orthopedic surgeon at St. Joseph's Hospital Health Center's outpatient Northeast Surgery Center  in Fayetteville, NY, speaks on platelet-rich plasma (PRP) therapy, an emerging treatment in a new health sector known as " orthobiologics." 

Education:
M.D., Yale University School of Medicine
B.A., University of Rochester

Residency:
New York Weill Cornell Medical Center

Fellowship:
Kerlan Jobe Orthopaedic

Areas of Expertise:
Arthroscopic & reconstructive surgery (shoulder, knee, elbow, hip & ankle)
Sports Injuries