Orthopaedic Surgery, Sports Medicine & Rehabilitation

News

Save the Date!
Sports Symposium slated July 9
WSU Student Union, Room E156

Area athletic trainers, coaches and primary care physicians are cordially invited to attend the Wright State Orthopaedics Sports Symposium to be held Friday, July 9, from 8 a.m. to 1 pm. at Wright State University.

Scheduled presentations include:

  • ACL Tears
  • Platelet Rich Plasma
  • Concussions
  • Cervical Spine Trauma
  • Rehabilitation of Patellofemoral Stress Syndrome and Insidious Onset Anterior Knee Pain

Look for more details closer to the symposium date.

Please RSVP to Anna Childers of Wright State Orthopaedics at (937) 208-8307, by Friday, July 2, 2010.


June 4, 2010
Wright State undergrads get up-close view of knee surgery

The grinding whir of bone saws and drills filled the air as orthopedic surgeon Matthew W. Lawless, M.D., demonstrated knee-replacement surgery on a set of synthetic bones. Then came the real thing — a taped video of an actual knee operation. All eyes in the class of 50 students were drilled into the screen, watching the flurry of action as clamps, forceps, a chisel and a suction tube worked their surgical magic.

The WSU biomedical engineering class, more than half pre-med students, is taught by Tarun Goswami, D.Sc., who holds a joint appointment in the College of Engineering and Computer Science and the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation. Dr. Lawless, assistant professor of orthopaedic surgery, was peppered with questions from the students following the video.

“Orthopedics is the one discipline where you have the merger of biomedical engineering and surgery,” Dr. Goswami said.“What I’m trying to do is connect my students with the surgery field so they see what the surgeons are doing and how we can improve the surgical procedures, the instruments, the devices.”


May 24, 2010
Neck injuries focus of major Wright State research effort

The Spine Research Group in the WSU Department of Biomedical, Industrial and Human Factors Engineering is conducting major cervical-spine research under the direction of Tarun Goswami, D.Sc., who holds a joint appointment in the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation within the Boonshoft School of Medicine. Other group members include medical students Matthew Binkley and Kelly Estes and orthopaedic surgery resident Chris Gayton, M.D., who is looking into the biomechanics of the spine.


April 2010
Joint Venture – Othopaedic Trauma

Matthew J. Di Paola, M.D., met with Michael J. Prayson, M.D., to discuss his orthopaedic trauma service at 30 East Apple Street, Suite 2200 in Miami Valley Hospital. Dr. Prayson serves as professor, vice chair, and Orthopaedic Trauma Fellowship director for Wright State Orthopaedic Surgery, Sports Medicine & Rehabilitation. To schedule an appointment with Dr. Prayson, please call (937) 208-2091.

Q: Thanks for meeting with me today to discuss your role in orthopaedic trauma for Joint Ventures. Why don’t you start by telling us how you became interested in orthopaedic trauma?

A: Trauma is an intriguing subspecialty because it encompasses a wide variety of injuries — from head to toe. Back in residency training, I had an interest in orthopaedic trauma and decided to pursue additional training in the form of a fellowship. This was an extra year spent focusing on traumatic injuries and related complications. I discovered that I really enjoyed the subspecialty. It is challenging. It can be difficult at times and it keeps you on your toes. I’ve been doing it for approximately 15 years now in practice and still have a keen interest in staying involved.

Q: Describe some of the challenges of orthopaedic trauma you find on a daily basis.

A: Some of it has to do with volume. We happen to be a very busy trauma center here at Miami Valley Hospital in Dayton, and the volume can sometimes be very difficult to manage. Some would even think of it as overwhelming at times. So that can be challenging on busy days where you’re trying to manage multiple patients who come in, sometimes arriving at the hospital in very close proximity to each other. You have to be intimately involved in the process and prioritize the care and management of all polytraumatized patients. Certain types of injuries we treat are also quite complex. Most notable for trauma surgeons are injuries of the pelvis and the hip ball-and-socket joint (acetabulum). Not many orthopaedic surgeons have an interest or proficiency in taking care of those injuries. Additionally, complex injuries such as significantly damaged joints, infections in bone and bones that don’t heal the first time around are some of the particular complexities that we face as orthopaedic trauma subspecialists.

Q: What do you find most gratifying about being an orthopaedic trauma surgeon?

A: With trauma, you see very active, very functional people sustain serious injuries and their ability to function changes dramatically. You take them through the process of the initial surgery — but that is only a small part of it. You follow them through afterwards and see their progress and their return to their daily lives and near normal function, and that, I think, is very, very gratifying.

Q: Do you treat specific types of cases more commonly than the average orthopaedic surgeon or do you take a particular interest within trauma? Are there particular areas of the body that you see more commonly?

A: I think for the most part all orthopaedic surgeons are qualified to handle fractures — that’s the basis of what we do in orthopaedic surgery. But as a traumatologist, I think your ability to handle more complex fractures — ones that are more splintered, ones that involve the joint surfaces and some areas that I mentioned before, like the pelvic and acetabular regions — certainly those types of injuries fall in the lap of the orthopaedic traumatologist just based on his or her training and proficiency in dealing with those types of fractures.

Q: You attended the American Academy of Orthopaedic Surgeons annual meeting in March. Why is attending that meeting important?

A: The Academy meeting is a large international meeting. It’s one of the best-attended meetings of orthopaedic surgeons across the world, and it’s a great opportunity for us to get together and focus on the latest research in our field. We have several opportunities throughout the year to do that, and this happens to be one of those meetings where we get that opportunity. Second, Specialty Day is one of the focused opportunities during the meeting. This is one full day devoted to each of the orthopaedic subspecialties and for me that’s obviously trauma. There’s a chance to get together, meet up with your colleagues in your subspecialty from across the nation and across the world and catch up on how things are going at other trauma centers and what people are doing to advance trauma care.

Q: Dr. Prayson, what does a typical week look like for you?

A: I take a fair amount of the trauma call here, usually about six or seven days per month. Outside of the trauma call structure, on Mondays I’m in the operating room all day performing surgeries. Tuesday we have a clinic that Miami Valley Hospital sponsors that provides care to the uninsured and underinsured — more so than any other hospital in Dayton — and I’m heavily involved in staffing that clinic. Tuesday afternoon is an open time, which I use for surgeries, meetings or research. Wednesday is another surgery day. Thursday I see patients all day in our Wright State Orthopaedic Surgery office at Miami Valley Hospital in Suite 2200. On Fridays, I am back in the operating room for more surgery. On the weekends, a lot of it depends on the trauma call schedule. This weekend for example, I am on call Friday and Sunday so I will be here most of the weekend performing surgeries and rounding on patients in the hospital.

Q: Thank you, Dr. Prayson for taking the time to discuss your area of expertise within our department.


March 2010
Joint Venture – Foot & Ankle

Matthew J. DiPaola, M.D., sat down with Richard T. Laughlin, M.D., to discuss his foot and ankle service at 30 East Apple Street, Suite 2200 in Miami Valley Hospital. Dr. Laughlin serves as professor, chair, residency program director, and foot and ankle service director for Wright State Orthopaedic Surgery, Sports Medicine and Rehabilitation. To schedule an appointment with Dr. Laughlin, please call (937) 208-2091.

Q: Dr. Laughlin, thanks for joining me to kick off our new series — Joint Venture. Joint Venture is going to be a regular communication between our department’’s surgeons and the community at large. It will provide a more intimate look at what we do on a daily basis and how we think about some of the issues that face us daily. The term Joint Venture is a bit of a play on words in the sense that, we as orthopedic surgeons, treat joint-related problems and endeavor to do so in a combined — or joint — decision-making process with our patients. This process is critical as it underscores the true partnership necessary for the surgeon-patient relationship to function effectively.

You recently became chairman of the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation. Tell us some of your new and unique responsibilities compared to your previous department role.

A: Obviously, being chairman, you take on more administrative duties. The most important part of my job is developing a vision for the department’s future. I’ve been with the department since 1994 and have seen its growth, which gives me a better perspective for charting a course for the future.

Q: The world is becoming more specialized in general and so is medicine — and orthopaedics. Tell us how you got interested in foot and ankle and what drew you to specialize in that.

A: As a resident in the late ’80s and early ’90s, I didn’t have a lot of foot and ankle training — I had an interest in trauma. I noted as we followed up with patients that a lot of the trauma patients had residual foot and ankle problems that were quite debilitating. Often they recovered from their other injuries, while their foot injuries remained a limiting factor to getting them back to full function. I also watched a few orthopaedic surgeons who concentrated on trauma gravitate towards foot and ankle as they got older, which triggered my interest. As I’ve grown in my career, I’ve realized quite a lot of foot and ankle problems go untreated — mainly deformity cases such as flat feet or forefoot deformities. Often patients are told nothing can be done for their deformities, so there’s a great opportunity to treat these patients. It’s become a niche within orthopaedics because the rest of the field has grown so much. Now with joint replacements, surgeons can completely focus their practice in that area without having to deal with foot and ankle.

Q: Is a general orthopaedist able to handle foot and ankle issues, or are there unique anatomic aspects that make it more complex or give you an advantage in specialization?

A: Probably more so than any other spot on the body, the foot is susceptible to many complications — wound healing problems and the swelling that impedes people from getting back into a shoe. With a lot of experience in treating these issues, you can avoid a lot of these complications with good end results.

Q: What is your general patient care philosophy? How do you approach surgical discussions with patients? What do you want them to know before treating a problem operatively or non-operatively?

A: With the foot — this sounds very obvious — but people have to walk. So anything you do to the foot is going to impede their mobility. It is extremely important for patients to understand their underlying pathology or problem. Second, patients must take an active role in their care. The first time I see a patient, I explain their specific problem and get them to start a foot exercise program, possibly some type of shoe modification, or other efforts to make them more comfortable. This helps them to start understanding what is involved in their treatment. With surgery, I think it’s really important to educate them on what they can expect after surgery, the length of recovery time and how that’s going to affect their daily life.

Q: How important is that pre-operative discussion in their overall patient care? Do you find patients come in with certain expectations that change over time? Is it an educational process?

A: The hardest part is telling patients the magnitude of their specific problem. In general, patients understand — like if someone has knee arthritis and they need a knee replacement, patients generally understand that. That’s usually the focus of our discussion. I try to explain their specific problem, but I also spend a lot of time telling them what to expect after surgery. I think patients really need to know how long it’s going to take to recover from surgery and what their recovery milestones will be: When can they put weight on their foot? When can they get back to work? When can they get back into a shoe? And, of course, How long do they have to use crutches, a walker or other ambulatory aid? Obviously, these are important milestones that impact their daily life a lot more than someone who has hand surgery or upper extremity surgery who can still walk while protecting their upper extremity.

Q: How many days per week do you operate and see patients in the clinic?

A: I see patients twice a week on Mondays and Wednesdays in our office at Miami Valley Hospital. I spend half a day weekly in an MVH-run multidisciplinary wound clinic and the rest of the time — Tuesdays, Thursdays, and Fridays — I perform surgeries at Miami Valley Hospital or Far Hills Surgical Center.

Q: Thank you for your time, Dr. Laughlin. I appreciate the time spent discussing your specialty and hope people have a better idea of your clinical focus and where to find you.