ORTHOPEDIC MEDICINE TARGETS BONE AND JOINT INJURIES, PAIN

Tiny incisions mean big business for local orthopedic surgeons.

Arthroscopic surgery is usually performed on knees, but the procedures can also be done on wrists, shoulders and ankle joints.

In arthroscopic surgery, small incisions are made into the affected area, then a tiny camera is inserted into the joint to locate the injury. Once the injury is pinpointed, the surgeon inserts very small instruments into the incisions to correct the damage.

"It obviates having to make the large incision," which speeds healing time, said Dr. William Kapp of Orthopaedic Associates in Cape Girardeau.

"We're doing lots of the arthroscopic stuff," said Dr. Walker A. Wynkoop, an orthopedic surgeon with Midwest Physicians and Surgeons in Cape Girardeau. "The wrists, I've done a lot of those."

Orthopedic surgeons treat bone and joint injuries ranging from fractures to total joint replacements.

Individuals may specialize in injuries to the hands, back or neck, sports injuries, joint replacements, work-related injuries and industrial medicine, said Dr. August Ritter of Orthopaedic Associates.

Advances in technology and techniques and a growing specialty medicine base in Cape Girardeau mean patients no longer have to travel to St. Louis or Memphis to get up-to-the-minute care.

"One of the things that perhaps has occurred over the years is people are realizing the level of talent that's available here in Cape Girardeau. Arthroscopies, bone transplants, and the level of procedures that we do here is equal to a lot of urban places that do work at the university level and is on par or ahead a lot of the community hospitals in St. Louis," Kapp said.

Most of the recent advances in orthopedic medicine have "refinements of previously existing techniques or technology," Ritter said.

Many of the advances are occurring at large research or university hospitals, Kapp said, "and it takes a while for those to filter down to the community level."

New materials, including metals and plastics, have made treating bone and joint injuries easier, Ritter said.

New developments include refinement of bone stimulators, used to repair severe bone injuries.

Said Kapp: "We can actually lengthen the bone now. Rather than in the past, having to amputate the leg, we can salvage the leg. We can do a bone transplant and actually make the bone longer."

A bone glue is in clinical trials now and will make a big difference in treating small fractures, Ritter said.

"I think the big advance in orthopedics is going to be in preventive care," Wynkoop said. "We're getting more people to exercise and not be overweight and things like that," he said, explaining that reduces risks of osteoporosis and injuries to bones and joints.

"The real-big breakthroughs are probably in the next five to 10 years, when we're going to be doing things on the hormone and tissue systems and to cause new healing," he said. New treatments will allow doctors to "turn on the hormone switch" and cause growth of new ligaments or cartilage, he said.

Wynkoop said he sees a lot of wrist injuries stemming from in-line skating and ankle injuries from basketball games.

"We see a lot more injuries from basketball than you'd probably imagine," he said. "A lot of it comes from the pick-up games."