Innovations

Cartilage Transplant Gives Knees New Life

For many years, the treatment options for patients suffering with Articular Cartilage defects or damage have been limited, but a revolutionary new procedure performed by Dan Adair, MD at Springfield Clinic offers hope.

Dr. Adair, specialist in Orthopedic Surgery, is one of the first in the area to perform chondral allograft transplantation, a method which removes the immature cartilage cells from a human tissue donor and transplants them into the host patient’s knee. The immature cells divide normally and create a more natural replacement for the patient’s missing or damaged cartilage. The procedure has been approved by the FDA and is endorsed by the International Cartilage Repair Society.

Articular Cartilage is a highly complex human tissue that provides cushion between bones in the knee and creates a smooth surface for its motion. Attempts to produce an artificial replacement for the tissue have met with little success. “Researchers thought they were ten years away about twenty years ago. Everything I read says we’re at least another ten years away from a product that can simulate our own tissue,” commented Adair.

More common alternatives, like Autologous Chondrocyte Implantation, where cartilage cells are grown in a lab, or Microfracture surgery, where tiny fractures are made in the bone to stimulate re-growth of the tissue, lack the durability desired. In some cases, knee arthroplasty (knee replacement surgery), depending on the patient’s condition, has yielded the best results.

“We’re very good at metal and plastic, but we’re looking for better solutions,” said Dr. Adair. “This new procedure allows us to biologically replace cartilage. The quality of the repair appears to be superior to traditional methods, especially when performed on younger patients.” According to Adair, chondral allograft transplantation is also less painful for the patient and is technically easier than alternatives, which makes it less expensive.

For more information, contact the Springfield Clinic Department of Orthopedic Surgery at 217.528.7541.

Innovative Endoscopic Procedure Available at Springfield Clinic
(view EUS video)

For years, the use of imaging in medicine has helped detect abnormalities in the digestive tract, including the esophagus, stomach, pancreas and liver. Until recently; however, patients would still require a biopsy or surgical resection to determine the nature of the problem. Patients would often undergo invasive procedures, which would require hospital stays, and, at times, lengthy periods of waiting for results. Now, a technologically advanced procedure performed at Springfield Clinic offers an alternative solution.

Ashish Chopra, MD, specialist in Gastroenterology at Springfield Clinic, is specially trained in the new diagnostic procedure known as Endoscopic Ultrasound (EUS) with Fine Needle Aspiration (FNA).

Endoscopic Ultrasound (EUS) combines endoscopy, introduced through a patient’s mouth, and ultrasound to explore internal organs. When a tissue sample is required, Fine Needle Aspiration, or FNA, uses a thin needle attached to the endoscope. The needle can be used to remove tissue samples, guide treatments, analyze masses, and help diagnose conditions. Using EUS with FNA, physicians are able to get a deeper biopsy, and can look through thin layers of tissue with minimal invasion. EUS with FNA can even be used to determine the stage of cancer once it discovers a nodule or mass.EUS with FNA has been available in larger markets for years. “Up until a few years ago, patients in the Springfield area were referred to Chicago or St. Louis for this procedure,” said Chopra. “Now it can be done locally.” Dr. Chopra performs EUS with FNA as an outpatient procedure in a hospital setting, but expects the service to soon be offered at Springfield Clinic’s Ambulatory Surgery & Endoscopy Center.

Dr. Chopra stresses the importance of having access to this kind of procedure in Springfield. “It’s here, it’s safe, and it offers good diagnostic accuracy to determine what’s going on.”

September 11, 2009 - For many years, patients suffering with Retinal Vein Occlusion (RVO), a common but serious inflammation of the retina, faced almost certain vision loss and eventual blindness. But a new treatment, the first and only to be approved by the US Food and Drug Administration (FDA), offers hope for these patients. 

The new medication, commercially known as Ozurdex, is contained in a thin implant, similar in size to a pencil lead, which is injected through a small needle into the area behind the lens known as the vitreous. The implant slowly dissolves, releasing a continuous and predictable dose of cortosteroid dexamethazone, a medication which reduces inflammation and helps reverse the vision loss caused by Retinal Vein Occlusion.

Amish Purohit, MD, a Retinal Surgeon with Springfield Clinic’s Department of Ophthalmology, has been involved with the development of the drug since the Phase I clinical trials began more than five years ago. Dr. Purohit recently served as one of 15 investigators from across the country to review the final clinical data and make recommendations to the FDA. He is now one of the first in the country to offer the therapy.

“I’ve treated hundreds of patients with this drug as part of clinical trials and am so excited that I can now offer it to my patients as an FDA approved therapy,” said Dr. Purohit.

RVO is common among the elderly and is frequently the result of natural aging or other contributing factors like high blood pressure and glaucoma. Symptoms often include dramatic blurring or loss of vision. Until now, only experimental therapies have been available, many of which have been costly, time-consuming or unpredictable in terms of their effectiveness.

“Ozurdex represents a major advancement in the treatment of RVO,” noted Dr. Purohit. “We can deliver a single dose of medication that can last up to nine months. This less invasive approach translates to improved patient comfort and fewer risks of bleeding and infection.”

Dr. Purohit added, “I treated my first patient earlier today and could not be happier with the results. The injection did not cause any pain or discomfort and the patient indicated it was much easier than she thought it would be.”

For more information about vision loss or its treatment, contact Amish Purohit, MD at Springfield Clinic’s Department of Ophthalmology by calling 217.528.7541.

In traditional open surgery, the physician makes an incision, then widens it to access the anatomy. In traditional minimally invasive surgery the surgeon operates using rigid, hand-operated instruments, which are passed through small incisions and views the anatomy on a standard video monitor. At Springfield Clinic, we are proud to offer an alternative solution.

Specialties offering robotic surgery: Colon and Rectal Surgery, Gynecologic Oncology, Obstetrics and Gynecology, Otolaryngology/Ear, Nose, Throat (ENT), Urology

Some of the major benefits of robotic surgery, using the daVinci Surgical System include:

• greater surgical precision
• increased range of motion
• improved dexterity and access
• enhanced visualization

Benefits experienced by patients who undergo robotic surgical procedures may include:

• a shorter hospital stay
• less pain, blood loss, risk of infection, scarring
• fewer transfusions
• faster recovery and quicker return to normal daily activities

None of these benefits can be guaranteed, as surgery is necessarily both patient- and procedure-specific.

Videos

Revolutionary GERD Procedure Available in Springfield

Patients who suffer from diseases like acid reflux often suffer in silence, taking over-the-counter and prescription medications to dull the effects without treating the condition itself, rather than undergoing a painful surgical procedure. Thanks to a revolutionary new procedure performed in a local setting exclusively by Springfield Clinic General Surgeons James Fullerton, MD, and Kristofer Mitchell, MD, patients can find relief without invasive surgery.

Gastroesophageal reflux disease (GERD) is a condition in which stomach contents can flow back into the esophagus causing inflammation. Treatment often involves long term medical therapy or an invasive abdominal surgery.

Open and laparoscopic surgical procedures have been used to treat GERD effectively for years. Unfortunately, even laparoscopic surgery has the potential for complications. For this reason, very few GERD patients currently choose surgery to treat their condition.

As opposed to laparoscopic and open procedures currently used to treat the condition, Transoral Incisionless Fundoplication (TIF) is a new procedure performed endoscopically. While the patient is under anesthesia, the recently developed EsophyX device is introduced into the stomach through the mouth. Folds of stomach tissue are gathered together creating a barrier to prevent reflux, leaving no scars and causing very little discomfort. Dr. Fullerton and Dr. Mitchell are the first surgeons in Springfield to introduce this procedure.

“Studies indicate after two years following this procedure, 79% of patients are able to stop taking medication for reflux disease completely,” said Dr. Fullerton. “Between the lower cost of the procedure versus surgery, and the cost of medication over time, there is certainly the potential for a lower overall cost.”

Typically completed in under an hour, the TIF procedure is performed under general anesthesia in a hospital setting. After an overnight stay, most patients can go home the following day, and are able to return to their regular activities within that week.