For many of us, the thought of undergoing surgery is terrifying – so, My City Wellness has “scrubbed in” to get up close with many talented local physicians as they performed a variety of procedures. Our sincerest thanks to doctors Susan Mosier-LaClair and Jeffrey Rohr for their gracious cooperation in creating this issue’s special section.
PROCEDURE: Total Ankle Replacement aka Total Ankle Arthroplasty (TAA) using the Wright Medical Infinity™ Total Ankle System
CREDENTIALS: A board-certified orthopedic surgeon, Dr. Mosier-LaClair earned an undergraduate degree in biochemistry from Oakland University, medical degree from the University of Michigan Medical School, completed residency at Wayne State University’s Detroit Medical Center and fellowship at Portland Orthopedic Foot & Ankle Center. She is ABOS foot and ankle fellowship trained through AOFAS with 16 years as Foot and Ankle Orthopedic Specialist at McLaren Medical Center. An Associate Clinical Professor with MSU College of Human Medicine, she has also taught/trained podiatry students for ten years in the Genesys Podiatric Residency program.
FACILITY: McLaren Surgery Center, Flint
TAA is for people with ankle arthritis and painful, limited range of motion who have exhausted non-surgical treatment. Similar to other joint replacements, it brings motion as close to normal as possible by resurfacing the arthritic joint. This way, instead of bone grinding on bone, there is a metal implant on the tibia and the talus with polyethylene in between to provide pain relief. This surgery is typically preferred over the other option: ankle arthrodesis or fusion, which relieves pain but eliminates up-and-down flexion/extension motion and permanently changes a person’s gait. Dr. Mosier-LaClair has performed TAA over 100 times in the last 16 years.
The advanced technology of TAA components allows for a better anatomic fit of the tibia and talus and requires less bone resection. Key to the success of this surgery is the Prophecy™ Preoperative Navigation System; the patient-specific surgical instrumentation system helps position the cutting guides in exactly the right spot for proper sizing, fit and motion of the implants. This is done with a combination of preoperative computer imaging and 3D CT scan. It increases accuracy, decreases complexity, duration and x-ray exposure.
The success rate with this procedure is over 90% in decreasing over 80-90% of pain experienced while walking and standing, and it allows patients to return to low-impact activities such as walking, biking and golfing.
Patients should be aware that TAA will not make their ankle brand new and not all people with ankle arthritis are candidates. Considerations include age, weight, medical history and prior trauma or deformity to the area. The outpatient procedure takes around two hours under general or spinal anesthesia. The patient will wear a short leg cast or splint for around two weeks to let the skin incisions heal, and then a short, removable boot cast. The healing process can take around six to eight weeks, during which the ankle should not bear weight. Patients then begin physical therapy for range of motion. Once the ankle replacement heals, the ankle can bear weight as tolerated and is ready for more aggressive physical therapy for around six to eight weeks.
This is a significant surgery and although it only takes six to eight weeks to heal, the leg is gravity-dependent, so it can feel sore and swollen for upwards of six months and takes around a year for maximum improvement. However, most people can return to a walking or standing job without restrictions after three to four months.
PROCEDURE: Clear Corneal Cataract Surgery
CREDENTIALS: Dr. Rohr is the Medical Director and Chief Surgeon of the Rohr Eye & Laser Center. Jeffrey Rohr, DO, obtained his undergraduate degree in biology from Michigan State University. He completed his medical school training at the Des Moines University School of Medicine and his ophthalmology residency at the Genesys Regional Medical Center. He is one of the few elite eye surgeons in the nation who is Fellowship Trained in Advanced Cataract and LASIK Surgery, and is board-certified by the American Osteopathic Board of Ophthalmology. Dr. Rohr has been honored with the NRCC 2005 Physician of the Year Award, SightPath Medical – Top Cataract Surgeon 2012 and 2013, among others. He is Assistant Clinical Professor, Department of Neurology and Ophthalmology, MSU, and has lectured to numerous ophthalmic surgeons about advances in refractive surgery.
FACILITY: Outpatient Surgery Centers Grand Blanc & Flint
Cataract surgery was once considered a difficult procedure that required hospital admission prior to surgery and patient compliance to complicated post-surgical instructions to achieve a satisfactory visual outcome. The technology of clear cornea – no needle, no stitch – offers patients tremendously improved vision with little or no downtime. The most significant benefit of this procedure is the positive impact on the patient’s life – providing them with the gift of sight almost immediately after surgery.
The introduction of clear corneal small incisions dramatically reduced surgical time and patient recovery periods, with no bleeding or need for sutures, and less surgically-induced astigmatism. In addition, revolutionary “multifocal” lens implants offer patients spectacle independence for both distance and reading vision. Special “Toric” lenses can lessen astigmatism for a better cataract surgery result, as well.
Patients should be aware that not every doctor performs cataract surgery the same way. Technology and surgeon experience can make a tremendous difference in the results a patient may achieve. In 1999, Dr. Rohr spent an additional year of training at the prestigious Colorado Eye Institute where during his first 750+, cases he had a mentor standing over his shoulder during each procedure.
Cataract surgery is one of the most highly performed and successful procedures performed in the U.S. Dr. Rohr has performed in excess of 10,000 cataract and LASIK procedures throughout his career. With the technology he uses, patients may return to most of their usual activities the very next day.
Photography by Eric Dutro