e-Health Radio Network Podcast Interview: Dr. Goradia
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[Host] Thanks for joining us once again here on the eHealth Radio Network. This is your host, Eric Michaels. Ehealth Radio gives you the most current health information, news and advice featuring some of the leading innovators in health care and wellness who are changing health care as we know it . For more ehealth Radio reports we invite you to visit our main radio channel site, at ehealthradionetwork.com.
Today, we’re speaking with Dr. Vic Goradia, a nationally known expert in arthroscopic surgery, sports medicine, joint replacement and regenerative medicine with a focus on shoulder and knee conditions. He’s developed his own surgical technique, known as PRESERVE ACL surgery and is one of a handful of surgeons in the U.S. offering this procedure. Dr. Vic is the leading orthopedic surgeon at G2 Orthopedics and Sports Medicine with locations in the West End and in Midlothian, Virginia. Dr. Goradia, thanks for joining us here today on the eHealth Radio.
[Dr. Goradia]: Absolutely. It’s good to be with you this morning.
[Host]: Hey, you bet. Really looking forward to learning a few things with you here today per your expertise. So, for starters, what are the most common types of knee surgeries? Let’s start there.
[Dr. Goradia]: So, the most common type is arthroscopic surgery, which is where we make some small incisions and put a camera inside of the joint and are able to repair torn cartilage or a type of cartilage known as the meniscus. That’s probably the most common surgery and followed closely by ACL surgery, which is the anterior cruciate ligament, a major ligament inside of the knee that can tear with sports activities or sometimes even work activities. And then after that, I’d say knee replacements, whether it’s a partial knee replacement or a total knee replacement, but those, of course, can’t be done through little cameras. And we have to make an incision for those.
[Host]: Also, Dr. Goradia, are there treatment options that can be used to avoid surgery?
[Dr. Goradia]: Yeah, you know we always try to start with non-surgical options when that’s truly an option for you. And that can be as simple as prescribing medications, most commonly non-steroidal medications similar to like an ibuprofen. But, you know, prescription variations of the type of a medication can help a lot. If there’s weakness in muscles or inflexibility or something like that, occasionally we’ll do cortisone injections. Cortisone is a type of steroid that can be injected into a body part and it is a strong anti-inflammatory that can help with pain.
Unfortunately, it doesn’t necessarily fix the problem if you have a tear of some type. Other options are a little bit more advanced and fall into the regenerative category, such as PRP, which is Platelet Rich Plasma where we draw some blood from the patient. We spin it down and we isolate the platelets, which are a type of blood cells that have a lot of natural healing and reparative properties.
And then beyond that, we do procedures such as stem cells or lipogems injections. Stem cells come from a patient’s bone marrow and they can help with healing. Lipogems comes from a patient’s fatty tissue and they can also help with natural healing and can sometimes help people avoid surgery long-term. Unfortunately, if you have a torn meniscus or cartilage or an ACL, sometimes those will not heal even with the stem cells.
[Host]: Now a complete knee replacement sounds like a big operation. Has there been any advances for this type of surgery? Touch on some of those details, if you would.
[Dr. Goradia]: Yeah, there’s been a lot of advances in the past you know, even five or 10 years, which makes the procedure much less invasive. So, we still have to make an incision to get into the knee, but we now have things like computer guidance systems that are really about the size of an iPhone that I can use in the operating room. And it helps us to get the alignment of the knee exactly right so that everything is just as straight as we want it, and we have the right sizing and everything for the implants. And the reason that’s less invasive is that the traditional knee replacements require us to put various types of rods inside of the bone in order to check the alignment, how straight, or how bowed, or how locked knee a patient’s knee is. And by not having to do that it results in less pain and discomfort after surgery. The other big advance is we work with the Anesthesiologist to achieve a pain control system that is not just taking into account one type of medicine. We use multiple different types of medicines that attack the pain from different angles and that combined with the computer guidance, allows patients to feel much more comfortable when they wake up from the surgery so they’re ready to begin their rehab process, which ultimately leads to better results. And in some cases, now we’re able to do a patient’s knee replacement completely as an outpatient. So, they come in, they have it done and they’re able to go home the same day, and we have a nurse and physical therapist come to their house the next day.
For patients that are staying in the hospital, we’re able to have them stay just one night in the hospital and they can go home the very next day. So, there have been a lot of advances and I think those will continue to improve the outcomes of our patients.
[Host]: And I’d say that’s outstanding news. Looking ahead today, we are with Dr. Vic Goradia, a nationally known expert in arthroscopic surgery, sports medicine, joint replacement and regenerative medicine with a focus on shoulder and knee conditions here on ehealth Radio’s Health News Channel, a part of the ehealth Radio Network. Now tell us which sports knee injuries require surgery the most?
[Dr. Goradia]: Yeah, well we’re right in the start of football season here, in the middle of football season, so we see a lot of sports injuries but it’s not just sports like football. We see them from the Weekend Warriors that are out exercising and trying to stay in shape or play in recreational activities. And the most common injury is a tear in the cartilage or the meniscus. The meniscus is, as I mentioned earlier, a type of cartilage in the knee that acts like a shock absorber between the bones, and with a twisting or pivoting type of an injury the meniscus can tear. And that can cause a lot of swelling, pain, catching, locking types of symptoms, which usually requires arthroscopic surgery to go in and repair the meniscus or in some cases, we have to remove the torn part of the meniscus.
And so that’s probably the most common sports knee injury that requires surgery followed by ACL injuries. And the ACL, again, is the ligament inside of the knee that helps provide stability so that the knee doesn’t give way and similar to the meniscus, that can happen with a twisting or pivoting injury. A lot of times it’ll be a hyper extension type of injury where the knee bends backwards. It can occur from contact, so in a sport like football where someone gets hit in the knee, but the most common is what we call a non-contact injury, where someone is just running and they try to change directions and their foot gets stuck and the knee gives way and that can tear the ligament. We actually see more of these injuries in female athletes than even male athletes. Then finally, we can see injuries like kneecap dislocation that can require surgery to repair ligaments around the kneecap.
[Host]: There’s certainly some interesting information and a big Sports Fan here. So, I certainly see a lot of ACL injuries out there as we do hear about athletes tearing their ACL and needing surgery that keeps them out from playing for a year or longer… do you offer any options to get these athletes and others back faster after an ACL injury?
[Dr. Goradia]: Well, we have developed a procedure several years ago, called the ACL PRESERVE Surgery. What makes that different is about 20 to 30 percent of ACL injuries can be a candidate for this procedure. What we do is actually repair the patient’s own ACL and that’s possible when the ACL tear is directly off of the bone, which again occurs about 20 to 30 percent of the time and I can put sutures, (stitches) into the ACL ligament arthroscopically and then reattach it back to the bone. Afterwards we can follow up with either stem cells or the lipogems (fat cell injections) to further stimulate the healing process and that can get patients back faster and the reason is that there is something inside a ligament that we call proprioception, which means it gives you a sense of balance when you’re jumping or running. It kind of lets your brain know where your knee is in space, and those appropriate deceptive fibers are inside of the ligament.
So, with a traditional ACL reconstruction what happens is the ACL is so badly torn that we have to just remove the torn fibers, and then we replace it with the new ligament that comes from the patient’s body from another area. And in that case the ligament will heal in a few months, but those fibers that give you that sense of space, the proprioception can take a longer time to heal. That’s why its season ending, because it can take up to a year or so to get that sense of confidence back in the knee.
So, we try to do the ACL PRESERVE whenever that’s an option, but in 70 to 80 percent of patients it’s not an option so we do a minimally invasive ACL reconstruction where we can again do the ACL reconstruction with another ligament but we have some techniques that make it less invasive, and again we can follow up with the stem cells to help promote the healing. Then finally, the other aspect that gets Athletes back sooner is an Accelerated Physical Therapy Program that’s closely supervised by me. And that just allows people to accelerate at a faster pace and get them back to their activities and their sport.
[Host]: Dr. Goradia, I really appreciate the information shared here today, and for what you do in this space, and really thank you as well for your time. In conclusion any closing thoughts or a takeaway tip? Anything else you’d like to share along the lines of our conversation today?
[Dr. Goradia]: Well, I think if you have an injury or having chronic pain in your knee, the smartest thing to do is to get to a knee specialist, because if you have a small injury or a small tear, you don’t want to let that become a bigger problem for you that requires a more invasive procedure later down the line.
[Host]: And thanks for those concluding remarks. Much appreciated. Of course, if listeners wanted to get in touch with you and get more information as well on your practice there in Virginia, your two locations, one in West End and the other in Midlothian, Virginia: G2 Orthopedics. Where can listeners get more information in all regards?
[Dr. Goradia]: Yeah, they can come to our website, which is www.g2orthopedics.com. Or they can call our telephone at 804-678-9000.
[Host]: Well Dr. Goradia, all the best. Thanks, so much for joining us here today on the ehealth radio certainly was our pleasure.
[Dr. Goradia]: Thank you.
[Host]: Again. We’ve been speaking with Dr. Vic Goradia, a nationally known expert in arthroscopic surgery, sports medicine, joint replacement and regenerative medicine with a focus on shoulder and knee conditions. And for all the details, visit G2orthopedics.com.
Again, this has been your host, Eric Michaels. We do thank you for your continued support of the ehealth Radio Network. Join us again soon for another episode that will help further expand your knowledge on those things that are important to your health and wellness. For more ehealth Radio Reports, we invite you to visit our main radio channel site at eHealthradionetwork.com. And as always, we do thank you for tuning in.
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