Dr. Doug Lowery, Now Using Groundbreaking Technology for Guided Personalized Shoulder Replacement Surgeries

Evansville, Indiana – Doug Lowery MD, an orthopaedic surgeon with Orthopaedic Associates is now using new technology to offer guided personalized surgery for shoulder replacements in the area.

ExactechGPS® Guided Personalized Surgery is the latest advancement in technology that provides surgeons with real-time visual guidance and alignment data in total shoulder surgery.

Similar to a navigation device in your car, this advanced platform provides a visual map of the patient’s joint on a screen, allowing surgeons to combine preoperative planning with intraoperative computer-assisted technology, to perform implant alignment relative to the patient’s needs.

Dr. Lowery feels the technology is a great improvement over traditional techniques, stating: “A computerized plan combined with the computer-guided real-time information during surgery gives precision and accuracy to every step of the surgical process.”

ExactechGPS combines surgeon expertise with an advanced computer system to perform the patient’s shoulder surgery with a goal of improved accuracy and precision. Personalized for a patient’s unique bone structure and anatomy, ExactechGPS is designed to allow surgeons to decide where to remove bone and place the shoulder implant in the optimal position.

The technology’s preoperative planning tool allows surgeons to plan their cases in advance of the surgery through a virtual simulation. Surgeons can then execute their plan in real time during the surgery based on a 3-D anatomical model of the patient’s shoulder, making adjustments as needed.

“Shoulder navigation technology allows the surgeon to plan and implement placement of the shoulder in real time. The 3D video tracking technology allows me to precisely place the components in an optimal position which is individual for each patient.” said Dr. Lowery.

Combined with the Equinoxe® Shoulder System which has demonstrated excellent biomechanics and outcomes in its more than 10 years of use1, surgeons are able to have the best of both worlds – a proven implant foundation1 with today’s most modern surgical technologies.

Dr. Lowery has been teaching surgeons shoulder replacement techniques for over a decade in lab and lecture series across the country.  Dr. Lowery welcomes candidates for navigated shoulder technology exclusively at Orthopaedic Associates.

For more information about or to schedule an appointment with Dr. Doug Lowery, call (812) 424-9291 or visit https://oaevansville.com/douglas-j-lowery-m-d/.

Additional information about the technology can be found at www.ExactechGPS.com. Orthopaedic Associates (OA) is an independently owned and operated, full-service orthopaedic center. For over 75 years, OA and its dedicated surgeons have provided comprehensive orthopaedic care–diagnosis, surgery, and rehabilitation–to residents of Southwestern Indiana and the surrounding communities.  Specialty areas include joint replacement, sports medicine, orthopaedic trauma, arthritis treatment, occupational injuries, microvascular and microneural reconstructive surgery, and arthroscopy.

Regional Politicians Come to Celebrate OA Being the First Net-Zero Medical Facility in Indiana

Lieutenant Governor Suzanne Crouch, Congressman Larry Bucshon, and Senator Mike Braun to Attend Solar Array Ribbon Cutting

[Newburgh, Indiana, May 28th] Orthopaedic Associates will soon become the only healthcare facility in Indiana to have net-zero energy usage. The surgical practice has completed a 540kW solar array disguised as a parking canopy at 10455 Orthopaedic Drive Newburgh, IN. This project is one of the many ways that we are working to keep healthcare costs at a minimum for providers and patients. Orthopaedic Associates will be hosting an event on June 5th, 11:00am that will feature several regional politicians to help us celebrate this long term investment in going green. 

Leading Orthopaedic practice in Southern Indiana first medical practice in Indiana to become net-zero

“The progressive and proactive approach Orthopaedic Associates has historically taken clinically has always been a source of pride to me. This solar project is a true reflection of the culture here” stated Derek Shelton, the Clinical Operations Officer. Orthopaedic Associates takes pride in being a forward-thinking practice and the new solar array is an investment that will benefit the future of the company as well as the healthcare industry for many years to come. 

Orthopaedic Associates invests in solar energy as part of its long-term plan for patient care

The event is scheduled for June 5th at 10455 Orthopaedic Drive Newburgh, IN. Media interviews will start at 10:45 with the ribbon cutting ceremony following at 11:00. The ceremony will include speeches from Jerry Blanton, the Chief Executive Officer at Orthopaedic Associates, Dennis Beck MD, Orthopaedic Associates President, as well as Lieutenant Governor Suzanne Crouch, Congressman Larry Bucshon, and Senator Mike Braun. 

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Orthopedic practice based in Evansville, IN plans for the future of patient care

Orthopaedic Associates is a mid-size Orthopaedic practice based in Evansville, Indiana with 5 offices across Indiana and Kentucky. It is the area’s longest established group of Orthopaedic surgeons, advanced practice providers and healthcare professionals. For over 75 years, patients, athletes and medical experts across the region have trusted OA’s expertise and care.

OA Ensures Its Staff Members Are Financially Secure Through Coronavirus

FOR IMMEDIATE RELEASE – Today at 4:00 pm the CEO of Orthopaedic Associates, a mid-size Orthopaedic practice in Evansville, Indiana, announced to the entire staff via a video chat called late in the day that, even though the staff is working abbreviated hours during this Coronavirus pandemic, each staff member will be paid at his/her full base pay as if he/she is working at full normal work hours. 

According to CEO, Jerry Blanton, at this afternoon’s announcement to staff, all OA employees, regardless of their position and numbers of hours worked all regular full-time staff, “will be paid 40 hours’ per week full base pay starting this Friday for as long as we can.”

“We don’t want our people hurting.” That’s what the board of surgeons that own Orthopaedic Associates (OA) in Evansville, Indiana said during their board meeting earlier today. The surgeons that make up the board are: 

Dr. James Goris, Dr. Douglas Lowery ,Dr. Dennis Beck ,Dr. Gary Moore ,Dr. Robert Vraney ,Dr. Daniel Emerson

Dr. David King, Dr. Anthony Czaplicki, Dr. Isaac Fehrenbacher, Dr. Aaron Mull, Dr. Phillip Richardson

They immediately took action to help their staff get through the chaos and financial uncertainty of the Coronavirus.

Like many other organizations feeling the effects of the Corona virus, OA’s staff have been working abbreviated hours. 

Making sure the people that work at OA, no matter their position, are going to be financially ok was a top priority at a recent board meeting of the board group of surgeons and the CEO. 

Orthopaedic Associates is a mid-size Orthopaedic practice based in Evansville, Indiana with 5 offices in two states.

There’s a Cyst on my Wrist

Aaron Mull, Reconstructive Hand Surgeon, Plastic Surgeon

Your grandparents probably called them “Bible cysts” and “cured” them by whacking them with a large book, but ganglion cysts are the most common hand mass seen in orthopaedics accounting for 60-70% of patients. A ganglion cyst is usually asymptomatic but may just be an annoyance or considered unattractive to some patients. They often occur on the top or bottom of the hand or wrist and can grow larger over time. While ganglions are not harmful and safe to leave alone, many opt to have them either aspirated or removed surgically. Typically, the fluid inside a ganglion is thick, jelly-like and hard to aspirate and combined with the associated discomfort and high recurrence rate, it’s usually not worth it. Surgical removal has a better chance of fully removing the cyst but there is still a slightly lower, but still present, risk for the cyst to return. Finding a lump or growth can definitely cause some anxiety and concern for many patients, so it’s always best to have them checked to rule out anything more serious.

Tennis elbow; serious condition or just seriously annoying?

Daniel Emerson, Orthopaedic Surgeon

Tennis elbow, or lateral epicondylitis, is one of the most common causes for elbow symptoms in patients with elbow pain and affects 1-3% of adults annually. It’s most commonly seen in tennis players (hence the name) but can also be brought on by heavy or repetitive lifting or gripping. Pain from tennis elbow occurs primarily on the outside of the elbow but the pain can spread into the forearm and wrist and may increase with arm movement or simple activities such as bending the wrist back, shaking hands or turning a doorknob. In addition, the elbow may also be swollen and tender to the touch. Generally speaking, lateral epicondylitis is a self-limiting condition which means that in most, over time, it will go away. However, it is a nagging annoyance for many patients seen in our practice and can seem like it lasts forever to those suffering from the pain which can often intensify with even mundane daily activity. So how can patients improve their symptoms or make them tolerable until the issue resolves? Our physicians believe conservative treatment is best, and symptoms resolve in 95% of patients without surgical intervention. Treatment options available include oral NSAID’s (in moderation and with your PCP’s blessing of course), a simple wrist splint (to prevent the motions that aggravate), tennis elbow straps and Flexbar exercises (which involve eccentric exercises for the wrist extensors with a durable resistance device). Injections and surgery are a more aggressive approach and are controversial in the opinion of some physicians as current research indicates that injection treatments may actually prolong healing and increase pain (even if they provide initial relief of symptoms). While there are several surgical procedures performed for the condition, there isn’t a gold standard procedure practiced widely at this time and many patients are still left plagued by the same symptoms afterwards. Injections and surgery aren’t the “wrong” answer but simply put, there isn’t a quick and easy “fix” and the best treatment option available is patience!

While living with tennis elbow isn’t damaging or harmful per say, it’s definitely a pain in the…elbow. If you’re struggling with tennis elbow symptoms, feel free to make an appointment with our office for evaluation and treatment discussion with one of our orthopaedic specialists. 

Orthopaedic Associates Spine Surgeon First in Region to Perform Motion Preserving Spine Surgery Using the activL® Artificial Disc

FOR IMMEDIATE RELEASE

Orthopaedic Associates Spine Surgeon First in Region to Perform Motion Preserving Spine Surgery Using the activL® Artificial Disc

Robert Vraney, MD’s, Novel Procedure Gives Active Patients Suffering from Degenerative Disc Disease Hope for an End to Chronic Pain, Narcotic Dependency and Return to Work

Evansville, IN – March 13, 2019 – Orthopaedic Associates announced today the successful implantation of a new artificial spinal disc replacement device to address chronic low back pain caused by Degenerative Disc Disease in a Western Kentucky resident by Robert Vraney, MD of Orthopaedic Associates. Vraney is the first spine surgeon in Southern Indiana to perform this innovative surgery using the Aesculap Implant Systems (Center Valley, PA) activL® Artificial Disc. In contrast with other treatments such as spinal fusion, the activL Artificial Disc is designed to more closely mirror the natural movement of the healthy human spine following surgery.

Degenerative Disc Disease (DDD) and chronic low back pain are one of the most common reasons for lost work time in the United States, second only to the common cold. Injuries that lead to low back surgery are also associated with high rates of narcotic dependency. “The Level one evidence shows that two in three chronic low back pain sufferers are narcotic dependent by the time of their surgery and 30% are out of work,” said Vraney.  Vraney, who recognized the patient and societal benefits of motion preservation procedures, like the one using the activL Artificial Disc, early in their introduction, focuses on getting his patients back to a narcotic-free quality life.

“I have been an early adopter of motion preserving procedures because I have seen the value in both my own patients as well as in the academic literature,” said Robert Vraney, MD. “Based on outcomes from the activL Artificial Disc clinical trial, I believe that the activL Artificial Disc represents the next generation of spinal disc replacement technology. For my younger, more active, patients sometimes it does not make sense to do a spinal fusion.” Fusions have been associated with causing patients with DDD to start experiencing pain at levels adjacent to their initial fusion several years after their surgery. In clinical studies, patients who received a lumbar artificial disc were three times less likely to have adjacent level problems five years after their procedure than patients who received a fusion. “Lumbar total disc replacement is now considered a standard of care for DDD sufferers,” said Vraney.

The literature supports that within six-months of lumbar artificial disc surgery more than 86% of DDD patients will go back to full-time employment without restrictions and because of their decreased pain and increased function will be able to stay off narcotics. “The activL trial found that 98.5% of lumbar disc patients are still narcotic free more than five years after surgery,” said Vraney.

Vraney performed the first surgery using the activL Artificial Disc in early February. “One month following my patient’s initial surgery she is doing well,” said Vraney. “I am confident as she continues to heal that she will greatly benefit from receiving this artificial disc.”

If you have chronic low back pain and are interested in understanding if you are a candidate for lumbar total disc replacement, contact Orthopaedic Associates to schedule an evaluation with Dr. Vraney at 812-424-9291.

About Orthopaedic Associates, Inc.

Orthopaedic Associates (OA) is an independently owned and operated, full-service orthopaedic center. For over 75 years, OA and their dedicated surgeons have provided comprehensive orthopaedic care–diagnosis, surgery, and rehabilitation–to residents of Southwestern Indiana and the surrounding communities. Specialty areas include joint replacement, sports medicine, orthopaedic trauma, arthritis treatment, occupational injuries, microvascular and microneural reconstructive surgery, and arthroscopy.

About Aesculap Implant Systems, LLC

Aesculap Implant Systems, LLC, a B. Braun company, is part of a 175-year-old global organization focused on meeting the needs of the changing healthcare environment. Through close collaboration with its customers, Aesculap Implant Systems develops advanced spine and orthopaedic implant technologies to treat complex disorders of the spine, hip and knee.

Aesculap Implant Systems strives to deliver products and services that improve the quality of patients’ lives. For more information, call 800-234-9179 or visit aesculapimplantsystems.com.

Orthopaedic Associates names Clinical Operations Officer

For Immediate Release

February 7, 2019

Derek Shelton, Clinical Operations Officer

Evansville, Indiana – Orthopaedic Associates announces the promotion of Derek Shelton, APRN-BC to Clinical Operations Officer.  Shelton has been with Orthopaedic Associates for eight years as a Nurse Practitioner, and brings with him an expertise in patient satisfaction, clinical operations, and team management.

The Clinical Operations Officer will manage and oversee the daily operations of the clinical practice with administration of clinical protocols, integration of clinical process with affiliate health systems, and Human Resource management of direct reports including Scribes, Clinical Assistants, Advanced Practice Providers, and Radiology Techs.

“As we’ve continued to grow over the last decade, we realized a senior level position was needed to help our staff stay focused on patient care and positive outcomes,” says Jerry Blanton, Chief Executive Officer at Orthopaedic Associates.  “Derek’s background as a provider allows him an important perspective on maximizing patient experience, with efficiency and consistency.”

Shelton completed his Bachelor’s and Master’s Degree at University of Southern Indiana.  He is completing his Doctor of Nursing Practice from Murray State University.

“I’m looking forward to taking on this new role at Orthopaedic Associates,” says Shelton.
“This organization, its people, our patients have become like family over the past several years and I’m excited to continue my career with such a great team.”

Orthopaedic Associates (OA) is an independently owned and operated, full-service orthopaedic center. For over 75 years, OA and their dedicated surgeons have provided comprehensive orthopaedic care–diagnosis, surgery, and rehabilitation–to residents of Southwestern Indiana and the surrounding communities. Specialty areas include joint replacement, sports medicine, orthopaedic trauma, arthritis treatment, occupational injuries, microvascular and microneural reconstructive surgery, and arthroscopy.

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Orthopaedic Care of Degenerative Disc Disease

Robert T. Vraney, M.D.

Many patients diagnosed with degenerative disc disease are left wondering exactly what this diagnosis means for them. Common questions that patients have include:

  • If I have degenerative disc disease as a young person, will it get worse with age?
  • Will the degenerative disease become a crippling condition?
  • Will the degenerative disease spread to other parts of the spine?
  • Will the pain from the degenerative disease cause permanent damage?

Part of the confusion probably comes from the term “degenerative.” This term implies that it will worsen with age. While the disc degeneration is likely to progressive over time, the associated pain usually does not get worse; and in fact, often times gets better over time.

Another source of confusion is probably created by the term “disease.” Degenerative disc disease is not actually a disease but is more accurately described as a degenerative condition that at times can produce pain from a damaged disc. It is quite variable in nature and severity. As we age, all people exhibit changes in their discs consistent with degeneration. It is a natural process; however, not all people will develop symptoms.

Finally, some of the confusion likely comes from the medical community, as medical professionals have yet to agree on what the terms describes. Often times the “disease” is nothing more than a radiographic description. Because few practitioners agree on what does and does not constitute a diagnosis of degenerative disc disease, very few medical textbooks even attempt to give an accurate description. Therefore, while many practitioners believe that degenerative disc disease is a common cause of low back pain in young adults, very few agree on the implications.

For these reasons and others, I personally prefer to use the term “discogenic low back pain” or “disc incompetence.” The first term implies that it is the disc that is “generating” the patient’s pain. I often describe to patients that discs inability to handle forces and loads presented to it (“disc incompetence”) is the reason why a damaged disc can become a source of pain. I explain to patients that this damage can occur either through a natural degenerative process or can be accelerated through micro or macro trauma to the spine. Re-enforcing the issue of competence of the disc also illustrates to patients the potential for physical therapy to improve the symptoms. This is not by reversing an irreversible process, but rather by attempting to protect the disc via strengthening of the core extensor muscles.

I believe that providing good medical care and counseling are only part of my job here at Orthopaedic Associates. Patients have much to gain by becoming better educated about the conditions impacting their lives. This education is a vital part of the healing process and certainly one of the biggest services that we as physicians can provide.

For more information on Dr. Vraney, please visit his page. To schedule an appointment, click here.

Treating Joint Pain – What to do and when to see a Doctor

Jared Kiernicki, Physicians Assistant

If you’re experiencing pain in any joint—your knee, ankle, shoulder, hip, etc.—you need to know how to best treat it at home. It’s also important to know when it’s time to see a doctor.

Each day at Orthopaedic Associates, I help patients with joint pain. In most cases, it’s been going on for a while and the patient or caregiver has been trying to manage it for some time.

Below are tips for managing your symptoms at home. I also give guidance on when it’s time to see one of our experts.

Chronic joint pain vs. Acute joint pain

Chronic joint pain is something that’s been nagging for months to years. It has a predictable pattern, such as painful in the morning, after standing on your feet all day, etc.

Acute joint pain is from something sudden. For example, you’re playing a sport and you feel a “pop” or tearing feeling. Or acute injuries can result for a fall or other accident.

RICE treatment, medications at home

The methods below can be relevant and helpful for managing both types of pain at home, as nearly all joint pain benefits from the RICE method of treatment.

RICE is an acronym standing for Rest, Ice, Compression and Elevation. Each part helps in a different way.

  • Rest: Not only helps the injury heal, but prevents further irritation or injury from ongoing activity.
  • Ice: Ice stops the formation of new inflammation (swelling, pain, pressure), and helps with pain control. (More details on how to properly use ice below)
  • Compression: Helps minimize swelling and can also provide some stability.
  • Elevation: Elevating the irritated or injured body part above the level of the heart can help decrease swelling and pressure.

Also, some consider the “I” to “anti-inflammatory medications.” Anti-inflammatory medications not only reduce pain, but can help reduce the body’s inflammatory response to injury or irritation.

The most common OTC anti-inflammatory medication is ibuprofen, under brand names such as Advil and Motrin. Naproxen (brand name Aleve) is also an OTC anti-inflammatory medication.

Naproxen is typically taken twice per day, and ibuprofen is taken up to 4 times per day. Both work to reduce pain and address inflammation. Trying them for 7-10 days (in addition to other RICE methods) often works to reduce joint pain.

Also, acetaminophen (brand name Tylenol) helps treat pain, but doesn’t work to minimize inflammation. However, especially in combination with naproxen or ibuprofen, it can help with pain control.  It’s important to avoid any alcohol while taking acetaminophen.

If you find that you’re taking pain medication for a length of time, or you are at risk for stomach or kidney problems or other side effects, you should check with your primary care doctor.

When to see a doctor

Overall, if RICE and OTC medications don’t seem to help, it’s time to see a doctor.

It’s also time to see doctor when you experience the following:

  • Symptoms don’t improve, or even worsen with treatment. That means that the ankle or knee that was aching or sore is now throbbing and you can’t put weight on it.
  • Your pain has evolved to the point that it’s affecting your activities of daily living. Perhaps you now can’t go up or down stairs, or you can’t carry your child or bring in the groceries. If your life is impacted by joint pain that has become unmanageable on your own, it’s time to get help.
  • New symptoms, such as swelling that wasn’t there before, a “clicking” inside the joint, or a feeling that it’s locking up.
  • Signs of infection, such as heat and redness in the joint accompanied by a fever.

If you’re having these symptoms, you should see your primary care doctor. However, you can also visit a Deaconess Urgent Care or the Orthopaedic Associates Walk-In Urgent Care.

Visiting a doctor or other provider for severe or worsening joint pain can lead to a variety of treatment options, depending on the cause and type of pain.

  • Medication options may be considered, including oral or injected steroids, or prescription strength anti-inflammatory or pain medications.
  • Physical therapy—for strengthening, stretching, etc.—is important to help overcome many types of joint pain, and to teach self-care methods for the future, including a personalized therapy/exercise program.
  • Advanced imaging may be required. Some injuries may need to be diagnosed with the help of MRI, CT, x-ray, etc.
  • Equipment or supportive devices. This could include a brace, sling, crutches, or a “boot.” There are lots of options depending on type of injury.
  • Further referrals to an orthopaedic specialist may be needed. Joint injuries sometimes need surgery, and chronic conditions, such as arthritis, may lead to joint replacement. To learn more about what to expect from joint replacement, my colleague Brooke Kline has written an excellent Q&A article.

Tips for using ice and heat

I want to give some tips on effective use of ice for the most benefit.

  • Ice the entire joint. For example, applying ice all the way around the knee is more beneficial than just putting an ice pack on the front.
  • Applying compression WITH the ice is more beneficial than just placing an ice pack. Wrapping an elastic or compression wrap around the ice pack can give double benefit.
  • Always have a layer of some type of fabric between ice and skin. A hand towel, sock, etc. is fine—you just don’t want to damage your skin with direct contact.
  • Use ice multiple times throughout the day, 20-30 minutes at a time. Let your joint re-warm back to normal temperature between times of icing.

Now let’s talk about using heat. Some people report that using a heating pad can help with joint pain before going shopping, golfing, or other types of activity. With chronic joint pain, sometimes applying heat can help “loosen up” the joint and surrounding muscles. A few minutes with a heating pad or similar heat can help reduce pain during activity. I would still recommend icing afterwards to help with inflammation and swelling.
Note: For acute joint pain, such as from an injury (an ankle sprain is a good example), heat can increase swelling and inflammation, so avoid heat for the first 48 hours after an injury.