The Hospital for Joint Diseases at NYU Langone Medical Center recently opened the Joint Preservation Center of New York, a multidisciplinary clinic that focuses on providing specialized patient care and joint-related research for healthcare professionals. Eric Strauss, MD, assistant professor in the department of orthopedic surgery at NYU Langone Medical Center and co-director of the Joint Preservation Center, discusses the new facility and advantages of the model for the future.
1. Taking a multidisciplinary approach. The JPC provides patients with several different options for both surgical and non-surgical care, with a focus on biological solutions. The center also includes imaging studies and patient-specific rehabilitation protocols all accessible under one roof.
"We are setting up a center that enables the patient to see multiple specialists, depending on their need for care," says Dr. Strauss. "We're developing an opportunity to create a patient-specific treatment plan. Coupled with taking a biological approach to the management of joint related conditions, we feel this is the future of orthopedic care."
The center is targeted toward all active patients, whether they are in their 20s or 50s. They can be "weekend warriors" who have joint, muscle or tendon injuries, or people with functionally limiting joint related pain or discomfort. "We are looking help reduce symptoms and preserve joint function in patients who want to stay active," says Dr. Strauss. "The beauty of the JPC is that we have the ability to combine several different diagnostic and treatment modalities in an effort to best care for our patients."
2. Lowering economic impact of care. There are a large number of people who seek orthopedic care every year, many of which don't require surgical treatment. At the JPC, specialists listen to the patients' symptoms and histories before guiding them to the appropriate care pathways, leaving surgery as a last resort.
"If we can identify which patients would benefit from both operative and non-operative treatment early in their diagnosis of arthritis, it would have a large economic impact on the healthcare system," says Dr. Strauss. "We want to treat pain in the short term and delay arthritic progression in the long term. We're trying to apply what we feel are cutting edge surgical and non-surgical techniques to preserve our patients' joints and keep them pain free and functioning at a high level for as long as possible."
The techniques JPC surgeons and specialists use include injections, tailored physical therapy protocols, osteotomies and cartilage restoration procedures before opting for a partial or total joint replacement.
3. Focusing on biologics. The experts at the JPC believe biological solutions are a big part of providing the best care for orthopedic patients, especially those with arthritis. The center includes the capability to conduct a joint fluid biomarker analysis for patients, which has been the subject of multiple recent studies.
"Orthopedic surgeons have started using joint fluid biomarker analysis in problems affecting the knee and shoulder," says Dr. Strauss. "Our current research aims to identify any change in the microenvironment of the joint that could dictate not only the appropriate treatment, but also provide prognostic information for the patient once the treatment is administered."
Surgeons may find that patients with certain inflammatory biomarkers in their knee are better candidates for one treatment over another. With this knowledge, surgeons could potentially make better treatment recommendations based on each patient's specific pathology.
Radiologists at JPC are also working to employ biochemical imaging techniques, a non-invasive method of extracting information on the quality and composition of patients' cartilage. "The idea there is the presumption that if we can detect a cartilage injury and wear early, we can manage it to prevent the development of degenerative arthritis," says Dr. Strauss.
4. Promoting research and development. Every patient seeking care at the JPC has the opportunity to enroll in its Joint Preservation Registry. The registry collects data on patients' joint-related complaints and the treatments utilized to evaluate what works and what doesn't. Physicians can use the data in the registry to optimize new patient treatment plans and for data review studies.
"The research side of things is integrated into our standard of care," says Dr. Strauss. "We collect the participating patients' pain-related scores, fluid analysis and combine them with advanced imaging studies and patient-reported outcomes following treatment."
5. Future trends. As baby boomers and subsequent generations of Americans wish to remain active later in life, the number of patients with joint pain will increase. Current research and development in orthopedics and biologics has made it possible to begin returning these patients back to their normal activity level. "As our understanding of joint-related complaints improves, we are going to see things on the microenvironment level," says Dr. Strauss. "Our focus will be on treating degenerative diseases at an earlier time point, potentially allowing for an alteration in the natural history of arthritic conditions."
Dr. Strauss and his colleagues were able to work with NYU Langone Medical Center to create the JPC fairly easily because both parties saw a need for a multidisciplinary center focused on joint preservation. "I think we will rapidly fill a pressing need and both our surgeons and our patients will benefit from it," says Dr. Strauss. He feels this model will catch on and more joint preservation centers will sprout up around the country.
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"We are setting up a center that enables the patient to see multiple specialists, depending on their need for care," says Dr. Strauss. "We're developing an opportunity to create a patient-specific treatment plan. Coupled with taking a biological approach to the management of joint related conditions, we feel this is the future of orthopedic care."
The center is targeted toward all active patients, whether they are in their 20s or 50s. They can be "weekend warriors" who have joint, muscle or tendon injuries, or people with functionally limiting joint related pain or discomfort. "We are looking help reduce symptoms and preserve joint function in patients who want to stay active," says Dr. Strauss. "The beauty of the JPC is that we have the ability to combine several different diagnostic and treatment modalities in an effort to best care for our patients."
2. Lowering economic impact of care. There are a large number of people who seek orthopedic care every year, many of which don't require surgical treatment. At the JPC, specialists listen to the patients' symptoms and histories before guiding them to the appropriate care pathways, leaving surgery as a last resort.
"If we can identify which patients would benefit from both operative and non-operative treatment early in their diagnosis of arthritis, it would have a large economic impact on the healthcare system," says Dr. Strauss. "We want to treat pain in the short term and delay arthritic progression in the long term. We're trying to apply what we feel are cutting edge surgical and non-surgical techniques to preserve our patients' joints and keep them pain free and functioning at a high level for as long as possible."
The techniques JPC surgeons and specialists use include injections, tailored physical therapy protocols, osteotomies and cartilage restoration procedures before opting for a partial or total joint replacement.
3. Focusing on biologics. The experts at the JPC believe biological solutions are a big part of providing the best care for orthopedic patients, especially those with arthritis. The center includes the capability to conduct a joint fluid biomarker analysis for patients, which has been the subject of multiple recent studies.
"Orthopedic surgeons have started using joint fluid biomarker analysis in problems affecting the knee and shoulder," says Dr. Strauss. "Our current research aims to identify any change in the microenvironment of the joint that could dictate not only the appropriate treatment, but also provide prognostic information for the patient once the treatment is administered."
Surgeons may find that patients with certain inflammatory biomarkers in their knee are better candidates for one treatment over another. With this knowledge, surgeons could potentially make better treatment recommendations based on each patient's specific pathology.
Radiologists at JPC are also working to employ biochemical imaging techniques, a non-invasive method of extracting information on the quality and composition of patients' cartilage. "The idea there is the presumption that if we can detect a cartilage injury and wear early, we can manage it to prevent the development of degenerative arthritis," says Dr. Strauss.
4. Promoting research and development. Every patient seeking care at the JPC has the opportunity to enroll in its Joint Preservation Registry. The registry collects data on patients' joint-related complaints and the treatments utilized to evaluate what works and what doesn't. Physicians can use the data in the registry to optimize new patient treatment plans and for data review studies.
"The research side of things is integrated into our standard of care," says Dr. Strauss. "We collect the participating patients' pain-related scores, fluid analysis and combine them with advanced imaging studies and patient-reported outcomes following treatment."
5. Future trends. As baby boomers and subsequent generations of Americans wish to remain active later in life, the number of patients with joint pain will increase. Current research and development in orthopedics and biologics has made it possible to begin returning these patients back to their normal activity level. "As our understanding of joint-related complaints improves, we are going to see things on the microenvironment level," says Dr. Strauss. "Our focus will be on treating degenerative diseases at an earlier time point, potentially allowing for an alteration in the natural history of arthritic conditions."
Dr. Strauss and his colleagues were able to work with NYU Langone Medical Center to create the JPC fairly easily because both parties saw a need for a multidisciplinary center focused on joint preservation. "I think we will rapidly fill a pressing need and both our surgeons and our patients will benefit from it," says Dr. Strauss. He feels this model will catch on and more joint preservation centers will sprout up around the country.
Related Articles on Orthopedic Surgery:
5 Points on Developing a Concierge Sports Medicine Practice
The Orthopedics-Focused Hospital Advantage: Q&A With ProMedica Wildwood Orthopaedic and Spine Hospital Leaders
How do Orthopedists Compare? 5 Points on Surgeon Compensation