A new treatment for arthritic knees may ease pain and restore movement By Jean Amodea
I f you suffer from arthritis of the knee – you may already know that the condition is not “fixable.” However, there are a number of treatments available that can ease the pain and discomfort of this common condition. According to Gregory Rubin, DO, board-certified in sports medicine, common first-line treatments include weight loss, over-the-counter pain relievers such as ibuprofen and acetaminophen, physical therapy, and – when necessary – corticosteroid injections. “We try to use them infrequently,” explained Dr. Rubin of the steroid treatments, “because some data shows it can actually thin some of the cartilage.” However, all hope is not lost for patients who have tried all of these treatment options without success. The field of viscosupplementation came about as a conservative treatment option approved for knees in patients who have had cortisone with diminishing effect," said Dr. Rubin. A gel-like substance called hyaluronic acid is injected into the knee
joint using ultrasound guidance, said Dr. Rubin. The gel acts as a lubricant around the joints for those with osteoarthritis whose hyaluronic acid has diminished, causing pain. Originally derived from a rooster's comb, now there is a synthetic version of hyaluronic acid.
Gregory Rubin, DO.
"Hyaluronic acid is typically produced in the knee and acts as a support structure,” explained Dr. Rubin. “Some studies have found it helps support the cartilage itself. We know its volume, and in arthritic knees, the number of hyaluronic particles goes down and changes to a different form. Viscosupplementation provides the knee joint with good, healthy hyaluronic acid to pick up the slack of these functions." The challenge with viscosupplementation, said Dr. Rubin, is to mimic as close as possible what normal hyaluronic acid looks like. Many brands are different as far as weight and viscosity, and its use is based on the individual needs of each patient. Injections may be administered every six months, and aftercare is minimal; there may be soreness at the injection site for 24 hours. In rare cases, some brands of hyaluronic acid can cause an inflammatory response that could almost mimic an infection. "Outcomes are mixed,” said Dr. Rubin, “but some patients do wonderfully. It's a safe alternative, and it may give long-term benefits of pain relief.”
• Relief of arthritic symptoms • More movement in the knee joint • Provides the ability to resume normal activities Benefits of viscosupplementation injections
• Over-the-counter pain relievers • Physical therapy • Corticosteroid injections • Weight Loss • Viscosupplementation Typical Non-Surgical Treatments for arthritis of the knee
For more information, or to make an appointment, contact Dr. Gregory Rubin, DO at (239) 624-0310 or visit NCH Orthopedics , 1285 Creekside Blvd. East, Unit 102, Naples
For the Children – Two Pediatricians Join the NCH Family BY LANCE SHEARER BOTH DR. SHUSTER AND DR. VEDELLA ARE ACCEPTING NEW PATIENTS
If you live in the northern part of Collier County, NCH Physician Group has recently added two skilled pediatricians at two locations, and they’re ready to handle all your children’s medical needs. At NCH Northeast on Collier Blvd., Dr. Whitney Vedella, MD is accepting new patients. With a background in helping underserved populations, she has treated a wide variety of pediatric ailments in diverse conditions. She volunteered full-time
medical school, Dr. Shuster was headed for a career in general medicine until a rotation in the pediatrics department opened his eyes to his true passion.
for a year in a community health clinic in Washington, DC, established a system for enrolling uninsured or underinsured patients into patient assistance programs, and provided pediatric care to members of the Onondaga Nation in upstate New York.
“It’s great getting to people while they’re young,” he said. “Hopefully, you can influence
them to adopt healthy lifestyles.” Both Dr. Shuster and Dr. Vedella stressed the convenience they can provide to patient families, with quick, sometimes same-day appointments available, and virtual as well as in-person visits as an option.
Dr. Vedella is board-certified in pediatrics and, through the American Heart Association, pediatric advanced life support. She earned her medical degree at American University of the Caribbean School of Medicine, her bachelor of science, cum laude, at Salisbury University, and served her internship and residency at SUNY Upstate Medical University in Syracuse, New York. She has two small children of her own, and said with a laugh, “I am the oldest of five children myself. I’ve been taking care of kids all my life.” At the NCH Physician Group center on Veterans Park Drive off Immokalee Rd., Dr. Paul Shuster, MD, has joined the staff to augment the services of the two existing pediatricians, Dr. Danielle Silva and Dr. Tali Wojnowich. A fellow of the American Academy of Pediatrics, Dr. Shuster has worked as a pediatric emergency physician, and served as chairman of the Dept. of Pediatrics at Washington County Hospital in Hagerstown, Maryland. He earned his bachelor of science, cum laude, at American University, and his doctor of medicine degree at the University of Maryland School of Medicine, where he served his internship and residency at the UM Hospital for Children. With two sons of his own and two stepsons, including one preparing to apply to
Whitney Vedella, MD
Paul Shuster, MD
To schedule an appointment with Dr. Vedella call (239) 624-0600 To schedule an appointment with Dr. Schuster call (239) 624-0570
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