For P.M. ReleaseThursday, February 14, 2002
AJ Wright847-384-4034, [email protected]
Todd Schuetz847-384-4032, [email protected]
Claudette Yasell847-384-4035, [email protected]
Orthopaedic surgeon highlights pros, cons of alternative therapies
DALLAS-No substance is without potential complications, which includes "natural" and "herbal" remedies and dietary supplements, Harris Gellman, M.D., explained at a media briefing at the American Academy of Orthopaedic Surgeons (AAOS) 69th Annual Meeting.
"'Herbal' does not mean harmless," said Dr. Gellman, professor of orthopaedic surgery at the University of Miami. In fact, a growing body of evidence indicates that some natural and herbal products may have some value. They may also cause a variety of side effects and interact negatively with prescription and other medications.
"Patients planning to undergo surgery should make sure their surgeon knows every substance they are taking, including 'alternative' remedies and dietary supplements, prescription and traditional over the counter medications," said Dr. Gellman. "Orthopaedic surgeons need to be informed because many of these remedies can interfere with surgery or reduce the effectiveness of other medications prescribed."
Dr. Gellman moderated a symposium on complementary and alternative therapies at the AAOS meeting. He highlighted many of the complications linked to specific natural remedies. Gingko biloba, the popular herbal used as a circulatory stimulant or antioxidant; fever few, used to prevent migraine headaches; garlic, used to lower blood pressure and relieve nausea; and large doses of Vitamin E can interfere with blood clotting in the same way that aspirin does.
"Problems with blood clotting can cause major surgical complications," Dr. Gellman said. "If you're going to operate, you need to make sure that what the patient is taking isn't going to affect the procedure or interfere with a positive outcome."
In addition, St. John's wort, used as a mood enhancer, can interact with some anesthetic agents. Echinacea, used to boost the immune system, can reverse the effects of some steroids, that are commonly prescribed by orthopaedists to treat arthritis and other conditions.
As orthopaedic surgeons manage the potential harmful effects of specific alternative remedies, they are also learning about the potential benefits of others.
Arnica montana, a plant that can cause bruising and bleeding when ingested, shows some promise as a treatment when administered in "micro" doses. The remedy is employed by practitioners of the branch of alternative therapy known as homeopathy, which uses very small doses of specific natural substances to stimulate the body's healing responses. Some research suggests homeopathic agents may have their place in traditional medicine. Arnica montana, for example, may help reduce post-surgical swelling and bruising.
Other alternative therapies show potential in the treatment of musculoskeletal disorders as well. For example, a growing body of evidence points to the benefits of the ancient Chinese therapy of acupuncture in the non-surgical treatment of arthritis and pain syndromes, such as reflex sympathetic dystrophy (RSD) and fibromyalgia.
Dr. Gellman urged consumers to seek medical help before using the services of an acupuncturist or other alternative therapist. "At least rule out a treatable medical condition before embarking on alternative therapies," he said. "While the therapy may not help or hurt, it may also miss the diagnosis of a serious or life-threatening condition."
The 25,500 member American Academy of Orthopaedic Surgeons (www.aaos.org) or (http://orthoinfo.aaos.org), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public.
An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.bonejointdecade.org), the global initiative in the years 2000-2010 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.
The Academy's Annual Meeting is being held February 13-17, 2002, at the Dallas Convention Center, Dallas.
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