Helping hands

Durango surgeon has different approach to arthritis

During a recent surgery, Dr. Kane Anderson uses an endoscopic carpal tunnel release device, right, to cut the ligament pressing down on the nerve in the wrist. Enlarge photo

STEVE LEWIS/Herald

During a recent surgery, Dr. Kane Anderson uses an endoscopic carpal tunnel release device, right, to cut the ligament pressing down on the nerve in the wrist.

Dr. Kane Anderson, a surgeon at Durango Orthopedic Associates, apparently is the only doctor in the Four Corners offering the latest options in treating arthritic hands and carpal tunnel syndrome.

When creams, anti-inflammatory pills, cortisone injections or braces no longer ease people’s arthritis pain, Anderson may discuss replacing a knuckle with surgery.

“There are numerous misconceptions about hand conditions,” Anderson said during a recent interview. “The most common thing I hear patients saying is that they thought nothing could be done.”

He said it would be unfair to say his surgeries get better long-term results.

“At six months, it’s all the same,” Anderson said. “But my patients will have less scarring and can resume their activities sooner.”

Anderson received a bachelor’s degree in biochemistry from the University of Oregon and graduated from the University of Washington Medical School. He did a six-year residency at Dartmouth Hitchcock Medical Center in Lebanon, N.H., and a one-year fellowship (advanced study) in upper-extremity and microvascular surgery at the University of Washington.

He said the fellowship training in which he performed more than 800 shoulder, elbow and hand operations makes him comfortable doing hand surgeries that other physicians don’t do.

In treating osteoarthritis – the inflammation of joints from the gradual destruction of cartilage that results in painful bone-on-bone contact – Anderson makes an incision on the top of a knuckle to remove bone spurs and replace the joint with an implant of silicon or pyrocarbon.

If a patient has rheumatoid arthritis – an autoimmune disease that often causes disfigurement of the fingers – he also realigns the tendons when he replaces the joint to restore normal configuration of the hands.

Both types of arthritis in the hand are more common in women than men, Anderson said.

“I try to understand how arthritis affects my patients’ lives,” Anderson said. “Many people have arthritis, but not everyone needs or should have surgery. If the pain is intolerable, we talk about surgery, which involves an assessment of the demand on their hands and their goals after surgery.”

There is no perfect answer for severe arthritis pain, Anderson said.

“Heavy demand on relatively delicate joint replacements can lead to premature failure of the implants,” Anderson said. “The option for younger, male patients is to fuse the finger, which involves making the joint immobile.”

Implant patients can go about daily activities within four to six weeks and have full use of the fingers by eight to 10 weeks, Anderson said.

In treating carpal tunnel syndrome, caused by a pinched median nerve in the wrist that causes pain or numbness in the thumb and index and middle fingers, Anderson uses an approach that is often available only in larger urban areas but relatively uncommon in the Four Corners.

Instead of cutting into the palm, he makes an almost imperceptible incision in the crease of the wrist and inserts an endoscope – basically a tiny television camera on the end of a flexible cable.

Looking through the endoscope, he finds the ligament responsible for the pressure on the median nerve that is causing numbness and pain. He then cuts the ligament to expand the “tunnel” that houses the nerve and relieve pressure.

“Patients don’t have to use a cast or splint, so they can get back to normal life or work almost twice as fast as they would with open surgery,” Anderson said.

Many of his carpal tunnel patients who have surgery on a Friday can return to work the next Monday, Anderson said.

daler@durango herald.com

Dr. Kane Anderson, seen performing endoscopic carpal tunnel release surgery at Mercy Regional Medical Center, says his techniques can leave less scarring and get a patient back to work quicker. Enlarge photo

STEVE LEWIS/Herald

Dr. Kane Anderson, seen performing endoscopic carpal tunnel release surgery at Mercy Regional Medical Center, says his techniques can leave less scarring and get a patient back to work quicker.

This prosthesis, in red, takes the place of the metacarpophalangeal joint in finger joint replacement surgery. Enlarge photo

STEVE LEWIS/Herald

This prosthesis, in red, takes the place of the metacarpophalangeal joint in finger joint replacement surgery.

A look through the camera on the tip of the endoscope: Dr. Kane Anderson uses an endoscopic carpal tunnel release device to cut the ligament, top, pressing down on the nerve, left and right, in the patient’s wrist. Enlarge photo

STEVE LEWIS/Herald

A look through the camera on the tip of the endoscope: Dr. Kane Anderson uses an endoscopic carpal tunnel release device to cut the ligament, top, pressing down on the nerve, left and right, in the patient’s wrist.

Anderson displays a prosthesis placed in a hole drilled in the metacarpal during a demonstration of finger joint replacement surgery at Mercy Regional Medical Center. Enlarge photo

STEVE LEWIS/Herald

Anderson displays a prosthesis placed in a hole drilled in the metacarpal during a demonstration of finger joint replacement surgery at Mercy Regional Medical Center.