Affinity CEO Chris Zayid in conversation with Orthopedic Surgeon Dr.Ronald Lederman on the podcast show Connecting the Community with Chris.

Is Orthopedic Surgery Always the Answer? Dr. Lederman Weighs In!

In the latest episode of “Connecting the Community with Chris,” we had the pleasure of diving deep into the world of orthopedic medicine with the renowned Dr. Ronald Lederman. As a founding partner at the Lederman Kwartowitz Center for Orthopedics and Sports Medicine, Dr. Lederman brings a wealth of experience and a unique perspective on non-surgical treatments in the orthopedic world. From his early inspirations to the innovative treatments offered at his clinic, join us as we uncover the heart of orthopedic care and its transformative impact on patients.

Watch the full podcast or read the transcript below:

Chris: Hello! Welcome to Connecting the Community with Chris. We have an exciting podcast today with a special guest, Dr. Ron Lederman. Welcome to our show!

Dr. Lederman is a founding partner at the Center of Lederman and Kwartowitz Orthopedic and Sports medicine in Bloomfield Hills and specialize in orthopedic surgery for seniors.

So, welcome to our show, we’re honored to have you.

Dr. Lederman: Thank you! Happy to be here.

Chris: So, tell us a little bit about yourself, knowing how actually you know, you became a doctor and chose orthopedic surgery.

Dr. Lederman: Well, I shadowed my dad for years. He was a podiatrist on the far East Side, and I loved as a kid making the one-hour drive with him early in the morning. I would see how his patients loved him and I always had plans to go into Podiatry. And then when I was in high school, he suggested I go to medical school. I did, went through, went to University of Michigan for those four years and ended up going to the University of Michigan Medical School. So, I bleed Maize and Blue, I’ll warn you right now.

As it turns out, my partner, Dr. Kwartowitz bleeds green. He’s a Sparty okay, and our other partner Dr O’Keefe went to Notre Dame. We’ve got the whole mix here. Anyway, after going to medical school, I chose Orthopedics and did a five-year Orthopedic residency program in Cleveland and then chose an additional one year of Fellowship training in Memphis Tennessee. And that was for lower extremity, and we loved Memphis Tennessee, but back in, gosh, 30 years ago, we moved back here to the Detroit area where we’ve been ever since. And that’s when I started my Orthopedic practice and since brought on those other Sparty and an Irish and from Notre Dame. So, and we’re still growing and taking hopefully, great care of people.

Chris: Oh, that’s a great story. I know you and I had a connection in the beginning, my father was also a podiatrist.

Dr. Lederman: That’s right.

Chris: You know, and I also traveled with him when I was, you know, as a kid, and went to work and was always inspired about, and the main thing is that caring for people. I think we always had that connection.

Dr. Lederman: We did, and I loved whenever we’d get together, I’d see how proud your dad was with what you’ve done with Affinity and it is, it’s a special connection.

Chris: It is, you know, and we’re really lucky to be able to just build a relationship together over the years. And so, I wanted to first start out with, you know, the viewers to understand actually what is orthopedic medicine?

Dr. Lederman: Well, orthopedic medicine at Lederman Kwartowitz Orthopedics, I think it’s a little different than what you find in most other Orthopedic groups. Orthopedic medicine is almost an oxymoron because it’s really orthopedic surgery, and patients know that if they break a bone, they have severe arthritis of their hip, near shoulder, or they come into an orthopedic surgeon’s office with severe pain, most patients feel they’re going to end up with surgery. At Lederman Kwartowitz Orthopedics, we focus on non-surgical management, and we try and do everything we can to keep our patients out of the operating room, because frankly, that’s what I would want if me or my family member was going to an orthopedic surgeon, I want them to look at how can, how can they get me or my family better without surgery. And that’s exactly how we treat every patient that comes in. How can we get them better without surgery?

Now, having said that, you can’t always avoid surgery, but you certainly want to give it a shot if possible and then you want to make sure that your surgeon is Board Certified, Fellowship Trained, which is what all of us are here, and that they’re very skilled at it. So, by trying to avoid surgery doesn’t mean we don’t want to operate, that’s kind of our happy place, but unlike other very busy Orthopedic groups, where you know, they get them in, they get them out, they sign them up for surgery. I kid you not, patients will come to me and say, I saw the Doctor who said I needed surgery without even examining me, because he looked at my x-ray, he left the room and said my nurse will explain everything. And we never understood that.

You have to talk with your patients, you have to explain things. If we show them their x-rays here in the exam rooms, we have on-site Physical Therapy where we try and restore motion, mobility, balance, strength, especially with the elderly. And that’s where our practices overlap, is, we engage Affinity to come into the home and help our patients be able to safely live in their own home independently.

Chris: So, let’s talk a little bit more about alternative medicine. Now, there are some special features that you have in your office that are a little different than most Orthopedic offices in the area.

Dr. Lederman: Correct. That’s absolutely true, and I’m glad you mentioned it. In terms of alternative medicine, it’s really what is the alternative to just jumping into surgery, and in our practice here, we offer patients Physical Therapy, where we can oversee our therapist, because it’s right here. Very often we’ll pop right next door, see our patients while they’re getting their therapy. And I wouldn’t necessarily call physical therapy alternative, but as I said earlier, many Orthopedic groups jump right to the operating room. So, you can consider physical therapy alternative.

We have Class 4 Cold Laser Treatment which we’ve now had for six or seven years. We’ve treated over 3500 patients, with a 91% success rate in the 10 most common orthopedic diagnoses and one of those is arthritis, which affects, you know, the Elder.

Chris: So, if you have pain in your knee, that’s an alternative medicine option here.

Dr. Lederman: Absolutely. It doesn’t mean you jump and have surgery. Now, that patient might require surgery, but first, we’re going to do therapy and while they’re coming to therapy, they can get under the laser which actually has been shown to decrease inflammation, swelling, and pain. And if you can successfully do that and make the patient more comfortable, they can go grocery shopping, they can walk further, they can play with their grandkids, they can enjoy independent lifestyle than you want. That’s what you’re hoping to achieve with surgery.

Chris: Is that age limited, to be able to do?

Dr. Lederman: Okay, great question. It’s not age limited, but it becomes more and more important in the older population, if we know it takes them longer to heal from a surgery, some of them have more medical issues, so there could be a higher risk for surgery. So, if you can offer them a treatment that doesn’t put them at risk and only gives them the upside of decreased swelling, pain, increased mobility, and greater function, why not?

Chris: And our goal always is that to create them to be independent again in their life, you know, and be able to do the things that they want to do.

Dr. Lederman: Absolutely.

Chris: You know, and so that gives them that option. Now, how can Orthopedic issues in people over 55 be prevented?

Dr. Lederman: So, I can’t believe I’m sitting here and we’re talking now about the over 55 age group and that certainly is me. But look, we’re fortunate enough to get there, and it’s kind of interesting in our practice. We think that the principles that we use to treat our high school athletes, the college athletes, even some Semi-Pro athletes, you know, the modalities like Therapy, Laser, Regenerative Stem Cell Injections, PRP which stands for Plasma-Rich Protein, we’re right here in the office, we draw some blood, we have a high speed centrifuge, it spins down and you’re left with this material that has Plasma-Rich Protein, and we can inject that into the joints, or into an inflamed tendon like Achilles, or golfers elbow, tennis elbows, rotator cuff tendonitis.

Chris: And how quick are the results for that?

Dr. Lederman: Well, the results can be very quick, you know. Some people can notice an immediate improvement when you combine it with all of the other things we do, or it might take a month or six weeks to really decrease the pain.

Chris: Oh, a month is still great.

Dr. Lederman: Well, it’s better than six months of a recovery from a surgery. But to get to your point, the point I was going to make is that, we apply these same principles to the younger athletes, that we do to the 55, 60, 75, 90-year-old population, because, our concept is, we want to get you better faster and it actually becomes more important as you’re older, as you might have less of a social support network, you might be living on your own, and if you’re hobbled with an orthopedic condition, whether it be in your foot and ankle, your knee, hip, shoulder, neck, or back, whatever, and you can get them better faster and restore their ability to live independently, that actually becomes more and more important at that stage of their life.

So, people think when you get older, you don’t need all of the things that we offer our younger, healthier, more active people. But I think it’s the other way around.

Chris: Yeah, yeah, that’s great. I could see that, and I see with my mom, she’s been here plenty of times and you offered her alternative medicine, and they got her to be far more comfortable to do everything that she needed to do. The most important thing for her was she wanted to be with her grandchildren and be able to walk around, going up and down the stairs, and you offered that, and that’s just the simple quality of life things. That’s what we’re trying to do here, is that, get them back to their daily routine.

Dr. Lederman: Absolutely. And I’ll tell you what, that just, you just warmed my heart. Because everybody knows what it’s like – you get up every day, you go to work, and it can be a grind, but, when you hear stories like your mom, that’s the reason we do what we do, and interestingly enough it doesn’t always involve surgery, even though we love to do surgery as orthopedic surgeons. We take a lot of pride in getting people better faster without that surgery.

Chris: Yep. And so, for example, if someone were to come to your practice, and they would typically, did not know exactly everything that entails, what would you tell the public, is the type of cases that you are typically seeing now?

Dr. Lederman: That’s an easy, short answer. If you’re in pain, if you’re in pain with any body part, and we focus on extremities, start from the shoulder, all the way down elbow, hand and wrist, hips, knees, foot, and ankle, and then we have Dr Hyman in our practice, who is a board-certified, fellowship trained PMnR, which stands for Physical Medicine and Rehabilitation. He is an amazing diagnostician; he can diagnose why is someone’s neck and back hurting and 98% of severe neck and back pain doesn’t require surgery. If it does, he will then say I need to send you to this Neurosurgeon or this Orthopedic Spine Surgeon. But if you hurt and if it’s affecting your daily life, your activities of daily living, you can’t clean your home, you can’t make the bed, you can’t put your dishes away, because of a rotator cuff shoulder problem. If you hurt, come on in. And if you ignore those pains long enough, it could make a problem that could have been fixed without surgery, eventually require surgery, and not be able to get better without it.

Chris: And you know, I know we both work in the Aging population and that’s the hardest part, is actually to get here. It’s like when you work out, it’s actually they don’t want to actually set up the appointment to, you know, to solve this problem that they have in their life. So, we see a lot of the seniors that they push back, a lot of our clients, to even just go see a specialist.

Dr. Lederman: Well, a couple of reasons for that. I’m sorry to interrupt. Number one, they’re afraid that if they go to an orthopedic surgeon’s office…

Chris: You could have surgery.

Dr. Lederman: Exactly. And number two, it’s hard to get in. We hold urgent Orthopedic spots in our practice every day. So, if someone called and they were in so much pain that they were crying on the phone, it’s not unusual that we would tell them to come in the same day, and unlike other groups that you’re waiting three, four hours in the waiting room, we try and get people back within 15-20 minutes, so that they’re in they’re out. We kind of have a boutiquey Orthopedic practice, but we want to be available for everyone or anyone that has pain. And you touched on an important point, in the elderly – don’t ignore it, but don’t be afraid to come in. We’ll check you out, we’ll evaluate you.

Chris: Yeah, and I think that’s necessary to be able to feel comfortable, you know, and build a relationship with a good orthopedic surgeon in general, before you even reach 55 and up, because you know, as we age, we want to age gracefully, but also, I think the care team is most important, you know.

As a home care provider, I know for us, as we’re always telling family members is that, you should have your care team, and that doesn’t just mean your doctors, you know, your financial wealth advisor, you know, have funeral planning and trusts involved, who are your beneficiaries, like all these things are, also who are your Physicians, great relationship with your internal medicine doctor, your cardiologist, your orthopedic surgeon. Create that now, so that way you know, when your kids have to make a decision, they know all your people in your network.

And you know, and I wanted to touch point on one thing that you mentioned is that, do you see like clients that can’t even just get here, they don’t have any friends or family, or they can’t drive anymore, and they just, they’re in pain, but they just can’t make it to the office.

Dr. Lederman: That can be a real problem and fortunately with the advent of Uber and Lyft, it’s easier to get them than it is in a taxi. But sometimes the elderly don’t have the technology to even do that, it’s hard to get people here if they have absolutely no means to do so. But I have seen with the elderly population that they rely on neighbors, family, and friends, and the hope is between, someone will be able to get them here and get the help they need here.

Chris: Yeah, exactly. So, main point is to get here, you know, and then we can talk about other options. Now, what I want to touch upon is, like, what is joint replacement surgery exactly?

Dr. Lederman: Total joint replacement is when a joint, and the most common joint replacements is our hips, knees, shoulders, and now increasingly foot and ankle, of replacements, ankle joint replacements are on the rise. They finally made the technological advancements to make that a routine thing.

We have an amazing Foot and Ankle Surgeon, Dr. Sam Austin, who does a wonderful total ankle replacement, and an ankle replacement is when you have lost all the cartilage in your joint, you have bone on bone arthritis, and it’s so painful that you can’t walk or use your arm, that’s when you would get a joint replacement.

Chris: Wow, so full blown, every, almost every joint in this office can be taken care of. And so, what can be expected? So, I’m gonna have surgery, you’re committed to that and now it’s the day. The day is coming, so, what should I expect here, in this practice?

Dr. Lederman: Well, again, taking a slightly different approach than just signing up for surgery and see you on the day of surgery, we actually get patients, we make sure they get to their primary care doctor, so their heart, their lungs, everything is in good shape.

Chris: Going back to the care team, you want to make sure everything’s set in order.

Dr. Lederman: Absolutely. Safety is number one. Number two, we get patients into prehab, pre-rehab, or pre-physical therapy. If you can improve the range of motion, and the muscle strength around the joint that’s going to be replaced, that has been shown to shorten your recovery, make your recovery easier and have a better outcome.

So, we do that ahead of time. If someone is severely overweight, we ask them to try and make a small, healthy modification in their diet, so that they can slowly start bringing the weight down, because that will also help their ability to get up and move around after a hip, knee, or ankle replacement. And we take the holistic, total person approach, and not just look at them as a knee, or a hip, but we look at them as a whole person.

Chris: So, what is the average recovery time?

Dr. Lederman: For a hip replacement, we often, I mean Dr. Kwartowitz and Dr. Gibson are doing amazing hip replacements in this practice. And we have patients coming in 10 days after surgery, carrying the walker, sometimes lifting their walker, and doing the little dance stuff.

Chris: Yeah, I got my life back again! And this is for your knees, and hips, and shoulders.

Dr. Lederman: For the hips. For the knees they tend to be more uncomfortable, but again, now we use robotic knee replacement surgery, and robotic surgery has been shown to minimize the amount of bone you have to remove, the patients seem to have less post-operative pain, they recover faster, which is our goal – we want to get you better, faster. And total recovery after a hip replacement, the soft tissues are still healing at three to six months, but we have people walking day one. Same for total knees.

Chris: That’s great. And then, what about rotator cuff?

Dr. Lederman: So, rotator cuff surgery now can all be done minimally invasive through arthroscopy. Shoulder replacement surgery does still require an incision, but patients after shoulder replacement, are starting to get things moving within a couple of weeks, and usually it’s amazing. At two months, three months, patients that have the horrible shoulder pain…

Chris: Better range of motion.

Dr. Lederman: Absolutely. Better motion, you’ve eliminated that pain, and painful bone on bone, and Joint Replacements are very very successful these days.

Chris: Now, can you tell us about the healing process? Now, we know about the surgery day and then during, and then what about after, for hips and knee replacement? How does that work out and what advice are you giving to your patients?

Dr. Lederman: Well, we like to arrange for some home therapy, so that patients for the first couple of weeks, when it’s not really, they’re not able to get out of the house or drive themselves or do any of that safely, we try and bring therapy to them, very often through a company such as yourself, through Affinity, and we just get tremendous positive feedback whenever our patients have any of your team working with them.

And then we transition them at two, three, four weeks to outpatient therapy. That does a couple of things, get some out of the house, fresh air, you feel less of a patient and more of part of the real world, and then, also in a physical therapy department like we have, they’re interacting with the whole therapy team, with other patients, and it’s just all about making this a little speed bump in the road of life, for people to be able to continue to live their lives.

Chris: Why would you need a nurse after surgery?

Dr. Lederman: Well, nowadays, patients are going home very often same day or next day after joint replacements, any joint. When I was training 30 years ago, patients were in the hospital for 10 to 14 days, so you had the whole hospital staff laying eyes on your patients and monitoring for vitals and the wound and checking for infection or blood clots. So, to have a nurse in the house, coming daily, sometimes twice a day, and checking for anything that could potentially go wrong, you can jump all over it. If you see that the wound doesn’t look right, we might get a call from the nurse, if they can describe it or take a picture, we might be able to just prescribe oral antibiotics and it’s resolved. If on the other hand, something looks a little more serious, we might arrange to get them brought in. But the point is, you can head something bad, head it off at the pass and hopefully avoid more major surgery.

Chris: Sure, yeah, I mean, you’re doing this all alone, you’re not having a professional there.

Dr. Lederman: And its scary. People go home and they don’t always know what to expect. They don’t know what the incision is supposed to look like, and we get a lot of calls saying it’s red, it’s swollen. Well, to a certain degree that’s normal, after a joint replacement or any major surgery. But to have skilled, experience set of eyes like a nurse there, is invaluable.

Chris: To say this is something serious, and then communicate with you right away about it.

Dr. Lederman: Correct.

Chris: So, how long does an artificial joint typically lasts?

Dr. Lederman: I would say between 20 and 30 years. It’s definitely increased over time, but total joint replacements are lasting longer and longer, and it’s so great for the aging population.

Chris: Just because of technology and recovery time.

Dr. Lederman: The technology is improving everything; it’s making incision smaller. If you have a smaller incision, there’s less tissue disruption, an easier recovery time, less pain. And then of course, the technology that makes sure the joints are positioned properly with minimal bone resection, minimally invasive surgery, these are lasting longer, and patients are less scared of it.

Chris: Yeah. That’s so hopeful. Now, arthroscopic surgery, let’s like talk about that. What exactly is?

Dr. Lederman: Arthroscopic surgery means that you’re able to look into a joint, pretty much any joint, through tiny little poke holes. It’s almost always done in an outpatient surgery center, and the type of anesthesia varies, but patients are going home in less than an hour after that procedure.

Chris: An hour!

Dr. Lederman: Absolutely. Sometimes half an hour because you don’t need as heavy of an anesthesia. So, when I’m done with a 12-minute knee arthroscopy, they are awakened in recovery within five minutes and sometimes 20 minutes later they’re in the car on their way home. But it’s minimally invasive. Again, you want a surgeon, board-certified, fellowship-trained, that’s done a lot of these, that knows how to be delicate with the tissue, because the more delicate and careful you are with the tissue in the surgery…

Chris: The less pain.

Dr. Lederman: Exactly.

Chris: Yeah, which is the focus right. So, is there anything else that I have not touched regarding your practice, and what differentiates you, and what’s special here?

Dr. Lederman: Well, I can in summary say that number one, I believe Lederman Kwartowitz Center for Orthopedics and Sports Medicine is different, it’s a boutique type of practice, we do try and avoid surgery if at all possible. If our patients need surgery, they’re in very skilled hands, and we treat the patient as a whole, not just as a body part.

Chris: Thank you so much for being part of our community and serving our aging population and the young population as well too. But also, the focus is, when you’re in pain and if you’re not sure what to do, it seems like, you know, there’s no other better place for that is to check out Dr Lederman Kwartowitz office.

Well, we’re so honored to have you part of our community and thank you so much for being on our show.

Dr. Lederman: Thank you, Chris. I can tell you we feel the same way about you and all your people at Affinity.

Chris: Thank you.