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Advanced Orthopedic Care Hinges on Skill, Technology, Trust

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LOUISVILLE Spend time talking with Nyagon G. Duany, MD, and it’s easy to see why she has a passion for sports medicine and orthopedic surgery. As a college athlete and one of five children in her family who all excelled at competition, she and her siblings had numerous sports-related injuries during their school years.

The group developed a close personal relationship with a particular orthopedic surgeon. Duany recalls she had cause to see him often after injuring her shoulder while playing basketball on scholarship at Bradley University in Illinois.

That injury proved to be life-changing for the student athlete who already had a keen interest in biology. This happened in the 1990s, before arthroscopic procedures were widely used, so her injured shoulder repair required open surgery.

She saw the orthopedic surgeon often during her six months of therapy. His compassion and skill inspired her to study medicine.

“He took me under his wing and became a mentor,” Duany says.

Fast forward to today, and Duany is excited to work with a skilled team of orthopedists, neurologists, primary care physicians, certified athletic trainers, and physical therapists at Norton Sports Health. She joined Norton Orthopedic Institute in February 2019 after previously practicing in southern Indiana.

Duany now uses advanced technologies and procedures that make “a world of difference” in care and outcomes compared to what was available when she was in college. For example, most orthopedic conditions and sports injuries are currently diagnosed using magnetic resonance imaging (MRI) scans. Plus, new minimally invasive surgical techniques dramatically reduce treatment and recovery time.

“These days I can make a small finger-sized incision and work using a camera to fix a torn rotator cuff, so recovery is quicker than if we had to make a large incision and cut through layers of muscle,” she says.

Tackling Myths and Misconceptions

Duany is skilled at arthroscopic procedures, including anterior cruciate ligament (ACL) reconstruction in the knee and shoulder rotator cuff repairs. While her specialty is sports injuries, she also treats general orthopedic issues, including arthritis, fractures, and non-sport-related injuries.

One thing she loves about orthopedics is the opportunity to help patients return to living full, meaningful lives. She would, however, like to help change some misconceptions people may have about orthopedic care options. She shares a few examples that warrant a change in thinking.

Typical orthopedic patients are male “jocks.”
In reality, says Duany, she and her colleagues take care of high-level athletes to weekend warriors, people of various ages whose problems stem from many causes.

Male-dominated sports account for most ACL knee injuries.
Surprisingly, women have a higher risk than men for ACL injuries, which often result from various types of twisting or unstable movement. Physical differences in women — such as smaller joints and ACLs relative to body size — may account for this.

Most shoulder or knee “tears” require major surgery.
This is not the case at all. Many knee and shoulder problems can get better with conservative management options, including cortisol injections and physical therapy. Surgery is usually not the first course of action, but when it is indicated many tears can be fixed arthroscopically.

You must be over age 60 for joint replacement surgery.
Not necessarily. Typical replacement candidates are over age 60 with advanced shoulder, knee or hip arthritis, however patients of varying ages often indicate when they’re ready to consider joint replacement surgery. Their decisions are usually driven by severe bone-on-bone pain and loss of joint function. Duany notes that while implants are getting better and producing good results, they still involve major procedures so it’s good to exhaust other care options first.

Building Trust Builds Better Care

Duany came to the United States in the 1980s with her family, who left South Sudan to escape civil war. She grew up in Bloomington, Indiana and earned her medical degree from the Indiana University School of Medicine, Indianapolis. Her orthopedic surgery residency was at Howard University, Washington, DC, followed by a sports medicine fellowship at the University of Cincinnati, Ohio.

Duany moved to the Louisville area in 2016 with her husband, Kwadwo, a clinical pharmacist. The couple enjoys traveling and spending time with their two children, ages 4 and 2.

Throughout her career, building trust with patients has been a core tenet of her care philosophy. She credits her mentor for teaching her this. She points out this is especially valuable working with orthopedic patients whose recovery often hinges on prolonged therapy.

“A good bedside manner is crucial. Listening to patients and letting them get comfortable with you builds trust,” she says. “Building trust builds better results because it creates patients who are committed to following their treatment plans.”