If you have joint pain, or an acute injury, you want to know whats causing that pain without having to go through many tests and procedures to find out.
Lourdes Health System is now offering a new imaging device that can give patients realt time answers for joint injuries right in the comfort of the doctors office.
The innovative device uses a needle with an integrated camera and light source to perform a diagnostic arthroscopy in the doctor's office—enabling patients to learn the cause of their orthopedic pain immediately rather than having to wait for the results of an MRI. Lourdes is first in New Jersey to offer the device.
In this segment, Dr. Sean McMillan, chair of Orthopedics at Lourdes Health System, discusses the mi-eye™ system for faster results on the cause of your pain.
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Lourdes Offers New Imaging Device to Give Patients Real-Time Answers for Joint Injuries
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Learn more about Dr. Sean McMillan
Sean McMillan, DO
Sean Mc Millan, DO, a specialist in Orthopedic Sports Medicine, has recently joined Professional Orthopedics at LMA as the Director of Orthopedic Sports Medicine. He completed his Orthopedic Sports Medicine and Arthroscopy fellowship at the University of Massachusetts during which he had a concentration in hip, shoulder and knee arthroscopy, as well as open shoulder surgery such as shoulder replacements. Prior to this he completed his internship training in the UMDNJ-SOM/Kennedy Health system and his orthopedic residency in the Long Island Jewish Health System through The Peninsula Hospital Consortium. During his time here, Dr. Mc Millan was chosen as the Administrative Chief Resident. He also awarded the New York Osteopathic Orthopedic Research Foundation (NYOORF) Outstanding Orthopedic Resident Scholarship for his research in both the elbow and the meniscus of the knee. In addition to this research, Dr. Mc Millan has written or co-authored several academic papers and textbook chapters on topics such as hip and shoulder arthroscopy. He is a Board Certified Orthopaedic surgeon and Chief of Orthopaedics at Lourdes Medical Center in Burlington. He is also on the voluntary academic staff at the University of Medical and Dentistry of New Jersey - School of Osteopathic Medicine (UMDNJ-SOM) where he will be helping educate the orthopedic residents.Learn more about Dr. Sean McMillan
Transcription:
Melanie Cole (Host): If you have joint pain or an acute injury, you want to know what’s causing that pain without having to go through many tests and procedures to find out. Lourdes Health System is now offering a new imaging device that can give patients real-time answers for joint injuries right in the comfort of the doctor’s office. My guest today is Dr. Sean McMillan. He’s the Chair of Orthopedics at Lourdes Health System. Welcome to the show, Dr. McMillan. What has typically been the procedure that you’ve gone through?
Dr. Sean McMillan (Guest): When we meet a new patient, the first thing I do is get a good history to localize down to what could be going on. From there, based on their presentation on examination, often times they’ll be sent out for X-rays or MRIs to help give us some more information about what’s going on inside of the joint.
Melanie: So they’ve typically done all of this, and how long does that take to get their appointment with the MRI, to set that up, to come back to see you for the results, how long has this typically taken?
Dr. McMillan: Yes, that’s a great point. Typically, even in the fastest setting, it’s taking – from the appointment to getting the MRI approved, getting the MRI done and then back into the office – anywhere from ten days on the short side to maybe two or three weeks depending on the patient’s schedule and the doctor’s schedule.
Melanie: And plus, some people are not necessarily comfortable in an MRI, even if it’s maybe an open MRI, so that’s a whole expensive insurance thing besides – so now, you’ve got a new procedure that you’re able to do in the doctor’s office to assess the level of injury of a patient. Tell us about this Mi-Eye procedure. What is it, and what’s involved?
Dr. McMillan: Yeah, so this is a new technology we’re offering to our patients at Lourdes that lets us in real-time look inside of a shoulder or knee to be able to figure out what sort of pathology it is. It gives us optical, almost like we were in the operating room through a scope, to be able to see if there’s a tear or a bunch of cartilage floating around and it takes about maybe three minutes to do for us, which really helps the patient. It saves them from going and getting the MRI. It saves them the hour or so of sitting in the MRI machine, and most times it’s more cost-effective for them to do, as well.
Melanie: So let’s speak about the cost-effectiveness for just a minute and because so many different centers offer MRIs and there’s that whole procedural – how does that work as far as insurance? Are they covering this? Are they recognizing this procedure?
Dr. McMillan: This is covered by all insurances from Medicaid, Medicare, and commercial insurances. It’s considered a surgical procedure almost in the sense that it is covered and recognized and it usually is more cost-effective for the patient than getting the MRI done. Where there’s variability in the cost of MRIs from different insurance carriers, this pretty much has a standardized rate, which makes it pretty user-friendly for our patients and financially advantageous for them, as well.
Melanie: So who are the ideal patients?
Dr. McMillan: The ideal candidates, first and foremost, are patients who can’t get MRIs. I can’t tell you how many patients I have that have been having joint pain for years, but because they have metal in their body, or they have a pacemaker, have been unable to find out the root cause of their problem and have just been dealing with it.
Other patients are patients like you and I, patients that are booked and don’t have the time to be able to take off to the doctor’s twice, plus take off to get the MRI done and need to get the answers right away so they can be treated and get back to their life. These patients are the ones that need this the most because often times we put off our own healthcare because we just don’t have the ability to meet our needs. This wraps it up in one big, quick nutshell for the patient and gives them information so we can treat them more quickly and more effectively.
Melanie: So let’s speak about the Mi-Eye procedure for a minute, Dr. McMillan. Do any patients have issues tolerating the needle? Let’s speak just about the procedure. What really is involved? What do they do?
Dr. McMillan: To date, we’ve had no issues with patient tolerating the procedure. What’s done is this, if we decide we’re going to say look inside your knee to inspect an ACL injury or a meniscal injury, what we’ll do is we’ll just numb your skin up with a little bit of lidocaine or novocaine like you’ve had at a dental office. From there, once the skin is numb, we’re able to insert a small camera, which is only about a millimeter and a half in size, into the knee joint or shoulder joint, and look around. It’s painless. Once you numb the skin and the capsule right below it, there’s no pain involved with this. Patients will maybe say they feel pressure, but I would say the majority of the time the patients are looking at this monitor with me while I’m doing the procedure. I’m able to explain to them, “This is your cartilage, this is your meniscus, and here’s your tear.” Unlike an MRI where patients look at it, and it may look somewhat confusing or look like a hieroglyphic, this is something they can easily understand because they can see the tear and they can see what’s normal versus abnormal, and it gives them a sense of confidence in what the problem is. From there, we can make a decision as to how to treat them most effectively.
Melanie: Can they get a printout?
Dr. McMillan: What we do is we actually place the images on a little memory stick, so this feeds into a computer. The way the Mi-Eye works is it attaches to a surface tablet, so it’s easily transportable for me as a physician, and for the patients, I’m able to download their images or save them for myself for my EMR.
Melanie: Absolutely fascinating, and Dr. McMillan, what have you seen as far as patient satisfaction and results for continuing care as far as this Mi-Eye – are you finding that patients then see this tear or see their injury and are able to get treatment? What are you seeing as the effectiveness and benefits for the patient?
Dr. McMillan: It’s really opened up the patient’s eyes. This is something where it’s from word-of-mouth, that I have patients calling and requesting to get this done, or being sent in by their friends or their family physician. The patients feel a whole lot more confident now because they’ve been suffering from an injury and they’ve been afraid and within just a couple minutes I’ve been able to lay their fears to rest if we go into the knee or the shoulder and see there’s no tear there, then we can come up with a rehab plan that says, “All right, you have a sprain or a contusion and here’s what we’re going to do.” Or likewise, if they see the tear, they would understand why there may be a need for the surgery. Often times when we review MRIs and tell a patient there’s a tear that needs surgery, it’s sort of a nebulous though to the patient. They can’t quite understand what’s going on. But with this opportunity, I’m able to show the patients in real-time where the tear is in their tissue and what we need to do to reattach it to the right spot. It gives them more clarity and more trust in the physician as well.
Furthermore, it gives the patient a chance to really plan their life out because when they come into the office, they know now, this is my problem and here’s my treatment algorithm. I don’t have to wait two to three weeks, sort of in limbo, to find out what’s wrong with my knee or my shoulder.
Melanie: One of the most common tears, I imagine, that you see being rotator cuff because everybody – it just seems, so many people are getting rotator cuff tears today, whether they’re weekend warrior or older folks. Are you able to, with older people and some of these weekend warriors, also able to use the Mi-Eye to see these rotator cuff tears and then deal with them effectively?
Dr. McMillan: Absolutely. When we enter into the joint, the picture clarity is amazing. It’s like being in the operating room in the sense that I can see everything right there in its natural colors and its natural look. What’s nice about this is I can dynamically move the arm or the knee, so if I see the rotator cuff attached to the bone and it looks a little bit damaged, I can rotate the patient’s arm without causing any pain and see that tissue move the way it should, in unity, or unfortunately, sometimes I’ll see it move and it’s not in unity, meaning there’s a tear. At least that gives me good clarity. One of the problems with MRI is it’s static, so while an MRI is great in a lot of instances, in some cases, it doesn’t give us all the information that we need. This sort of obviates that problem.
Melanie: What an exciting innovation in sports medicine. Dr. McMillan, wrap it up for us, about the Mi-Eye procedure for patients with joint injury or joint pain and what you want them to know about coming to Lourdes Health System and checking this out.
Dr. McMillan: At Lourdes, we pride ourselves on being innovative and when it comes to orthopedic and sports medicine needs not only are we using this to find out what your problem is inside the joint, we’re using this to deliver treatment, too, whether it’s putting a biologic injection into a tear directly to make sure they heal appropriately, or just making sure that what we did previously surgical-wise has healed. We want to really get you back on your A-Game as quick as possible, so our goal is to get you in, get the answer, and devise a personalized plan for the patient that lets them get back to their life as quickly and safely as possible.
Melanie: Thank you, so much, for being with us today. It’s absolutely great information. You’re listening to Lourdes Health Talk, and for more information, you can go to LourdesNet.org, that’s LourdesNet.org. This is Melanie Cole. Thanks, so much for listening.
Melanie Cole (Host): If you have joint pain or an acute injury, you want to know what’s causing that pain without having to go through many tests and procedures to find out. Lourdes Health System is now offering a new imaging device that can give patients real-time answers for joint injuries right in the comfort of the doctor’s office. My guest today is Dr. Sean McMillan. He’s the Chair of Orthopedics at Lourdes Health System. Welcome to the show, Dr. McMillan. What has typically been the procedure that you’ve gone through?
Dr. Sean McMillan (Guest): When we meet a new patient, the first thing I do is get a good history to localize down to what could be going on. From there, based on their presentation on examination, often times they’ll be sent out for X-rays or MRIs to help give us some more information about what’s going on inside of the joint.
Melanie: So they’ve typically done all of this, and how long does that take to get their appointment with the MRI, to set that up, to come back to see you for the results, how long has this typically taken?
Dr. McMillan: Yes, that’s a great point. Typically, even in the fastest setting, it’s taking – from the appointment to getting the MRI approved, getting the MRI done and then back into the office – anywhere from ten days on the short side to maybe two or three weeks depending on the patient’s schedule and the doctor’s schedule.
Melanie: And plus, some people are not necessarily comfortable in an MRI, even if it’s maybe an open MRI, so that’s a whole expensive insurance thing besides – so now, you’ve got a new procedure that you’re able to do in the doctor’s office to assess the level of injury of a patient. Tell us about this Mi-Eye procedure. What is it, and what’s involved?
Dr. McMillan: Yeah, so this is a new technology we’re offering to our patients at Lourdes that lets us in real-time look inside of a shoulder or knee to be able to figure out what sort of pathology it is. It gives us optical, almost like we were in the operating room through a scope, to be able to see if there’s a tear or a bunch of cartilage floating around and it takes about maybe three minutes to do for us, which really helps the patient. It saves them from going and getting the MRI. It saves them the hour or so of sitting in the MRI machine, and most times it’s more cost-effective for them to do, as well.
Melanie: So let’s speak about the cost-effectiveness for just a minute and because so many different centers offer MRIs and there’s that whole procedural – how does that work as far as insurance? Are they covering this? Are they recognizing this procedure?
Dr. McMillan: This is covered by all insurances from Medicaid, Medicare, and commercial insurances. It’s considered a surgical procedure almost in the sense that it is covered and recognized and it usually is more cost-effective for the patient than getting the MRI done. Where there’s variability in the cost of MRIs from different insurance carriers, this pretty much has a standardized rate, which makes it pretty user-friendly for our patients and financially advantageous for them, as well.
Melanie: So who are the ideal patients?
Dr. McMillan: The ideal candidates, first and foremost, are patients who can’t get MRIs. I can’t tell you how many patients I have that have been having joint pain for years, but because they have metal in their body, or they have a pacemaker, have been unable to find out the root cause of their problem and have just been dealing with it.
Other patients are patients like you and I, patients that are booked and don’t have the time to be able to take off to the doctor’s twice, plus take off to get the MRI done and need to get the answers right away so they can be treated and get back to their life. These patients are the ones that need this the most because often times we put off our own healthcare because we just don’t have the ability to meet our needs. This wraps it up in one big, quick nutshell for the patient and gives them information so we can treat them more quickly and more effectively.
Melanie: So let’s speak about the Mi-Eye procedure for a minute, Dr. McMillan. Do any patients have issues tolerating the needle? Let’s speak just about the procedure. What really is involved? What do they do?
Dr. McMillan: To date, we’ve had no issues with patient tolerating the procedure. What’s done is this, if we decide we’re going to say look inside your knee to inspect an ACL injury or a meniscal injury, what we’ll do is we’ll just numb your skin up with a little bit of lidocaine or novocaine like you’ve had at a dental office. From there, once the skin is numb, we’re able to insert a small camera, which is only about a millimeter and a half in size, into the knee joint or shoulder joint, and look around. It’s painless. Once you numb the skin and the capsule right below it, there’s no pain involved with this. Patients will maybe say they feel pressure, but I would say the majority of the time the patients are looking at this monitor with me while I’m doing the procedure. I’m able to explain to them, “This is your cartilage, this is your meniscus, and here’s your tear.” Unlike an MRI where patients look at it, and it may look somewhat confusing or look like a hieroglyphic, this is something they can easily understand because they can see the tear and they can see what’s normal versus abnormal, and it gives them a sense of confidence in what the problem is. From there, we can make a decision as to how to treat them most effectively.
Melanie: Can they get a printout?
Dr. McMillan: What we do is we actually place the images on a little memory stick, so this feeds into a computer. The way the Mi-Eye works is it attaches to a surface tablet, so it’s easily transportable for me as a physician, and for the patients, I’m able to download their images or save them for myself for my EMR.
Melanie: Absolutely fascinating, and Dr. McMillan, what have you seen as far as patient satisfaction and results for continuing care as far as this Mi-Eye – are you finding that patients then see this tear or see their injury and are able to get treatment? What are you seeing as the effectiveness and benefits for the patient?
Dr. McMillan: It’s really opened up the patient’s eyes. This is something where it’s from word-of-mouth, that I have patients calling and requesting to get this done, or being sent in by their friends or their family physician. The patients feel a whole lot more confident now because they’ve been suffering from an injury and they’ve been afraid and within just a couple minutes I’ve been able to lay their fears to rest if we go into the knee or the shoulder and see there’s no tear there, then we can come up with a rehab plan that says, “All right, you have a sprain or a contusion and here’s what we’re going to do.” Or likewise, if they see the tear, they would understand why there may be a need for the surgery. Often times when we review MRIs and tell a patient there’s a tear that needs surgery, it’s sort of a nebulous though to the patient. They can’t quite understand what’s going on. But with this opportunity, I’m able to show the patients in real-time where the tear is in their tissue and what we need to do to reattach it to the right spot. It gives them more clarity and more trust in the physician as well.
Furthermore, it gives the patient a chance to really plan their life out because when they come into the office, they know now, this is my problem and here’s my treatment algorithm. I don’t have to wait two to three weeks, sort of in limbo, to find out what’s wrong with my knee or my shoulder.
Melanie: One of the most common tears, I imagine, that you see being rotator cuff because everybody – it just seems, so many people are getting rotator cuff tears today, whether they’re weekend warrior or older folks. Are you able to, with older people and some of these weekend warriors, also able to use the Mi-Eye to see these rotator cuff tears and then deal with them effectively?
Dr. McMillan: Absolutely. When we enter into the joint, the picture clarity is amazing. It’s like being in the operating room in the sense that I can see everything right there in its natural colors and its natural look. What’s nice about this is I can dynamically move the arm or the knee, so if I see the rotator cuff attached to the bone and it looks a little bit damaged, I can rotate the patient’s arm without causing any pain and see that tissue move the way it should, in unity, or unfortunately, sometimes I’ll see it move and it’s not in unity, meaning there’s a tear. At least that gives me good clarity. One of the problems with MRI is it’s static, so while an MRI is great in a lot of instances, in some cases, it doesn’t give us all the information that we need. This sort of obviates that problem.
Melanie: What an exciting innovation in sports medicine. Dr. McMillan, wrap it up for us, about the Mi-Eye procedure for patients with joint injury or joint pain and what you want them to know about coming to Lourdes Health System and checking this out.
Dr. McMillan: At Lourdes, we pride ourselves on being innovative and when it comes to orthopedic and sports medicine needs not only are we using this to find out what your problem is inside the joint, we’re using this to deliver treatment, too, whether it’s putting a biologic injection into a tear directly to make sure they heal appropriately, or just making sure that what we did previously surgical-wise has healed. We want to really get you back on your A-Game as quick as possible, so our goal is to get you in, get the answer, and devise a personalized plan for the patient that lets them get back to their life as quickly and safely as possible.
Melanie: Thank you, so much, for being with us today. It’s absolutely great information. You’re listening to Lourdes Health Talk, and for more information, you can go to LourdesNet.org, that’s LourdesNet.org. This is Melanie Cole. Thanks, so much for listening.
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