Three orthopedic surgeons connected with Becker’s to discuss the cases they were most proud of in 2024.
Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all orthopedic surgeon and specialist responses.
Next question: What was the biggest obstacle you have faced in your career? How did you overcome it?
Please send responses to Claire Wallace at cwallace@beckershealthcare.com by 5 p.m. Central time Friday, March 14.
Editor’s note: Responses were lightly edited for clarity and length.
Question: What is the case you were most proud of in 2024?
Joseph Koressel, MD. Orthopedic Surgeon at Hoag Orthopedic Institute (Irvine, Calif.): I had a patient who underwent total knee arthroplasty by another surgeon. Due to spine issues that created weakness in the patient’s legs, the patient developed significant instability in the replaced knee. The spine issues were eventually fixed, but the knee instability remained, with approximately 30 degrees of hyperextension. The patient could no longer walk or perform activities of daily living. I revised the knee to a hinged component due to the recurvatum deformity. The patient was very thankful and was able to get their life back.
Bryanna Vesely, DPM. Foot and Ankle Specialist at the Orthopaedic & Spine Center (Newport News, Va.): Whenever you hear someone has had three surgeries on a foot already, often we think, “why would a fourth one help?” A kind, 64-year-old woman came in unable to wear shoes due to her forefoot deformity. She told me she has had three surgeries by two outside doctors already and still can’t tolerate shoes. As we all know, forefoot surgeries can be tricky as sometimes deformities reoccur despite our best efforts. We had a thorough discussion about the risks of having a fourth surgery and the difficult nature of revision surgery. However, she wanted to give it a try. I performed revision HIPJ arthrodesis for previous non-union, 2nd Weil osteotomy and 2-5 revision hammer toes. Happy to say, she has recovered beautifully and can now wear regular shoes. Her correction has maintained (so far) and she is ambulating with no pain. While a lot of time the idea of a (triple) revision surgery makes us want to lean towards conservative treatment, I am happy to say this surgery worked and the patient is ecstatic.
Erick Westbroek, MD. Neurospine Surgeon at Providence St. Jude Medical Center (Fullerton, Calif.): If I had to pick the surgical case I’m most proud of from 2024, it would be a 50-year-old man who had been living with the devastating effects of an old thoracolumbar trauma. Years ago, he had undergone a thoracolumbar decompression and fusion, but over time, things deteriorated — his hardware was removed, and he developed severe compression fractures at T12, L1, and L2. The result? An 83-degree kyphotic deformity that made it impossible for him to stand upright or even lie flat.
When I first met him, his quality of life had been completely stolen by his condition. He couldn’t rest comfortably, and every movement was a struggle. We decided on a two-part surgical plan: first, an L1-L2 XLIF with anterior column release, followed by T11-T12, T12-L1, and L1-L2 Ponte osteotomies and a long-instrumented fusion from T4 to the pelvis. It was an extensive reconstruction, but it gave him the best chance at regaining a more natural posture and, most importantly, a life without constant discomfort.
The moment that will always stick with me happened in the PACU. As he was waking up from anesthesia — still groggy, still half-dreaming — he kept repeating the same thing over and over: “It’s the first time I’ve been able to lie flat in years.” That moment, right there, reminded me why I do this work.
