“When I talk to a patient after surgery, my goal is that they are happy to have had surgery”
“When I talk to a patient after surgery, my goal is that they are happy to have had surgery,” says Dr. Milan Moore, an fellowship-trained and board-certified hip and knee surgeon at OOA. In fact, he hopes that patients have such a positive surgical experience that they would be willing to do it all again in a heartbeat. According to Dr. Moore, much of a patient’s success is determined by their readiness for surgery and active participation in the process. “If you don’t enjoy the journey, you won’t like the destination,” he says.
With years of advanced training and experience in the latest joint procedures and innovative protocols, Dr. Moore actively pursues holistic medicine that combines traditional methods with consideration of individual needs, anatomy, and lifestyle. Here’s how he does it.
An Individualized Approach
“In total joint replacement surgery, we know that not all outcomes are the same,” says Dr. Moore. Although surgeons can be very consistent in what they do, patient outcomes may differ greatly. This has been an intriguing issue to Dr. Moore, who has spent his career identifying patient variables and looking for ways to achieve optimal outcomes.
Throughout his quest, he has identified key factors such as inflammation, body habitus (muscle versus fat content), muscle conditioning, overall balance, and range-of-motion. His goal is to meet people where they are with these various factors and get them to an optimal state before proceeding with surgery. As part of his individualized approach, he often coaches patients on conditioning, range-of-motion, and nutrition/weight management.
“We tend to focus on objective factors but my sole goal is to get the individual the best result. This requires an individualized approach.”—Dr. Milan Moore
Conditioning
In non-COVID times, Dr. Moore encourages his patients to establish a fitness routine at the local gym to maintain muscle conditioning, sometimes at a local gym. During the pandemic, Dr. Moore has encouraged his patients to find alternative methods to condition and tone their muscles. One solution that he recommends at all times is yoga because of its unique ability to increase the strength of joints. Yoga combines range-of-motion exercises with endurance training and balance-improving positions. It also avoids the rigours and high-impact nature of fitness programs such as Crossfit or aerobic classes.
“Yoga is exactly what we need for life through the aging process: endurance, strength, flexibility, and balance,” comments Dr. Moore. The simple things in life—like being able to tie shoes, shower independently, and reach a top shelf—can be challenged by age-related orthopaedic issues. Dr. Moore wants all of his patients to enjoy true independence, no matter what their age might be. For him, yoga is the right answer to this challenge. He also recommends water aerobics for fairly debilitated patients, who can benefit from range-of-motion exercises and some marginal strengthening in a low-impact setting.
Range-of-Motion
When discussing how to make a joint replacement successful, Dr. Moore tells his patients that he is only part of the equation. “I can achieve alignment and stability through surgery,” says Dr. Moore, “but achieving great range-of-motion depends on you!”
Patients can do this by actively participating in physical therapy and putting in the hard work to build up muscle. In order to avoid increased pain or a stiff joint in the future, a patient needs to use their new joint regularly.
When deciding what may work best for each patient, Dr. Moore talks to patients about their personal goals. Some people may simply want to be able to walk to their mailbox while others may want to run a marathon. As a baseline goal, patients are encouraged to walk a little farther each day after surgery. And, of course, Dr. Moore also recommends yoga for this important aspect of surgical readiness and recovery!
Nutrition & Weight Management
“It’s important to me to look at the patient rather than the condition. I’m not treating a hip or knee, I’m treating an individual,” says Dr. Moore. As part of this approach, Dr. Moore examines an individual’s nutritional state as part of their overall health picture. He has been particularly interested in the role of vitamin D as a foundation of health. According to Dr. Moore, most individuals living in the Pacific Northwest are vitamin D deficient. As part of a surgical or non-surgical treatment strategy, he works with patients to build up adequate vitamin D stores.
“When is the last time your doctor asked you what you ate?”—Dr. Milan Moore
Dr. Moore educates patients on the importance of excellent nutrition following surgery. “Many patients think that pain may be the most limiting factor after surgery. Actually, it’s often fatigue. Healing requires a huge amount of metabolic energy.” Orthopaedic surgery—even if it is done arthroscopically through small incisions—is significant surgery. It requires a lot of effort for your body to heal, so good nutritional resources (like green leafy vegetables) are essential for a good recovery.
Although it’s now standard to do weight management as part of a surgical readiness program, Dr. Moore incorporated this strategy into his practice decades ago. In the past, he personally ran biweekly weight management programs. Now that he works with the multidisciplinary team at OOA, he encourages his patients to take advantage of speaking with Dr. Leila Borders, who is a weight loss/surgical readiness specialist who works with our Sports Medicine team among other things.
Teamwork Makes the Dream Work
At its core, Dr. Moore’s approach to patient care is one of teamwork. He believes in candid communication and mutual accountability.
“We’re working on your body as a team,” he says. “That’s probably why I tend to have many patients who want to really understand what is going on with their body and be an active participant in their health.”
As part of his teamwork approach, Dr. Moore listens intently to his patients and works to explain things clearly. It’s important to him to understand where patients are at in their journey and meet them there. This involves an evaluation of the whole person, including their activity goals and expectations in relation to their joint function. From there, Dr. Moore works closely with patients to set goals and create a customized treatment plan to get them there.
Want to book an appointment with Dr. Moore to discuss how his holistic approach can help you? Book here.
Dr. Milan Moore
Board Certified Orthopaedic Surgeon
Dr. Moore graduated summa cum laude with his undergraduate degree from Yale University in New Haven, Connecticut. He went on to Boston, Massachusetts, to earn his graduate degree in public health and his medical degree from Harvard T.H. Chan School of Public Health and Harvard Medical School. After receiving his surgical internship and orthopaedic residency training from Walter Reed Army Medical Center in Washington, D.C., Dr. Moore served as the chief of orthopaedic service at Carl R. Darnall Army Medical Center in Fort Hood, Texas.
After choosing to undergo additional specialty training, Dr. Moore completed a joint replacement fellowship at Anderson Orthopaedic Clinic and Anderson Orthopaedic Research Institute in Alexandria, Virginia. He was certified by the American Board of Orthopaedic Surgery in 2000, and he joined Olympia Orthopaedic Associates in April 2017. When he is not seeing patients, Dr. Moore enjoys skiing and practicing yoga.