Physician Q & A

Dr. David W. Waddell, MD

About Dr. Waddell
A leading orthopedic surgeon, Dr. Waddell is a member of one of the largest orthopedic clinics in the southern United States. His practice focuses on disorders of the knee, arthroscopy, joint replacement, sports medicine, and general orthopedics. He is one of the most experienced physicians in the country regarding the use of viscosupplementation in the treatment of osteoarthritis (OA) knee pain—with over 2,500 patients treated—and the author of numerous articles on the subject. A Fellow of the American Academy of Orthopaedic Surgeons (AAOS), Dr. Waddell has been certified by the American Board of Orthopaedic Surgery since 1980.

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. Waddell is a paid consultant of the Genzyme Corporation.

Dr. David W. Waddell, MD

“…the more favorable dosing schedule of SYNVISC, combined with its magnitude of pain relief and tolerability profile, makes it my viscosupplement of choice.”

Leadership Forum (LF): Over 12,000 SYNVISC injections—that’s a significant number. How has viscosupplementation changed the way you treat OA knee pain?

David Waddell (DW): It’s given me an effective and well-tolerated option for those patients who have failed on other conservative treatments. I have a knee-only practice, so I see a lot of patients who have already run the range of nonpharmacologic and oral therapies for knee OA, including physical therapy, analgesics, and NSAIDs. For these patients, viscosupplementation has become one of my primary treatment considerations.

I also see a significant portion of patients, referred to my practice by other physicians, who might otherwise be candidates for knee replacement. Viscosupplementation is a viable alternative for those patients who would like to avoid, or at least delay, surgery.

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. Waddell is a paid consultant of the Genzyme Corporation.

Dr. Nicholas DiNubile, MD

About Dr. DiNubile
An orthopedic surgeon specializing in sports medicine, Dr. DiNubile is in private practice in Pennsylvania. He is also Clinical Assistant Professor at the Hospital of the University of Pennsylvania and author of FrameWork: Your 7-Step Program for Healthy Muscles, Bones, and Joints. His related activities have included being an advisor to The President’s Council on Physical Fitness and the orthopedic consultant to the Philadelphia 76ers and Pennsylvania Ballet. In addition, Dr. DiNubile has been extensively featured in broadcast media, including CNN, Good Morning America, and NPR; and in print media such as The New York Times, The Wall Street Journal, and Newsweek. His professional affiliations include the American Academy of Orthopedic Surgery and the American Orthopedic Society for Sports Medicine.

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. DiNubile is a paid consultant of the Genzyme Corporation.

Dr. Nicholas DiNubile, MD

“Compared to prior generations, a significantly larger proportion of the boomer generation are participating in sports and fitness activities, putting added strain on aging knees.”

Leadership Forum (LF): You’ve spoken many times on the dramatic increase in the incidence of knee osteoarthritis (OA) among baby boomers. To what do you attribute this increase?

Nicholas DiNubile (ND): Based on the kind of middle-aged patients who present with knee OA in my practice, I think the reason for this “boomeritis” is twofold. First, a lot more of these people are staying active later—compared to prior generations, a significantly larger proportion of the boomer generation are participating in sports and fitness activities, putting added strain on aging knees. At the other end of the spectrum, a key risk factor for knee OA is obesity. Ironic, isn’t it?

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. Shields is a paid consultant of the Genzyme Corporation.

Dr. Clarence L. Shields, Jr. MD

About Dr. Shields
Specializing in sports medicine, Dr. Shields is an orthopedic surgeon at the Kerlan-Jobe Orthopaedic Clinic in Southern California. In addition to holding faculty positions at the University of Southern California and the Charles Drew School of Medicine, Dr. Shields is the author of more than 40 publications, including textbooks and journal articles. In addition, he is affiliated with more than 15 professional organizations and societies and has been a facilitator for over 200 lectures. Board certified by the American Board of Orthopaedic Surgery and the National Board of Medical Examiners, Dr. Shields is a past president of the American Orthopaedic Society for Sports Medicine.

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. Shields is a paid consultant of the Genzyme Corporation.

Dr. Clarence L. Shields, Jr. MD

"Before considering viscosupplementation, I look to the modifiable factors, such as changing activities, decreasing body weight, and increasing strength…"

Leadership Forum (LF): Where does viscosupplementation fit in the treatment spectrum for your patients with mild to moderate knee osteoarthritis (OA)?

Clarence Shields (CS): Before considering viscosupplementation, I look to the modifiable factors, such as changing activities, decreasing body weight, and increasing strength, which improves the shock-absorbing ability of the knee joint. These steps give many patients a certain level of symptom relief. Next, I would probably start them on anti-inflammatory medication along with physical therapy. If after a couple of months those steps prove to be insufficient, or if I’d like to provide patients with a greater magnitude of relief, I might recommend viscosupplementation.

The OA Leadership Forum is a service of Genzyme Corporation.
Dr. Shields is a paid consultant of the Genzyme Corporation.