Specialist in Minimally Invasive Surgery Joins Foot and Ankle Service

Lorena Bejarano-Pineda, MD was born in Bogota, Colombia, and swam competitively in her early life. Her senior year of high school, she moved to Ontario, Canada, and discovered an interest in other sports, including basketball and soccer. Dr. Bejarano-Pineda attended medical school at the University of Antioquia in Medellin, Colombia, before pursuing a research fellowship in transplant surgery at the University of Illinois at Chicago. She then completed a residency in orthopedic surgery at the Pontifical Bolivarian University, where she focused her research on sport pathologies such as posterolateral instability of the knee, glenohumeral instability and rotator cuff tears of the hip.

After residency, Dr. Bejarano-Pineda returned to the U.S. to continue her medical training. She completed a research fellowship in foot and ankle surgery at Duke University, focusing on clinical outcomes after total ankle arthroplasty, total talus replacement, ankle fractures and midfoot arthritis. She followed this with a clinical fellowship, also at Duke University, in sports medicine, before joining the foot and ankle fellowship at Massachusetts General Hospital in 2020. Dr. Bejarano-Pineda then moved to France to wrap up her extensive training with a six-month travelling fellowship in percutaneous and minimally invasive techniques for foot and ankle surgery.

In 2022, following her work in Europe, she joined Mass General's renowned Foot and Ankle Service. Dr. Bejarano-Pineda currently sees patients on our main campus in Boston, as well as at our outpatient facilities at Mass General Waltham and Newton-Wellesley Hospital. We sat down with Dr. Bejarano-Pineda to learn more about her experience, her research interests and what led her to call Mass General home.

Why did you choose to work in health care?
I like the daily interaction with people and how much I learn from each encounter. There's a feedback loop—I share my knowledge with you, the patient, and you give me something back. I am very passionate about helping people improve their bodies' function and, ultimately, their quality of life!

What led you to orthopedics, and why, specifically, have you focused on foot and ankle care?
In medical school, I became fascinated with diagnosing people based on how they walk, their gait. There are many ways to help someone simply by addressing their posture, their step and their pace. As trauma specialists with rotations in the ER, our work does save lives, but most of the time we are focused on improving quality of life for non-emergency patients. This work matters just as much as keeping someone alive! I want my patients to be active, healthy and enjoy life, and orthopedic surgeons are the ones who can help make that happen.

I chose foot and ankle because of the diversity of the procedures involved. We have about 33 joints and 26 bones in each foot; a complex system that works in sync to allow us to bear weight and walk. We are constantly learning new techniques and developing devices that allow us to achieve better outcomes in our field. Our feet allow us to be active, work, spend time with family and friends; they play an integral role in daily life, and I enjoy being able to help people with something that matters so much.

Do you have any areas of specialization—something you're particularly focused on in your research or your practice currently?
I just returned from a fellowship in France, where I focused on minimally invasive surgical techniques that result in faster recovery times, less risk of infection and less postoperative pain. My plan is to build a strong minimally invasive surgery program here at Mass General. For foot and ankle, there are arthroscopic and fluoroscopic procedures that can be performed percutaneously, or “through the skin,” using small incisions. For those who may not know, an arthroscope is a camera with which the interior of a joint may be inspected before, during and after operation; a fluoroscope is an instrument used for observing the internal bony structures by means of X-rays. These innovative procedures allow us to treat many foot conditions on an outpatient basis—patients can leave the same day they have surgery! Mass General’s Waltham facility is ideal for treating foot and ankle conditions in a fast and convenient outpatient setting, and I’m looking forward to seeing patients there.

I also recently completed a sports medicine fellowship where I focused on cartilage restoration. These days, most of us try to lead an active lifestyle and are involved in a variety of sports and other athletic activities. We need healthy joints and cartilage to keep up this active lifestyle.

What brought you to Mass General?
During my fellowship at Mass General, I witnessed team unity and a strong spirit of collaboration. Mass General enabled me to work with an array of colleagues and specialized teams across the Mass General Brigham system—all with the shared goal of caring for and improving outcomes for the patient. Orthopedic surgeons here frequently collaborate with plastic surgeons, oncologists, infectious disease experts, cardiologists and more. Another thing I love about Mass General is the strong research focus. Our Foot and Ankle Service here works very closely with the Foot and Ankle Research and Innovation Lab (FARIL), so the clinical and research aspects of my work are side-by-side, both in my mind and in our physical facilities.

What do you see as the future of foot and ankle care? What are some innovations or trends in the field that have interested you?
I see a massive transition in orthopedic surgery towards minimally invasive procedures and outpatient surgery. This has been the trend for several years globally, and I think the COVID-19 pandemic has accelerated the transition to minimize in-hospital and recovery times. I've also noticed an increased focus on preventative medicine. As more people participate in sports, especially high-impact sports like running and triathlons, orthopedic clinicians need to work together with physical therapy and rehabilitation providers to educate athletes on overuse injury prevention. Mass General Brigham is invested in comprehensive sports medicine, and these sorts of collaborative clinical approaches are quite commonplace here.

What advice would you give to an athlete in terms of caring for their feet?
Focusing on just one sport may put a lot of stress on your joints. For example, if you're a runner, you need to do strength training exercises, such as weightlifting or using resistance bands. You need to activate all your muscles to avoid injury. It’s also very important to have good equipment, including footwear. There isn't one brand that’s the right fit for everybody—you have to get to know your body and pay attention to how equipment fits and feels when you put it on. Replacing your footwear with some frequency, based on the amount of training you do, is also important for injury prevention.

How would you describe your care philosophy?
Like any relationship, there has to be give and take between provider and patient. It's like a marriage, or a business. I am here to help you; however, to get great results, I need a little bit from you. Patients can contribute to their own care by thinking carefully about their condition and what factors are important to them (like mobility, speed of recovery time, long-term health, etc.). If they're able to focus on what they need help with, it’s much easier for providers to recommend the best, most appropriate care. With surgical treatment especially, patients playing an active role in their early recovery is key to achieving good outcomes.

What have you learned from your patients?
I’ve learned that you need to acknowledge and listen carefully to the human being that is in your office in order to help. I once treated a patient who came to me with foot pain. She had flatfoot deformity and a bunion. While the complexity and severity of the deformity interested me, it was also clear the patient's main concern was her bunion. She was uncomfortable and unable to fit in her shoes. So, I treated her bunion while letting her know she would continue to experience pain due to her deformity, and that surgery was typically recommended. She was ultimately happy that I had listened to her and focused my care on treating the bunion. This made me realize that while I have the specialized knowledge to advise patients on many conditions and take a holistic approach to their health, I am ultimately there to address their needs according to their wishes.

When you're not practicing medicine, what do you like to do in your free time?
I love running and have completed several half marathons! I do a little cross-training and HIIT between races to keep up a healthy exercise balance. I also like to listen to audiobooks, and I love to dance! Coming from Colombia, dance is a part of my heritage. If I'm working and tired, sometimes I will listen to some salsa music or even bust out some moves to bring my energy levels up. It's so fun!