Greenwich Orthopedics Archives - Orthopaedic & Neurosurgery Specialists

Another Award for Dr. Sethi

Posted on February 27, 2018

Congratulations to ONS orthopedic surgeon, Dr. Paul Sethi, who has earned the 2018 AAOS Achievement Award again this year from the American Academy of Orthopaedic Surgeons. The AAOS Award recognizes members for their active volunteer efforts and their contributions to education, research and advocacy in the profession of orthopedic surgery. Dr. Sethi received this prestigious award in 2017 as well.

A sports medicine, shoulder and knee specialist, Dr. Sethi is also a leading research physician who speaks at academic and instructional medical conferences in the US and abroad. His research on surgical advances for the shoulder, elbow and knee is regularly published in leading medical journals including the Journal for Shoulder and Elbow Surgery, Arthroscopy, and the Journal of American Academy for Orthopaedic Surgery. He also collaborates with outside companies for education and research purposes and to develop medical procedures on the shoulder, elbow and knee. He is a member of the prestigious American Shoulder and Elbow Society and American Academy of Orthopedic Surgeons.

As President of the ONS Foundation for Clinical Research and Education, Dr. Sethi’s research has recently included clinical study of the use of a long lasting analgesic, Exparel, during surgery. This will reduce the need for opioids to control post-surgical pain; the establishment of better methods for surgical skin preparation (cleaning) to lower the risk of surgical infection; development of a new technique to repair chronic or weakened biceps tendons; and the evaluation of surgical needles in tendon surgery to establish international guidelines on needle use.

ONS Dr. Seth Miller is Featured in WAG

Posted on September 28, 2017

Top shoulder surgeon Dr. Seth Miller is featured in an article titled “A (Medical) Shoulder to Lean On” in the October issue of the Westchester magazine, WAG. The piece, written by Jane Dove, was released online on September 26, 2017. Ms. Dove delivers a comprehensive view of Dr. Miller’s distinguished career and founding prinicple of ONS, one of the region’s premier orthopedic and neurosurgical practices. She is also able to capture the unique formula that sets ONS apart from the competition: the highest standard of care, the collaborative approach among specialists in the practice and patients, and the compassion for patients’ individual conditions and treatment goals.

The entire article is copied below:

A (MEDICAL) SHOULDER TO LEAN ON by Jane Dove

“I am personally very proud of our practice — Orthopaedic & Neurosurgery Specialists (ONS) and the way we treat each patient as an individual,” says Seth R. Miller, an orthopedic surgeon who specializes in arthroscopic shoulder surgery and shoulder replacement.

With offices in Greenwich and Stamford and now Harrison, ONS takes a conservative approach to patient care. “We recommend surgery to only about 10 percent of our patients,” says Miller, who is also a clinical assistant professor of orthopedic surgery at the Hospital for Joint Diseases; a staff orthopedic physician at Greenwich Hospital and an assistant attending physician in orthopedic surgery at New York-Presbyterian Hospital. “We want to make sure it is really needed, because we realize that surgery in any of our subspecialties is a traumatic event for our patients. If it can be avoided, so much the better.”

A leading specialist in shoulder replacement surgery with 1,000 total shoulder and reverse shoulder replacements to his credit, Miller helped found ONS in 1998. There he remains committed to providing excellent orthopedic and neurosurgical care through professional cooperation while showing compassion for patients. By setting the highest of standards, ONS can offer patients a wide range of choices that leads to the best possible outcomes.

“For example, if needed, we will have two surgeons involved in a complicated procedure,” he says. “We do everything we can to ensure the results our patients get are the very best possible. And we deliver those results with compassion and understanding along the way.”

SPOTLIGHT ON SHOULDERS

After graduating from Harvard University in 1978, Miller went on to get his M.D. at the Mount Sinai School of Medicine, followed by a residency in general surgery and then a sought-after one-year residency in shoulder surgery at Columbia-Presbyterian Medical Center.

“I studied under the renowned Dr. Charles S. Neer, who offered me this wonderful opportunity,” he says. “I was always interested in the shoulder and had a great year with him, from l988 to 1989. At about the same time, I met another shoulder specialist who invited me to join him at Greenwich Hospital.”

Miller says Greenwich had many orthopedic surgeons on staff but most practiced in the general area. “I did my share of general orthopedic surgery but really wanted to do as much shoulder surgery as possible. I spoke with several other subspecialists who, like me, wanted to improve patient care by combining several of our doctor’s groups into one entity.”

In 1998, the group took the plunge and founded ONS, starting with only eight physicians.

EXPANSION

ONS now has 22 subspecialty physicians trained in orthopedic surgery, sports medicine, physical medicine and rehabilitation.

“Things really took off when patients realized they could get specialty care of the highest quality right in Greenwich. We now have two specialists for every part of the body.”

The successful reception ONS earned from the local patient community there led to its expansion, first to Stamford and then to a new facility in Harrison.

Miller says he believed one of the keys to the success of ONS has been the one-stop approach the practice offers.

“Our patients just love that we can provide so much under one roof,” he says. “Everything is right here and there is no need to trek from outside office to outside office for tests, scans and blood work. We function as a team of doctors and other medical professionals, working closely and seamlessly together.”

If a question about care or a procedure that can best be answered by another specialist comes up, Miller says, “All we have to do is walk down the hall. Patients find this very comforting and we pride ourselves as working as a collaborative team. At ONS you get the best possible care all under one roof. While our practice is large, it is very effective and attuned to the patient, what he or she really needs.”

SATISFIED PATIENTS

He believes ONS is well-served, as are its patients, by not being a part of a larger patient care “network system.” The proof is in the response. “We get positive feedback in the 96 to 97 percent range,” he says.

“As a result, we are not controlled so much by cost-cutting to enhance the bottom line of the network. As a private practice, we control our own destiny and even have our own foundation. We are free and now big enough to control our financial destiny on our own.”

Orthopedic Patients Applaud New Pain-Reducing Procedure

Posted on October 28, 2016

OPIOIDS AFTER ORTHOPEDIC SURGERY COULD BECOME A THING OF THE PAST.

Recovery from total shoulder replacement surgery usually includes weeks of excruciating pain. This was not the case for Manhattan, NY resident, Marjorie Purnick, 71, who was out to dinner with friends the night after Dr. Paul Sethi performed the procedure using a new, slow release analgesic called Exparel. Marjorie said she has never taken a single pill for pain in the four months since her shoulder replacement surgery.

“It was incredible. I kept waiting for the pain to hit, but it never did. Friends who have had the same surgery don’t believe me when I tell them that I had no pain,” she said. With the help of physical therapy, Marjorie has regained close to 100 percent of her range of motion, a recovery that she said is 4 to 8 months quicker than her friends. “I think I’ve recovered so quickly because I didn’t have pain holding me back. I could get started with therapy right away.”

As soon as 49 year old Michele Herrera of Rye, NY heard about this new pain treatment, she asked Dr. Sethi to use it during her surgery to correct torn biceps and bone spurs in her right shoulder. Vivid memories of the agonizing pain she had endured following a similar surgery on her left shoulder five years ago had been preventing her from undergoing the procedure again.

“I was petrified to have the surgery again because of that pain,” she recalled. This time around, however, it was completely different. “I am the happiest person in the world. I had surgery on Thursday and I was out walking the dog that same day.” When the medication did start to wear off 4 days later, she said she took pain medication because she afraid of how intense the pain would be. She was pleasantly surprised. “I only took one pill instead of two, and once I realized that I only felt a little sore, I switched to Tylenol.”

The search for an alternative to opioids at ONS is borne from a real concern about the increasing national opioid addiction epidemic and the role prescribed opioids like oxycodone and hydrocodone play in addiction. Every day, 78 Americans die from an opioid overdose, according to The Centers for Disease Control and Prevention. Since the late 1990s, the number of deaths from prescription opioids has quadrupled.

“It is frightening as a surgeon to think that an opioid prescription that is intended to help a patient recover could lead to a lifelong battle with addiction or death,” said ONS orthopedic surgeon, Paul Sethi, MD. He has seen college athletes in need of surgery who are willing to suffer great amounts of pain if it means avoiding opioids post-surgery.

Dr. Sethi and ONS colleagues Seth Miller, MD, Katherine Vadasdi, MD and Marc Kowalsky, MD, have been performing shoulder surgeries with the use of this new analgesic, that is injected directly into the surgical site and numbs the area for three days or more. Some patients who have been administered Exparel have not needed any narcotics for pain, or if they did, they’ve needed far fewer than with traditional post-surgical pain control, Sethi said.

“When patients need additional pain relief instead of prescribing 30 narcotic pills post-surgery for instance, there is only a need to prescribe 10,” he said.

Moreover, patients are able to regain movement more quickly because they are not consumed by pain.

Physicians at ONS are optimistic that as more non-narcotic methods of pain relief are made available, the number of prescribed opioids for surgical pain will plummet. Sethi and others in the practice are conducting a peer-reviewed study about Exparel’s overall effectiveness in reducing pain after other types of surgeries. “The injection has to be specifically tailored to each surgery in order for it to be effective,” Dr. Sethi said.
They plan to expand its use for other surgical procedures such as repairs to ruptured anterior cruciate ligaments (ACL).
Currently, about 70 percent of opioids used for non-medical reasons are obtained through family or friends and 18 percent through a prescribing doctor, according to the Substance Abuse and Mental Health Services Administration.

Solutions for Hand, Wrist and Elbow Pain

Tips to manage chronic hand, wrist and elbow pain.

Chronic upper extremity pain affects as much as 20% of the population at any given time and can lead to significant disability and time away from work and activities. It can originate anywhere from the neck to the fingertips and can have a wide range of underlying causes from nerve compression and ligament injury to degenerative arthritis. Learn about common causes of hand, wrist and elbow pain, ways to lower your risk of developing it, and strategies to keep the pain under control at this informative discussion by ONS orthopedic surgeon, Matt Cantlon, MD, a specialist in upper extremity conditions. There will be time for audience questions following the presentation. Free. Registration required. Call 203.863.4277 or register online at greenwichhospital.org

New Pain Reducing Procedure Studied by ONS Orthopedic Surgeons

Posted on October 3, 2016

GREENWICH ORTHOPEDIC SURGEON DR. PAUL SETHI AND THE ONS PRACTICE WERE FEATURED IN AN ARTICLE IN GREENWICH PATCH FOR USING A NEW PAIN-REDUCING PROCEDURE THAT CAN REDUCE OR ELIMINATE THE NEED FOR NARCOTICS.

In the article, Greenwich Surgeon Strives to Combat Opioid Epidemic with New Procedure, Greenwich Patch staff writer, Rich Scinto, wrote that oftentimes opioid addiction begins after surgery.

Following is the article in its entirety:

Opioids post-surgery have become a double-edged sword in the wake of an increasing addiction epidemic. While they have great pain-reducing powers, they also carry the risk of addiction and the chance that pills can fall into the hands of an addict.

A group of orthopedic surgeons based in Greenwich are using a new pain-relieving method that helps reduce a patient’s reliance on opioids.

Dr. Paul Sethi with Orthopaedic and Neurosurgery Specialists recently has seen collegiate athletes in need of surgery who are willing to suffer great amounts of pain if it means staying off of opioids post-surgery.

“Young people are becoming more aware of how dangerous of a problem it is,” Sethi said about opioid addiction.

It is also frightening as a surgeon to think that an opioid prescription that is intended to help a patient recover could lead to death or a lifelong battle with addiction, he said.

Sethi has been performing shoulder replacement surgeries with the use of Exparel, which is an injection of long-lasting liposomal bupivacaine that can last for three days post-surgery. Some patients have used no narcotics or a greatly reduced amount after the surgery, Sethi said.

Instead of prescribing 30 narcotic pills post-surgery generally there is only a need to prescribe 10, he said. That translates to less pills that could fall into an addict’s hands.

The prescription of opioid pain relievers has skyrocketed. In 2013 health-care providers wrote 259 million prescriptions, enough for every American adult to have a bottle of pills, according to the CDC.

About 70 percent of opioids used for non-medical reasons are obtained through family or friends and 18 percent through a prescribing doctor, according to the Substance Abuse and Mental Health Services Administration.

Sethi and others are conducting a peer-reviewed study about Exparel’s effectiveness in reducing pain after surgery.

Sethi and others at the practice plan to expand the use of Exparel to other types of shoulder surgery and there is potential to use it in operations such as ACL repairs. The injection has to be specifically tailored to each surgery in order for it to be effective, he said.

Surgeons should spend a good amount of time educating their patients about pain management and the potential for opioid abuse.

“In medicine we are pressed for time, but I think this is one of the most important things we teach our patients about,” he said.

The injection costs about $300 extra, which is a bargain if it can save a person from an overdose death or a long struggle with addiction, Sethi said.

For now narcotics still are prescribed in case pain comes back after Exparel wears off.

ONS Shoulder Surgeon Katherine B. Vadasdi, MD, is Published

Posted on August 4, 2016

STUDY FINDS SUCCESS IN TREATMENT FOR FROZEN SHOULDER.

Promising results of a new study by ONS orthopedic shoulder surgeon Katherine Vadasdi, MD and other researchers were published this month in the Journal of Shoulder and Elbow Surgery. The study, The Effect of Myofibroblasts and Corticosteroid Injections in Adhesive Capsulitis, was conducted to investigate the effect that steroid injections administered directly into the shoulder joint would have on the painful and limiting condition called Adhesive Capsulitis.

Also known as Frozen Shoulder, Adhesive Capsulitis is a common, severely painful condition that leads to stiffness and reduced range of motion in the joint. In the study, Dr. Vadasdi and the research team evaluated the changes in the lining of the joint that contributes to or causes Frozen Shoulder. They discovered an increase in a certain cell type called myofibroblasts, which cause the capsule surrounding the shoulder joint to contact and form scar tissue, leading to pain and increasing stiffness. Steroid injections directly into the joint, however, reduced the increase in myofibroblasts, and helped reverse and prevent progression of the condition.

Frozen Shoulder most commonly affects women between the ages of 40 and 60 years. Most cases of Frozen Shoulder can be resolved non-operatively through stretching, physical therapy, anti-inflammatory medications and cortisone injections. In severe cases, a procedure known as arthroscopic capsular release is performed to break up the adhesions. The findings in Dr. Vadasdi’s study suggest a more rapid resolution of the condition and possibly a decrease in cases needing surgery.

The Effect of Myofibroblasts and Corticosteroid Injections in Adhesive Capsulitis, Carolyn M. Hettrich, MD, MPH, Edward F. DiCarlo, MD, Deborah Faryniarz, MD, Katherine B. Vadasdi, MD, Riley Williams, MD, Jo A. Hannafin, MD, PhD. 1274-1279. Journal of Shoulder and Elbow Surgery (25) 2016

Dr. Vadasdi is an orthopedic surgeon and sports medicine physician who specializes in conditions of the shoulder, knee and elbow. She is the Director of the Women’s Sports Medicine Center at ONS and is a sought after speaker on the topic of women and sports injury and prevention. Her chosen area of medical specialty reflects her personal interests. She is an accomplished triathlete, having completed Ironman competitions in 2007 and 2009. Dr. Vadasdi is also an alpine climber and has ascended Mount Kilimanjaro, Mount Rainier, and the Grand Teton, among others.

ONS Names Sally Frank Chief Operating Officer

Posted on August 1, 2016

Orthopaedic & Neurosurgery Specialists (ONS) announced today the appointment of Sally Frank to the new position of Chief Operating Officer. Frank has been an integral part of the practice since 2004, starting first as a Marketing and Communications Consultant. She was hired as Director of Marketing in 2009, and two years later became Director of Operations. In 2013, she was promoted to Executive Director.

During Frank’s tenure, she has overseen the development of the ONS brand as representing excellence in orthopedic and neurosurgical care in Fairfield and Westchester counties and beyond. Operationally, she has managed the rapid expansion of the practice to accommodate additional specialists and the growing demand for physical therapy services at 6 Greenwich Office Park in Greenwich. Last year, Frank directed the opening of a second ONS location, a state-of-the-art 14,000 square foot office and physical therapy center at 5 High Ridge Park in Stamford. Currently, Frank is preparing for the 2017 opening of a third, similar facility in Westchester and further expansion at the new Stamford office.

“Sally has deftly implemented communications strategies and operational structures that have allowed ONS to manage significant growth while keeping the focus squarely on high quality patient care,” said ONS president, Seth Miller, MD. As COO, Frank will build on strategic initiatives to keep ONS at the forefront of an increasingly competitive market, he said.

Presently, ONS has more than 150 employees and 23 physicians, MRI and digital X-ray suites, and two physical therapy departments with 15 physical therapists. One driving force behind ONS’s success is the caliber of its physicians, who are handpicked by the ONS partners from the most respected medical institutions in the country. The practice has become known and admired across the region not only because of its exceptional orthopedic and neurosurgical care, but for its emphasis on the patient experience. ONS physicians work as a team within specialties to deliver the best possible outcomes for patients. The physicians are fellowship-trained and sub-specialized and take a conservative approach to treatment whenever possible. For that reason, only 10 percent of ONS patients require surgery. ###

The Dangers of Sports Specialization

Posted on July 14, 2016

Every young athlete dreams of the pride and exhilaration of hitting the game winning home run, or scoring the goal that clinches the championship. In today’s competitive sports environment, youth are under more pressure than ever to train harder and longer to excel in their sport, often with debilitating consequences, writes sports medicine specialist and orthopedic surgeon, Demetris Delos, MD in the latest issue of The Magazine for Greenwich Hospital.

The greatest shift in youth sports in the last generation has been the trend toward sports specialization and year-round training. Twenty years ago, young athletes typically played a particular sport only during that sport’s season (i.e. football in the fall, baseball in the spring and summer), and most kids sat out a season or a summer. Today’s young competitors don’t seem to enjoy that luxury. Unfortunately, this has also led to a surge of sport specific injuries.

A recent study at the Departments of Kinesiology, Orthopedics and Rehabilitation at the University of Wisconsin-Madison, for instance, found that high school athletes who trained in one sport for more than 8 months were more likely to report a history of overuse knee and hip injuries, than those who had played a variety of sports throughout the year or played sports at less intense levels.

The results of this study reflect what orthopedists have noticed in the last decade with the increasing number of kids showing up in our offices with throwing injuries, torn knee cartilage and stress fractures.

PROFESSIONAL LEVEL INJURIES

The growing corps of young adolescents and pre-adolescent baseball pitchers is now throwing excessive numbers of pitches during an unusually high number of innings for immature arm muscles. This has led to an epidemic of young athletes suffering ulnar collateral ligament (UCL) injuries, requiring the so-called Tommy John Surgery. Tommy John was a left handed pitcher for the Los Angeles Dodgers in the 1970’s, who was the first baseball player to undergo UCL reconstruction surgery. His successful recovery and return to achieve a record of 288 career victories.

Anterior cruciate ligament (ACL) tears in youth athletes are also increasing at an alarming rate. While ACL tears are not so closely related to a particular sport statistic the way UCL injuries are tied to pitch count, clearly the rapid rise of sports that involve running and sudden pivoting – think soccer, lacrosse, football, basketball and rugby – increases the likelihood of season ending ACL tears and reconstructive surgery.

OVERUSE INJURIES

Unlike ACL injuries, which can be dramatic on-field experiences with players being helped off the field, the vast majority of injuries associated with excessive specialization and training are overuse injuries. Overuse injuries develop slowly over time, starting perhaps as a mild twinge before progressing into relentless, often debilitating pain. Ironically, these injuries are relatively easy to treat with a period rest and activity modification. All too often, players, their coaches and, sadly, parents, are often reluctant to have the athlete sit out a few practices and games. Left untreated, overuse injuries can lead to tears in the muscles and tendons of the affected area, which require a lengthier rehabilitation and sometimes surgery.

Overuse injuries are typically sport specific. In baseball, the upper extremity is most often affected. With Little league shoulder, the growth place of the humerus (arm bone) becomes inflamed by the repetitive motion of throwing with excessive force. Similarly, Little league elbow involves injury to the growth plate along the inner portion of the elbow.

In the lower extremity, overuse injuries of the knee and ankle are very common. Osgood Schlatter and Jumper’s knee are injuries to the growth plate of the knee that can be a frustrating source of pain. These injuries are typically associated with repetitive impact activities (running, jumping, etc.) as seen in basketball, soccer and track. In the ankle, Sever’s disease can lead to pain in the back of the heel.

HOW CAN WE PREVENT INJURIES?

The solution is simple but that doesn’t mean it is easy. Rest and activity modification can be difficult to execute in the middle of the season when the athlete is invested in playing and when parents have already invested much time and money to the sport.

Nevertheless, it is incumbent upon parents to insist their child rest to give the body the opportunity to heal before more serious injury occurs. If a week or two of rest doesn’t resolve the condition, the young athlete should be evaluated by an orthopedist or sports medicine specialist.

Repetitive activities such as throwing or running can lead to changes in the development of growing bones and joints. It has been known for some time now that significant amounts of pitching during adolescence can change the rotation and shape of the shoulder.

Moreover, there is a growing body of evidence indicating certain sports played excessively during adolescence are associated with the development of femoroacetabular impingement syndrome (hip impingement), which can lead to hip problems often requiring surgery in adulthood.

In addition, numerous studies have shown that exposure in youth to a range of different sports that utilize different muscle groups and mechanical skills lead to the greater overall athleticism and better athletes.

ONS is Proud Sponsor of KIC-IT Triathlon

Posted on May 25, 2016

ONS IS PROUD TO SPONSOR THE KIDS IN CRISIS KIC-IT TRIATHLON SPORTING EVENT FOR THE THIRD YEAR.

KIC-IT is a vital fundraiser for Kids in Crisis, Connecticut’s only free, round-the-clock crisis counseling center and temporary emergency shelter for children of all ages and families dealing with abuse, neglect, homelessness, mental health issues or extreme family conflict. More than 800 athletes from throughout the Tri-state area are expected to participate in this popular two-day event. ONS is proud to support our community’s children in need and the important work of Kids in Crisis.

The Kids Triathlon takes place on Saturday, June 11 at Cove Beach in Stamford. Adults will compete on Sunday, June 12, in a variety of contests including the ninth annual Navigators Stamford KIC IT Olympic Triathlon, third annual Navigators Stamford KIC IT Sprint Triathlon and second annual Navigators Stamford KIC IT 5k and 10k races. These USAT-sanctioned races lead athletes over courses along the Long Island Sound and throughout the city of Stamford.

Visit our booth during the Family Festival on Sunday from 9 am – 12 noon, where you can Spin to Win and test your knowledge of the body’s musculoskeletal system, injuries and treatments!

2016 Joint Replacement Symposium

Considering Joint Replacement Surgery?

If severe joint pain is interfering with your enjoyment of daily life, come hear orthopedic surgeons Frank Ennis, MD, Brian Kavanagh, MD and Seth Miller, MD, from ONS and Greenwich Hospital joint replacement specialists present an informative and comprehensive panel discussion about the latest advances in joint replacement surgery. From your first office appointment through surgery and recovery, you will learn what to expect before, during and after the procedure. Topics will include computer-assisted surgery, minimally-invasive & muscle sparing techniques, pain management and physical rehabilitation. There will be an opportunity to have your questions answered following the presentation.

Double Shoulder Replacement Restores Mobility

Posted on May 5, 2016

SHOULDER REPLACEMENT REGAINS HIS ACTIVE LIFESTYLE JUST MONTHS FOLLOWING SURGERY.

Arthritis had taken its toll on Dave’s shoulders. He was in constant pain. Sleeping was difficult and it was nearly impossible for him to take part in activities that he loves. Then, two friends with similar shoulder issues referred Dave to shoulder surgeon, Dr. Seth Miller at ONS. “When I met him, I immediately knew he was the doctor I wanted to care for me. He was thorough, thoughtful and patient. He has a great bedside manner and took the time to completely answer all my questions,” he recalled.

Dave had his first shoulder replacement in January, 2013; the second one was done a year later. In both instances, the therapists had him doing exercises the day after surgery, which he continued at home within the week. Through a physical therapy program over the next few months, Dave was able to build muscle mass to help support his new shoulders.

Just 16 weeks after surgery, Dave was back on the water kayaking pain free. These days, he goes to the gym 2- 3 times a week and kayaks quite a bit on ponds, lakes and streams. He can even carry his kayak.

“I am so grateful to have my active life back, thanks to ONS!” he said.

Shoulder replacement surgery and reverse shoulder replacement surgery is not for everyone. In many cases, treatment such as icing, anti-inflammatory medication and physical therapy can help get shoulder pain from arthritis under control. However, if pain persists, as it did with Dave, it may be time to consider a surgical option, notes Dr. Miller.

With arthritis and some fractures and injuries, the cartilage of the shoulder gradually wears away, creating a situation where bone is rubbing against bone. The resulting inflammation is extremely painful and makes shoulder mobility progressively more difficult. This condition typically develops later in life and gets worse over time.

The shoulder replacement procedure replaces the damaged joint with a highly-polished metal ball attached to a stem and a plastic socket. As long as a patient has an intact functioning rotator cuff, it can be an extremely successful procedure.

However, there is a group of patients that not only have significant cartilage damage in their shoulder, but also have a torn rotator cuff that is beyond repair. The rotator cuff is a group of muscles that run from the shoulder blade to the upper arm and allows patient to elevate their arm. Twenty years ago, treatment options were limited. In 2004, the FDA approved a reverse shoulder replacement procedure that was being used successfully overseas.

The surgery takes about two hours and involves a small incision, usually about three to four inches in length. Patients can expect to stay in the hospital somewhere from one to three days. Further, patients will be released with their arm in a sling, and undergo exercises to reestablish range of motion with the joint.

Between four and eight weeks after surgery, patients should be able to raise their arms above their heads without pain. Three to four months after surgery, patients are gradually resuming the activities of daily living. Many patients remark after recovery that they feel like they’ve been given their life back.

ONS’ Dr. Seth Miller was one of the first in the metropolitan area to perform reverse shoulder replacement surgery. He will take part in a Joint Replacement Symposium at Greenwich Hospital with ONS colleagues and joint replacement surgeons Drs. Frank Ennis and Brian Kavanagh.

The event will be held on Wed. May 11 starting at 6 p.m. To register, call 203-863-4277 or online.

High Spirits at BCA 5K

Posted on May 3, 2016

TEAM ONS’ SPIRITS WERE HIGH AT THE BCA 5K.

Despite the rainy weather and cool temperatures, ONS orthopedic surgeons Marc S. Kowalsky, MD and Katherine B. Vadasdi, MD along with members of the ONS physical therapy department were in good form for the first annual Breast Cancer Awareness 5K run/1 mile walk. Team ONS ran, walked, (some did both) and manned the ONS sponsor’s table to greet fellow BCA supporters and educate them about the comprehensive orthopedic and neurosurgery services that are provided by the Women’s Sports Medicine Center at ONS.

ONS Physical Therapy Manager, Alicia Hirscht, DPT, SCS, CSCS, led a pre-run warm up routine before the runners took to the wet but beautiful course which started on Mason Street. wound its way down Steamboat Road and through Bruce Park before returning to Richards 3.1 miles later. Many thanks to Dr. Kowalsky, Dr. Vadasdi, Alicia, Chalon Lefevbre, PT, LMT, Betsy Kreuter, PT, CLT, Tanya Kalyuzhny, DPT, MDT, Caitlin Yauch, PT, PT technicians Carolina Castillo and Kristin Sury, and PT front desk rep Rachel Olsen, for their enthusiastic support.

Youth Rugby Safety Talk

Posted on April 29, 2016

ONS SPORTS MEDICINE SPECIALIST MARC S. KOWALSKY, MD, TO SPEAK ABOUT YOUTH RUGBY SAFETY ON MAY 4

Dr. Marc Kowalsky will discuss safe participation in youth rugby, the fastest growing sport among young athletes in the United States.

The informative lecture for coaches, players and parents of players presented by the Rye Rugby Club will take place on Wednesday, May 4 beginning at 7 pm at the Rye High School Performing Arts Center at One Parsons Street in Rye New York.

Dr. Kowalsky will draw from his extensive experience caring for rugby players at every level of competition in this discussion of strategies for injury prevention. Topics will include optimal diet and nutrition, as well as strength and conditioning in these athletes. Dr. Kowalsky will also touch on the value of protective equipment in youth rugby. The critical role of coaching and officiating in maintaining safety of the game will be covered, as will prevention and management of concussion. The importance of collaboration among parents, coaches, trainers, and physicians will be addressed as well.

A former rugby player, Dr. Kowalsky serves as team physician for the USA Rugby National Team, the White Plains Rugby Football Club, Iona College Rugby Football Club, and the CT State Champion Greenwich High School Rugby Team.

ONS Surgeon Named Doctor of Distinction

Posted on April 20, 2016

PAUL SETHI, MD, WAS NAMED ONE OF FAIRFIELD COUNTY’S DOCTORS OF DISTINCTION BY WESTFAIR COMMUNICATIONS.

Dr. Sethi, a sports medicine specialist and orthopedic surgeon at ONS, will be presented with the Cutting Edge Award at the annual Fairfield County Doctors of Distinction Awards ceremony on Tuesday, May 3. Dr. Sethi has received this recognition from Westfair Communications for his ongoing research into improving orthopedic surgical procedures and help in creating international orthopedic surgical standards.

As President of the ONS Foundation for Clinical Research and Education, Dr. Sethi’s research has recently included the establishment of better methods for surgical skin preparation (cleaning) to lower the risk of surgical infection; development of a new technique to repair chronic or weakened biceps tendons; and the evaluation of surgical needles in tendon surgery to establish international guidelines on needle use. Additionally, Dr. Sethi has recently contributed a textbook chapter on shoulder fractures, and two chapters on treating elbow injuries in throwing athletes.

Learn more about Dr. Sethi’s outstanding career here.

An Added Level of Safety to Young Athletes

Posted on April 19, 2016

THE ORTHO ACCESS PROGRAM AT ONS OFFERS AN ADDED LEVEL OF SAFETY TO YOUNG ATHLETES WHO ARE INJURED ON THE FIELD.

If you missed yesterday’s Well column in The New York Times, it focused on the lack of national safety standards to protect student athletes from crippling or fatal injuries. Individual states and the schools within them, for the most part, haven’t yet adopted injury prevention and treatment policies or procedures for children who play organized or league sports either. The responsibility is all too often left to coaches and parents to assess what measures to take when a young athlete is injured and when they can return to play. 500 student athletes died last year due to poor decisions made immediately following injury, according to the article. The ORTHO ACCESS program at ONS is designed to add an extra layer of medical support and injury prevention education for coaches, athletes, and parents. During the first critical moments after a player is hurt, ONS ORTHO ACCESS sports medicine physicians helps to determine the best immediate course of action to take. Read more.

Regenerative Medicine Benefits

Posted on March 8, 2016

ONS PAIN MANAGEMENT SPECIALIST, CHRISTOPHER SAHLER, MD, WILL DISCUSS THE BENEFITS OF REGENERATIVE MEDICINE AT GREENWICH HOSPITAL TALK.

Does your own blood hold the key to healing your medical condition? The evolving field of regenerative medicine uses biomedical materials, often from your own body, to regenerate cells and rebuild diseased and damaged tissues. Join Dr. Christopher Sahler to learn about this exciting new medical field that uses therapies from blood, platelets and stem cells to treat pain and cure complex, often chronic conditions of the musculoskeletal system. Healing Yourself: The Promise of Regenerative Medicine for Chronic Pain and Orthopaedic Care will take place on Thursday, March 10 at Greenwich Hospital’s Noble Auditorium. 6 – 7:30 pm. Free. To register, call 203-863-4277 or go to greenwichhospital.org.

(203) 869-1145

Tag: Greenwich Orthopedics