Webinar: ACL Tears in Young Athletes: An Ounce of Prevention

The incidence of ACL tears in young athletes continues to rise, due in part to increased participation in cutting and pivoting sports throughout the year.  Athletes are participating in competitive sports at younger ages, and more young women are competing than ever before.  Body structure, biomechanics, and joint laxity increase risk among young women by as much as ten times compared to young men.

Unfortunately, an ACL tear can take a young athlete off the field for at least six months.  An ACL tear typically requires surgery to reconstruct the ligament, followed by extensive rehabilitation.  Join ONS Sports Medicine Specialist, Dr. Marc Kowalsky live to learn about how this vital ligament helps the knee to function, why it doesn’t heal on its own, and what young athletes can do to prevent a tear or rupture.

Click on this link for the Microsoft Teams Live Event.  Note: IOS users may need to download the free Microsoft Teams app to access the webinar.

Tips to Prevent Injuries from Running

Prevent Running Injuries
Proper fitting running shoes can help prevent injury


There can be many causes for the aches and pains associated with running, but sometimes it is as simple as wearing the wrong running shoe. Improperly fitting sport shoes can lead to a variety of painful foot, ankle, knee and hip conditions, according the ONS Sports Medicine specialist Katherine B. Vadasdi, MD.

“The best running shoe is one that keeps the foot in a neutral position. It’s important to know if your feet are neutral when you stand or run, or if they are pronated (roll to the inner side of the foot) or supinated (roll to the outside of the foot),” said Dr. Vadasdi.  In general, people whose feet have low arches tend to pronate, while people with high arches tend to supinate. Today there are dozens models of sports shoes that are specifically designed to support each of these conditions. Knowing your foot’s anatomy will help you make the right decision.


The other thing you have to consider is the type of running that you do. This will determine the level of cushioning and stability you will need. For instance, trail runners need a shoe that offers more stability for the rugged terrain. A marathon runner may need a training shoe with more cushion. An athlete training for shorter distances may use a track shoe.

Past injuries should also be taken into consideration when making your selection. If you’ve had plantar fasciitis, for instance, an over-the-counter insert may help put your foot in a more neutral position. If you’ve had hamstring tendinitis or tightness in your calves, you should opt for a greater heel to toe incline – called an offset.


When you get a new pair of running shoes, gradually introduce them into your routine, using them only two times in the first week or two alternating with your previous pair, and then gradually increase the numbers of days that you run in them. It can be difficult to determine if your running shoes are at the root of your pain, but in general, if you develop a new pain or discomfort shortly after switching running shoes, stop using them until the pain is resolved. Consult a physician if the pain persists for more than a week.

ONS MDs to Discuss Chronic Pain


Maintaining quality of life while living with chronic pain is no easy feat. Two orthopedic specialists from ONS will discuss effective new treatments to help people with relentless pain return to the WavenyPain Flyer (2)activities they enjoy.  Join Demetris Delos, MD, an orthopedic surgeon who specializes in sports medicine an comprehensive knee and shoulder, and interventional pain management physiatrist, Christopher Sahler, MD for this informative talk on Wednesday, May 11 at The Inn at Waveny, 73 Oenoke Ridge in New Canaan.  Doors open at 4:00 pm for refreshments. Presentation begins at 4:30. RSVP at 203-594-5310 or [email protected]


Regenerative Medicine and Chronic Pain


In the past, most cases of damaged tissue within the body were considered irreversible, but developments in regenerative medicine hold the potential to change all that, writes Christopher Sahler, PRPMD, an interventional pain management specialist at ONS, in this week’s edition of the Greenwich Sentinel.  Although research into harnessing the body’s own healing process using amniotic fluids, blood, tissues, growth factors and stem cells is ongoing, certain biomedical therapies are in use today to help ordinary people suffering from orthopedic conditions and chronic pain.  The most common treatment, using platelet rich plasma collected from a patient’s own blood, is administered in a physician’s office using ultrasound guided injections directly into the diseased or damaged tissue to restart and increase the healing process.  Read the full article in the April 1 edition of Greenwich Sentinel.

New ACL Repair Study


Today’s New York Times reports that using a patient’s own blood to help heal an ACL tear has shown promising results in a small study conducted by the Boston Children’s Hospital.  While having a torn ligament heal itself could be the holy grail of ligament surgery, ONS knee surgeon, Demetris Delos, MD, cautions that more thorough research is ACL-Injury-300dpi-illustrationneeded.  The trial involved only 10 patients and recovery was tracked just a few months after surgery. “These early results are exciting,” Dr. Delos said, “but it is important to see how these patients do in the medium and long term (several years after surgery) especially when it comes to returning to active lifestyles and the trials need to be expanded to much larger groups of  people to see how it translates to the population at large.”  Until the long term safety and efficacy can be determined, he said, current ACL reconstruction surgery, which replaces the injured ligament with a tendon from other areas of the body such as the hamstring or patellar tendon, will remain the standard as it has proven successful with predictable results and allows the majority of patients to return to their pre-injury activities.

Female Athletes and ACL Injuries


Woman playing tennis at the professional tournamentDifferences in pelvis width, the size of the ACL and the intercondylar notch (where the ACL crosses the knee joint), are all thought to play a role. What’s more, the upper part of a female’s shin bone at the joint is much shorter and more rounded than a male’s, which creates a greater laxity in the joint. Women also tend to have an inward angle to their knees, otherwise known as knocked knees, which places more stress across the outer knee joint and ligaments, particularly when it comes to sudden or extreme movements, such as an abrupt change in direction or pivot. Women also move differently than men. For instance, they tend to land from a jump with their knees in a somewhat straight position, pulling on the quadriceps rather than the hamstrings. Because of this, the force of the impact is transferred to the knee, creating a high risk for an ACL rupture. Men, on the other hand, are better able to absorb the impact because they tend to land with bent knees.

For these reasons, it is crucial for female athletes of all ages to modify their natural biomechanics through neuromuscular training programs that can teach them better ways to move their bodies and protect their knees, said orthopedic surgeon Katie Vadasdi, MD, who heads the Women’s Sports Medicine Center at ONS. “Through neuromuscular training programs, we can help female athletes significantly reduce the risk of ACL ruptures by developing balance between the quadriceps and hamstrings and improving the landing biomechanics with more bent knees and hips to avoid a knock-kneed position on impact.”

Preventing ACL injuries has both near and long term benefits so the sooner you get started with this kind of a conditioning program the better. Studies indicate that there is a tenfold increase in the incidence of osteoarthritis in the knees of women who suffered an ACL injury at some point in their lives. Moreover, injuries that were incurred during youth seem to result in the onset of osteoarthritic symptoms at a much earlier age in adulthood.

Learn more about ACL injuries here.

ONS Surgeon Demetris Delos, MD Speaks about Knee and Shoulder Conditions on Health IQ

Demetris Delos, MD
Demetris Delos, MD

ONS orthopaedic surgeon Demetris Delos, MD, was a featured guest on Pleasantville Community Television’s series, Health IQ, hosted by Dr. Alan Siegel of ProClinix. During the fascinating thirty-minute interview, Dr. Delos, a specialist in knee and shoulder conditions, spoke in detail about common cartilage, ligament and tendon injuries. Age, gender and type of activity can play a role in a person’s susceptibility to orthopedic problems, he said. Using models and computer generated images, Dr. Delos described the non-surgical and surgical options to repair or replace damaged tissue and joints.  Functional and strength training, he stressed, are key for injury prevention and rehabilitation. Dr. Delos also provided a glimpse into future treatments including the development of synthetic tissue products and the advances in biologic medicine which uses biomedical materials such as blood, platelets and stem cells to treat pain and complex, often chronic conditions of the musculoskeletal system.




Orthopaedic Surgeon and Sports Medicine Specialist Dr. Demetris Delos on NY Giants Victor Cruz’s Injury

Dr. Delos served as Assistant NFL Team Physician for the New York Football Giants and

Demetris Delos, MD
Demetris Delos, MD

team physician for local high school and college athletes. His practice is focused on sports medicine and arthroscopic treatment of knee and shoulder disorders including knee preservation surgery, shoulder instability and rotator cuff repair. Upon hearing about the NY Giants’ Wide Receiver Victor Cruz’s knee injury, we reached out to Dr. Delos to give us insight on Victor’s type of injury. Dr. Delos said:

“Victor Cruz sustained a devastating injury to his knee last night, an injury that will cost him the rest of the season. While attempting to catch a ball in the end zone, he tore the patellar tendon in his right knee. The patellar tendon is a structure that attaches the kneecap (patella) to the shinbone (tibia). When the patellar tendon is torn, the player cannot straighten (extend) his knee and obviously cannot perform at the high level expected in the NFL.

Patellar tendon ruptures are relatively uncommon injuries that occur in otherwise healthy players without any predisposing factors. The mechanism of injury is typically eccentric overload (forcibly bending the knee while the quadricep is firing).

Studies of NFL players with this injury report that the vast majority are able to return to NFL level play after surgery and extensive rehabilitation. Let’s wish Victor a speedy recovery so we can watch him salsa in the end zone again!”

For more information on knee injuries, visit Our Specialties page.

Looks like more snow is in the forecast, we have some skiing tips for you!

skierThe knee is the most vulnerable body part for any athlete, including skiers. Downhill skiing produces large amounts of torque on the knee, challenging the integrity of ligaments and tendons. Whether from a fall or overuse, the most common injuries in skiers are tears to the MCL (Medial Collateral Ligament) or ACL (Anterior Cruciate Ligament), two important structures that give our knee stability.  When a skier is thrown off balance, his skis will sometimes shoot out in front of him, creating extra torque on the knees and damaging our stabilizing structures.

Both novice and experienced skiers are at risk of hurting their knees. We frequently see novice skiers hurt themselves when they do not know how to turn, stop or fall properly. Taking lessons and working with an instructor goes a long way in preventing knee injuries for beginner skiers. Experienced skiers frequently take risks and assume that they can manage faster speeds on any slope.  Many injuries, whether you are a beginner or an experienced skier, are related to weather conditions. It is important to realize that as visibility and surface conditions deteriorate, the slope or trail level goes up. In poor visibility or icy conditions, a beginner trail becomes an intermediate trail, and an intermediate slope becomes advanced slope. Keep injury prevention in mind, if the conditions are difficult, ski down a level.

A second reason injuries occur is fatigue. Most skiers’ bodies are not accustomed to exercising 6-8 straight hours. In addition, many skiers push their bodies to take advantage of the whole day, even when they start to feel tired and stiff.  For this reason, injuries tend to happen at the end of the day.

Having the knowledge of what places skiers at a higher risk for knee injuries, we are passing on recommendations about how to stay safe on the slopes.  Both beginners and experienced skiers can benefit from these tips!

  1. Start a conditioning program a few months before your first ski trip. Leg strengthening, flexibility and balance are important aspects of an adequate ski conditioning program.
  2. Ski with good technique. Maintain your balance and control, keep your hips above your knees, keep your arms forward, and maintain a safe speed.
  3. Learn how to fall correctly: keep your legs together, keep your chin to your chest and your arms up and forward.
  4. Pay attention to weather conditions and remember to ski down a level if conditions deteriorate.
  5. Listen to your body. If you start to feel pain or stiffness upon exiting the lift chair, then you should probably make that run your last. Head to the lodge and enjoy a warm drink by the fire.

Good luck and stay warm!

If you become injured, while skiing, remember, ONS sports medicine physicians are trained at the top universities and hospitals in the country and have expertise in the latest treatments for sports-related injuries in high-performance and recreational athletes.

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit http://onsmd.i9e.co/ or call 203.869.1145.


ONS Knee Specialist Dr. Katie Vadasdi discusses Olympic Athlete Lindsey Vonn’s Injury

The ONS Women’s Sports Medicine Center team of experts consists of current and former athletes and fitness enthusiasts who know firsthand what it takes to train and excel in a sport. With the 2014 Olympics just a few weeks away, ONS orthopedic surgeon and women’s sports medicine specialist, Katie Vadasdi, MD, shared her expert opinion on one of the latest setbacks in Olympic history.


In recent news, US skiing champion, and Olympic gold medalist Lindsey Vonn stated that she would be pulling out of the 2014 Sochi Olympics in Russia. The famed downhill skier experienced a series of knee injuries which led to her decision not compete.  When asked about Lindsey’s decision, Dr. Vadasdi said, “Vonn has made an appropriate but difficult decision to pull out of the winter Olympics this year in order to give her knee the medical attention it requires.  Her sport requires an incredible amount of strength and having an unstable knee puts her in a dangerous position where she might further injure her knee or cause other injuries.”

Last February, Lindsey tore two ligaments in her right knee and broke a bone in the same leg during an intense crash at the world championships. Upon returning to the sport, Vonn reinjured her surgically repaired ACL (anterior cruciate ligament) when she crashed during a training session. Two weeks later, Lindsey suffered another injury when she sprained her MCL (medial collateral ligament), during a downhill event. After reconstructive knee surgery in February 2013, Vonn posted on Facebook that she “is devastated” to miss the Olympics, “but the reality has sunk in that my knee is just too unstable to compete at this level.”

Each year, at least 1 in 3,000 Americans between the ages of 14 and 55 tear an ACL while exercising or playing sports.  Skiers are among the group of athletes who are more likely to experience an ACL injury. Dr. Vadasdi said of Vonn’s injury, “she will undergo ACL reconstruction which will provide her knee the stability it requires to return to such highly-competitive skiing.” A reconstructed ACL not only stabilizes the knee, but also prevents damage to the menisci cartilage that often occurs due to an unstable joint.

“By making the decision now to withdraw from the Olympics and to undergo the surgery, she will allow herself the necessary time to recover and fully rehab her knee to get her back on the slopes safely and at her height competitive level.”

To learn more about ACL Injuries, click here: http://onsmd.i9e.co/condition_treatment/acl-injuries/ and visit our Women’s Sports Medicine Center at http://onsmd.i9e.co/sports-medicine/womens-sports-medicine-center/.

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.i9e.co or call 203.869.1145.


Calendar of Health Information Programs by ONS Physicians at Greenwich Hospital


This year the physicians at ONS will present health information seminars for the public on a variety of topics ranging from joint replacement to common soccer injuries, injury prevention and treatments. Sessions to take place in the Noble Conference Center at Greenwich Hospital, 5 Perryridge Road, Greenwich, and followed by a question and answer period where the public may pose questions to the presenters. To register for upcoming ONS programs at Greenwich Hospital, please call (203) 863-4277 or (888) 305-9253, or register on-line at http://www.greenhosp.org/.

2 APRIL 2014 – Joint Symposium, Noble Conference Center at Greenwich Hospital, 5 Perryridge Road, Greenwich <read more>

Past Topics

Knee Pain Seminar

Chichi_knee anatomy
For millions of Americans, knee pain is a daily reality. Many people try to ignore pain caused by arthritis in the knee joint for as long as possible in hopes that it will go away. However, arthritis is a progressive disease and for many, will even become debilitating. On December 3, 2013, orthopedic surgeon Dr. Demetris Delos presented a “Knee Pain Seminar” addressing treatment options for knee pain due to early-stage arthritis. He discussed non-operative and operative solutions from therapeutic injections, arthroscopic procedures to osteotomy and partial knee replacement. The seminar was free and open to the public.

Speaker: Orthopedic Surgeon Demetris Delos, MD

ONS is an advanced multi-specialty orthopedic and neurosurgery practice serving patients throughout Fairfield and Westchester Counties and the New York Metropolitan area. ONS physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, visit www.onsmd.i9e.co, or call (203) 869-1145.

Osteoporosis: Prevention, Treatment and Managementgraphic

Osteoporosis, a disease that weakens the bones and leads to fractures, affects 28 million Americans and contributes to an estimated 1.5 million bone fractures every year. Half of all women older than 65 and one in five men is affected by osteoporosis. On Wednesday, October 23, 2013 at 6:30 pm, physicians with ONS and Greenwich Hospital hosted a seminar on Osteoporosis: Prevention, Treatment and Management. The public was invited to hear from medical experts what measures may be taken to prevent bone loss or minimize its effects. Presenters included Orthopedic Surgeon Steven Hindman, MD, Endocrinologist Ranee Lleva, MD, and Physical Therapist Betsy Kreuter. The program took place in the Noble Conference Center at Greenwich Hospital, 5 Perryridge Road and was free of charge. To register for ONS programs at Greenwich Hospital, please call (203) 863-4277 or (888) 305-9253, or register on-line at www.greenhosp.org. For more information on topics related to orthopedics, visit www.onsmd.i9e.co

Speakers: Orthopedic Surgeon Steven Hindman, MD, Endocrinologist Ranee Lleva, MD, and Physical Therapist Betsy Kreuter. Wednesday, October 23, 6:30-8 pm

Cartilage Transplantation Offers New Hope for Damaged Knees

Delos Office Vertical
Dr. Demetris Delos

Cartilage transplantation offers exciting new treatment options for adults under the age of 50 who have had their knee damaged through acute or chronic trauma to the knee. The surgeon uses small cylindrical plugs of good cartilage and inserts them into the damaged areas. This procedure has been shown to be highly effective in patients who have sustained a specific injury to the knee cartilage or joint lining, and who have not yet developed arthritis. Many competitive athletes who have undergone the treatment have returned to their full performance level after surgery.

Speaker: Orthopaedic Surgeon and Sports Medicine Specialist Demetris Delos, MD

Women’s Sports Medicine Center forum at Greenwich Hospital

WSMC group photo cu

Who would know better how to treat active women of all ages and levels of sports activity than the ONS Women’s Sports Medicine Center physician and physical therapy team?

In addition to being experts in their fields as orthopedic surgeons and sports medicine specialists, the ONS Women’s Sports Medicine Center team is comprised of current and former athletes and fitness enthusiasts who know first-hand what it takes to train and excel in a sport. (In fact, Dr. Katie Vadasdi, an orthopedic surgeon, is an accomplished tri-athlete who has completed two Ironman competitions, is an alpine climber and has ascended Mount Kilimanjaro, Mount Rainier and the Grand Teton.)

Come hear the ONS Women’s Sports Medicine Center panel discussion hosted by Greenwich Hospital:

“Women Treating Women”

The event, which took place in the Noble Conference Room at Greenwich Hospital, featured the ONS Women’s Sports Medicine experts in a panel discussion regarding the latest diagnostic and medical management techniques for injuries and conditions common in female athletes.

The public was invited to bring their sports injury or fitness-related questions and get answers from a team of physicians who have provided medical support to five Olympic Games, international biking and fencing championships, and medical coverage for the Columbia University sports teams and Greenwich High School sports.

Women’s Sports Medicine Panel:

Katie Vadasdi, MD, Orthopedic Surgeon, Sports Medicine Specialist Fellowship Training: Columbia University Medical Center

Gloria Cohen, MD, Primary Care Sports Medicine, Olympic Team Physician Post Graduate Sports Medicine, University of British Columbia

Tamar Kessel, MD, Physiatrist, Interventional Sports and Spine Fellowship Training: Hospital for Special Surgery

Laura Liebesman, PT, Director of ONS Physical Therapy Specialties- Golf mechanics, Orthopedics and Spine PT Certification – University of Pennsylvania


Got knee pain? Torn knee cartilage is a common painful summer sports injury

One of the most common summer sports injuries is a torn meniscus (knee cartilage). Although an injury that happens year-round in high energy and contact sports athletes, many people increase their risk for knee injuries during the summer when their involvement in sports intensifies.

The meniscus is a C-shaped rubbery cushion that serves as a shock absorber between the bottom of the thigh bone and the top of the shin bone. The meniscus helps to evenly distribute the body’s weight over the knee joint and allows the joint to move and turn smoothly.

With so much emphasis on staying healthy and keeping active, meniscal tears are on the rise and often occur in combination with other injuries such as a ligament tear to the ACL or MCL. Tennis players commonly run, twist and pivot as they play. Likewise, a golfer’s swing relies heavily on a twisting motion through the body.  A sudden twist too far or a stumble can strain the knee beyond its normal range, causing injury to the cartilage.  However, you don’t have to be involved in sports to tear your meniscus. Even day to day activities like getting out of a car have been known to cause a meniscus tear.

The most common symptoms of a torn meniscus are pain and swelling, persistent soreness on one side of the knee and sometimes a tendency for the knee to lock or have difficulty straightening. A diagnosis is made by x-ray and MRI. Unfortunately, the meniscus cannot heal itself due to the lack of blood supply in that area. Fortunately, a simple 20 to 30 minute surgery can be done that will allow the knee to function normally again. Continue reading “Got knee pain? Torn knee cartilage is a common painful summer sports injury”