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

Study finds success in treatment for Frozen Shoulder.Dr. Katharine Vadasdi, Shoulder Surgeon

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.

High Spirits at BCA 5K

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 Group Shot2greet 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.

ONS is awarded AIUM Ultrasound Practice Accreditation

The Ultrasound Practice Accreditation Council of the American Institute of Ultrasound in Medicine (AIUM) has awarded ONS with ultrasound practice accreditation in the area of MSK Print(Ultrasound-guided Interventional Procedures).

ONS achieved this recognition by meeting rigorous voluntary guidelines set by the diagnostic ultrasound profession. All facets of the practice were assessed, including the training and qualifications of physicians and sonographers; ultrasound equipment maintenance; documentation; storage, and record-keeping practices; policies and procedures to protect patients and staff; quality assurance methods; and the thoroughness, technical quality and interpretation of the sonograms the pracitice performs.

The AIUM is a multidisciplinary medical association of more than 9900 physicians, sonographers, and scientists dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines and accreditation.

 

2015 ONS Scholarship Award

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In June, Dr. Delos, MD, presented the ONS Scholarship to graduating student athlete Matheus Chaves.

The 2015 ONS Scholarship was awarded to Greenwich High School senior,  Matheus Chaves.

As a way of giving back to the community, ONS awards a yearly scholarship to a graduating high school student that has exceled in both academics and athletics. This June, Dr. Demetris Delos presented Matheus Chaves with the ONS scholarship. Matheus is set to begin courses at Florida Atlantic University this fall where he plans to study Exercise Science. He hopes to become an athletic trainer and after completion of his bachelor’s degree Matheus plans to return to the Fairfield County area to continue his education and become a physical therapist.

For the past three years, Matheus has worked with local youth at the Greenwich Boys and Girls Club as a camp counselor where he was awarded the Boy’s and Girl’s Club, Youth of the Year Award. We congratulate Matheus for his contribution to the community and his high school academic and sports career that involved soccer, track and field and wrestling.

When we asked Matheus what advice he would like to offer upconing high school seniors he said, “while going through the college selection process everything works out for a reason. Don’t worry if you don’t get in to the one you thought was your top pick, all things work out.”

From all of us at ONS, we wish Matheus well!

An Arthritic Reality Check

Arthritis affects more than 52 million adults in the United States and is the most common cause of disability,” according to the CDC. The pain from arthritis can set the stage for a decline in physical activity and make it difficult to prevent chronic health problems. Unfortunately, some who suffer from this ailment stop their activity and become depressed from thoughts of the mobility they once had.

Solutions for Knee Pain ArticleJane E. Brody, author of the “Keep  Moving to Stay a Step Ahead of Arthritis” article in The New York Times recently attempted to relate to those suffering from arthritis by speaking of her own battle with having to put down the tennis racket after decades of enjoying the sport, and her story did not end there. Two years after that, she had joint replacement surgery, picked up an assortment of other activities that successfully replaced tennis as a main source of activity. Therefore, encouraging others to do the same and not succumb to the depression that can sometimes come in hand with arthritis.

The reality is that the majority of people dealing with arthritis do not fully understand what they are capable of. Less than 10% of participants with arthritic knees in a 10-year study met the national guidelines of doing two and a half hours of moderate physical activity a week. Yes, you read that correctly, a week! It gets better though. Participants did notice a significant improvement of function when the amount of activity per week was increased. Additional weight on the body creates unnecessary stress on the major joints as well, leaving a 10% decrease in weight able to make a noticeable difference. With this fact a recommendation of starter exercises were mentioned, including walking laps in a swimming pool and then increasing activity as the muscles gain strength.

For more insightful tips, come to Dr. Delos’ talk about “Solutions for Knee Pain in Active Patients with Arthritis” tonight! The program is free and open to the public! Registration Requested. Aside from the talk, please consult your physician if this article has hit home and/or your quality of life is not what it once was; ONS provides excellent service and care for those in need, proudly keeping up-to-date with developments in the field.

Joint Replacement Symposium at Greenwich Hospital

hip replacementOn Wednesday, April 22nd, at 6:00 p.m., orthopedic surgeon/ joint replacement specialists from ONS and Greenwich Hospital will present a joint replacement symposium in the Noble Conference Center at Greenwich Hospital located at 5 Perryridge Road. Knee and hip specialists Frank Ennis, MD and Brian Kavanagh, MD; and shoulder specialist Seth Miller, MD will present information about the latest advances in joint replacement, including computer-assisted and minimal incision, muscle sparing techniques. Information about preparing for joint replacement, pain management and what to expect from the recovery process will be addressed by hospital anesthesiology, nursing and physical therapy department staff.

Many people suffer from severe pain caused by arthritis, a fracture or other conditions that make common activities such as walking, putting on shoes and socks or getting in and out of a car, extremely difficult. Today, over 900,000 hip and knee replacement surgeries are performed each year in the United States. An additional 53,000 shoulder replacements are performed. Deciding if and when it’s time to consider joint replacement surgery are important decisions.  This educational symposium is designed to provide anyone who is considering joint replacement with pertinent information to assist them in making the right decision for them.

Frank Ennis, MD specializes in hip and knee replacement and is fellowship trained in adult reconstructive surgery. Dr. Ennis is among the first orthopedic surgeons in the New York area to perform computer-assisted joint replacement. He completed undergraduate studies at Yale University and post-baccalaureate pre-medical studies at Harvard University. He graduated from Duke University School of Medicine and completed a residency at Yale University Department of Orthopaedic Surgery. He received his fellowship training at New England Baptist Hospital in Boston.

Dr. Kavanagh
Dr. Kavanagh

Brian Kavanagh, MD has performed over 6500 joint replacement surgeries in the past 25 years. He graduated Princeton University and earned a medical degree at University of Connecticut School of Medicine. He did his internship and residency at the Mayo Clinic, Mayo Graduate School of Medicine in Rochester, Minnesota, and served on the faculty at the Mayo Graduate School of Medicine for seven years. Dr. Kavanagh was on the teaching staff at Yale University School of Medicine in New Haven for five years. Dr. Kavanagh was also an instructor in the hip and knee total joint fellowship program.

Seth Miller, MD is a graduate of Mount Sinai School of Medicine in New York. After his residency at New York Columbia-Presbyterian Medical Center, he completed a research fellowship at the Hospital for Special Surgery in New York and a shoulder surgery fellowship at Columbia-Presbyterian Medical Center. He served as an orthopaedic consultant to the New York Mets for more than eight years.  He is the current President of ONS.

All three surgeons are on staff at Greenwich Hospital, a recipient of The Joint Commission’s “Gold Seal of Approval™” for total hip and knee replacement surgery and spinal fusion. The certification for hip and knee replacement procedures recognizes the hospital’s commitment to maintain clinical excellence and patient satisfaction, while continuously working to improve patient care.  Greenwich Hospital’s total joint replacement program offers a level of continuity that sets it apart from other facilities. A clinical resource nurse helps patients every step of the way – before, during and after surgery and throughout rehabilitation and recovery. Patients receive the practical information, emotional support and follow-up care they need to guide them through the entire process.

You will have the opportunity to ask questions at the conclusion of the talk.  The program is free and open to the public. Registration Requested. Call (203) 863-4277 or register online at www.greenhosp.org.

“Maximizing Your Child’s Athletic Potential” Success

Delos_Houston_
Dr. Delos with Allan Houston

Last Thursday’s talk on “Maximizing Your Child’s Athletic Potential” was a success. A big thank you goes out to the Junior League of Greenwich for making it possible with their focus on improving the community and empowering others to further health and education! Ultimately they brought together the perfect combination of experts to inform the public about the youth and the sports they love.

Dr. Delos, of ONS and Greenwich Hospital, was a panel speaker at this event. He specializes in sports medicine and arthroscopic treatment of knee and shoulder disorders. Before ONS, Dr. Delos was the Assistant NFL Team Physician for the New York Giants and was team physician for a number of local high school and college athletes.

Other panel members consisted of Andy Barr, Director of Performance and Rehab for the New York Knicks, Mubarak “Bar” Malik, Head of Strength and Conditioning for the New York Knicks, and Allan Houston, one of NBA’s all-time greatest long range shooters and Olympic gold medalist, as the moderator. Each participant reinforced the importance of parents taking interest in the development of their young athlete and properly guiding them to the path of success. Parents attending this event were very attentive, and came prepared with questions.

Conversations covered the fundamental topics, like proper sleep habits and nutrition. For example, a young athlete’s nutrition should increase in relation to the amount of activity they experience daily. This may be common knowledge to an adult but for an adolescent, proper amounts of sleep and good nutrition that balances the amount of activity should be added to their routine.

Aside from the basic topics of discussion, there was a myth to be busted as well; to find out the details of the myth and for more information about the questions that were asked at the event, please read the article written by the Greenwich Freepress.

Delos_Group_2
Photography credit goes to the Delos family, thank you!

Ready for Spring Sports?

Golfer

Foot and ankle, hand and wrist injury prevention tips by orthopedics specialists

When: February 25, 2015 at 6:30 p.m.
Where: Noble Auditorium, Greenwich Hospital
SpeakersSean Peden, MDMark Vitale, MD, and Paddle and Tennis Professional Patrick Hirscht

If golf or racket sports are in your plans for the spring you will want to hear tips from fellowship trained orthopedic foot and ankle specialist Sean Peden, MD and fellowship trained hand/wrist/elbow specialist Mark Vitale, MD, MPH who will discuss common injuries seen in golf and racket sports. Special guest and local tennis pro Patrick Hirscht will also speak. Learn about common injuries, and how to choose footwear, braces and exercises to prevent injury and play your best; whether it’s the foot, hand, wrist or elbow, they’re all at risk for injury when you’re active. Dr.Peden and Dr.Vitale will discuss nonsurgical and surgical treatments, along with ailments particular to racquet sports. You will have the opportunity to ask questions at the conclusion of the talk. The program is free and open to the public. Registration Requested. Call (203) 863-4277 or register online at www.greenhosp.org.

ONS Success Story: William McHale

William McHale TestimonialWilliam McHale started off as many other athletes did, full of energy and feeling invincible. As we all know, that feeling of invincibility is only a feeling. In the 7th grade, young William broke his ankle playing football; fortunately he was then referred to Dr. Paul Sethi.

Dr. Sethi considers all of the athlete’s needs which helps set the stage for a successful and timely recovery period and translates into an ideal patient-doctor experience.  When McHale got older, he started as a linebacker in 30 consecutive games between his sophomore and senior years at  Yale University. During his senior year though, the labrums in both of his shoulders tore. Time was of the essence if he wanted to recover in time for his Pro Day in front of NFL Scouts. Who did he contact? None other than our very own Dr. Sethi.

The MRIs originally taken of the injury did not reveal the full extent of the damage but Dr. Sethi corrected all issues encountered during the surgery. After the procedure, William was scheduled to go to physical therapy multiple times a week and overall, it took about six to seven months for a full recovery. Since then, William has not had any other issues regarding his shoulders.

Where is William McHale now? He played to his full potential on Pro Day, was invited to Minicamp with the New Orleans Saints, and just returned from playing football in France; congratulations!

What do you do when you are diagnosed with an old (chronic) Achilles tendon rupture?

Sean C. Peden, MD
Sean C. Peden, MD

Sean Peden, MD is an orthopedic surgeon who specializes in foot and ankle surgery. Dr. Peden has expertise in treating a variety of foot pain and deformity related conditions including Achilles tendonitis, ankle instability, cartilage injuries, bunions and hammer toes.  His practice will also focus on youth athlete sports injuries and the types of injuries seen in field athletes, gymnasts and ballet dancers.

Achilles tendon ruptures will often not be discovered for months after the injury. In the months between injury and showing up at the doctor’s office, the torn tendon develops scar tissue which decreased the quality and elasticity of the tissue. Because of this, directly repairing the torn tendon, as is done in an acute injury, becomes is less than ideal. In this situation, we will supplement the tendon repair with a tendon transfer. Essentially, we borrow a tendon that bends the big toe (there is another tendon that compensates when it is borrowed), reroute it, and reattach it to the heel bone. This does two very important things:

 

1. It supplements the strength of the torn Achilles, allowing a quicker and better recovery.

2.It provides improved blood supply to the Achilles repair, providing healing factors to the area of diseased tendon.

In summary, ruptures of the Achilles Foot_AnklePictendon are increasingly common in our aging yet increasingly active population. In cases where an Achilles rupture is missed or the rupture cannot be repaired directly under normal tension, adding the flexor hallicus longus tendon transfer allows for significantly improved results with a shorter recovery.

If you suffer from foot and ankle pain and would like to attend a free seminar, Dr. Peden of ONS and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage is an orthopedic surgeon specializing in foot and ankle surgery. He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

Suffer from Bunion Pain? Dr. Clain Offers Solutions

Michael Clain, MD
Michael Clain, MD

Bunions are a common deformity encountered in the foot where the big toe is out of alignment. This creates pain in that toe and often in the lesser toes as well. The deformity makes it difficult to find shoes that fit comfortably.  Ill-fitting shoes can contribute to the situation but the underlying deformity is genetic. This is why most patients can recall a parent or grandparent that had the problem.

In consultation, I often tell patients that the options are to accommodate the foot with wider shoes, gentle arch supports and sometimes padding or I encourage them to consider surgery.  The decision to proceed with surgery should be based on the overall level of discomfort and deformity.  This will differ from patient to patient.  It is rare that the patient that must have bunion surgery.  Most people will choose surgery due to the accumulation of annoyances, discomfort, pain and deformity in other toes.

Actual X-ray of patient of Dr. Clain before bunion surgery
X-ray of patient of Dr. Clain before bunion surgery
Same Patient. Post-Bunionechotmy
Same Patient. Post-Bunionechotmy

It is very important, from my point of view, to communicate realistic expectations for the procedure and the ultimate result. I try hard to be very specific about the time involved in recovery and give every patient a written “expected surgical recovery.” It is obviously difficult to remember everything when you as the patient are given a great deal of information so it’s helpful to have a summary to refer to.

Not all bunions are the same. Routinely, I perform about six different surgical procedures.  The goal is to do the most appropriate operation for your particular foot and circumstance.  With careful communication and a well thought-out plan it is highly likely that we should be able to get a great result for almost any foot.”

For more information about Dr. Clain, click here.

If you suffer from bunions and would like to attend a free seminar on foot pain Dr. Peden of ONS and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage is an orthopedic surgeon specializing in foot and ankle surgery. He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

ONS Physiatrist, Christopher Sahler, MD presents “Exercise as Treatment for Chronic Pain”

Christopher Sahler, MD
Christopher Sahler, MD

Christopher Sahler, MD of ONS and Greenwich Hospital, is an interventional physiatrist specializing in sports medicine. His focus is non-operative treatment of musculoskeletal injuries, restoring proper function, reducing pain and promoting active lifestyles.

If you are suffering from chronic pain, you are not alone. It is estimated that 100 million Americans are currently living with chronic pain. The pain may make it difficult just to get out of bed or do household chores, let alone be active and exercise. Studies have shown this inactivity can actually cause you to experience a worsened level of pain and for a longer period of time. Exercise actually improves your pain threshold. Even simple exercises such as walking can provide some benefit.

Join Dr. Sahler as he presents his first health Seminar “Exercise as Treatment for Chronic Pain” at Greenwich Hospital. Come learn how staying active and performing exercise may help treat an array of chronic pain conditions.

When: December 2nd, 2014
Time: 6:00 p.m.
Place: Noble Auditorium at Greenwich Hospital

The program is free and open to the public. Registration Requested.
Call (203) 863-4277 or register online at www.greenhosp.org.

ONS Physiatrist, Christopher Sahler, MD on post New York City Marathon Tips for Runners

Christopher Sahler, MD
Christopher Sahler, MD

Christopher S. Sahler, MD of ONS is an interventional physiatrists specializing in sports medicine. His focus is non-operative treatment of musculoskeletal injuries, restoring proper function, reducing pain and promoting active lifestyles.

“Each year 50,000 people participate in the NYC marathon. If you are in that group and completed the race this past weekend, congratulations! It is an exciting accomplishment that you will remember for the rest of your life.

Now that the race is over, there are a few key points to remember that will help to maximize your recovery and minimize pain. Many athletes experience worsening soreness over the following days after the race. This is known as delayed onset muscle soreness and typically is most painful 48-72 hours later. After the race, your body is in a depleted state so it is important to take in plenty of water and healthy food. A combination of complex carbohydrates and protein help the muscles to repair themselves and re-build their energy stores. It is also recommended that you perform light, short duration activities such as walking, gentle jogging, biking, swimming etc. This helps to increase blood flow to the muscles and tissues that need the nutrients the most and helps to wash away the built up metabolic byproducts such as lactic acid. Gentle stretching and soaking in a warm bath may also help loosen up the muscles. Depending on your previous activity level, it is important to give your body time off before re-starting any intense exercise routines. Most runners should take at least one month off.

Congratulations again on the race!”

Dr. Sahler will present “Exercise as Treatment for Chronic Pain.” Learn how exercise can be used as a safe and effective treatment for chronic pain conditions. This free health seminar will be in the Noble Conference room at Greenwich Hospital Tuesday, December 2 at 6:00 p.m.  To register call 203-863-4277 or register online at https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=5348

 

Do You Experience Foot or Ankle Pain?

Sean Peden, MD will be speaking at the Noble in Greenwich Hospital December 9th at

Sean Peden, MD
Sean Peden, MD

6:30pm to address Solutions for Foot & Ankle Pain: Beyond Foot Massage. Here is a summary of what he will present:

A painful foot or ankle condition can limit a patient’s function and quality of life with every step. Conditions from the toes to the Achilles tendon will be discussed with emphasis on surgical and nonsurgical options, including old standards and the most cutting edge new technologies. Topics covered will include foot and toe deformities such as bunions, hammertoes, flat feet, and high arches, with special attention to when and how these conditions should be treated or when they should be left alone. Plantar fasciitis and Achilles tendonitis will be discussed in detail with emphasis on the natural progression of the disease, what we know works and what is experimental. Arthritic conditions of the foot, ranging from the big toe to the ankle will be included.

A team approach is an important aspect of foot and ankle care. ONS physical therapist Alicia Hirscht, DPT, SCS, CSCS will discuss and answer questions about the role of physical therapy to improve foot and ankle pain and dysfunction.

ONS Senior Clinical Specialist Alicia Hirsch
ONS Senior Clinical Specialist Alicia Hirsch, DPT, SCS, CSCS

Dr. Peden will introduce an orthotic maker he typically works with and will discuss when and how orthotics are used, from inexpensive over-the-counter inserts to custom molded prostheses. Other options to be discussed will include stem cell technology and image-guided injections.

Dr. Peden will open up a question and answer session following the seminar. This event is free registration requested, call (203) 863-4277 or (888) 305-9253, or register online at:  https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=7253

Foot Ankle Pain Brochure

ONS Physical Therapist Betsy Kreuter’s P is for Posture When Sitting or During Chores!

OSTEO_graphicMost Americans spend too much time sitting and should take advantage of these tips to help keep good posture.

First, when sitting in a chair make sure your buttocks is all the way to the back of the chair. Using a lumbar roll in the small of your back will help to keep optimal alignment.

Second, if you  sit at a computer, your monitor should be at eye level, feet firmly on floor, hands and wrists in a straight line, shoulders back and elbows at 90 degrees. A break from sitting every 30 minutes will relieve your back of stresses placed on it while sitting. For a more detailed guide to improve seated posture, download Work Station Ergonomics  as a reference.

Posture is equally important when doing chores. While working, make sure your lower back is in a neutral position to avoid a forward curve in your spine. Watching your posture over the years will help avoid vertebral compression fractures due to osteoporosis.

Osteoporosis, or thinning bones, can result in painful fractures. Risk factors for osteoporosisosteoporosis include aging, being female, low body weight, low sex hormones or menopause, smoking, and some medications.

To learn more about osteoporosis, bone anatomy, fracture prevention exercises to promote bone health, updates on treatments, measures to promote strong bones and personal risk factors, register to attend a free health seminar on October 14, 2014 at Greenwich Hospital in the Noble Conference Room.  The panel of speaker include ONS Orthopedic Surgeon Steven Hindman, MD, Greenwich Hospital Endocrinologist Renee Ileva, MD and ONS Physical Therapist Betsy Kreuter, PT, CLT . After the seminar you will be able to ask the doctors and therapist questions.

ONS Orthopedic Surgeon and Hand Specialist, Mark Vitale, MD Presents at 69th Annual American Society for Surgery of the Hand (ASSH)

Dr Vitale Portrait -sm web
Mark Vitale, MD

September 19, 2014, ONS orthopedic hand surgeon Dr. Mark Vitale traveled to Boston at the 69th annual American Society for Surgery of the Hand (ASSH), the premier annual hand surgery meeting where the nation’s leading hand surgeons gather to present new research and techniques for the care of hand, wrist, nerve and upper extremity problems.

Dr. Vitale presented two of the conferences’ 84 podium presentations to the community of hand surgeons in the U.S. and abroad. One of his presentations entitled, “Intra-articular fractures of the sigmoid notch of the distal radius: an analysis of progression to distal radioulnar joint arthritis and impact on upper extremity function in surgically treated fractures,” was a study that looked at fractures of one of the understudied joints of the wrist. This study will help surgeons guide treatment of these fractures to optimize wrist function in surgically treated fractures.

Traditional treatments for thumb arthritis involve removing the arthritic bone in the wrist called the trapezium which forms a joint with the base of the thumb and then using part of a patient’s own tendon to reconstruct the thumb. Dr. Vitale’s research revealed that the results with this more traditional “trapeziectomy” surgery are excellent and time tested.21

Dr. Vitale Speaking at the ASSH His second presentation, “A comparison of pyrolytic carbon hemiarthrioplasty versus Thompson suspensionplasty in the treatment of trapezial metacarpal arthritis,” was a study that compared a traditional treatment for thumb arthritis with a new pyrocarbon joint replacement for the thumb.

Pyrolytic carbon joint replacement is a synthetic implant to replace the arthritic thumb/wrist joint that was initially developed and first used in conjunction with hand surgeons at the Mayo Clinic in Rochester, MN. It resurfaces the base of the arthritic thumb metacarpal bone while leaving more of the native trapezium bone in place. The pyrolytic joint replacement implant has been used since the early 2000s. The result of this study found some improved function in patients treated with the pyrocarbon joint replacement, but also a higher risk of need for future surgeries in those treated with the newer joint replacement.

Hand surgeons today debate about what surgical procedures are most appropriate for severely arthritic thumbs. The results of Dr. Vitale’s research will now help guide surgeons around the country to better treat patients.

Dr. Vitale commented, “The ASSH conference was a great success. The ONS Foundation for Clinical Research and Education has provided us with an incredible state of the art research and biomechanics lab from which we continue to drive the field of hand surgery, sports medicine and orthopedic surgery.”

Orthopaedic and Neurosurgery Specialists PC (ONS) is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.