New Pain Reducing Procedure Studied by ONS Orthopedic Surgeons

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.

Double Shoulder Replacement Restores Mobility

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 issuesD.Hapke in Kayak 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. 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.

ONS Physicians Open State-of-the-Art Ambulatory Surgery Center

Stamford ASC is a new ultra-modern ambulatory surgery center designed specifically for orthopedic surgery and neurosurgery. Clain ASC_edited-1

The Stamford ASC has recently received Connecticut State Department of Health approval for license and is now open for physicians to treat patients. Stamford ASC specializes in musculoskeletal surgeries and interventional pain management. The center includes two surgical suites built specifically for orthopedic and neurosurgical procedures, equipped with the latest arthroscopic and computer-assisted technology. The facility also has a procedure room for interventional pain management, a comfortable waiting room, and pre-operative and post-operative areas designed for utmost safety, comfort and efficiency. The technologically advanced surgery center offers patients access to the same arthroscopic and open surgery options found in a hospital setting but in a smaller, more comfortable environment.
Entrance 2 (2)

The warm surroundings of the center and emphasis on caring, individualized attention minimizes the stress often associated with surgery. Patients are released within hours of their procedure so they may complete their recovery in the comfort of home. Covered parking and a ground level entrance help make the patient experience as easy and convenient as possible.
“The Stamford ASC is the result of several years of research and planning, which began when ONS partners with a shared mission set out to build an industry-leading surgical care facility,” said Mark Camel, M.D., one of the Stamford ASC partners.

Formed by 14 experienced and respected orthopedic surgeons and neurosurgeons affiliated with Orthopaedic and Neurosurgery Specialists (ONS) in Greenwich and Stamford CT, the Stamford ASC reflects the standard of excellence that patients have come to expect from surgeons at ONS. “In the current healthcare environment, patients are looking for a more personalized surgery experience that is first and foremost, safe and efficient,” said Dr. James Cunningham, Medical Director of Stamford ASC. “This center will provide service that meets, if not exceeds, the most stringent Government safety requirements and infection controls.” The center was surveyed and approved by the Connecticut State Department of Health earlier this month.

“High quality outpatient facilities such as Stamford ASC best position physicians for healthcare industry challenges by combining cost efficiency with cutting edge technology and a new kind of patient experience,” said Dr. Cunningham. “I fully expect that the Stamford ASC will set the standard for efficient, cost-effective and patient-focused care in the region.”

Read the local press coverage in Greenwich Time and on the Daily Voice

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.

Greenwich Hospital Announces New Chief of Staff, ONS Neurosurgeon Paul Apostolides, MD

Paul Apostolides, MD Neurosurgeon
Paul Apostolides, MD
Neurosurgeon

Dr. Paul Apostolides, Section Head of the division of Neurosurgery at Greenwich Hospital, has been appointed hospital Chief of Staff as of January 1. Dr. Apostolides joined Greenwich Hospital’s medical staff in 1998 and has served on many committees including the credentialing committee, executive committee and peer review committee. For three years prior to his current appointment, he was Assistant Chief of Staff. He has served on the Greenwich Hospital Board since 2012.

A graduate of Stanford University and University of Massachusetts Medical School, Dr. Apostolides completed his residency and fellowship training at the Barrow Neurological Institute. He is board certified by the American Board of Neurological Surgery, and is in practice with Orthopaedic & Neurosurgery Specialists (ONS) in Greenwich. He specializes in minimally invasive as well as complex reconstructive spinal surgeries.

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.com, or call (203) 869-1145.

Accomplished Orthopedic Surgeon joins ONS Sports Medicine Team

Marc Kowalsky MDOrthopedic surgeon and fellowship trained sports medicine specialist Marc Kowalsky, MD has joined the ONS team. Dr. Kowalsky has expertise in conservative and operative treatments of upper and lower extremity sports injury, as well as complex shoulder and elbow pathology including degenerative disease, and trauma.  He has a particular interest in the management of shoulder and elbow arthritis, instability, rotator cuff tears, labral injury, and cartilage disorders.

Dr. Kowalsky looks for rehab-focused, non-operative solutions whenever possible, recommending surgery when it will be most effective. His goal is to return patients quickly, safely and fully to their best function and performance.

Dr. Kowalsky earned his medical degree at Tufts University School of Medicine, Boston, MA where he also earned an MBA in Health Management. He did his residency in orthopedic surgery at Columbia University Medical Center, New York Orthopaedic Hospital in New York, NY. He also completed fellowship training in shoulder and elbow surgery at Washington University School of Medicine, Saint Louis, MO and in sports medicine at Lenox Hill Hospital, Nicholas Institute of Sports Medicine & Athletic Trauma, New York, NY.

He has authored original research manuscripts, review articles, and textbook chapters focusing on AC joint reconstruction, rotator cuff repair, and shoulder replacement. He currently serves as a reviewer for the Journal of the American Academy of Orthopaedic Surgery and the Journal of Shoulder and Elbow Surgery.

“Dr. Kowalsky will be a great asset to our practice as we meet the growing demand for musculoskeletal care in Fairfield and Westchester counties,” said Dr. Seth Miller. “His high level of training and accomplishments reflect the ONS standard of offering the highest level of care possible to our patients.” He is in network with Aetna and Oxford/United Healthcare.

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.

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.

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.

Foot and Ankle Surgeon and Physiatrist join ONS

Specialists in foot and ankle surgery and physiatry added to growing practice.

We are pleased to announce that orthopedic surgeon Sean Peden, MD and interventional physiatrist Christopher Sahler, MD have joined the ONS team.

Sean Peden, MD
Sean Peden, MD Foot and Ankle Surgeon

Dr. Peden earned his medical degree at Washington University in St. Louis School of Medicine. He did his residency in orthopedic surgery at The George Washington University in Washington, DC and completed fellowship training in operative and non-operative care of the foot and ankle at Michigan International Foot and Ankle Center, Pontiac, MI.

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 also focuses on youth-athlete sports injuries and the types of injuries seen in field athletes, gymnasts and ballet dancers.

Christopher Sahler, MD
Christopher Sahler, MD Physiatrist

Dr. Sahler completed his residency in physical medicine and rehabilitation at the Mount Sinai Hospital in Manhattan where he was elected Chief Resident. He continued his training at the Mount Sinai to complete a fellowship in sports medicine and interventional spine treatments. During that time, he also served as team physician for the Globe Institute Junior College sports teams, and was a physician and team captain for the New York City Marathon. He is board certified in sports medicine.

Dr. Sahler uses biomechanical assessments and diagnostic ultrasound to determine the precise source of a problem. He applies non-operative modalities to treat musculoskeletal injuries and restore proper function including ultrasound and X-ray guided steroidal injections, viscosupplementation and PRP (Platelet Rich Plasma) to treat pain and restore proper mobility. Both doctors are in network with Aetna, Oxford/United Healthcare, and Yale New Haven Anthem. “We are pleased to bring two new sub-specialty trained physicians into our practice to meet the growing demand for musculoskeletal care in Fairfield and Westchester counties,” said Dr. Seth Miller. “Dr. Peden and Dr. Sahler are both highly trained and will be great assets to our practice.”

Upcoming Events at Greenwich Hospital

  • On Tuesday, December 2, from 6 to 7 p.m., Dr. Sahler will speak about exercise as a treatment for chronic pain.
  • On Tuesday, December 9, from 6:30 to 7:30 p.m., Dr. Peden will talk about solutions for foot and ankle pain; beyond foot massage.

Both talks will be held in the Noble Conference Center and are open to the public. ONS is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopaedic, spine and brain surgery, joint replacement and trauma. 

ONS Sports Medicine Specialists and Orthopedic Surgeons awarded 2nd place at The American Orthopaedic Society for Sports Medicine Meeting for “Incidence of Culture Positive Propionibacterium Acnes in Shoulder Arthroscopy”

UNDERSTANDING AND PREVENTING SURGICAL SITE INFECTION

The American Orthopaedic Society for Sports Medicine (AOSSM) was founded primarily as a forum for research and education for orthopedic surgeons, physicians and health care professionals in the field of sports medicine. Each year the AOSSM holds a conference to highlight areas of recent research, surgical techniques and to debate and share clinical insights about hot topics in the field of sports medicine. Physicians are recognized and awarded for their efforts in research and presentations about sports medicine conditions.

At the annual AOSSM meeting held in Seattle, Washington this July 10th-13th, ONS orthopedic surgeons Timothy Greene, MD, Katie Vadasdi, MD, director of the ONS Women’s Sports Medicine Center and Paul Sethi, MD, President of the ONS Foundation for Clinical Research and Education, were awarded 2nd place for research presented on “Incidence of Culture Positive Propionibacterium Acnes in Shoulder Arthroscopy.” This research is best described in a statement below from Dr. Paul Sethi:

“As the field of shoulder surgery and, particularly, shoulder replacement grows, the risk of developing shoulder infection increases. When treated imperfectly, infection may cause devastating complications. Our goal is to help develop a universal measure to absolutely minimize post-surgical infection. Reducing complications adds value to patient experience and avoids the costly road of infection eradication. The bacterium (Proprionibacter Acnes) most commonly attributed to shoulder infection is a very unusual organism. Until recently, it was not properly recognized because it was so difficult to identify.

Now that one of the greatest bacterial offenders (in the shoulder) has been more clearly identified, we are looking for ways to prevent it from infecting patients. In our last study we took over three hundred cultures and studied them. After careful analysis, we were able to identify when (during surgery) patients are most susceptible to this bacterial infection and were able to determine just how frequently this bacteria is present. Now that we know when this bacterium may gain its access to patients, we are developing ways to attack it at the patient’s point of vulnerability.”

Paul Sethi, MD
Paul Sethi, MD
Katie Vadasdi, MD
Katie Vadasdi, MD
Timothy Greene, MD
Timothy Greene, MD

Sethi PM, Greene T, Vadasdi K, Miller S.  Incidence of P. Acnes Culture after Primary Shoulder Arthroscopy.  AOSSM Annual Meeting. Seattle, WA. July 2014

Posters are judged by the AOSSM Education Program Committee. With just three poster awards available, we congratulate our physicians on their research and 2nd place award.

ONS Foundation Awarded 2nd Place in AOSSM Poster Contest
ONS Foundation Awarded 2nd Place in AOSSM Poster Contest

For more information on the AOSSM Annual Meeting, please click here: http://www.sportsmed.org/Education/Meetings/Annual_Meeting_2014/2014_Annual_Meeting/

Program:
http://www.sportsmed.org/uploadedFiles/Content2/Education/Meetings/Annual_Meeting_2014/AOSSM%202014%20Final%20Program.pdf

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 orthopaedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.

 

 

ONS Orthopedic Surgeon and Sports Medicine Specialist, Timothy Greene, MD Gives Insight on Paul George Injury

Time Greene, MDTeam USA’s scrimmage this past Friday night was definitely one to remember; and not in a good way. ONS Orthopedic Surgeon and fellowship trained Sports Medicine Specialist, Timothy Greene, MD, gives us some insight on NBA Super Star, Paul George’s gruesome injury that caused jaws to drop and made an entire arena become strikingly silent.

“NBA star Paul George sustained a gruesome leg injury during Friday night’s Team USA basketball game in Las Vegas. While trying to contest a layup, George’s leg hit the basketball stanchion causing an open tibia/fibular fracture. The injury consists of a complete break of the shin bone and small bone in the lowerleg that penetrates through the skin. When the bone penetrates the skin, there is an increased risk of infection and thus an urgent surgery was preformed the night of the incident to clean and repair the ends of the bone and skin and place a rod in the shin bone.

The road to recovery will most likely be a long one for the NBA superstar. When the bone penetrates the skin, it increases the time for healing. Studies examining these types of injury show that it can take up to 6 months to get complete healing of the bone. Although we often see our professional athlete’s recover and return to a high level of play in a surprisingly rapid timeframe, it is not unreasonable to expect that Paul George may take an entire year to return to elite level basketball.”

To learn more about the incident, read this article by The Huffington Post.

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 orthopaedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com. 

ONS Docs Included in Castle Connolly New York Top Doctors Guide, 17th edition

14 Specialists from ONS included in New York Area Medical Guide Book top primary care and specialty care doctors in the tri-state metropolitan New York area.

Fourteen physicians from Orthopaedic and Neurosurgery Specialists (ONS) on Valley Drive are included in the latest edition of Castle Connolly Top Doctors, New York Metro Area guidebook. The resource directory, which is in its seventeenth edition, is a guide to finding the top primary care and specialty care doctors in the tri-state metropolitan New York area. It details information on over 6,400 physicians in 65 specialties. Physicians profiled in the guide were nominated by their peers and screened by a research team at Castle Connolly.

ONS Neurosurgeon Paul Apostolides, MD
Paul Apostolides, MD
Mark Camel, MD
Mark Camel, MD
Doctor Photos_Fiore_web
Amory Fiore, MD
Scott Simon, MD
Scott Simon, MD
Michael Clain, MD
Michael Clain, MD
Doctor Photos_Crowe
John Crowe, MD
James Cunningham, MD
James Cunningham, MD
Frank Ennis, MD
Frank Ennis, MD
Brian Kavanagh, MD
Brian Kavanagh, MD
Seth Miller, MD
Seth Miller, MD
Paul Sethi, MD
Paul Sethi, MD
Katie Vadasdi, MD, orthopaedic surgeon and sports medicine specialist
Katie Vadasdi, MD
Jeffrey Heftler MD, Physiatrist
Jeffrey Heftler, MD

Castle Connolly Top Doctors® are nominated by their peers including physicians and hospital executives throughout the New York metropolitan region in an online survey process. Nominations are open to all board certified MDs and DOs. Nominated physicians are selected by the Castle Connolly physician-led research team based on criteria including medical education, training, hospital appointments, disciplinary histories and much more.

ONS physicians included in the 17th edition of the guide are neurosurgeons Paul Apostolides, MD; Mark Camel, MD;  Amory Fiore, MD; and Scott Simon, MD, orthopedic surgeons Michael Clain, MD; John Crowe, MD; James Cunningham, MD; Frank Ennis, MD; Steven Hindman, MD; Brian Kavanagh, MD; Seth Miller, MD; Paul Sethi, MD; and Katie Vadasdi, MD and physiatrist Jeffrey Heftler, MD.

“We congratulate our physicians who have been recognized as ‘Top Doctors’ by Castle Connolly,” said hand and wrist specialist Dr. John Crowe. “Having fourteen of our fine doctors included in this authoritative guide is a reflection of the commitment and quality of excellence of all our physicians and entire staff at ONS. The multidisciplinary nature of ONS makes it possible to provide patients with access to the most advanced care available in orthopedics, neurosurgery and physiatry.”

Survey recipients are asked to nominate those doctors who, in their judgment, are the best in their field and related fields– especially those to whom they would refer their own patients and family members.

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 orthopaedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.

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