Greenwich Hospital Archives - Orthopaedic & Neurosurgery Specialists

Solutions for Hand, Wrist and Elbow Pain

Tips to manage chronic hand, wrist and elbow pain.

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

Your Aching Feet: Common Causes and Treatments for Foot Pain

Foot massages are a great way to ease foot pain, but the relief won’t last long if an underlying condition is the cause of your discomfort. Orthopedic surgeon Sean Peden, MD, a foot and ankle specialist at ONS, will discuss common foot ailments including plantar fasciitis that result in pain in the heel and bottom of the foot and metatarsalgia, inflammation at the ball of the foot. The informative presentation will include evidence-based treatments including effective home remedies and non-surgical care. He will also highlight some the new technological advances in foot care, including developments in regenerative medicine that helps promote self-healing.

2016 Joint Replacement Symposium

Considering Joint Replacement Surgery?

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

Double Shoulder Replacement Restores Mobility

Posted on May 5, 2016

SHOULDER REPLACEMENT REGAINS HIS ACTIVE LIFESTYLE JUST MONTHS FOLLOWING SURGERY.

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

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

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

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

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

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

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

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

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

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

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

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

ONSF 7th Annual Medical Education Conference Features NBC Sports Broadcaster, Dan Hicks

Posted on October 16, 2015

ONSF will hold its 7th Annual Medical Education Conference, entitled Caring for Athletes of All Ages, on Saturday, November 7th at the Greenwich Hospital Noble Auditorium. Dan Hicks, NBC Sports – Lead Host and Play by Play Broadcaster will deliver the Keynote presentation. ONS orthopedic specialists, Tamar Kessel, MD and Mark Vitale, MD are the conference chairs. Intended for physicians, nurses, physician assistants, physical and occupational therapists and athletic trainers and coaches, the one-day conference will feature presentations from 13 orthopedic specialists from ONS who will discuss different sports injuries in athletes of different ages and the newest approaches to effective rehabilitation. Read more about the conference here.

There is no fee to attend this conference, but registration is required at www.ONSF.org or by calling 203-869-3131.

Solutions for Knee Pain in Active Patients with Arthritis

Posted on April 12, 2015

SOLUTIONS FOR KNEE PAIN
in Active Patients with Arthritis

WHEN: Thursday May 7, 6:00 p.m.
WHERE: Greenwich Hospital Noble Conference Center
SPEAKER: Demetris Delos, MD

Are you suffering from knee arthritis pain? Middle-aged and older adults are staying more active than ever but some are unable due to pain and debilitation of knee arthritis. Demetros Delos, MD of ONS and Greenwich Hospital will discuss non-operative and operative treatments for knee arthritis for those who wish to remain active in sports and physical activities, without resorting to a total knee replacement.

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

Posted on March 28, 2015

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.

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

Posted on November 13, 2014

Mark Yakavonis, MD, MMS, is an orthopedic surgeon who specializes in foot and ankle surgery. Dr. Yakavonis 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 tendon 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. Yakavonis of ONS is an orthopedic surgeon specializing in foot and ankle surgery, and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage . He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

07/10/2019

Suffer from Bunion Pain? Dr. Clain Offers Solutions

Posted on November 10, 2014

“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

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. Yakavonis 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.

07/10/2019

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

Posted on November 3, 2014

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?

Posted on October 30, 2014

Mark, Yakavonis, MD, MMS, will be speaking at the Noble in Greenwich Hospital December 9th at

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 tendinitis 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, DPT, SCS, CSCS

Dr. Yakavonis 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. Yakavonis 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

07/10/2019

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

Posted on October 3, 2014

Most 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 osteoporosis 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)

Posted on September 29, 2014

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

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.

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”

Posted on August 11, 2014

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 10^th-13^th, 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 2^nd 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

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 2^nd place award.

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

Posted on August 5, 2014

Team 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

Posted on July 2, 2014

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.

Paul Apostolides, MD			Mark Camel, MD		Amory Fiore, MD	Scott Simon, MD
Michael Clain, MD			John Crowe, MD		James Cunningham, MD	Frank Ennis, MD

Brian Kavanagh, MD		Seth Miller, MD		Paul Sethi, MD
Katie Vadasdi, MD		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 17^th 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.