ONS Archives - Orthopaedic & Neurosurgery Specialists

ONS Turns 20!

Posted on October 29, 2018

THE ONS STORY

This month, Orthopaedic and Neurosurgery Specialists, PC (ONS) entered its 20^th year as one the most respected and trusted orthopedic and spine practices in the region. Through the years, the practice has stayed true to its mission of putting the patient first and providing the highest standard of specialty care.

A BOLD NEW PLAN

Back in October of 1998, the concept for ONS was bold and new: to build a community practice of elite fellowship-trained subspecialists and neurosurgeons whose training , skill and expertise rivaled that of the doctors at large, city hospitals. Today, ONS’s physicians rank top among their counterparts by national, regional and local peer ranking agencies.

The original ONS was created with the merger of the practices of orthopedic surgeons Seth Miller, MD, John Crowe, MD (who retired in 2015), and neurosurgeon Mark Camel, MD, each of whom had top-tier specialty training in their respective fields. Their business model focused on providing specialized care of the entire musculoskeletal system. Their belief was, and continues to be, that patients have better outcomes when treated by a physician who specializes in their particular type of condition or injury. With this in mind, they assembled the practice with doctors who had specialty training in all the major body parts; shoulder and elbow, hand and wrist, knee, foot and ankle, joint replacement and the spine.

“Twenty years ago, it was a common belief that you had to drive to New York City to get the best specialized care,” said ONS president Dr. Miller. “We set out to challenge that assumption by recruiting exceptionally qualified physicians from the most elite specialty fellowship programs in the country to come work here in Greenwich, CT. We wanted to deliver world class care in a convenient and friendly environment so people could avoid the hassle of going to the city.”

This business model also supported a team-based approach to patient care. At ONS, physicians do not compete with one another for patients. Instead, ONS physicians work in collaboration with each other to ensure that a patient is seen by the most appropriate physician to treat that individual’s condition. That unique model consistently earns the practice patient satisfaction scores higher than 90%.

INVESTING IN THE FUTURE

From its humble origins on the first floor of Building 6 at Greenwich Office Park in Greenwich, patient satisfaction and word of mouth propelled the practice’s expansion. ONS now occupies the entire building and has satellite locations in Stamford, CT and Harrison NY, where 26 orthopedic and spine physicians provide comprehensive musculoskeletal care from head to toe. All ONS locations feature physical therapy centers and digital X-ray. The Greenwich and Stamford locations also offer state-of-the-art MRI services. In addition, ONS leases space in Building 9 of Greenwich Office Park to house the finance and accounting departments and the Call Center.

With a focus on delivering the best possible patient outcomes, ONS has invested in leading edge technologies like digital X-ray systems and ultrasound to stay at the forefront of patient care. They were leaders in adopting electronic medical records (EMRs) to replace paper charts, and ONS is still among the few independent practices to offer onsite MRI services.

In 2004, ONS was among the first private practices to offer physiatry. Also known as physical medicine and rehabilitation, physiatry is a field of medicine that specializes in the diagnosis and non-surgical treatment of the musculoskeletal system and the diseases and conditions that affect a person’s ability to function in a normal capacity.

ONS fellowship-trained physiatrists use non-surgical, opioid-free treatments including epidural injections and image-guided steroidal injections as alternatives to surgery. With the advent of regenerative medicine therapies using stem cells, platelet rich plasma and other natural substances, physiatrists also perform the newest biologic treatments that promote self-healing.

ACHIEVEMENTS AND MILESTONES

During the past two decades, ONS physicians have broken clinical ground in a number of areas. They were among the first to do computer-assisted joint replacements, image-guided therapeutic injections, and Cyberknife® procedures.

In 2006, Dr. Miller became the first surgeon in Connecticut to perform a reverse shoulder replacement. The previous year, Dr. Francis Ennis was the first in the region to perform a computer-assisted knee replacement. More recently, Drs. Clain and Dr. Yakavonis were among the first to use a new synthetic cartilage to treat MTP joint arthritis. In August of this year, spine specialist, Dr. Scott Simon, was the first neurosurgeon in Fairfield and Westchester counties to perform spine surgery using a highly advanced robotic navigation system. ONS surgeons have also been ahead of the curve in developing opioid-free pain management protocols and opioid-sparing surgery.

ONGOING RESEARCH AND DISCOVERY

ONS physicians don’t just rely on the research of others. Through the establishment of the non-profit ONS Foundation for Clinical Research and Education (ONSF) ten years ago, ONS physicians have studied and developed better techniques to improve patient outcomes. ONSF research has been published in the most respected national and international medical journals and ONS physicians are often called upon to speak at medical conferences. ONSF president, Dr. Paul Sethi helped establish guidelines for surgical techniques and helped set surgical standards for needle use during certain surgical procedures. Dr. Sethi and other ONS physicians have taken a lead role in developing new national guidelines for the use of opioids to manage post-surgical pain. Now most ONS surgical patients can avoid addictive pain medication due to the use of new pain management protocol delivered during surgery. The Foundation’s community outreach projects include injury prevention seminars, a mini-med school summer program for high school students who have an interest in a career in medicine, class trips from local schools and technical demonstrations to outside clinicians.

A FOCUS ON SPORTS MEDICINE

As sports and athleticism gained popularity with people of all ages and abilities, ONS established a Sports Medicine specialty center that has attracted physicians into the practice who have had affiliations with professional sports teams such as the New York Mets, Los Angeles Dodgers and Texas Rangers as well as local college and high school teams. ONS sports medicine specialists apply the same treatment strategies used for high performance professionals to care for semi-pro, student and recreational athletes. ONS sports medicine specialists also launched ONS Ortho Access, a resource for school trainers and coaches to have immediate access to a physician by phone to assist in determining the best way to manage a student who has been injured during a game or practice.

AMBULATORY SURGERY

In 2016, ONS Partners opened the Stamford Ambulatory Surgery Center(ASC), at First Stamford Place in Stamford, CT. The ASC is a brand new facility specifically designed for musculoskeletal surgeries and interventional pain management. The Center includes four surgical suites designed for orthopedic and neurosurgical procedures with the latest arthroscopic and computer-assisted technology. Particular attention was paid to patient comfort when designing the waiting room, and pre-operative and post-operative areas. The Stamford ASC is Accredited by the Association of Ambulatory Health Care (AAAHC), and licensed by the Connecticut Department of Public Health (DPH).

EXPANDED HOURS FOR PATIENT CARE

In June 2018, ONS launched ONS Urgent Ortho Care. The after-hours, convenient walk-in service provides a fast, cost-effective alternative to an emergency room visit for sudden injuries or other musculoskeletal problems. Urgent orthopedic care is available on Mondays through Fridays from 5:00 – 8:00 pm and from 12:00 – 4:00 pm on Saturdays. There are plans to expand the service later in the year.

The practice employs over 200 in staff including operations, call center, billing office and clinical operations. Some of whom have been with ONS since its founding. ONS is in network with all major insurances and many smaller insurance providers.

In this day and age of costly concierge medicine and large hospital physician networks, ONS has always held true to its founding mission: to provide world-class, specialized care to patients in Fairfield and Westchester County, with the convenience and personal touch of a small, independent community practice. That unique ONS brand of care and compassion will never change with age.

ONS Surgeon Named Doctor of Distinction

Posted on April 20, 2016

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

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

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

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

Will Your Knees Be Ready to Ski? Tips from ONS to Avoid Injury

Posted on December 2, 2015

Although the forecasts are not yet predicting snow, skiers and snowboarders would be wise to take up a targeted conditioning program now to avoid the aches and injuries that often plague them on the slopes. Winter activities tend to tax muscles and muscle groups that are used very little during the rest of the year. As a result, even the best athletes can suffer when taking on the extreme stresses of downhill sports.

Orthopedic surgeon Steven Hindman, MD of Orthopaedic and Neurosurgery Specialsts (ONS) in Greenwich and Stamford, CT, suggests that preseason conditioning exercises can help avert pain and the most feared knee injury of all – a season-ending tear to the ACL (anterior cruciate ligament) .

“Ideally, people should start a conditioning program two to three months before they get near the mountain,” said Dr. Hindman. “But it’s never to late to benefit from a preventive exercise routine.” Too often, he noted, people go from their car to the ski lift without a single stretch. Such lack of preparation greatly increases the risk of injury.

One of four ligaments that provide stability to the knee, the ACL can tear when there is a sudden strain, abrupt change of direction, or twisting of the knee joint while the feet remain in a single direction. Skiers are at greatest risk to strain the ACL to the point of tearing when they try to recover from a fall with their body weight in back of the skis, if they don’t land a jump correctly, or if improperly set ski bindings don’t release during a a critical moment. ACL tears usually require surgery and a lengthy recuperation to repair.

Since the major leg muscles work the hardest when skiing and snowboarding, exercises should focus on strengthening thighs, hamstrings, calves and hips. Workouts that incorporate these muscle groups will help maintain good balance, stabilize the knee during stress situations and build endurance for a full day on the mountain. Adding practices such as yoga and Pilates will also develop strength and balance while improving the body’s flexibility and core fitness.

As important as conditioning is off the slopes, knowing your body’s limit is key on the slopes. Studies show that the majority of injuries happen at the end of the day with the combination of fatigue, flat light, and deteriorating snow conditions. “When you get tired, stop,” said Dr. Hindman.

ONS is In-Network with Cigna Insurance

Posted on October 15, 2015

ONS is pleased to announce that all of our doctors and ONS Physical Therapy are now in-network with Cigna Insurance. Cigna joins the growing list of in-network insurances with which ONS participates. ONS continues to look for opportunities to expand our accessibility to patients throughout our community. Look for additional insurance announcements in the coming months. If you have questions about our insurances, please call 203-869-1145, ext. 226.

Click here for a full list of in-network insurances at ONS.

Overuse Injuries: Cause and Effect (Part I)

Posted on January 7, 2015

Gloria Cohen, MD is a specialist in non-operative sports medicine who believes in taking an integrative approach to medical management by considering a patients’ bio-mechanics, cardio-vascular and pulmonary function as it relates to athletic performance. Aside from her impressive medical career, Dr. Cohen is a successful competitive runner who has qualified twice for the New York Marathon and is also an off-road and road cyclist. Her academic insights are a combination of both research and real-world experience, the following article is her most recent commentary on the topic of “overuse injuries”:

What is an “overuse injury”?
An “overuse injury” is an injury that results when excessive stress is applied over a period of time to bones, muscles, tendons, and other supporting soft tissue structures of a particular body part. This differs from an acute injury which happens quickly and is traumatic in nature. Too much stress to a body part will cause the tissues to break down faster than healing can occur, thereby resulting in an injury. A good analogy would be to consider what happens to a credit card or a piece of metal when you bend it back and forth repetitively – first you see the stress reaction, and then with continued stress the item breaks in two. As you can appreciate, we want to avoid the latter situation when it comes to the body.

What are some common examples of “overuse injuries”?
Every body part can be affected by an overuse injury. Some common examples you might be familiar with are: rotator cuff injuries of the shoulder; epicondylitis or tennis elbow; patellofemoral pain syndrome of the knee; and tibial stress syndrome or “shin splints” for the lower leg. Here are a few case examples of classic overuse syndromes:

A 40 year old male has recently increased the intensity and frequency of his swimming activity over the summer months. He now complains of pain in the front of his shoulder with overhead and rotation motion. Diagnosis: Rotator cuff tendinitis
A 30 year old female has been playing tennis daily, now competing in matches at a more difficult level. She complains of increasing soreness in the outside aspect of her elbow. She had tried to play through the pain, but had to stop. She says that she can barely lift a coffee cup now because of the elbow pain. Diagnosis: Tennis Elbow /Lateral epicondylitis
A 20 year college student takes up running during her summer break from school. When she returns to school, she decides to train for a half marathon. As she increases her mileage, and adds speed work to her training program, she develops pain in the inside aspect of one shin. She now complains of pain with just walking. Diagnosis: Shin splints/Medial Tibial Stress Syndrome

What are some of the specific causes of these “overuse injuries”?
As a primary care sports medicine physician I recognize that there are sport specific issues which may contribute to the resulting injury; but there are common “intrinsic” and “extrinsic” factors which play a major role in the development of these types of injuries. “Intrinsic” factors refer to the elements that we cannot control but that we can modify. These include biomechanical alignment, such as knock knees, bowl legs, flat feet or high arched feet; leg length difference; muscle imbalance; muscle weakness; and lack of flexibility. These factors can be modified to maximize the individual’s performance, and thereby treat or prevent injury. An example would be a conditioning program and sport specific training. The “extrinsic factors” include training errors, such as doing “too much too soon”; training surfaces – running on too hard a surface, or playing on an uneven surface; shoes – it is important to wear the appropriate type of shoe for your foot mechanics and the sport; equipment; and environmental conditions. Paying attention to the “extrinsic factors” will help you modify the “intrinsic” ones.

… to be continued in the next segment, Overuse Injuries: Recovery (Part II)

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 Orthopedic Surgeon Seth Miller, MD, Elected to Join Elite Medical Society

Posted on October 28, 2014

At the October Closed Meeting of the American Shoulder and Elbow Surgeons (ASES), held in Pinehurst, NC, ONS (Orthopaedic and Neurosurgery Specialists) orthopedic surgeon Dr. Seth Miller was elected to join the ASES organization. “Membership in ASES is a privilege and an honor” said Dr. Jim Cunningham, ONS Vice President. Membership in American Shoulder and Elbow Surgeons is by invitation only. Only experienced orthopedic surgeons who have completed a fellowship in shoulder surgery, elbow surgery, and/or sports medicine are considered for membership.

Dr. Miller, in his 25^th year in practice at ONS in Greenwich, has ascended quickly in his career being recognized with such a national honor. Candidates must meet strict academic and clinical requirements to become members of ASES.

“ASES is a remarkable collection of like-minded surgeons, and researchers who, through their collaboration and the sharing of techniques and outcomes, work together to solve the most complicated and pressing shoulder and elbow disorders. Founded on the premise that by such sharing of ideas we can determine the most efficient, cost effective, high quality shoulder and elbow care” said Dr. Robert Bell, ASES President.

The American Shoulder and Elbow Surgeons was created to enhance the study of shoulder and elbow surgery and to foster advances in the field, serving as an educational body responsible for scientific programs and advances. The Mission of the ASES is to support the ethical practice of evidence-based, high quality, cost-effective, shoulder and elbow care.

The society global impact on quality shoulder and elbow care is achieved through leadership, medical education, scientific research, and patient advocacy. Congratulations to Dr. Miller on becoming an Associate Member of the society.

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.

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

Posted on October 14, 2014

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

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

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

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

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

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

ONS SPONSORS NEWS 12 SCHOLAR ATHLETE AWARD

Posted on October 13, 2014

October 2014 – June 2015, NEWS 12 CONNECTICUT will introduce and recognize a local area high school student athlete by featuring the student and their school during the NEWS 12 CONNECTICUT SCHOLAR ATHLETE weekly segment sponsored by ONS. Students who excel in both academics and athletics are nominated by coaches and athletic directors with extracurricular activities and leadership qualities noted. At the end of each academic year, scholarships are awarded to three NEWS 12 CONNECTICUT Scholar Athletes.

Watch NEWS 12 CONNECTICUT on Mondays 5 p.m. to midnight to catch the stories of the nominees. Cross-channel airing will run on CNBC, ESPN, ESPN2, MSG-TV, NBCS-TV or visit <NEWS 12 Sports online>.

Missed a segment? Links to our NEWS12 SCHOLAR ATHLETES are listed below:
Matt Doyle
Jamie Kockenmeister
Olivia Haskell
Simon Whiteman
Ali Weiner
Lars Pederson
Hannah Caldwell
Elizabeth Miller
Dugald Shannon

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.

Train Right, Run Free! ONS Physical Therapist Alicia Hirscht Shows Us how to Train for a Marathon

Posted on September 16, 2014

The ONS Foundation’s Annual 5K Run/Walk is coming up this Sunday, September 21^st in Old Greenwich! ONS supporters, staff and former patients will participate in this fun-filled event. It would be great to see you all come down and enjoy a nice morning jog. Some of you may be casual joggers, others might want to participate in the local race circuit, or you might be training for the NYC Marathon.

Whether you are a casual runner, training for the marathon, or just someone who supports local causes with a 5K run…all runners are at risk of developing injuries if they are not training properly. A question I ask all my runners in the clinic is, “What else do you do for training, besides running?” More often than not, the answer is, “nothing” or “I stretch sometimes.” What many runners do not know is that research has shown an effective leg and core strengthening program can reduce the incidence of hip, knee and ankle pain.

A proper program needs to have exercises specific for running: weight bearing on one leg, focused on shock absorbing muscle groups, and emphasizing hip and core strength. Many runners feel that stretching in their training can help prevent injury. However, many injuries occur because of inherent muscle weakness, not necessarily because of tightness. To address this weakness, incorporate the exercises below into your routine: 3 times per week. Good luck with your training!

Hamstring Curls with the Ball:

1. Lie on your back with your legs up on a ball.

2. Lift your hips, bend your knees and roll the ball in towards your buttocks.

3. Roll the ball back out and lower your hips.

One Legged Bridges:

1. Lie on your back with one knee bent, the other straight in the air.

2. Pushing through the bent knee, lift your hips off the ground. Lower back down.

Repeat: 3 sets of 15 reps on each leg.

Sideplanks:

1. Lie on your side, heels in line with your shoulders.

2. Supporting yourself on your elbow, lift your body off the ground. Lower back down, repeat:

3. Lower back down, repeat:

Hip Dips:

1. Stand on your left leg only.

2. Let your trunk bend forward while extending your right leg straight back. Let your arms fall freely, keep your left knee slightly bent. Keep your stomach muscles tight and your back in neutral, bend through your hip.

3. Return to start position, repeat: 2 sets of 15 reps on each leg.

One Legged Heel Raises:

1. Stand off the edge of a step, letting your heel hang below the step.

2. Push up onto your toes. Lower back down slowly.

Repeat: 3 sets of 15 reps on each leg.

Lateral Squats:

1. Stand sideways on a step.

2. Sit your hips back and bend your knee, lowering your opposite leg to the ground. Do not let your knee fall inward and do not let it bend past your toes.

3. Lift back up and repeat: 2 sets of 15 reps

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.

Foot and Ankle Surgeon and Physiatrist join ONS

Posted on August 28, 2014

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

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

Dr. Yakavonis learned his medical degree at New York Medical College, in Valhalla, NY. He did his residency in orthopaedic surgery at Boston University Medical Center, in Boston, MA and completed fellowship training in foot and ankle surgery at Harvard-Massachusetts General Hospital in Boston, MA.

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

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. Yakavonis 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. Yakavonis 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”

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.