Osteoarthritis is the most common form of arthritis affecting middle-aged to elderly patients. Commonly known as the joints’ wear and tear arthritis, osteoarthritis involves all the structure forming the synovial joint rather than just the cartilage at the ends of the...
Pain from musculoskeletal conditions may be debilitating and affect the day to day life of patients. The pain such as knee pain or hip pain may begin suddenly after an injury or maybe a result of a long-standing underlying condition. The physicians usually prescribe...
Ultrasound therapy in the form of sustained acoustic medicine (SAM) has been used for the management of chronic pain due to arthritis. The SAM device is a noninvasive device with ease of applicability which may be used on a number of body parts. The SAM device...
A continuous passive motion (CPM) is a machine designed to help patients regain joint movement after a surgical procedure. The knee joint needs motion for its healthy function. A joint which is not moving for an extended period may become stiff. Many patients may...
Tennis elbow is known as lateral epicondylitis. Tennis elbow occurs most commonly between the ages of 30 and 50 years. Despite the name, the painful condition is more common among non-athletes rather than athletes. The pain is due to inflammation and tears of the...
Wrist pain is a common condition that affects all age groups. A number of different causes may lead to wrist pain. The pain may arise suddenly after an injury or may develop over time due to repetitive stress or arthritis. Daily activities such as driving, writing,...
A CPM machine utilizes a motorized part to move a joint without the effort of the patient. The machine may be used to increase the range of motion of the shoulder joint. Many patients may experience shoulder stiffness after surgical procedures such as rotator cuff...
Plantar fasciitis is a common condition causing heel pain. The pain is caused by inflammation of the plantar fascia at its insertion in the heel bone. The condition commonly affects athletes and nonathletes alike. The condition is associated with known risk factors...
Flat feet or pes planus is a common orthopedic condition that may lead to significant pain and deformity in the foot. Flat feet is an absence or low lying arch on the inner side of the foot. The main functions of the foot are to support the body weight and lever the...
Fusion Surgeries: ACDF – one of the most common cervical spine surgery. It’s done from the front, very safe surgery, minimal blood loss, patients usually can be sent the same day or the next day out of the hospital. In which we clean the disc, put a bone...
To start with, we’ll start with the clinical case, there’s a 78 year old male presents with bilateral hand clumsiness and balance problems. He has a history of a distant fall about four years back, which was managed conservatively and he had no fracture,...
So, spine surgery is not without complications and I think actually, it has more complications than other orthopedic surgeries. Rather, a big study from the database showed that long, degenerative deformity correction surgeries can have risk of minor and major...
One of the surgeries that we usually do. These are some of the surgeries that we do. This is a transarticular C1-C2 screw. In this case, we try to save the mobility on the CCJ, craniocervical junction. This is another fusion, harms fusion, or a C1-C2 fusion. This is...
Presentation: Those patients of degenerative spine usually present with radiculopathy which is characterized by the dermatomal levels from C4. Most common involvement is C6, but C5, 6, 7, 8. Occasionally T1 can be involved, and the radiculopathy is mostly diagnostic....
The natural history of these patients. So, most Odontoid fractures in elderly population can be treated conservatively, non-surgically, they are put in a C collar, they do really well. Only patients, either if there’s a young patient who has an Odontoid fracture...
As a clinical case, there’s an 80 year old male who is active and healthy, presents with clumsiness, has a fall, neurological status declining since two to three weeks, and then suddenly increased neurological deterioration following fall. Patient has upper...
90% of these patients get better over four to six weeks. They may have recurring episodes, they may have deterioration. As I talked, patients with spondylolisthesis, instability, 33% will worsen overtime, 33 will stay stable, 33 will get better. So patients who are...
Various type of surgeries that we do: Non-fusion surgeries, these are nobel surgeries, these are surgeries in which we are trying to keep the motion of the cervical spine intact because restricting the motion in the form of fusion leads to many other problems. So,...
So, what are the pathologies that we usually see on a cervical spine? This is a case of a congenital cervical stenosis. These patients usually are asymptomatic throughout their life, unless they have superimposed degenerative changes or superimposed injury. In case of...
So, apart from this, there are thoracic spine, rarely the patients can have a thoracic spine problems, mostly they are fractures, which are treated conservatively. Sometimes patients can have, rarely, can have thoracic myelopathy in which there is a bad disc, causing...
What are recent advances into the field of spine surgery? So we have started using more of navigation now. We have these sensors, infrared sensors. We have these fiducial we put down the bone, and then our drill, the sleeves, they are all marked. So these help us in...
Prosthetic joint infection (PJI) is a dreaded complication of joint replacement surgery. Any symptoms of fever and discharge from the surgery site warrant a thorough investigation. The diagnosis of joint replacement infection usually involves a history, physical...
Hip and knee joint replacement surgeries are one of the most successful surgeries in the history of modern medicine. The surgeries relieve the pain and disability caused by arthritis not amicable by conservative management options. But like all surgeries, there is are...
Presentation: Dermatomal Presentations. So most of the patients with spine pathologies will have some back pain, but more of radiculopathy. And radiculopathies patients who have radiculopathy do better with surgical treatment. The dermatomal level status where the...
A clinical case, 70 year old male presents with L4-5 degenerative spondylolisthesis, severe spinal stenosis L4-5, treated conservatively with multiple epidural injections. Had relief at some point of time, but deteriorates. So these patient’s natural history is...
These are the non-fusion decompression surgeries. So these are the patients who have stable spine, who have single or multiple level stenosis. These can even be done at all five levels of decompression. These are done from the back essentially. This is central...
Differential diagnosis can be anything from SI joint, visceral pathologies, hip, knee, neuropathies, and in fact, most patients who are in the older age group usually need a neurological consult also. They get a pain physician who will help them get epidural...
Next we have the lumbar spine. The next most mobile segment of our spine. Lumbar spine has five lumbar vertebrae, and it articulates with sacrum below. So actually sacrum also comes into the same gambit. Read more about Back Pain here
This is a degenerative spondylolisthesis. This is also a degenerative condition, essentially though it can happen in young, but it’s a desiccation, disc desiccation which causes this, leading with annular tear, posterior PLL (Posterior Longitudinal Ligament)...
So what are the non-fusion surgeries on lumbar spine? These are essentially done for fractures, kyphoplasty and vertebroplasty. These are patients who have what you call a compression fracture. They have no breach posteriorly, sometimes we did do them on the patients...
So, last slide. This is who needs spine surgery, finally. So cervical radiculopathy. So cervical radiculopathy – not relieved for four weeks despite measures, epidural injections, medications. Lumbar radiculopathy not relieved for four to six weeks. This should...
So what are the non-fusion surgeries on lumbar spine? These are essentially done for fractures: kyphoplasty and vertebroplasty. These are patients who have a vertebral compression fracture. They have no breach posteriorly. Sometimes we did do them on the patients who...
These are the usual fusion surgeries. There’s a whole gambit of fusion surgeries. Now, we can go from front, back, side, lateral, this, that everything, what we can find an angle, we can go do a fusion surgery. This is the most common one, TLIF. We go from the...
Hip and knee replacement surgeries have transformed the treatment of arthritis. Hip replacement is a surgery to replace the diseased parts of the hip joint with metal and plastic parts. The prosthetic parts duplicate the function of the natural, healthy joint. The...
Total hip replacement has revolutionized the treatment of hip pain resulting from arthritis. The hip pain may severely affect daily activities such as walking, bending, sitting, navigating stairs, or driving a car. The symptom which is often not discussed with the...
Long term alcohol intake is a common cause of avascular necrosis of the head of the femur. Chronic steroid intake and alcohol account for more than 60% of non-traumatic causes of avascular necrosis in the United States. Avascular necrosis commonly affects the head of...
Femoroacetabular impingement is treated with arthroscopic surgery or with open surgical dislocation and debridement. Signs You May Need Surgical Hip Dislocation The surgical hip dislocation is a unique procedure typically reserved in elective cases for people...
We are doing everything possible to keep patients and our doctors and staff safe during this tough time. Before giving patients an appointment to “physically” come into the office, our staff first prescreens all patients on phone. Patients then have a televisit with...
What can patients with pain in their joint or pain in knee or shoulder or hip or any other musculoskeletal pain do to decrease their pain as well as improve their quality of life during these circumstances of COVID-19 pandemic? Patients who have pain in any part of...
What can patients with cervical or lumbar radiculopathy (Sciatica) do to decrease their pain and improve their quality of life during these circumstances of COVID-19 pandemic? Patients with radiculopathy either cervical or lumbar (also known as Sciatica) have mild to...
I had a patient from Canada who underwent hip replacement surgery on both sides and he emailed me these tips to pass along… Get dental work done 8 weeks before surgery Talk to your family physician to ensure he/she is willing to do follow-up when you get home....
In today’s circumstances, we at Complete Orthopedics are committed to our patients. During this tough period of COVID-19 breakout and subsequent social distancing as needed to control the pandemic, we are working hard to bring optimal care to our patients right at...
The basketball season is here! The NBA season has arrived, and National Basketball Day is November 6th. Unfortunately, with basketball, comes injuries. There are certain injuries in the game of basketball that commonly occur with players: some avoidable, some not so...
Between each vertebral body there is an intervertebral disc. The disc allows to cushion the vertebral bodies, as well as allows movement. The intervertebral disc is made up annulus fibrosus, which surrounds a central gel-like material called the nucleus pulposus. Due...
The most common complaints of patient with diseases of shoulder joint is pain. This pain is usually worsened with activity, especially with overhead activities. These patients may also complain of weakness or stiffness of the shoulder joint. Occasionally,...
A cervical spine is made up of seven vertebrae stacked over each other. The vertebrae have two parts, the front and the back. The front of the vertebrae is called the vertebra body. The back of the vertebrae is made up of a pair of joints, the laminae and the...
Shoulder surgeries are usually same-day surgeries. Patient are called in on the day of surgery and are taken in a holding area. Patients are usually given a brachial block, so as to numb their nerves of the shoulder as well as their upper extremity. In the...
The shoulder joint is made up of three bones. The arm bone, or the humerus, the collarbone, or the clavicle, and the shoulder blade, or the scapula. The bones are connected to each other at two joints. The shoulder joint in itself in the acromioclavicular...
Labral tear and shoulder instability is usually caused by injuries, especially in throwing athletes and people who do overhead activities. It can also be caused due to aging, or it may be of congenital origin. Patients with labral tear or shoulder instability...
Rotator cuff tendinitis is inflammation of the tendons of the rotator cuff. It may involve any of the four tendons, but most commonly involves the supraspinatus and infraspinatus. This is caused by repetitive actions of the shoulder, especially overhead activities and...
Between each vertebral body there is an intervertebral disc. The disc allows to cushion the vertebral bodies, as well as allows movement. The intervertebral disc is made up annulus fibrosus, which surrounds a central gel-like material called the nucleus...
Crepitus is a crunching or grating sound, or sensation felt in a joint on moving it. It is common in old age but not all joint crepitus signifies an underlying disease. However, when associated with pain or swelling joint crepitus usually denotes joint damage....
The recovery outlook of a knee surgery involves pain, swelling and physical therapy for an extended period of time. Following knee surgery, patients typically show signs and symptoms such as pain, stiffness, and increased edema around or below the surgical site....
This is the third part of Dr. Vaksha’s appearance on local cable access… Larry Mikorenda: Hi, I’m Larry Mikorenda, welcome to this edition of Excelsior Forum & Profiles, and back with us for part three is Dr. Vaksha. Dr. Vaksha, thank...
How do you handle authorization for physical therapy for a patient who is injured in a worker’s compensation injury? We are going to get into real specifics here! At our office, where we treat workers comp patients, we use the MG-2 form which is the “Attending...
This video recently appeared on local cable access TV here in Long Island New York… Transcription: Larry Mikorenda: Hi I’m Larry Mikorenda and welcome to this edition of “Profiles” and with us today is Vedant Vaksha. He is a spinal surgeon, and...
This video appeared on local cable access TV in Long Island New York… Transcription: Larry Mikorenda: Hi. I’m Larry Mikorenda and welcome to Excelsior Forum, and with me today is Vedant Vaksha. He is a spinal surgeon and if we have heard that terminology,...
In New York, Workers’ Compensation Law claim resolutions are very different than a personal injury law suit. Pain and suffering is not taken into account under the Workers’ Compensation Law and the amount of money you receive is based on the percentage of permanent...
Traveling is supposed to be a break from your daily stresses, where you can relax and disconnect from reality. But unfortunately, sometimes unexpected accidents and injuries happen while we’re on vacation. This can be a particularly difficult experience if you’re...
When you get injured, your first thought is how you will pay your medical bills and recover any lost compensation. A personal injury lawsuit is one way to recover financial losses due to an injury, and workers’ compensation is a way to help recover from an...
Do you work in a physically demanding field? If so, then you are at a higher risk of suffering from an orthopedic injury. Orthopedic injuries often involve the foot, knee, ankle, hip, shoulder, wrist, elbow and spine. They can happen any time and anywhere. Injuries...
In 2015, OSHA estimates that a little over 13 workers per day died from workplace injuries. That is a lot of fatal workplace injuries, but it also represents a lot of different injury situations. Sometimes a workplace injury is an honest accident that could not have...
Worker’s compensation is financed exclusively+- by your employer. According to the Social Security Administration, benefit payments under workers compensation programs totaled $63.6 billion in 2013. If you’ve been injured at work, chances are you will be...
In 2013, rotator cuff injuries caused nearly two million Americans to visit an orthopedic doctor. Many rotator cuff injuries are work related, and they can get worse if they are not treated quickly. Other examples of workers’ compensation cases that would...
A number of workers risk injuries on a daily basis due to repetitive movements that can lead to them getting hurt and suffering orthopedic injuries. Orthopedic injuries that are most commonly reported are any injuries related to the foot, ankle, knee, hip, ankle,...
Many times when you are involved in a Bronx, New York auto accident, or an auto crash anywhere in NY State, you sustain injuries to your neck. Injuries to your neck are called “cervical spine injuries,” because they involve the portion of your back known as your...
If you sustained any orthopedic or neurological injuries in a New York State auto accident the first thing you need to do is ensure that you complete an application for NY No Fault medical benefits to ensure that your medical treatment is covered and paid for. The New...
Whenever you sustain lumbar spine injuries in an auto accident you could be entitled to a huge recovery from the driver that caused your injury. Often time the violence associated with a NY auto accident causes you injury and compression to your central nervous system...
Tibial osteotomies are often performed for knee injuries such as total lateral compartment collapse following a motor vehicle accident. Patients sometimes wonder “What is the recovery time for tibial osteotomy?” Generally you will wear a cast for 4 to 8 weeks, then...
Apparently, no second opinion is needed on the benefits of technology in health care. Doctors and patients agree the tremendous advances in technology have a lot to do with improvements in medical care. Tracking your blood sugar can be done on a smartphone. There soon...
