Our Blog
Custom Knee Replacement Surgical Plan – 62 YO Male
Today I will be talking about the ConforMIS iview. The current iview I am looking at is from a right knee. The iview consists of two pages. The first page is the tibial side of the procedure. The second page is for the femoral side of the procedure. On the first page,...
Custom Knee Replacement Surgical Plan – 55 YO Female
Today I am going to be talking about a Conformis iView. The first page of the iView will give us all the detailed information as it relates to the tibial section of the procedure. The first image in the tibial section is going to show us the placements of the first...
Custom Knee Replacement Surgical Plan – 54 YO Female
Today, I am going to talk about the Conformis iView. The iView is a customized plan that is provided to the surgeon by Conformis, that is based off of the patient's CT. The surgeon will receive this plan about two weeks before the procedure is set to begin. That way,...
Custom Knee Replacement Surgical Plan – 53 YO Male
Today, I will be talking about the Conformis iView. The Conformis iView is a customized plan for a patient's knee replacement that is based off of the patient's CT scan, and it's provided to the surgeon approximately 2 weeks before the procedure. The iView does...
Custom Knee Replacement Surgical Plan – 51 YO Male
Today, I would like to discuss the conformance eye view. The first eye view that I am looking at here is of a right knee. The eye view is broken down into two pages. The first page provides the tibial images. The first set of images on the first page of the eye view...
Custom Knee Replacement Surgical Plan – 43 Year old Male
Currently looking at a Conformis eye view for a right knee. The first page of the eye view is going to show us various reference points for the tibia. On this page the first image is of the tibial cutting jig. What we're looking for here is to see how the jig should...
Custom Knee Replacement Surgical Plan – 42 YO Female
On this patient's left knee, eye view, first image I'm looking at is the placement of the tibial cutting jig. This image is going to show you exactly where the image, where the jig should sit. This is important because every once in a while, during the procedure, you...
Custom Knee Replacement Surgical Plan – 41 YO Female
Today I'd like to talk a little about the conformace eye view. The first one I'm looking at is a left knee. The very first page of the eye view will reference the tibia. The first image on this page is going to show us how the tibial iJig should be seated on the bone....
Custom Knee Replacement Surgical Plan – 39 YO Female
Today, we are going to discuss a Conformis iView of a patient's right knee. The first page of the iView shows us all of the tibial images that we need. The very first image that we are provided with details the proper location for the T1 tibial cutting jig. The...
Custom Knee Replacement Surgical Plan – 38 YO Female
Today I will be discussing the ConforMIS iView. The iView consists of two pages and is provided for each patient to the surgeon around two weeks before the procedure is scheduled to take place. The iView is a customized plan based off of a patient's CT scan. The first...
Custom Knee Replacement Surgical Plan – 61 YO Female
Okay, so looking at this eye view, I see it's a left knee. First thing I want to look at is the first image on the tibial page of the eye view. I'm looking to see if we have a lot of osteophytes that will serve as good reference points to make sure that the jig is...
Custom Knee Replacement Surgical Plan – 58 YO Male
The Conformis iView I will be discussing is a left knee. The first page of the iView is the tibia. The very first image on the tibial page of the iView is going to discuss the tibial cutting jig or T1. This image will show us where the jig should sit on the bone. What...
Custom Knee Replacement Surgical Plan – 36 YO Male
Today, I am going to discuss the Conformis iView. The Conformis iView is a unique plan that is customized for each patient's surgery. And is provided to the surgeon at least two weeks before the procedure. The iView that I am currently looking at is of a right knee....
Osteoarthritis
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...
Heat, Cold, and Compression Therapy
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...
Sustained Acoustic Medicine (SAM) Wearable Ultrasound Device
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...
Continuous Passive Motion (CPM) Machine after Knee Surgeries
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 – Causes & Management
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 – Causes and Management
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,...
Continuous Passive Motion (CPM) Machine for the Shoulder Joint
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 – Causes & Management
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 – Causes & Management
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 of Lower Cervical Spine
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 graft or an implant or a cage...
Clinical Case C1-C2 Instability
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, no diagnosis...
Complications of Spine Surgery
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...
Surgeries of Upper Cervical Spine Diseases
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 of Lower Cervical Spine Diseases
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....
Natural History of Odontoid Fracture
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...
Clinical Case Cervical Spondylotic Myelopathy
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 extremity...
Natural History of Lumbar Spine Disease
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...
Non-Fusion Surgeries of Lower Cervical Spine
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,...
Lower Cervical Spine Diseases
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...
Spine Surgery Set-up
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...
Recent Advances in Spine Surgery
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...
Joint Replacement Infection – Diagnosis & Management
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...
Joint Replacement Infection – Causes & Symptoms
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 of Lumbar Spine Diseases
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...
Clinical Case Lumbar 4-5 Spondylolisthesis with Lumbar Canal Stenosis
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 that...
Laminectomy and Minimal Invasive Decompression
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 of Lumbar Spine Diseases
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...
Lumbar Spine Anatomy
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
Lumbar Spine Diseases
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) tears,...
Vertebroplasty and Kyphoplasty
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...
Who Needs Spine Surgery?
So, last slide. This is who needs spine surgery, finally. So cervical radiculopathy - not relieved for four weeks despite measures, epidural injections, medications. Lumbar radiculopathy not relieved for four to six weeks. This should be debilitating. Patients should...
Non Fusion Surgeries of Lumbar Spine
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...
Fusion Surgeries of Lumbar Spine
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 back,...
Robotic Hip Replacement Procedures
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...
Intimacy after Total Hip Replacement
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...
Alcohol Intake & Avascular Necrosis of the Hip
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...
Surgical Hip Dislocation for Femoroacetabular Impingement
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...
Patient Visits During Coronavirus Pandemic (Masks are required in the office!)
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...
Managing Musculoskeletal Pains During COVID-19
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...
Managing Radiculopathy During COVID-19
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...
Medical Tourism Tips from a Former Patient in Canada
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....
Covid 19 Update
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...
Common Basketball Injuries & How to Treat Them
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...
Dr. Vaksha on the Intervertebral Disc
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...
Dr. Vaksha – Pain in the Shoulder Joint
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,...
Dr. Vaksha – Anatomy of the Cervical Spine
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...
Dr. Vedant Vaksha Planning for Shoulder Surgery
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...
Dr. Vedant Vaksha – The Shoulder Joint
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...
Dr. Vedant Vaksha Shoulder Tear & Instability
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...
Dr. Vaksha – Rotator Cuff Tendinitis
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...
Dr. Vaksha – The Intervertebral Disc
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...
Joint Crepitus and it’s Relevance to Arthritis
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....
Cryotherapy & Compression Therapy for Knee Surgery
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....
Dr. Vedant Vaksha – Cures and Surgeries for Back & Neck Pain
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 you so much for...
Authorizing Physical Therapy with Workers Comp
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...
Dr. Vedant Vaksha – That Pain in My Neck: What’s Going On?
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 he has been helping...
Dr. Vedant Vaksha – Why Does My Back Hurt?
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, "Oh, my...
New York State Workers’ Compensation Claim Resolutions
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...
What Should You Do When You Suffer an Orthopedic Injury On Vacation?
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...
Personal Injury Vs. Workers’ Comp
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 injury that...
Orthopedic Injuries At Dangerous Jobs
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...
What Are The Most Common Types Of Workplace 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...
What You Should Do If Worker’s Comp Denies Your Physical Therapy
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 able to get...
An Attorney Is A Necessity For An Orthopedic Workers Comp Case
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 require an...
Orthopedic Injuries And What You Need to Know About Workers’ Compensation
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,...
Cervical Laminectomy Surgery for Injuries Sustained in an Auto Accident
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...
Medical Insurance for Orthopedic Injuries Sustained in Auto Accidents
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...
Lumbar Laminectomy Surgery for Injuries Sustained in an Auto Accident
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...
Recovery Time For Tibial Osteotomy
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...
The Digital MD – Part 1 Embrace the Change
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...