New York State Medical Treatment Guidelines for

Tarsal Tunnel Syndrome in workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Tarsal Tunnel Syndrome.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Tarsal Tunnel Syndrome (TTS)

The very uncommon illness known as tarsal tunnel syndrome (TTS) is characterised as an tibial nerve entrapment neuropathy or one of its branches from its entrance site under the flexor retinaculum, from its lateral and medial ends, down to the medial malleolus the posterior and plantar calcaneal branches, which supply the foot’s arch with nerve fibres.

TTS is defined by the combination of sporadic tingling, numbness, or burning feelings Toe and plantar surfaces of the foot paresthesias.

In the absence of sensory or motor involvement from neuropathic findings, four to six weeks of It might make sense to use conservative care before resorting to invasive ones. commonly used Pressure and pain relief is the goal of the prescribed conservative treatments. These include freezing, tape, extending the posterior tibial nerve, exercises, painkillers, splints, orthotics, and supportive footwear.

TTS does not have any defined, accepted diagnostic standards. Clinicians ought to keep a keen eye out for TTS in patients who come with pain and plantar foot paresthesias that get worse after prolonged standing and walking, or cause sleep disruption.

Diagnostic Studies for Tarsal Tunnel Syndrome in workers compensation patients

  1. Nerve Conduction Studies (NCS) for Diagnosis and Pre-operative Assessment of TTS Patients

    Nerve Conduction Studies (NCS) for Diagnosis and Pre-operative Assessment of TTS Patients are recommended for patients that do not improve with conservative treatment or when considering surgical release after ruling out alternative reasons including polyneuropathy and radiculopathy. for confirming the diagnosis of tibial nerve entrapment at the ankle.

     

  2. NCS for Initial Evaluation of TTS Patients

    NCS for Initial Evaluation of TTS Patients is not recommended for the initial assessment and the majority of TTS patients as NCS does not alter how the condition is managed during the initial while trying out conservative therapy, for four to six weeks.

     

  3. Electromyography (EMG) for Initial Evaluation, Diagnosis or Preoperative Assessment of TTS Patients

    Electromyography (EMG) for Initial Evaluation, Diagnosis or Preoperative Assessment of TTS Patients are not recommended for the first assessment, diagnosis, or pre-operative evaluation of patients with TTS. As opposed to a nerve conduction study, electromyography is often not advised because there is little reliable data proving its value in TTS diagnosis.

    Rationale for Recommendations: It is advised to use NCS for diagnosis. of tibial nerve impingement at the ankle and for pre-operative although it is not advised for initial evaluation, most TTS patients.

     

  4. MRI for Diagnosis of Tarsal Tunnel Syndrome

    MRI for Diagnosis of Tarsal Tunnel Syndrome is recommended It is suggested that NCS be used for diagnosis. for both pre-operative treatment of tibial nerve impingement at the ankle and Despite being discouraged during initial evaluation, most TTS patients.

     

  5. MRI to Diagnose Tarsal Tunnel Syndrome

    MRI to Diagnose Tarsal Tunnel Syndrome is not recommended for the TTS’s initial assessment.

     

  6. Use of Ultrasound as an Aid to NCS for Tarsal Tunnel Syndrome

    Use of Ultrasound as an Aid to NCS for Tarsal Tunnel Syndrome is recommended as a help to NCS since it might be useful to identify suspected tarsal tunnel space-occupying lesions following ineffective conservative therapy, or as an adjuvant to help direct interventional therapies.

     

  7. Routine Use of Diagnostic Ultrasound

    Routine Use of Diagnostic Ultrasound is not recommended as a standard diagnostic examination for TTS. The routine use of ultrasonography for the first examination is not advised, for the following reasons. Only patients who have failed conventional therapy should have ultrasound exams. Use as a supplement to direct interventional therapy could be beneficial.

Medications for Tarsal Tunnel Syndrome

Ibuprofen, naproxen, or other NSAIDs from an earlier generation are suggested as first-line treatments for the majority of patients. For patients who are not candidates for NSAIDs, acetaminophen (or the analogue paracetamol) may be a viable alternative, even if the majority of research indicates it is just marginally less effective than NSAIDs.

There is proof that NSAIDs are less dangerous and just as effective in treating pain as opioids, such as tramadol.

  1. Non-Steroidal Anti-inflammatory Drugs (NSAIDs) and Acetaminophen for Tarsal Tunnel Syndrome

    Non-Steroidal Anti-inflammatory Drugs (NSAIDs) and Acetaminophen for Tarsal Tunnel Syndrome are recommended for treatment of TTS

    Indications: For TTS Pain, NSAIDs are recommended for treatment. Over-the-counter (OTC) agents may suffice and should be tried first.

    Frequency/Duration: As needed use may be reasonable for many patients.

    Indications for Discontinuation: Resolution of foot/ankle pain, lack of efficacy, or development of adverse effects that necessitate discontinuation.

     

  2. NSAIDs for Patients at High-Risk of Gastrointestinal Bleeding

    NSAIDs for Patients at High-Risk of Gastrointestinal Bleeding is recommended Cytoprotective drugs should be taken into consideration for patients with a high-risk factor profile who also have indications for NSAIDs, especially if longer-term treatment is needed.

    Indications: For patients with a high-risk factor profile who also have indications for NSAIDs, cytoprotective medications should be considered, particularly if longer term treatment is contemplated. At-risk patients include those with a history of prior gastrointestinal bleeding,

    elderly, diabetics, and cigarette smokers.

    Frequency/Dose/Duration : Proton pump inhibitors, sucralfate, H2 blockers, and misoprostol are recommended. dose and cycles as specified by the manufacturer. Normally, nothing is assumed to be there. NSAIDs have varied degrees of efficiency in avoiding gastrointestinal bleeding. Intolerance, the onset of negative effects, or ceasing use are all reasons to quit.

     

  3. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

    NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended for patients with a high-risk factor profile who also need NSAIDs should take cytoprotective medications into account, especially if a prolonged course of treatment is required. People having a history of cardiovascular disease or multiple risk factors for It is important to think about the benefits and drawbacks of NSAIDs for cardiovascular disease.

     

  4. Acetaminophen for Treatment of Tarsal Tunnel Syndrome

    Acetaminophen for Treatment of Tarsal Tunnel Syndrome is recommended for the management of TTS discomfort, particularly in patients who have Contraindications for NSAIDs.

    Indications: Every TTS patient is in pain. Perhaps acetaminophen will do. to enable the sufferer to exercise or perform more effectively.

    Dose/Frequency:As per the manufacturer’s recommendations; can be used as required. Over four gm/day, there is evidence of liver toxicity.

    Indications for Discontinuation: pain, side effects, or intolerance are gone.

     

  5. Oral Systemic Glucocorticosteroids for Treatment of TTS

    Oral Systemic Glucocorticosteroids for Treatment of TTS is recommended can alleviate TTS discomfort, especially in those who have NSAID contraindications.

    Indications – bracing-resistant tarsal tunnel syndrome. The majority of patients should not be given oral steroids. However, for patients who reject injection, oral glucocorticoids can be required.

    Frequency/Dose: It is advised that one 10- to 14-day course be prescribed oral glucocorticoids rather than repeated treatments. It is advised to write prescriptions for low doses rather than excessive amounts. reduce the possibility of negative consequences.

Opioids for Tarsal Tunnel Syndrome

Patients with TTS have occasionally received treatment with opioids. These drugs have mainly been utilised for a couple of nights following surgery (see Non Acute Pain Guideline).

  1. Routine Use of Opioids for Treatment of Pain from TTS

    Routine Use of Opioids for Treatment of Pain from TTS is not recommended to treat people who have TTS-related pain.

    Rationale for Recommendations: The majority of TTS patients do not experience pain that is severe enough to warrant the use of opioids. Patients who have such levels of discomfort should typically have tests done to rule out other diseases. They should not be used frequently. Opioids are advised for limited, selective usage in postoperative patients, with nighttime use being the main time for use.

     

  2. Opioids for Pain Treatment of TTS in Select Patients Post Op

    Opioids for Pain Treatment of TTS in Select Patients Post Op is recommended restricted use (not to exceed seven days) for a chosen group of patients

    Indications:Patients with extensive incisions who have recently had tarsal tunnel release has experienced serious consequences and whose pain is uncontrollable by other means.

     

  3. Diuretics for Routine Treatment of TTS

    Diuretics for Routine Treatment of TTS is not recommended for the regular management of TTS.

    Rationale for Recommendation: Edema or swelling of the lower extremities is not a common symptom of the majority of medical illnesses that are listed as TTS risk factors.

     

  4. Vitamins, Including Pyridoxine for Tarsal Tunnel Syndrome

    Vitamins, Including Pyridoxine for Tarsal Tunnel Syndrome is not recommended Edema or swelling of the lower extremities is not a common symptom of the majority of medical illnesses that are listed as TTS risk factors.

     

  5. Lidocaine Patches for Treatment of TTS

    Lidocaine Patches for Treatment of TTS is recommended for the treatment of a few TTS cases.

    Indications:Patients with moderate to severe TTS who have eliminated all other curable reasons of their discomfort and who report pain as their primary symptom. Usually, more effective therapeutic methods need to have been used in the past.

    Frequency/Duration: as per the advice of the manufacturer.

    Indications for Discontinuation:Problem-solving, intolerance, negative impacts, inability to deliver benefits or make progress after at least a few trial weeks.

Treatments for Tarsal Tunnel Syndrome

  1. Self-application of Ice or Heat for Treatment of TTS

    Self-application of Ice or Heat for Treatment of TTS or recommended for the treatment of TTS.

    Rationale for Recommendations: Ice and heat may help particularly with more acute symptoms.

    Mobilization / Immobilization for Tarsal Tunnel Syndrome

     

  2. Nocturnal Splints for Treatment of TTS

    Nocturnal Splints for Treatment of TTS is not recommended nocturnal splinting for treatment of TTS.

Rehabilitation for Tarsal Tunnel Syndrome (TTS)

Rehab (supervised formal therapy) needed after a work-related injury should be concentrated on regaining the functional ability needed to meet the patient’s daily and work obligations and enable them to return to work, with the goal of returning the injured worker to their pre-injury status to the extent that is practical.

Active therapy calls for the patient to put in an internal effort to finish a particular activity or assignment. The procedures known as passive therapy rely on modalities that are administered by a therapist rather than the patient exerting any effort on their side.

Passive therapies are typically seen as a way to speed up an active therapy programme and achieve concurrently objective functional gains. Over passive interventions, active initiatives should be prioritised.

To sustain improvement levels, the patient should be advised to continue both active and passive therapies at home as an extension of the therapeutic process. To facilitate functional gains, assistive devices may be used as an adjuvant measure in the rehabilitation strategy.

  1. Rest for Treatment of More Symptomatic Cases of TTS

    Rest for Treatment of More Symptomatic Cases of TTS is recommended for the treatment of TTS.

    Rationale for Recommendations: For more symptomatic situations when constant standing or walking are aggravating issues, ankle rest may be helpful.

     

  2. Exercise

    Exercise is recommended for the treatment of TTS.

    Rationale for Recommendation: workout routines for It may be appropriate to glide a tendon or a nerve. evidence of increased function and reduced pain.

     

  3. Taping

    Taping is not recommended for the treatment of TTS.

     

  4. Magnets

    Magnets are not recommended for the treatment of TTS.

     

  5. Acupuncture

    Acupuncture is not recommended for the treatment of TTS.

    Rationale for Recommendation: Other therapies have been shown to be effective. As a result, it is not advised to utilise acupuncture to treat TTS.

     

  6. Manipulation and Mobilization of the Distal Lower Extremity

    Manipulation and Mobilization of the Distal Lower Extremity is not recommended for the treatment of TTS.

     

  7. Ultrasound

    Ultrasound is not recommended for the treatment of TTS

     

  8. Iontophoresis

    Iontophoresis is not recommended for the treatment of TTS. Justification for Recommendation: Since other therapies have

     

  9. Phonophoresi

    Phonophoresis is not recommended for the treatment of TTS.

    Rationale for Recommendation:Other forms of therapy demonstrated efficacy and ought to be utilised first.

Injection Therapy for Tarsal Tunnel Syndrome (TTS)

Injection Therapy for Tarsal Tunnel Syndrome

Injection Therapy for Tarsal Tunnel Syndrome is recommended as a component of a cautious management plan for TTS treatment.

Rationale for Recommendation: Injections are frequently mentioned as a component of conservative therapy and as an additional method for confirming a TSS diagnosis. Therefore, glucocorticosteroid injections may be used to treat the problem if a more cautious approach fails to do so. be useful.

BInsulin Injections

BInsulin Injections are not recommended for the treatment of TTS.

Botulinum Injections is not recommended for the treatment of TTS

Surgery for Tarsal Tunnel Syndrome (TTS)

Surgical Release for Space Occupying Lesion

Surgical Release for Space Occupying Lesion is recommended after nonsurgical treatment fails and a space-occupying lesion is present, the impingement of the posterior tibial nerve at the tarsal tunnel may need to be surgically released. Otherwise, surgical release for cases with generalised aetiology is predicted to have variable outcomes, and patients should be advised about any probable lack of benefit before considering surgery.

Other for Tarsal Tunnel Syndrome (TTS)

Orthotics for Treatment of Select Patients with TTS is Recommended – specifically for individuals who have TTS that is believed to have a biomechanical aetiology.

What our office can do if you have Tarsal Tunnel Syndrome.

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

Call Us Now!

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Based on 96 reviews
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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5.0
Based on 96 reviews
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.