General Guideline Principles for Medication

for 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 Medication.

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.

Medication

Naproxen, Ibuprofen, or other NSAIDs from an earlier generation are suggested as first-line treatments for most patients.

For individuals who are not applicants for NSAIDs, acetaminophen (or the analog paracetamol) may be a viable option, even if most of the 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) for Treatment of Acute, Subacute, or Chronic Neck Pain

    Non-Steroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Acute, Subacute, or Chronic Neck Pain are recommended for the treatment of sudden, gradual, or persistent neck discomfort

    Indications: NSAIDs are advised as a therapy for neck discomfort that is either acute, subacute, or chronic. First, try over the counter (OTC) medications to see whether they work.

    Frequency/Duration: For many patients, usage only, when necessary, may be appropriate.
    Indications for Discontinuation: Symptoms go away, the medication is ineffective, or negative side effects arise that require stopping the medication.

  2. NSAIDs for Patients at High Risk of Gastrointestinal Bleeding

    NSAIDs for Patients at High Risk of Gastrointestinal Bleeding is recommended proton pump, sucralfate, histamine Type 2 receptor blockers, misoprostol, and inhibitors for individuals at high risk of gastrointestinal bleeding when used together with cytoprotective medication groups.

    Indications: Cytoprotective drugs should be taken into consideration for patients with a great danger factor outline who also have indications for NSAIDs, especially if a prolonged course of therapy is planned. Patients who have a history of gastrointestinal bleeding in the past, the elderly, diabetics, and smokers are at risk.

    Frequency/Dose/Duration: H2 blockers, misoprostol, sucralfate, and proton pump inhibitors are advised. dosage recommendations from the manufacturer. It is generally accepted that there are no significant differences in effectiveness for preventing gastrointestinal bleeding.

    Indications for Discontinuation: Intolerance, the emergence of negative effects, or the stopping of NSAID use.

  3. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

    NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended When it comes to cardiovascular side effects, acetaminophen or synthetic compound as first-line medication seems to be the safest option. If necessary, non-selective NSAIDs are recommended over COX-2-specific medications.

    To reduce the chance that an NSAID will negate the protective benefits of low-dose aspirin in individuals receiving it for primary or secondary cardiovascular disease prevention, the NSAID shall be taken a maximum of half an hour after or 8 hours earlier than the daily aspirin.

  4. Acetaminophen for Treatment of Neck Pain

    Acetaminophen for Treatment of Neck Pain is recommended to relieve neck discomfort, especially in individuals who have NSAID contraindications
    Indications: All neck pain sufferers, including those with acute, subacute, chronic, and postoperative pain.

    Dose/Frequency: As per the manufacturer’s guidelines; can be used as required. Over four gm/day, there is evidence of liver toxicity.
    Indications for Discontinuation: the disappearance of discomfort, side effects, or intolerance.

  5. Topical Medications are recommended In certain people, ointments, lidocaine patches, and topical creams may be used to relieve the pain brought on by acute, subacute, or chronic neck discomfort.

    The rationale for Recommendation: In certain people, TOPICAL DRUGS (such as topical lidocaine, capsaicin, topical NSAIDs, and topical salicylates and no salicylates) may be an appropriate type of therapy.

    To get the desired effect and prevent potential toxicity, a topical medication should be given with precise dosage instructions and a daily use limit. Since the long-term consequences of usage are uncertain for most patients, episodic use may be preferable.

    Patients whom l e prefer topical therapy to oral drugs may utilize these substances. Depending on the medicinal agent employed, localized cutaneous responses may happen. The possibility of hazardous blood levels from topical treatment should be considered by prescribers.

    Capsaicin offers a secure and efficient substitute for systemic NSAIDs, albeit local sharp tingling or burning sensation that usually goes away with repeated usage limits its use.

    To prevent accidental contact with eyes and mucous membranes, patients should be instructed to apply the cream using gloves made of plastic or an applicator of cotton o the afflicted region. Capsaicin usage for an extendeperiodme is not advised

    Topical Lidocaine is only suggested when the identification of neuropathic pain has been made in writing. In this case, a trial lasting no more than four weeks may be taken into consideration; further usage will require proof of functional improvements.

    Topical NSAIDs used topically, such as diclofenac gel, may area potentially therapeutic tissuconcentrationsic. When systemic administration is generally forbidden, the low amount of systemic absorption might be favorable overall by enabling the topical use of these drugs (like renal insufficiency, cardiac failure, peptic ulcer disease, or ate to with hypertension.

    Topical Salicylates or No salicylates Overall, topical NSAIDs tend to be more efficacious than topical salt or ester of salicylic acid or no salicylates (such as ethyl salicylate). Especially in individuals with chronic illnesses where systemic medicine is often contraindicated, it may be utilized for a brief course of treatment. It may also be used as an initial treatment for cancer.

  6. Opioids of Medication

    Opioids of Medication is not recommended for neck discomfort that is sudden, gradual, or ongoing for a brief (no more than seven days) used as an adjuvant therapy to more potent therapies for postoperative pain control.

    Indications: A brief prescription of opioids is frequently needed for postoperative pain control, especially at night, as an addition to more effective medications (notably NSAIDs, and acetaminophen.

    Frequency/Duration: As needed during the day, solely at night thereafter, and finally totally discontinued.

    The rationale for Recommendation: When NSAIDs are ineffective in relieving a patient’s pain, opioids should be used sparingly, especially at night. Opioids are advised for brief, selective usage in postoperative patients, with nighttime use being the main recommendation for achieving postoperative sleep.

  7. Anti-Depressants
    1. Tricyclic anti-depressants (TCAs)

      Tricyclic anti-depressants (TCAs) is recommended for chronic neck discomfort that is not well managed by NSAIDs and exercise. Where there is late midnight sleep disturbance and moderate dysthymia, this intervention may be beneficial.

      Frequency and Duration: amitriptyline is often recommended at a very low dose at bedtime and progressively raised (e.g., twenty-five mg at bedtime, increase by twenty-five mg each week) until a less than maximal or maximum dose is obtained, adequate effects are achieved, or undesirable effects occur.

      Since there is no proof that larger dosages of amitriptyline result in greater pain relief, most doctors choose lower doses (e.g., 25–75 mg/day) to prevent side effects and the need for blood level monitoring. depression level is sedating; therefore, it could be a better choice if there is carryover daytime drowsiness.

      Discontinuation: a reduction in the discomfort, tolerance, or emergence of negative consequences.

      There is very weak evidence that tricyclic antidepressants (TCAs) are somewhat more effective than a placebo at reducing pain scores when used to treat radicular pain.

    2. Selective Serotonin Reuptake Inhibitors (e.g., paroxetine, as well as bupropion and trazodone)

      Selective Serotonin Reuptake Inhibitors (e.g., paroxetine, as well as bupropion and trazodone) are not recommended for the management of chronic neck discomfort. (However, as previously mentioned, they could be advised for the treatment of depression.)

      Note: It is not advised to use these drugs to treat non-acute neck pain in the absence of depression as there is significant evidence that doing so is not beneficial.

      The effectiveness of antidepressants in the analysis of acute neck discomfort is not backed by high-quality research. This technique is not advised for the therapy of acute neck discomfort if there are no other signs that the patient requires such care.

  8. Anti-Seizure Drugs of Medication
    1. Topiramate

      Topiramate is recommended several other treatment options, including trials of various NSAIDs, aerobic activity, targeted pull out/sprawl exercise, buttress/toughen exercise, tricyclic antidepressants, disbands tracdistractionsanipulation, have failed in a small number of individuals with non-acute neck pain.

      Frequency/Dose: The dosage of this drug is progressively increased to start. Patients should be closely watched for the emergence of unfavorable events.

      Discontinuation: the reversal or emergence of negative consequences. Due in part to increased risks for sedating deleterious effects on the central nervous system (CNS), careful monitoring of patients who are working is advised.

      Topiramate is not recommended for peripheral neuropathy and neuropathic pain.

    2. Carbamazepine

      Carbamazepine is recommended for the perioperative treatment of pain to lessen the requirement for opioids, especially in individuals who have opioid adverse effects. In certain individuals with spinal stenosis-related severe neurogenic claudication or persistent relating to the painful opinions, emotions, or behavior with short-distance walking.

      Carbamazepine is not recommended, axial or non neuropathic pain is not advised.

      Discontinuation: either tolerance or resolution. The heightened risks of CNS-sedating side effects call for careful monitoring of patients who are working.

    3. Gabapentin and Pregabalin

      Gabapentin and Pregabalin are recommended for perioperative management of pain to reduce need for opioids, particularly in those with side effects from opioids.

      Gabapentin and Pregabalin are recommended in select patients for the treatment of severe neurogenic claudication from spinal stenosis or chronic radicular pain syndromes with limited walking distance.

      Gabapentin and Pregabalin are not recommended for axial or nonneuropathic pain.

      Discontinuation: Resolution or intolerance. Careful monitoring of employed patients is indicated due in part to elevated risks for CNS-sedating adverse effects.

  9. Compound Medications

    Compound Medications are not recommended chemical drugs for topical, oral, and/or systemic use.

  10. Skeletal Muscle Relaxants
    • Skeletal Muscle Relaxants

      Skeletal Muscle Relaxants is recommended For certain situations of moderate to dangerous pain l the neck discomfort, muscle relaxants (except carisoprodol) are advised as a send-line therapy.

      Note- These medications are often not advised because alternative treatments, continuing walking, and other activities may usually control the symptoms just as well.

      In general, it is advised that these medications be started at night and not during the working day or when patients intend to drive. Skeletal muscle relaxants should be prescribed with caution to those who have a history related to depression, personality disorders, drug addiction, and/or misuse, including alcohol or cigarette use.

      Cyclobenzaprine should be tested as a muscle relaxant if one is deemed required for individuals with such issues since it has a chemical structure with tricyclic antidepressants and because it seldom leads to addiction or misuse.

      Frequency/Duration: This first dose needs to be taken in the evening. When the CNS-sedating effects are limited and there is little fear that the sedation would compromise function or safety, daytime usage is appropriate.

      No proof taking more medicine would help (e.g., cyclobenzaprine ten mg over five mg). If severe daytime somnolence develops, the drug may need to be stopped, especially if it interferes with the ability to undertake aerobic boitbrightnessrcise and other rehabilitation plan components.

      It is not advised to take the first dose before beginning a shift at work or before operating a car or other piece of equipment.

      Discontinuation: the pain is gone, there is no tolerance, there are considerable sedative effects that last throughout the day or there are other negative consequences.

      Discontinuations are recommended as second or third-line treatments for post-operative pain that is assumed to be musculoskeletal in origin or moderate to severe radicular pain syndromes. There may be other treatments that are more effective at reducing radicular discomfort.

    • Skeletal Muscle Relaxants

      Skeletal Muscle Relaxants is recommended as second- or third-line treatments for post-operative pain that is assumed to be musculoskeletal in origin or moderate to severe radicular pain syndromes. There may be other treatments that are more effective at reducing radicular pain.

      Frequency/Duration: typically, one week, but no longer more than 14 days, or if used only night then can use more than two weeks.

      Discontinuation: the pain is gone, there is no tolerance, there are considerable sedative effects that last throughout the day or there are other negative consequences.

      Skeletal Muscle Relaxants is not recommended for prolonged usage in subacute or non-acute neck pain or for lenient to average acute neck pain owing to issues with side effects (other than acute exacerbations).

  11. Systemic Glucocorticosteroids (aka “Steroids”)

    Systemic Glucocorticosteroids (aka “Steroids”) is recommended in a small number of individuals for the treatment of acute severe radicular pain syndromes to reduce discomfort temporarily.

    Systemic Glucocorticosteroids (aka “Steroids”) is recommended in a small number of individuals for the treatment of acute severe radicular pain syndromes to reduce discomfort temporarily.

    Frequency/Duration: For a specific episode of radicular pain, a single course (five days to two weeks) of oral medicine (i.e., a tapering dosage of methylprednisolone) should be provided. Epidural steroid vaccinations are preferred if further therapy is required because they more effectively deliver the drug to the injured tissue.

    Systemic Glucocorticosteroids (aka “Steroids”) is not recommended for axial pain. For neck discomfort that is non-radicular, acute, or chronic, or for mild to severe radiculopathy.

    Intravenous Steroids
    Intravenous Steroids is recommended Only hospitalized patients who are during a severe neurological emergency should be included.

    Experts on the spinal cord should be consulted to decide the dosage and period of intravenous steroids. In an emergency circumstance, the danger of pharmacologic bad consequences of steroids typically outweighs the risk of long-term neurological impairment from acute spinal cord compression.

What our office can do if you have workers compensation injury

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!

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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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.