Tag Archives: Orthopedic surgeon westchester

New York Spine Surgeon describes the O-Arm CAT Scanner

Posted on: December 19, 2013

Meet the O-Arm:  New technology in the OR

By John Abrahams, MD, FAANS, Chief of Neurosurgery, Co-Director of Spine Surgery, Orthopedic and Spine Institute

Dr. John Abrahams Northern Westchester HospitalThe Orthopedic & Spine Institute of Northern Westchester Hospital recently brought new technology into the operating room – the O-Arm from Medtronic.

The O-Arm is an intra-operative CAT Scanner with Image Guidance used to make placement of spinal instrumentation more accurate and safer. 

Typically, the O-Arm would be mainly used for patients undergoing spine surgery that need instrumentation placed such as rods and screws.  During these procedures, patients are put to sleep with general anesthesia and prepped for surgery.  An incision is made over the surgical site and then the O-Arm is brought in to obtain a CAT Scan with three-dimensional imaging. Continue reading

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New York Orthopedic Specialist Discusses Ankle Sprains

Posted on: June 24, 2013

The Pain of Ankle Sprains

By – Dr. Kurt Voellmicke, Director of Foot and Ankle Section for the Orthopedic and Spine Institute, Northern Westchester Hospital.

foot-swarm As a doctor I find that it is common for many to be confused over what constitutes a sprained ankle.  What is a sprain, and what should you do if you have one? You’ll be happy to know that the answers are pretty straightforward.

 The Definition

A sprain is defined as a stretched or torn ligament — the tough, fibrous tissue that connects one bone to another and supports your joints. By far the most common type of sprain is in the ankle.  Typically people roll their ankle outward and damage the ligaments on the outside of the ankle. Basketball and volleyball players are the most susceptible to sprains, followed by soccer and lacrosse players. Jumping and then landing unevenly or on the side of another player’s foot is the typical cause of a sprain.  Ankle sprains can also occur sliding into a base or running on an uneven surface. Having high arches can put you at higher risk of a sprain: The foot is like a tripod. The higher one’s arch, the more the tripod tends to tilt to the side.  Other risk factors include weakness of the supporting leg muscles or poor balance.

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Common Sports Injuries: What you should know

Posted on: May 10, 2013

Although they rank among the most common sports-related injuries, anterior cruciate ligament (ACL), medial collateral ligament (MCL), and meniscus injuries are often misdiagnosed and/or perpetuated.

To understand the issues around diagnosis, we sat down with Victor Khabie, M.D. , FAAOS, FACS, Chief of the Department of Surgery, Co-Director of the Orthopedic and Spine Institute and Chief of Sports Medicine at Northern Westchester Hospital…

new york orthopedistTo achieve timely diagnosis and treatment, Dr. Khabie stresses the importance of physicians and athletic coaches recognizing the signs of each injury and knowing when it is appropriate to refer to a specialist.

According to Dr. Khabie, the signature characteristic of an ACL injury is an audible pop in the knee accompanied by swelling, difficulty walking and an inability to continue certain activities. While MCL and meniscus injuries also result in swelling and pain, athletes may still be able to move and participate, albeit in a diminished capacity. Patients may attempt to treat these injuries at home with propping and icing; however, many find their injuries do not improve. Continue reading

Westchester Orthopedist Describes New Technique for Knee Replacement Implants

Posted on: August 6, 2012

3-D Computer-Aided Design: 
Building Better Knee Replacements

An Interview with David Yasgur, MD, FAAOS

Until recently, a surgeon’s only option for customizing knee replacements was to make adjustments during the actual surgery. Once the patient was under anesthesia and incisions were made, the surgeon would fine-tune the fit of the replacement joint. If you think that sounds like a less-than-ideal way to proceed, you won’t get any argument from Dr. David Yasgur, Director of Quality and Outcomes at the Orthopedic & Spine Institute at Northern Westchester Hospital. “During surgery we needed to have a large variety of instruments out and available for making adjustments to the size and alignment of the implants—all while the patient was undergoing the procedure. This wasted time and placed additional stress on the patients.” 

Now, new 3D-modeling technology enables surgeons to simulate the placement of the knee implants and design and order custom-made surgical instruments to assist in the accurate positioning of knee replacements weeks before the surgery takes place. “Essentially, all the decision-making and fitting that would happen during surgery can be done on a computer four to six weeks ahead of time,” says Dr. Yasgur.

Surgeons are able to upload magnetic-resonance images (MRIs) of the knee to a computer program that creates a three-dimensional image and allows viewing of the damaged knee from all angles. “It’s really exciting to use this software because I am able turn the image on the computer screen to see it from all angles,” Dr. Yasgur says.  Once adjustments are made to the design, the manufacturer uses the surgeon-approved pre-operative plan to design and produce pin placement guides to the patient’s exact specifications. “You have tremendous control in fitting the implant to meet each patient’s unique needs—how much cartilage is left in the joint, for example, or how a previous trauma like a fracture will alter wear and tear.”

Using the custom-made positioning instruments, which serve as an intraoperative guide, knee replacements have the potential to last much longer, says Dr. Yasgur—a big advantage, though not the only one. Because the fitting is done in advance, he says, the patient spends 15 to 20 minutes less time in surgery. “That reduces the risk of infections, bleeding, and other complications.” And with a quicker, less traumatic surgery, the patient’s recovery time can be shorter as well.

“I was somewhat hesitant to use this technology at first, but once I realized the benefits, I was convinced,” Dr. Yasgur says. Interestingly, he has a history with computer-aided design. “Before medical school, I designed and developed prostheses for total joint replacement surgery at the Hospital for Special Surgery. Now I’ve come full circle and I’m using computers again to design custom-made knee replacements for my patients.” And given the results Dr. Yasgur has seen, he’s pleased to have made the journey.

View animated videos of knee surgery.

New York Orthopedist Explains Benefits of Anterior Approach to Hip Replacement

Posted on: July 3, 2012

Benefits of Anterior Approach to Hip Replacement

by Dr. Eric Grossman

Dr. Eric Grossman Orthopedic Surgeon New YorkTypically after patients have a hip replaced with the conventional approach, they go to inpatient rehab following 3 to 4 days in the hospital.  When patients eventually return home, they are given strict “hip precautions” because of increased risk of dislocation during the first 6 -8 weeks after surgery.  These precautions include no bending more than 90 degrees from the waist and no crossing of the legs, and they must sleep with a pillow between their legs for 6 weeks.  Because the anterior approach spares major muscles and tendons, patients are at low risk for hip dislocation and therefore do not need to follow “hip precautions.”  This allows them to have a more natural & “comfortable” recovery without worrying about “hip precautions.” Another major benefit of the anterior approach is that due to the fact that muscles and tendons are not detached, the patient returns to a more normal walking pattern more quickly. After undergoing an anterior approach hip replacement, patients typically return home after 1- or 2-day hospital stay, and do not require inpatient rehab.

Patients are typically up and walking with a cane, if needed, the day after surgery and typically stand and walk the same day as surgery.  Another benefit of this approach is decreased pain.

The anterior surgery approach may not be appropriate for all patients, including those who have extra abdominal fat, which could interfere with incision healing and lead to postsurgical infection.

It’s vital that physicians consider their patients on a case-by-case basis.  Whether or not a patient receives this type of surgery also depends on the surgeon’s comfort level and experience with the procedure.

Editor’s Note:  Eric Grossman, MD, FAAOS, Co-Director, Joint Replacement at Northern Westchester Hospital’s Orthopedic and Spine Institute, www.nwhOrthoandSpine.org