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Alyssa Klein, PT, a member of NewYork-Presbyterian Lawrence Hospital's inpatient physical therapy team, assists a post-operative patient. The physical therapy and rehabilitation team at NYP Lawrence Hospital has many patients up and walking within hours of their hip or knee replacement. They also offer expert off-site physical therapy services for orthopedic patients following discharge. Sports Medicine Specialist George Zambetti, MD, Assistant Professor of Orthopedic Surgery at Columbia University Medical Center, visits a post- operative patient in a special unit at NewYork-Presbyterian Lawrence Hospital dedicated to treating orthopedic patients. Meet the Physician: George J. Zambetti Jr., MD GEORGE J. Z A MBE T TI JR., MD, Assistant Professor of Orthopedic Surgery at Columbia University Medical Center, earned his medical degree from Albany Medical College. He completed a residency in general surgery at Roosevelt Hospital and in ortho- pedic surgery at NewYork-Presbyterian/Columbia University Medical Center. Certified by the American Board of Orthopaedic Surgery, Dr. Zambetti is a member of the AMA, the American Orthopedic Society of Sports Medicine and the American Board of Orthopaedic Surgery. He has published research on surgical techniques, including bloodless orthopedic surgery. Over the course of his 35-year career, Dr. Zambetti has been referring physician or team physician for numerous organizations, including Fordham University, Cardinal Hayes High School, Fordham Preparatory School, Mount St. Michael High School and Xavier High School. approach to cha nge the way the joint is used. For exa mple, work on the abdomina ls a nd back may relieve knee stress a nd chronic pa in. " W hat many people don't rea lize is that core streng thening is ver y impor ta nt for the function of the knee," Dr. Za mbetti says. " If someone's core is wea k, he or she w i l l put more stress on the knee joint a nd be more prone to stress-related problems. If the core a nd hip structures a re strong, they ca n eff iciently ta ke some of the burden off the knee. The more a patient 's core, hips a nd glutes ca n absorb the stress of a n activity, the less stress will be placed on his or her extremities, pa r ticula rly the patellofemora l joint." ORTHOPEDIC PRIMARY CARE " We a re at t he foref ront of pr i m a r y ca re or t hoped ic s ," Dr. Za mbet ti says. " We believe that most of the issues we see as or thopedic surgeons — overuse syndromes, tendinitis, impingement problems — we should treat conser vatively. "Columbia Doctors Or thopedics currently has four boa rd- cer ti f ied pr i ma r y ca re or t hopedic specia list s," he adds. "Their focus is to treat a full spectrum of or thopedic injuries, especia lly spor ts injuries, in a conser vative ma nner." Of ten, this involves adva nced treatment for the chronic and overuse injuries that frequently aff lict athletes. Patients may present with pa in but no obvious tea rs or fractures. He gives the exa mple of knee pa in when descending sta irs. A prima r y ca re or thopedist will exa mine the motion of going down sta irs, identif ying where stress occurs, such as when the heel strikes the f loor. The physicia n will a lso determine when stress happens with a particular activity — for instance, at the beg inning or end of a tra ining session. Then he or she will prescribe a n appropriate remedy. Patient s may be su r pr ised at f i rst , but t he or t hopedic pr i ma r y ca re physicia n w i l l of ten prescr ibe Pi lates a nd exercises such a s sit-ups, pla n ks a nd Russia n t w ists for knee pa in. Cross-tra ining a nd other kinds of physica l work a re as much a pa r t of the spor ts medicine a rma menta rium as surger y or medication. 0 8C O V E R F E A T U R E