Issue link: http://viewer.e-digitaledition.com/i/897394
The new orthopedics program includes a growing and dedicated clinical staff to provide additional support for the expanding surgical service. Dr. Geller reviews surgical equipment with orthopedics nursing team leader Deidre Cavanagh, RN. Drs. Geller and Zambetti discuss a case in one of NewYork-Presbyterian Lawrence Hospital's new operating rooms. The state-of-the-art suite of ORs sets a new standard of care for orthopedic surgery in Westchester County. "Prima r y ca re or thopedists treat each patient as a whole person," Dr. Za mbetti expla ins. For at h letes a nd ot her active indiv idua ls or for people who w ish to rega in a higher level of activ it y in their da i ly lives, physicia ns at N Y P Lawrence embrace a n or thopedic prima r y ca re model. When a patient at NYP Lawrence has a primary sports medi- cine provider, it is a simple matter to shif t to a n or thopedic specia list, ma king for smoother tra nsitions a nd minimiz- ing redunda ncy. " We a ll have access to the sa me electronic medica l record system, which helps us avoid repeating tests," Dr. Za mbetti says. "Prima r y ca re or thopedists get to know their patients well and a lign their treatment programs with their particular needs and abilities, from the amateur to the professiona l level." AGING IN MOTION Older patients have unique or thopedic needs. For insta nce, their joints may have deteriorated from long yea rs of use, a nd conditions such as diabetes ca n complicate treatment. "In these cases, preparation and medica l optimization prior to surger y a re at lea st a s impor ta nt a s the surger y itself," Dr. Geller says. "I ca n do a beautiful job with a n a nterior hip replacement , but if the patient ha s uncontrol led diabetes a nd develops a n infection, it doesn't mat ter how wel l the surger y went. We approach older patients globa lly, looking at issues such a s their physica l readiness for surger y a nd their rehabilitation options." Toward that end, clinicians and other staff at NYP Lawrence provide patients comprehensive education. Prospective joint replacement patients meet a socia l worker, physica l therapist, nutritionist a nd others who help pla n their entire surg ica l journey, down to the deta ils of how they will get g roceries a f ter the procedure. " This g loba l, col laborative approach is comfor ting a nd reduces stress a nd a n xiet y," Dr. Gel ler says. " We've had a positive response and reduced hospita l time because patients can ma ke effective preparations for recovery. This attention to detail, plus cutting-edge knowledge of the latest advancements in hip a nd knee replacement surger y, bring New York Cit y ca re to Westchester in a sma ller, more intimate atmosphere. My patients get the sa me ca re in Bron x ville a s they get on the Upper West Side." TOTAL ANKLE REPL ACEMENT Injured feet and ankles pose particular treatment cha llenges. Dr. Greisberg describes their complexit y as a kin to that of a symphony — ever y thing works together in intricate harmony until there is a disruption, a nd the whole performa nce fa lls apa r t. Dr. Greisberg has ex tensive experience in performing complex procedures to help patients recover from foot a nd a nk le injur y. "I get subspecia lty referra ls and a lso see people the day after injur y," he says. "A t y pica l morning might include fractures a nd fa i led foot a nd a n k le surgeries from other prov iders. Of ten a n a n k le surger y ha sn't gone wel l a nd patients a re asking what to do nex t." Dr. Greisberg d raws on nea rly 20 yea rs of ex per ience focused a lmost exclusively on feet and ankles, stemming from a fellowship directed by a pioneer of modern trauma ca re, Sig va rd T. Ha nsen, MD, Director of the Sig va rd T. Ha nsen Foot & A nk le Institute in Seattle. Under his tra ining a nd in the yea rs since, Dr. Greisberg has perfected surgeries to the forefoot, ba ll, hindfoot a nd a nk le. He notes, for exa mple, that the hindfoot works like a uni - versa l joint. It must be mobile to meet the terra in but stable enough not to roll over the a nkle. The liga ments a nd tendons must work to measure the foot 's position a nd help ma inta in 0 9 M D N E W S . C O M /// M D N E W S L O W E R H U D S O N / B R O N X ■ 2 017