Sunday, March 27, 2011

Operation Walk Syracuse

The pain and mobility limitations of arthritis can not only be severely disabling, but life altering.  Imagine living in a place where there are not enough skilled medical professionals to help you, or that the cost of treatment is too high.  Sadly, millions of people around the world live without the hope of getting better.  The orthopedic resources so commonly available in the United States unfortunately are unavailable in much of the world.
For these very reasons, we have created Operation Walk Syracuse and are eager to introduce you to the wonderful work we plan to do.  Our organization will provide free hip and knee replacement surgeries to underserved populations around the world.  We are excited to embark on our first journey to Nepal in November, 2011.  We plan to perform joint replacement procedures on more than 75 patients during our week long trip.
Compelling patient stories emphasize the need for our services:
He slowly made his way across the dirt floor to the window, taking care not to lose his footing.   A fall with a resulting broken hip would most certainly mean death for him.  After all, the nearest hospital was more than an hour away from his small village.  Transportation there for those in good health was a lengthy trek; for those with restricted or no mobility, an impossibility.  As he peered out the window of his thatched roof hut with straw walls, he wondered if they had forgotten him.  Anxiety began to mount as he realized how very dependent (life and death dependent) he was on those in the village who came to his aid.  Unable to shuffle more than a few steps due to his painfully disabling arthritis, he relied on the good will of others to bring him his daily meal and fresh water.  It was degrading to him to have to have others tend to his bodily needs (food, water, hygiene, and toileting) but for lack of choice, he accepted it.   It was well past the usual arrival time and he worried that someday they may forget him and there he would be; hungry, thirsty, in pain, and most importantly, alone.  He spied the child carrying the basket just turning onto the bamboo path outside his house.  He breathed a sigh of relief.  It would be okay, at least for today.

Imagine living a life like this.  Alone and isolated simply because access to this life-altering surgery is not available to you.  Something that we take for granted here in the United States because it is so common and nearly available to everyone, is a luxury restricted to very few or even none in other parts of the world.  There are countless individuals awaiting our arrival in Nepal in November of this year (2011).  The medical volunteers of Operation Walk Syracuse will travel to the other side of the world to perform joint replacement surgery on more than 75 patients.  The stories will be heart-breaking and heart-warming as well as humbling, but with no possibility of joint replacement surgery for these people, we will bring hope, inspiration, and the opportunity to dramatically change the lives of the people.
Our patients are poor individuals who have no access to specialized orthopedic care and would otherwise have to suffer and live in pain.  We have performed more than 15,000 joint replacement procedures on patients in the United States and want to serve the larger world as well.  Our goal is simple:  to make these people better, more mobile, and free from pain so they can return to their families and society, earning a living and caring for those who depend upon them.
Operation Walk Syracuse is an all-volunteer medical organization.  We will take an entire team of surgeons, medical doctors, nurses, anesthesiologists, physical therapists, and others who provide the same state of the art services that our patients receive here at home.  All the implants, medical supplies and services are provided at no cost to these needy individuals.
Thousands of people throughout the world who could not walk without pain have returned to productive and active lives as the result of the charitable work performed by other Operation Walk Mission Teams and the generosity of their supporters.  We are eager to join in these very worthy efforts. Our goal is simple, to “restore hope through motion…one joint at a time.”
We are also excited about a local effort that will launch before the end of the year.  Operation Walk Syracuse will also participating in a program that will bring hip and knee replacement to patients here in Syracuse who would otherwise not be able to have this surgery. 
You can visit to learn more about our organization. 

Brett B. Greenky MD               Seth S. Greenky, MD                Kimberley Murray, RN
Co-Executive Director              Co-Executive Director                Clinical Director
Operation Walk Syracuse        Operation Walk Syracuse          Operation Walk Syracuse


“We make a living by what we get, but we make a life by what we give.”  - Winston Churchill

Operation Walk Syracuse

Sunday, March 20, 2011

St. Patrick's Day Limerick

Frank O'Panzetta
A limerick is a kind of a witty, humorous, or nonsense poem  composed in a strict rhyme scheme.  The origin of the limerick is not known, however, it is generally believed that it references the County of Limerick in Ireland.

The standard form of a limerick is a stanza of five lines, with the first, second and fifth usually rhyming with one another and having three feet of three syllables each; while the shorter third and fourth lines also rhyme with each other, but have only two feet of three syllables.

In honor of St. Patrick’s Day this week, we invited St. Joseph’s Hospital’s very own Frank O’Panzetta, Director of Human resources, to pen a limerick for our blog.


                      Some might find the limerick form odd,
                 But we thought we would give it a nod.
                 To honor St. Pat,
                 Who could argue with that,
                 Afterall, the bones are the frame for the bod.

                So let’s keep those bones healthy and strong;
                Nourished and aligned where they belong.
                And if something is seen,
                Where we must intervene,
                Rest assured that we’ll all get along.

Happy St. Patrick's Day!

Sunday, March 13, 2011

Orthopedic Blog: Roadtrip to Boston

Brett Greenky
Kim Murray

Back to Boston

As you drive up to the New England Baptist Hospital in Boston the origins of the facility as a turn of the 18th Century Tuberculosis Asylum is evident.  The hospital is perched on a hill overlooking the then farmland of Brookline, now a bustling extension of the classic New England Metropolis.  The architecture is classic New England brick and stone with waves of more modern extensions.  One could easily mistake the campus for an internal quad of one of the Hospital’s affiliated nearby academic institutions of Harvard and Tufts Universities. A banner over the front entrance announces the institution’s recent designation of one of the nation’s best Orthopedic medicine providers.

Entering the building I immediately flashback to my interview for the prestigious Aufranc Fellowship in Joint Replacement Surgery in 1988.  We all entered at 8am, myself and the other 39 applicants who competed for the 2 positions. We were the survivors of the initial screening process of a much larger candidate pool.  The interview process consisted of a series of three interviews that mirrored the oral component of Orthopedic Surgery Board examination.  We all rotated through three conference rooms each with eight Attending Surgeons.  We were asked typical interview questions, but also grilled on treatment options for carefully selected case presentations accompanied by X rays.

Back in Syracuse some 5 days later I was both pleased and humbled by the call notifying me I had been selected for one of the two fellowship positions. Thus began my real education in both the art and the science of Joint Replacement.  In medicine you never stop being a student.  The process of education is life-long as the obligation to our profession and our patients requires continued learning.  Even as the tradition has passed to Seth and me to be the teachers and professors, we continue to be students. 

As such myself and the team (Betsey Caiello, Dave Grygiel, Lynn Leo, Kim Murray, Diane Waldon, and Tammi Walker) left the Baptist with a more complete understanding of the equipment available to bring our hospital to the cutting edge with respect to efficiency in instrument processing.

More on Baptist recollections in future blogs.

Nuts and Bolts of Our Visit

Seventeen Operating Rooms, 40,000+ square feet of clinical and support space, state of the art/cutting edge technology, advanced telecommunications, and enhanced care delivery systems describe the surgical suite design that has been created as the result of more than two years of work by a multidisciplinary team comprised of nurses, physicians, and other clinical representatives.  A daunting task to say the least, but as this design phase draws to a close, we continue to review and refine specific elements to ensure that no stone has been left unturned when it comes to meeting our goals of optimized safety, efficiency, and care processes.
The fixed and mobile equipment necessary to deliver patient care is both expansive and complicated.  Amongst other challenges, selecting equipment that has a proven track record, will remain functional for years to come, and is not cost prohibitive is critical to a successful project and to meet the desired outcomes.  Item by item we have researched, investigated, and validated each item that will be introduced into the new OR’s. 
A particular challenge is the equipment that is necessary to render surgical instrumentation sterile.  Instruments, drills, retractors, and other specialty surgical implements become grossly contaminated with blood, tissue, and bone during surgical procedures.  Effective decontamination, cleaning, and sterilization equipment which minimizes the need for hand cleaning/preparation is necessary and is a critical step in the prevention of surgical infections.
A recent site visit to New England Baptist Medical Center, an orthopedic hospital in Boston, Massachusetts, provided us the opportunity to witness firsthand the advances in cleaning and sterilization processes and equipment.  A tour through the central sterile/processing area introduced us to a high performing service with state of the art equipment.  Our research had suggested to us that the equipment in use at The Baptist, as well as the processes and procedures that they have developed, are considered best practice.  Although inconvenient and time-consuming, our team of seven that travelled to the hospital found that validation that we were seeking.  Taking the time and exerting the effort for critical decisions such as this is well worth the inconvenience and hassle.  We left confident that we had discovered the best equipment for our new surgical suite.  This is a process that has been done, and will be repeated, over again until all equipment decisions have been finalized.


Friday, March 11, 2011

Coming Sunday

Visit to New England Baptist Medical Center
By Dr. Brett Greenky
  • explore new technology
  • revisit old stomping grounds

Monday, March 7, 2011

AAOS 2011 Annual Meeting, San Diego (Orthopedic Blog)

In mid-February more than 30,000 orthopedic surgeons, health care clinicians, and other orthopedic industry professionals from around the globe descended on the city of San Diego.  One of the nation’s largest medical meetings, the American Academy of Orthopedic Surgeons (AAOS), was about to launch its 2011 annual meeting.
The American Academy of Orthopedic Surgeons is the premier, world-renowned group that serves as the organized entity for orthopedic surgeons and related health professionals.  Education for orthopedic specialists, sharing of meritorious clinical research findings, and advocacy for improved patient care are the primary functions of the group.  Founded in 1933, it has grown to include more than 36,000 members worldwide.  Many of these individuals convene annually to network, share knowledge, and collaboratively work to enhance the quality of musculoskeletal care.
There are a limited number of US cities which have the infrastructure to effectively host a meeting of this size and caliber.  San Diego, one of the few cities able to accommodate this meeting, has been a frequent site for the gathering, a boon to any host city because of the anticipated $112 million economic impact that will result.  Attendees arrived from near and afar, flying in from the other side of the world, trekking from the east coast of the US, or simply driving from contiguous locations in southern California.  Some surgeons arrived solo having temporarily closed the small rural clinics in which they practice, while others came in contingencies from some of the most regarded academic medical centers in the world.  Despite the dramatic differences in their practices, all have one thing in common, the desire to learn, share, and improve the care that they deliver to their patients.
Speakers and presenters represented the world as well.  The international flair was clearly apparent.  The Guest Nation for the meeting was Turkey.  While the Turkish contingency profiled to the group the unique issues facing the Turkish orthopedic community, other speakers from around the world provided a global perspective and fostered awareness of the contributions made to orthopedics from other nations throughout the world.
The meeting featured a multitude of educational formats which appealed to everyone.  Symposia provided the opportunity for several speakers to present and discuss innovative topics, often with differing opinions, before an audience.  Instructional Courses are solidly evidence based presentations made by renowned individuals focusing on principles and techniques.  Surgical Skills Courses include both a lecture component as well as a hands-on saw bones lab.  Orthopedic Review Courses provide an opportunity to participate in all day courses that focus on the diagnosis and management of orthopedic problems.   Paper Presentations involve groups of three papers presented each in six minute increments followed by an audience discussion led by skilled moderators.  Poster Presentations afford the opportunity for a self-guided learning activity which features cutting edge scientific research.  Scientific Exhibits vividly depict a study or complex surgical procedure using AV or interactive enhancements in addition to the poster.  Both poster presentations and scientific exhibits are categorized by subspecialty (hip, knee, research, foot/ankle, hand/wrist, pediatrics, practice management, shoulder/elbow, spine, sports medicine, trauma, tumor/metabolic disease, and allied health).  The Multimedia Education Center offers the opportunity to view peer reviewed videos and multimedia programs developed by orthopedic colleagues.  The Technical Exhibits Hall affords an opportunity to view cutting edge medical devices, equipment, diagnostic products, and health information systems.  An interesting sidebar for these displays is that there are often time devices and other technologies on display that are not FDA approved for use in the United States.  Since this is truly a global meeting, technology from around the world is available for review for all attendees.
With literally hundreds of meeting and session choices before us, we four had to make difficult choices.  The week quickly flew past us and when all was said and done, our attendance tally included a broad array of hip/knee reconstruction courses, practice management events, and nursing sessions.  Evening hours were spent in dinner meetings debating important research topics, exploring cutting edge technology opportunities, and forging important relationships.   One of the highlights of our trip was the pleasure of meeting the world-renowned founder of Operation Walk, Dr. Lawrence Dorr.  He was both delightful and inspirational to us as we begin our own mission work emulating his very successful program.   We returned home exhausted, but armed with a wealth of information to assimilate and incorporate into our care practices.  It was an experience not to be missed.

Reference:  Americal Academy of Orthopedic Surgeons