Friday, March 22, 2013

We Have Moved!

Our orthopedic blog has now moved to our new home in The Center for Orthopedic & Spine Care at St. Joseph's Hospital Health Center! Please visit us at to read the latest posts and stay up-to-date on all things relevant to orthopedic and spine care.

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Thank you for your continued interest!

Thursday, March 21, 2013

Richard Zogby, MD: 6/25/58 - 2/14/2013

By Dr. Seth Greenky

There are some people who are truly special - I was fortunate enough to personally know one. Rick and I were more then acquaintances, but less then close friends. I have known him for over 30 years. We shared the same medical school; the same Orthopedic residency; we practiced in the same city; and ultimately in the same practice.

Rick had many strengths and some are so obvious that they almost don't merit talking about - his surgical prowess being one. There are other traits that truly made him exceptional. TS Eliot wrote, "I never saw a wild thing sorry for itself. A bird will fall frozen dead from a bough without ever having felt sorry for itself." Through out his illness that extended over 10 years he never complained. It wasn't for lack of pain; it wasn't lack of emotional turmoil; it wasn't because of lack of frustration - it was his inner strength, his grasp of the important aspects of everything.

He took time to "smell the roses" and share the smell with those around him. He would greet his patients, his colleagues, office staff, hospital staff, even strangers with equal respect and warmth. He was a mentor in so many ways to so many people - surgical to residents, a visionary and leader for our group (Syracuse Orthopedic Specialists), and a courageous example to all of us. His family was the epicenter for him and the strength that sustained him.

What begins as a  ripple when a small pebble is dropped into a pond quickly grows into larger ripples that cascade outwardly until they reach the confines of the shoreline. Such was the impact that Rick Zogby had on the lives of everyone with whom he interacted. His actions impacted individuals far beyond those he physically touched through this ripple effect; the epitome of the Butterfly Effect. Every single thing he did mattered; to those who knew him personally, as well as to those who experienced a ripple of an action from him.

A beautiful and wonderful man is no longer with us in body, but in spirit he will live on in the hearts of all who knew him. I myself feel most fortunate that I took the time to become his colleague and his friend.

How appropriate it is that the beam that supports the new St Josephs OR was signed in memory of Rick Zogby - a physical representation of a life of strength and accomplishment.

Friday, March 1, 2013

Shoulder Arthritis

By Dr. Brett Greenky                                                                                         The Center for Orthopedic & Spine Care @ St. Joseph's Syracuse Orthopedic Surgeons, PC
The shoulder joint is really made up of two Joints: The AC Joint and the Glenohumeral Joint. The AC joint is so named because the Acromion and the Clavicle touch together here. The Acromion is part of the shoulder blade. The AC joint can and does become arthritic. Spurs develop underneath the AC joint and these spurs can agitate the tendons of the rotator cuff. The rotator cuff tendons rub back and forth underneath the AC joint when the shoulder moves. The arthritic spurs of the AC joint can impinge on the rotator cuff tendon during shoulder motion. The resultant rotator cuff tendonitis is the most common cause of shoulder pain in adults over 40.

The Glenohumeral Joint (GHJ) is the main “ball and socket” part of the Shoulder. Arthritis of the ball and socket (GHJ) part of the shoulder is a less common affliction than AC joint arthritis. Many patients with mild to moderate degrees of (GHJ) arthritis can be treated with medications, activity modification and physical therapy or home based exercises. The purpose of these exercises is to that tone the rotator cuff muscles. When toned these muscles can help reduce the amount of rubbing in the GHJ. It is when the GHJ arthritis progresses to the severe stage that these techniques tend to no longer be adequate and total shoulder replacement  (TSR) surgery is considered. Since patients do not need to walk on the shoulder joint, severely symptomatic shoulder arthritis comes late in the disease progression. As a result, most patients who seek treatment for severely symptomatic shoulder arthritis are already at the stage when TSR is the only treatment to afford dramatic relief.

Total Shoulder Replacement (TSR) has a high success rate in reducing or eliminating shoulder arthritis pain. In general the operation is easier to navigate for the patient when compared to Total Hip or Total Knee replacement surgery since the Shoulder is a non-weight bearing joint. The operation is however requires a one to two day hospital stay and some postoperative physical therapy.  A return to near normal function requires a well functioning rotator cuff. Much of the post operative treatment is directed to the strengthening of the rotator cuff muscles which often atrophy during the period of worsening arthritis. Since a functioning and intact rotator cuff is essential for traditional TSR surgery to be successful, the joint replacement specialist may need to do additional preoperative tests (MRI scan) to check the patient’s rotator cuff condition.

A special version of TSR is available for the patient with shoulder joint arthritis who does NOT have a functioning rotator cuff. This operation is called Reverse Shoulder Replacement. The operation reverses the polarity of the ball and socket of the shoulder thus explaining the name. This novel technique allows for pain reduction in the rotator cuff deficient patient but it does not restore the function of the rotator cuff itself. Patients without an intact rotator cuff are usually unable to elevate their arm much above the waist.

Dr. Brett Greenky the Co-director of the Joint Replacement Program at St. Joseph's Hospital. He is
a Board Certified Orthopedic Surgeon specializing in hip, knee, shoulder arthritis, reconstruction/surgery, minimally invasive hip and knee replacement, anterior approach hip surgery and revision hip/knee joint surgery.

Dr. Greenky is an Associate Professor of Orthopedics at SUNY Upstate Medical College and is the founder of Operation Walk Syracuse and Co-Executive Director.

Dr. Greenky completed his undergraduate studies at Northwestern Universityand received his M.D. from SUNY Upstate Medical Center. For more information on Dr. Greenky, visit