- Orthopaedic & Neurosurgery Specialists PC (ONS)

Ted Stolar - Arthroscopic repair for a torn shoulder rotator cuff

After Greenwich resident and Brunswick Academy teacher Ted Stolar seriously injured his shoulder, he sought relief from disabling pain and a loss of mobility from leading shoulder specialist Dr. Seth Miller. "I'd been taking lots of anti-inflammatory medication," said Stolar who enjoys recreational softball and kayaking adventures with his students. "I kept trying to work through the problem but eventually realized I was losing strength in my arm." Dr. Miller determined that Ted had torn a tendon of his rotator cuff, but an arthroscopic surgical procedure could repair the damage and end his pain.

By using the latest arthroscopic technique, the tendons heal at about the same rate as in traditional surgery, but the less-invasive procedure has several big advantages. Arthroscopy is a same-day surgery and can be performed with local anesthesia. Patients experience substantially less pain after arthroscopy, which allows them to get back to their normal routine quicker.

"Not all rotator cuff tears can be resolved with arthroscopy. However, the newer procedure has clear benefits," says Dr. Miller. "Ted had same day surgery and returned to his classroom the following day with his arm in a sling." Two months after the surgery, he had regained a complete range of motion and had full use of his shoulder. He was able to resume all his normal activities and even went on a rafting trip with his students.

Cynthia Cottman - Knee replacement surgery

Cynthia Cottman of Greenwich was just 49 when she began to feel intermittent pain in her right knee. Occasionally the joint would even lock in place. Eventually, the pain worsened. She consulted her doctor who told her it was probably arthritis, which is prevalent in her family. X-rays of her knee did not reveal any irregularities so she tried to continue with life as usual.

Cynthia had always lead an active life and she was discouraged by how difficult even walking had become. When the pain elevated to "sharp and shooting" she became alarmed and made another appointment, this time to see Dr. Brian Kavanagh. He ordered another set of x-rays but this time he wanted Cynthia to be standing. The difference was dramatic. The new images revealed that, in fact, no cartilage remained between the bones in her knee. "Dr. Kavanagh explained that the condition of my knee would not improve," said Cynthia. "Sooner or later, I would need a knee replacement."

She stayed at Greenwich Hospital for three and a half days, followed by seven days in a rehabilitation center. Her progress was steady. By the time she came home, she was walking without a walker or cane. "I did physical therapy three times a week, which was tough work but the continual progress was very motivating." After six months she was completely recovered and back doing all her normal activities.

Louis Larizza, 15, Trauma surgery

Port Chester High School freshman Louis Larizza was 15-years old when he broke both bones in his right forearm while playing football in a game in Chappaqua, NY. His mother Nella recalls how excruciating her son's pain was as they raced to Greenwich Hospital.

Dr. Frank Ennis was on call in the Emergency Room that afternoon. When he saw the deformed appearance of Louis' forearm, he knew Louis had suffered significant fractures in both his right ulna and radius. The bones were out of alignment and very unstable. Urgent surgery was required. Nella remembers, "It was very scary but Dr. Ennis' calm and reassuring way in the Emergency Room made us feel he had things under control."

It took two and a half hours for Dr. Ennis to insert two permanent plates and eleven screws to align and secure the bones. Everything went as expected and Louis' recovery was smooth. Dr. Ennis gave him some exercises to do on his own, which Louis did conscientiously. His recovery exceeded expectations and Louis completely regained the mobility of the arm.

Louis is an avid basketball player and had been worried he wouldn't be able to play on his school varsity team that November. "We didn't think it was possible, but not only did he make it to his basketball season on time, he had a great season," said his mother. "Dr. Ennis even came to a game to see him in action and congratulate him on his recovery." Nella continues to carry Dr. Ennis' business card in her purse but admits that she hopes she'll never need to call him.

Elmer Stannard - Reverse Total Shoulder Replacement

Elmer Stannard, a 73-year-old from Wilton, CT enjoyed skeet and trap shooting for many years and was a serious competitor in regional tournaments until twelve years ago. He noticed his left shoulder was "catching" as he followed his target with his gun. It didn't sweep in the smooth arc that he was accustomed to. Before long, the problem became painful and began to affect other activities including putting on shoes and even driving a car.

After consulting an orthopaedic surgeon, he learned that years of wear and tear had resulted in a torn rotator cuff. A year later, after losing much of his arm's mobility and living with increasing pain, he underwent surgery to repair the tear. The result was only modestly successful and over the next nine years, he underwent two more surgeries. His condition continued to deteriorate, eventually forcing him to retire from his work as a plumbing contractor.

After the failure of his third surgery, Stannard's doctor referred him to Dr. Seth Miller who was successfully using a brand new procedure known as a reverse shoulder replacement. Approved by the FDA in 2004, "reverse shoulder replacement" has been performed in Europe for nearly 20 years. The surgery uses a metal and plastic implant that works the opposite of a normal shoulder by placing the ball onto the shoulder blade and the socket onto the top of the upper arm bone. The reversed position of the ball and socket alters the mechanics of the shoulder, changing the center of the shoulder's rotation. The strength needed to move the arm is shifted away from the damaged rotator cuff muscles, allowing the deltoid muscle to take over.

"A reverse shoulder replacement is a real breakthrough for patients whose rotator cuffs are degenerated to the point they no longer function and cannot be repaired," said Dr. Miller. "Many of these people, like Mr. Stannard, are unable to raise their arm more than a few inches and a traditional shoulder replacement is not an option because the tendons aren't healthy enough to hold the shoulder ball into the socket. Until the reverse shoulder replacement was invented, there was no solution for a patient with such a badly damaged shoulder."

Dr. Miller performed the surgery and Stannard remained in the hospital for three days. Soon after, he began a home exercise program to strengthen and train the deltoid muscle for its new job. In only a few weeks, he began to regain the ability to lift his arm and within two months, he was able to raise his arm well over his head, something he hadn't been able to do for years. "This is the greatest thing to happen to me in years," said Stannard.

Jason Mager, 24, ACL Reconstruction

Jason Mager, a 24-year-old from Cos Cob was playing basketball with friends when he tore his ACL. He jumped to reach a ball coming off the basket rim. As he grabbed the ball, his body twisted in the air. But when he came down, slightly off balance, his left foot planted hard on the court. He fell to the floor and pain shot through his left knee. Almost immediately, it swelled. An x-ray at Stamford Hospital indicated no broken bones but Jason was advised to see an orthopedist. The next day, he visited James Cunningham, MD. A physical examination determined he had most likely ruptured his ACL. An MRI confirmed the diagnosis.

"An avid basketball player and all-round athlete, Jason was a good candidate for an ACL reconstruction," said Dr. Cunningham who, in the surgery last April, used part of Jason's patellar tendon to reconstruct the ACL. The surgery included work on a partially torn meniscus and reconstruction of the ACL. The surgery lasted one and a half hours and Jason went home later the same day. His recovery was steady and his pain was managed with Advil. After five days he began a physical therapy program, which he followed three days a week for the first month and gradually reduced over the following few months.

Today Jason's knee has regained full flexibility and he's back to playing basketball with his friends.