• Patient Education: Rotator Cuff Surgery

    Posted by Orthopaedic Specialists

    Rotator Cuff Surgery Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Preparation For Surgery; The Night Before

    • Rotator cuff surgery is performed as an outpatient procedure.
    • Do not eat or drink after time given by Dr. Grossfeld’s staff
    • Wear loose-fitting clothing
    • Bring Insurance information and picture ID
    • List of medications and drug allergies
    • Arrange for someone to drive home after procedure

    Upon arrival at the surgery center you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team. Vital signs, such as blood pressure and temperature, will be measured.

    A clean hospital gown will be provided. All jewelry, dentures, contact lenses, and nail polish must be removed. An IV will be started to give you fluids and medication during and after the procedure. Your shoulder will be scrubbed and shaved in preparation for surgery. An anesthesiologist will discuss the type of anesthesia which will be used. Dr. Grossfeld will confirm and initial the correct surgical site with a marking pen.

    Anesthesia

    Prior to the procedure you will meet the anesthesiologist. At that time, they will discuss your medical/past anesthesia history with you. The anesthesiologist will place a nerve block to numb your shoulder and arm. The numbing medicine will last for 18 hours. This is a great way to reduce post operative pain. Even after the nerve block wears off, your pain level is reduced because of the anti-pain effect of the nerve block.

    After the nerve block is placed, you will go to the operating room where the surgery is performed. The anesthesiologist will administer a general anesthesia, so you are completely asleep for the procedure. You will not hear or see anything going on in the operating room.

    Surgical Procedure

    Dr. Grossfeld will perform the rotator cuff repair arthroscopically. This procedure takes between 45-90 minutes. After you head back to the operating room it takes about 40-50 minutes to go to sleep and get positioned on the operating room bed, so your family may not see you for 2.5 hours depending on how extensive the surgical procedure. Dr. Grossfeld will make five to six small incisions that are less than a ½ an inch in length around the shoulder joint. A small high-definition camera, about the size of a pencil, will be placed into the shoulder joint. After the camera is inserted, inspection of the whole shoulder joint is completed. Each compartment of the shoulder is viewed. The location of the rotator cuff tear will be identified. If there are any bone spurs those will be removed. Removal of the bone spur is called a subacromial decompression, and/or an AC joint excision. Any other abnormal findings will also be addressed at the time of the surgery and repair.

    An overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The repair of the rotator cuff is done by placing three or four suture anchors into the shoulder bone.
    Suture anchors are made out of a synthetic bone, the anchors will incorporate into your own bone. The image to the left is a suture anchor used to repair torn rotator cuffs.

    A surgical overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The first image above reveals the anchor being screwed into the shoulder bone (the x marks the torn rotator cuff tendon). The middle image shows the suture anchor secured into the shoulder bone. The last image shows how the sutures are now “anchored” into the humerus and ready to be sutured through the torn rotator cuff tendon.

    An overview of rotator cuff surgery with Dr. Stacie Grossfeld of Louisville, KY.

    The images above show how the suture is sewn through the torn rotator cuff tendon. The sutures are pasted through the torn rotator cuff tendon with a special instrument designed specifically for the task.

    An overview of rotator cuff surgery when you schedule with Dr. Stacie Grossfeld of Louisville, KY.

    The three images above show the knots that are tied to hold the torn tendon against the shoulder bone. The second and third image show the second set of anchors that reinforce the repair. The final picture is a repaired rotator cuff tendon.
    The repaired tendon will be reattached to the bone. The sutures are there to hold the tendon securely up against the bone while the healing process takes place.

    If there are any bone spurs, they will be removed with a small tool that similar to a Dremel.
    The incision site/portal sites are closed with a blue colored suture called Prolene. The sutures will be removed when you are seen in the office at 10 to 14 days post-surgery.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites followed by ABD pads which are a larger fluffy dressing, followed by surgical tape. Your specialized shoulder sling will be fitted in the operating room.

    You will get a detailed set of instructions on wound care upon discharge from the surgery center.

    Night of Surgery

    It is very important you stay on top of the pain. Ice is key. Use ice as MUCH as possible. Dr. Grossfeld recommends continuous use of ice around the clock. The rule is you cannot use too much ice. Whether it is a Polar Care unit or bags of frozen peas: use it continuously for 6-7 days after surgery.

    Polar Care units are available for purchase Orthopaedic Specialists for $150.00. They are not covered by insurance. Polar Care is a motorized ice machine which consist of a neoprene wrap that gets placed over the operative shoulder and a cooler that is filled with ice and water. A hose connects to a neoprene wrap that goes around the shoulder, and will push water through the neoprene wrap for up to nine hours. Please freeze eight water bottles before your surgery. Put four frozen water bottles into the Polar Care unit. Then, fill with water. This will keep the with water colder longer. When the four water bottles defrost, replace with four more frozen bottles and put the defrosted bottles back into the freezer. Continue to repeat this cycle. Use ice around the clock, even when sleeping. Ice is the best source of pain control and swelling.

    Set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours OR Meloxicam 15 mg every 24 hours can also help to reduce post operative pain. Do not use Motrin or Meloxicam if you are on blood thinner or have a history of stomach ulcers or kidney disease

    Sleeping in a recliner, in an upright position, or using lots of pillows to support your shoulder will be more comfortable. Some people will sleep in a recliner for up to 4 weeks after surgery. Lying flat in bed allows your shoulder to roll back which tugs on the repair, and will cause pain.

    Sling Use

    You will wake up in the recovery room with your sling on. Occasionally you may take the sling off while at rest, (NOT asleep), as long as you place your arm against your belly. When asleep the sling must be on.

    Surgical Dressing

    A dressing, consisting of 4×4 gauze pads, ABD pads and special surgical tape will be placed on the surgical site(s). Please refer to your post operative orders given to you the day of surgery for dressing change details.

    Dressings to purchase before your surgery day are: 10-15 4×4 gauze pads, an extra 6-inch ace wrap, peroxide, paper tape and waterproof Band-Aids. Kits are available for purchase at Orthopaedic Specialists.

    First Post-Operative Visit

    Your first post operative visit will be 10-14 days post-surgery. Sutures will be removed by an assistant. Dr Grossfeld or Bess Fley, PA-C will go over your operative report, surgical photos, and answer any remaining questions. Physical therapy may be ordered. Typically, physical therapy is only once or twice a week for the first six weeks. PT will vary from person to person based on the size of the tear and repair quality.

    Home Exercises & Physical Therapy

    Exercises will be given to do post op. A link to these exercises is on the post operative instructions/orders given the day of your surgery. The link will show you how to do some gentle post operative exercises. A set of pulleys, which can be purchased from our office for $20, allow you to work on passive range of motion exercises at home after the surgery.

    Physical therapy is divided into three 6-week blocks. The first 6 weeks you will attend once a week to work on gentle passive range of motion exercises.

    The second six weeks therapy involves active range of motion of the shoulder with some gentle strengthening. You will attend 1-3 times a week, depending on your repair and other factors.
    The third six weeks of physical therapy involves increasing range of motion and further strengthening. This is about a five-to-six-month recovery before you are back to your normal activities involving the operative shoulder.

    Driving

    You may begin to drive after you’re off all narcotic pain medications. Once you begin driving your sling needs to be taken off while driving. It is recommended you place your hand, of the operative side, at the bottom of the steering wheel and your non-surgical hand at the top of the steering wheel to do most of the work.

    Return to Work

    If you work a labor type job, you may not return until you are released 100%. However, if your employer can accommodate light duty options you may return as soon as two to four weeks after surgery. Light duty options require no use of the surgical extremity, except for simple tasks such as using a computer.

    If you have an office type job, you can most likely get back to work between two to four weeks. Return to work also is dependent upon pain level. Some people have a lot of pain after this particular surgery, some people have very little. Pain is very personal, and we will supply you with pain medication in accordance to our office policy and Kentucky state law. Pain medication will be prescribed appropriately in regards dosages, amount, and time.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

    Bess Fley, PA-C, May 2023 Newsletter: Tennis Elbow

    Posted by Orthopaedic Specialists

    Sports Medicine in Louisville, KY, Orthopaedic Specialists, Bess Fley PA-C, Dr. Stacie Grossfeld Supervising Doctor

    From the Desk of Bess Fley: Tennis Elbow

    It’s that time of year when everyone is itching to get outside and enjoy the nice weather, and what better way than to play tennis or pickleball? Below, we’ll will discuss tips for both on and off the court to help prevent and successfully treat tennis elbow.

    What is Tennis Elbow?

    Tennis elbow, a.k.a. lateral epicondylitis, is when repetitive movement causes inflammation of the tendon that connects the elbow to the forearm muscles. This tendon is called the common extensor tendon. Read below for some easy prevention tips, signs of injury, what puts you at higher risk for developing this condition, and what you can do to treat it.

    Bess Fley, P.A., at Orthopaedic Specialists in Louisville, KY treats a variety of different injuries, including tennis elbow.

    Risk Factors for Lateral Epicondylitis

    • Playing a racket sport for more than 2 hours at a time
    • Poor form
    • Increased age
    • Those who work jobs with repetitive movements

    Physical Symptoms

    • Pain over the outside of the elbow (lateral epicondyle)
    • Pain with forced wrist extension

    Treatment Options

    Tennis Modifications That May Help

    • Book a private lesson at your club to work on form
    • Decrease the tension in the strings
    • Double grip the racket to decrease grip strength
    • Add a shock absorber

    If you or anyone you know is struggling with nagging tennis elbow, come in and see us! Not every treatment option is ideal for every patient, so we will discuss the risks and benefits to tailor a treatment plan that will best serve you!

    If you or someone you love has suffered a tennis elbow injury in the Louisville, Kentucky-area, Orthopaedic Specialists, PLLC can help! Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Patient of the Month: Joyce Koch

    Posted by Orthopaedic Specialists

    Meet this month’s patient in the spotlight, Joyce Koch!

    Joyce Koch suffered from arthritis in her knees, which Dr. Stacie Grossfeld at Orthopedic Specialists in Louisville, KY was originally treating her for, when she was rear-ended twice and needed physical therapy for back pain.

    If you were previously a student at St. Agnes, Assumption High School, or Presentation Academy, then Joyce’s name might be familiar. Having been a teacher since 1968, with 29 years spent at Assumption High School and the other 24 spent between Presentation Academy and St. Agnes teaching English and math, Joyce has had a long career in the Louisville educational field.

    What makes Joyce a true spotlight patient, though, is that she sought opportunities to become better and initiated changes in her community that benefited the students she taught, the teachers she worked alongside, and her school as a whole.

    When mainstream technology and computers became popular in the early 80’s, Joyce saw it as an opportunity to grow and took it, obtaining a degree in computer education at Spalding University along with her higher education degrees she already had in other areas. This led her to become first the technology coordinator at Assumption, and then the IT Director 9 years later, where she led the school in becoming leaders in educational technology for 20 years.

    Joyce Koch was a teacher at Assumption High School, Presentation Academy, and St. Agnes before she was injured in a car accident and needed physical therapy in Louisville from Dr. Grossfeld at Orthopaedic Specialists.

    Now retired since 2021, Joyce would have liked to have spent her last few years working as she always had: with pep, passion and without any pain. For much of her life, Joyce was able to enjoy being a mother, teaching, reading, yoga, stretching, and walking for miles without any difficulties. In fact, she belongs to 2 different book clubs, listens to audiobooks regularly, and lives her life with the motto that, “You always have time for the things you put first,” – something that she always managed to apply to her stretching routine! She loves walking through Louisville’s myriad of beautiful parks, and was even in the habit of walking the mile from her home to school every day when she was working at Assumption High School.

    Her time doing what she loved was cut short unexpectedly, though, when she experienced a series of injuries that put her out of commission in 2019.

    Joyce’s Story

    One After Another

    Before her recent injuries, Joyce’s relationship with Dr. Grossfeld and Orthopaedic Specialists dates back to 2005, when an instructional yoga video with her daughters triggered an arthritis flair-up in her right knee. This particular injury didn’t seem all that serious – when Dr. Grossfeld headed her PT, her pain went away and she had no complications until 2019, when her other knee began giving out on her. Deciding to take her issue to Dr. Grossfeld again, she made an appointment, but before she was able to address her knee, she was rear-ended in a car accident and began experiencing back pain that was much worse than her knee pain.

    Dr. Grossfeld was able to address her pain and injuries with medications and another bout of physical therapy, this time for her back, but before she experienced relief, less than a month from her accident, Joyce was rear-ended again, which worsened her condition to the point that standing and walking caused her severe pain. Now using a cane and having difficulties sleeping that also led to a pop-up case of temporomandibular disorder (TMD), Joyce felt it was time to take a leave of absence so that she could focus on resolving her pain. Dr. Grossfeld was able to send her to a pain specialist, who diagnosed a pinched nerve in her vertebrae that would require a series of treatments over the course of a few weeks.

    But, in the midst of her pain, the world was hit by the pandemic and Joyce’s pain center closed, leaving her without treatment until June of 2020. Even struggling with pain, Joyce managed to contribute to Assumption’s success during the age of online learning before her injury ever happened – she’d had the foresight to begin teaching the teachers about online instruction and how to navigate that world a whole year before, and her colleagues and students had never been more grateful, even as she was on leave.

    By the time she was able to receive treatment, Joyce’s back pain had caused her knees to worsen without the ability to walk or keep stretching, which led to her right knee replacement in 2021. But, as her right knee improved, Joyce found that her left knee’s development was moving in the opposite direction. Sure enough, Dr. Grossfeld completed a knee arthroscopy surgery to remove a meniscal tear in her left knee, which fixed her pain until her arthritis came back and she was sent to get her left knee replaced.

    Recovery and Joyce Today

    From her original concerns until her last knee replacement surgery, Joyce says that her recovery took around a total of 3 years. At the height of her pain, Joyce felt unable to do most things that she loved, including walking, stretching, and even cooking! While she tried to supplement some parts, like taking up water-walking at Dr. Grossfeld’s advice, the lack of sleep and weakness her injuries caused left her mood suffering.

    These factors combined with the effects of the pandemic caused her retirement to come earlier than she intended, but it allowed her to put 100% into getting better and back to a quality of life that was as close to where she was before as possible.

    Joyce Koch was the IT Director at Assumption High School and a leader in educational technology. When she was rear-ended and injured her back, Dr. Grossfeld at Orthopaedic Specialists in Louisville gave her the diagnoses and physical therapy she needed to recover.

    (Pictured Above: Mary Lang, President of Assumption High School, and Joyce Koch on March 22, 2023, when she was awarded a “Distinguished Educator” trophy and an honorary diploma.)

    “Dr. Grossfeld truly listens to what you are feeling and hones in on the correct plan of action. She and her staff are caring, compassionate people treating the whole person, not simply one offending joint. I have recommended them to my family and friends who feel the same way about them as I,” Joyce says, having done plenty of physical therapy and treatments with Dr. Grossfeld throughout the time she was injured and recovering.

    With the help of Dr. Grossfeld’s diagnoses and recovery methods, now, with the back pain under control and both knees replaced, Joyce is back to stretching first thing in the morning for 20-30 minutes to start her day and is able to walk 3 or 4 miles a day as she had before. Sleeping through the night and the ability to cook homemade meals every night once more has become normal, and Joyce says that the work was difficult in many ways, but that she’s grateful to be back to doing what she loves!

    If you or someone you love has suffered a knee or back injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Educación del paciente: Reparación del codo de tenista

    Posted by Orthopaedic Specialists

    Descripción General de la Reparación del Codo de Tenista
    Especialistas Ortopédicos 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    La cirugía de codo de tenista se realiza como un procedimiento ambulatorio.

    A su llegada al centro quirúrgico, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería.

    Anestesia

    La siguiente persona que conocerá es el médico de anestesia. En este momento, el anestesiólogo discutirá el proceso y abordará cualquier pregunta o inquietud que tenga sobre la anestesia. El anestesiólogo puede colocar un bloqueo nervioso para adormecer su brazo o el Dr. Grossfeld puede inyectar un anestésico local al final del procedimiento.

    Usted irá al quirófano donde se realiza la cirugía. Luego, el anestesiólogo administrará una anestesia general, por lo que estará completamente dormido para el procedimiento. Debido a que es una anestesia general, no escuchará ni verá nada de lo que sucede en la sala de operaciones.

    Procedimiento quirúrgico

    Una visión general de la cirugía de reparación del codo de tenista con el Dr. Grossfeld.

    El Dr. Grossfeld luego realizará la cirugía de codo de tenista. Este procedimiento dura entre 30-40 minutos. Tenga en cuenta que después de regresar a la sala de operaciones, toma entre 40 y 60 minutos irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 1.5 a 2 horas, dependiendo de qué tan extenso sea el procedimiento quirúrgico y qué deba solucionarse.

    El Dr. Grossfeld hará una incisión alrededor de la articulación del codo. Ella desbridará cualquier tendón no saludable y reparará el tendón desgarrado.

    Los anclajes de sutura están hechos de un hueso sintético, por lo que los anclajes se incorporarán realmente a su propio hueso. Los anclajes de sutura se colocan en el hueso que luego “ancla la sutura” y esas suturas se cosen a través del tendón extensor común para reparar el tendón dañado. La incisión se cierra con 2 capas de suturas que son solubles. Habrá tiras blancas estériles que también se utilizan para ayudar a cerrar el sitio de la incisión.

    Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD, que son un apósito esponjoso más grande, seguido de un relleno de yeso. Luego se aplicará una férula de yeso para que no pueda doblar el codo o la muñeca. En su primera visita postoperatoria, se retirará la férula y se le colocará un aparato ortopédico para el codo que permita un poco de movimiento del codo. También se le colocará una férula para la muñeca para limitar el movimiento de la muñeca.

    Una visión general de la cirugía de reparación del codo de tenista con el Dr. Grossfeld.

    Noche de Cirugía

    Es muy importante que te mantengas al tanto del dolor.

    Ella recomienda que configure su despertador y tome su medicamento para el dolor cada 4 a 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas o Meloxicam 15 mg cada 24 horas puede ayudar a controlar el dolor. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal.

    Primera visita postoperatoria

    Su primera visita postoperatoria será de 10 a 14 días después de la cirugía. Usted será visto en la oficina en ese momento y le quitarán los extremos de las suturas. El Dr. Grossfeld o Bess Fley, PA-C responderán cualquier otra pregunta.

    Fisioterapia

    La fisioterapia no se iniciará hasta la semana 6-7 después de la cirugía después de que se suspendan los frenillos. Esto es aproximadamente una recuperación de tres a cuatro meses antes de que vuelva a sus actividades normales que involucran el codo operatorio.

    Conducción

    La mayoría de las personas comenzarán a conducir una vez que hayan dejado de tomar todos los analgésicos y se haya retirado la férula en la primera visita postoperatoria: 10-14 días después de la cirugía.

    Regreso al trabajo

    Si trabaja en un trabajo de tipo laboral, lo más probable es que no regrese a ese trabajo hasta que sea liberado al 100%. Esto podría ser de 3 a 4 meses dependiendo de la descripción de su trabajo.
    Si su empleador tiene opciones de trabajo ligero, lo más probable es que sea liberado en cualquier lugar entre dos y cuatro semanas de regreso al trabajo liviano, y generalmente el servicio liviano no requerirá el uso del lado quirúrgico / el lado en el que se realiza su cirugía, excepto para tareas simples como usar una computadora o contestar un teléfono.

    Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre una y cuatro semanas. El regreso al trabajo también dependía del nivel de dolor y la descripción del trabajo. Algunas personas tienen mucho dolor después de esta cirugía en particular, algunas personas tienen muy poco. El dolor es muy personal y diferente de persona a persona.

    FMLA y papeleo de discapacidad

    Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

    Patient Education: Tennis Elbow Repair

    Posted by Orthopaedic Specialists

    Tennis Elbow Repair Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Tennis Elbow surgery is performed as an outpatient procedure. Upon arrival at the surgicenter you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team.

    A step-by-step guide of the tennis elbow repair surgery with Dr. Grossfeld in Louisville, KY.

    Anesthesia

    The next person you will meet is the anesthesia doctor. At this time the anesthesiologist will discuss the process and address any questions or concerns you have about the anesthesia. The anesthesiologist may place a nerve block to numb up your arm or Dr. Grossfeld may inject a local anesthetic at the end of the procedure.

    You will go to the operating room where the surgery is performed. The anesthesiologist will then administer a general anesthesia, so you are completely asleep for the procedure. Because it is a general anesthesia you will not hear or see anything going on in the operating room.

    Surgical Procedure

    Dr. Grossfeld will then perform the tennis elbow surgery. This procedure takes between 30-40 minutes. Keep in mind after you head back to the operating room it takes about 40-60 minutes to go to sleep and get positioned on the operating room bed so your family may not see you for 1.5 to 2 hours depending on how extensive the surgical procedure is and what needs to be fixed.

    Dr. Grossfeld will make one incision around the elbow joint. She will debride any unhealthy tendon and repair the torn tendon.

    The suture anchors are made out of a synthetic bone so the anchors will actually incorporate into your own bone. The suture anchors are placed into the bone which then “anchors the suture” and those sutures are then sewn through the common extensor tendon to repair the damaged tendon. The incision is closed with 2 layers of sutures that are dissolvable. There will be white sterile strips that are also used to help close the incision site.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites, followed by ABD pads, which are a larger fluffy dressing, followed by cast padding. A plaster splint will then be applied so you are unable to bend your elbow or wrist. At your first post operative visit the splint will be removed and you will be placed into an elbow brace that allows some elbow motion. You will also be placed in a wrist splint to limit wrist motion.

    An overview to tennis elbow repair surgery with Dr. Grossfeld.

    Night of Surgery

    It is very important that you stay on top of the pain.

    She recommends that you set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours or Meloxicam 15 mg every 24 hours can help control pain. Do not use either Motrin or Meloxicam if you are on blood thinners or have a history of stomach ulcers or kidney disease.

    First Post-Operative Visit

    Your first post operative visit will be 10-14 days post-surgery. You will be seen in the office at that time and have the ends of the sutures removed. Dr Grossfeld or Bess Fley, PA-C will answer any other questions.

    Physical Therapy

    PT will not be started until your 6-7th week after surgery after the braces are discontinued. This is about a three to four month recovery before you are back to your normal activities involving the operative elbow.

    Driving

    Most people will start driving once they are off all pain medication and the splint has been removed at the first post operative visit: 10-14 days after surgery.

    Return to Work

    If you work a labor type job, you will most likely not return back to that job until you are released 100%. This could be 3-4 months depending on your job description.

    If your employer has light duty options, you will most likely be released anywhere between two to four weeks back to light duty, and typically light duty will not require the use of the surgical side/the side your surgery is performed on, except for simple tasks such as using a computer or answering a phone.

    If you have an office type job, you can most likely get back to work between one to four weeks. Return to work also depended on pain level and job description. Some people have a lot of pain after this particular surgery, some people have very little. Pain is very personal and different from person to person.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

    An April Newsletter From the Desk of Bess Fley, PA-C

    Posted by Orthopaedic Specialists

    Sports Medicine in Louisville, KY, Orthopaedic Specialists, Bess Fley PA-C, Dr. Stacie Grossfeld Supervising Doctor

    What is a PA?

    PA is an abbreviation for ‘physician assistant,’ which has been recently changed to ‘physician associate.’ According to the American Academy of Physician Assistants, “a PA is a licensed clinician who practices medicine in every specialty and setting.” This can include:

    • Diagnosing and treating medical conditions
    • Prescribing medications and therapy
    • Assisting in surgery
    • Performing procedures in the office or hospital settings

    PAs require direct supervision by a supervising physician – Dr. Grossfeld is my supervising physician! We have a very close working relationship and collaborate daily for our patients’ best interest.

    What Do I Do with Dr. Grossfeld?

    I see patients in the office on a daily basis and regularly perform a physical exam, obtain any imaging studies, and determine a treatment plan for patients based on my findings. Treatment plans differ for every patient, but for my cases, I commonly prescribe anti-inflammatory medications, apply casts and splints, order labs and imaging, write prescriptions for physical therapy, give cortisone or hyaluronic acid injections, and assist in surgery!

    How Can You Become a PA?

    PAs must first complete a four-year bachelor’s degree at a university. There are many pre-requisite courses required prior to acceptance into PA school. These include, but are not limited to:

    • General chemistry
    • Organic chemistry
    • Psychology
    • Multiple biology courses
    • Anatomy
    • Physiology
    • Statistics

    Patient contact hours, shadowing hours, recommendation letters, and scoring in the 50th percentiles on the GRE are additional requirements, too! PA school is 2.5-3 years long, comprised of one year spent completing a classroom learning and skills lab while the remainder is spent in clinical rotations of all specialties. Finally, you then must pass the national licensure exam – the PANCE – which is comprised of 300 questions about any and all disease states.

    If you have any questions for me about what I do here at Orthopaedic Specialists, don’t hesitate to reach out and contact me at our office number (502) 212-2663!

    If you or someone you love has suffered an injury in the Louisville, Kentucky-area, Orthopaedic Specialists, PLLC can help! Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Sleeping Tips for Post-Operative Pain

    Posted by Orthopaedic Specialists

    When sleeping is hard with pain after surgery, here are some tips from Stacie Grossfeld, orthopedic surgeon in louisville, KY

    When faced with an issue on our phones, laptops, or other various technological devices, oftentimes we know that by turning it off and then on again will reset the device, and things will begin working normally again. A good night’s sleep can sometimes do the same for humans! You go to sleep with a stomachache, or maybe you have a headache, or sore throat, and you wake up feeling just fine – a nice 8 hours seems to fix it better than any medicine would.

    Sleep is obviously not the cure-all for every condition, but it is a critical factor in the body’s natural healing process. Proper sleep allows the body to heal in plenty of different ways, but specifically, it:

    • Prompts your immune system to activate the release of a type of small proteins called ‘cytokines,’ which fight inflammation, infection, and trauma
    • Allows you heart to take a break by dropping blood pressure, slowing breath, and relaxing the muscles of the body, which reduces inflammation
    • Replenishes your body’s energy and balances the hormones that contribute to hunger and stress
    • Slows brain activity, which can lead to a more productive attitude and positive feelings

    When we’re in physical pain, though, as the result of a surgery, injury, or operation, it can be difficult to find a good night’s sleep in the cards. Especially if your injury affects your normal sleeping position, you might have a hard time catching your Z’s.

    Here’s a few tips for sleeping with post-op pain, as well as the best sleeping positions for 4 common operations that Dr. Stacie Grossfeld, Orthopaedic Surgeon and Sports Medicine Specialist, helps rehabilitate.

    General Post-Op Pain Sleeping Tips:

    • Practice Your Sleep

    If you know you’ll be having an operation in the near future that will affect a part of your body for an extended period of time, practice your sleeping! An abrupt change in position might contribute to restlessness and, when combined with new pain, can be unmanageable. If you start shifting your position and sleeping differently before the pain is introduced, you’ll have a better chance at getting more sleep.

    • Take Pain Medications Strategically Before Bed

    Pain medications differ in many ways, from potency, contents, time it takes to be effective, and the time it stays effective. Talk to your doctor beforehand about the medications you’ll be prescribed and get the scoop on side effects and if there are stipulations to when you can take them, because you’ll want that relief to help lull your body to sleep. This can be an important tool in your pain-fighting toolbox, so get your information from the source!

    • Establish a Strong Internal Clock

    Waking up and going to bed at the same time everyday isn’t always the most glamorous nor the most convenient, but it helps a lot in the long run. Not only with pain! Having a consistent schedule leads to more, higher-quality sleep year-round, and that has proven to help you:

    • Get sick less often
    • Stay at a healthy weight
    • Lower your risk for serious health problems, like diabetes and heart disease
    • Reduce stress and improve your mood
    • Think more clearly and do better in school/at work
    • Get along better with people
    • Make better decisions to avoid injuries

    The Best Sleeping Position for…

    1. Knee Surgery and Knee Arthroscopy

    For the best healing results after knee surgery, sleep on your back with your leg propped up and straight. However, DO NOT place the propping pillows directly under the knee, as this bends the knee slightly – instead, place them under your calf or foot so that the knee remains completely straight while elevated.

    Most doctors don’t recommend sleeping on your side until further along in your treatment and healing, but side sleeping may be more comfortable for some and, with the right support, completely fine, as well. On some procedures, it’s better to wait for side sleeping until your doctor gives the green light, but it’s always important to keep a couple of pillows between your legs to keep your knee up.

    2. Shoulder Surgery and Rotator Cuff Surgery

    For any shoulder surgeries, including rotator cuff surgery, sleeping with an incline is the most recommended position. Whether this is on a recliner, with a wedge, or with a simple pillow-pile, an incline prevents you from rolling to your healing shoulder. This is a risk that sleeping on your non-operative side or back presents, and that cuts off the proper blood flow and put tension and pressure on the injury, potentially re-injuring it or slowing the healing process down.

    If you or someone you love has suffered an injury and have undergone surgery for it in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help with your recovery. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Educación del paciente: Cirugía Labral /SLAP/Bankart

    Posted by Orthopaedic Specialists

    Descripción General de la Cirugía Labral / SLAP / Bankart
    Especialistas Ortopédicos 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    Una descripción general de las reparaciones de Labral, Bankart y SLAP.

    La reparación del labrum, reparación SLAP, y la cirugía de reconstrucción de Bankart se realizan como un procedimiento ambulatorio.

    A su llegada al centro quirúrgico, primero se reunirá con la persona de registro para registrarlo. Luego lo llevarán de regreso al área preoperatoria y se reunirá con su equipo de enfermería.

    Anestesia

    La siguiente persona que conocerá es el médico de anestesia. En este momento, el anestesiólogo discutirá el proceso y abordará cualquier pregunta o inquietud que tenga sobre la anestesia. El anestesiólogo colocará un bloqueo nervioso para adormecer el hombro y el brazo. El medicamento anestésico durará 18 horas. Esta es una excelente manera de reducir el dolor postoperatorio. Incluso después de que el bloqueo nervioso desaparece, su nivel de dolor se reduce debido al efecto antidolor del bloqueo nervioso.

    Después de colocar el bloqueo nervioso, usted irá a la sala de operaciones donde se realiza la reparación del labrum, la reparación SLAP y la cirugía de reconstrucción de Bankart. Luego, el anestesiólogo administrará una anestesia general, por lo que estará completamente dormido para el procedimiento. Usted puede ser intubado o no. Hay múltiples factores que determinan el tipo de anestesia. Su anestesiólogo discutirá eso con usted en detalle. Debido a que es una anestesia general, no escuchará ni verá nada de lo que sucede en la sala de operaciones.

    Procedimiento quirúrgico

    El Dr. Grossfeld realizará la reparación del labrum, SLAP, y Bankart artroscópicamente. Este procedimiento dura entre 45-60 minutos. Tenga en cuenta que después de regresar a la sala de operaciones, toma alrededor de 40-50 minutos irse a dormir y colocarse en la cama de la sala de operaciones, por lo que es posible que su familia no lo vea durante 2.5 horas, dependiendo de qué tan extenso sea el procedimiento quirúrgico y qué deba solucionarse.

    El Dr. Grossfeld hará de tres a cuatro incisiones pequeñas, que tienen menos de un centímetro de largo alrededor de la articulación del hombro. Ella colocará una pequeña cámara de alta definición, aproximadamente del tamaño de un lápiz, en la articulación del hombro. Después de insertar la cámara, se completa la inspección de toda la articulación del hombro. Se ve cada compartimento del hombro. Ella identificará dónde se encuentra el desgarro del labrum, SLAP, y Bankart. La reparación del labral/SLAP/Bankart se realiza colocando dos o más anclajes de sutura.

    Los anclajes de sutura están hechos de un material óseo de tipo sintético, por lo que los anclajes se incorporarán realmente a su propio hueso. Unidos a la cabeza del anclaje de sutura están los puntos que se utilizan para reparar el labrum desgarrado. Los anclajes de sutura se colocan en el hueso que luego “ancla la sutura” y las suturas se cosen alrededor del labrum desgarrado. Los nudos se atan tirando del labrum desgarrado hacia el hueso donde estaba unido antes de que ocurriera el desgarro.

    Si hay espolones óseos, se eliminarán con una pequeña herramienta que es similar a una herramienta Dremel. Si se extirpan los espolones óseos, el procedimiento se denomina descompresión subacromial y/o escisión de la articulación AC.

    Al final de la cirugía, el sitio de la incisión/sitios portales se cierran con una sutura de color azul llamada Prolene. Las suturas se retirarán cuando lo vean en el consultorio entre 10 y 14 días después de la cirugía. No deje que las suturas o el sitio de la incisión se mojen. Puede limpiar los sitios de incisión con peróxido. Usted recibió instrucciones postoperatorias detalladas el día de la cirugía que explicarán el cuidado postoperatorio de la herida.

    Al salir de la sala de operaciones, se le colocará una gasa de 4 x 4 sobre los sitios de incisión, seguida de almohadillas ABD, que son un apósito esponjoso más grande, seguido de cinta quirúrgica. Su cabestrillo de hombro especializado se colocará en la sala de operaciones.

    Recibirá un conjunto detallado de instrucciones sobre el cuidado de la herida al ser dado de alta del centro quirúrgico.

    Noche de Cirugía

    Es muy importante que te mantengas al tanto del dolor. El hielo es clave. Es muy importante usar hielo tanto como sea posible. El Dr. Grossfeld recomienda el uso continuo de hielo durante todo el día. La regla es que no puedes usar demasiado hielo. Ya sea una unidad Polar Care, una bolsa de hielo o una bolsa de guisantes o maíz congelados: úselo continuamente durante 6-7 días después de la cirugía.

    Tenemos una unidad Polar Care que se puede comprar a través de nuestra oficina. Básicamente es una máquina de hielo motorizada que tiene una envoltura de neopreno que se coloca sobre el hombro operatorio. Es un refrigerador que está lleno de hielo y agua. Sugerimos congelar 8 botellas de agua llenas de agua. Coloque cuatro de las botellas congeladas en la máquina y luego vierta agua alrededor de las botellas congeladas. Cuando las botellas se descongelen, cámbielas por las otras cuatro botellas de agua congelada que están en su congelador.

    La unidad Polar Care tiene una manguera que se conecta a una envoltura de neopreno que rodea el hombro y empujará el agua helada a través de la envoltura de neopreno durante un máximo de nueve horas. De hecho, le recomendamos que use hielo durante todo el día. Es la mejor fuente de control del dolor y ayuda a reducir la hinchazón.

    Ella recomienda que configure su despertador y tome su medicamento para el dolor cada 4 a 6 horas durante las primeras 24 horas para mantenerse al tanto de su dolor. Agregar 800 mg de Motrin cada 6 horas o Meloxicam 15 mg cada 24 horas puede ayudar a controlar el dolor. No use Motrin o Meloxicam si está tomando anticoagulantes o tiene antecedentes de úlceras estomacales o enfermedad renal.

    Puede ser más cómodo dormir en posición semi vertical. Dormir en un sillón reclinable o usar muchas almohadas para apoyar el hombro será más cómodo. Algunas personas dormirán en un sillón reclinable hasta 4 semanas después de la reparación del labrum / reparación SLAP / y la cirugía de reconstrucción Bankart. Cuando está acostado en la cama, permite que su hombro ruede hacia atrás y tira de la reparación, lo que puede causar dolor.

    Uso de cabestrillo

    Usted se despertará en la sala de recuperación con el cabestrillo en su lugar. Puede quitarse el cabestrillo siempre y cuando coloque el brazo contra el abdomen. El Dr. Grossfeld recomienda que duerma en el cabestrillo porque evitará que su brazo se mueva durante la noche.

    Apósito quirúrgico

    Al final de la cirugía, el Dr. Grossfeld, se pondrá un vendaje. El apósito es un montón de almohadillas de gasa 4×4, una almohadilla abd y luego una cinta quirúrgica especial va encima del apósito.

    Consulte sus órdenes postoperatorias que recibirá el día de la cirugía para conocer los detalles del cambio de vendaje.

    Los apósitos para comprar antes del día de su cirugía son: de diez a 15: almohadillas de gasa 4×4, cinta médica de papel, tiritas a prueba de agua y peróxido.

    Primera visita postoperatoria

    Su primera visita postoperatoria será de 10 a 14 días después de la cirugía. Usted será visto en la oficina en ese momento y le quitarán las suturas. El Dr. Grossfeld o Bess Fley, PA-C revisarán sus fotos quirúrgicas y responderán cualquier pregunta. En esta visita lo más probable es que se ordene fisioterapia. Por lo general, la fisioterapia es solo una o dos veces por semana durante las primeras seis semanas. El TP variará de persona a persona según el tamaño del desgarro y la calidad de la reparación.

    Fisioterapia

    Se le darán ejercicios para hacer post operatorio. Hay un enlace en sus instrucciones / órdenes postoperatorias que recibirá el día de su reparación del labrum, reparación SLAP y cirugía de reconstrucción Bankart. El enlace le mostrará cómo hacer algunos ejercicios postoperatorios suaves. En la primera visita postoperatoria, también deberá comprar un juego de poleas (puede comprar en nuestra oficina por $ 20) para permitirle trabajar en ejercicios de rango de movimiento pasivo en casa.

    PT se divide en dos o tres bloques de 6 semanas, dependiendo de qué tan extensa sea la reparación.

    Las primeras 6 semanas asistirás una o dos veces por semana para trabajar en ejercicios suaves de ROM pasiva.

    Las segundas seis semanas, la terapia implica un rango activo de movimiento del hombro con un fortalecimiento suave. Asistirá de 1 a 3 veces a la semana, dependiendo de su reparación y otros factores.

    Las terceras seis semanas de fisioterapia implican aumentar el rango de movimiento y fortalecer aún más.

    Esto es aproximadamente una recuperación de cuatro a cinco meses antes de que vuelva a sus actividades normales que involucran el hombro operado.

    Conducción

    La mayoría de las personas comenzarán a conducir una vez que hayan dejado de tomar todos los analgésicos. Una vez que se inicia la conducción, su cabestrillo debe quitarse mientras conduce. Se recomienda que coloque su mano en el lado quirúrgico en la parte inferior del volante y su mano no quirúrgica en la parte superior del volante para hacer la mayor parte del trabajo.

    Regreso al trabajo

    Si trabaja en un trabajo de tipo laboral, lo más probable es que no regrese a ese trabajo hasta que sea liberado al 100%. Si su empleador tiene opciones de trabajo ligero, lo más probable es que sea liberado entre dos y cuatro semanas de regreso al trabajo ligero. Por lo general, el trabajo ligero no requiere el uso del lado quirúrgico / el lado en el que se realiza la reparación de labros, la reparación de BOFETADAS y la cirugía de reconstrucción de Bankart, excepto para tareas simples como usar una computadora o contestar un teléfono. Tenga en cuenta que si todavía está tomando analgésicos, no puede conducir un vehículo.

    Si tiene un trabajo de oficina, lo más probable es que pueda volver a trabajar entre dos y cuatro semanas. El regreso al trabajo también dependía del nivel de dolor. Algunas personas tienen mucho dolor después de la reparación del labrum, la reparación de SLAP y la cirugía de reconstrucción de Bankart, algunas personas tienen muy poco. El dolor es muy personal, y le proporcionaremos medicamentos para el dolor para cubrir su dolor según sea necesario. Se administrarán analgésicos durante un período de tiempo apropiado.

    FMLA y papeleo de discapacidad

    Nuestra oficina ofrece el servicio de completar el papeleo para FMLA y / o discapacidad por una tarifa de $ 40, por conjunto de documentos, y se completa en el orden en que se recibe, generalmente toma de 7 a 10 días hábiles. Todas las solicitudes deben originarse con su empleador, ya que su elegibilidad para FMLA y / o discapacidad se basa en sus beneficios con su empleador. Si bien cada paciente es único, hacemos todo lo posible para estimar el tiempo de recuperación y, a menudo, sobreestimamos la cantidad de tiempo para evitar un lapso en los beneficios y / o requerir papeleo adicional. Muchas veces las compañías de discapacidad requieren actualizaciones después de cada cita. Es responsabilidad del paciente comunicar esta solicitud a la oficina. Las actualizaciones no se completan automáticamente. Cualquier pregunta al respecto puede dirigirse a Dorothy.

    Patient Education: Labral/SLAP/Bankart Surgery

    Posted by Orthopaedic Specialists

    Labral/SLAP/Bankart Surgery Overview
    Orthopaedic Specialists 502-212-2663
    Stacie Grossfeld, M.D. / Bess Fley, PA-C

    An overview of Labral, Bankart, and SLAP Repairs.

    Labral repair, SLAP repair, and Bankart reconstruction surgery is performed as an outpatient procedure.
    Upon arrival at the surgicenter you will first meet with the registration person to check you in. You will then be brought back to the pre-op area and meet with your nursing team.

    Anesthesia

    The next person you will meet is the anesthesia doctor. At this time the anesthesiologist will discuss the process and address any questions or concerns you have about the anesthesia. The anesthesiologist will place a nerve block to numb up your shoulder and arm. The numbing medicine will last for 18 hours. This is a great way to reduce post operative pain. Even after the nerve block wears off, your pain level is reduced because of the anti-pain effect from the nerve block.

    After the nerve block is placed, you will go to the operating room where the Labral repair, SLAP repair, and Bankart reconstruction surgery is performed. The anesthesiologist will then administer a general anesthesia, so you are completely asleep for the procedure. You may be intubated or not. There are multiple factors that determine type of anesthesia. Your anesthesiologist will discuss that with you in detail. Because it is a general anesthesia you will not hear or see anything going on in the operating room

    Surgical Procedure

    Dr. Grossfeld will then perform the labral / SLAP / Bankart repair arthroscopically. This procedure takes between 45-60 minutes. Keep in mind after you head back to the operating room it takes about 40-50 minutes to go to sleep and get positioned on the operating room bed, so your family may not see you for 2.5 hours depending on how extensive the surgical procedure is and what needs to be fixed.

    Dr. Grossfeld will make three to four small incisions, which are less than a centimeter in length around the shoulder joint. She will place a small high-definition camera, about the size of a pencil, into the shoulder joint. After the camera is inserted, inspection of the whole shoulder joint is completed. Each compartment of the shoulder is viewed. She will identify where the labral / SLAP / Bankart tear is located. The repair of the labral / SLAP/ Bankart is done by placing two or more suture anchors.

    The suture anchors are made out of a synthetic-type bone material, so the anchors will actually incorporate into your own bone. Attached to the head of the suture anchor are the stitches that are used to repair the torn labrum. The suture anchors are placed into the bone which then “anchors the suture” and the sutures are then sewn around the torn labrum. Knots are tied pulling the torn labrum back down to the bone where it was attached before the tear occurred.

    If there are any bone spurs, they will be removed with a small tool that is similar to a Dremel tool. If bone spurs are removed, the procedure is called a subacromial decompression, and/or an AC joint excision.

    At the end of the surgery the incision site/portal sites are closed with a blue colored suture called Prolene. The sutures will be removed when you are seen in the office at 10 to 14 days post-surgery. Do not let the sutures or the incision site get wet. You can clean the incision sites with peroxide. You received detailed post operative instructions the day of the surgery that will explain post operative wound care.

    Upon leaving the operating room, you will have 4 x 4 gauze placed over the incision sites followed by ABD pads, which are a larger fluffy dressing, followed by surgical tape. Your specialized shoulder sling will be placed on in the operating room.

    You will get a detailed set of instructions on wound care upon discharge from the surgery center.

    Night of Surgery

    It is very important that you stay on top of the pain. Ice is key. It is very important to use ice as MUCH as possible. Dr. Grossfeld recommends continuous use of ice around the clock. The rule is you cannot use too much ice. Whether it is a Polar Care unit, ice pack or a bag of frozen peas or corn: use it continuously for 6-7 days after surgery.

    We do have a Polar Care unit that can be purchased through our office. It is basically a motorized ice machine that has a neoprene wrap that gets placed over the operative shoulder. It is a cooler that is filled with ice and water. We suggest freezing 8 water bottles filled with water. Put four of the frozen bottles in the machine then pour water around the frozen bottles. When the bottles thaw out swap them out for the other four frozen water bottles that are in your freezer.

    The Polar Care unit has a hose that connects to a neoprene wrap that goes around the shoulder, and will push ice water through the neoprene wrap for up to nine hours. We actually recommend you use ice around the clock. It is the best source of pain control and helps to reduce swelling.

    She recommends that you set your alarm clock and take your pain medication every 4 to 6 hours for the first 24 hours to stay on top of your pain. Adding 800 mg Motrin every 6 hours or Meloxicam 15 mg every 24 hours can help to control pain. Do not use either Motrin or Meloxicam if you are on blood thinners or have a history of stomach ulcers or kidney disease.

    It may be more comfortable to sleep in a semi-upright position. Sleeping in a recliner or using lots of pillows to support your shoulder will be more comfortable. Some people will sleep in a recliner for up to 4 weeks after labral repair / SLAP repair / and Bankart reconstruction surgery. When lying flat in bed, it allows your shoulder to roll back and tugs on the repair, which can cause pain.

    Sling Use

    You will wake up in the recovery room with your sling in place. You may take the sling off as long as you place your arm against your belly. Dr. Grossfeld recommends that you sleep in the sling because it will prevent your arm from moving around during the night.

    Surgical Dressing

    At the end of the surgery, Dr. Grossfeld, will put on a dressing. The dressing is a bunch of 4×4 gauze pads, an abd pad and then a special surgical tape goes on top of the dressing. Please refer to your post operative orders that you will receive day of surgery for dressing change details.
    Dressings to purchase before your surgery day are: ten to 15: 4×4 gauze pads, paper medical tape, water proof band aids and peroxide.

    First Post-Operative Visit

    Your first post operative visit will be 10-14 days post-surgery. You will be seen in the office at that time and have your sutures remove. Dr. Grossfeld or Bess Fley, PA-C will go over your surgical photos and answer any questions. At this visit most likely physical therapy will be ordered. Typically, physical therapy is only once or twice a week for the first six weeks. PT will vary from person to person based on the size of the tear and repair quality.

    Physical Therapy

    You will be given exercises to do post op. There is a link on your post operative instructions/orders that you will get the day of your labral repair, SLAP repair, and Bankart reconstruction surgery. The link will show you how to do some gentle post operative exercises. On the first post operative visit you will also need to purchase a set of pulleys (can purchase from our office for $20) to allow you to work on passive range of motion exercises at home.

    PT is divided into two to three 6-week blocks depending on how extensive the repair.

    The first 6 weeks you will attend once or twice a week to work on gentle passive ROM exercises.

    The second six weeks, the therapy involves active range of motion of the shoulder with some gentle strengthening. You will attend 1-3 times a week, depending on your repair and other factors.
    The third six weeks of physical therapy involves increasing range of motion and further strengthening.

    This is about a four to five month recovery before you are back to your normal activities involving the operative shoulder.

    Driving

    Most people will start driving once they are off all pain medication. Once driving is started your sling needs to be taken off while driving. It is recommended that you place your hand on the operative side at the bottom of the steering wheel and your non-surgical hand at the top of the steering wheel to do most of the work.

    Return to Work

    If you work a labor type job, you will most likely not return back to that job until you are released 100%. If your employer has light duty options, you will most likely be released anywhere between two to four weeks back to light duty. Typically, light duty will not require the use of the surgical side/the side your labral repair, SLAP repair, and Bankart reconstruction surgery is performed on, except for simple tasks such as using a computer or answering a phone. Keep in mind if you are still taking pain medication you cannot drive a vehicle.

    If you have an office type job, you can most likely get back to work between two to four weeks. Return to work also depended on pain level. Some people have a lot of pain after labral repair, SLAP repair, and Bankart reconstruction surgery, some people have very little. Pain is very personal, and we will supply you with pain medication to cover your pain as needed. Pain medication will be given for an appropriate amount of time.

    FMLA and Disability Paperwork

    Our office offers the service of completing paperwork for FMLA and/or disability for a fee of $40, per set of paperwork, and is completed in the order that it is received, typically takes 7-10 business days. All requests must originate with your employer, as your eligibility for FMLA and/or disability is based on your benefits with your employer. While each patient is unique, we do our best to estimate the time of recovery and often times over-estimate the amount of time to prevent a lapse in benefits and/or require additional paperwork. Often times disability companies require updates after each appointment. It is the patient’s responsibility to communicate this request with the office. Updates are not automatically completed. Any questions regarding this can be directed to Dorothy.

    An Interview with Dr. Grossfeld: A (Late) Celebration of National Women Physician Day

    Posted by Orthopaedic Specialists

    We celebrate National Women Physician Day everyday with Dr. Stacie Grossfeld, double board certified sports medicine and orthopedic surgeon

    On February 3rd, the nation came together to celebrate a group of professionals that deserve 100% of the glory: women physicians. National Women Physician Day gives due credit to women, who have worked long and hard to get to where they are today, and Orthopaedic Specialists, PLLC is quite a special place, as we get to celebrate women physicians everyday – we’re owned and operated by our very own female physician, Dr. Stacie Grossfeld, M.D.

    We might be a little late to Women Physician Day, but we figured that International Women’s Day was just as fitting!

    About Dr. Grossfeld, M.D.

    Dr. Stacie L. Grossfeld started her journey to being the double bard-certified orthopaedic surgeon she is today as a graduate of the University of Louisville School of Medicine. She served her internship and residency at the University of Minnesota and then additionally completed a fellowship in Sports Medicine at the Fowler- Kennedy Sports Medicine Center. Now, Dr. Grossfeld is an independent, non-hospital employed orthopedic surgeon practicing in private practice at Orthopedic Specialists in Louisville, Kentucky and double board-certified in orthopedic surgery by the American Board of Orthopedic Surgeons and in sports medicine, also through the American Board of Orthopedic Surgeons.

    To get Dr. Grossfeld’s extensive history, opportunities, awards, achievements, and work, visit her About page on the website! To celebrate her practice and work, we got a small interview to get her perspective on how it feels to be a woman in the medical field, along with a few get-to-know-you questions for her patients to enjoy!

    An Interview with Dr. Grossfeld

    1. What interests you most about your area of work?

    Dr. Grossfeld: “Every day is different. Every patient has different problems and needs and it’s extremely rewarding to help patients regain their mobility, independence, and return to their job or sporting activity!

    1. What is your favorite part of your work?

    Dr. Grossfeld: “Truly helping people is my favorite part. When the patients come back in the office and I see that they are so happy to be out of pain, it’s the best feeling ever.”

    1. When going through medical school, what was the most challenging for you?

    Dr. Grossfeld: “Medical School required a lot of information to be learned at a rapid pace. I made sure I studied really hard everyday so that I never had to cram for exams, because that would have been too stressful for me, personally. However, I really had to be super focused and put most of my life on hold during those years because the intensity of medical school, and I found that to be very challenging for who I am and my personality.”

    1. If you weren’t double board-certified in Orthopedic Surgery and Sports Medicine, what areas or other careers do you think you would be practicing in?

    Dr. Grossfeld: “The fashion industry, for sure! I think I would fit right in working for the House of Gucci or the House of Chanel, personally.”

    1. In your opinion, what are the best opportunities your work has brought you?

    Dr. Grossfeld: “Besides the day-to-day opportunity to work with my patients, the ability the teach other doctors and mentor other females in business and in medicine has been something I love doing and am extraordinarily grateful for.”

    1. What are your favorite things to do outside of work?

    Dr. Grossfeld: “In my free time, I am avidly into sports! I love to play tennis, ride my bike, ski, and do various other stuff with my family.”

    1. What accomplishments have you achieved and which are you most proud of?

    Dr. Grossfeld: “Personally, I’m most proud of being able to run my own practice, teach the U of L residents, and still continue to be able to maintain a home-life with my husband and son.”

    We thought it might be pertinent to mention that there is a very long list of other accolades listed on her page, including:

    • The recipient of the National Association of Women Business Owner’s (NAWBO) Small Business Owner of the Year Award in 2016
    • The Most Compassionate Doctor Award
    • A place on the Top Ten Orthopedic Doctor list in Louisville, Kentucky
    • The Patient’s Choice Award as a top-rated doctor on vitals.com
    • The YMCA’s Volunteer of the Year award given to her by the Norton Commons YMCA
    • Orthopaedic Specialists PLLC has received the 2017 Business of the Year Award from Louisville Business First
    1. When (or if) you plan to retire, what will you miss most about your work?

    Dr. Grossfeld: “Ha! Good question – my husband asks me what I am going to do when I retire and my answer is always ‘work’. I would miss the daily interaction with the patients, my staff, and the residents. But I don’t think I could stop working and contributing and learning! I’ve thought about perhaps opening up a glass blowing studio or starting a community garden when the time comes.”

    1. Have you ever found it difficult to be a female physician?

    Dr. Grossfeld: “I have not, but I know that many women in ortho have, as closely-tied to sports as it is, and they are infinitely deserving of National Women Physician Day. We all know how it is when it comes to most men and sports – they want to be as close to the action as possible, and that means that it can be very competitive and male-dominated in some areas (most areas, actually, since only about 11% of practicing orthopedic surgeons in the US were women in 2022). Fortunately, I was in a residency that had a lot of female residents, and I have received countless compliments from patients that state they feel female doctors listen better and are more compassionate compared to male doctors, so I would strongly advise not letting the gender disparity stop women from entering the field of ortho medicine!”

    1. Is there any advice you would give to other women going into the medical field?

    Dr. Grossfeld: “Do what you love; this is a career, not a job, and we cannot do it all. You’ll need help if you are going to have a family – either a husband that works from home or close relatives that can help raise your kids. It truly takes a village in this line of work!”

    National Women Physician Day acknowledges the roadblocks and barriers that have been presented to women throughout history, and honors how they paved the way for today’s generation of women. Although there is still struggle and gender disparity, we’re slowly closing it. To learn more about the history behind National Women Physician Day, visit the University of Madison-Wisconsin’s blog!

    If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, double board-certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments can be available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.