INSTRUCTIONS FOR SURGERY

Transcription

1 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) INSTRUCTIONS FOR SURGERY In rder t make yur admissin and hspital stay smth and mre pleasant, please cmply with the fllwing instructins: c If yur surgery is n MONDAY, please reprt t: NYU Hspital fr Jint Diseases 301 East 17 th Street New Yrk, NY If indicated by yur physician, schedule yur pre-surgical testing, lcated at nd Avenue, 1 st Flr Suite 16 New Yrk, NY c If yur surgery is n FRIDAY, please reprt t: NYU Langne Outpatient Surgery Center 339 East 38 th Street New Yrk, NY If indicated by yur physician, please call t schedule yur pre-surgical testing, lcated at 240 East 38 th St. New Yrk, NY Mezzanine Level *One business day prir t yur surgery, hspital staff will cntact yu t finalize yur surgery time. A. Bring jgging/warm-up pants, shrts/skirt if having knee surgery. B. Bring a shirt/bluse that buttns pen in frnt instead f a pullver if having shulder/elbw surgery. C. If yu wn crutches, bring them with yu, if having knee, ankle r hip surgery. D. Bring all medicatins r a list f current medicatins yu are taking with yu. Als bring a list f any allergies. E. Bld pressure medicatin shuld be taken as usual with a sip f water the mrning f surgery. DO NOT take a diuretic r fluid pill. Seizure medicatins may be taken befre surgery. F. DO NOT take ral diabetes medicatins (pills) the night befre r the day f surgery. If yu are n insulin, DO NOT use insulin the mrning f surgery unless yu are a "prblem diabetic" in which case yu need t cnsult yur physician regarding the prper insulin dse fr yu t use prir t surgery. Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

2 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) G. Please DO NOT wear makeup r nail plish the day f surgery. Yu will need t remve cntact lens (including extended wear), denture, r bridges prir t surgery. Please bring yur wn cntainers fr strage. H. Leave all jewelry and valuables at hme. The hspital will nt take respnsibility fr lst r missing items. I. Yu need t reprt any skin irritatin, fever, cld, etc., t Dr. Jazrawi. J. Yu will need t bring yur insurance card/infrmatin with yu. K. DO NOT eat, drink (including water), chew gum, candy, smke cigarettes, cigars, use smkeless tbacc, etc., after midnight the night befre surgery r the mrning f yur surgery. The nly exceptin is a sip f water t take necessary medicatins the mrning f surgery. L. Yu must arrange smene t drive yu hme when ready t leave the hspital. Yu will nt be allwed t drive yurself hme after surgery. We can assist yu if yu need transprtatin t the airprt r htel, hwever, yu need t let us knw in advance (if pssible) s we can make the arrangement. M. NOTE: DO NOT take any aspirin, aspirin prducts, anti-inflammatries, Cumadin r Plavix at least 5 days prir t surgery. Yu are allwed t take Celebrex up t yur day f surgery. If yur medical dctr r cardilgist has yu n any f the abve medicatins. Please check with him/her befre discntinuing the medicatin. Yu may als take Tylenl r Extra-Strength Tylenl if needed. Nnsteridal Anti-Inflammatry (Arthritis) Medicatins: Sme f the mst cmmn names fr frequently used NSAID's include: Mtrin, Indcin, Nalfn, Naprsyn, Naprelan, Arthrtec, Tlectin, Feledene, Vltaren, Clinril, Dlbid, Ldine, Relafen, Daypr, Advil, Aleve, Ibuprfen. Yur first fllw up appintment is usually scheduled fr apprximately 2 weeks after yur surgery at the 333 East 38th street ffice. The date and time f yur fllw-up is. If yu cannt make this appintment r need t change the time, please cntact the ffice. If yu have any questins regarding yur surgery, please cntact the ffice at ptin 4, ptin 2 r via the internet at Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

3 Laith M. Jazrawi, MD Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Hme Supplies Fr Yur Surgery Laith M. Jazrawi M.D. Open Surgery A. Open knee surgery (ACL recnstructins, ALL (Anterlateral ligament) recnstructins, Autlgus Chndrcyte Implantatin, PCL recnstructins, High tibial stetmy, Distal femral stetmy, Psterlateral crner recnstructin, MCL recnstructin, OATS (stechndral autgraft), Ostechndral allgraft,) a. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. Bandage changes fr pen knee surgery dne pst-p day #3. B. Open shulder surgery, (Biceps Tendeis, Latarjet, Open capsulrrhaphy, Glenid recnstructin using Distal tibial allgraft): a. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. Als, a bx f Bandage changes fr pen shulder surgery are dne pst-p day #3. C. Open Ankle Surgery (Achilles Tendn Repair, Os Trignum Excisin, Ankle OCD, Mdified Brstrm- Guld Prcedure, Perneus Lngus/Brevis Repair)- Yu d nt have t wrry abut dressing changes as yur leg will be in splint/cast fr the first tw weeks D. Open Elbw surgery (Distal Biceps Repair, LCL Recnstructin, Radial Head r Capitellum ORIF, Radial Head Replacement/Resectin, Triceps Repair, UCL Recnstructin Tmmy Jhn Surgery)- Yu d nt have t wrry abut dressing changes as yur arm will be in splint/cast fr the first tw weeks. Fr Tennis Elbw surgery (lateral epicndylitis) and Glfer s Elbw Surgery (medial epicndylitis), dressing changes are are started n pst-p day #3. Yu will need 4x4 (r similar size) waterprf bandages fr furteen days. E. Hamstring repair Yu will have a special dressing placed n at the time f surgery that will be kept n fr the first 2 weeks after surgery. Yu will then need 4x4 (r similar size) Tegaderm r Telfa waterprf dressings. Als, a bx f 4" by 4" gauze spnges if there is bleeding at the incisin site. Arthrscpic Surgery A. Fr Arthrscpic shulder, elbw, knee, r ankle surgery: a. Regular adhesive bandages ( Band-aids ) can be used fr arthrscpic prtals x 2 weeks. b. If biceps tendesis was perfrmed, use 4x4 (r similar size) waterprf bandages n wunds. c. In general, dressing changes fr arthrscpy are dne n pst perative day 3 Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

4 Pst-Operative Medicatin Administratin Knee Arthrscpy Pain- Mtrin 800mg. 1 tab three times daily, as needed Adjunctive pain: Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed fr adjunctive pain Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Knee Ligament Recnstructin Pain- Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed. Breakthrugh Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT prphylaxis- Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start pst-perative day #1 Nn-weight bearing Lwer Extremity Surgery (Meniscal Repair, Meniscal Rt Repair, Distal Femral Ostetmy, High Tibial Ostetmy, Tibial Tubercle Ostetmy, Cartilage Transplant) Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT prphylaxis- Aspirin 81mg; 2 tabs daily x 14 days ******Antibitics and Aspirin start pst-perative day #1 Shulder/Elbw Surgery Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain.

5 Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days Ankle fracture surgery & Achilles Tendn Surgery Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start POD #1 Ankle arthrscpy +/- Micrfracture and Achilles repair Pain- Perccet (Oxycdne/Acetaminphen) 10/325; One tab every 6 hurs as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Aspirin starts pst-perative day #1 Hamstring repair Antibitic Keflex 500mg; One tab 4 times daily x 4 days Keflex allergy Clindamycin 300mg; One tab twice daily x 7days. Pain- Perccet (Oxycdne/Acetaminphen)10/325; One tab every 6 hurs as needed. Adjunctive Pain Dilaudid (Hydrmrphne) 2mg; 2-3 tabs every 8 hurs as needed fr adjunctive pain. Cnstipatin Dcusate (Clace) 100mg; 1 tab twice daily as needed. DVT Prphylaxis - Aspirin 81mg; 2 tabs daily x 14 days ****Antibitics and Aspirin start POD #1

6 Assciate Prfessr f Orthpaedics Chief, Divisin f Sprts Medicine Tel: (646) Pst-Operative Instructins Shulder Arthrscpy and Rtatr Cuff Repair +/-Biceps Tendesis Day f Surgery A. Diet as tlerated. B. Icing is imprtant fr the first 5-7 days pst-p. While the pst-p dressing is in place, icing shuld be dne cntinuusly. Once the dressing is remved n the first r secnd day, ice is applied fr 20-minute perids 3-4 times per day. Care must be taken with icing t avid frstbite. Alternatively, Crycuff r Game-ready ice cuff can be used as per instructins. Yu will be cntacted by Gtham surgical brace cmpany regarding an ice cmpressin unit t be used after surgery. This helps with pain and swelling but typically is nt cvered by insurance. The cst is $ fr a 2-week rental. Alternatively, ice gel packs with a shulder r knee sleeve can be prvided by the hspital fr a minimal charge. C. Pain medicatin as needed every 6 hurs (refer t pain medicatin sheet) First and Secnd Pst-Operative Day A. Cntinue Icing. B. Pain medicatins as needed Third Pst-Operative Day A. Yu may remve surgical bandage and shwer this evening. Apply regular bandages t these wunds prir t shwering and when shwering is cmplete apply fresh regular bandages. Yu will need t fllw this rutine fr 2 weeks after surgery. Physical Therapy A. Physical Therapy shuld begin at 4 weeks. Please call yur preferred facility t make an appintment. *Nte: Yur shulder will be very swllen. It may take a week r lnger fr this t g away. It is als cmmn t ntice burning arund the shulder as the swelling reslves. If excessive bleeding ccurs, please ntify Dr. Jazrawi. Call ur ptin 4, ptin 2 t cnfirm yur first pstperative visit, which is usually abut 1-2 weeks after surgery. If yu are experiencing any prblems, please call ur ffice r cntact us via the internet at Center fr Musculskeletal Care 333 E. 38 th St, New Yrk, NY Tel: (646) / Fax: (646) /

7 Dr. Laith M. Jazrawi Chief, Divisin f Sprts Medicine Assciate Prfessr Department f Orthpaedic Surgery Rehabilitatin Prtcl After Arthrscpic Rtatr Cuff Repair The anatmic cnfigura0n f the shulder jint (glenhumeral jint)is 8en cmpared t that f a glf ball n a tee. This is because the ar0cular surface f the rund humeral head is apprximately fur 0mes greater than that f the rela0vely at shulder blade face (glenid fssa)1. This cnfigura0n prvides less bney stability than a truer ball and scket jint, like the hip. The stability and mvement f the shulder is cntrlled primarily by the rtatr cuff muscles, with assistance frm the ligaments, glenid labrum and capsule f the shulder. The rtatr cuff is a grup f fur muscles: subscapularis, supraspinatus, infraspinatus and teres minr (Figure 1). Rtatr cuff tears can ccur frm repeated stress r frm trauma. Thrwing a baseball can create up t 750 newtns f distrac0ve frce n the shulder2. This places a significant amunt f stress n the rtatr cuff while trying t dissipate this frce. This stress and frce may be even greater if there is imprper frm r mechanics while thrwing. This repeated stress may lead t rtatr cuff tears. Rtatr cuff trauma als may result frm falling n yur arm, bracing yur arm in an accident, arm tackling in ftball r any large sudden frce applied t the arm. Mst rtatr cuff tears invlve the supraspinatus and/r the infraspinatus. Occasinally islated tears f the subscapularis can ccur. This usually results frm trauma rta0ng the shulder utward. The rtatr cuff tendns als underg sme degenera0n with age. This prcess alne can lead t rtatr cuff tears in lder pa0ents. Pa0ents ver 50 years f age are mre suscep0ble t sustaining a significant rtatr cuff tear frm trauma th St. New Yrk, NY (646) newyrkrth.cm!

8 Rehabilitatin Prtcl After Arthrscpic Rtatr Cuff Repair Rtatr cuff tears can be classified in varius ways. The first classifica0n is a par0al thickness r a full thickness tear. Nrmal tendn thickness is 9 t 12 mm. Par0al thickness tears start n ne surface f the tendn, but d nt prgress thrugh the depth f the tendn. These can be bursal surface tears r ar0cular sided tears. Figure 2 shws the nrmal anatmy f the bursal and ar0cular side f the rtatr cuff. Bursal surface tears ccur n the uter surface f the tendn and may be caused by repe00ve impingement. Ar0cular sided tears (Figure 3) ccur n the inner surface f the tendn, and are mst 8en caused by internal impingement r tensile stresses related t verhead sprts. Full thickness r cmplete tears (Figure 4) extend frm ne surface f the tendn all the way thrugh t the ther surface f the tendn. Full thickness tears are 8en caused by trauma, such as falling n the arm. Since a pr0n f the tendn is cmpletely disrupted, there als will be sme tendn retrac0n. Retrac0n is mvement f the tendn away frm its inser0n pint back tward the muscle.4 A8er determining the type f tear, a classifica0n system is used t assess the size f the tear. Type I tears are tears less than 2 cm in width and Type II tears are greater than 2 cm. Surgical repair f a rtatr cuff tear can be dne arthrscpically r with a mini- pen prcedure. A 2007 review published in The Jurnal f Bne and Jint Surgery stated that equally successful utcmes can be a[ained frm either technique5. The primary gal f a rtatr cuff repair is t restre the nrmal anatmy by apprxima0ng the rtatr cuff tendn back t its nrmal a[achment site n the greater tubersity f the humerus. This is dne by passing sutures thrugh the tendn and then tying the tendn dwn t suture anchrs that have been placed in the humerus. Prir t bringing the tendn back t its inser0n, the edges f the tear may need t be brught tgether, referred t as side-t-side repair r cnvergence (Figure 5). Nt all rtatr cuff tears are repairable. A tear may be un-repairable if the tear is t large, there is t much retrac0n, r the 0ssue quality is t pr. The degree f success fr tears that are repaired is related t varius factrs, including tear size, the number f tendns invlved, pa0ent age, assciated injuries and pst pera0ve rehabilita0n 6, th St. New Yrk, NY (646) newyrkrth.cm!

9 Rehabilitatin Prtcl After Arthrscpic Rtatr Cuff Repair Rehabilita0n is vital t regaining m0n, strength and func0n f the shulder a8er surgery. Ini0ally pa0ents will use a sling t prtect the repair site and allw healing f the tendn back t the bne. During this 0me, passive m0n exercises are started t prevent the shulder frm ge^ng s0ff and lsing mbility. The rehabilita0n prgram will gradually prgress t mre strengthening and cntrl type exercises. The rehabilita0n guidelines will vary depending n the size f the tear and quality f the tendn. The rehabilita0n guidelines fr Type I and Type II tears f the supraspinatus r infraspinatus and islated subscapularis tears are presented belw in a criterin based prgressin. General 0me frames are given fr reference t the average, but individual pa0ents will prgress at different rates depending n their age, assciated injuries, pre-injury health status, rehabilita0n cmpliance and injury severity th St. New Yrk, NY (646) newyrkrth.cm!

10 Rehabilitatin Prtcl After Arthrscpic Rtatr Cuff Repair Phase I (Surgery t 4 weeks after surgery) Precautins Sling immbilizatin with supprting abductin pillw t be wrn at all times except fr shwering and rehab under guidance f PT (if instructed t start befre 4 weeks pst surgery)! Range f Mtin Therapeutic Exercises True Passive Range f Mtin Only t Patient Tlerance! Gals: 140 Frward Flexin, 40 External Rtatin with elbw at side, Abductin withut rtatin, Limit Internal Rtatin t 40 with the shulder in the abducted psitin! Maintain elbw at r anterir t mid-axillary line when patient is supine! N canes r pulleys during this phase Cdman exercises/ pendulums Elbw/wrist/hand range f mtin and grip strengthening Other Suggestins Heat/Ice befre and after PT sessins Phase II (4 weeks t 8 weeks fllwing surgery) Precautins D/C sling immbilizatin ROM 4-6 weeks: Gentle passive stretch t reach ROM gals frm Phas I 6-8 week: Begin AAROM -> AROM as tlerated Range f Mtin Exercises Therapeutic Exercises Increase Frward Flexin, Internal/External Rtatin t full mtin as tlerated 4-6 weeks: Begin gentle AAROM exercises (supine psitin), gentle jint mbilizatins (grades I and II), cntinue with Phase I exercises 6-8 weeks: Prgress t active exercises with resistance, shulder flexin with trunk flexed t 45 in upright psitin, begin deltid and biceps strengthening Other Suggestins Mdalities per PT discretin th St. New Yrk, NY (646) newyrkrth.cm!

11 Rehabilitatin Prtcl After Arthrscpic Rtatr Cuff Repair Phase III (8 weeks t 12 weeks fllwing surgery) ROM Prgress t full AROM withut discmfrt Therapeutic Exercises Cntinue with scapular strengthening Cntinue and prgress with Phase II exercises Begin internal/external rtatin ismetrics Stretch psterir capsule when arm is warmed-up Other Suggestins Mdalities per PT discretin Phase IV (3 mnths t 6 mnths fllwing surgery) ROM Full range f mtin withut discmfrt Therapeutic Exercises Advance strengthening as tlerated: ismetrics -> therabands-> light weights (1-5 lbs) 8-12 repetitins/2-3 sets fr rtatr cuff, deltid and scapular stabilizers Return t sprts at 6 mnths if apprved Other Suggestins Mdalities per PT discretin ***If biceps tendesis was perfrmed n biceps strengthening un0l 8 weeks pst-p References th St. New Yrk, NY (646) newyrkrth.cm!

12 Laith M. Jazrawi, M.D. Chief, Divisin f Sprts Medicine Assciate Prfessr f Orthpaedic Surgery Tel: (646) ptin 4, ptin 2 Fax: (646) Web: newyrkrth.cm rthsurgery.med.nyu.edu/sprts-medicine Rehabilitatin Prtcl: Arthrscpic Rtatr Cuff Repair Name: Diagnsis: Date: Date f Surgery: Phase I (Weeks 0-4) Sling immbilizatin with supprting abductin pillw t be wrn at all times except fr shwering and rehab under guidance f PT (if instructed t start befre 4 weeks pst surgery) If physician wants therapy t start befre 4 weeks pst p: Range f Mtin True Passive Range f Mtin Only t Patient Tlerance Gals: 140 Frward Flexin, 40 External Rtatin with elbw at side, Abductin withut rtatin, Limit Internal Rtatin t 40 with the shulder in the abducted psitin Maintain elbw at r anterir t mid-axillary line when patient is supine Therapeutic Exercise N canes r pulleys during this phase Cdman Exercises/Pendulums Elbw/Wrist/Hand Range f Mtin and Grip Strengthening Ismetric Scapular Stabilizatin Heat/Ice befre and after PT sessins Phase II (Weeks 4-8) Discntinue sling immbilizatin Range f Mtin 4-6 weeks: Gentle passive stretch t reach ROM gals frm Phase I 6-8 weeks: Begin AAROM AROM as tlerated Therapeutic Exercise 4-6 weeks: Being gentle AAROM exercises (supine psitin), gentle jint mbilizatins (grades I and II), cntinue with Phase I exercises 6-8 weeks: Prgress t active exercises with resistance, shulder flexin with trunk flexed t 45 in upright psitin, begin deltid and biceps strengthening** Mdalities per PT discretin Phase III (Weeks 8-12) Range f Mtin Prgress t full AROM withut discmfrt Therapeutic Exercise Cntinue with scapular strengthening Cntinue and prgress with Phase II exercises Begin Internal/External Rtatin Ismetrics Stretch psterir capsule when arm is warmed-up Mdalities per PT discretin Center fr Musculskeletal Care 333 East 38 th Street, New Yrk, NY 1001 (646) cmc.med.nyu.edu

13 Laith M. Jazrawi, M.D. Chief, Divisin f Sprts Medicine Assciate Prfessr f Orthpaedic Surgery Tel: (646) ptin 4, ptin 2 Fax: (646) Web: newyrkrth.cm rthsurgery.med.nyu.edu/sprts-medicine Phase IV (Mnths 3-6) Range f Mtin Full withut discmfrt Therapeutic Exercise Advance strengthening as tlerated: ismetrics therabands light weights (1-5 lbs), 8-12 repetitins/2-3 sets fr Rtatr Cuff, Deltid and Scapular Stabilizers Return t sprts at 6 mnths if apprved Mdalities per PT discretin Cmments: **IF BICEPS TENODESIS WAS PERFORMED - NO BICEPS STRENGTHENING UNTIL 8 WEEKS POST-OP Frequency: times per week Duratin: weeks Signature: Date: Center fr Musculskeletal Care 333 East 38 th Street, New Yrk, NY 1001 (646) cmc.med.nyu.edu

14 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) PHYSICAL THERAPY LOCATIONS **Please schedule yur pst-perative physical therapy appintments BEFORE yur surgery** Other Lcatins: Manhattan Sprts and Manual Physical Therapy 10 East 33rd Street, 2nd Flr New Yrk, NY (646) Center fr Musculskeletal Care PT 333 E 38 th St, 5 th Flr New Yrk, NY (646) BROOKLYN R.P.T. Physical 335 Curt Street Cbble Hill (718) Therapy One n One PT 2133 Ralph Ave Flatlands (718) One n One PT 17 Eastern Parkway Prspect Heights (718) One n One PT th Ave Bay Ridge (718) One n One PT 1390 Pennsylvania Ave Canarsie (718) One n One PT 1715 Avenue T Sheepshead Bay (718) MANHATTAN- DOWNTOWN Health SOS 594 Bradway New Yrk (212) Occupatinal & Industrial 63 Dwning Street New Yrk (212) Orthpaedic Center Prmbility 401 Bradway New Yrk (646) MANHATTAN EAST SIDE Harkness Center fr Dance 614 Secnd Ave New Yrk (212) (PT Service) RUSK at the Men's Center 555 Madisn Ave New Yrk (646) RUSK Physical Therapy 240 E. 38th Street New Yrk (212) STAR Physical Therapy 160 E. 56th Street New Yrk (212)

15 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Therapeutic Inspiratins 144 E. 44th St New Yrk (212) MANHATTAN UPPER EAST SIDE Health SOS 139 E. 57th Street New Yrk (212) Premier PT 170 E. 77th Street New Yrk (212) Rusk PT at Wmen 's 207 E. 84th Street New Yrk (646) Health Center SPEAR PT 120 E. 56th Street New Yrk (212) Sprts PT f NY 1400 Yrk Ave New Yrk (212) MANHATTAN UPPER WEST SIDE Premier PT 162 W. 72nd Street New Yrk (212) Sprts PT f NY 2465 Bradway New Yrk (212) MANHATTAN WEST SIDE Sprts Medicine at Chelsea 22 West 21st Street New Yrk (646) Suite 400 Chelsea Physical Therapy & 119 W. 23rd Street New Yrk (212) Rehabilitatin SPEAR Physical Therapy 36 W. 44th Street New Yrk (212) QUEENS Erg Physical Therapy P.C. Susan Schilir, PT (Hand & Upper Extremity nly) Queens Frest (718) Blvd Hills th Rad Reg Park (718) STATEN ISLAND One n One PT One n One PT 31 New Drp Lane 1 st, Flr 33 Richmnd Hill Rd Staten Island Staten Island (718) (718) LONG ISLAND Health SOS 375 Deer Park Ave Babyln (631)

16 Assciate Prfessr f Orthpaedics Chief - Divisin f Sprts Medicine Tel: (646) Hand in Hand Rehabilitatin (Hand & Upper Extremity nly) Hme PT Slutins Bi-Cunty Physical Therapy & Rehabilitatin Bi-Cunty Physical Therapy & Rehabilitatin 346 Westbury Ave Carle Place (516) W. Old Cuntry Rd. Hicksville (516) Hillside New Hyde (718) Ave Park Willis Ave Willistn (516) Park WESTCHESTER Health SOS 1015 Saw Mill River Ardsley (914) Premier PT 223 Katnah Ave Katnah (914) PRO Sprts PT f 2 Overhill Rad Scarsdale (914) Westchester Westchester Sprts 672 White Plains Scarsdale (914) Physical Therapy, PC Rad Rye Physical Therapy and 411 Thedre Fremd Rye (914) Rehabilitatin Rye Physical Therapy and Rehabilitatin Ave 15 Nrth Bradway; Suite K White Plains (914) CONNECTICUT Premier PT 36 Old Kings Hwy S Darien (203) NEW JERSEY Jersey Central Physical Rute 27 Edisn (732) Therapy & Fitness Jag PT 34 Muntain Blvd Warren (908) Jag PT 622 Eagle Rck Ave West Orange (973)