# Practice ## Home Source: / Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # A Leader in Orthopaedic Surgery Dr. Taylor’s mission is to provide every patient the highest quality of care possible by combining modern surgical techniques with compassionate care and to be a leader in orthopaedic surgery and sports medicine through research and education. Learn more about Dr. Taylor ## An Athlete’s Advocate As a former intercollegiate and avid recreational athlete, Dr. Taylor has a unique understanding of the demands and anxieties faced by athletes at all levels. Learn more about Dr. Taylor ## A Trusted Provider Dr. Taylor currently serves as the Team Physician for the NY Giants and the Fire Department of New York (FDNY) football teams. Learn more about Dr. Taylor ## Compassionate Care Dr. Taylor’s mission is to provide his patients the exceptional and compassionate care they deserve. Learn more about Dr. Taylor ## Hospital for Special Surgery At the #1 hospital for orthopedics, according to the U.S. News & World Report, patients can expect friendly, knowledgeable, and experienced staff to ensure superior delivery of care throughout every phase. Learn more about Dr. Taylor ## ABOUT DR. TAYLOR Dr. Taylor is a sports medicine specialist at Hospital for Special Surgery who is dedicated to getting you back in the game. As a former intercollegiate and avid recreational athlete, he has developed a unique understanding of the demands and anxieties faced by injured athletes at all levels. His mission is to deliver the highest quality care by combining modern surgical techniques with compassion. ## TREATMENT & CONDITIONS Dr. Taylor is a leader and innovator in sports medicine and orthopaedic surgery. His clinical expertise includes minimally invasive and reconstructive techniques of the shoulder, elbow, and knee. Dr. Taylor prides himself on patient education and delivery of the most modern surgical techniques to suit the needs of each individual patient. ## PATIENT INFORMATION  Dr. Taylor participates in Aetna, Blue Cross HMO POS, Blue Cross PPO, Cigna, Medicare, Oxford, and United Healthcare. If your provider is not listed, please contact our office to review your out-of-network benefits. Dr. Taylor sees patients in both Stamford and Manhattan. ## Minimally Invasive Orthopaedic Procedures Dr. Taylor’s goal is making his procedures as minimally invasive as possible. Dr. Taylor believes surgery should be performed only after non-surgical treatment options have been exhausted. He utilizes state-of-the-art technology and extensive expertise to reduce the severity of invasive surgery allowing you to heal and recover more quickly. Minimally invasive techniques can also reduce the amount of visible scarring you may experience after treatment. ## Testimonial I suffered a right shoulder dislocation with socket fracture. It was a real douse. I cracked nearly 30% of my socket. I was dreading surgery, but once I got to the hospital I was put at ease. The whole process was a lot easier than I imagined. Dr. Taylor was able to repair and stabilize my shoulder all through a scope with only a few poke holes in my skin. I would absolutely recommend Dr. Taylor to anyone with a bad shoulder injury. To that end, I just played golf for the first time in nearly 4 months since surgery. I had absolutely no issues with the shoulder. In fact, I scored one of my best rounds ever. Dr. Taylor will improve your golf game!! Jeff S. ## Contact Us Today If you have questions or want to schedule a consultation with Dr. Taylor, please connect with a member of our office team by phone or email: ## Stamford, CT  203.705.0750  Get Directions to the Stamford, CT office ## Manhattan, NY  646.714.6324  Get Directions to the Manhattan, NY office - Follow - Follow - Follow Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 # About ## About Samuel A. Taylor, MD - Samuel A. Taylor, MD Source: /about/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # About Dr. Taylor As a former intercollegiate and avid recreational athlete, Dr. Taylor has developed a unique understanding of the demands and anxieties faced by injured athletes at all levels. His clinical expertise includes minimally invasive and reconstructive techniques of the shoulder, elbow, and knee. After graduating from Greenwich High School, Dr. Taylor attended Harvard University where he studied biology and played four years of varsity football.  In medical school at Columbia University College of Physicians and Surgeon, he was selected to the Arnold P. Gold Humanism in Medicine Honors Society. During his residency in orthopaedic surgery at Hospital for Special Surgery, the faculty awarded Dr. Taylor the Weill Cornell Alumni Council Distinguished Housestaff Award for exemplary all-around service and his peers selected him recipient of the Jean C. McDaniel Award for leadership, professionalism, and ethics in patient care. Dr. Taylor served as the administrative Co-Chief Fellow during his final year of training in Sports Medicine and Shoulder Surgery. Following fellowship, Dr. Taylor received additional training in complex shoulder, knee, and elbow conditions during a Traveling Fellowship that included nationally and internationally renowned experts, Dr. James Andrews (Pensacola, FL), Dr. Dan Cooper (Dallas, TX), Dr. John Conway (Fort Worth, TX), Dr. Felix Savoie (New Orleans, LA), and Dr. Laurent LaFosse (Annecy, France). Dr. Taylor has served as an assistant team physician for several amateur and professional organizations, including: the New York Football Giants, The Fire Department of New York (FDNY) semi-professional football team, and the New York Red Bulls MLS franchise. He has also published extensively in his field, authoring more than 20 peer-reviewed papers and 13 book chapters. His seminal work on the long head of the biceps tendon was recognized with the J. Whit Ewing Award at the 2014 Annual Meeting of the Arthroscopy Association of North America. As a student, athlete, and researcher, Dr. Taylor has come to admire the wondrous capabilities and frightening limits of the human body. He has dedicated himself to restoring mobility by combining the latest minimally invasive surgical treatments with compassionate care. ## Education  Undergraduate – Harvard University: Cambridge, MA  Medical School – Columbia University College of Physicians and Surgeons: New York, NY Residency in Orthopaedic Surgery – Hospital for Special Surgery: New York, NY Fellowship in Sports Medicine & Shoulder Surgery – Hospital for Special Surgery: New York, NY ### Sports Team Coverage Team Physician – New York Football Giants ### Download Dr. Taylor’s CV Dr. Taylor holds academic appointments at both, Hospital for Special Surgery and Weill Cornell Medical College. His award winning study on the Biceps-Labrum Complex and innovative research on the Bicipital Tunnel have been presented nationally and internationally. ### The HSS Advantage Hospital for Special Surgery is the #1 ranked hospital in the nation for orthopaedics by U.S. News & World Report. Every surgeon, doctor, scientist, nurse, and therapist is a specialist in caring for orthopaedic patients. Founded in 1863, HSS is the nation’s oldest orthopaedic hospital built upon traditions of innovation, research, education, and excellence. Today, more than 25,000 surgical procedures are performed annually including many of the most complex cases encountered. Furthermore, HSS has one of the lowest infection rates in the nation. Nursing, radiology, and anesthesia have all been nationally and internationally recognized for their excellence. Nursing has been recognized with the Magnet Award for Nursing Excellence and was the first hospital in the State of New York to be re-designated with Nursing’s highest honor. Hospital for Special Surgery is one of the largest academic centers for musculoskeletal imaging. The anesthesiologists pioneered the use of regional anesthesia techniques, which have been associated with less post-operative pain, less nausea, reduced blood loss, and lower incidence of blood clots. Hospital for Special Surgery is dedicated to training tomorrow’s leaders. The orthopaedic surgery residency program is one of the most sought after programs in the country and routinely gets over 500 applications for 9 positions available each year. Professional teams and elite athletes from around the world trust HSS. Doctors and therapists from Hospital for Special Surgery have the distinction of being the team physicians and athletic trainers for the New York Football Giants, New York Mets, New York Knicks, Brooklyn Nets, New York Liberty, New York Red Bulls, US Rowing, USA Swimming, and FIFA among many others. Not only do specialists send their patients, our patients recommend HSS to their friends and family. When benchmarked against other hospitals across the nation, HSS ranked in the 99th percentile for overall patient satisfaction and likelihood to recommend to others. ## Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- # Testimonials ## Testimonials - Samuel A. Taylor, MD Source: /testimonials-2/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Testimonials SHARE YOUR EXPERIENCE Dr. Taylor is a relatively new doctor – if you consider 10+ years of post graduate work to be “new”. I found Dr. Taylor to be the best kind of surgeon; one that is up to date and extremely technically proficient but also having a very warm, patient and communicative bedside manner. What more could you ask for in a surgeon.  I had arthroscopic knee surgery for damaged cartilage from years of running. I felt that Dr. Taylor did a very thorough analysis of my situation and presented me with all of the options – including not having surgery. He gave me realistic expectations for what my surgery could fix and what it could not. He appraised me of potential risks so that I felt fully informed as I made my decision to have surgery. Fortunately, none of those risks occurred. The surgery and my recovery went very smoothly. Dr. Taylor was as attentive post operatively as he was when I initially met him.  While I hope not to need any additional surgery, I would certainly return to Dr. Taylor if necessary and would confidently recommend him to others. - Wendy S. I suffered a right shoulder dislocation with socket fracture. It was a real douse. I cracked nearly 30% of my socket. I was dreading surgery, but once I got to the hospital I was put at ease. The whole process was a lot easier than I imagined. Dr. Taylor was able to repair and stabilize my shoulder all through a scope with only a few poke holes in my skin. I would absolutely recommend Dr. Taylor to anyone with a bad shoulder injury. To that end, I just played golf for the first time in nearly 4 months since surgery. I had absolutely no issues with the shoulder. In fact, I scored one of my best rounds ever. Dr. Taylor will improve your golf game!! - Jeff S. Dr. Taylor and the rest of the staff were very helpful and accommodating. Additionally, they are so friendly that you feel at home the minute you walk into their office. In the future, the only doctor I would see for orthopedic issues is Dr. Taylor. My shoulder already feels 100% better from Dr. Taylor’s treatment after only a few months. - Anonymous The office staff was very welcoming when I showed up for the appointment.  Dr. Taylor was very patient with me when I was telling him about my pain and symptoms.  He was thorough and discussed all available treatment options with me.  Dr. T’s passion for providing the highest quality patient care is very reassuring and not only would I see Dr. Taylor again; I would highly recommend other patients to see him. - Dennis The office staff was very welcoming when I showed up for the appointment.  Dr. Taylor was very patient with me when I was telling him about my pain and symptoms.  He was thorough and discussed all available treatment options with me.  After choosing which treatment would be best I have been pain free.   Dr. T’s passion for providing the highest quality patient care is very reassuring and not only would I see Dr. Taylor again; I would recommend him to anyone. - Jenn Dr. Taylor immediately put me at ease by communicating in understandable medical terms, in-depth description and diagnosis of my shoulder injury, prescribed treatment and a warm, friendly, professional manner. HSS is the best of the best, and Dr. Samuel Taylor exceeded my highest expectation. - Deidre Thank you Dr. Taylor, Kerry, and all the wonderful people at HSS for getting me walking by the start of our trip to Sicily! Without you, I would never have made it to the top of all these steps! - Mark Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- # Patient Information ## Insurance Information - Samuel A. Taylor, MD Source: /patient-resources/insurance-information/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Aetna - Blue Cross HMO POS - Blue Cross PPO - Cigna - Medicare - Oxford - United Healthcare If your provider is not listed, please contact our office to review your out-of-network benefits. Dr. Taylor sees patients in both Stamford and Manhattan. Patients Enrolled in Participating Health Plans: - You as the patient will be responsible for all applicable co-payments, co-insurance and deductibles that your plan requires to fulfill payment responsibility. Please make sure you have your insurance card at every visit and if at any time your insurance changes please provide our office with the new insurance information - If your insurance requires a referral from your primary care physician, it is your responsibility to provide our office with that referral. If a referral is not provided, payment is due at the time services are rendered - If your insurance carrier is billed and you are reimbursed directly, you are responsible for endorsing and forwarding all payments to Dr. Samuel A. Taylor’s office Patients with Non-Participating Plans: - Full payment is due at the time of service Work Related or Motor Vehicle Injury: - You are responsible for providing all pertinent information regarding your accident and billing information with you. Information such as your insurance claim number, date of injury, description and location of injury as well as guarantors mailing address and telephone number. In you are unable to provide the necessary information; payment in full must be made at the time services are rendered. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Patient Forms - Samuel A. Taylor, MD Source: /patient-resources/patient-forms/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Please download and complete the following forms that pertain to you. Filling out these forms in advance will save time during your visit. NEW PATIENT FORMS Initial Visit Forms CURRENT PATIENT FORMS Postoperative Questionnaire Follow-Up Questionnaire Completed forms can be submitted via this website, emailed to tayloroffice@hss.edu, or printed and brought with you to your visit. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- # Other Pages ## ASK THE EXPERT: BICEPS TENDINITIS - Samuel A. Taylor, MD Source: /ask-the-expert-biceps-tendinitis/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # ASK THE EXPERT: BICEPS TENDINITIS by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized | 0 comments In this week’s installment of Ask the Expert, Drs.Samuel Taylor & Stephen J. O’Brien, discuss biceps tendinitis. Popeye’s Problem… Cartoons depicting Popeye’s bulging biceps after he guzzled down a can of spinach only told half the story. Unfortunately, our favorite sailor went on to develop intense pain in the front of his shoulders as the years passed and was diagnosed with “biceps tendinitis”. Interestingly, the medical term used to describe the deformity that occurs after a degenerated long head of the biceps tendon (LHBT) ruptures carries his namesake and is called a “Popeye Sign”. Biceps come from Latin “bi” meaning “two” and “ceps” meaning “heads”, because this important muscle attaches to the front of the scapula by two different tendons (heads). The short head is the most important for function and enables 90% of power. While the LHBT is quite meager in comparison, it is a widely accepted source of pain in the shoulder. Biceps tendinitis is a catchall term that describes pain related to the LHBT stemming from a wide array of different lesions. Our recent research efforts have helped expand our understanding of this important disease process. (1-6) Does MRI always show biceps disease? No. Recently we compared MRI reports with surgical findings from a large group of patients undergoing shoulder surgery and found that, when present, lesions were often unrecognized by MRI. (5) Does arthroscopy always show biceps disease? No. In our award winning study just published in Arthroscopy Journal, we showed that only 55% of the LHBT could actually be seen during routine shoulder surgery and that 45% of 277 patients with chronic biceps related pain had “hidden” lesions. (1-2) Physical examination remains king? Dr. Stephen O’Brien devised a series of physical examination maneuvers called the 3-Pack that have been shown the most effective tool available for diagnosing biceps disease when present. (6) What are nonsurgical treatment options? Biceps tendinitis is incredibly common, and fortunately the vast majority of people get better without needing surgery. Anti-inflammatory medications by mouth, changing your activities to avoid those things that produce pain and structured physical therapy are the most useful first line treatment. What are surgical treatment options? In a small subset of patients surgery may provide the best opportunity for recovery of function and alleviation of pain. Treatment options include tenotomy (surgeon cuts the LHBT thereby relieving painful tension on the tendon) or tenodesis/transfer (surgeon cuts the LHBT and moves it to another location).  (3-4) - Taylor SA, Khair MM, Gulotta L, Dy CJ, Baret NJ, Newman AM, Pearle AD, O’Brien SJ. Standard Diagnostic Glenohumeral Arthroscopy Fails to Fully Evaluate the Biceps-Labrum Complex. Arthroscopy. 2014 Dec 10 [Epub ahead of print]. Arthroscopy 2015 Feb; 31(2):215-24. - Taylor SA, Fabricant PD, Bansal M, Khair MM, McLawhorn A, DiCarlo E, Shorey M, O’Brien SJ. The Anatomy and Histology of the Bicipital Tunnel of the Shoulder. JSES. 2014 Nov 18 [Epub ahead of print]. - Taylor SA, Fabricant PD, Baret NJ, Newman AM, Sliva N, Shorey M, O’Brien SJ.  Midterm Clinical Outcomes for Arthroscopic Subdeltoid Transfer of the Long Head of the Biceps Tendon to the Conjoint Tendon.Arthroscopy. 2014 Sep 17. [Epub ahead of print] - Kelly AM, Drakos MC, Fealy S, Taylor SA, O’Brien SJ.  Arthroscopic Release of the Long Head of the Biceps Tendon: Functional Outcome and Clinical Results. Am J Sports Med. 2005 Feb;33(2):208-213. - Taylor SA, Newman AM, Baret NJ, Delos D, O’Brien SJ.  MRI Fails to Fully Evaluate the Biceps-Labral Complex. [Manuscript Under Review: Arthroscopy 2015] - O’Brien SJ, Newman AM, Taylor SA, Dawson C, Gallagher KA, Bowers A, Nguyen J, Baret N. The Accurate Diagnosis of Biceps-Labral Complex Lesions with MRI and “3-Pack” Physical Examination: A Retrospective Analysis with Prospective Validation. Orthopaedic Journal of Sports Medicine 2013 1: DOI: 10.1177/2325967113S00018. Dr. Samuel Taylor, Sports Medicine Surgeon, has developed a unique understanding of the demands and anxieties faced by injured athletes at all levels. His clinical expertise includes minimally invasive and reconstructive techniques of the shoulder, elbow, and knee. Dr. Taylor currently serves as Associate Team Physician for the New York Giants and team physician for the Fire Department of New York (FDNY) semi-professional football team. Dr. Stephen J. O’Brien is an Attending Orthopedic Surgeon at Hospital for Special Surgery, specializing in orthopedic surgery and sports medicine. Dr. O’Brien has also been actively involved in research throughout his career. He has authored 20 book chapters and 85 peer-reviewed or review articles. Currently, his research interests have focused on an algorithm he developed for the diagnosis and treatment of biceps-labral disorders.  Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Dr. Sam Taylor, Author at Samuel A. Taylor, MD Source: /author/dr-sam-taylor/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Dr. Sam Taylor, Author ## Tips to Avoid Tommy John Injuries by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized Keep their elbow out of the OR… Only a few weeks into the 2015 MLB preseason and players have already succumbed to ulnar collateral ligament (UCL)injuries. The surgery to reconstruct the UCL named after Tommy John, who produced a 3.1 ERA over many seasons following... ## ASK THE EXPERT: BICEPS TENDINITIS by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized In this week’s installment of Ask the Expert, Drs.Samuel Taylor & Stephen J. O’Brien, discuss biceps tendinitis. Popeye’s Problem… Cartoons depicting Popeye’s bulging biceps after he guzzled down a can of spinach only told half the story. Unfortunately, our... ## Overuse Among Youth Throwers : My son takes Advil before he pitches by Dr. Sam Taylor | Jun 10, 2015 | Injuries Pain in the shoulder and/or elbow is NOT normal for adolescent throwing athletes and is usually a sign that something is wrong. Why does the arm hurt, you ask? While the answer is occasionally complex, most commonly it’s quite simple: OVERUSE and IMBALANCE. Today,... #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Blog - Samuel A. Taylor, MD Source: /blog/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Blog ## Tips to Avoid Tommy John Injuries Jun 10, 2015 Keep their elbow out of the OR… Only a few weeks into the 2015 MLB preseason and players have already succumbed to ulnar collateral ligament (UCL)injuries. The surgery to reconstruct the UCL named after Tommy John, who produced a 3.1 ERA over many seasons following... ## ASK THE EXPERT: BICEPS TENDINITIS Jun 10, 2015 In this week’s installment of Ask the Expert, Drs.Samuel Taylor & Stephen J. O’Brien, discuss biceps tendinitis. Popeye’s Problem… Cartoons depicting Popeye’s bulging biceps after he guzzled down a can of spinach only told half the story. Unfortunately, our... ## Overuse Among Youth Throwers : My son takes Advil before he pitches Jun 10, 2015 Pain in the shoulder and/or elbow is NOT normal for adolescent throwing athletes and is usually a sign that something is wrong. Why does the arm hurt, you ask? While the answer is occasionally complex, most commonly it’s quite simple: OVERUSE and IMBALANCE. Today,... Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Elbow Archives - Samuel A. Taylor, MD Source: /bodyparts/elbow/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Elbow Archives ## Elbow Anatomy by Dr. Sam Taylor | Mar 27, 2015 The elbow allows you to bend and straighten your arm as well as rotate your forearm. Its function depends on complex interactions among bones, muscles, tendons, and ligaments. Furthermore, all of the nerves that control your hand pass by the elbow. Elbow problems... ## Elbow Arthroscopy by Dr. Sam Taylor | Mar 27, 2015 Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to... ## UCL (Tommy John) by Dr. Sam Taylor | Mar 27, 2015 General Every season numerous MLB players (primarily pitchers) succumb to ulnar collateral ligament (UCL) injuries and undergo surgery to reconstruct this ligament named after Tommy John, who famously produced a 3.1 ERA over 18 seasons following this surgery. The... ## Distal Biceps/Triceps Injury by Dr. Sam Taylor | Mar 27, 2015 General Injuries to the distal (down at the elbow) biceps and triceps tendons are relatively rare. Distal biceps and triceps tendon tears may be partial or complete. They most often occur in men age 30-60 years and usually in the dominant arm. Anatomy The... ## Epicondylitis (Tennis/Golfer’s Elbow) by Dr. Sam Taylor | Mar 27, 2015 General Lateral epicondylitis also known as tennis elbow is the most common cause of elbow pain. As one may expect, given its name, lateral epicondylitis is quite common among tennis players (50% lifetime risk), but may occur in anyone who performs repetitive wrist... #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Knee Archives - Samuel A. Taylor, MD Source: /bodyparts/knee/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Knee Archives ## Knee Arthritis by Dr. Sam Taylor | Mar 27, 2015 Arthritis means joint inflammation. Osteoarthritis is one of the most common causes of knee pain. Often times, the onset of pain is insidious and you may not recall a particular injury. Osteoarthritis is due to the breakdown or wear of the cartilage surfaces of the... ## Knee Anatomy by Dr. Sam Taylor | Mar 27, 2015 The knee is the largest joint in the body and one of the most easily injured. It is made of four main components: bones, cartilage, ligaments, and tendons. You knee is made up of many important structures (below) any of which can be injured. The most common knee... ## Knee Arthroscopy by Dr. Sam Taylor | Mar 27, 2015 Arthroscopy of the knee is a surgical procedure in which a small fiberoptic camera (arthroscope) is inserted into the knee joint through a small incision to see the inside of the knee joint. This enables Dr. Taylor to visualize the inside of the joint on a monitor in... ## ACL Tear by Dr. Sam Taylor | Mar 27, 2015 General information ACL sprains or tears are among the most common knee injuries More than 200,000 ACL reconstructions are performed annually in the US. ACL tears are more common among female athletes than their male counterparts Anatomy and Function The ACL... ## ACL Graft Choice by Dr. Sam Taylor | Mar 27, 2015 There are several choices regarding the graft to be used during ACL reconstruction.  The following is general information to help you become educated on the pros and cons of each graft choice. Dr. Taylor will discuss graft selection with you in more detail during your... « Older Entries #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Other Archives - Samuel A. Taylor, MD Source: /bodyparts/other/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Other Archives ## Viscosupplementation by Dr. Sam Taylor | Jun 10, 2015 Viscosupplementation (Hyaluronic Acid) or “lubricating” injections, have been shown to relieve pain in some patients who cannot get relief from nonmedicinal measures or non-steroidal anti-inflammatory (NSAID) medications. Hyaluronic Acid is a naturally occurring... ## Useful Other Items by Dr. Sam Taylor | Jun 10, 2015 While frequently not covered by insurance, you may consider purchasing one or more of the following items that some patients have found helpful in their recovery. These often represent out of pocket expense. Dr. Taylor has NO financial interests in any of the... ## Suture Removal by Dr. Sam Taylor | Jun 10, 2015 During your first postoperative visit with Dr. Taylor, sutures will be removed (if necessary) and steri-strips will be applied to your incision(s). DO NOT remove steri-strips, they will fall off on their own over the ensuing two weeks. As they begin to peel off, the... ## Risks and Benefits of Surgery by Dr. Sam Taylor | Jun 10, 2015 It is important to understand the problem we are trying to solve with surgery, goals of treatment, potential risks involved, and postoperative rehabilitation expectations. If you do not understand these things or have additional questions, please contact our office... ## Platelet-Rich-Plasma (PRP) by Dr. Sam Taylor | Jun 10, 2015 While many high profile athletes have been treated with PRP, its most appropriate and effective uses remain a source of debate and ongoing research. Your blood contains a liquid (plasma), different type of cells, and other factors. Platelets are important for clotting... « Older Entries #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Shoulder Archives - Samuel A. Taylor, MD Source: /bodyparts/shoulder/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Shoulder Archives ## AC Arthritis by Dr. Sam Taylor | Jun 10, 2015 General AC stands for acromioclavicular. The AC joint is where the bone at the top of the shoulder (acromion) meets the collarbone (clavicle). Anatomy The AC joint is stabilized by the acromioclavicular (AC) ligaments, the coracoclavicular (CC) ligaments, joint... ## AC Separation by Dr. Sam Taylor | Jun 10, 2015 General “Shoulder separation” is term commonly used for an injury to the AC (acromioclavicular) joint that makes it unstable. The AC joint is where the bone at the top of the shoulder (acromion) meets the collarbone (clavicle). Injuries to the AC joint are quite... ## Frozen Shoulder by Dr. Sam Taylor | Jun 10, 2015 General Information “Frozen shoulder,” also known as “adhesive capsulitis” is a slowly progressing, painful loss of shoulder motion due to inflammation and thickening of the capsule that surrounds the joint Occurs in 2% of the general population Most commonly occurs... ## Shoulder Anatomy by Dr. Sam Taylor | Mar 27, 2015 The shoulder is the most moveable joint in your body. It helps you to lift your arm, to rotate it, and to reach up over your head. It is able to turn in many directions. The shoulder joint may be described as a “ball and socket”. However it is a relatively large ball... ## Shoulder Arthroscopy by Dr. Sam Taylor | Mar 27, 2015 Arthroscopy of the shoulder is a surgical procedure in which a small fiberoptic camera (arthroscope) is inserted into the shoulder joint through a small incision to see the inside of the shoulder. This enables Dr. Taylor to visualize the inside of the joint on a... « Older Entries #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Surgical Animations Archives - Samuel A. Taylor, MD Source: /bodyparts/surgical-animations/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Surgical Animations Archives ## Knee Animations by Dr. Sam Taylor | Jun 10, 2015 Diagnostic Arthroscopy ACL Reconstruction Partial Meniscectomy Meniscal Repair Microfracture High Tibial Osteotomy Patella Chondroplasty Removal Plica Removal Loose Body Synovectomy ## Elbow Animations by Dr. Sam Taylor | Jun 10, 2015 UCL (Tommy John) ## Shoulder Animations by Dr. Sam Taylor | Jun 10, 2015 Diagnostic Arthroscopy Subacromial Decompression  Trimming Torn Labrum Rotator Cuff Repair Distal Clavicle Resection Labrum Repair Bankart Repair SLAP Repair Total Shoulder Replacement #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Injuries Archives - Samuel A. Taylor, MD Source: /category/injuries/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Injuries Archives ## Overuse Among Youth Throwers : My son takes Advil before he pitches by Dr. Sam Taylor | Jun 10, 2015 | Injuries Pain in the shoulder and/or elbow is NOT normal for adolescent throwing athletes and is usually a sign that something is wrong. Why does the arm hurt, you ask? While the answer is occasionally complex, most commonly it’s quite simple: OVERUSE and IMBALANCE. Today,... #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Uncategorized Archives - Samuel A. Taylor, MD Source: /category/uncategorized/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Uncategorized Archives ## Tips to Avoid Tommy John Injuries by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized Keep their elbow out of the OR… Only a few weeks into the 2015 MLB preseason and players have already succumbed to ulnar collateral ligament (UCL)injuries. The surgery to reconstruct the UCL named after Tommy John, who produced a 3.1 ERA over many seasons following... ## ASK THE EXPERT: BICEPS TENDINITIS by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized In this week’s installment of Ask the Expert, Drs.Samuel Taylor & Stephen J. O’Brien, discuss biceps tendinitis. Popeye’s Problem… Cartoons depicting Popeye’s bulging biceps after he guzzled down a can of spinach only told half the story. Unfortunately, our... #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Nutrition Optimization - Samuel A. Taylor, MD Source: /conditions/920-2/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage If you have been injured or will be having surgery, it is important to help your body undergo the healing process by making sure that you are getting adequate nutrition. Your body needs carbohydrates, protein, fat, vitamins, and minerals, as well as water to heal. - Your body needs CALORIES. In order to heal, your body needs more nutrients than it does regularly. In fact, you need to consume 15-20 calories per pound of your current body weight to maximize healing. Recovering from injury is NOT the time to start or continue a diet!! - To calculate how many calories you should be consuming each day multiply your body weight in pounds by 15-20.   That means that a 150 pound person needs to consume 2,250-3,000 calories per day!! - Your body also needs HYDRATION. You should drink a minimum of 8 cups of water or non-caffeinated, non-alcoholic fluid each day. You may need more fluid depending on the types of medication you are taking. Adequate hydration not only helps with healing, it also helps prevent constipation caused by some of the medications you may have been prescribed. - You need to eat WELL-BALANCED MEALS. Your body needs all types of nutrition including carbohydrates, fats, and proteins. You should try to take in 6-12 ounces of protein each day. - Your body needs VITAMINS. Dr. Taylor recommends taking an over-the-counter multivitamin. Vitamin D is important for bone healing. Vitamin C, zinc, and vitamin A are important for preventing infection. - You may consider adding a nutritional supplement such as Carnation Instant Breakfast, Muscle Milk, Ensure, or Boost if your appetite is decreased to ensure that you are getting adequate nutrition. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## AC Arthritis - Samuel A. Taylor, MD Source: /conditions/ac-arthritis/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - AC stands for acromioclavicular. The AC joint is where the bone at the top of the shoulder (acromion) meets the collarbone (clavicle). Anatomy - The AC joint is stabilized by the acromioclavicular (AC) ligaments, the coracoclavicular (CC) ligaments, joint capsule, and deltoid and trapezius muscles. Risk Factors - Prior AC joint separation injury - Repetitive overhead activities - Increased age Symptoms - Pain with overhead activity - Pain with bringing arm across the chest Diagnosis - Physical examination Areas that reproduce pain - Pain with range of motion - Specific tests to reproduce pain - X-rays look at the space between the collarbone and the acromion and evaluate for signs of arthritis. - Injection of steroid and local anesthetic medication that relieves a patient’s pain is both diagnostic (helps determine that this is in fact the source of symptoms) and therapeutic (may make symptoms get better or disappear). Treatment is based upon the extent of injury - Non Surgical – vast majority of patients get better without surgery Activity Modification, or change your activities to avoid those things that cause irritation. - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation in the short term to allow more effective physical therapy. - Injection of Steroid medication into the AC joint may be an option for some patients depending on the type of injury and specific patient needs - Physical Therapy is an important tool to help you strengthen and retrain the muscles that support the shoulder. - Surgery is used in a small subset of patients with persistent symptoms. AC joint resection may be appropriate for some patients who have persistent pain at the AC joint from prior injury that do not require a formal reconstruction procedure. In this surgery, a small portion of the acromion and end of the collarbone are removed with a shaver so that they do not rub against each other and cause pain. - Physical therapy after surgery is critical to your recovery. Surgery removes the structural causes of the problem, but does not restore the strength and coordination of the muscles and tendons that provide stability and function to the shoulder. Adherence to a structured physical therapy program after surgery is essential. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## AC Separation - Samuel A. Taylor, MD Source: /conditions/ac-separation/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - “Shoulder separation” is term commonly used for an injury to the AC (acromioclavicular) joint that makes it unstable. - The AC joint is where the bone at the top of the shoulder (acromion) meets the collarbone (clavicle). - Injuries to the AC joint are quite common and make up nearly 10% of all shoulder injuries. - The mechanism of injury is typically a direct blow to the top of the shoulder with the arm at the side. Anatomy - The AC joint is stabilized by the acromioclavicular (AC) ligaments, the coracoclavicular (CC) ligaments, joint capsule, and deltoid and trapezius muscles. Symptoms - Most common symptom is pain at the AC joint. - Right after the injury, the AC joint will be swollen and tender. It hurts more when the weight of your arm pulls down and when things push on it (like a bag strap). - You may feel a “click” or “clunk” as you move your arm overhead. This is often painful. - In high-grade injuries, there may be a visual deformity that looks like the collarbone is sticking up. Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Signs of other injury - X-rays are taken of both shoulders to help compare one side to the other so that Dr. Taylor can determine the extent of injury. - In some patients, Dr. Taylor may order an MRI (magnetic resonance imaging) to get better assess the injury to the stabilizing soft tissue structures and look for any other damage to the shoulder. Classification of Injury - Type I – Sprain of the AC ligaments. Patients have pain on examination but normal X-Rays. Treated without surgery. - Type II – Tear of the AC ligaments but the CC ligaments remain intact. Patients have pain on examination and a mild degree of vertical separation of the collarbone from the acromion. Treated without surgery - Type III – Tear of the AC and CC ligaments. Patients have pain on examination and significant deformity on X-Ray. The majority of patients are successfully treated without surgery, but a subset of patients will continue to have symptoms that affect their activities and ultimately need surgery. - Type IV – Tear of the AC and CC ligaments with the collarbone abnormally positioned backward. This is an uncommon injury but generally requires surgery. - Type V – Tear of the AC and CC ligaments, along with a tear of the deltotrapezial fascia that results in a collarbone that is positioned directly under the skin. This generally requires surgery. - Type VI – Rare injury that requires surgery. Treatment is based upon the extent of injury - Non Surgical – Type I, II, and III injuries are initially treated without surgery. Rest and Sling – duration dictated by extent of injury. - Activity Modification, or change your activities to avoid those things that cause irritation. - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation in the short term to allow more effective physical therapy. - Injection of Steroid medication into the AC joint may be an option for some patients depending on the type of injury and specific patient needs - Physical Therapy is an important tool to help you strengthen and retrain the muscles that support the shoulder. - Surgery is used to treat those with Type IV, V, and VI injuries as well as the subset of patients with Type III injuries who continue to have symptoms after a course of non-surgical treatment. Arthroscopic Internal Strut can be performed in the acute setting to hold the collarbone in a reduced position and allow your body form scar and “heal” the ruptured ligaments in an acceptable position. - AC Joint Reconstruction uses an accessory hamstring tendon taken either from your own leg or one taken from a deceased donor (only with your permission) to reconstruct the injured ligaments and hold the collarbone down in a reduced position. - AC joint resection may be appropriate for some patients who have persistent pain at the AC joint from prior injury that do not require a formal reconstruction procedure. In this surgery, a small portion of the acromion and end of the collarbone are removed with a shaver so that they do not rub against each other and cause pain. - Physical therapy after surgery is critical to your recovery. Surgery removes the structural causes of the problem, but does not restore the strength and coordination of the muscles and tendons that provide stability and function to the shoulder. Adherence to a structured physical therapy program after surgery is essential. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## ACL Graft Choice - Samuel A. Taylor, MD Source: /conditions/acl-graft-choice/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage There are several choices regarding the graft to be used during ACL reconstruction.  The following is general information to help you become educated on the pros and cons of each graft choice. Dr. Taylor will discuss graft selection with you in more detail during your pre-surgical visit. Graft Choices in ACL Surgery There are two major types of graft tissues that can be used in ACL reconstruction surgery. “Autograft” is tissue from your body that is taken from one location and moved to reconstruct the ACL. “Allograft” is tissue and comes from a deceased donor. Dr. Taylor is very specific with the type and style of allografts he uses during ACL reconstruction. The decision between autograft and allograft is based on many factors such as your age and the sport and activity level you will be returning to. AUTOGRAFTS BONE-PATELLAR TENDON-BONE (BTB) AUTOGRAFTS PROS: - Strongest initial fixation due to the bone on each end of the graft - Bone-to-bone healing - Longest successful track record in the orthopaedic literature - Most commonly used graft used by NFL team physicians CONS: - More initial post-operative pain than other graft choices because the middle third of the patellar tendon is taken along with a bone fragments from the bottom of the kneecap (distal pole of the patella) and the top of the shinbone (tibia tubercle) - Patellar tendonitis and pain in the front (anterior) of the knee may occur in10-20%. This almost always goes away, but can take time. - Anterior knee pain and discomfort with kneeling (particularly relevant for patients whose occupation requires frequent kneeling such as plumbers, firemen, etc.) - Risk of patella fracture (very uncommon) - Incision needed to harvest the graft is larger HAMSTRING AUTOGRAFTS PROS: - Accessory hamstring tendons - Generally have less immediate post-operative pain than BTB - Often quicker return to Activities of Daily Living (ADLs) - Smaller incision than that for BTB CONS: - Initial fixation not as strong, so caution is advised during early rehabilitation - Mild hamstring weakness may occur (important consideration for sprinters) - If the size of the hamstring tendons is inadequate, Dr. Taylor may need to harvest the hamstrings from the other leg or supplement with allograft (donor) tissue. ALLOGRAFTS PROS: - No risk of complications from graft harvest because it is donor tissue - Fastest return to Activities of Daily Living (ADLs) - Least painful immediately post-operatively - Smaller incisions because no autograft tissue is harvested CONS: - Potential risk of viral transmission (HIV, Hepatitis, Clostridia) - Risk of HIV infection from donor graft tissue is 1 in 1.8 million - Risk of Hepatitis C infection from donor graft tissue is 1 in 750,000 - Risk of graft rejection (very uncommon) - High failure rates in young/active patients (25% if age <25 years) Dr. Taylor will discuss with you in depth given your specific injury and the risks and benefits of each graft choice so that the best graft choice is selected for you based upon your concerns and goals. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## ACL Tear - Samuel A. Taylor, MD Source: /conditions/acl-tear/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General information - ACL sprains or tears are among the most common knee injuries - More than 200,000 ACL reconstructions are performed annually in the US. - ACL tears are more common among female athletes than their male counterparts Anatomy and Function - The ACL (anterior cruciate ligament) is one of the two ligaments in the center of the knee. One end is attached to the femur (thigh bone) and the other end is attached to the tibia (shin bone). This ligament helps hold the femur and tibia in proper position to each other. - The ACL plays an important role in providing stability to the knee joint in everyone, but is especially important for people engaged in activities that require side-to-side movement and pivoting. ACL Injury - The typical ACL injury is described as a “tear” that can be partial or complete. The tear may occur near the center of the ACL or at either end, pulling it away from its attachment to bone. - The majority of ACL injuries are “non-contact” meaning that the knee was NOT struck by another object or player. Rather, a twisting and/or hyperextension of the knee commonly cause the injury. - Patients frequently describe feeling or hearing a “pop” when the foot was planted and their knee rotated for pivoted. Pain and swelling follows. - Often times, the injury that tore the ACL also caused damage to other structures in the knee, such as the cartilage, meniscus, or other ligaments. Risk Factors - Activities that involve Changing direction rapidly - Stopping suddenly - Slowing down while running - Landing from a jump incorrectly - Direct contact or collision - Gender: the female to male ratio is more than 4:1. This is due to many factors including knee anatomy, alignment, and neuromuscular factors. - Personal or family history of ACL tear. Symptoms - A “pop” feel or sound upon injury - Sense of instability or “giving way” - Pain with swelling - Inability to bend and straighten the knee - Inability to bear weight Diagnosis - Physical examination is the most important diagnostic tool. Dr. Taylor will evaluate your knee for areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures and other bony abnormalities. - MRI may be ordered to confirm a diagnosis and/or better evaluate some of the soft tissue structures in the knee that may have been injured as well Treatment Despite what you may have read, not all ACL tears need to be treated with surgery. The decision to reconstruct the ACL is based upon many factors such as your age, activity level, goals, symptoms, injury mechanism, and associated injuries. Dr. Taylor will discuss your options, both surgical and non-surgical in detail during your appointment. Non-Surgical - Older, less active patients, and non-pivoting athletes may be successfully treated without surgery by working with physical therapists to build up the thigh muscles and core muscles that help control the knee. While traditional teaching suggests that the ACL does not “heal” it may scar down in a position that affords adequate stability among a subset of patients. Surgical - In young, active patients, and those with sporting demands that require cutting and pivoting, ACL reconstruction is often the most reliable option to eliminate symptoms of instability and regain function. - In preparation for ACL reconstruction, Dr. Taylor will have you work with a physical therapist for “ACL Pre-hab” focused on reduction of swelling, recovery of knee motion, and strengthening of the thigh muscles. This is essential to a successful surgical outcome. - An ACL reconstruction is performed by using a tendon graft from another source and replacing the torn ACL. Drill holes are made in the femur and tibia and the new tendon graft is weaved into place and secured using screws or surgical buttons. - Graft options include autograft (your tissue) or allograft (donor tissue). Selection of the ideal graft is patient specific. Please refer to ACL Graft Options section for more detailed information. Dr. Taylor will also discuss your options during your visit. - Effective postoperative rehabilitation is critical to a successful surgical outcome and return to your desired sport/activity. The rehabilitation process typically takes 9 months (6-12 months). - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Allografts - Samuel A. Taylor, MD Source: /conditions/allografts/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Allograft tissue will not be used unless you have consented to its use.   ABOUT ALLOGRAFTS: - “Allografts” are human tissues (bone, ligament, tendon, or cartilage) that have been taken from a deceased person, who consented to donate their tissue, and are transplanted into another person - Allograft tissues are harvested under sterile conditions, within 12-24 hours of the donor’s death by trained professionals working for government accredited tissue banks. - Allografts are used in a variety of procedures at Hospital for Special Surgery and in more than one million surgical procedures annually across the United States. REASONS TO USE ALLOGRAFTS: - As an alternative to a patient’s own (autograft) bone, soft tissue, or cartilage, which limits risks, surgical time, and additional pain associated with autograft harvest. - As an alternative to synthetic bone, soft tissue, and cartilage products. - Because there is not enough of a patient’s own tissue to perform the intended operation. RISKS OF ALLOGRAFTS: - Allografts may transmit an infection from the donor. This occurs rarely, and in most of those cases, the infection was present in the donor when he/she died but it was not detected. - Estimated risk of acquiring HIV is 1 in 1.8 million - Estimated risk of acquiring Hepatitis C is 1 in 750,000 - To reduce this risk, bone, soft tissue, and cartilage for allografts are collected (harvested) by personnel working for and trained by tissue recovery agencies. Federal law requires these tissue recovery agencies to register with the U.S. Food and Drug Administration (FDA) and comply with the FDA’s tissue recovery regulations. - Tissue recovery agencies screen potential donors of allografts for possible infections in a variety of ways, including by performing a physical assessment and reviewing the medical history for a number of risk factors; these risk factors are very similar to those examined for blood donors. If no risk factors are present, the potential donor is then tested for infectious diseases (including HIV, Hepatitis B, Hepatitis C, and syphilis). If all of the tests are negative, then bone, soft tissue, and/or cartilage may be donated. - Because HSS is very concerned with the safety of the allografts we use, we impose strict requirements on our allograft suppliers, including a requirement to comply with the FDA regulations, New York State law, and the accreditation standards of the American Association of Tissue Banks (AATB). However, because HSS does not harvest or process allografts, we cannot guarantee the safety of the allografts we use. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Anterior Instability - Samuel A. Taylor, MD Source: /conditions/anterior-instability/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General Information - The shoulder is the body’s most mobile joint. - The same anatomy that gives the shoulder its amazing mobility and range of motion also makes it vulnerable to dislocating or becoming unstable, a condition called instability. - Instability is a catch-all term that means the ball does not stay in the socket the way that it should giving you a sense of abnormal looseness or the sensation that it is going to come out when you put your arm into certain positions. - There are several different types of shoulder instability such as: By the direction of instability – anterior (front), posterior (back), or multidirectional. - By the way it happened – traumatic (from a specific injury) or atraumatic (without a specific injury). - By the degree of instability – dislocation (completely came out of socket) or subluxation (ball came part way out of the socket). - Anterior shoulder instability is the most common type of instability Anatomy & Function The shoulder is a ball-in-socket joint, but the socket (glenoid) is very shallow making the shoulder look like a golf ball on a tee. - The glenoid labrum is a soft tissue structure that goes around the rim of the glenoid forming a bumper that helps to deepen the shallow glenoid socket. - The labrum also serves as an attachment site for the capsule that surrounds the shoulder and the glenohumeral ligaments that help keep the ball in the socket. - The rotator cuff is a series of four tendons that work together to stabilize the shoulder, keeping the ball appropriately positioned in the socket during shoulder motion. - A Bankart lesion is defined as damage to the bone and/or labrum along the front of the glenoid socket that happens in 90% of shoulder dislocations. - A Hill-Sachs lesion is a bony indentation in the back of the humeral head that commonly happens when it contacts the front of the glenoid socket during an anterior shoulder dislocation - The axillary nerve is a large nerve that provides motor function to the large deltoid muscle and sensation to the skin on outside of the shoulder. This nerve can be damaged when the shoulder dislocates. Injury is usually temporary, but it may affect the timing of surgery. Injury & Risk Factors - Dislocation is when the ball comes completely out of the socket, usually during a forceful twisting outward motion (external rotation) when the arm is above the level of the shoulder. Some dislocated shoulders will pop back in on their own, while others may require a “reduction” which is when another person puts it back in place. - 30% of patients over the age of 40 years, and 80% of patients over the age of 60 years, who dislocate their shoulder will also have a rotator cuff tear. - Subluxation is when the ball partially comes out of the socket. This can cause similar injuries to a full dislocation. - Micro-instability occurs over longer periods of them due to repetitive injury and damage to the structures that keep the ball in the socket. This can result in a loose or painful shoulder. - Age is the most important risk factor for recurrent shoulder instability (another dislocation or subluxation). The rate of recurrent instability without surgery is more than 90% in those younger than 20 years, 60% for those between 20 and 40 years, and less than 10% if over 40 years old. - Contact sports put people at higher risk of shoulder instability and recurrent shoulder instability. - Generalized laxity - Bone deficiency Signs & Symptoms - At time of injury: - Feels like it “popped out” - Pain - Prominence about the front of the shoulder - Arm is rotated outward - Sensation of a “dead arm” - After the injury: - Pain - Bruising - Afraid to do certain activities (apprehension) because of fear that it will come out Diagnosis - Physical examination Apprehension - Range of motion - Rotator cuff strength - Positions and movements that reproduce pain - X-rays help determine that the shoulder is in place (reduced) and helps us see if there are any injuries to the bone. X-rays do not show soft tissues very well. - CT (computerized tomography) scan is a specialized tool that shows the bone in great detail. If Dr. Taylor is particularly concerned about the amount of damage to the bone caused by your injury he may request a CT scan. - MRI (magnetic resonance imaging) is a very useful tool that lets Dr. Taylor look at the soft tissue anatomy of your shoulder to help determine the extent of your injury and the best treatment strategy. Treatment Options Treatment plan is specific to an individual patient and requires many factors to be considered such as age, level of activity, and the severity of injury. Below are general considerations. Dr. Taylor will work with you to help create the best treatment plan for you. Non-Surgical Care - Non-surgical approach is a reasonable option for many patients, especially after the initial dislocation event. - In general, the younger the patients age and the greater their level of activity, the higher the risk of recurrent instability without surgery. For example, there is a greater than 90% chance in someone under the age of 20 years, 60% in someone between 20 and 40 years, and less than 10% in people over age 40. - The shoulder will be briefly immobilized with a sling and then be prescribed physical therapy to regain range of motion and then strengthen the muscles that stabilize the shoulder. - All high-risk activities, such as playing a sport, should be restricted until a full painless range of motion has been regained, the strength around the shoulder is back to normal, and Dr. Taylor has cleared you for the activity. Surgical Treatment - Surgical treatment is often needed in young and/or high demand patients who have had recurrent instability after attempted non-operative treatment. - In the majority of patients, the surgery is performed arthroscopically through small poke-holes in the skin. The damaged or torn capsule and labrum are repaired to the glenoid using small anchors that are placed into the bone. - In some patients, the surgery needs to be done through an open incision. This decision will be made based upon the extent of the injury and the magnitude of injury to the bone. - The time to return to activity varies by patient but is typically around 6 months. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Anti-Inflammatories - Samuel A. Taylor, MD Source: /conditions/anti-inflammatories/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Non-Steroidal Anti-Inflammatory Drugs (NSAID) are commonly used and prescribed for pain and inflammation control. - Common names for frequently used NSAIDs include Aspirin, Aleve, Advil, Motrin, Indocin, Naprosyn, Voltaren, Celebrix, and Mobic. - NSAIDs are frequently used to treat pain and inflammation associated with arthritis, bursitis, tendonitis, synovitis, and other inflammatory processes. - While many different medications comprise this drug class, they share some common gastrointestinal (GI) side effects: Heartburn - Upset stomach - Diarrhea - We recommend you take these medications after meals or with food to reduce the symptoms of GI upset. - NSAIDs also may increase the risk of bleeding. If you have a history of ulcers, you should not take these medications unless your primary care physicians approves. - For patients taking high blood pressure medication, you should continue to monitor your blood pressure more frequently while taking NSAIDs. Occasionally these medications can interact with your blood pressure medications and make them less effective. Let your primary care physician know. - If you have heart or kidney problems, you should contact your primary care doctor before starting NSAIDs. Your doctor may elect to draw additional blood tests, to check your kidney and electrolyte function. - Patients taking blood thinners, particularly Coumadin (Warfarin), usually are not given NSAID medications. - Some patients experience headaches from these medications and/or dizziness. - There are a number of much less common side effects that can involve the liver, kidneys, eyes, and bone marrow, but these usually occur when the medications are taken for prolonged periods of time. - IT IS IMPORTANT THAT IF YOU EXPERIENCE ANY SIDE EFFECTS OTHER THAN MILD GI UPSET, THAT YOU STOP TAKING THE MEDICATION AND CALL YOUR PHYSICIAN. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Biceps/SLAP - Samuel A. Taylor, MD Source: /conditions/bicepsslap/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - The long head of the biceps tendon (LHBT) is a well-recognized pain generator in the shoulder. - “Biceps tendinitis” is a catchall term that describes pain related to the LHBT stemming from a wide array of different lesions. Our recent research efforts have helped expand our understanding of this important disease process (1-6). - Biceps tendinits may occur independently or accompany other common shoulder ailments such as rotator cuff tears. - SLAP (Superior Labrum Anterior Posterior) are tears of the labrum where the LHBT attaches to the socket within the shoulder joint. Sometimes a SLAP tear is the source of pain, while other times the LHBT may be the culprit. - Biceps and SLAP are complex and evolving topics. Dr. Taylor will discuss with you in detail during your visit. Anatomy - Biceps come from Latin “bi” meaning “two” and “ceps” meaning “heads”, because this important muscle attaches to the front of the scapula by two different tendons (heads). - The short head is the most important for function and enables 90% of power. - The long head of the biceps (LHBT) is quite meager in comparison and contributes little to strength. - The glenoid labrum is a soft tissue structure that goes around the rim of the socket (glenoid) forming a bumper that helps to deepen the shallow socket. - The LHBT attaches to the labrum at the top (superior) part of the glenoid within the shoulder joint. - The LHBT then leaves the shoulder joint and travels along the front of the shoulder within the “bicipital tunnel” before it merges with the short head and becomes muscle. Risk Factors - Repetitive overhead activities - Fall onto outstretched arm - Traction to the arm - Shoulder conditions such as impingement and rotator cuff tears Symptoms - Pain in the front of the shoulder - Vague pain deep within the shoulder joint - Painful clicking within the shoulder - Sensation of a “dead arm” - Shoulder weakness and fatigue Diagnosis - Physical examination Areas that reproduce pain - Special tests to elicit pain - Range of motion - X-rays look at the bony structures of the shoulder for abnormalities - MRI scan may be useful in some cases - Ultrasound guided injections to the bicipital tunnel assist in diagnosis and treatment. Important Questions Does MRI always show biceps disease? No. Recently we compared MRI reports with surgical findings from a large group of patients undergoing shoulder surgery and found that, when present, lesions were often unrecognized by MRI (5). Does arthroscopy always show biceps disease? No. In our award winning study just published in Arthroscopy Journal, we showed that only 55% of the LHBT could actually be seen during routine shoulder surgery and that 45% of 277 patients with chronic biceps related pain had “hidden” lesions (1-2). Physical examination remains king? Dr. Stephen O’Brien devised a series of physical examination maneuvers called the 3-Pack that we have shown the most effective tool available for diagnosing biceps disease when present (6). What are nonsurgical treatment options? Biceps tendinitis is incredibly common, and fortunately the vast majority of people get better without needing surgery. Anti-inflammatory medications by mouth, changing your activities to avoid those things that produce pain, and structured physical therapy are the most useful first line treatment. What are surgical treatment options? In a small subset of patients surgery may provide the best opportunity for recovery of function and alleviation of pain. Treatment options include tenotomy (surgeon cuts the LHBT thereby relieving painful tension on the tendon) or tenodesis/transfer (surgeon cuts the LHBT and moves it to another location) (3-4). Treatment - Non Surgical – vast majority of patients get better without surgery Oral anti-inflammatory medication - Activity modification to avoid activities that cause symptoms - Physical therapy - Ultrasound guided steroid (cortisone injection) - Surgery is used in a small subset of patients with persistent symptoms. SLAP repair is performed in young patients without evidence of biceps tendinitis. - Biceps tenotomy (cutting the LHBT) is an effective treatment in patients over the age of 65 years. - Biceps tenodesis/transfer (cutting the LHBT and moving it to another location) is an effective treatment for younger/active patients with biceps tendinitis. References - Taylor SA, Khair MM, Gulotta L, Dy CJ, Baret NJ, Newman AM, Pearle AD, O’Brien SJ. Standard Diagnostic Glenohumeral Arthroscopy Fails to Fully Evaluate the Biceps-Labrum Complex. Arthroscopy. 2014 Dec 10 [Epub ahead of print]. Arthroscopy 2015 Feb; 31(2):215-24. - Taylor SA, Fabricant PD, Bansal M, Khair MM, McLawhorn A, DiCarlo E, Shorey M, O’Brien SJ. The Anatomy and Histology of the Bicipital Tunnel of the Shoulder. JSES. 2014 Nov 18 [Epub ahead of print]. - Taylor SA, Fabricant PD, Baret NJ, Newman AM, Sliva N, Shorey M, O’Brien SJ. Midterm Clinical Outcomes for Arthroscopic Subdeltoid Transfer of the Long Head of the Biceps Tendon to the Conjoint Tendon. 2014 Sep 17. [Epub ahead of print] - Kelly AM, Drakos MC, Fealy S, Taylor SA, O’Brien SJ. Arthroscopic Release of the Long Head of the Biceps Tendon: Functional Outcome and Clinical Results. Am J Sports Med. 2005 Feb;33(2):208-213. - Taylor SA, Newman AM, Baret NJ, Delos D, O’Brien SJ. MRI Fails to Fully Evaluate the Biceps-Labral Complex. [Manuscript Under Review: Arthroscopy 2015] - O’Brien SJ, Newman AM, Taylor SA, Dawson C, Gallagher KA, Bowers A, Nguyen J, Baret N. The Accurate Diagnosis of Biceps-Labral Complex Lesions with MRI and “3-Pack” Physical Examination: A Retrospective Analysis with Prospective Validation. Orthopaedic Journal of Sports Medicine 2013 1: DOI: 10.1177/2325967113S00018. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Cartilage Injury - Samuel A. Taylor, MD Source: /conditions/cartilage-injury/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General information - Cartilage is an important structure that covers the ends of bones allowing them to glide over each other with minimal fraction. - Cartilage injury can occur acutely as a result of a specific injury, chronic wear-and-tear, infection, or inflammatory arthritis such as rheumatoid arthritis. - Cartilage has limited potential for regrowth and is a subject of intense research Anatomy and Function - Articular cartilage lines the surfaces of the thighbone (femur), shinbone (tibia), and kneecap (patella). - Loss of cartilage predisposes to arthritis, a painful condition that results abnormal friction between the bones in the knee. Causes - Sports-related cartilage injury can be due to sudden injury or chronic wear and tear. - Abnormal alignment of the knee bones may predispose cartilage injury. - The type and extent of cartilage injury helps dictate treatment. Symptoms - Pain with walking or running (impact activities) - Swelling - Stiffness - Popping, clicking, locking, catching - Difficulty bending and straightening the knee Diagnosis - Physical examination is an important diagnostic tool. Dr. Taylor will evaluate your knee for alignment, areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures, arthritis, and other bony abnormalities. - MRI may be ordered to help aide in diagnosis and/or better evaluate some of the soft tissue structures in the knee that may have been injured as well Cartilage Injury Grading - The degree of cartilage injury is graded: - Grade 1: cartilage is softened or blistering - Grade 2: cartilage has visible tears/fraying - Grade 3: cartilage has an injury extending more than 50% of its thickness - Grade 4: cartilage has a full-thickness tear and the underlying bone is exposed Treatment Treatment of cartilage injury depends on the activity of the patient and type of injury - Non-Surgical Rest, ice, compression, and elevation (RICE) - Activity modification to avoid activities (high impact) that produce symptoms - NSAIDs (i.e. aspirin or ibuprofen) reduce pain and swelling - Physical therapy and rehabilitation can be used to strengthen the muscles around the knee to alleviate the forces transmitted to cartilage - Surgical Surgical treatment may be needed for young and/or high demand patients, those with specific findings on examination and imaging studies, and those who have had recurrent knee pain/swelling after prolonged non-operative treatment. - Surgery may be performed either arthroscopically through small poke-holes in the skin and a camera to allow maximal visualization of the knee’s internal structures, or through and open incision depending on the extent of injury. - Numerous approaches for treating cartilage injury have been developed (i.e. chondroplasty, microfracture, osteochondral allograft transplantation, osteochondral autograft transfer, etc.) Dr. Taylor will discuss the most appropriate surgical option for you during the visit. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Chronic Pain Management - Samuel A. Taylor, MD Source: /conditions/chronic-pain-management/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Your pain control is important to us, and we will make every effort to make you comfortable throughout the recovery process. Patients with chronic narcotic needs may be referred to a pain management specialist for their clinical expertise. A board certified specialist in pain management can optimize your pain control during both the day and at night using special medications and narcotic doses that Dr. Taylor does not prescribe. We can refer you to specialists here at HSS to help you with this. All patients are assessed on an individual basis. NON-OPERATIVE PATIENTS: - Taylor may give non-surgical patients who have chronic pain issues a narcotic prescription for one time only with no refills if clinically appropriate. - Patients who need continued or long-term narcotic medications for non-surgical problems may be referred to a non-surgeon physician or pain management specialist for further care. PRE-OPERATIVE PATIENTS: - Patients with complex chronic pain issues prior to surgery often have unique post-operative pain needs. - Please ask your current pain management specialist to fax us a letter indicating their recommendations for postoperative pain management. POST-OPERATIVE PATIENTS: - Most patients require less pain medication as they recover from surgery. Extended or increasing need for post-operative pain medications may warrant a referral to a pain management specialist. - A pain management specialist can assess needs and carefully formulate a comprehensive plan to help control pain, minimize medication side effects, and ensure a better recovery.   For a list of pain management specialists at Hospital for Special Surgery please visit the HSS website and select “find a physician” and then “pain management.” - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Clavicle Fracture - Samuel A. Taylor, MD Source: /conditions/clavicle-fracture/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The clavicle, which is also known as the collarbone, is one of the most commonly broken bones among people of all age groups. The majority of clavicle fractures are treated without surgery, but a subset of fracture patterns are best addressed surgically to maximize healing and chances of full return to desired activities.  General - Clavicle fractures make up 5-10% of all broken bones - Usually result from direct blow onto the shoulder - Healing takes longer if you smoke or have diabetes  Anatomy - Clavicle is located between the chest bone (sternum) and the shoulder blade (scapula). It essentially connects the arm to the rest of the body. - Many important nerves and blood vessels sit directly below the clavicle. - When the clavicle breaks it usually does so in the middle portion (80-85%), but can also break more toward the outside (lateral) or inside (medial).  Risk Factors - Young age - Contact sports  Symptoms - Pain - Inability to move your arm - Sagging shoulder (down and forward) - Painful click or sense that bones are rubbing against each other - Deformity or “bump” - Bruising, swelling, and/or tenderness over the collarbone  Diagnosis - Physical examination Areas that reproduce pain - Amount of deformity assessment of the overlying skin – cases where the bone threatening the skin causing “tenting” of it, or where the bone has pierced the skin require an operation. - Assessment of your nerves and blood vessels - X-rays look at the bony alignment and fracture pattern in the injured shoulder and also X-rays of the uninjured shoulder for comparison. - CT scan may be useful in some cases to evaluate the fracture pattern if Dr. Taylor is considering surgical care  Treatment - Non Surgical – The vast majority of patients get better without surgery. You will have to follow up with Dr. Taylor on several occasions so that he can check your X-rays and confirm that it is healing appropriately. In some cases the bone heals in an improper alignment, called a “malunion”, or does not heal at all, called a “nonunion” (1-5%). If this happens and its symptoms are troublesome surgery may be an option. Sling and Arm Support for a period of time to be determined by Dr. Taylor. - Pain Medication such as Tylenol may be taken as needed. Depending the injury, Dr. Taylor may suggest additional medications. - Physical Therapy is an important tool to help you strengthen and retrain the muscles that support the shoulder after the bone has healed sufficiently. - Follow-up visits: you will have to come back 2 weeks after your first visit for repeat X-rays to confirm fracture alignment and the start of healing. You will have to come back 6 weeks after your first visit again for X-rays. - Surgery is used in a small subset of patients with significant shortening and displacement, or those with persistent symptoms. For these patients, surgery results in improved functional outcome, less pain with overhead activities, faster healing, decreased rates of symptomatic nonunions and malunions, increased shoulder strength and endurance. Open Reduction Internal Fixation (ORIF) – In order to fix the collarbone, Dr. Taylor will make an incision in skin (open), put the bones back in their proper alignment (reduction), and hold the bones together using plates and screws (internal fixation). If the plate and screws causes symptoms in the future (~30% of patients), they can be removed after the bone has healed. If they do not bother you, they can stay in forever. - Physical therapy is an important part of the healing process. Specific exercises will help restore movement and strengthen your shoulder. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Coming Soon - Samuel A. Taylor, MD Source: /conditions/coming-soon/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Cortisone Injection - Samuel A. Taylor, MD Source: /conditions/cortisone-injection/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Orthopaedic doctors have used injectable corticosteroid mediations, commonly called “cortisone” since the 1950’s to help treat a variety of conditions.   It works by reducing the body’s inflammatory response to injury. - These are NOT performance enhancing “steroids” that have been on the news. They are powerful anti-inflammatories that are COMPLETELY LEGAL to use. - Corticosteroids are injected along with local anesthetics into bursae, around tendons and ligaments, and in joints. The local anesthetic in the injection works immediately and will last for several hours. If it improves your symptoms temporarily, it helps us know that the medicine was delivered to the correct location. - Corticosteroids are powerful anti-inflammatory medications that will become effective in 3-7 days and may last for several weeks to months (or help cure the condition altogether). - The effectiveness of steroid injections is not always predictable. Some people get long lasting pain relief while others do not. - For the first 24-48 hours, you should be protective of the joint or area of the body that was injected and rest. It is OK to go about you normal daily activities, but you should avoid running, working out, and playing sport during the first two days. - If the injection has been given around a nerve, you may find that the local anesthetic will cause numbness in the area of that nerve distribution. This should resolve over a period of several hours. - In some cases, there will be local bleeding from penetration of the needle and you may experience some pain for 12-24 hours. - If you are a diabetic patient, you should check your blood sugars more frequently for the first 48 hours after injection and adjust your medications as directed by your primary care doctor. A cortisone injection can elevate your blood glucose level due to absorption of the medication into the bloodstream. - Complications from the injection are very uncommon but may include: Sterile technique is used to minimize the risk of infection. - “Cortisone flare” is a reaction to the steroid itself. This reaction happens in about 2% of patients and may cause increased local redness and worse pain. It usually does not last long and resolves within 12-48 hours. - Fat atrophy where there is a thinning of the layer of fat just under the skin giving a small sunken appearance to the skin. - Whitening or lightening of the skin pigmentation at the site of injection in patients with darker skin tones. - In rare cases, steroid can weaken a tendon or ligament and lead to tendon rupture. - If you experience swelling, redness, heat, or pain at the injection site, an ice or cold pack may be helpful. A mild pain pill such as Tylenol or Advil may help as well. - If these symptoms persist for more than 24 hours, please contact our office. - It is important that you keep a record of how the injection made you feel so that you can communicate this to Dr. Taylor on your next visit. In particular we want to know how much improvement you had in your symptoms immediately after the injection and how long you had improvement (days, weeks, months.). This will help us direct your treatment in the future. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Distal Biceps/Triceps Injury - Samuel A. Taylor, MD Source: /conditions/distal-bicepstriceps-injury/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - Injuries to the distal (down at the elbow) biceps and triceps tendons are relatively rare. - Distal biceps and triceps tendon tears may be partial or complete. They most often occur in men age 30-60 years and usually in the dominant arm. Anatomy - The biceps tendon attaches the large biceps muscle in the front of your upper arm to the radius. The biceps is important for bending (flexing) and rotating the forearm palm up (supination). - The triceps tendon attaches the large triceps muscle in the back of your upper arm to the olecranon (tip of the ulna). It is important for straightening your elbow. Risk Factors - Age - Degeneration of tendon - Poor blood supply to tendon - Certain sports (competitive weightlifting, body building, football) - Systemic illness - Anabolic steroid use - Local steroid injection - Floroqunolone use Symptoms - Patients often hear a “pop” - Pain - Swelling - Bruising - Deformity or “balling up” of the muscle - Decreased strength Diagnosis - Physical examination is very important and looks to identify areas that reproduce pain, identify any tendon defects, test strength and range of motion. - X-rays look at the bony structures of the elbow. - MRI may be useful to get a better look at the soft tissue structures. Treatment - Non-Surgical May be an option for older or sedentary patients who are willing to accept decreased strength and function. - People with distal biceps injuries who choose non-surgical treatment can expect to lose 50% or supination (rotation of the forearm to palm up), 30% of elbow flexion (bending), and 15% of grip strength. - Non-operative treatment included activity modification to avoid activities to avoid those things that cause irritation, use of non-steroidal anti-inflammatory (NSAID) medication to reduce pain and inflammation, and physical therapy to strengthen the other muscles in the area. - Surgery is often recommended for patients with high-grade partial or complete tendon tears to give the best opportunity for acceptable strength and function. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Elbow Anatomy - Samuel A. Taylor, MD Source: /conditions/elbow-anatomy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The elbow allows you to bend and straighten your arm as well as rotate your forearm. Its function depends on complex interactions among bones, muscles, tendons, and ligaments. Furthermore, all of the nerves that control your hand pass by the elbow. Elbow problems commonly result in pain and lost motion. To better understand how the elbow works, you must understand some basic anatomy. The elbow is made up of three bones, Arthritis is the name of the conditions when articular cartilage becomes damaged. There are several important ligaments in the elbow. Ligaments are soft tissue structures that connect bones to bones. Bones - The elbow is essentially a hinge joint that also allows for rotation of the forearm - The elbow is made up of thee bones, the humerus (upper arm bone), the ulna (larger bone in the forearm on the opposite side of the thumb), and the radius (smaller bone of the forearm, on the same side as the thumb). Cartilage - The ends of the bone are covered by articular cartilage. - Cartilage is a slippery substance helps your elbow bones glide smoothly across each other as you bend, straighten, and rotate. - Cartilage protects the ends of the bone and acts as a shock absorber. - When injured, cartilage heals poorly and can result in pain, swelling, and progression of a condition known as arthritis Capsule - The elbow is encased in a sheath (capsule) that secretes a nutrient-rich fluid (synovial fluid). Synovial fluid is an important lubricant of the joint - When the lining of the elbow becomes inflamed and irritated it produces extra fluid that results in swelling and pain. Ligaments - Ligaments are soft tissue structures that connect bone to bone. - The ulnar collateral ligament (UCL) also known as the medial collateral ligament of the elbow is on the inside of the elbow and is particularly important for throwing athletes. The surgery to reconstruct this ligament if it is torn is called “Tommy John Surgery” named after the famous baseball player. - The lateral collateral ligament complex is on the outside of the elbow and also is important for stability. - The annular ligament wraps around the radial head and holds it tight against the ulna. Tendons - Tendons are soft tissue structures that attach muscle to bone. In the elbow there are several important tendons that deserve mention. - The biceps tendon attaches the large biceps muscle in the front of your upper arm to the radius. The biceps is important for bending (flexing) and rotating the forearm palm up (supination). - The triceps tendon attaches the large triceps muscle in the back of your upper arm to the olecranon (tip of the ulna). It is important for straightening your elbow. - The muscles that allow you to bend your wrist back (extend) attach to the outer bony prominence of the elbow (lateral epicondyle). Tennis elbow is irritation and damage to the insertion of these tendons. - The muscles that allow you to bend your wrist down (flex) attach on the inner bony prominence of the elbow (medial epicondyle). Golfer’s elbow is irritation and damage to the insertion of these tendons. Nerves - All of the nerves that control movement and sensation to your hand pass by the elbow and thus are vulnerable to injury. Numbness, tingling, and burning sensation in the forearm and/or hand may be a sign of injury to a nerve. - The ulnar nerve also called the “funny bone” passes just behind the medial epicondyle. The Median nerve crosses the front of the elbow. The radial nerve passes around the outside of the elbow. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Elbow Animations - Samuel A. Taylor, MD Source: /conditions/elbow-animations/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage UCL (Tommy John) - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Elbow Arthroscopy - Samuel A. Taylor, MD Source: /conditions/elbow-arthroscopy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joint.” During elbow arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your elbow joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, Dr. Taylor can use very small incisions (cuts), rather than the larger incision needed for open surgery. This results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities. Elbow arthroscopy has been performed since the 1980s. It has made diagnosis, treatment, and recovery from surgery easier and faster than was once thought possible. Improvements to elbow arthroscopy occur every year as new instruments and techniques are developed. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Epicondylitis (Tennis/Golfer’s Elbow) - Samuel A. Taylor, MD Source: /conditions/epicondylitis-tennis-elbowgolfers-elbow/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - Lateral epicondylitis also known as tennis elbow is the most common cause of elbow pain. As one may expect, given its name, lateral epicondylitis is quite common among tennis players (50% lifetime risk), but may occur in anyone who performs repetitive wrist extension. Lateral epicondylitis is particularly common among painters, plumbers, carpenters, butchers, mechanics, and chefs, but can occur in anyone. - Medial epicondylits also known as golfer’s elbow is far less common than lateral epicondylitis. It affects men and women equally and most commonly occurs in the dominant arm. Anatomy - The muscles that allow you to bend your wrist back (extend) attach to the outer bony prominence of the elbow (lateral epicondyle). Tennis elbow is irritation and damage to the insertion of these extensor tendons. The tendon most commonly involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB). The ECRB muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain. - The muscles that allow you to bend your wrist down (flex) attach on the inner bony prominence of the elbow (medial epicondyle). Golfer’s elbow is irritation and damage to the insertion of these tendons. Risk Factors - Overuse - Repetitive activities - Age 30-50 years Symptoms - Tennis Elbow Pain over the outside of the elbow - Pain and weakness with wrist extension and grip - Golfer’s Elbow Pain over the inside of the elbow - Pain and weakness with wrist flexion and grip - Inflammation of the ulnar nerve is common Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Specific tests to reproduce pain - X-rays look at the bony structures of the elbow for abnormalities - MRI may be useful to get a better look at the soft tissue structures if symptoms fail to resolve with initial conservative care or if the diagnosis is questionable. - EMG is a nerve test that may be performed if Dr. Taylor suspects nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of medial and lateral epicondylitis. This is more common for Golfer’s elbow. Treatment - Non Surgical – vast majority of patients (95% of tennis elbow and 80% of golfer’s elbow) get better without surgery Rest and Activity Modification to change your activities to avoid those things that cause irritation. - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation in the short term to allow more effective physical therapy. - Equipment Check if you participate in racquet sports, Dr. Taylor may encourage you to have your equipment checked for proper fit. - Counterforce Brace is a strap that goes around the forearm and may be helpful to relieve symptoms. - Physical Therapy is an important tool to help stretch the injured muscle/tendon. Specific strengthen exercises are used to improve symptoms and prevent recurrence. - Platelet-Rich-Plasma (PRP) Injection has been shown to help lateral epicondylitis if initial non-operative treatments (above) have failed. - Cortisone Injection is NOT recommended by Dr. Taylor for this problem. - Surgery is used in a small subset of patients with persistent symptoms (>6 months). The diseased tissue is removed and healthy tissue is repaired to bone. - Physical therapy is an important part of recovery after surgery. - Typical recovery time is 4-6 months for full return to activities. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Frozen Shoulder - Samuel A. Taylor, MD Source: /conditions/frozen-shoulder-2/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General Information - “Frozen shoulder,” also known as “adhesive capsulitis” is a slowly progressing, painful loss of shoulder motion due to inflammation and thickening of the capsule that surrounds the joint - Occurs in 2% of the general population - Most commonly occurs in women between the ages of 40 and 60 - Three major categories: Primary Idiopathic Frozen Shoulder– which means it just happens spontaneously without a specific reason - Secondary Frozen Shoulder – which means that it occurs in response to another problem in the shoulder - Post Traumatic – which means that it develops after an acute injury to the shoulder or sometimes following shoulder surgery - Frozen shoulder is a very frustrating condition for both patient and surgeon because it often takes a long time to resolve Anatomy and Function - The shoulder is a ball-and-socket joint in which the ball-shaped head of the humerus (arm bone) interfaces with the glenoid (socket) - Encasing this ball-and-socket joint is a capsule that helps to stabilize the ball’s position in the socket - Within the joint capsule, a nutrient-rich fluid (synovial fluid) bathes the joint and capsule to lubricate the shoulder for increased range of motion - The lining that secretes the synovial fluid can become inflamed, which causes the capsule to react and thicken - This inflammatory reaction decreases the shoulder’s range of motion causing it to become “frozen” and painful Time Course - Frozen Shoulder occurs in three distinct phases Freezing: gradual increase of pain and decrease of shoulder motion that can last up to 9 months - Frozen: pain is much decreased, but daily activities become very difficult range of motion is at its worst. This can last up to 6 months - Thawing: shoulder motion improves slowly over a period that can last up to 24 months - Early recognition of the problem by patient and doctor helps get treatment started ASAP and can reduce the time course of the condition Risk Factors - While the cause of Frozen Shoulder is not well understood, there exist associated factors Personal history of frozen shoulder. 40-50% of patients who develop frozen shoulder on one side, will get a frozen shoulder on the other side at some point - Diabetes is a major risk factor. 10-20% of patients with diabetes will develop a frozen shoulder at some point during their lifetime - Other general risk factors include thyroid disease, high cholesterol, COPD, osteopenia, Dupuytren’s disease, and coronary artery disease - Shoulder immobilization because of another injury to the shoulder or same arm may increase the risk of a frozen shoulder - Some injuries to the shoulder itself can start the process of inflammation leading to a frozen shoulder Symptoms - Pain and stiffness are the most common symptoms - Pain can be extremely severe and debilitating, especially during the early stage - Dull, aching sensation in the shoulder - Night pain - Decreased range of motion in all planes of motion Diagnosis - Physical Examination Areas that reproduce pain - Careful assessment and documentation of range of motion - X-rays and MRI Taylor may order radiographic tests to rule out other conditions such as arthritis, fracture, or rotator cuff tear Treatment - The goal in treatment is to eliminate pain, restore range of motion, and regain strength - Nonsurgical – 90% of Frozen Shoulder patients can recover using the below conservative measures: Non-steroidal anti-inflammatory (NSAID) medication by mouth can control your pain - Steroid injections directly into the shoulder under ultrasound guidance are a powerful anti-inflammatory that can help reduce the pain and allow better progress with physical therapy - Physical Therapy is an important tool to help you improve range of motion with specific exercises and stretches - Surgical – The decision to operate is patient specific and may be discussed with Dr. Taylor only if conservative measures have failed. Dr. Taylor will review with you the options, which may include: Shoulder arthroscopy with manipulation under anesthesia cuts bands of thickened capsule and then forcefully moves the shoulder in a controlled fashion while you are under anesthesia to free the shoulder from its tightened restrictions to allow for normal range of motion - Postoperative physical therapy is critical to maintaining the range of motion that we regain from surgical treatment in the OR - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Impingement - Samuel A. Taylor, MD Source: /conditions/impingement/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage There is a “bony and ligament archway” in the shoulder that is comprised of the top of the arm bone and the end of the shoulder blade. The rotator cuff muscles are located in and travel below this archway when the arm is raised. Certain conditions can cause the archway to become smaller and increase the chance of compressing or irritating the rotator cuff. This can be caused by bony “spurs” that may form on the acromion or humeral head, or from dysfunction of the rotator cuff. These can irritate the bursa and rotator cuff further, producing more pain and dysfunction. General Information - Impingement, subacromial bursitis, and rotator cuff tendinitis are common causes of shoulder pain Anatomy and Function - The shoulder consists of a large ball (head of the humerus) and a shallow socket (glenoid) and is the most mobile joint in the human body. - The rotator cuff is a series of four tendons that attach muscle to bone at the top of the arm bone (humerus) and work together to center the ball in the socket and stabilize the shoulder joint. - There is normally a lubricating bura sac that sits above the rotator cuff and below the top bone in the shoulder (acromion) that helps the rotator cuff glide freely. - The acromion is the bone on the top of your shoulder. In some patients a bone spur develops that can irritate and damage the rotator cuff below. - The long head of the biceps tendon is a nearby structure that attaches deep within your shoulder and runs down the front of the shoulder. Injury - Subacromial bursitis occurs when the normally thin smooth bursa becomes irritated and inflamed. It has many nerve fibers and thus can be quite painful. - The rotator cuff sits directly below the subacromial bursa and can also become inflamed and irritated in a condition called rotator cuff tendinitis. - Impingement occurs when you raise your arm to shoulder height and the space between the acromion and the rotator cuff narrows. The acromion can rub against, or “impinge” on the bursa and tendons of the rotator cuff resulting in pain and dysfunction. - Impingement is a vicious circle whereby the subacromial bursa and underlying rotator cuff become irritated producing significant pain that results in dysfunction. As a result, the ball rotates abnormally within the socket during shoulder motion, which in turn leads to rubbing on the undersurface of the acromion, producing even more irritation, pain, and dysfunction. Interventions (listed below) are aimed at breaking this terrible cycle by reducing pain and allowing physical therapy to help restore normal motion and strength. - Irritation of the long head of the biceps tendon, called biceps tendinitis, may occur at the same time because of its close proximity to the rotator cuff, subacromial bursa, and acromion. - In some cases, where this process continues for long periods of time, it can lead to abrasion and tearing of the rotator cuff. Risk Factors - Repetitive lifting and overhead movements such as throwing, weight training, daily chores, and manual labor can produce overuse injury. - Sometimes this results from an acute injury, other times it happens without any trauma. - Bone spurs on the underside of the acromion bone can cause abnormal rubbing when you lift your arm and lead to rotator cuff injury. Symptoms - Most common symptom is pain - Sharp shoulder pain, particularly with overhead activities - Pain at night that wake you from sleep - Pain is not the same for everyone. Sometimes it is felt deep within the shoulder, other times people feel pain over the outside of the shoulder, or even extending down the biceps muscle to the elbow. - Pain with every day activities like scratching your head, putting on a shirt, laying down on the affected side, and carrying a moderately light object - An overall sense of weakness and pain that causes you to keep your shoulder inactive - “Crepitus” or crackling sensation when you move your shoulder in certain positions results from thickened and inflamed bursa. Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Rotator cuff strength - Positions and movements that reproduce pain (impingement tests) - X-rays help determine if you have any arthritis in the shoulder and if there are any bone spurs. X-rays show the doctor bones, but do not show soft tissues. - In some patients, Dr. Taylor may order an MRI (magnetic resonance imaging) to get a better look at the soft tissue anatomy, such as the rotator cuff, to determine the extent of injury and help guide management. Treatment - The goal of treatment is to reduce pain and regain function, by breaking the vicious impingement cycle. - Non-Surgical – Most patients improve with non-surgical treatments aimed at reducing the painful inflammation associated with this condition. Rest – if it hurts, don’t do it - Activity Modification, or change your activities to avoid those things that cause irritation - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation around the rotator cuff - Injection of steroid (cortisone) medication into the bursa sac above the rotator cuff to help reduce the inflammation and allow you to more effectively work with physical therapy - Physical therapy is an important tool to help you strengthen and retrain the muscles of the rotator cuff to work better together. - Surgery may be an effective treatment for a small subset of patients who do not respond appropriately to the aforementioned conservative care. Arthroscopic subacromial decompression is performed through the use of specialized camera and small instruments through a series of small poke-holes in the skin around your shoulder. The chronically thickened and irritated subacromial bursa is removed with a shaving device. If a bone spur is present on the undersurface of the acromion it will be removed as well. The goal is to remove painful bursa and create more room for the rotator cuff to move below the acromion during shoulder motion. - Biceps tenodesis is the removal of a chronically injured biceps tendon from the shoulder joint and sewing it to another location. This procedure is only performed if the biceps is contribution to your symptoms. - AC joint resection is not routinely performed but may be done in patients who have significant AC (acromioclavicular) joint arthritis that is contributing to their symptoms. In this surgery, a small portion of the acromion and end of the collarbone are removed with a shaver so that they do not rub against each other and cause pain. - Physical therapy after surgery is critical to your recovery. Surgery removes the structural causes of the problem, but does not restore the strength and coordination of the muscles and tendons that provide stability and function to the shoulder. Adherence to a structured physical therapy program after surgery is essential. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Internship Program - Samuel A. Taylor, MD Source: /conditions/internship-program/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Knee Anatomy - Samuel A. Taylor, MD Source: /conditions/knee-anatomy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The knee is the largest joint in the body and one of the most easily injured. It is made of four main components: bones, cartilage, ligaments, and tendons. You knee is made up of many important structures (below) any of which can be injured. The most common knee injuries include fractures, dislocations, and sprains and tears of the soft tissues. Pain and swelling are the most common signs of knee injury. In addition, some injuries can cause the knee to feel like something is catching, locking, or giving way. Bones - The knee is a hinge joint made up of three bones: thighbone (femur), leg bone (tibia), and knee cap (patella) - The tibiofemoral joint is made up of the interface between the end of the thighbone (distal femur) and the closer end of the leg bone (proximal tibia) - The patellofemoral joint is the interface between the underside of the knee cap (patella) and the trough (trochlea) on the far end of the thighbone (distal femur) Cartilage - The ends of the femur and tibia, and the underside of the patella are covered by articular cartilage. - Cartilage is a slippery substance helps your knee bones glide smoothly across each other as you bend and straighten your knee. - Cartilage protects the ends of the bone. - When injured, cartilage heals poorly and can result in pain, swelling, and progression of a condition known as arthritis Capsule - The knee is encased in a sheath (capsule) that secretes a nutrient-rich fluid (synovial fluid) - Synovial fluid is an important lubricant of the joint - When the lining of the knee becomes inflamed and irritated it produces extra fluid that results in swelling of the knee joint. Meniscus - Each knee has two C-shaped structures sandwiched between the far end of the thighbone and closer end of the leg bone called menisci (medial and lateral meniscus) - Menisci look and act somewhat like bumpers on a pool table. - They serve as natural “shock absorbers” that cushion high-impact forces and protect from bone-on-bone grinding. ACL and PCL - ACL stands for “anterior cruciate ligament” and functions to keep the shin bone (tibia) from sliding too far forward (anterior) relative to the thigh bone (femur). - When the ACL is torn some patients experience a sense of instability or abnormal movement within the knee. The ACL does not heal very well when injured and often (but not always) requires surgery if its torn. - PCL stands for “posterior cruciate ligament” and functions to keep the tibia from sliding too far backward (posterior). The PCL has great healing potential and the majority of people with PCL injuries never need surgery. MCL and LCL - The knee has two ligaments found on the sides of your knee called collateral ligaments. - The MCL stands for “medial collateral ligament” is a thick and powerful ligament on the inside of the knee that connects the femur and tibia. - The LCL stands for “lateral collateral ligament” and is an important stabilizing structure on the outside of the knee that connects the femur with the fibula. Quadriceps Tendon and Patellar Ligament - The thigh muscles (quadriceps) come together to form a tendon (quadriceps tendon) that attaches to the surface of the kneecap (patella). - The patellar tendon (actually a ligament) originates on the surface of the knee cap (patella and connects with a bony ridge (tibial tubercle) on the front of the tibia. - The quadriceps tendon and patellar tendon work in concert provide the knee its mechanical leverage to bend and straighten. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Knee Animations - Samuel A. Taylor, MD Source: /conditions/knee-animations/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Diagnostic Arthroscopy - ACL Reconstruction - Partial Meniscectomy - Meniscal Repair - Microfracture - High Tibial Osteotomy - Patella Chondroplasty - Removal Plica - Removal Loose Body - Synovectomy - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Knee Arthritis - Samuel A. Taylor, MD Source: /conditions/knee-arthritis/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Arthritis means joint inflammation. Osteoarthritis is one of the most common causes of knee pain. Often times, the onset of pain is insidious and you may not recall a particular injury. Osteoarthritis is due to the breakdown or wear of the cartilage surfaces of the joint. Cartilage acts as a cushion and a slippery surface that allows one surface to move against another without rubbing or causing irritation. Cartilage wear is not always detectible by X-rays during its early stages. As it progresses, however, the space between the ends of the bone becomes narrower and we can see other signs of abnormal rubbing such as bone spurs. The knee is divided into three compartments: - Medial compartment (inside of knee) - Lateral compartment (outside of knee) - Patellofemoral joint (area under the kneecap) A patient can have arthritis involving any one or a combination of all three compartments. Osteoarthritis causes pain, stiffness and swelling of the knee. Common complaints may include pain with ambulating, difficulty climbing and descending stairs and early morning stiffness or stiffness after sitting for long periods of time. As arthritis progresses, a patient may experience periodic swelling and pain. Ultimately, the best solution for some patients is total or partial knee arthroplasty (replacement). Dr. Taylor does not perform this procedure, but can refer you to a trusted colleague who does if it is appropriate. Early osteoarthritis is generally treated without surgery. Below are some of the non-surgical treatments that can provide symptomatic relief. Weight loss can be a very powerful treatment. The knee sees 4-5 times the body’s weight when ascending and descending stairs and up to 7 times the body’s weight when jumping. Losing 20lbs, therefore, can tremendously reduce the stress on your knee. Activity modification to avoid things that excessively load the knee such as climbing stairs, squatting, lunging, knee extension, and running helps reduce the stresses on your knee. Low impact activities, such as bicycling, swimming, elliptical trainer and Nordic track are much better tolerated by a knee with arthritis. Ice/Heat treatments: Heat treatments before activities can be beneficial. Ice treatments after activities help control pain and swelling. Medications: Prescription Anti-Inflammatory Medications: Naproxen, Relafen, Celebrex, Mobic and Voltaren are prescription strength non-steroidal anti-inflammatories (NSAID’s). These should be taken with food. Over-the-Counter Anti-Inflammatory Medications: Advil, Ibuprofen, Aleve should also be taken with food. If you are taking prescription NSAIDs, you should not take these medications at the same time. Supplement Medications: - Glucosamine-chondroitin – Studies have suggested these all-natural supplements may help relieve arthritis pain by replenishing chemicals that are the building blocks for cartilage growth. The benefit is slight and variable from patient to patient. Dr. Taylor would suggest brands Cosamin DS or Osteo Bi-Flex, available in nutrition stores. However, the cost may be high and the benefit small. Recommended dosing is glucosamine 1500mg/day with or without chondroitin 1200mg/day. If no benefit is realized by 8 weeks, it is unlikely that any will occur. - Turmeric Curcumin – This is an Indian spice with an herbal anti-inflammatory effect. Some patients respond dramatically well to this. You can get this at a nutrition store and try it for one month. - Wobenzym – This is an enzymatic supplement that has an anti-inflammatory property. Again, you can try this for one month and see what type of pain relief you get from this supplement. Injections (Cortisone Type): Corticosteroid injections: Steroid injections directly into the joint, reducing inflammation and pain. This is only recommended every 3-4 months. These are very effective, but generally used after the wear is advanced. Injections (Supplemental Type): Euflexxa, Hyalgan, Synvisc, Orthovisc and Supartz are natural lubricants injected directly into the joint. This can be given as one injection or as a series of three injections, one time per week for three weeks. Most insurance companies will cover these injections. It is important to note that 1/3 of patients see significant long-term relief, 1/3 see moderate relief, and 1/3 see no benefit at all. Braces: Unloader braces help to unload a specific compartment, which may help to slow the progression. These are expensive and more practical for use in low demand sports rather than everyday life. Custom fit braces are most comfortable and seem to work better, but the financial cost is greater. These braces are not very effective in patients with bigger (thicker) legs. Bariatric Surgery: For many patients that are very overweight, bariatric surgery is a reasonable and excellent option. This surgery has become increasingly effective for weight loss with a very good safety profile. If you were able to lose up to 100 pounds, then this greatly improves knee pain and delays the need for knee replacement surgery. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Knee Arthroscopy - Samuel A. Taylor, MD Source: /conditions/knee-arthroscopy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Arthroscopy of the knee is a surgical procedure in which a small fiberoptic camera (arthroscope) is inserted into the knee joint through a small incision to see the inside of the knee joint. This enables Dr. Taylor to visualize the inside of the joint on a monitor in the operating room. Other small incisions are made through which specialized instruments are inserted to allow him to perform the procedure in the most minimally invasive way possible. During the procedure, fluid is inserted into the knee to distend the joint and allow for visualization. The knee is examined for damaged tissue. Arthroscopy is used for many procedures of the knee. The benefits of arthroscopy include smaller incisions, faster healing, more rapid recover, less scaring, and minimal blood loss. Patients commonly go home the same day of surgery. Knee Arthroscopy - Knee arthroscopy can take as little as 30 minutes for some procedures and is done on an outpatient basis, meaning you will be in and out of the hospital in the same day. - Common reasons for arthroscopy include tears to the structures within the knee (torn meniscus, torn cartilage, loose fragments of cartilage or bone, inflamed synovial tissue, torn ACL, etc.). - Like any surgical procedure, pre-operative tests may be ordered to ensure you are healthy for arthroscopy. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## MCL Injury - Samuel A. Taylor, MD Source: /conditions/mcl-injury/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Posterior Cruciate Ligament (PCL) injuries commonly result from a direct impact to the front of the shinbone (tibia) such as falling on a bent knee or striking the shin against a dashboard during a car accident. PCL injuries may also occur with hyperextension of the knee. While PCL injury is relatively common (5-20% of all knee ligament injuries), the majority of PCL injuries are successfully treated without surgery. Anatomy and Function - The PCL is one of the two ligaments in the center of the knee. One end is attached to the femur (thighbone) and the other end is attached to the tibia (shinbone). This ligament helps hold the femur and tibia in proper position relative to each other. - The PCL plays an important role in providing stability to the knee joint. The role of the PCL is to prevent the tibia from moving abnormally backward. - Unlike the ACL, the PCL has great healing potential. Classification - PCL injury may be isolated or occur in combination with other knee injuries. - Grading of injury is based upon physical examination Grade I: partial tear - Grade II: complete PCL tear - Grade III: complete PCL tear with associated ligamentous injuries Symptoms - Pain - Swelling - Difficulty walking - Feeling of “giving out” Diagnosis - Physical examination is the most important diagnostic tool. Dr. Taylor will evaluate your knee for areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures and other bony abnormalities. - MRI may be ordered to confirm a diagnosis and/or better evaluate some of the soft tissue structures in the knee that may have been injured as well Treatment Treatment of PCL injuries depends on the extent of injury and your needs. - Non-Surgical PCL often heals well without surgery - Rest, Ice, Compression, and Elevation (RICE) - Knee brace (some patients) - Physical Therapy focused on core and quadriceps muscle strengthening - Expected return to sport 2-8 weeks depending on injury/patient - Surgical Surgical treatment may be recommended for patients who sustained an injury to several ligaments in the knee, specific tear patterns, and persistent symptoms of pain and/or instability after prolonged non-operative treatment. - In some instances, Dr. Taylor may repair the torn PCL. This is not always possible, in which case he would reconstruct it, which means that he replaces the PCL with tissue from another source. - Physical therapy after surgery is critical. Complete recover may take 6-12 months. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Meniscus Tear - Samuel A. Taylor, MD Source: /conditions/meniscus-tear/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports are at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to the meniscus. General information - Meniscal tears are among the most common knee injuries. - Many people have meniscus tears and don’t know they do. - The majority of meniscal tears in older patients will get better without surgery. - Knee arthroscopy to remove torn meniscus may make symptoms worse if there is significant arthritic change (cartilage wear). Anatomy and Function - Each knee has two C-shaped structures sandwiched between the femur (thighbone) and tibia (shinbone) called menisci. One of these menisci is on the inside of the knee (medial) and the other is on the outside (lateral) part of the knee. - Menisci look and act somewhat like bumpers on a pool table and are natural “shock absorbers” that cushion high-impact forces and protect from bone-on-bone grinding. - The outside one-third of the meniscus has a rich blood supply. A tear in this “red” zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear. - The inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this “white” zone cannot heal. These complex tears are often in thin, poor quality tissue. Because “white” zone tears do not heal the surgical treatment is to trim away what is torn. - Meniscus tears occur in a number of different patterns and locations. Common tear patterns include longitudinal, parrot-beak, flap, bucket handle, and complex. Causes - Meniscal tears can occur suddenly during high-demand activities and involve squatting, twisting the knee, or a direct blow to the knee. - Meniscal tears that develop over time, called “degenerative meniscal tears” usually occur in patients over 40 years old and those with with pre-existing articular cartilage wear (arthritis). Over time our meniscal tissue becomes more brittle and prone to tears. Sometimes it only takes very minor trauma (getting up from a chair or a gentle twist of the knee) to cause a tear. Symptoms - Pain - Stiffness - Swelling - Catching or locking within the knee - Sense of instability or giving way Diagnosis - Physical examination is an important diagnostic tool. Dr. Taylor will evaluate your knee for alignment, areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures, arthritis, and other bony abnormalities. - MRI may be ordered to help aide in diagnosis and/or better evaluate some of the soft tissue structures in the knee that may have been injured as well Treatment - Non-Surgical Rest, ice, Compression, and Elevation (RICE) - Activity modification to avoid activities (high impact) that produce symptoms - Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as aspirin, ibuprofen, etc. may be helpful for reducing pain and swelling - Steroid (cortisone) injection is a powerful anti-inflammatory medication that may be appropriate for some patients to calm down the acute inflammation. - Physical therapy and rehabilitation can be used to strengthen the muscles around the knee to alleviate the forces transmitted to cartilage. - Surgical Surgical treatment is typically reserved for patients with particular meniscal tear patterns, high demand patients, and those who have had recurrent knee pain and mechanical symptoms after attempted non-operative treatment. - The surgery is usually performed arthroscopically through small poke-holes in the skin and a camera to allow maximal visualization of the knee’s internal structures. Depending on the type and location of injury, the meniscus will be either repaired or removed. Dr. Taylor will discuss options during the office visit. Partial Meniscectomy – is removal or trimming away of the torn/damaged part of the meniscus so that it does continually irritate the knee. This procedure is performed when the meniscus is more common than repair. Because the torn tissue is removed, full recovery can be expected relatively quickly. - Meniscal Repair – is performed when the location and pattern of tear are favorable for healing. Repairable tears are fixed by by suturing (stitching) the torn pieces back together. This represents the minority of meniscal tears. Because the meniscus must heal back together, recovery time for repair is much longer than from a meniscectomy. - The type and duration of rehabilitation following surgery depends on whether the meniscal tear was removed or repaired. Dr. Taylor will review expectations during your office visit. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Multidirectional Instability - Samuel A. Taylor, MD Source: /conditions/multidirectional-instability/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - The shoulder is the body’s most mobile joint. - The same anatomy that gives the shoulder its amazing mobility and range of motion also makes it vulnerable to dislocating or becoming unstable, a condition called instability. - Instability is a catch-all term that means the ball does not stay in the socket the way that it should giving you a sense of abnormal looseness or the sensation that it is going to come out when you put your arm into certain positions. - There are several different types of shoulder instability such as: By the direction of instability – anterior (front), posterior (back), or multidirectional (MDI). - By the way it happened – traumatic (from a specific injury) or atraumatic (without a specific injury). - MDI is typically atraumatic and often occurs in both shoulders. It usually responds well to non-surgical treatment   Anatomy - The shoulder is a ball-in-socket joint, but the socket (glenoid) is very shallow making the shoulder look like a golf ball on a tee. - The glenoid labrum is a soft tissue structure that goes around the rim of the glenoid, forming a bumper that helps to deepen the shallow socket. - The labrum also serves as an attachment site for the capsule that surrounds the shoulder and the glenohumeral ligaments that help keep the ball in the socket. - The rotator cuff is a series of four tendons that work together to stabilize the shoulder, keeping the ball appropriately positioned in the socket during shoulder motion.   Injury & Risk Factors - Overuse - Generalized laxity - Collagen disorders   Signs & Symptoms - Pain - Instability - Weakness - Crepitus - Instability during sleep Diagnosis - Physical examination Range of motion - Rotator cuff strength - Positions and movements that reproduce pain - Assessment of general ligamentous laxity (“double jointed”) - X-rays help determine that the shoulder is in place (reduced) and helps us see if there are any injuries to the bone. X-rays do not show soft tissues. - MRI (magnetic resonance imaging) is a very useful tool that lets Dr. Taylor look at the soft tissue anatomy of your shoulder to help determine the extent of your injury and the best treatment strategy.   Treatment Non-operative care focused on strengthening the network of muscles that control the shoulder and shoulder blade are the most effective treatment. The vast majority of patients will respond to this type of care, but the physical therapy and rehabilitation process can take many months. Non-Surgical Care - Activity modification – avoid activities and movements that cause symptoms - Non-surgical approach is a reasonable option for many patients. - Structured physical therapy protocol to strengthen the muscles that stabilize the shoulder Surgical Treatment - Surgical treatment is reserved for patients who have failed extensive conservative measures. Efforts are made to tighten the ligaments and capsule within the shoulder to improve stability. The surgery may be performed either arthroscopically or through and open incision based upon individual factors. Dr. Taylor will discuss your case with you in detail. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Patellofemoral Pain - Samuel A. Taylor, MD Source: /conditions/patellofemoral-syndrome/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Patellofemoral pain syndrome is a broad term used to describe pain in the front (anterior) part of the knee. It is one of the most common complaints seen by physicians very common among young women. Patellofemoral pain syndrome results from a combination of structural factors and muscular imbalance. While the causes are many, patients often see dramatic improvement with oral anti-inflammatory medication and a structured physical therapy program. Anatomy and Function - The knee is the largest joint in the body and is made up of three bones: thighbone (femur), kneecap (patella), and shinbone (tibia) all of which need to move in a coordinated fashion normally. - The kneecap (patella) rests in a groove of the thighbone (femur) called the trochlea. As you bend and straighten your knee the patella slides up and down within the groove. - Both the underside of the patella and the trochlea are normally covered by thick cartilage that allows them to slip and slide past each other without much friction. - Many muscles in your CORE, butt, hip, and thigh have to be strong and coordinate their actions to ensure that the patella tracks in the trochlea as it should. When there is muscle imbalance, the patella no longer tracks within the trochlea as it shoulder leading to abnormal rubbing and pressure on the cartilage and pain. - Synovium is a tissue that lines the knee, secretes joint fluid (synovial fluid) that lubricates the knee. - Physical therapy is focused on addressing deficits in strength and coordination. Causes - Patellofemoral pain syndrome may result from numerous factors: Misalignment of the lower extremity that result in a kneecap that shifts too far toward the outside or inside of the knee, or rides too high in the trochlea. - Flattened trochlea - Laxity of soft tissue constraints - Muscular imbalance - Chondromalacia (softening/breakdown of cartilage on underside of patella) Symptoms - Pain during exercise (squatting, running, jumping, etc.) - Pain with stairs (going down often worse than going up) - Pain related to change in activity level, intensity, playing surface, or equipment. - Popping or crackling sounds in the knees when climbing stairs or after prolonged sitting. Diagnosis - Physical examination is the most important diagnostic tool. Dr. Taylor will evaluate your knee for areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures and other bony abnormalities. - MRI may be ordered for some patients with particularly concerning findings on examination. Treatment Treatment of Patellofemoral Syndrome can almost always be successfully managed without surgery. - Non-Surgical Rest, Ice, Compression, and Elevation (RICE) - Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as aspirin, naproxen, or ibuprofen are helpful to reduce pain and swelling - Orthotic shoe inserts can help align and stabilize your foot and ankle, taking stress off of your lower leg. These can be custom made or off the shelf. - Steroid (cortisone) injection may be appropriate in some patients - Viscosupplementation (lubricating shots) may be appropriate for some patients - Physical therapy focused on CORE, hip, thigh strengthening, flexibility, and coordination is essential for recovery. - Surgical Surgical treatment is rarely needed but can range from chondroplasty, which is simple removal of unstable cartilage flaps, to advanced cartilage restoration procedures, and bony and soft tissue realignment procedures. - Rehabilitation following surgery will be necessary. - Taylor will discuss options during your visit. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## PCL Injury - Samuel A. Taylor, MD Source: /conditions/pcl-injury/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Posterior Cruciate Ligament (PCL) injuries commonly result from a direct impact to the front of the shinbone (tibia) such as falling on a bent knee or striking the shin against a dashboard during a car accident. PCL injuries may also occur with hyperextension of the knee. While PCL injury is relatively common (5-20% of all knee ligament injuries), the majority of PCL injuries are successfully treated without surgery. Anatomy and Function - The PCL is one of the two ligaments in the center of the knee. One end is attached to the femur (thighbone) and the other end is attached to the tibia (shinbone). This ligament helps hold the femur and tibia in proper position relative to each other. - The PCL plays an important role in providing stability to the knee joint. The role of the PCL is to prevent the tibia from moving abnormally backward. - Unlike the ACL, the PCL has great healing potential. Classification - PCL injury may be isolated or occur in combination with other knee injuries. - Grading of injury is based upon physical examination Grade I: partial tear - Grade II: complete PCL tear - Grade III: complete PCL tear with associated ligamentous injuries Symptoms - Pain - Swelling - Difficulty walking - Feeling of “giving out” Diagnosis - Physical examination is the most important diagnostic tool. Dr. Taylor will evaluate your knee for areas of tenderness, amount of swelling, range of motion, evidence of abnormal laxity, and for co-existing injury of other structures in and around the knee - X-ray is important to look for fractures and other bony abnormalities. - MRI may be ordered to confirm a diagnosis and/or better evaluate some of the soft tissue structures in the knee that may have been injured as well Treatment Treatment of PCL injuries depends on the extent of injury and your needs. - Non-Surgical PCL often heals well without surgery - Rest, Ice, Compression, and Elevation (RICE) - Knee brace (some patients) - Physical Therapy focused on core and quadriceps muscle strengthening - Expected return to sport 2-8 weeks depending on injury/patient - Surgical Surgical treatment may be recommended for patients who sustained an injury to several ligaments in the knee, specific tear patterns, and persistent symptoms of pain and/or instability after prolonged non-operative treatment. - In some instances, Dr. Taylor may repair the torn PCL. This is not always possible, in which case he would reconstruct it, which means that he replaces the PCL with tissue from another source. - Physical therapy after surgery is critical. Complete recover may take 6-12 months. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Platelet-Rich-Plasma (PRP) - Samuel A. Taylor, MD Source: /conditions/platelet-rich-plasma-prp/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - While many high profile athletes have been treated with PRP, its most appropriate and effective uses remain a source of debate and ongoing research. - Your blood contains a liquid (plasma), different type of cells, and other factors. Platelets are important for clotting blood and scab formation. Platelets also contain hundreds of proteins called growth factors which are important for healing injuries. - PRP is made by separating out the platelets, along with some plasma, from the rest of your blood and putting them into a concentrated form. The ultimate concentration of platelets can be 5-10 times greater than that of normal blood, hence the term “platelet rich plasma”. - PRP is then injected around the site of injury with the intention of stimulating and/or speed up a healing response. - While some doctors use PRP for a wide variety of conditions, mixed results have been reported in the orthopaedic literature. The fact is that we do not yet know the best way to prepare or deliver PRP and we don’t know what conditions it best treats. That being said, some studies have shown PRP effective for Chronic tendon injuries such as tennis elbow and jumper’s knee - Some patients with knee arthritis - Some throwing athletes with UCL injury (Tommy John ligament) - There is not adequate evidence to suggest PRP is helpful for acute injuries. - PRP is rarely covered by insurance, and thus may represent significant out of pocket expense to you. You should check with your insurance carrier before proceeding with such treatment. - Dr. Taylor does not perform PRP treatments, but will refer you to an appropriate care provider who does if it is the most appropriate treatment strategy. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Posterior Instability - Samuel A. Taylor, MD Source: /conditions/posterior-instability/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General Information - The shoulder is the body’s most mobile joint. - The same anatomy that gives the shoulder its amazing mobility and range of motion also makes it vulnerable to dislocating or becoming unstable, a condition called instability. - Instability is a catch-all term that means the ball does not stay in the socket the way that it should giving you a sense of abnormal looseness or the sensation that it is going to come out when you put your arm into certain positions. - There are several different types of shoulder instability such as: By the direction of instability – anterior (front), posterior (back), or multidirectional. - By the way it happened – traumatic (from a specific injury) or atraumatic (without a specific injury). - By the degree of instability – dislocation (completely came out of socket) or subluxation (ball came part way out of the socket). - Posterior shoulder dislocations are less common (2-5%) than anterior and more commonly missed on diagnosis Anatomy & Function - The shoulder is a ball-in-socket joint, but the socket (glenoid) is very shallow making the shoulder look like a golf ball on a tee. - The glenoid labrum is a soft tissue structure that goes around the rim of the glenoid forming a bumper that helps to deepen the shallow glenoid socket. - The labrum also serves as an attachment site for the capsule that surrounds the shoulder and the glenohumeral ligaments that help keep the ball in the socket. - The rotator cuff is a series of four tendons that work together to stabilize the shoulder, keeping the ball appropriately positioned in the socket during shoulder motion. - A reverse Bankart lesion is caused by damage to the bone and/or labrum along the back of the glenoid - A reverse Hill-Sachs lesion is a bony indentation in the front of the humeral head that commonly happens because of a posterior dislocation - The axillary nerve is a major nerve that provides motor function to the large deltoid muscle and sensation to the skin on outside of the shoulder. This nerve can be damaged when the shoulder dislocates. Injury is usually temporary, but it may affect the timing of surgery. Injury & Risk Factors - Dislocation is when the ball comes completely out of the socket, usually during a forceful injury. Some dislocated shoulder will pop back in on their own, while others may require a “reduction” which is when another person puts it back in place. - Subluxation is when the ball partially comes out of the socket. This can cause similar injuries to a full dislocation and is more common cause of posterior instability. - Micro-trauma occurs over longer periods of them due to repetitive injury and damage to the structures that keep the ball in the socket. This can result in a loose or painful shoulder. This is common among football linemen. - Seizures and electric shock cause a powerful contraction of the muscles around the shoulder and can result in posterior dislocation/instability - Contact sports put people at higher risk of shoulder instability and recurrent shoulder instability. - Generalized laxity - Bone deficiency Signs & Symptoms - At time of injury: - Feels like it “popped out” or “slipped” - Pain - Sensation of a “dead arm” - After the injury: - Pain - Bruising - Afraid to do certain activities (apprehension) because of fear that it will come out Diagnosis - Physical examination Apprehension - Range of motion - Rotator cuff strength - Positions and movements that reproduce pain - X-rays help determine that the shoulder is in place (reduced) and helps us see if there are any injuries to the bone. X-rays do not show soft tissues. - CT (computerized tomography) scan is a specialized tool that shows the bone in great detail. If Dr. Taylor is particularly concerned about the amount of damage to the bone caused by your injury he may request a CT scan. - MRI (magnetic resonance imaging) is a very useful tool that lets Dr. Taylor look at the soft tissue anatomy of your shoulder to help determine the extent of your injury and the best treatment strategy.   Treatment Options Treatment plan is specific to an individual patient and requires many factors to be considered such as age, level of activity, and the severity of injury. Below are general considerations. Dr. Taylor will work with you to help create the best treatment plan for you. Non-Surgical Care - Non-surgical approach is a reasonable option for many patients. - Initial immobilization - Structured physical therapy protocol to strengthen the muscles that stabilize the shoulder Surgical Treatment - Surgical treatment may be needed in young and/or high demand patients and those who have had recurrent instability or pain after attempted non-operative treatment. - In the majority of patients, the surgery is performed arthroscopically through small poke-holes in the skin. The damaged or torn capsule and labrum are repaired to the glenoid using small anchors that are placed into the bone. - In some patients, the surgery needs to be done through an open incision. This decision will be made based upon the extent of the injury and the magnitude of injury to the bone. - The time to return to activity varies by patient but is typically around 6 months. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Principal Software Architect - Samuel A. Taylor, MD Source: /conditions/principal-software-architect/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Position Summary: Our company is small, skilled, and nimble. You will be integral to the design and creation of client-focused software for clinical trials, research labs, and diagnostic companies. You’ll have the unique opportunity to mentor a team of programmers and invent cool software. We take our commitments to our customers seriously, but are also committed to a lively, collaborative, and fun environment. Experience: 7 years of experience with senior-level design capabilities using modern technologies Training and Education: College diploma in CS/Engineering/Sciences or equivalent experience Skill Set: - Java, JavaScript, Linux, and server management - Bonus points for C, C#, Python, SQL, PL/SQL, .NET, Google Web Toolkit - Able to organize and maintain flexibility - Comfortable presenting to both large and small audiences in person and remotely - Experienced in modeling data in RDBMS environments - Must be able to stay sane during sales meetings, marketing meetings, software design meetings, and daily SCRUM - Demonstrated professional written and verbal communication skills - Working knowledge of statistical analysis, including data reduction - Extra bonus points for expertise in molecular biology, genomics, translational science, and personalized medicine Roles and Responsibilities: - Participate in design of new, customer-focused sample tracking software - Provide support and guidance for entry-level and intermediate-level programmers - Design R&D prototyping - Lead design collaborations with teams of end-users (lab techs, clinical-trial coordinators), as well as in-house programmers, product managers, and testers - Tailor existing modern code base to meet customer’s unique needs Light travel (up to 10%) may be required. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Proximal Humerus Fracture - Samuel A. Taylor, MD Source: /conditions/proximal-humerus-fracture/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - The terms “fracture” and “broken” mean the same thing and can be used interchangeably. - Account for 4-6% of all fractures - Most common among elderly women - Result from low-energy falls among older patients with poor bone quality. - Result from very high-energy trauma among younger patients with excellent bone quality. Anatomy - “Proximal” means towards the top and “humerus” is the upper arm bone. So a proximal humerus fracture is what some people call a broken shoulder. - Proximal humerus is the attachment site for many important muscles Risk Factors - Older age - Osteoporosis - Female gender Symptoms - Pain - Bruising - Swelling - Inability to move arm Diagnosis - Physical examination Areas that reproduce pain - Assessment of nerves and blood vessels - X-rays look at the bony structures of the shoulder for fracture pattern and to make sure the shoulder is not dislocated. - CT scan may be useful in some cases to evaluate the fracture pattern if Dr. Taylor is considering surgical care Treatment - Non-Surgical – The vast majority of patients get better without surgery. You will have to follow up with Dr. Taylor on several occasions so that he can check your X-rays and confirm that it is healing appropriately. In some cases the bone heals in an improper alignment, called a “malunion”, or does not heal at all, called a “nonunion”. If this happens and its symptoms are troublesome surgery may be an option. Sling and Arm Support for a period of time to be determined by Dr. Taylor. - Pain Medication such as Tylenol may be taken as needed. Depending the injury, Dr. Taylor may suggest additional medications. - Physical Therapy is an important tool to help you strengthen and retrain the muscles that support the shoulder after the bone has healed sufficiently. - Follow-up visits: you will have to come back 2 weeks after your first visit for repeat X-rays to confirm fracture alignment and the start of healing. You will have to come back 6 weeks after your first visit again for X-rays. - Surgery for patients with specific fracture patterns that would do poorly without surgical intervention. Open Reduction Internal Fixation (ORIF): In order to fix the proximal humerus, Dr. Taylor will make an incision in skin (open), put the bones back in their proper alignment (reduction), and hold the bones together using plates and screws (internal fixation). If the plate and screws causes symptoms in the future (~20% of patients), they can be removed after the bone has healed. If they do not bother you, they can stay in forever. - Arthroplasty (Shoulder Replacement) may be the best option for some patients with severe fractures that are unlikely to heal or cannot be repaired. If this is an option, Dr. Taylor will discuss details with you. - Physical therapy is an important part of the healing process. Specific exercises will help restore movement and strengthen your shoulder. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Patella/Quad Tendon Tear - Samuel A. Taylor, MD Source: /conditions/quadricepspatella-tendon-injury/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The quadriceps tendon connects the muscles in the front of the thigh with the top of the kneecap and allows you to straighten you knee. Although anyone can tear the quadriceps tendon, these tears are more common among middle-aged people. A complete quadriceps tendon tear usually requires surgery. Anatomy & Function - The quadriceps muscles are a group of four that meet to form the quadriceps tendon, which connects to the top part of the kneecap (patella). - The patella tendon attaches the kneecap to the shinbone (tibia). - The quadriceps tendon and patella tendon work together to allow you to straighten your knee and do so with adequate power. When either of these two tendons is torn, the connection is disrupted resulting in an inability to straighten your knee. Injury - Mechanism of injury: Quadriceps and patella tendon tears typically occur when there is a heavy load placed on the leg with the foot planted and the knee partially bent, such as an awkward landing after a jump while playing basketball or stepping down from a high step. Tears can also result from direct trauma to the front of the knee. - Partial tears: many tears do not completely disrupt the soft tissue. This is similar to a rope stretched so that some of the fibers are torn, but the rope is still in one piece. - Complete tears: are exactly what they sound like, complete disruption of the tendon into two pieces. When either the quadriceps tendon or the patella tendon are completely torn, the muscle connection between the femur an tibia is disrupted and thus the knee cannot straighten when the quadriceps muscles contract. Risk Factors Chronic Tendinitis: often results in abnormal quadriceps/patella tendon tissue, which is weaker than normal tissue and thus more vulnerable to acute injury. This condition is most common among people who participate in running and jumping sports. - Chronic Diseases: Several conditions result in weakened tendons and predispose them to injury risk. Some such conditions include: Chronic renal failure - Renal dialysis - Hyperparathyroidism - Gout - Leukemia - Rheumatoid arthritis - Lupus (SLE) - Diabetes mellitus - Injection - Metabolic diseases - Steroid use has been linked to increased tendon weakness - Fluoroquinolones are a special type of antibiotic that have been linked to increased risk of tendon tears. Symptoms - A tearing or popping sensation is felt at the time of injury - Pain - Swelling - Tenderness - Inability or weakness with straightening the knee - Inability to bear weight - Change in position of the patella compared with other side (higher suggests patella tendon injury, lower suggests quadriceps tendon injury). Diagnosis - Physical examination is an important diagnostic tool. Dr. Taylor will evaluate your knee for gaps in the tendon, areas of tenderness, amount of swelling, range of motion, ability to straighten the knee, and strength. - X-ray is important to look for fractures, arthritis, and other bony abnormalities. - MRI may be ordered to help aide in diagnosis and/or better evaluate some of the soft tissue structures. Treatment Decisions regarding particular treatments for patellar and quadriceps tendon injuries depend on several factors such as type and size of your tear, anticipated level of activity, and age among others. - Non-Surgical Small, partial tears may do well with non-operative treatment that will include a period of immobilization in a brace followed by a structured physical therapy protocol. - Surgical Complete tears of the patellar or quadriceps tendon often require, surgery to ensure functional and symptomatic recovery. - Surgery is best performed early for these types of injury to reduce complication rates, simplify the procedure, and maximize functional recovery. - Strict adherence to Dr. Taylor’s protocol and a structured physical therapy program is essential to a successful outcome. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Risks and Benefits of Surgery - Samuel A. Taylor, MD Source: /conditions/risks-and-benefits-of-surgery/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage It is important to understand the problem we are trying to solve with surgery, goals of treatment, potential risks involved, and postoperative rehabilitation expectations. If you do not understand these things or have additional questions, please contact our office and Dr. Taylor will discuss with you. - Goals of surgery are to reduce pain and improve function. - Please review the material provided on this website, video content, and diagrams that Dr. Taylor drew for you at your visit to become as informed about your problem as possible. - As you review the education material, we encourage you to write out any questions that come up so that Dr. Taylor can address them prior to your surgery. - The risks of surgery include but are not limited to infection, blood loss, potential injury to nerves or blood vessels, deep vein thrombosis, pulmonary embolism, stroke, complications related to anesthesia, death, failure of fixation, failure of implanted hardware, failure of healing, joint stiffness, weakness, lost range of motion, joint stiffness, persistent pain, complex regional pain syndrome, need for future operations, and the risk of re-injury. We make every effort to minimize the aforementioned risks, but complications do occasionally occur despite the best efforts or surgeon, anesthesiologist, and patient. Dr. Taylor will review all of these risks with you in person as well as any specific to the planned surgical procedure. - You always have the option to NOT have surgery. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Rotator Cuff - Samuel A. Taylor, MD Source: /conditions/rotator-cuff-tear/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The rotator cuff is a group of four muscles with tendons that drape over and attach to the humeral head. They contribute to the stability of the shoulder and play a large role in raising the arm. The cuff muscles or tendons may be torn or bruised by a traumatic event, such as a fall on an outstretched hand. However, many rotator cuff injuries are of the overuse type. Many repetitive activities, especially overhead, such as throwing, tennis or swimming, put a great deal of stress on the rotator cuff. Eventually, the tissues can breakdown and tear. This can result in pain, loss of strength, loss of range of motion, and even instability, all of which can result in loss of function. General Information - Rotator cuff injury is a common cause of pain and disability, but less than 5% of patients will actually need surgery. - An exercise program can be effective for 85% of patients with atraumatic rotator cuff tears. - In the United States, more than 2 million people each year will see a doctor because of rotator cuff problems. Anatomy and Function - The shoulder consists of a large ball (head of the humerus) and a shallow socket (glenoid) and is the most mobile joint in the human body. - The rotator cuff is a series of four tendons attach muscle to bone at the top of the arm bone (humerus) - Connect the top of the arm bone (humerus) connecting it to the shoulder blade (scapula) - The four rotator cuff tendons work together to help stabilize the shoulder joint and hold the ball of the arm bone (head of the humerus) to the socket (glenoid) of the shoulder blade. - There is normally a lubricating bura sac above the rotator cuff and below the top bone in the shoulder (acromion) that helps the rotator cuff glide freely. - The acromion is the bone on the top of your shoulder. In some patients a bone spur develops that can irritate and damage the rotator cuff below. - The long head of the biceps tendon is a nearby structure that attaches deep within your shoulder and runs down the front of the shoulder. Injury to this tendon commonly occurs when the rotator cuff is torn. Injury - Rotator cuff injuries are very common and can result from a specific injury or over longer periods of time because of chronic irritation. - When the rotator cuff is injured, it is usually the tendons that are injured. - Injury can range from mild strain and irritation to a large tear. - Typically the severity the injury dictates the level of pain and dysfunction. - Some patients, however, can have relatively large tears without much pain or functional limitation. - Three types of rotator cuff conditions: Tendinitis happens when the rotator cuff tendons become inflamed as a result of overuse or overload. This commonly results from repetitive overhead activities that occur during sports and/or activities of daily living. - Bursitis is an inflammation of the fluid-filled sac (bursa) between the rotator cuff and the bone above it (acromion) that happens when it becomes irritated. This can also result from overhead activity or overuse of the shoulder. - Tear of the rotator cuff can occur from an acute injury or over time if tendinitis and bursitis are not treated. Acute tears are due to a specific injury like falling down onto an outstretched arm or lifting an object that was too heavy. Degenerative tears happen over time because the tendon has been slowly worn down and is more common as we get older. Tears of the rotator cuff may require more invasive treatments such as surgery. Rotator cuff tears can be partial in that only part of the tendon is injured, but not completely severed. They can also be complete or “full-thickness” meaning that its entire connection to bone has been disrupted leaving a hole. Risk Factors - Age – as we get older the normal blood supply to the rotator cuff tendon and the overall quality of the tendon tissue decreases making it more vulnerable to injury. - Repetitive lifting and overhead movements such as throwing, weight training, daily chores, and manual labor can produce overuse injury. - Bone spurs on the underside of the acromion bone can cause abnormal rubbing, in a condition called impingement, when you lift your arm and lead to rotator cuff injury. Symptoms - Most common symptom is pain - Sharp shoulder pain, particularly with overhead activities - Pain at night can be quite intense and wake you from sleep - Pain is not the same for everyone. Sometimes it is felt deep within the shoulder, other times people feel pain over the outside of the shoulder, or even extending down the biceps muscle to the elbow. - Pain with every day activities like scratching your head, putting on a shirt, laying down on the affected side, and carrying a moderately light object - An overall sense of weakness and pain that causes you to keep your shoulder inactive - Crepitus or crackling sensation when you move your shoulder in certain positions. Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Positions and movements that reproduce pain - Weakness, especially with the arm in certain positions - X-rays help determine if you have any arthritis in the shoulder and if there are any bone spurs that may be causing injury to your rotator cuff. X-rays allow the doctor to evaluate bones, but are not extremely helpful for soft tissue. - MRI (magnetic resonance imaging) is a very useful tool that lets Dr. Taylor look at the soft tissue anatomy, such as the rotator cuff, of your shoulder and determine the extent of your injury. Treatment - The goal of treatment is to reduce pain and regain function. - Non-Surgical – Most patients with mild to moderate injury improve with non-surgical treatments like those listed below. These therapies are aimed at reducing the painful inflammation associated with the injury. Many time, controlling the inflammation allows you to strengthen the rotator cuff and make it function again normally. Rest – If you have a mild injury to the rotator cuff, simply resting it may improve your symptoms - Activity Modification, or change your activities to avoid those things that cause irritation. - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation around the rotator cuff - Injection of Steroid medication into the bursa sac above the rotator cuff to help reduce the inflammation - Physical Therapy is an important tool to help you strengthen and retrain the muscles of the rotator cuff to work better together. - Surgical – Moderate injuries that do not improve with conservative care and severe injuries to the rotator cuff may need surgery to return you to the activities you love. Arthroscopic Rotator Cuff Repair is the most commonly performed surgery to sew a torn rotator cuff back to bone. This is the most minimally invasive technique available. Dr. Taylor uses a specialized camera and set of small instruments through a series of small poke-holes in the skin around your shoulder to repair the torn tendons back to he arm bone (humerus) where they normally insert. Using arthroscopic techniques minimizes the surgery time, blood loss, and postoperative pain. Recovery time is typically 4 months, but depends on many factors such as tear size, the quality of the tissues, and level of activity. - Open Rotator Cuff Repair is sometimes undertaken for very large tears of the rotator cuff that cannot adequately be treated by arthroscopic means. Before the advent of arthroscopic techniques, all rotator cuff tears were repaired in this fashion. An incision is made in the skin and the large muscle on the outside of the shoulder (deltoid) is split to allow the surgeon to see and repair the rotator cuff. Today, open repairs of the rotator cuff are very uncommon and reserved for very difficult tears. It is unlikely that Dr. Taylor to need to perform this procedure. - Tendon Transfer may be used in rare cases for patients with massive rotator cuff tears that are not repairable. In this procedure, we move a tendon from one location to another location to help regain some of the function lost by the rotator cuff. This is often a last step or a salvage type of surgery. - Reverse Total Shoulder Replacement is another type of salvage surgery that is most commonly performed in patients with both rotator cuff tear and severe arthritis of the shoulder. The procedure is designed to replace the arthritic shoulder and allow another large muscle in your shoulder, the deltoid, to move the shoulder joint. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Shoulder Anatomy - Samuel A. Taylor, MD Source: /conditions/shoulder-anatomy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage The shoulder is the most moveable joint in your body. It helps you to lift your arm, to rotate it, and to reach up over your head. It is able to turn in many directions. The shoulder joint may be described as a “ball and socket”. However it is a relatively large ball in a shallow socket. Many people have described it to be like a golf ball on a tee. This allows the shoulder to provide a wide range of motion required to perform many athletic activities, such as throwing, swimming, serving a tennis ball, and functional movement in many directions. The shoulder is made of three bones. The “ball” component is made of the head of the humerus (upper arm bone). The “socket” component, called the glenoid, is made up of the outer portion of the scapula (shoulder blade). The third bone is the clavicle (collar bone). The labrum is a rim of cartilage on the socket that helps stabilize the joint. The stability of the shoulder joint mainly depends on the capsule, an envelope of fluid surrounding the joint, ligaments connecting bones in the shoulder, tendons that attach muscles to bones, and the muscles themselves, which initiate and control the position and action of the shoulder. The rotator cuff is an important contributor to shoulder stability and function. It is made up of four muscles that all attach to the humerus and work in a coordinated effort (normally) to keep the ball centered in the socket. The subscapularis is a large rotator cuff muscle that attaches to the front of the humerus and allows you to rotate your arm inward. The supraspinatus and intraspinatus muscles attach at the top of the humerus and allow you to raise your arm overhead and rotate outward. These are the two most commonly injured tendons. The teres minor attaches in the back of the humerus and allows you to rotate your arm outward. Above the rotator cuff and below the acromion is a bursa. Bursa tissue is normally thin and slippery and allows the rotator cuff to move freely below the bone. When bursa becomes inflamed, a condition called bursitis, it can produce severe pain and lead to dysfunction of the rotator cuff below. The AC joint is the connection of the acromion (A) to the clavicle (C). When injured or arthritic, this joint can cause pain and dysfunction. The long head of the biceps tendon traverses the front of the shoulder and attaches deep within the shoulder. It is a common source of pain by itself or in addition to other lesions when inflamed. Shoulder injuries can result from acute traumatic events such as a fall onto an outstretched hand or a direct blow. They can also result from repetitive overuse activities. Many repetitive overhead activities, such as tennis, swimming and baseball can result in injury to the capsule, ligaments and muscles that surround the joint. In addition, lifting weights too frequently or incorrectly can lead to shoulder injury. Oftentimes symptoms can be improved without surgery by reducing inflammation and strengthening/retraining the muscles that support the shoulder’s movement through structured physical therapy exercises. Some injuries either will not or do not get better without surgery. Untreated conditions can have other consequences. For example, chronic instability of the shoulder may result in subsequent damage to other structures leading to more pain and dysfunction. If you have such an injury, Dr. Taylor will discuss with you your options in detail. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Shoulder Animations - Samuel A. Taylor, MD Source: /conditions/shoulder-animations/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Diagnostic Arthroscopy - Subacromial Decompression  - Trimming Torn Labrum - Rotator Cuff Repair - Distal Clavicle Resection - Labrum Repair - Bankart Repair - SLAP Repair - Total Shoulder Replacement - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Shoulder Arthritis - Samuel A. Taylor, MD Source: /conditions/shoulder-arthritis/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Anatomy and Function - The shoulder joint is made up of three bones, the arm bone (humerus), the shoulder blade (scapula), and the collar bone (clavicle) - The ends of the bones are covered by a slippery and shiny material called cartilage. - Cartilage acts as a shock absorber and allows the joint to glide. Types of Arthritis - There are four major types of shoulder arthritis. While the exact cause of arthritis may be different, they all share in that the normal smooth cartilage surface on the ends of the bone has been destroyed leaving bone rubbing on bone. Osteoarthritis is a degenerative shoulder condition that many people refer to as “wear-and-tear”.   This type of shoulder arthritis is most common in people over the age of 50 years. - Post Traumatic Arthritis is a form of osteoarthritis that develops many years after an injury, such as a fracture or dislocation of the shoulder. - Cuff Tear Arthropathy is uncommon, but occurs in people who have had a large rotator cuff tear for many years. Treatment for this type of arthritis may be with a reverse total shoulder arthroplasty, which replaces the damaged shoulder joint and allows the large muscle on outside of the shoulder (deltoid) to move the shoulder without a rotator cuff. - Inflammatory Arthritis can affect people of any age and usually causes problems in multiple joints on both sides of the body. An example of inflammatory arthritis is Rheumatoid arthritis, which is an autoimmune disease. Risk Factors - Age – most common among older patients - Personal or family history of arthritis - Inflammatory conditions such as rheumatoid arthritis - Repetitive lifting and overhead movements such as throwing, weight training, daily chores, and manual labor can produce overuse injury. Symptoms - Most common symptom is pain, including pain at night that wakes you from sleep. - Another common symptom is stiffness and loss of motion, which causes difficulty lifting, reaching or stretching the arm. - The type of pain experienced is quite variable and may be dull and aching or sharp and stabbing. - Pain is almost always made worse by activity and progressively worsens. - Crepitus (crackling) and grinding sensation deep within the joint is common Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Rotator cuff strength - Positions and movements that reproduce pain - X-rays help determine the extent of arthritis in the shoulder X-rays show the doctor bones, but do not show soft tissues. - MRI (magnetic resonance imaging) helps us look at the soft tissues like the rotator cuff tendon. - CT (computed tomography) scan may be necessary we decide to perform a shoulder replacement surgery. Treatment - The goal of treatment is to reduce pain and regain function. - Non-Surgical – Most patients can be managed for long periods of time or even forever without needing surgery. Because we don’t walk on our hands, the shoulder does not have to bear weight the same way a hip or knee does. Rest and Activity Modification can allow your shoulder inflammation a chance to calm down. You may also be able to change your activities to avoid those things that cause pain. - Non-steroidal anti-inflammatory (NSAID) medication by mouth can improve the inflammation and help manage symptoms. - Injection of Steroid medication into the shoulder joint itself can help reduce inflammation and pain. These shots can be given up to 3-4 times each year as necessary. - Injection of Lubricant called viscosupplementation may improve symptoms in a subset of patients. This treatment is not yet approved by many insurance companies and therefore carries an out of pocket expense for patients. - Platelet-Rich-Plasma (PRP) – may improve symptoms in a subset of patients. PRP is acquired by using a portion of your own blood that contains anti-inflammatory products to inject within the shoulder. This treatment remains experimental rarely covered by insurance so it comes as an out of pocket expense for patients. - Physical Therapy is an important tool to help you strengthen and retrain the muscles of the rotator cuff to work better together. - Surgical – Arthritis that does not improve with conservative care may be treated with a shoulder replacement. Total shoulder arthroplasty (replacement) is very effective for pain relief and improving function. Replacing the humeral head with a metal ball and replacing the socket with a new one constructed of a special plastic replaces what was arthritic and damaged. A standard total shoulder replacement requires that your rotator cuff not be torn. Additional imaging studies such as an MRI may be required in some patients if there is concern. - Reverse total shoulder arthroplasty (replacement) is an important innovation that provides an option for patients with severe arthritis that do not have a rotator cuff. The “reverse” gets its name because the arthritic ball is replaced with a socket and the arthritic socket is replaced with a ball. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Shoulder Arthroscopy - Samuel A. Taylor, MD Source: /conditions/shoulder-arthroscopy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Arthroscopy of the shoulder is a surgical procedure in which a small fiberoptic camera (arthroscope) is inserted into the shoulder joint through a small incision to see the inside of the shoulder. This enables Dr. Taylor to visualize the inside of the joint on a monitor in the operating room. Other small incisions are made through which specialized instruments are inserted to allow him to perform the procedure in the most minimally invasive way possible. During the procedure, fluid is inserted into the shoulder to distend the joint and allow for visualization. The shoulder is examined for damaged tissue. Arthroscopy is used for many procedures of the shoulder. The benefits of arthroscopy include smaller incisions, faster healing, more rapid recover, less scaring, and minimal blood loss. Patients commonly go home the same day of surgery. Shoulder Arthroscopy - Shoulder arthroscopy can take as little as 30 minutes for some procedures and is done on an outpatient basis, meaning you will be in and out of the hospital in the same day. - Common reasons for arthroscopy include tears to the structures within the shoulder (torn rotator cuff, torn labrum, loose fragments of cartilage or bone, inflamed synovial tissue, etc.). - Like any surgical procedure, pre-operative tests may be ordered to ensure you are healthy for arthroscopy. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Suture Removal - Samuel A. Taylor, MD Source: /conditions/suture-removal-2/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage During your first postoperative visit with Dr. Taylor, sutures will be removed (if necessary) and steri-strips will be applied to your incision(s). - DO NOT remove steri-strips, they will fall off on their own over the ensuing two weeks. As they begin to peel off, the edges curl upward. You can trim these loose edges if they are a problem, but please do not pull them off. - You may shower (get incisions wet) 48 hours after your sutures have been removed. You can get the steri-strips wet at this time. After showering, simply pat your surgical site dry. - Once your steri-strips have fallen off you do not need to reapply more. - Slight bleeding after suture removal is normal. - If you have fluid leakage, bleeding that does not stop, redness, or the wound opens up, please contact us. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## UCL (Tommy John) - Samuel A. Taylor, MD Source: /conditions/ulnar-collateral-ligament-tommy-john/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage General - Every season numerous MLB players (primarily pitchers) succumb to ulnar collateral ligament (UCL) injuries and undergo surgery to reconstruct this ligament named after Tommy John, who famously produced a 3.1 ERA over 18 seasons following this surgery. The increasing number of Tommy John surgeries occurring annually in the US has led some to call it an epidemic. While the surgery has demonstrated great success, it is important to realize that some 10-30% of people never return to the same level of play after surgery. The most important form of treatment is actually prevention. - Tommy John surgery does NOT make you throw harder. It is only performed in high demand throwing athletes who have sustained an injury. - More information provided by Major League Baseball can be found at http://m.mlb.com/pitchsmart/ Anatomy - The ulnar collateral ligament (UCL) also known as the medial collateral ligament of the elbow is on the inside of the elbow and is particularly important for throwing athletes. The surgery to reconstruct this ligament if it is torn is called “Tommy John Surgery” named after the famous baseball player. - The UCL functions to stabilize the elbow during the throwing motion (valgus stress). It is divided into three components (anterior, posterior, and transverse bands). The anterior band is the strongest and most important for throwing. Risk Factors - Baseball - Pitching - Javelin - Overuse - Poor throwing mechanics - Throwing for the radar gun - Injury/weakness of shoulder that increase the load sustained at the elbow Symptoms - Pain over the inside (medial) part of the elbow - “Pop” during a single throw - Loss of throwing velocity and accuracy - Numbness and tingling in the ring and little fingers Diagnosis - Physical examination Areas that reproduce pain - Range of motion - Specific tests to reproduce pain - Assessment of laxity - X-rays look the bony anatomy for abnormalities. - MRI looks at the soft tissue structures. Treatment - The treatment algorithm is complex and requires careful assessment of a patient’s timing and sports goals. - Non-Surgical – is first line treatment - Rest - Physical therapy - Platelet-Rich-Plasma (PRP) injection may be useful in some patients - Surgical – is used for high-level throwers that want to continue competitive sports and those who have failed non-operative management and are willing to undergo extensive rehabilitation. The surgery, referred to as Tommy John surgery, involves reconstructing the UCL with tissue taken from another part of the patient’s body (palmaris tendon from the forearm or gracilis tendon from the leg). 75-90% of patients are able to return to competitive throwing after approximately 12 months of rehabilitation. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Useful Other Items - Samuel A. Taylor, MD Source: /conditions/useful-other-items/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage While frequently not covered by insurance, you may consider purchasing one or more of the following items that some patients have found helpful in their recovery. These often represent out of pocket expense. Dr. Taylor has NO financial interests in any of the following. - Ice Machines: Icing is very important and helps reduce inflammation and improve pain control. You may wish to purchase one of the commercially available ice machines (GameReady®, AirCast®, Cothera®, etc.). These are rarely covered by insurance, so they may represent out of pocket costs (typically $225-$350). Most patients who purchase one of these ice machines are very happy with their investment. One of the HSS vendors will reach out to you prior to surgery. - Mobilegs Crutches: If you will be required to use crutches for a prolonged period of time, you may consider purchasing Mobilegs crutches which are lighter, more comfortable, and more ergonomic than standard crutches. The average cost is around $130. - Vitamin Supplements: Vitamin D and Calcium have been shown to help bone healing and some soft tissue healing. Dr. Taylor recommends that you take in 1,500 miligrams of Calcium per day and 400-800 IU of Vitamin D every day. Calcium and Vitamin D supplements can be purchased at your local pharmacy. Please check with the pharmacist for brand recommendations. - Nutritional Supplements: You may consider adding a nutritional supplement such as Carnation Instant Breakfast, Muscle Milk, Ensure, or Boost if your appetite is decreased to ensure that you are getting adequate nutrition. - Scar Reduction: There are many compounds designed to minimize scar formation after surgery. Mederma® may help reduce the size, soften the texture, and improve the color of post-surgical scar. More information can be found at http://www.mederma.com. It is also important to remember to use high-SPF sunblock on the scar during the first 6-12 months following surgery to prevent scar discoloration. - Viscosupplementation: Also called “lubricating” injections, have been shown to relieve pain in some patients with arthritis of the knee. These can be expensive, averaging from $400 – $1500 per series. While not approved by insurance, some patients with shoulder arthritis may also experience significant relief. For more information see the link for “viscosupplementation”. - NMES Quadriceps Stimulators: These devices offer electrical stimulation to generate coordinated quadriceps contractions. They aid in re-education of the quadriceps muscle and minimize quadriceps atrophy to accelerate recovery following knee surgery. The out of pocket costs can be substantial. Kneehab XP®: This product comes as a wrap applied to the knee for treatments. More information can be found at http://www.neurotechgroup.com/us/products/kneehab-xp - CyMedica QB1TM: Available as a stimulator sleeve similar to Kneehab XP or in conjunction with a postoperative brace. More information can be found at http://cymedicaortho.com - Bone Stimulator: May be helpful for bony procedures such as corrective osteotomies or fracture fixation. Many companies have versions of bone stimulators. For more information please inquire with Dr. Taylor’s office. - Special Physical Therapy Evaluations: The HSS Rehabilitation Department and many other physical therapy groups offer specialized evaluations for return-to-play after injury and sport specific evaluations such as running, golf, and throwing. These evaluations may be helpful in recognizing specific deficits to help you and your therapist better guide care. These evaluations are typically NOT covered by insurance providers. If you are interested please inquire with our office or your physical therapist. - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Viscosupplementation - Samuel A. Taylor, MD Source: /conditions/viscosupplementation-2/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage - Viscosupplementation (Hyaluronic Acid) or “lubricating” injections, have been shown to relieve pain in some patients who cannot get relief from nonmedicinal measures or non-steroidal anti-inflammatory (NSAID) medications. - Hyaluronic Acid is a naturally occurring substance found in the synovial (joint) fluid that acts as a lubricant and a shock absorber. Patients with osteoarthritis often have a lower-than-normal concentration of hyaluronic acid in their joint. - The injection works to relieve pain may be helpful for as many as 2/3 of patients, but it does not work for everyone. - Viscosupplementation will not reverse or delay the progression of osteoarthritis. - Hyaluronic Acid is manufactured by many pharmaceutical companies (Synvisc®, Orthovisc®, Supartz®, Euflexxa®, etc) and comes in several formulations. - It is typically given as one shot each week for 3 consecutive weeks depending on the brand. - Viscosupplementation can be expensive, averaging from $400 – $1500 per series, and may not be covered by your insurance policy. - In today’s current healthcare insurance environment, many healthcare plans are electing to not cover the cost of the injections. As a courtesy for our patients, we can contact your insurance plan to see if you are covered. - We do not stock the medication and it may take several weeks to arrive. - Your appointment for injection will not be made until your medication has been received in the office. Once received, we will call you to schedule your injection.   - Shoulder Shoulder Anatomy - Shoulder Arthroscopy - Rotator Cuff - Impingement - Frozen Shoulder - Biceps/SLAP - Anterior Instability - Posterior Instability - Multidirectional Instability - AC Separation - AC Arthritis - Shoulder Arthritis - Proximal Humerus Fracture - Clavicle Fracture - Elbow Elbow Anatomy - Elbow Arthroscopy - Epicondylitis (Tennis/Golfer’s Elbow) - Distal Biceps/Triceps Injury - UCL (Tommy John) - Knee Knee Anatomy - Knee Arthroscopy - ACL Tear - ACL Graft Choice - PCL Injury - MCL Injury - Meniscus Tear - Cartilage Injury - Patellofemoral Pain - Patella/Quad Tendon Tear - Knee Arthritis - Other Anti-Inflammatories - Cortisone Injection - Viscosupplementation - Platelet-Rich-Plasma (PRP) - Nutrition Optimization - Chronic Pain Management - Allografts - Suture Removal - Useful Other Items - Risks and Benefits of Surgery - Surgical Animations Shoulder Animations - Elbow Animations - Knee Animations Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Education - Samuel A. Taylor, MD Source: /education/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Education #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## File Upload - Samuel A. Taylor, MD Source: /file-upload/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # File Upload [contact-form-7 id=”814″ title=”File Upload”] #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Overuse Among Youth Throwers : My son takes Advil before he pitches - Samuel A. Taylor, MD Source: /overuse-among-youth-throwers-my-son-takes-advil-before-he-pitches/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Overuse Among Youth Throwers : My son takes Advil before he pitches by Dr. Sam Taylor | Jun 10, 2015 | Injuries | 0 comments Pain in the shoulder and/or elbow is NOT normal for adolescent throwing athletes and is usually a sign that something is wrong. Why does the arm hurt, you ask? While the answer is occasionally complex, most commonly it’s quite simple: OVERUSE and IMBALANCE. Today, kids are playing baseball year-round, playing on multiple teams, and participating in showcases. This adds up and leads to overuse injuries. Parents and coaches can help reduce these injuries by communication, adherence to pitch counts, and ensuring adequate rest (http://www.stopsportsinjuries.org/baseball-injury-prevention.aspx#prevention). Muscle and motion balance also plays an important role in injury prevention.  The shoulder and elbow are the last components of what we call the “kinetic chain” for throwing. Proper mechanics and core muscle strengthening are equally if not more Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Patient Resources - Samuel A. Taylor, MD Source: /patient-resources/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # What to Expect Our goal is to provide you the quality care that you deserve. We do our best to streamline the process and be respectful of your time. You can help us by filling out the ‘Initial Visit Medical History’ and other important information listed below in ‘What to Bring’ section. You should arrive 30 minutes early to allow time for registration and any additional X-rays requested by Dr. Taylor prior to your scheduled visit.It is very important that you understand your injury and proposed treatment. It is normal to feel somewhat overwhelmed after a visit and therefore very helpful and important to review the educational material compiled by Dr. Taylor under the ‘Education’ section of this website. You are encouraged to ask questions throughout the evaluation and treatment process. A written list of questions can be quite helpful. If questions remain after your visit, please feel free to call the office. ## Insurance Information - Aetna - Blue Cross HMO POS - Blue Cross PPO - Cigna - Medicare - Oxford - United Healthcare If your provider is not listed, please contact our office to review your out-of-network benefits. Dr. Taylor sees patients in both Stamford and Manhattan. Patients Enrolled in Participating Health Plans: - You as the patient will be responsible for all applicable co-payments, co-insurance and deductibles that your plan requires to fulfill payment responsibility. Please make sure you have your insurance card at every visit and if at any time your insurance changes please provide our office with the new insurance information - If your insurance requires a referral from your primary care physician, it is your responsibility to provide our office with that referral. If a referral is not provided, payment is due at the time services are rendered - If your insurance carrier is billed and you are reimbursed directly, you are responsible for endorsing and forwarding all payments to Dr. Samuel A. Taylor’s office Patients with Non-Participating Plans: - Full payment is due at the time of service Work Related or Motor Vehicle Injury: - You are responsible for providing all pertinent information regarding your accident and billing information with you. Information such as your insurance claim number, date of injury, description and location of injury as well as guarantors mailing address and telephone number. In you are unable to provide the necessary information; payment in full must be made at the time services are rendered. ## What to Bring In order to provide you the best possible recommendation and return you to action as soon as possible, it is important that you bring all pertinent information to your initial visit with Dr. Taylor. If you have had any X-rays, CT scans, or MRI’s, please bring the actual disc with you in addition to the radiologist’s report. ### Pre-Visit Checklist - Previous Images (X-ray, CT scan, MRI, etc.) - Medical Records - Operative Reports - Home Medications - Primary Care Referral - Insurance Card - Government Issued ID - Medical Questionnaires - Workers’ Compensation - Co-Pay - List of Questions ## Patient Forms Please download and complete the following forms that pertain to you. Filling out these forms in advance will save time during your visit. NEW PATIENT FORMS Initial Visit Forms  CURRENT PATIENT FORMS Postoperative Questionnaire Follow-Up Questionnaire  Completed forms can be submitted via this website, emailed to tayloroffice@hss.edu, or printed and brought with you to your visit. ## Preoperative Instructions TYPE OF SURGERY: - Ambulatory Surgery: are procedures from which you are able to go home the same day without an overnight stay.  Ambulatory surgery is also called outpatient surgery.  The majority of surgeries performed by Dr. Taylor are ambulatory. - 23-Hour Stay: some patients may be advised to stay overnight for observation, pain control, or due to a late case.  Patients with sleep apnea are required to stay overnight for observation unless cleared by the anesthesiologist. - Inpatient: are surgeries with an anticipated hospital stay greater than 23-hours.  Details regarding room allocation, private rooms, television, telephone, Internet, and private duty nursing are available upon request. MEDICAL CLEARANCE: - Depending upon the planned surgical procedure and your medical history, you may be required to undergo Pre-Admission Testing, medical clearance, and/or obtain clearance from a specialty consultant such as a cardiologist or hematologist. - No Medical Clearance required: young healthy patients scheduled for ambulatory surgery are not required to undergo any special pre-admission testing. - Pre-Admission Testing (PAT), also known as Pre-Surgical Screening, is an HSS service completed within 10 days of your surgical procedure. Includes blood and urine tests, x-rays, and EKG. - Patients scheduled for inpatient surgery will also have a consultation with a medical doctor. - Bring your medications (prescribed and over the counter) with you to the PAT appointment. - Medical Clearance: may be obtained from your primary care doctor or by appointment at HSS main campus. - If your primary care doctor is to clear you for surgery, they must fill out the “Adult Medical Consultation” form. This form can also be downloaded from our website, www.SamTaylorMD.com. You are responsible for providing this form to your doctor. - Medical clearance must be completed no more than 10 days prior to your scheduled surgery. - All outside test results and the medical clearance note must be faxed to our office, (203) 705-2929, no later than the Thursday prior to your scheduled surgery. - Cardiologist Clearance: is required if you have cardiac stents, a pacemaker, history of an arrhythmias, have had any kind of heart surgery, or have had a heart attack. - Hematology Recommendations: may be requested if you have a personal history of blood clot (DVT or PE) or a strong family history of blood clots. - Additional Medical Subspecialty Recommendations: may be requested based upon specific aspects of your health history. - Blood Thinners: If you take a blood thinner (Warfarin, Coumadin, Plavix, Clopidogrel, Aspirin, Heparin, Aggrenox, Lovenox, Enoxaparin, Xarelto, Rivaroxaban, etc.), you MUST have specific instructions from the prescribing physician regarding stopping and restarting of these medications.  In general, we recommended these medications be discontinued approximately 7-10 days prior to your planned procedure. Please follow your prescribing doctor’s recommendations. MEDICATIONS: - Please contact your medical doctor before discontinuing any medications. - You take Tylenol up to the time of surgery as needed for pain. - Do NOT take anti-inflammatories (Aspirin, Naprosyn, Aleve, Advil, Motrin, Ibuprofen, etc.) within 10 days of surgery.  These medications increase the bleeding risk during/after surgery. - Do NOT take any herbal medications, natural products, or vitamin supplements (alfalfa, capsicum, celery seed, chamomile, chondroitin, clove, dandelion, dong quai, feverfew, fish oil, flax seed, gamma linoleic acid, garlic, ginger, gingko, ginseng, glucosamine, horseradish, licorice, liver oil, melatonin, onion, papain, papaya, parsley, passionflower, poplar, resveratrol, sweet cover, turmeric, willow bark, etc.) within 10 days of surgery. Many of these increase bleeding risk during/after surgery. - Birth Control: may increase the risk of developing a blood clot following lower extremity surgery. It is recommended that you stop birth control until you are full weight bearing and are walking normally without crutches. - Blood Thinners: As above. PREPARING FOR SURGERY: - Insurance Coverage: our office will call for pre-certification with insurance if required.  Please be advised that this process does take time. You should contact your insurance company directly with any questions regarding coverage and benefit information. - Immunization Record: anyone under 18 years of age must obtain a copy of the immunization records from your school or pediatrician’s office. - Bring Imaging Studies: (X-ray, MRI, or CT scan) performed outside of HSS with you on the day of surgery. - Arrange Escort: Please make arrangements for someone to take you home.  The hospital requires that ambulatory surgery patients arrange for an escort home. You will not be allowed to leave the hospital without an escort. In some cases, surgery may be cancelled if you have not established this arrangement upon registration. - Ice Machine: icing is very important and helps reduce inflammation and improve pain control. You may wish to purchase one of the commercially available ice machines (GameReady®, AirCast®, Cothera®, etc.). These are rarely covered by insurance, so they may represent out of pocket costs (typically $225-$350). Most patients who purchase one of these ice machines are very happy with their investment. One of the HSS vendors will reach out to you prior to surgery. DAY BEFORE SURGERY: - Wash Body with Hibiclens: which is a special type of soap that kills germs on contact and can continue working for up to 24 hours!  It can be purchased at your local pharmacy (www.hibiclens.com) without a prescription. Hibiclens kills the bacteria on your skin that can cause infection after surgery.  It is gentle enough for sensitive skin and has been shown to reduce infection rates. Do NOT use if you have an allergy to chlorohexidine gluconate. Below are instructions for its use: Wash your hair first using using regular shampoo. - Rinse hair and body thoroughly with warm water to remove any shampoo residue. - Move away from the shower stream when applying Hibiclense to avoid it rinsing off too soon. - Apply Hibiclens directly on your skin or using a wet washcloth. - Allow Hibiclens to sit on your skin for 2-5 minutes - Rinse thoroughly with warm water. - Do NOT use regular soap after applying and rinsing Hibilens. - Do NOT apply any lotions to your skin. - Do NOT eat or drink anything after midnight before your surgery unless specifically instructed by an HSS representative over the phone. - You will receive a call from a member of the HSS nursing staff between 2pm and 7pm on the day before your surgery regarding the time of the procedure and when you need to arrive.  In general, you should plan on arriving at the hospital 2 hours before the planned start time. Recorded pre-operative information is available by calling (212) 606-1630. - If you have not heard from HSS by 7pm the day before your scheduled surgery, please call (212) 606-1710 and explain that you are awaiting pre-surgical instruction. - HSS (not our office) determines the surgical schedule.  As such, changes/delays in your OR time may occur due to unforeseen emergencies.  Please be understanding of the dynamic nature of the OR schedule. DAY OF SURGERY: - What to Bring: One Small Bag: will be securely stored during surgery. - Verification of Identity: bring a government issued identification. - List of Medications: including prescribed, over-the counter, and herbals. - Immunization Records: mandatory for those younger than 18 years. - Telephone numbers of people you want to call. - Primary Care Physician’s Contact Info - Pregnancy Test: is mandatory for all women who are menstruating and menopausal women who have menstruated within the preceding year. - History and Physical Examination: will be performed by an HSS physician assistant. - Dr. Taylor will meet with you before surgery, confirm the planned surgical procedure, answer any remaining questions, and mark the operative site with his initials. - Anesthesia: You will meet with the anesthesiologist prior to surgery and have the opportunity to ask questions about the type of anesthesia you will be receiving. Regional (nerve block) Anesthesia: is a technique where a portion of the patient’s body is rendered insensitive (numb) so that you don’t feel any pain during surgery. You will also be given sedation so that you sleep through the procedure, however you continue to breath on your own. We prefer regional anesthesia for most patients. - General Anesthesia: is when you are completely asleep during the procedure, and require a breathing tube. AFTER SURGERY: - Recovery Room (PACU): the anesthesia team and nursing staff will monitor your postoperative care and your return to full awareness. Regardless of the type of anesthesia performed, you will stay at the hospital until your condition is stable and you are safe to leave. - Postoperative Instructions: you will be provided detailed postoperative instructions after surgery. If you wish to review general postoperative instructions and answers to frequently asked questions prior to your surgery you can do so on our website www.SamTaylorMD.com. - Prescriptions: you will be given prescriptions for pain medication and any other required medications after surgery. - Discharge: in order to be considered safe to go home you must be able to stand up and walk without felling dizzy or lightheaded, tolerate food and drink, and be able to urinate. When you are considered safe to leave, the person escorting you home will be asked to bring the car to the main hospital entrance. HSS surgical personnel will escort you to the car and assist with your departure. - Phone Call: Dr. Taylor will call you the day after surgery to check on you and answer questions. - First postoperative visit: typically occurs 10-14 days after surgery. Please call the office to arrange. RETURNING TO WORK OR SCHOOL: - This varies widely by patient and type of surgery performed - Many patients are able to return to sedentary work or school 3-7 days after surgery. - You must no longer require narcotic pain medication during work/school hours. - Dr. Taylor will determine when you may return to more physically rigorous demands. - If you require any specific letters for work or school please let us know. BILLING: - The surgical fee will include three post-operative visits within 90 days of surgery.  If you have any questions and would like to speak with someone from the billing department please call our office (203) 705-0750 or (646) 714-6324. DIET: - Begin with clear liquids and light foods (jello, soup, etc.). Progress to normal diet as tolerated if you are not nauseated. - Avoid greasy or spicy foods for the first 24hrs to avoid GI upset. - Increase fluid intake (water, Gatorade, etc.) to help prevent constipation. ANESTHESIA: - The anesthesia team may have placed a nerve block prior to surgery to help with post-operative pain control. As a consequence, you may have numbness or inability to move the limb after surgery. Do not be alarmed as this may last 8-36 hours depending upon the amount and type of medication used by the anesthesiologist. - If you are experiencing numbness after 36 hours, please call the office. - When the nerve block begins to wear off, you will feel a tingling sensation, like pins and needles. It is important that you start taking the pain medication at that time to ensure that you stay ahead of the pain.   PRESCRIBED MEDICATIONS: - Narcotic pain medicine (Percocet or Norco): may cause constipation, nausea, itching, and excessive drowsiness. You should take an over-the-counter stool softener (Colace and/or Senna) while taking narcotics to prevent constipation, but stop if you develop diarrhea. If you experience itching, over the counter Benadryl may be helpful. Narcotic pain medications often produce drowsiness and it is against the law to operate a vehicle while taking these medications. - Anti-inflammatory (NSAID) medicine (Naprosyn or Mobic): do NOT take this medication if you have had an ulcer in the past unless you have cleared this with you primary care doctor. You should take NSAIDs with food to reduce the chance of upset stomach. - Anti-nausea medicine (Zofran): sometimes patients experience nausea related to either anesthesia or the narcotic pain medication. If this is the case you will find this medication helpful. - DVT prophylaxis (Aspirin, Xarelto, Lovenox, or Coumadin): For most patients, activity alone is sufficient to prevent dangerous blood clots, but in some cases your personal risk profile and/or the type of surgery you have undergone makes it necessary that you take medication to help prevent blood clots. - Stool softener (Colace and/or Senna): are available over the counter at your local pharmacy and should be taken while you are taking narcotic pain medication to avoid constipation. You should stop taking these medications if you develop diarrhea. Over the counter laxatives may be used if you develop painful constipation ICE: - Ice is a very important part of your recovery. It helps reduce inflammation and improves pain control. You should ice several times each day for 30 minutes at a time. Please make sure there is a thin piece of material (sheet or towel) between the ice and your skin. - If you opted for one of the commercially available ice machines and a compression setting is available, you should use LOW or no compression during the first 5 days. After that, you may increase compression setting as tolerated. If the compression is bothering you then do not use compression. - Ice as much as possible (30 minutes on, 30 minutes off, etc.). The more you ice during the first 2 weeks, the less pain, swelling, and inflammation you will experience. - If you have a known diagnosis of RSD or CRPS, please discuss with Dr. Taylor before using ice. BANDAGES: - You may remove the outer dressing after 3 days. - Do NOT remove Steri-strips if present. - Steri-strips may come off on their own, which is normal. INCISION: - Keep your incision clean and dry until your first postoperative visit, approximately 10-14 days after surgery. Do NOT get incisions wet as this increases the risk of developing an infection. - After the bandage has been removed, you may leave the incisions open to air. Alternatively, if you prefer to keep them covered, you may do so with Band-Aids, a light gauze dressing, or a clean ACE wrap. - Do NOT apply any ointment or creams to the incision. - Do NOT clean the incision.   CONSTIPATION Begin the following if no bowel movement by 3 days after surgery. All of the medications listed below can be obtained from your local pharmacy over-the-counter.  Stop if you develop diarrhea. Patients under age 18 should NOT use this regimen. - Postoperative Day 4-5: Colace 100mg caps 3 times per day AND Senna 2 tabs at bedtime. Increase by 2 tabs at mealtimes up to a maximum of 8 tabs per day if no bowel movement. - Postoperative Day 6: Continue above medications AND add Milk of Magnesia 30ml (2 tablespoons) 1-2 times per day. - Postoperative Day 7: Continue above medications AND add a Biscodyl rectal suppository or try a Fleets enema.   SHOWER: - You may shower after the bandage has been removed (3 days), but it is very important that you keep sutures dry. Covering them with saran wrap is often a very inexpensive and effective way to stay dry. There are a number of other water-repellent bandages available at your local pharmacy that works as well. - You may remove your sling or brace to shower, unless otherwise instructed. As your balance may be affected by recent surgery, we recommend placing a plastic chair or bench in the shower to help prevent falls. - Do NOT take baths, go into a pool, or soak the operative site until approved by Dr. Taylor at your first postoperative visit. PHYSICAL THERAPY: - You do not need to start any formal physical therapy unless otherwise instructed by Dr. Taylor. If he would like you to start physical therapy before your first post-operative visit, then you will be provided with a prescription.   DRIVING: - You may drive when you are (1) no longer wearing a sling or knee brace on the right leg and (2) when you are no longer taking narcotic pain medication. - It is against the law to drive while wearing (or should be wearing) a sling on either upper extremity or a brace on the right lower extremity. - It is against the law to drive while taking any narcotic pain medication (even when legally prescribed). TRAVEL: - Avoid long distance traveling after surgery. It is important to discuss your travel plans with Dr. Taylor, as additional medications may need to be prescribed to help prevent blood clots if certain travel is unavoidable. RETURNING TO WORK OR SCHOOL: - Typically, you may return to sedentary work or school 3-7 days after surgery if pain is tolerable and you are no longer requiring narcotic pain medication during work/school hours. - Taylor will determine when you may return to more physically rigorous demands. - If you require any specific letters for work or school please let us know. NORMAL SENSATIONS AND FINDINGS AFTER SURGERY: - PAIN: surgery hurts. We do everything possible to make your pain/discomfort level tolerable, but some amount of pain is to be expected. - WARMTH: mild amount of warmth around the operative site is normal for up to 3 weeks. - REDNESS: small amount of redness where the sutures enter the skin is normal. If redness worsens or spreads it is important that you contact the office. - DRAINAGE: a small amount is normal for the first 48-72 hours. If wounds continue to drain after this time, you need to contact the office. - NUMBNESS: around the incision is common. - BRUISING: is common and often tracks down the arm or leg due to gravity and results in an alarming appearance, but is common and will resolve with time. - FEVER: low-grade fevers (less than 101.5°F) are common during the first week after surgery. You should drink plenty of fluids and breathe deeply. A low-grade temperature is normal for a week after the surgery. PLEASE BE ADVISED OF THE FOLLOWING: Most orthopedic surgical procedures are uneventful. However, complications can occur. The following are things to be aware of in the immediate postoperative period. - FEVER – Low-grade fever is common after orthopaedic surgery, particularly within the first 5 days. Please notify Dr. Taylor if your temperature rises above 101.5ºF. - BLEEDING – It is fairly common to have minor bleeding that can even soak through the bandages. Notify us if the wound drains any fluid more than 4 days after surgery. - CARDIOVASCULAR – Chest pain, shortness of breath, palpitations, or fainting spells must be taken seriously. Go to the emergency room (or call 911) immediately for evaluation. Someone should notify both Dr. Taylor and your primary care doctor. - BLOOD CLOTS – Orthopaedic surgery patients are at risk for blood clots. While the risk is higher for lower extremity surgery, even those who have undergone upper extremity surgery are at an increased risk. Please notify Dr. Taylor if you or someone in your family has had blood clots or any type of known clotting disorder. Obesity or use of oral contraceptives can increase the risk of blood clots. Women should consider stopping oral contraceptive use until able to walk normally without crutches, brace, or cast on the leg. - Traveling after surgery – Long flights or car trips may increase the chance of blood clots. If you need to travel in the first 4 weeks after surgery, please inform us so that addition medication may be prescribed as necessary. - Signs of blood clots may include calf pain or cramping, diffuse swelling in the leg and foot, or chest pain and shortness of breath. Please call if you recognize any of these symptoms. There is noninvasive testing available to rule out this potentially life threatening condition. - CONSTIPATION – It is common to become constipated from taking narcotic pain medications so you may need to use a stool softener or laxative. These are available over the counter at any pharmacy. NOTIFY US IMMEDIATELY FOR ANY OF THE FOLLOWING: - Temperature greater than 101.5°F. - Severe nausea, vomiting, diarrhea, or constipation. - Chest pain or shortness of breath (go to ER). - Sutures become loose or fall out and incision becomes open. - Change is noted to your incision (increased redness or drainage). - Drainage persists greater than 4 days or becomes yellow or foul smelling. - Increased pain unrelieved by medication or measures mentioned above. FOLLOW-UP: - Follow-up appointment should be arranged for 10-14 days after surgery. If one has not been provided, please call the office to schedule. ## Office Staff Kerry Sullivan (Office Manager): Kerry is a native of Bronx, NY and a graduate of Pace University. She brings with her 12 years of healthcare administrative experience at Liberty Management/Arms Acres and NY Presbyterian Hospital. She works hard to ensure that the patient experience is smooth from initial phone call to final office visit. ## Directions HSS Stamford View Directions HSS Main Campus View Directions ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Postoperative FAQ’s - Samuel A. Taylor, MD Source: /patient-resources/faqs/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage What are some warning signs of infection? - If you have a ­measured temperature greater than 101.5°F, recurrent chills, yellow or foul smelling drainage, or increasing redness around the incisions you should call the office. What if I have a low-grade fever after surgery? - A have a low-grade fever (less than 101.5°F) during the first week after your surgery is common. This is a normal response by your body to the stress of surgery. Drinking plenty of fluids and taking deep breaths is helpful. Is the swelling normal? - Yes, some swelling is normal. For lower extremity surgery, it will be worse when the leg is down and better when the leg is elevated. Elevation and ice can be very helpful. If the swelling does not go down or you start to develop calf pain please notify the office. For upper extremity surgery, movement of the wrist/hand/fingers, particularly repetitive squeezing an object such as silly putty can help reduce swelling Why is there bruising that tracks down the operative limb? - This is normal after surgery. Blood from the surgical site is pulled down by gravity and causes bruising in locations away from the area that was operated on. Some people get bruising into the foot after knee surgery or the fingers after shoulder surgery. You should not be alarmed it will resolve over 3-5 weeks. The amount of such bruising varies by person. Is pain normal? - Yes, surgery is painful. The most pain will occur within the first 72 hours after surgery. There is no purpose in “being a hero” during this time. During the early postoperative period, pain is like fire, if you wait too long to put it out it gets out of control. Take your pain medicines when scheduled for the first few days and then you can begin to space them out. Remember, it takes 30-45 minutes for a pain pill to begin working, so do not wait for the pain to become unbearable before taking the next dose. Also, ice is one of the most important parts of pain relief. How often should I ice? - Ice and elevation are your best friends! You should ice around the clock (30 minutes on, 30 minutes off) for the first 3-5 days. Then ice at least 3 times per day thereafter. Be sure to place a thin towel between the ice and your skin. Should fluid draining from the incisions alarm me? - If you had arthroscopic surgery, some draining fluid onto the dressing is normal during the first 24-48 hours because we use large amount of water during the surgery and it is therefore only natural for some of this fluid to leak out while your body absorbs the rest. If the bulky bandage becomes wet and red, do not be alarmed; just reinforce it with another bandage. If you have persistent drainage 4 days after surgery, please contact the office. How do I take off the bandage? - You may remove the dressing 72 hours after surgery. For knee surgery, remove the ACE wrap and gauze underneath throw it away. For shoulder surgery, carefully peal back the tape and remove the gauze underneath. If there are pieces of yellow gauze you may remove them. Do NOT remove any steri-strips if present. The incisions can stay open to air at this point. You may cover them if you wish with a clean ACE wrap, Band-Aids, or loose gauze dressing so it does not rub/catch on your clothes. Do NOT apply any ointments, creams, or gels.  How do I elevate? - For lower extremity surgery, prop the leg up (elevation) using several pillows or blankets underneath. Elevation is extremely important to limits swelling and pain after surgery. Proper elevation works by gravity. The foot should be higher than the knee, which should be higher than the hip allowing gravity to pull the fluid/swelling back towards the heart.   What activities can I do? - It is very important for you to do as much activity as possible while still adhering to the limits imposed by Dr. Taylor. Simply getting up and walking around the house is important. This will decrease the possibilities of post-anesthesia problems such as pneumonia and blood clots. Generally, if you have a job with little physical activity, you may return to work 3-7 days after surgery. If your job requires excessive lifting or use of the arm, then discuss your return to work date with your doctor. When can I drive? - You cannot drive for at least 6 weeks following shoulder surgery or at least 4 weeks following knee surgery depending on the side and type of surgery. Prescription narcotic pain medications impair your motor skill, reaction time and judgment. It is against the law to drive while taking prescription pain medications (even if they were prescribed for you). It is also against the law to drive while you are (or should be) in a sling or brace. What happens at my first post-operative visit? - Your first postoperative visit typically occurs 10-14 days after surgery. Dr. Taylor will review your surgery and any arthroscopic photographs. He will outline your post-operative physical therapy protocol. If you have sutures that need to be removed, they will be. You will be provided a copy of your operative report and any arthroscopic pictures for your records. What if I need a pain medicine refill? - Only your doctor and his staff can call in pain medication. During the weekend, on call doctors will NOT call in prescriptions for you.       Therefore, if you feel that you will need a prescription during the weekend, please call the office during regular business hours. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Office Staff - Samuel A. Taylor, MD Source: /patient-resources/office-staff/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Kerry Sullivan (Office Manager): Kerry is a native of Bronx, NY and a graduate of Pace University. She brings with her 12 years of healthcare administrative experience at Liberty Management/Arms Acres and NY Presbyterian Hospital. She works hard to ensure that the patient experience is smooth from initial phone call to final office visit. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Postoperative Instructions - Samuel A. Taylor, MD Source: /patient-resources/postoperative-instructions/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage DIET: - Begin with clear liquids and light foods (jello, soup, etc.). Progress to normal diet as tolerated if you are not nauseated. - Avoid greasy or spicy foods for the first 24hrs to avoid GI upset. - Increase fluid intake (water, Gatorade, etc.) to help prevent constipation. ANESTHESIA: - The anesthesia team may have placed a nerve block prior to surgery to help with post-operative pain control. As a consequence, you may have numbness or inability to move the limb after surgery. Do not be alarmed as this may last 8-36 hours depending upon the amount and type of medication used by the anesthesiologist. - If you are experiencing numbness after 36 hours, please call the office. - When the nerve block begins to wear off, you will feel a tingling sensation, like pins and needles. It is important that you start taking the pain medication at that time to ensure that you stay ahead of the pain.   PRESCRIBED MEDICATIONS: - Narcotic pain medicine (Percocet or Norco): may cause constipation, nausea, itching, and excessive drowsiness. You should take an over-the-counter stool softener (Colace and/or Senna) while taking narcotics to prevent constipation, but stop if you develop diarrhea. If you experience itching, over the counter Benadryl may be helpful. Narcotic pain medications often produce drowsiness and it is against the law to operate a vehicle while taking these medications. - Anti-inflammatory (NSAID) medicine (Naprosyn or Mobic): do NOT take this medication if you have had an ulcer in the past unless you have cleared this with you primary care doctor. You should take NSAIDs with food to reduce the chance of upset stomach. - Anti-nausea medicine (Zofran): sometimes patients experience nausea related to either anesthesia or the narcotic pain medication. If this is the case you will find this medication helpful. - DVT prophylaxis (Aspirin, Xarelto, Lovenox, or Coumadin): For most patients, activity alone is sufficient to prevent dangerous blood clots, but in some cases your personal risk profile and/or the type of surgery you have undergone makes it necessary that you take medication to help prevent blood clots. - Stool softener (Colace and/or Senna): are available over the counter at your local pharmacy and should be taken while you are taking narcotic pain medication to avoid constipation. You should stop taking these medications if you develop diarrhea. Over the counter laxatives may be used if you develop painful constipation ICE: - Ice is a very important part of your recovery. It helps reduce inflammation and improves pain control. You should ice several times each day for 30 minutes at a time. Please make sure there is a thin piece of material (sheet or towel) between the ice and your skin. - If you opted for one of the commercially available ice machines and a compression setting is available, you should use LOW or no compression during the first 5 days. After that, you may increase compression setting as tolerated. If the compression is bothering you then do not use compression. - Ice as much as possible (30 minutes on, 30 minutes off, etc.). The more you ice during the first 2 weeks, the less pain, swelling, and inflammation you will experience. - If you have a known diagnosis of RSD or CRPS, please discuss with Dr. Taylor before using ice. BANDAGES: - You may remove the outer dressing after 3 days. - Do NOT remove Steri-strips if present. - Steri-strips may come off on their own, which is normal. INCISION: - Keep your incision clean and dry until your first postoperative visit, approximately 10-14 days after surgery. Do NOT get incisions wet as this increases the risk of developing an infection. - After the bandage has been removed, you may leave the incisions open to air. Alternatively, if you prefer to keep them covered, you may do so with Band-Aids, a light gauze dressing, or a clean ACE wrap. - Do NOT apply any ointment or creams to the incision. - Do NOT clean the incision.   CONSTIPATION Begin the following if no bowel movement by 3 days after surgery. All of the medications listed below can be obtained from your local pharmacy over-the-counter.  Stop if you develop diarrhea. Patients under age 18 should NOT use this regimen. - Postoperative Day 4-5: Colace 100mg caps 3 times per day AND Senna 2 tabs at bedtime. Increase by 2 tabs at mealtimes up to a maximum of 8 tabs per day if no bowel movement. - Postoperative Day 6: Continue above medications AND add Milk of Magnesia 30ml (2 tablespoons) 1-2 times per day. - Postoperative Day 7: Continue above medications AND add a Biscodyl rectal suppository or try a Fleets enema.   SHOWER: - You may shower after the bandage has been removed (3 days), but it is very important that you keep sutures dry. Covering them with saran wrap is often a very inexpensive and effective way to stay dry. There are a number of other water-repellent bandages available at your local pharmacy that works as well. - You may remove your sling or brace to shower, unless otherwise instructed. As your balance may be affected by recent surgery, we recommend placing a plastic chair or bench in the shower to help prevent falls. - Do NOT take baths, go into a pool, or soak the operative site until approved by Dr. Taylor at your first postoperative visit. PHYSICAL THERAPY: - You do not need to start any formal physical therapy unless otherwise instructed by Dr. Taylor. If he would like you to start physical therapy before your first post-operative visit, then you will be provided with a prescription.   DRIVING: - You may drive when you are (1) no longer wearing a sling or knee brace on the right leg and (2) when you are no longer taking narcotic pain medication. - It is against the law to drive while wearing (or should be wearing) a sling on either upper extremity or a brace on the right lower extremity. - It is against the law to drive while taking any narcotic pain medication (even when legally prescribed). TRAVEL: - Avoid long distance traveling after surgery. It is important to discuss your travel plans with Dr. Taylor, as additional medications may need to be prescribed to help prevent blood clots if certain travel is unavoidable. RETURNING TO WORK OR SCHOOL: - Typically, you may return to sedentary work or school 3-7 days after surgery if pain is tolerable and you are no longer requiring narcotic pain medication during work/school hours. - Taylor will determine when you may return to more physically rigorous demands. - If you require any specific letters for work or school please let us know. NORMAL SENSATIONS AND FINDINGS AFTER SURGERY: - PAIN: surgery hurts. We do everything possible to make your pain/discomfort level tolerable, but some amount of pain is to be expected. - WARMTH: mild amount of warmth around the operative site is normal for up to 3 weeks. - REDNESS: small amount of redness where the sutures enter the skin is normal. If redness worsens or spreads it is important that you contact the office. - DRAINAGE: a small amount is normal for the first 48-72 hours. If wounds continue to drain after this time, you need to contact the office. - NUMBNESS: around the incision is common. - BRUISING: is common and often tracks down the arm or leg due to gravity and results in an alarming appearance, but is common and will resolve with time. - FEVER: low-grade fevers (less than 101.5°F) are common during the first week after surgery. You should drink plenty of fluids and breathe deeply. A low-grade temperature is normal for a week after the surgery. PLEASE BE ADVISED OF THE FOLLOWING: Most orthopedic surgical procedures are uneventful. However, complications can occur. The following are things to be aware of in the immediate postoperative period. - FEVER – Low-grade fever is common after orthopaedic surgery, particularly within the first 5 days. Please notify Dr. Taylor if your temperature rises above 101.5ºF. - BLEEDING – It is fairly common to have minor bleeding that can even soak through the bandages. Notify us if the wound drains any fluid more than 4 days after surgery. - CARDIOVASCULAR – Chest pain, shortness of breath, palpitations, or fainting spells must be taken seriously. Go to the emergency room (or call 911) immediately for evaluation. Someone should notify both Dr. Taylor and your primary care doctor. - BLOOD CLOTS – Orthopaedic surgery patients are at risk for blood clots. While the risk is higher for lower extremity surgery, even those who have undergone upper extremity surgery are at an increased risk. Please notify Dr. Taylor if you or someone in your family has had blood clots or any type of known clotting disorder. Obesity or use of oral contraceptives can increase the risk of blood clots. Women should consider stopping oral contraceptive use until able to walk normally without crutches, brace, or cast on the leg. - Traveling after surgery – Long flights or car trips may increase the chance of blood clots. If you need to travel in the first 4 weeks after surgery, please inform us so that addition medication may be prescribed as necessary. - Signs of blood clots may include calf pain or cramping, diffuse swelling in the leg and foot, or chest pain and shortness of breath. Please call if you recognize any of these symptoms. There is noninvasive testing available to rule out this potentially life threatening condition. - CONSTIPATION – It is common to become constipated from taking narcotic pain medications so you may need to use a stool softener or laxative. These are available over the counter at any pharmacy. NOTIFY US IMMEDIATELY FOR ANY OF THE FOLLOWING: - Temperature greater than 101.5°F. - Severe nausea, vomiting, diarrhea, or constipation. - Chest pain or shortness of breath (go to ER). - Sutures become loose or fall out and incision becomes open. - Change is noted to your incision (increased redness or drainage). - Drainage persists greater than 4 days or becomes yellow or foul smelling. - Increased pain unrelieved by medication or measures mentioned above. FOLLOW-UP: - Follow-up appointment should be arranged for 10-14 days after surgery. If one has not been provided, please call the office to schedule. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Preoperative Instructions - Samuel A. Taylor, MD Source: /patient-resources/preoperative-instructions/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage TYPE OF SURGERY: - Ambulatory Surgery: are procedures from which you are able to go home the same day without an overnight stay.  Ambulatory surgery is also called outpatient surgery.  The majority of surgeries performed by Dr. Taylor are ambulatory. - 23-Hour Stay: some patients may be advised to stay overnight for observation, pain control, or due to a late case.  Patients with sleep apnea are required to stay overnight for observation unless cleared by the anesthesiologist. - Inpatient: are surgeries with an anticipated hospital stay greater than 23-hours.  Details regarding room allocation, private rooms, television, telephone, Internet, and private duty nursing are available upon request.  MEDICAL CLEARANCE: - Depending upon the planned surgical procedure and your medical history, you may be required to undergo Pre-Admission Testing, medical clearance, and/or obtain clearance from a specialty consultant such as a cardiologist or hematologist. - No Medical Clearance required: young healthy patients scheduled for ambulatory surgery are not required to undergo any special pre-admission testing. - Pre-Admission Testing (PAT), also known as Pre-Surgical Screening, is an HSS service completed within 10 days of your surgical procedure. Includes blood and urine tests, x-rays, and EKG. - Patients scheduled for inpatient surgery will also have a consultation with a medical doctor. - Bring your medications (prescribed and over the counter) with you to the PAT appointment. - Medical Clearance: may be obtained from your primary care doctor or by appointment at HSS main campus. - If your primary care doctor is to clear you for surgery, they must fill out the “Adult Medical Consultation” form. This form can also be downloaded from our website, www.SamTaylorMD.com. You are responsible for providing this form to your doctor. - Medical clearance must be completed no more than 10 days prior to your scheduled surgery. - All outside test results and the medical clearance note must be faxed to our office, (203) 705-2929, no later than the Thursday prior to your scheduled surgery. - Cardiologist Clearance: is required if you have cardiac stents, a pacemaker, history of an arrhythmias, have had any kind of heart surgery, or have had a heart attack. - Hematology Recommendations: may be requested if you have a personal history of blood clot (DVT or PE) or a strong family history of blood clots. - Additional Medical Subspecialty Recommendations: may be requested based upon specific aspects of your health history. - Blood Thinners: If you take a blood thinner (Warfarin, Coumadin, Plavix, Clopidogrel, Aspirin, Heparin, Aggrenox, Lovenox, Enoxaparin, Xarelto, Rivaroxaban, etc.), you MUST have specific instructions from the prescribing physician regarding stopping and restarting of these medications.  In general, we recommended these medications be discontinued approximately 7-10 days prior to your planned procedure. Please follow your prescribing doctor’s recommendations.  MEDICATIONS: - Please contact your medical doctor before discontinuing any medications. - You take Tylenol up to the time of surgery as needed for pain. - Do NOT take anti-inflammatories (Aspirin, Naprosyn, Aleve, Advil, Motrin, Ibuprofen, etc.) within 10 days of surgery.  These medications increase the bleeding risk during/after surgery. - Do NOT take any herbal medications, natural products, or vitamin supplements (alfalfa, capsicum, celery seed, chamomile, chondroitin, clove, dandelion, dong quai, feverfew, fish oil, flax seed, gamma linoleic acid, garlic, ginger, gingko, ginseng, glucosamine, horseradish, licorice, liver oil, melatonin, onion, papain, papaya, parsley, passionflower, poplar, resveratrol, sweet cover, turmeric, willow bark, etc.) within 10 days of surgery. Many of these increase bleeding risk during/after surgery. - Birth Control: may increase the risk of developing a blood clot following lower extremity surgery. It is recommended that you stop birth control until you are full weight bearing and are walking normally without crutches. - Blood Thinners: As above.  PREPARING FOR SURGERY: - Insurance Coverage: our office will call for pre-certification with insurance if required.  Please be advised that this process does take time. You should contact your insurance company directly with any questions regarding coverage and benefit information. - Immunization Record: anyone under 18 years of age must obtain a copy of the immunization records from your school or pediatrician’s office. - Bring Imaging Studies: (X-ray, MRI, or CT scan) performed outside of HSS with you on the day of surgery. - Arrange Escort: Please make arrangements for someone to take you home.  The hospital requires that ambulatory surgery patients arrange for an escort home. You will not be allowed to leave the hospital without an escort. In some cases, surgery may be cancelled if you have not established this arrangement upon registration. - Ice Machine: icing is very important and helps reduce inflammation and improve pain control. You may wish to purchase one of the commercially available ice machines (GameReady®, AirCast®, Cothera®, etc.). These are rarely covered by insurance, so they may represent out of pocket costs (typically $225-$350). Most patients who purchase one of these ice machines are very happy with their investment. One of the HSS vendors will reach out to you prior to surgery.  DAY BEFORE SURGERY: - Wash Body with Hibiclens: which is a special type of soap that kills germs on contact and can continue working for up to 24 hours!  It can be purchased at your local pharmacy (www.hibiclens.com) without a prescription. Hibiclens kills the bacteria on your skin that can cause infection after surgery.  It is gentle enough for sensitive skin and has been shown to reduce infection rates. Do NOT use if you have an allergy to chlorohexidine gluconate. Below are instructions for its use: Wash your hair first using using regular shampoo. - Rinse hair and body thoroughly with warm water to remove any shampoo residue. - Move away from the shower stream when applying Hibiclense to avoid it rinsing off too soon. - Apply Hibiclens directly on your skin or using a wet washcloth. - Allow Hibiclens to sit on your skin for 2-5 minutes - Rinse thoroughly with warm water. - Do NOT use regular soap after applying and rinsing Hibilens. - Do NOT apply any lotions to your skin. - Do NOT eat or drink anything after midnight before your surgery unless specifically instructed by an HSS representative over the phone. - You will receive a call from a member of the HSS nursing staff between 2pm and 7pm on the day before your surgery regarding the time of the procedure and when you need to arrive.  In general, you should plan on arriving at the hospital 2 hours before the planned start time. Recorded pre-operative information is available by calling (212) 606-1630. - If you have not heard from HSS by 7pm the day before your scheduled surgery, please call (212) 606-1710 and explain that you are awaiting pre-surgical instruction. - HSS (not our office) determines the surgical schedule.  As such, changes/delays in your OR time may occur due to unforeseen emergencies.  Please be understanding of the dynamic nature of the OR schedule.  DAY OF SURGERY: - What to Bring: One Small Bag: will be securely stored during surgery. - Verification of Identity: bring a government issued identification. - List of Medications: including prescribed, over-the counter, and herbals. - Immunization Records: mandatory for those younger than 18 years. - Telephone numbers of people you want to call. - Primary Care Physician’s Contact Info - Pregnancy Test: is mandatory for all women who are menstruating and menopausal women who have menstruated within the preceding year. - History and Physical Examination: will be performed by an HSS physician assistant. - Dr. Taylor will meet with you before surgery, confirm the planned surgical procedure, answer any remaining questions, and mark the operative site with his initials. - Anesthesia: You will meet with the anesthesiologist prior to surgery and have the opportunity to ask questions about the type of anesthesia you will be receiving. Regional (nerve block) Anesthesia: is a technique where a portion of the patient’s body is rendered insensitive (numb) so that you don’t feel any pain during surgery. You will also be given sedation so that you sleep through the procedure, however you continue to breath on your own. We prefer regional anesthesia for most patients. - General Anesthesia: is when you are completely asleep during the procedure, and require a breathing tube.  AFTER SURGERY: - Recovery Room (PACU): the anesthesia team and nursing staff will monitor your postoperative care and your return to full awareness. Regardless of the type of anesthesia performed, you will stay at the hospital until your condition is stable and you are safe to leave. - Postoperative Instructions: you will be provided detailed postoperative instructions after surgery. If you wish to review general postoperative instructions and answers to frequently asked questions prior to your surgery you can do so on our website www.SamTaylorMD.com. - Prescriptions: you will be given prescriptions for pain medication and any other required medications after surgery. - Discharge: in order to be considered safe to go home you must be able to stand up and walk without felling dizzy or lightheaded, tolerate food and drink, and be able to urinate. When you are considered safe to leave, the person escorting you home will be asked to bring the car to the main hospital entrance. HSS surgical personnel will escort you to the car and assist with your departure. - Phone Call: Dr. Taylor will call you the day after surgery to check on you and answer questions. - First postoperative visit: typically occurs 10-14 days after surgery. Please call the office to arrange.  RETURNING TO WORK OR SCHOOL: - This varies widely by patient and type of surgery performed - Many patients are able to return to sedentary work or school 3-7 days after surgery. - You must no longer require narcotic pain medication during work/school hours. - Dr. Taylor will determine when you may return to more physically rigorous demands. - If you require any specific letters for work or school please let us know.  BILLING: - The surgical fee will include three post-operative visits within 90 days of surgery.  If you have any questions and would like to speak with someone from the billing department please call our office (203) 705-0750 or (646) 714-6324. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## What to Bring - Samuel A. Taylor, MD Source: /patient-resources/what-to-bring/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage In order to provide you the best possible recommendation and return you to action as soon as possible, it is important that you bring all pertinent information to your initial visit with Dr. Taylor. If you have had any X-rays, CT scans, or MRI’s, please bring the actual disc with you in addition to the radiologist’s report. ### Pre-Visit Checklist - Previous Images (X-ray, CT scan, MRI, etc.) You need to obtain and bring with you BOTH the actual films as the radiologist generated report. We prefer that you bring these studies in yourself rather than mailing them to our office to ensure that they make it to Dr. Taylor in time for your visit. If you bring a disc, we will upload the images to our system and return the disc to you after your visit. - Medical Records Please obtain and bring with you a copy of your medical records, especially if you have already seen another orthopaedic surgeon. - Operative Reports If you have previously undergone surgery to the body part of concern, it is important that you bring a copy of the operative report and operative pictures if available. - Home Medications Please bring a list of any prescription and over the counter medications that you are currently taking along with their doses. - Primary Care Referral If required by your insurance carrier, obtain a referral from your primary care physician and bring it with you. - Insurance Card Bring your insurance card. We will need to make a copy of the card for our records. - Government Issued ID Bring a photo ID (driver’s license, passport, state-issued ID card, etc.). - Medical Questionnaires You will need to complete a medical questionnaire. You can download a copy of the medical questionnaire and complete it before your visit. - Workers’ Compensation If this is a work-related injury, please bring a copy of the first report of your injury including your claim number. Bring any imaging films and reports that relate to this injury. If, for any reason, workers’ compensation contests or denies your claim we can submit the charges to your health insurance only if you have followed their rules and have obtained a referral, if required. - Co-Pay You insurance may require a co-pay that must be paid at the time of your visit. We accept cash, check, Mastercard, Visa, American Express and Discover - List of Questions Dr. Taylor will make every effort to answer your questions. Having a list in advance can be helpful. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## What to Expect - Samuel A. Taylor, MD Source: /patient-resources/what-to-expect/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Our goal is to provide you the quality care that you deserve. We do our best to streamline the process and be respectful of your time. You can help us by filling out the ‘Initial Visit Medical History’ and other important information listed below in ‘What to Bring’ section. You should arrive 30 minutes early to allow time for registration and any additional X-rays requested by Dr. Taylor prior to your scheduled visit. It is very important that you understand your injury and proposed treatment. It is normal to feel somewhat overwhelmed after a visit and therefore very helpful and important to review the educational material compiled by Dr. Taylor under the ‘Education’ section of this website. You are encouraged to ask questions throughout the evaluation and treatment process. A written list of questions can be quite helpful. If questions remain after your visit, please feel free to call the office. ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Lecture Circuit Archives - Samuel A. Taylor, MD Source: /presstypes/lecture-circuit/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Click on title to view PDF or article. OCD of the Humeral Capitellum HSS Rehabilitation Network Annual Meeting. New York, NY. March 10,2015 An Update on Shoulder Instability HSS Resident Lecture Series. New York, NY. January 13, 2015 Managing Rotator Cuff Disease HSS Resident Lecture Series. New York, NY. January 6, 2015 The Bicipital Tunnel: Expanding our Understanding of “Biceps Tendinitis” Andrews Institute of Orthopaedics and Sports Medicine Grand Rounds. Gulf Breeze, FL. November 10, 2014 The Bicipital Tunnel: Expanding our Understanding of “Biceps Tendinitis” “W” Society Annual Meeting at AOSSM. Seattle, WA. July 11, 2014 Standard Diagnostic Arthroscopy Fails to Fully Evaluate the Biceps-Labral Complex AANA Annual Meeting. Hollywood, FL. May 1-3, 2014. ** Winner of the 2014 J. Whit Ewing Resident/Fellow Essay Award – Clinical. Clinical Examination of the Athlete’s Knee Current Concepts in Sports Medicine Course. Hospital for Special Surgery. New York, April 26, 2014 The Bicipital Tunnel: Expanding our Understanding of “Biceps Tendinitis” Annual West Point Sports Medicine Fellows Conference. West Point, NY. June 12, 2014 Arthroscopic Transfer of the Long Head of the Biceps Tendon: 2-10 Year Clinical Results Podium presentation – AAOS Annual Meeting, New Orleans, LA. March 13, 2014 The Impact of Coronal Alignment on DRUJ Stability After Distal Radius Fracture New York Society for Surgery for the Hand (NYSSH). New York, NY. May 14, 2013 Arthroscopic Transfer of the Long Head of the Biceps Tendon: 2-10 Year Functional Outcomes and Clinical Results AANA Annual Meeting. Hollywood, FL. May 1-3, 2014 Hidden Lesions of the Long Head of the Biceps Tendon: A Cadaveric and Clinical Analysis AAOS Annual Meeting. Chicago, IL. March 19-23, 2013 Early-Term Results of Shoulder Arthroplasty Utilizing a Mini-Stem Humeral Component AAOS Annual Meeting. Chicago IL. March 19-23, 2013 Hidden Lesions of the Long Head of the Biceps Tendon: A Cadaveric and Clinical Analysis HSS Chief Resident Research Day. New York, NY. March 14, 2013 Everything I Wish Someone Told Me About Residency HSS Orientation. June 2011 Osteoarthritis and Exercise HSS Geriatrics Conference. May 2011 Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Media Archives - Samuel A. Taylor, MD Source: /presstypes/media/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Click on title to view PDF or article. TIPS TO AVOIDING TOMMY JOHN INJURIES 2015 ASK THE EXPERT: BICEPS TENDINITIS 2015 Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Published Research Archives - Samuel A. Taylor, MD Source: /presstypes/published-research/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Click on title to view PDF or article. Quantitative Assessment of Patellar Vascularity Following Bone-Patellar Tendon-Bone Autograft Harvest for ACL Reconstruction 2015 Jan 22 Open and Arthroscopic Anterior Shoulder Stabilization 2015 Standard Diagnostic Glenohumeral Arthroscopy Fails to Fully Evaluate the Biceps-Labrum Complex 2014 Dec 10 The Anatomy and Histology of the Bicipital Tunnel of the Shoulder 2014 Nov 18 Online Resources for Shoulder Instability: What Are Patients Reading? 2014 Oct 15 Midterm Clinical Outcomes for Arthroscopic Subdeltoid Transfer of the Long Head of the Biceps Tendon to the Conjoint Tendon 2014 Sep 17 The Impact of Coronal Alignment on DRUJ Stability After Distal Radius Fracture 2014 May 20 Osteoid Osteoma of the Triquetrum: A Delayed Diagnosis 2014 Compartment Syndrome: Diagnosis, Management and Unique Concerns in the Twenty-first Century 2014 Arthroplasty for Proximal Humerus Fractures: A Review of Current Management 2013 Dec 28 Augmentation Techniques for Isolated Meniscal Tears 2013 Jun Synthetic Playing Surfaces and Athlete Health 2013 May The Arthroscopic “SubDeltoid Approach” to the Anterior Shoulder 2013 Apr Evaluation and Management of Proximal Humerus Fractures 2012 Dec 18 Does the Quality, Accuracy, and Readability of Information About Lateral Epicondylitis on the Internet Vary with the Search Term Used? 2012 Dec A Review of Synthetic Playing Surfaces, the Shoe-Surface Interface, and Lower Extremity Injury in Athletes 2012 Nov Evaluation and Management of Elbow Tendinopathy 2012 Sept Peripheral Nerve Injuries in Sports-Related Surgery: Presentation, Evaluation and Management: AAOS Exhibit Selection 2012 Aug 15 The Effect of Search Term on the Quality and Accuracy of Online Information Regarding Distal Radius Fracture 2012 Jul 31 An Analysis of the Shoulder & Elbow Section of the Orthopaedic In-Training Examination 2012 Feb Digital Artery Pseudoaneurysm Following Percutaneous Trigger Thumb Release 2012 Jan 18 Arthroscopic Transfer of the Long Head of the Biceps Tendon: Functional Outcome and Clinical Results 2008 Feb Biceps Transfer Using Subdeltoid Arthroscopy 2007 Biceps Transfer Using Subdeltoid Arthroscopy 2008 Arthroscopic Release of the Long Head of the Biceps Tendon: Functional Outcome and Clinical Results February 2005 Arthroscopic Release of the Long Head of the Biceps Tendon: Functional Outcome and Clinical Results 2005 Feb Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Upcoming Talks Archives - Samuel A. Taylor, MD Source: /presstypes/upcoming-talks/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Click on title to view PDF or article. The Role of MRI In Diagnosing Biceps Chondromalacia Podium presentation at AOSSM Annual Meeting. Orlando, FL. July 10, 2015 Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Share Your Experience - Samuel A. Taylor, MD Source: /share-your-experience/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Share Your Experience #### Contact Us: E. tayloroffice@hss.edu Stamford Office HSS Stamford Outpatient 1 Blachley Road Stamford, CT 06902 Tel 203.705.0750 Fax 203.705.2929 Manhattan Office Hospital for Special Surgery 535 East 70th Street New York, NY 10021 Tel 646.714.6324 Fax 646.714.6378 [contact-form-7 id=”492″ title=”Experience”] You may also wish to share your story about how Dr. Taylor helped get you back in the game on the HSS website. You can submit your story with a picture or video at https://backinthegame.hss.edu Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Thank You - Samuel A. Taylor, MD Source: /thank-you/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Stamford Office HSS Stamford 1 Blachley Road Stamford, CT 06902 Tel 203.705.0750 Fax 203.705.2929 Office Hours: Monday: 9am – 4pm Tuesday: 9am – 4pm Wednesday: 9am – 4pm Thursday: 9am – 4pm Friday: 9am – 4pm Manhattan Office Hospital for Special Surgery 535 East 70th Street New York, NY 10021 Tel 646.714.6324 Fax 646.714.6378 Office Hours: Monday: 9am – 4pm Tuesday: 9am – 4pm Wednesday: 9am – 4pm Thursday: 9am – 4pm Friday: 9am – 4pm # CONTACT INFO ## If you any question or if you would like to schedule an appointment, contact us today. # Thank You Your message has been received. Dr. Taylor's office will be in touch shortly. ← Return to the homepage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## The HSS Advantage - Samuel A. Taylor, MD Source: /the-hss-advantage/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # The HSS Advantage Hospital for Special Surgery is the #1 ranked hospital in the nation for orthopaedics by U.S. News & World Report. Every surgeon, doctor, scientist, nurse, and therapist is a specialist in caring for orthopaedic patients. Founded in 1863, HSS is the nation’s oldest orthopaedic hospital built upon traditions of innovation, research, education, and excellence. Today, more than 25,000 surgical procedures are performed annually including many of the most complex cases encountered. Furthermore, HSS has one of the lowest infection rates in the nation. Nursing, radiology, and anesthesia have all been nationally and internationally recognized for their excellence. Nursing has been recognized with the Magnet Award for Nursing Excellence and was the first hospital in the State of New York to be re-designated with Nursing’s highest honor. Hospital for Special Surgery is one of the largest academic centers for musculoskeletal imaging. The anesthesiologists pioneered the use of regional anesthesia techniques, which have been associated with less post-operative pain, less nausea, reduced blood loss, and lower incidence of blood clots. Hospital for Special Surgery is dedicated to training tomorrow’s leaders. The orthopaedic surgery residency program is one of the most sought after programs in the country and routinely gets over 500 applications for 9 positions available each year. Professional teams and elite athletes from around the world trust HSS. Doctors and therapists from Hospital for Special Surgery have the distinction of being the team physicians and athletic trainers for the New York Football Giants, New York Mets, New York Knicks, Brooklyn Nets, New York Liberty, New York Red Bulls, US Rowing, USA Swimming, and FIFA among many others. Not only do specialists send their patients, our patients recommend HSS to their friends and family. When benchmarked against other hospitals across the nation, HSS ranked in the 99th percentile for overall patient satisfaction and likelihood to recommend to others. Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Tips to Avoid Tommy John Injuries - Samuel A. Taylor, MD Source: /tips-to-avoid-tommy-john-injuries/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Tips to Avoid Tommy John Injuries by Dr. Sam Taylor | Jun 10, 2015 | Uncategorized | 0 comments Keep their elbow out of the OR… Only a few weeks into the 2015 MLB preseason and players have already succumbed to ulnar collateral ligament (UCL)injuries. The surgery to reconstruct the UCL named after Tommy John, who produced a 3.1 ERA over many seasons following this surgery. The increasing number of Tommy John surgeries occurring annually in the US has led some to call it an epidemic. While the surgery has demonstrated great success, it is important to realize that 10-30% of people never return to the same level of play after surgery. The most important form of treatment is actually prevention. UCL injury is related to overuse. Many adolescents today focus their athletic efforts on a single sport year round.  This unremitting stress on the throwing shoulder and elbow can increase the risk of injury. Keep track of innings and pitch counts. It is not uncommon for kids to play on several teams with overlapping seasons, which can result in inadequate throwing rest. There is a 3.5x increased injury risk if >100 innings are pitch in 12 months and 5x risk if >8 months of consecutive play. All innings and pitches should count towards the total (even showcase innings). Don’t throw for the radar gun. Forced attempts to hit higher than normal velocity may result in poor throwing mechanics and fatigue which have been correlated with increased risk of UCL injury. Communication is critical. Comprehensive care of the throwing athlete demands open lines of communication among player, parents, coaches, and trainers to ensure that pitchers are not intentionally or unintentionally overused. Listen to your child. Shoulder and elbow pain is not normal in the adolescent athlete. They should not take anti-inflammatory medications to “push through the pain” to play. Such symptoms should be taken seriously and prompt further evaluation. Dr. Samuel Taylor, Sports Medicine Surgeon, has developed a unique understanding of the demands and anxieties faced by injured athletes at all levels. His clinical expertise includes minimally invasive and reconstructive techniques of the shoulder, elbow, and knee. Dr. Taylor currently serves as Associate Team Physician for the New York Giants and team physician for the Fire Department of New York (FDNY) semi-professional football team.  Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- # Contact ## Contact - Samuel A. Taylor, MD Source: /contact/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Stamford Office HSS Stamford 1 Blachley Road Stamford, CT 06902 Tel 203.705.0750 Fax 203.705.2929 Office Hours: Monday: 9am – 4pm Tuesday: 9am – 4pm Wednesday: 9am – 4pm Thursday: 9am – 4pm Friday: 9am – 4pm Manhattan Office Hospital for Special Surgery 535 East 70th Street New York, NY 10021 Tel 646.714.6324 Fax 646.714.6378 Office Hours: Monday: 9am – 4pm Tuesday: 9am – 4pm Wednesday: 9am – 4pm Thursday: 9am – 4pm Friday: 9am – 4pm # CONTACT INFO ## If you any question or if you would like to schedule an appointment, contact us today. Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Directions - Samuel A. Taylor, MD Source: /patient-resources/directions/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage HSS Stamford Outpatient Facility View Directions to HSS Stamford (PDF) HSS Main Campus View Directions to the HSS Main Campus (PDF) ## Patient Resources - What to Expect - Insurance Information - What to Bring - Patient Forms - Preoperative Instructions - Postoperative Instructions - Postoperative FAQ’s - Office Staff - Directions Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- # Legal ## Accessibility Statement - Samuel A. Taylor, MD Source: /accessibility-statement/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Accessibility Statement Samuel A. Taylor, MD is committed to providing a website that is accessible to as many people as possible, including people with disabilities. We use the Web Content Accessibility Guidelines (WCAG) 2.2 Level AA as a reference for our accessibility efforts. ## Our Accessibility Efforts We take steps to improve website accessibility, including providing text alternatives for meaningful images, supporting keyboard navigation, maintaining readable color contrast, and properly labeling forms and interactive elements. We also use automated and manual accessibility testing as part of our website review process. ## Accessibility Preferences Our website includes an optional accessibility preferences tool, available through the accessibility icon on each page. The tool allows visitors to adjust features such as text size, contrast, spacing, and motion. This tool is provided as an additional convenience and is not a substitute for accessible website design. Accessibility is also addressed through the underlying structure, content, and code of the website. ## Third-Party Content Some features may be provided by third-party services, such as appointment scheduling, videos, maps, reviews, or other embedded content. Because these services are provided by third parties, some accessibility features may be outside our direct control. If you experience difficulty accessing third-party content through our website, please contact us so we can assist you with the information or service you need. ## Need Assistance or Found an Accessibility Problem? If you have difficulty accessing any part of this website or need information provided in an alternative format, please contact us: Stamford Office Phone: 203.705.0750 Address: 1 Blachley Road, Stamford, CT 06902 Manhattan Office Phone: 646.714.6324 Address: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 When contacting us, please let us know which page or feature you were trying to access and the difficulty you experienced. We will make reasonable efforts to provide the information, service, or assistance you need. You may also call our office during regular business hours to schedule an appointment or obtain information available on this website. Last updated: October 9, 2026 #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Privacy Policy - Samuel A. Taylor, MD Source: /privacy-policy/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Privacy Policy Your privacy is very important to us. Accordingly, we have developed this Policy in order for you to understand how we collect, use, communicate and disclose and make use of personal information. The following outlines our privacy policy. - Before or at the time of collecting personal information, we will identify the purposes for which information is being collected. - We will collect and use of personal information solely with the objective of fulfilling those purposes specified by us and for other compatible purposes, unless we obtain the consent of the individual concerned or as required by law. - We will only retain personal information as long as necessary for the fulfillment of those purposes. - We will collect personal information by lawful and fair means and, where appropriate, with the knowledge or consent of the individual concerned. - Personal data should be relevant to the purposes for which it is to be used, and, to the extent necessary for those purposes, should be accurate, complete, and up-to-date. - We will protect personal information by reasonable security safeguards against loss or theft, as well as unauthorized access, disclosure, copying, use or modification. - We will make readily available to customers information about our policies and practices relating to the management of personal information. We are committed to conducting our business in accordance with these principles in order to ensure that the confidentiality of personal information is protected and maintained. #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 --- ## Terms and Conditions - Samuel A. Taylor, MD Source: /terms-and-conditions/ Skip to content - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage # Terms and Conditions ### 1. Terms By accessing this web site, you are agreeing to be bound by these web site Terms and Conditions of Use, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. If you do not agree with any of these terms, you are prohibited from using or accessing this site. The materials contained in this web site are protected by applicable copyright and trade mark law. ### 2. Use License - Permission is granted to temporarily download one copy of the materials (information or software) on Sam Taylor MD’s web site for personal, non-commercial transitory viewing only. This is the grant of a license, not a transfer of title, and under this license you may not: modify or copy the materials; - use the materials for any commercial purpose, or for any public display (commercial or non-commercial); - attempt to decompile or reverse engineer any software contained on Sam Taylor MD’s web site; - remove any copyright or other proprietary notations from the materials; or - transfer the materials to another person or “mirror” the materials on any other server. - This license shall automatically terminate if you violate any of these restrictions and may be terminated by Sam Taylor MD at any time. Upon terminating your viewing of these materials or upon the termination of this license, you must destroy any downloaded materials in your possession whether in electronic or printed format. ### 3. Disclaimer - The materials on Sam Taylor MD’s web site are provided “as is”. Sam Taylor MD makes no warranties, expressed or implied, and hereby disclaims and negates all other warranties, including without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, Sam Taylor MD does not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of the materials on its Internet web site or otherwise relating to such materials or on any sites linked to this site. ### 4. Limitations In no event shall Sam Taylor MD or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption,) arising out of the use or inability to use the materials on Sam Taylor MD’s Internet site, even if Sam Taylor MD or a Sam Taylor MD authorized representative has been notified orally or in writing of the possibility of such damage. Because some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages, these limitations may not apply to you. ### 5. Revisions and Errata The materials appearing on Sam Taylor MD’s web site could include technical, typographical, or photographic errors. Sam Taylor MD does not warrant that any of the materials on its web site are accurate, complete, or current. Sam Taylor MD may make changes to the materials contained on its web site at any time without notice. Sam Taylor MD does not, however, make any commitment to update the materials. ### 6. Links Sam Taylor MD has not reviewed all of the sites linked to its Internet web site and is not responsible for the contents of any such linked site. The inclusion of any link does not imply endorsement by Sam Taylor MD of the site. Use of any such linked web site is at the user’s own risk. ### 7. Site Terms of Use Modifications Sam Taylor MD may revise these terms of use for its web site at any time without notice. By using this web site you are agreeing to be bound by the then current version of these Terms and Conditions of Use. ### 8. Governing Law Any claim relating to Sam Taylor MD’s web site shall be governed by the laws of the State of New York without regard to its conflict of law provisions. General Terms and Conditions applicable to Use of a Web Site. #### Navigation - Dr. Taylor’s HSS Profile Page - About - Education (About Dr. Taylor) - Team Coverage - Download CV - HSS Advantage Designed By MyPracticeOnline.com Sitemap | Privacy Policy | Terms & Conditions | Accessibility Copyright 2022 ---