By Hillary Eames
Tuesday, June 22, 2021
Syracuse Orthopedic Specialists’ One-Day Surgery Center offers patients the comfort and convenience of an outpatient facility combined with the expertise of fellowship-trained surgeons and nationally recognized success rates.
Since opening its doors in 1999, Syracuse Orthopedic Specialists (SOS) has been a leading name in providing comprehensive orthopedic care. With specialties including sports medicine, foot and ankle, hand and wrist, spine, and joint care, patients have always trusted SOS to offer high-quality care.
Providing Joint Replacement Patients a Choice in Upstate New York and Beyond
For patients in New York and throughout the country, total joint replacement is on the rise, specifically for hip and knee joints. As the demand for leading-edge orthopedic care increases, SOS physicians and staff — one of the largest specialty-trained joint replacement teams in the country — are able to accommodate the growing need for joint replacement while meeting patients’ expectations for excellence.
Each of the eight joint replacement surgeons on staff at SOS is fellowship-trained in joint replacement surgery, and many have made extensive contributions to orthopedic research. This evidence-based and comprehensive approach to care gives them a reputation that extends well beyond Central New York, with patients travelling from the Mohawk Valley, North Country and Southern Tier regions to seek care at SOS.
“Our additional training has allowed us to build a large program for joint replacement patients over the last 25 years,” says joint replacement surgeon Brett Greenky, MD, President of SOS. “We perform more than 3,000 joint replacements per year.”
Building a Joint Replacement Legacy at SOS
Dr. Greenky works alongside his brother Seth Greenky, MD, orthopedic surgeon at SOS, and will soon welcome his nephew, Max Greenky, MD, to the team in August to join his father and uncle as a fellowship-trained joint replacement specialist. (See “Introducing Dr. Max Greenky to Syracuse Orthopedic Specialists.”)
“Our three younger physicians are Dr. Max Greenky, Dr. Kevin Kopko, and Dr. Anthony Orio, and all three are amazingly talented,” Dr. Brett Greenky says. “They’re well-educated and highly skilled physicians establishing their joint replacement practices, and they are in the top of their class.”
Dr. Brett Greenky uses sports to illustrate why the combination of experienced physicians, such as himself, and specialty-trained younger physicians, such as his nephew, heightens their level of orthopedic care.
“It’s like managing a baseball team,” he says. “If your shortstop or hitter are getting older, you’ve got to make sure you’re bringing on newer players. The more established physicians like me are in our last decade of practice. We’re making sure we have excellent talent on board, especially because the need for joint replacement is only increasing.”
Revolutionizing Joint Replacement at Specialists’ One-Day Surgery Center
As the push for patients to receive total joint replacements at outpatient facilities receives wider acceptance, SOS is prepared.
“There’s a trend where 50% of patients, maybe even 60%, may not go to a hospital for joint replacement care,” says Kevin Kopko, MD, joint replacement surgeon at SOS. “This could happen within the next four or five years.”
Already ahead of the curve, the Specialists’ One-Day Surgery Center offers total hip and knee replacements to qualifying patients on an outpatient basis. To date, success rates at the facility are equal to or better than national averages. The SOS research department reports that, of their outpatient surgery recipients, nine out of 10 patients who receive total hip or knee replacements report less pain and improved quality of life in as little as six weeks following their procedures.
“We select patients who are low-risk for anesthesia complications, have fewer comorbidities, and are planning a discharge to their home after joint replacement,” Dr. Kopko says. “We take our healthiest patients — roughly 20% to 25% of surgery recipients — to the surgery center and provide the same level of care they would receive at the hospital, in an environment designed specifically for orthopedic care.”
“Some patients have no other health concerns besides their hip or knee arthritis,” says Anthony Orio, MD, adult reconstruction surgeon at SOS. “For those patients, or patients with well-controlled comorbidities who are otherwise healthy, getting surgery at the center gives them the safest, most efficient way to receive a joint replacement, and it gets them back to where we believe is the most effective place for patients to recover — their own homes.”
A Standardized Pathway to Stellar Results
The Specialists’ One-Day Surgery Center outpatient joint replacement program focuses on key elements such as a standardized clinical pathway. This includes essential components such as proper patient selection, preoperative patient and family coach education, perioperative multidisciplinary coordination, multi-modal pain management, and early and effective post discharge planning for the return to home. High-risk patients receive the same quality care within the hospital, but for many patients, the convenience and comfort of the Specialists’ One-Day Surgery Center is an attractive option.
“A majority of hip and knee replacement patients go home the same day as their surgery,” Dr. Kopko says. “That’s because we’ve designed a facility and team centered around giving our patients comprehensive orthopedic care. This includes a hands-on systematic approach to each patient’s surgical process and recovery.”
While the typical patient goes home the day of their surgery, for those traveling more than two hours, or needing further recovery time, the Specialists’ One-Day Surgery Center also includes eight rooms for overnight stays. These hotel-like rooms allow patients and their loved ones to receive post-operation care while still maintaining outpatient status.
“At our surgery center we have a highly skilled, multidisciplinary team caring for patients from arrival until departure,” Dr. Kopko says. “The team has a direct communication pathway to the surgeon and has ready access to him whenever needed.”
“Our outpatient program has an emphasis on quality and safety outcomes,” Dr. Kopko explains. “The team focuses on evidence-based protocols and pathways, including critically important early postoperative mobilization, pain management, blood conservation, state-of-the-art wound management and VTE prophylaxis.”
Nurse Navigation Improves the Patient Journey
Nurse navigators Sarah Brandt, RN, and Tammi Walker, RN, at Syracuse Orthopedic Specialists (SOS) begin their work as soon as a patient elects to have a procedure by collaborating with the patient and his or her providers to ensure high-quality, personalized and comprehensive care is delivered from start to finish and beyond.
“The nurse navigators perform comprehensive assessments with each patient,” Brandt says. “We make individualized care plans for them based on their goals after surgery and current health status, and we share those with the team at the outpatient surgery center.”
Before patients undergo surgery, one of the requirements is to participate in an education session. This session covers what to expect before and after surgery, including their stay at the surgery center. In addition to the educational video, the nurse navigators also educate patients on what medical equipment will need to be obtained and when to schedule physical therapy. If needed, nurse navigators also assist patients with coordinating after-discharge care needs. The nurse navigators maintain communication with the surgery center to keep staff and providers abreast of patient needs and conditions.
“We check office and triage notes, and if there are any red flags, we call patients to follow up with them to make sure nothing is missed,” Walker says. “Then, we’ll check physical therapy notes to make sure they’re progressing.”
The goal is to make sure every patient they see is fully supported and cared for every step of the way.
“After surgery, we’re ensuring patients stick to the plan we collaboratively created,” Brandt says. “We educate patients on pain management and encourage them to reach out if they have any concerns. We stay in contact throughout their road to recovery.”
Low Infection Rates
By limiting the amount of time spent in the facility, patients limit their exposure to potential causes of infection.
“Infection is probably the single thing that can cause joint replacement patients to have problems,” Dr. Kopko says. “Generally, the risk of infection is between 2% to 3% around the country. At our facility it’s less than 0.03%.
“If there’s one thing we’ve learned from COVID-19, it’s that social distancing works,” he adds. “The fewer interactions patients have after surgery, the lower their risk of infection.”
Advancing Care With Advanced Technology
The Specialists’ One-Day Surgery Center is one of the largest ambulatory surgery centers in the Northeast and currently one of the only outpatient facilities in the region to offer robotic surgery. Leading-edge robotic technology allows for patients with certain anatomical nuances who still meet outpatient qualifications to receive the benefits of robotic surgery as well as outpatient surgery. For some patients, robotic surgery for total or partial knee replacement is available with use of the robotic surgical system at the surgery center. The handheld operating technology assists the surgeon in achieving extremely precise implant placement and alignment.
“I tell patients that all eight of us can hit the bull’s-eye for hip and knee replacement, but the robot allows us to hit dead center,” Dr. Orio says. “It’s not something necessary for every case, but it provides extra information that lets us perform surgeries with even greater precision for certain indications.”
A Collaborative Care Team
To ensure patients are an excellent fit for outpatient joint replacement surgery, a high-quality, continuum-of-care team at SOS enables providers to consistently communicate with each other throughout the patient journey.
As soon as a patient elects to undergo joint replacement, the nurse navigators at SOS are there to ensure patients and physicians are provided with the most accurate and up-to-date information. (See “Nurse Navigation Improves the Patient Journey.”)
“We want to make sure patients have everything in order for a successful recovery,” Dr. Orio says.
Prior to surgery, patients also meet with the physical therapy team to create their rehabilitation plan and schedule their first post-operative appointment. Physical therapists stay in constant communication with surgeons during patient recovery, ensuring patients are reaching the goals established prior to their surgery. In many cases, physical therapy and physician offices are within the same building, and therapists can provide updates to physicians with a quick walk down the hall.
“Surgeons provide patients with a joint replacement, but we’re only a part of their full recovery,” Dr. Orio says. “We need the well-established practice of other providers and services at SOS for a successful patient outcome.”
Once a month, physicians also collaborate with each other through joint replacement council meetings. These monthly meetings serve as a place to update best practices, review current research and literature, and discuss difficult cases with SOS colleagues.
“We have eight fellowship-trained doctors experienced in joint replacement surgery with significant experience, and each of us think differently in regard to how cases should be handled,” Dr. Orio says. “It’s a good sounding board for us to bounce ideas off of one another.”
“Communication is the reason our success rates are so high,” Dr. Kopko adds. “Our joint council has run for the last decade, and it’s where we learn about what’s going on nationally and within the community.”
SOS also runs a joint replacement registry, a robust database to collect information about joint surgeries, types of prosthetics, and patient outcomes, and has contributed 10 years of joint replacement data to the national databank. Not only does the data allow physicians to track success rates of surgery and prosthetic types, but it offers real-data comparisons to illustrate the SOS team’s remarkable numbers.
“The success of our program is documented by our numbers compared to national data,” Dr. Brett Greenky says. “When compared, our data points are equal to or greater than national averages, which offers evidence of the quality of care patients receive here.”
SOS Fellowship-Trained Joint Replacement Surgeons
Stephen Bogosian, MD
Michael Clarke, MD
Brett Greenky, MD
Max Greenky, MD — Joining August 2021
Seth Greenky, MD
Timothy Izant, MD
Kevin Kopko, MD
Anthony Orio, MD
The SOS Joint Registry and Research Stats on Outpatient Joint Surgery
9 out of 10
Nine out of 10 hip replacement patients report less pain by six weeks after surgery.
99%
Ninety-nine percent of hip replacement patients report less pain by six months after surgery.
95%
Ninety-five percent of hip replacement patients report that surgery met or exceeded their expectations with regards to motion and strength one year after surgery.
9 out of 10
Nine out of 10 knee replacement patients report less pain by six weeks after surgery.
> 96%
More than 96% of knee replacement patients report less pain by three months after surgery.
Introducing Dr. Max Greenky to Syracuse Orthopedic Specialists
Max Greenky, MD, joint replacement surgeon at Syracuse Orthopedic Specialists (SOS), will officially join the team in August 2021. He will work alongside Seth Greenky, MD, joint replacement surgeon at SOS, and Brett Greenky, MD, joint replacement surgeon and President of SOS — his father and uncle, respectively.
“I saw how much my dad and uncle loved going to work every day,” Dr. Max Greenky says. “It’s hard for that not to influence you when you’re growing up.”Even still, Dr. Max Greenky planned to explore other specialties in medical school, as he attended Thomas Jefferson University Medical College with an open mind.
“There was nothing I loved more than orthopedics,” he says. “These are operations that help people and help them quickly. For the right patient, it’s a successful way to help them regain their quality of life.”
A Syracuse native, Dr. Max Greenky is currently completing his fellowship at Duke University. He will return to the area with his wife and children to join the family business.
“I loved growing up in Upstate New York, and a lot of my friends and family are still in the area,” he says. “I’m excited to return.
