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Complex Knee Surgeries


									                                                                                                       Spring 2011

                                                                       Getting back to your life.

Knee Surgeries
Restore High-Velocity Lifestyle

   AlexAndriA • Arlington • Burke • FAir oAkS • FAirFAx • Herndon • reSton • SpringField • tySonS Corner
Nascott Orthotics
and Prosthetics

    With you for life.
3601-A Chain Bridge Road • Fairfax, VA 22030 • 703-691-0606
102 Irving Street, NW • Washington, DC 20010 • 202-877-1497
15005 Shady Grove Road • Rockville, MD 20850 • 301-424-2341
                                                                                             Caring, dependable, supportive.
Nascott is the premier provider of adult
and pediatric orthotics and prosthetics
in the Washington, DC Metropolitan
area. At Nascott, we build lasting patient
relationships to ensure the medically
appropriate orthopedic brace or prosthetic
fits you and your changing daily activities.

800-801-3335                                                      Commonwealth Orthopedics
                                                                 PROUD PARTNER

         Diagnostic Health
     Your Imaging Center of Choice!
                                                                                 HomeCare for BoneCare

                                                              When Home Rehabilitation Matters…
                                                                Select an Agency with Experience!

Services we offer:
ƒ   MRI/MRA (High-Field, 1.5T & 3.0T)
ƒ   Arthrograms (CT-guided injection)
ƒ   Computed Tomography (CT Scan)
ƒ   Ultrasound/Doppler
ƒ   X-ray                                                                                        Services Provided
               Monday – Friday                                                        Orthopaedic Rehabilitation
            7:00 a.m. to 10:00 p.m.                                                    PT/ OT/ RN/ LPN/ CNA
             Saturday & Sunday
       7:30 a.m. to 5:00 p.m. (MRI only)
                                                                                    Ask your Doctor or Nurse about
                                                                                  requesting OrthoCareRN services.

      7799 Leesburg Pike, Suite 104-S
          Falls Church, VA 22043
                                                                             Call 703.481.1919
     P: 703.893.2820 | F: 703.827.2685                        

                                                                      Welcoming Remarks
                                                                      I am pleased to present the 10th issue of Commonwealth Orthopaedics
                                                                      Magazine! When we began this publication back in 2007, our goal was
                                                                      to reach out to our fellow physicians in the community to keep you,
                                                                      your staff, and your patients informed about the latest advancements in
                                                                      orthopaedic care and services.
                                                   Now, we’ve expanded our communication efforts with the launch of our new
                                                   Commonwealth Orthopaedics Blog. For nearly six months, our physicians have been
           Corporate Office
      11240 Waples Mill Rd., Ste. 403              sharing their expertise and advice about a variety of orthopaedic conditions, cutting-edge
            Fairfax,VA 22030                       treatments, and injury prevention techniques. Our blog includes first-person accounts,
   (703) 810-5200 • (703) 383-6465 fax             Q&A, physician videos, surgical animations, and more. We encourage you and your
                            staff to visit at or via our website, And be sure to
                                                   recommend the blog to your patients.
             Office Locations
        Alexandria       Herndon                   At Commonwealth, we like to think of ourselves as one big family. For two of our
                                                   physicians – Frank Pettrone, MD and Sarah Pettrone, MD – it’s actually true. In this issue
         Arlington       Reston                    of our magazine, read how this father-daughter duo inspire and challenge each other every
             Burke       Springfield               day.
            Fairfax      Tysons Corner             We also have some compelling patient stories to share. Find out about a triathlon coach
         Fair Oaks                                 who is back on the Ironman circuit after arthroscopic hip surgery, a Division 1 lacrosse
                                                   player whose shoulder repair finally fixed recurring dislocations, a Herndon mother’s
                                                   complex and technically demanding knee surgeries, and an Annandale homemaker who
                President                          overcame her fears to have successful spinal fusion.
            Gordon L. Avery, MD
                                                   As always, we appreciate your support and the opportunity to provide your patients with
         Chief Executive Officer                   world-class orthopaedic and rehabilitation services in Northern Virginia.
            William L. Harvey
        Chief Operating Officer
           Maureen M.R. Cook

         Chief Financial Officer
            Richard T. Givens                      Gordon L. Avery, MD
      Director of Physical Therapy                 Commonwealth Orthopaedics
           Jo-Anne Burton, PT

     Director of Human Resources
             Michelle Melito

         Directors of Marketing
             Suzanne M. Kelly
            Deborah R. Martin                                                         “Ben Is The Man” ........................................................................4
                                                                                      Like Father, Like Daughter ........................................................6
                                                                                      Treating a Pain in The Neck ......................................................8
Editorial Mission:           Commonwealth
Orthopaedics magazine is an educational                                               Nothing to Fear ........................................................................ 10
and informative resource for physicians,
health care professionals, employer groups,                                           Targeted Relief for Low Back Pain ....................................... 12
and the general public. This publication
provides a forum for communicating news                                               Commonwealth Orthopaedics in the Community .......... 13
and trends involving orthopaedic-related             On the cover:
diseases, injuries, and treatments, as well as       Mary underwent two sur-          Best Foot Forward................................................................... 14
other health-related topics of interest.
                                                     geries on her knee to enable     Going The Distance ................................................................. 16
                                                     her to continue with her ac-
                                                     tive lifestyle. In one short     Complex Knee Surgeries Restore
                       Commonwealth Orthopaedics     year following the surgeries,    High-Velocity Lifestyle ............................................................. 18
                       magazine is designed
                                                     Mary was hiking in the Great
                       and published by                                               In Memoriam ............................................................................. 20
Medical                Custom Medical                Smoky Mountains and skiing
                       Design Group, Inc. To         black diamond slopes. See        Advertiser Directory .............................................................. 21
                       adver tise in an upcoming     her story on page 18.
issue please contact: 800.246.1637 or                                                 Orthotics & Braces.................................................................. 21
This publication may not be reproduced in par t                                       Keeping Patients Informed and Educated ........................... 22
or whole without the express written consent
of Custom Medical Design Group, Inc                                                   Meet Our Physicians................................................................ 23
   “Ben Is the Man”
                      Shoulder Surgery Returns Local Lacrosse Player
                      to Highest Level of Competition

Following surgeries
for a dislocated                                      s a star lacrosse player in high school, Sam dislocated his
                                                      shoulder so many times he became an expert at popping
shoulder, Sam is having                               it back in. Eventually, his concerned parents took him
a successful season                                   to see Ben Kittredge, MD, an orthopaedic surgeon
playing Division I                         and sports medicine specialist at Commonwealth Orthopaedics.
                                           Dr. Kittredge had a simple message for the Edgewater, Maryland
lacrosse at Lehigh                         teenager: “If you want this to stop, you’ll have to have surgery.”
                                           Sam’s multiple shoulder dislocations had caused an injury known
                                           as a Bankart lesion in the lower part of his labrum, the cartilage that
                                           surrounds and cushions the shoulder joint. Both Bankart injuries
                                           and SLAP lesions, which damage the uppermost area of the labrum,
                                           are common in young overhead athletes, especially throwers,
                                           swimmers and those playing contact sports. Treatment includes
                                           physical therapy and rehabilitation to strengthen the shoulder
                                           muscles or, in more serious cases, arthroscopic or open surgery to
                                           reattach the torn tissue.
                                            “At Commonwealth, we see a very large athletic population and do a
                                           lot of these procedures,” says Dr. Kittredge, who performed surgery
                                           to repair Sam’s left shoulder and later his right shoulder. “Many of
                                           us have fellowship training in sports medicine, which makes us
                                           highly qualified. In addition, the quality of a patient’s diagnostic
                                           tests – and the expertise of the radiologist who reads and interprets
                                           those tests – is extremely important to ensure timely, appropriate
                                           treatment. We send our patients to the area’s best facility with the
                                           best radiologists for MRIs and arthrograms.”
                                           If an athlete suffers a Bankart or SLAP injury in the middle of
                                           the season, non-operative methods are sometimes an option.
                                           “We might try using a brace to protect the shoulder so it doesn’t
                                           dislocate, and we work with the physical therapist to strengthen
                                           the surrounding shoulder girdle muscles to try to keep the ball
                                           in the socket and provide muscular stability,” says Kevin Sumida,
                                           MD, a Commonwealth Orthopaedics surgeon and sports medicine
                                           Older patients with SLAP tears are often able to avoid surgery
                                           with rest, anti-inflammatory medication, and other conservative
                                           treatments. But the vast majority of patients under 20 with a
                                           dislocated shoulder will typically require an operation.
                                           If surgery is necessary, Commonwealth offers the latest minimally
                                           invasive techniques. “Because we perform these procedures
 Video Extra!                              arthroscopically, we don’t need to make an open incision or disrupt
                                           the normal anatomy to get to where the problem is,” explains David
 Dr. Sumida explains Shoulder              Novak, MD, an orthopaedic surgeon and sports medicine specialist
 Bankart Repair at                         at Commonwealth. “This tendon-preserving method is not only                      much easier on the patient, it also allows us to access all areas of
                                           the shoulder joint and create a more balanced repair better than a
                                           traditional, open procedure.”

  4 Commonwealth Orthopaedics |
                  Both of Sam’s surgeries were extremely successful
            and he has not had a shoulder dislocation since. In each
   case, he spent six months in rehabilitation before returning to the
playing field. He is now a freshman playing Division I lacrosse at
Lehigh University in Pennsylvania, where he was recruited out of
high school. The season includes games against top teams such as
Army, Navy, and Bucknell.
“Sam had a great outcome and our family was very pleased with the
whole experience at Commonwealth,” says Sam’s father, Bruce. “We
would recommend Dr. Kittredge to anyone. He has a great demeanor
and he tells it like it is. Sam doesn’t always listen to me, but he listens
to Dr. Kittredge. He follows his rules and he respects him. As Sam
says, ‘Ben is the man.’ ”                                                     At Professional Risk Associates we focus
                                                                              solely on Physician Professional Liability
                   Ben W. Kittredge, IV, MD earned an                           Insurance. This is what we have been
                   undergraduate degree from the University of                         doing for over 20 years.
                   Virginia and a Masters degree in Physiology
                   from Georgetown University. Dr. Kittredge
                   then returned to the University of Virginia to                We currently serve several thousand
                   attain his medical degree. He then completed a              physicians and healthcare providers in
                   general surgery internship at Roanoke Memorial
Hospital and an orthopaedic residency at the University of Virginia.
                                                                               the Mid-Atlantic region, and represent
Additionally, Dr. Kittredge completed a fellowship in sports                  several of the industry’s largest medical
medicine at Jefferson Medical College and Pennsylvania Hospital in                  professional liability carriers,
                                                                                 all rated “Excellent” by A.M. Best.
                  David J. Novak, MD earned a BA in Economics
                  from the University of Pennsylvania and received            Use our experience and personal attention
                  his medical degree from Georgetown University.                 for your practice to help select the
                  He remained in Washington, DC, at Georgetown
                  University Medical Center to complete a                        right coverage and carrier for you.
                  residency in orthopaedic surgery. He then
                  completed advanced fellowship training in sports             If you are interested in finding out how
medicine and arthroscopy at the Southern California Orthopedic
Institute in Van Nuys, California.                                            Professional Risk can assist your practice,
                                                                               please give us a call at 1-800-318-9930
                    Kevin D. Sumida, MD, graduated with a
                    BA from DePauw University in Greencastle,
                                                                                            or email us at:
                    Indiana and then earned a medical degree from       
                    the University of Kentucky College of Medicine
                    in Lexington. He completed his orthopaedic
                    surgery training in Lexington before completing
                                                                                        Visit us on the web at
                    a fellowship in Sports Medicine at the University           
of North Carolina at Chapel Hill. In addition to his orthopaedic
practice, he is also a clinical assistant professor at Georgetown

For full biographies and a complete directory of the physicians
at Commonwealth Orthopaedics who perform these and other
procedures visit our website at

                                                                    Commonwealth Orthopaedics | 5
 Like Father,                                                              Sarah Pettrone, MD, continues her

 Like Daughter                                                             father’s legacy, Dr. Frank Pettrone,
                                                                           as an orthopaedic surgeon at
                                                                           Commonwealth Orthopaedics.

                  hen his daughters were young, Commonwealth                For Dr. Sarah Pettrone, becoming an orthopaedic surgeon like her
                  Orthopaedics surgeon Frank Pettrone, MD,                  father was not always in the cards. She excelled academically and
                  would often take them along on rounds at the              athletically and was initially interested in a career in women’s health.
                  hospital. “They’d come with me on the weekends,”          After graduating summa cum laude from Notre Dame, she earned
he recalls. “They spent a lot of time in the doctor’s lounge listening      her medical degree from the University of Virginia, where she was
to everyone, or they’d be in the anesthesia lounge while I was in           selected a Bowman Scholar. It was during her clinical rotations in
the next room working on a case.” That early exposure rubbed off.           medical school that she realized she liked orthopaedics best. She
Two of his daughters are now physicians: Kristen, an emergency              went on to complete an internship and residency in joint disease
medicine doctor in Winchester, VA, and Sarah, a hand and upper              at New York University, followed by a hand and upper extremity
extremity specialist at Commonwealth Orthopaedics.                          fellowship at the University of Washington in Seattle.

Having another orthopaedic surgeon in the family makes Dr. Frank            When it came time to look for a job, her first choice was
Pettrone one proud dad. “As a parent, you are always happy to see           Commonwealth Orthopaedics. The timing was right:
your children succeed in life and in careers, but it’s a special feeling    Commonwealth needed a hand surgeon, and Sarah happily
when they choose to do what you do. It makes you feel you did               returned home to Northern Virginia to begin her medical career
something right while they were growing up,” he says.                       working alongside her father.

 6 Commonwealth Orthopaedics |
                                                                        Because your knees
“My dad has always been my role model,” she says. “It’s hard                 support your game.
not to be influenced by someone who, 30 years on, still loves
his job as much as the day he started. Growing up, I never once                                                If you have osteoarthritis (OA) of the knee, and pain
                                                                                                               relievers aren’t helping, there is a non-surgical option
heard my dad say he didn’t want to go to work. He loves being                                                  that may help keep you moving and get your knees
around people and he loves his patients. He’s always running                                                   back in the game.
                                                                                                               ORTHOVISC® provides up to 6 months of knee pain
late in clinic because he will sit and talk to each patient. As a                                              relief with just three injections. Made from ultra-pure
new physician, these are important skills I am trying to learn                                                 natural hyaluronan, which is found in healthy joints,
                                                                                                               ORTHOVISC® acts to cushion, protect and lubricate
from my dad: how to talk to patients, make them feel at ease,                                                  your knee.
and really listen to what they are telling me.”                                                                As an Official Health and Fitness Provider for the PGA
                                                                                                               TOUR and CHAMPIONS TOUR, ORTHOVISC® may be
Now, father and daughter not only share a profession, but also                                                 just what you need to get back on the course.
                                                                                                               To learn more, call DePuy Mitek at 1-800-382-4682
participate in medical research and collaborate on cases. Sarah                                                or visit
recently performed surgery on a George Mason University
basketball player with a difficult wrist fracture and dislocation.
Her father was her surgical assistant. “Looking across the table
and watching my daughter preside over such a complicated                                                                                                   AN OFFICIAL HEALTH AND FITNESS PROVIDER

case, where she’s the boss, really made me think back to when
she was a little girl accompanying me on my hospital rounds,”        Important Safety Information
                                                                     ORTHOVISC® is for patients who do not get adequate pain relief from simple pain relievers like acetaminophen
he says.                                                             or from exercise and physical therapy. ORTHOVISC® is not for use in people with known allergy to hyaluronate
                                                                     preparations, to gram bacterial proteins, with infections or skin diseases in the area of the injection site or joint.
                                                                     Common side effects include joint pain, back pain, headaches and pain or redness at the injection site.
All three Pettrone physicians – Frank, Sarah and Kristen –
                                                                     ORTHOVISC® is manufactured by and is a registered trademark
volunteer their time and expertise on medical missions around        of Anika Therapeutics, Inc.

the world. Sarah and Kristen traveled together to Bhutan, an
isolated mountain kingdom located high in the Himalayas, and
the sisters plan to go on a mission to Ethiopia later this year.

Sarah may have followed in her father’s footsteps, but Frank
Pettrone knows his daughter stands on her own two feet.
“To see someone as smart and active as Sarah, who is hard
working and well respected, succeed beyond anyone’s dreams
is an amazing feeling,” he says. “Around here, Sarah used to be
known as Frank’s daughter. Now, I am Sarah’s dad.”

                   Frank A. Pettrone, MD, earned a BA from
                   Brown University and a medical degree
                   from Georgetown University. Dr. Pettrone
                   completed both his internship and residency               LAMBERT, RIDDLE
                   program at Georgetown University Medical
                   Center. Then, before joining Commonwealth               SCHIMMEL & COMPANY
                   Orthopaedics, he served a tour in the United                                                 (Established 1917)
                   States Navy as an orthopaedic surgeon.

                   Sarah Pettrone, MD, graduated summa cum                  Serving the Business and Personal Insurance
                   laude from the University of Notre Dame                  Needs of Northern Virginia for Over 90 Years
                   with a BS in Biology and earned her medical
                   degree from the University of Virginia School
                   of Medicine. Dr. Pettrone completed an                          omas P. Schimmel, C.P.C.U. & James D. Riddle
                   orthopaedic surgery internship and residency                                     Partners
                   at New York University-Hospital for Joint
                   Diseases as well as a hand fellowship at the
                   University of Washington in Seattle.
                                                                                                        (703) 691-1300
                                                                      3931 UNIVERSITY DRIVE FAIRFAX, VIRGINIA 22030

                                                               Commonwealth Orthopaedics | 7
Treating a Pain
in the Neck
Advanced Care for Cervical Spine Conditions

           hen Hayley’s right arm began to hurt several years        and held together with metal plates and screws. Following
           ago, she wasn’t sure what was wrong. The 48-year-         surgery, the body begins its natural healing process and new
           old Springfield mother stopped playing tennis and         bone cells are formed around the graft.”
wore a wrist brace, but the pain only intensified. Eventually, she
came to Commonwealth Orthopaedics for steroid injections              two of the biggest surgical advancements that
and physical therapy. Although the treatments didn’t stop the        Commonwealth offers are bone graft substitute
pain, they did reveal a surprising fact about its source: it was
coming from her neck.                                                        and high-tech instrumentation.
Hayley consulted Commonwealth surgeon Thomas Mazahery,               “Instead of taking bone from the patient or using an allograft
MD, who has a special interest in treating conditions of the         from a cadaver, as we did in the past, we now use man-made
cervical spine. Sure enough, an MRI showed two severely              plastic, ceramic, or bioresorbable compounds. This material
ruptured discs in her neck compressing nearby nerves. Dr.            is packed with shavings of living bone tissue inside a cage,”
Mazahery recommended she have surgery right away.                    explains Edward Lane, MD, a Commonwealth physician
                                                                     who performs spine surgery and many other orthopaedic
“Patients with this condition, known as cervical radiculopathy,      procedures. “Coupled with the newest minimally invasive
typically feel pain that radiates from their neck into their         surgical instruments and high-tech surgical microscopes, it
shoulder blade, down their arm and possibly into their hand,”        makes surgery much easier on our patients. They experience far
he says. “It can affect any age group, from those in their late      less pain and blood loss, fewer complications, and a significantly
teens and early 20s to people in their 70s and 80s. Younger          faster recovery.”
patients usually have a soft disc herniation, while older ones
have arthritic or degenerative changes that create bone spurs        Hayley’s anterior cervical discectomy and fusion provided
that dig into the nerves. At Commonwealth, we also see patients      instant pain relief and her condition continues to improve. She
with a combination of both.”                                         spent one night in the hospital and returned to her job with the
                                                                     Department of the Navy two weeks later. Within six weeks, she
The good news is that about 70 to 80% of patients respond to         was back to her regular schedule and activities. She is currently
conservative treatment. This can include time to see if the nerve    working hard to strengthen her arm so she can play tennis again
calms down, anti-inflammatory medications, physical therapy          later this spring.
with traction to take pressure off the nerve, or cortisone shots
in the neck. For patients such as Hayley whose pain persists,        “My entire Commonwealth experience was positive,” she says.
or who have progressive weakness or instability of the spine,        “Dr. Mazahery is a great doctor – very down to earth and
Commonwealth offers the latest minimally invasive surgical           personable. And the surgery was extremely successful. It’s such
options.                                                             a relief to be rid of the pain, which was making me sad and had
                                                                     changed my life. Now I definitely recommend surgery to others
“Anterior cervical discectomy and fusion is the most common          in my condition. There’s no reason to live in constant pain.”
procedure for cervical radiculopathy,” says Ron
Childs, MD, a Commonwealth Orthopaedics
spine specialist. “The surgeon makes a small           Video Extra!
incision in the front of the neck and removes the
damaged disc to take pressure off the nerve. The       Check out the symptoms and treatment for pinched
open disc space is then filled with a bone graft,      nerves in the video by Thomas Mazahery, MD
which helps the adjacent vertebrae to fuse. The
bone graft and vertebrae are often immobilized

8 Commonwealth Orthopaedics |
                 Ronald C. Childs, MD, earned a BA in
                 Psychobiology from Boston University before
                 going on to complete his medical degree and
                 orthopaedic surgery residency at Howard
                 University. Dr. Childs then pursued additional
                 training in Chicago where he completed a
                 spine surgery fellowship program at Rush-
                 Presbyterian—St. Luke’s Medical Center.
                 H. Edward Lane, III, MD, earned his medical
                 degree from Georgetown University School of
                 Medicine in Washington, DC. He then completed
                 his internship and orthopaedic surgery residency
                 at Georgetown University Medical Center.

                 Thomas Mazahery, MD, received a BA in
                 Biology from the University of Virginia and
                 earned his medical degree from the Medical
                 College of Virginia. He then completed a
                 general surgery internship and an orthopaedic
                 surgery residency at Northwestern University.
                 Additionally, Dr. Mazahery completed a spine
                 fellowship at Case Western Reserve University.
For full biographies and a complete directory of the physicians
at Commonwealth Orthopaedics who perform these and other
procedures visit our website at

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                                                              Commonwealth Orthopaedics | 9
 Nothing to Fear
 Safe, Effective Spine Surgery Helps Relieve Low Back Pain

           aced with the prospect of spine surgery,                treatment, acupuncture, yoga and Pilates. If these fail
           Sandra admits she was scared. The 54-year-old           to provide suitable relief, or there is any significant
           Annandale homemaker had been experiencing               weakness or numbness, we recommend surgery. While
     increasingly severe back pain for several years. When         there is a lot of fear in the lay population, surgery is
     an MRI revealed she had two bulging discs in her lower        very safe, very effective, and most people achieve their
           back, she knew she had to take action. Sandra was       desired level of no or minimal pain.”
            already a Commonwealth Orthopaedics patient
            for her knees, so she looked at a list of physicians   One of the biggest advancements in spine fusion surgery
            on the Web site and selected spine specialist          is the use of bone graft substitute. “We used to take
             Steven Hughes, MD to treat her back pain.             bone from the patient’s hip as part of the procedure,”
                                                                   says Tushar Patel, a Commonwealth Orthopaedics spine
              At her first appointment, Dr. Hughes laid out        specialist. “Now we use genetically engineered proteins,
               the options: Sandra could have surgery or she       which stimulate bone growth naturally in the body, or a
                could try non-surgical treatments to manage        ceramic synthetic product such as INFUSE®. As a result,
                the pain. “At that point, my attitude was          there’s much less pain and blood loss, and recovery is
                 ‘anything but surgery,’” she recalls. “I was      significantly faster because we no longer harvest bone
                  quite fearful and tried to convince myself       directly from the patient.”
                  my back pain wasn’t all that bad. Dr. Hughes
                  was very understanding and didn’t pressure       Other advancements that Commonwealth offers include
                   me at all. He let me make the decision and      the minimally invasive TLIF and XLIF procedures.
                    I chose the non-surgical route.”               During TLIF (transforaminal lumbar interbody fusion),
                                                                   surgeons approach the spine from the side of the spinal
                         Sandra tried medication, physical         canal through a midline incision in the patient’s back,
                         therapy and steroid injections, to        sparing nerves and muscles. XLIF (extreme lateral
                        no avail. When the pain became so          interbody fusion) is performed through the patient’s
                       excruciating she had trouble standing,      side, avoiding the major muscles of the back.
                           bending and doing housework,
                                                                   Dr. Patel cautions that minimally invasive spine fusion
                          dr. Hughes sent her for targeted         surgery is not for everyone. “The circumstances
                       epidural steroid injections using x-ray     surrounding each case are different, so we must evaluate
                      guidance. the x-rays revealed she had        patients carefully, as individuals, to determine the
                        several spinal cysts and one of them       best course of action. In many cases, surgery is not
                                    had ruptured.                  indicated. In others, traditional open spinal fusion
                                                                   produces results that are as good as, or better, than the
                      That discovery, along with the               less invasive alternative. Obtaining a successful result
                      knowledge that her worsening knee            depends on a host of factors, and patients should discuss
                      problems would eventually require            these thoroughly with a qualified spine surgeon before
                   replacement surgery, forced Sandra
                    to overcome her fears and have back
                    surgery. Dr. Hughes performed a
                 minimally invasive fusion of her lumbar             Video Extra!
                spine. As he explains, her course of                 Dr. Hughes explains How to
                treatment is typical for patients with low           Diagnose & Treat Back Pain in
                back pain. “We often try non-operative               a special video feature at
               measures first, such as physical therapy,   
             non-steroidal drugs, injections, chiropractic

10 Commonwealth Orthopaedics |
making any decisions.”
Sandra is now pain free and had such a positive
experience she has since sent her son, husband,
and mother to Dr. Hughes for surgery. “My
family and I cannot speak highly enough about
the wonderful care we’ve received from Dr.
Hughes and Commonwealth Orthopaedics,”
she says. “My only regret is that I didn’t have
surgery sooner. I would have spared myself so
much pain and effort, and maybe done less
damage. If I could say just one thing to others
in my situation, it is this: don’t let your fear
stop you from getting the help you need.”

                   Steven S. Hughes, MD, graduated
                   summa cum laude from the
                   University of Rochester and
                   completed his medical degree with
                   honors from the University of
                   Rochester School of Medicine. Dr.
                   Hughes worked as a surgical intern
 at Bethesda Naval Hospital and was later honorably
 discharged after serving as a Commander in the
 United States Navy. Following his internship, he
 completed an orthopaedic surgery residency at Strong
 Memorial Hospital in Rochester and a fellowship in
 spinal surgery at Case Western Reserve Hospital.

                  Tushar Ch. Patel, MD, earned his
                  medical degree from the University
                  of Pennsylvania in Philadelphia and
                  completed his orthopaedic surgery
                  residency at George Washington
                  University Medical Center. He
                  then went on to do a fellowship in
 Spinal Surgery at the Cleveland Clinic Foundation in      “The XLIF procedure             Lisa – Centreville
 Cleveland, Ohio.                                          really changed my life.          XLIF Spine Surgery

 For full biographies and a complete directory of
                                                           I feel like I can get back to
 the physicians at Commonwealth Orthopaedics               my life, and I am so glad to
 who perform these and other procedures visit our
 website at
                                                           be able to do that.”

                                                        Commonwealth Orthopaedics | 11
For Low Back Pain

       ow back pain is one of the most common medical conditions,
       affecting more than 80 percent of American adults at some
       point in their lives. The low back is vulnerable to many pain-
provoking disorders, ranging from simple strains to herniated discs,
degenerative disc disease, or spinal stenosis (narrowing of the spinal
canal). Certain conditions can also cause radicular pain – burning,
numbing or tingling that radiates down the leg due to a compressed
or inflamed nerve.
                                                                             “I had three shots over a
At Commonwealth Orthopaedics, epidural steroid injections (ESI)              period of six weeks…
are an effective treatment option for many forms of low back and leg         Since then, I’ve gotten back
pain. This targeted procedure, which deposits a long-lasting steroid
directly into the epidural space surrounding the spine, is often used
                                                                             to all my regular activities.”
in conjunction with other non-operative measures such as physical
therapy to delay or prevent the need for surgery. 

“ESI is highly effective for patients with disorders of the spine,” says         Maureen – Oak Hill
Brett Robinson, MD, an anesthesiologist and Commonwealth pain              Non-Surgical Pain Management
management specialist. “While it is most useful for acute injuries
that have occurred within six months, it can also be helpful for
longer standing problems.”                                                                   Brett M. Robinson, MD, a native of New
                                                                                             York city, earned a BA in Psychology from Yale
In some cases, epidural steroid injections are used after other
                                                                                             University before going on to receive his medical
methods of pain control have failed. ESI can be more effective                               degree from Tulane University. He then completed
than oral steroids or anti-inflammatory drugs because it delivers                            a rotational internship and an anesthesiology
medication directly to the source of the pain. Physicians use X-ray                          residency at the University of New Mexico,
or contrast dye to better target the area of concern, allowing more                          Department of Anesthesiology and Critical Care
medicine to go where it is needed.                                                           Medicine, in Albuquerque, New Mexico.

“ESI is used to quiet nerve inflammation and decrease or eliminate                           Amanda B. Trucksess, MD, graduated cum
                                                                                             laude from the College of William and Mary with
acute pain associated with conditions such as a herniated disc,
                                                                                             a major in kinesiology. She went on to earn her
stenosis, or sciatica,” explains Amanda Trucksess, MD, who
                                                                                             medical degree from the Virginia Commonwealth
specializes in physical medicine and rehabilitation at Commonwealth                          University School of Medicine at the Medical
Orthopaedics. “A specific type of ESI – a transforaminal approach –                          College of Virginia. Dr. Trucksess completed a
can be used as a diagnostic procedure as well in order to localize a                         four year residency in Physical Medicine and
specific nerve root that is the source of a patient’s pain.”                                 Rehabilitation at the University of Virginia.

ESI are very simple and safe procedures. They can be done up to            For full biographies and a complete directory of the physicians
three times in six months, if necessary, with the goal of returning        at Commonwealth Orthopaedics who perform these and other
                                                                           procedures visit our website at
patients to their full, pain-free function and activity. 

  12 Commonwealth Orthopaedics |
Commonwealth Orthopaedics
                                                                  in the Community

                                                                     Commonwealth Orthopaedics’
                                                                     Physicians Speak at
                                                                     The Virginia Youth
                                                                     Soccer Association

                                                                              ore than 650 people attended the
                                                                              Virginia Youth Soccer Association,
       Dr. Ben Kittredge presents information on how to prevent               (VYSA) annual soccer convention and
       running injuries.                                             awards luncheon in Crystal City, in January
                                                                     2011. Soccer coaches, administrators, referees,
ATC Workshop                                                         parents and players gathered to see coaching
                                                                     demonstrations and attend lecture sessions

      or the fifth year in a row, certified athletic trainers        to learn how to better serve the players and
      (ATC's) from Fairfax, Arlington and Loudoun County             parents of our soccer community.
      Public Schools as well as physicians attended a free           Physicians from Commonwealth Orthopaedics
workshop, "Collaborating Care Between Sports Medicine                presented information on common soccer
Physicians and Athletic Trainers," on Sat., Feb. 26 at The           injuries such as foot and ankle injuries, knee
Mason Inn in Fairfax, Va.                                            and ACL injuries, and concussions. ■
“The workshop provided a great opportunity for the
certified athletic trainers from local high schools to interact
with physicians and other health care providers from
Commonwealth Orthopaedics to improve skills, share
information and develop a working relationship that will have
a positive impact toward the overall health care provided
to student athletes,” said Jon Almquist, ATC, FCPS Athletic
Training Program Administrator.

“At Commonwealth Orthopaedics we are committed
to working closely with certified athletic trainers at area
high schools. We see them as critical partners in providing
student athletes with information about injury prevention
and rehabilitation,” said Gordon Avery, President of
Commonwealth Orthopaedics. ■

                                                         Commonwealth Orthopaedics | 13
     Best Foot Forward

        njoying a glass of iced tea in his kitchen, Kevin            develops. Patients with chronic untreated extensor tendon
        misjudged the counter height and broke the glass,            lacerations have difficulty controlling the toes when attempting
        sending a razor-sharp shard into his left foot. The jagged   to put on socks or shoes; the toe tends to catch on them.”
glass lacerated a tendon, covering the floor of his Alexandria
                                                                     Dr. Lutta performed Kevin’s tendon repair four days after the
home with blood. When emergency room doctors discovered
                                                                     initial injury. Despite the large open wound and risk of the
Kevin couldn’t move one of his toes, the diagnosis was clear:
                                                                     tendon ends retracting, potentially making repair difficult, the
he had severed his extensor tendon and would need surgery to
                                                                     surgery was a success. Kevin spent a week on crutches with a
repair it immediately.
                                                                     soft cast and then had a walking boot put on so he could return
Kevin, 51, consulted Commonwealth Orthopaedics surgeon               to work and basic activities. After a month, he came back to
Kevin Lutta, MD, who specializes in foot and ankle procedures.       Commonwealth for physical therapy, which he continued on
“I was apprehensive because I had done enough research               his own at home. His pain was minimal, his recovery rapid, and
to know that tendon reattachment is tricky and I wanted an           he has since returned to all the things he loves – golfing, biking,
experienced surgeon to perform the operation,” Kevin recalls.        and working out in the gym.
“Dr. Lutta put me at ease right away. He had a great disposition
                                                                     “I feel great and I’m very pleased with the care I received at
and reassured me that he had done this type of surgery many
                                                                     Commonwealth Orthopaedics,” he says. “I wholeheartedly
times before.”
                                                                     recommend the entire team, especially Dr. Lutta. He’s a pro
Treatment of extensor tendon injuries varies depending on            who does a tremendous job and I’m a living, breathing – and
whether the injury is a laceration, like Kevin’s, or a rupture.      walking – example of that.”
The first step is a careful physical examination to evaluate the
specific extensor tendon involved, especially in lacerations                             Kevin Lutta, MD graduated with a BA in
where multiple tendons and other structures such as nerves                               Biology from Clark University. He earned
and blood vessels may be damaged as well. These, too, may                                his medical degree from Howard University
                                                                                         College of Medicine, where he was named to
need to be repaired.
                                                                                         Alpha Omega Alpha Medical Honor Society. He
                                                                                         completed his residency in orthopaedic surgery
Commonwealth Orthopaedics’ experienced surgeons offer the
                                                                                         at Howard University Hospital and went on
most advanced repair techniques available. “Extensor tendons          to a fellowship in foot and ankle reconstruction at Pennsylvania
in the foot are relatively superficial and easily lacerated with      Hospital, part of the University of Pennsylvania Health System.
trauma,” Dr. Lutta explains. “In these cases, surgery is the best
treatment option. The goal is to restore extension function           For full biographies and a complete directory of the physicians
to the lesser toes. It has been shown that when the extensor          at Commonwealth Orthopaedics who perform these and other
                                                                      procedures visit our website at
tendons are transected and not repaired, a claw toe deformity

14 Commonwealth Orthopaedics |
After severing his extensor
tendon in his foot, Kevin had
surgery to reattach the tendon                                Kevin – Alexandria
and recovered rapidly so he can                    Lacerated Extensor Tendon Repair
enjoy his golf game again.

                                  Commonwealth Orthopaedics | 15
 Going the Distance

                                                          Minimally invasive
                                                   arthroscopic hip surgery
                                                      allowed Laurie to get
                                                  back to what she loves—
                                                    competing in triathlons
                                                 and training women for all
                                                 types of endurance events.

                                                     Laurie – Potomac Falls
                                               Minimally Invasive Hip Arthoscopy

16 Commonwealth Orthopaedics |
         ompeting in an Ironman® triathlon is a pipe dream          Surgical candidates include anyone for whom non-operative
         for most of us. For Laurie, it’s all in a day’s work.      treatment such as pain medication, steroid injections or
         The 40-year-old USA Triathlon-Certified Coach              physical therapy has failed, except those with advanced
and mother of two is the founder of Amaiza Fitness. Amaiza          arthritis.
Fitness’ tri4women program trains women to compete
in triathlons and other endurance events. She is also a             One of the biggest benefits of hip arthroplasty is faster
competitive triathlete and runner herself. But when nagging         recovery time. Most patients can begin light activities such
hip pain spread to her back and leg, Laurie was forced to hang      as biking or swimming within a few weeks. Laurie was home
up her wetsuit, bike and running shoes, and watch her beloved       one hour after waking up from her surgery. She had minimal
triathlon races from the sidelines.                                 pain, and was able to walk with a crutch. A few days later she
                                                                    was swimming, and soon she returned to a stationary bike to
“The situation was really frustrating, and I spent a year           stay in shape. Four months after her surgery, she was running
trying all sorts of non-operative remedies to get rid of the        again.
pain,” she says. “I saw lots of doctors, had lots of tests, went
to a chiropractor, tried massage, but nothing really worked.”       “I had such great results and Dr. Parker was awesome,” she
Finally, an MRI with contrast showed the bone needed to be          says. “He’s one of the leading physicians doing this procedure
shaved down. A friend recommended she consult Andrew                in the area and he’s done it lots of times, so I felt very confident
Parker, MD, a Commonwealth Orthopaedics surgeon with                about everything. He was available whenever I needed to talk,
special interest and experience in hip arthroscopy.                 and he always encouraged me to make my own decisions. He’d
                                                                    say, ‘If you were my sister, this is what I’d recommend,’ but he
Dr. Parker offered Laurie two choices. She could have a             never made the choice for me.”
relatively simple procedure to clean up the cartilage in her hip,
or more complex surgery to also shave the bone. The latter          Laurie also praised Commonwealth’s Outpatient Surgery
would require a longer recovery before she could return to          Center, which she found more comfortable and personable
running and competing, but the results would be permanent.          than a hospital. She was in and out fast, without a lot of
Laurie didn’t hesitate, telling Dr. Parker, “Get me in ASAP so I    waiting time, and felt at ease with the attentive, one-on-one
can get on with my life.” Last June, she had minimally invasive     care from the staff.
arthroscopic hip surgery at Commonwealth’s Outpatient
                                                                    Her hip pain is gone and her range of motion is back in full.
Surgery Center in Herndon.
                                                                    Just eight months after her surgery, she will compete in the
Arthroscopic techniques have revolutionized                         2011 Rohto Ironman 70.3 California – a race that consists of
hip surgery. Historically, physicians had to cut through            a 1.2-mile swim, a 56-mile bike ride and a 13.1-mile run. She
connective tissue and dislocate the joint to find and correct       will follow that up with a full Ironman – a 2.4 mile swim, 112-
the problem. Now, they make a tiny incision and insert a            mile bike ride and 26.2-mile run – in Lake Placid, NY. “My
pencil-sized optical device (called an arthroscope) with a          recovery from surgery was amazingly quick and I was back to
video camera attached, which transmits magnified images of          normal very fast,” she says. “People shouldn’t hesitate to have
the inside of the joint to a TV monitor. Guided by the images,      this done.”
surgeons use miniature instruments to perform the procedure.
                                                                                    D. Andrew Parker, MD earned a BS in Biology
“Hip arthroscopy allows us to repair and restore the
                                                                                    and Chemistry from Wake Forest University. Dr.
normal anatomy of the hip joint in a minimally invasive                             Parker then graduated magna cum laude from
fashion, thereby allowing patients to return to everyday                            medical school at the University of Louisville.
life, recreation and sports much more quickly,” explains Dr.                        He completed his internship and residency in
Parker. “Commonwealth offers the latest minimally invasive                          orthopaedic surgery at Northwestern University.
techniques for hip arthroscopy to treat conditions such as                          Dr. Parker concluded his formal medical
labral tears, traumatic cartilage injuries, early osteoarthritis    education by completing a fellowship in sports medicine at the
and femoroacetabular impingement, which occurs when                 Baylor Sports Medicine Institute in Houston, Texas.
the head of the femur does not have full range of motion
within the socket. In fact, arthroscopic procedures to treat        For full biographies and a complete directory of the physicians
femoroacetabular impingement may remove a major risk                at Commonwealth Orthopaedics who perform these and other
                                                                    procedures visit our website at
factor in the development of osteoarthritis.”

                                                          Commonwealth Orthopaedics | 17
                                                “I was very motivated to
                                                 get back to my previous
                                               activities and lifestyle and
                                                   I couldn’t have done it
                                                   without Dr. Lawhorn.”

                                                         Mary – Herndon
                                                     ACL Reconstruction and
                                                         Meniscus Transport

18 Commonwealth Orthopaedics |
  Complex Knee Surgeries
Restore High-Velocity Lifestyle
                                                       New treatment methods offer options for
            urtling down the most difficult double black                      “Mary had a large, traumatic isolated defect of her articular
                                                       patients with knee damage
            diamond ski slopes doesn’t faze Mary, but when                    cartilage, the connective tissue that covers the knee joint,” Dr.
                                                 By D. Andrew Parker, MD Lawhorn explains. “To undergo ACI, it was imperative she
            she faced a series of technically demanding
knee surgeries, she was grateful to have one of the most                      have an intact ACL and stable knee, reasonable remaining
                                                                              meniscus function to minimize the compressive forces on
experienced orthopaedic surgeons to perform them. last decade, a number of highly tech- commonly injured knee ligament. Collisions on
                                                 During the
                                                                              her articular cartilage, and normal alignment snapping or
                                                 nological options for treating patients with carti- the field sometimes twist the knee, of the knee
                                                 lage damage freak
Mary, who is in her late 40s, had injured her knee in a have developed. They add to a tearing the ACL.
                                                                              and leg.”
accident at an exercise boot camp near hergrowing spectrum of choices for treatment.
                                                   Herndon home.
                                                                                                     One in six people with an ACL injury also has an
Subsequent diagnostic tests and procedures revealed a host                    First, Dr. Lawhorn performed an ACL reconstruction to
                                                 Injuries to the Knee                                injury in another ligament or in the meniscus, a
of problems: an acute ACL tear, a complete radial split of her                                       defined harvest the cells for her cartilage
                                                                              strengthen her knee and pad of knee cartilage known as fibrocar-
                                                 In damage.                   regeneration surgery. He later performed the medial
medial meniscus, and a large area of cartilage general, younger patients sustain knee carti- tilage that fills the space where the femur (thigh-
                                                 lage damage from a traumatic event, while older bone) and the tibia (shinbone) meet. And closer
                                                                              meniscus transplant and ACI – two lengthy, complicated
She was referred to orthopaedic surgeon Keith Lawhorn, MD, to experience degenera- to the bone is hyaline cartilage, the real shock
                                                 patients are more likely
                                                                              procedures – at the same time.
who determined she needed ACL reconstruction, knee cartilage as a result of osteoarthritis. absorber in the joint.
                                                 tion of a meniscus
                                                 But there are many exceptions.
transplant, and cartilage regeneration surgery – a technique                                         Damaged meniscal or hyaline cartilage can
                                                                              In a meniscus transplant, fibrocartilagetissue from a donor
                                                                              cadaver is symp- cause significant pain. Consequently, when we
known as autologous chondrocyte implantation (ACI). This may have earlysize-matched and transplanted into the knee using
 Athletes use the flex and strength of A 40-year-old runner
 the knee to compete, and they depend toms of osteoarthritis.                  the same time, he treat a patient with a knee injury, cartilage
two-part procedure involves harvesting the patient’s own At an arthroscopic-assisted, mini-open approach. Because the
              cartilage cells
 on kneegrowing the— theinbuffer of mayand injecting
cartilage,                             a laboratory,
                                                       experience a knee injury that damages restoration is often part of the protocol.
                                                                              operation is technically challenging and requires months of
 tissue between articulating surfaces — to do so cartilage as well as other structures, most
them back into the damaged elastic, spring- typically ligaments.
 without pain. Healthy cartilage is                                           post-operative rehabilitation, meticulous and appropriate
                                                                                                     Cartilage Implantation
 ing back in response to pressure. When chon-                                 patient selection is critical for success.  “This procedure
 drocytes, or cartilage cells, are damaged, friction   Football fans certainly have heard of the anterior   Swedish researchers were able to culture hyaline
                                                                                                                                          Continued on page 20
 builds and pain is sometimes severe.                  cruciate ligament (ACL), which is the most           cartilage cells outside the body for the first time

     Five Steps of Carticel
      1.                            2.                            3.                            4.                            5.

     1. An initial biopsy of normal joint surface is removed from the non–weight-bearing portion of the knee. 2. The biopsy is sent to a
     Genzyme lab, where it is cultured and grown into a solution of the patient’s cartilage cells. 3. During the second procedure, the sur-
     geon makes an incision in the knee and removes any damaged cartilage. 4. A piece of lining is then removed from the adjacent upper
     tibia bone and sewn over the defect. 5. This creates a water-tight membrane to contain the cultured cartilage cells. The patient’s cells
     are then injected into the defect. Images courtesy of Genzyme Corporation.

 8   Commonwealth Orthopaedics
                                                                      Commonwealth Orthopaedics | 19
Complex Knee Surgeries - continued from page 19
                                                                                                     In Memoriam
is typically reserved for patients under 40, but can be
considered in patients up to 50 if they are highly active
and have minimal arthritic changes,” says Christopher
Annunziata, MD, who performs these complex surgeries
at Commonwealth Orthopaedics. “It should be used only
after exhausting all nonsurgical measures, except in cases
where there is concomitant ACL and medial meniscus
deficiency with significant rotational instability that may
compromise success of ACL reconstruction alone.”

With the right patient, meniscus transplant and ACI
performed together rather than separately can significantly
improve outcomes in the most difficult cases.

Following her surgeries, Mary spent two days in the
hospital and returned home for an intensive, year-long
rehabilitation. During the first two months, she used
crutches and built up her strength on a continuous passive
motion (CPM) machine. She began walking again at 10
weeks and spent another 10 months in physical therapy at
Commonwealth Orthopaedics. One month later she went
hiking in the Great Smoky Mountains, and a few months
after that she was finally back on the black diamond ski
slopes she loves so much.                                                         Charles R. Ubelhart, MD
“I was very motivated to get back to my previous activities                  Caring, Expert Orthopaedic Physician
and lifestyle – and keep up with my 10-year-old son – and                      Commonwealth Orthopaedics
I couldn’t have done it without Dr. Lawhorn,” she says. “He                              1999-2011
went above and beyond and did an amazing job. He is so
technically gifted. My pain is gone and my scar is so small
you can barely see it; everything looks fabulous. Now I
recommend him to others all the time.”

                  Christopher C. Annunziata, MD, earned                           Keith W. Lawhorn, MD, graduated with a BA
                  a BS from Boston College before graduating                      in Chemistry from the University of Virginia
                  with his medical degree from Georgetown                         and continued his education at the University
                  University. He completed an orthopaedic                         of Virginia School of Medicine, where he earned
                  surgery residency at Georgetown University                      his medical degree . He completed a general
                  Medical Center and went on to complete                          surgery internship and orthopaedic residency at
                  a fellowship in Sports Medicine/Knee                            the Medical College of Virginia. Dr. Lawhorn
                  and Shoulder Surgery at the University of                       served on active duty in the U.S. Air Force for
                  Pittsburgh Sports Medicine Center.                              eight years, reaching the rank of Lt. Colonel.

                  For full biographies and a complete directory of the physicians at Commonwealth Orthopaedics
                             who perform these and other procedures visit our website at

20 Commonwealth Orthopaedics |
                                                                                                               Custom Orthotics and
                                                                                                         Announcing New Products for
                                                                                                           Foot Products for Patients
                                                                                                          Our Foot and Ankle Patients

                                                                            Commonwealth Orthopaedics now offers custom foot orthotics and
                                                                     Commonwealth Orthopaedics now offers custom foot
                                                                       braces for patients. To make an appointment with Dr. Kevin Lutta, our foot
                                                                     orthotics and braces for patients. For more information or to
                                                                       and ankle specialist, please call the Herndon office at 703-810-5204 or
                                                                     make an appointment with Dr. Kevin Lutta, our foot and ankle
                                                                       the Tysons office at 703-810-5225.
                                                                     specialist, please call the Herndon office at 703-810-5204.

             New Online Store for Foot and Ankle Medical Products
         Advertiser Directory foot problems, please visit our new online store at
          For other medical products for your
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                   Herndon, VA 20170
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     Fairfax,Virginia 22030                          Insurance & Investment Planning                                                                                                   Since 1982, West Financial Services’
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         Herndon Office • 13350 Franklin Farm Road, Suite 220 • Herndon,VA 20171 • 703-810-5204 21
                                                  Commonwealth Orthopaedics |
Keeping Patients
Informed & Educated

         ommonwealth is committed to keeping our patients and
         community updated on the latest orthopaedic advancements.
         Here’s how we are communicating:

●    The new Commonwealth Orthopaedics blog
     ( features information and advice
     from our physicians about orthopaedic conditions, innovative
     treatments, videos, surgical animations, and more.
●    Commonwealth Orthopaedics is on Facebook! Patients can now
     stay connected to the most current Commonwealth Orthopaedics
     news and share it with family and friends.
●    Every two months, our patients receive an e-newsletter with
     timely items about orthopaedic care.You can sign up to receive this
     e-newsletter on our website home page at ■

Outpatient Surgery                                              Rockstar Run Raises
Centers Reach                                                   Scholarship Funds
                                                                           ore than 500 runners and walkers participated in

                                                                           the second annual Rockstar 8K Run and one mile
        ommonwealth Orthopaedics’ Outpatient                               fun run on April 10, 2011. The event raises money
        Surgery Centers achieved a milestone                     for the Celebrate Cherie Scholarship Fund established when
        in 2010: 30,000 surgeries have been                      Cherie Yadao, a Commonwealth Orthopaedics physical
performed at these state-of-the art facilities since             therapist and manager, died of a rare cancer in 2009. ■
they opened in 1999 (Herndon) and 2001 (Fairfax).

As the only outpatient surgery centers dedicated
exclusively to orthopaedics in the region, they offer
patients many advantages over a hospital setting
including comfort, convenience, personalized one-
on-one care, and fewer delays and disruptions.

Quality and safety are never compromised. The
centers are accredited by The Joint Commission,
which means they are held to the same high
standards as a hospital. For more information about
our outpatient surgery centers go to www.c-o-r.
com/outpatientsurgery. ■

    22 Commonwealth Orthopaedics |
                                                 Meet Our Physicians

    George Aguiar, MD        Christopher C. Annunziata, MD     Gordon L. Avery, MD         Anne M. Bielamowicz, MD         Ronald C. Childs, MD          Nancy R. Couleman, MD
      Reston, Herndon             Arlington, Tysons Corner      Arlington, Tysons Corner    Outpatient Surgery Centers            Fairfax                 Outpatient Surgery Centers

 Alexander S. Croog, MD           Allen G. DeLaney, MD        Robert M. Dombrowski, MD        J. Mark Evans, MD          Mark C. Hartley, MD                 Steven S. Hughes, MD
     Fairfax, Fair Oaks          Outpatient Surgery Centers         Fairfax, Fair Oaks               Fairfax                    Reston                        Alexandria, Tysons Corner

Ben W. Kittredge, IV, MD          Thomas J. Klein, MD         H. Edward Lane, III, MD         Keith Lawhorn, MD          Charles S. Lefton, MD                Kevin C. Lutta MD
   Alexandria, Springfield             Reston                      Fairfax, Fair Oaks               Fair Oaks             Arlington, Tysons Corner            Herndon, Tysons Corner

  Mark P. Madden, MD            Thomas A. Martinelli, MD      B. Thomas Mazahery, MD        John P. McConnell, MD        Mark R. McMahon, MD                  David J. Novak, MD
         Reston                   Alexandria, Springfield          Reston, Springfield        Arlington, Tysons Corner          Fair Oaks                       Fairfax, Fair Oaks

  D. Andrew Parker, MD            Tushar Ch. Patel, MD         Frank A. Pettrone, MD          Sarah Pettrone, MD         Brett M. Robinson, MD               David W. Romness, MD
          Reston                     Fairfax, Fair Oaks         Arlington, Tysons Corner       Reston, Tysons Corner     Outpatient Surgery Centers           Arlington, Tysons Corner

Kevin D. Sumida, MD        Daniel E. Thompson, MD Amanda B. Trucksess, MD Brantley P. Vitek, Jr., MD Daniel E. Weingold, MD        Young J. You, MD             Bruce S. Zimmer, MD
Arlington, Tysons Corner     Alexandria, Springfield Reston, Tysons Corner    Fairfax, Fair Oaks        Burke, Springfield         Alexandria, Springfield         Burke, Springfield

                                                                                Commonwealth Orthopaedics | 23
      Commonwealth Orthopaedics
      11240 Waples Mill Rd., Ste. 403
      Fairfax, VA 22030

                                                                                                                  Specializing in Practice

                                                                                                          Barbara J. Grant, CPA, AIBA, CVA
                                                                                                                  (404) 266-9876

SpeedBridge Ad 7.875x4.875.indd 1                                                            6/21/10 4:26 PM

                                                                Specializing in:
                  •	      Medical	Assistants               •	    Office	Managers                               •	 Ophthalmic	Techs
                  •	      Receptionists                    •	    Administrators                                •	 Med	Lab	Techs
                  •	      Secretaries                      •	    Consultants                                   •	 Physical	Therapists	and	
                  •	      Surgical	Posters                 •	    LPN’s,	RN’s                                      Licensed	Assistants
                  •	      Transcriptionists                •	    Nurse	Practitioners                           •	 Physicians	&	Physicians	
                  •	      Bookkeepers                      •	    Ultrasounds,	X-Ray,	CT,		                        Assistants
                  •	      Insurance	Billing	&	                   MRI	&	Nuclear	Med	Techs                       •	 Doctors	of	Medicine
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