Morwood Published in Injury: International Journal of the Care of the Injured

Our very own Dr. Morwood has been published in the journal, Injury.

Dr. Morwood recently wrote about treating tibial fractures around total knee replacements. Although they are rare, tibial fractures can cause some serious complications, but chances of successful healing can be improved with the techniques detailed in Dr. Morwood’s paper!

You can read Dr. Morwood’s piece by clicking here.

Morwood Published in The Journal of Orthopaedic Trauma

The Journal of Orthopaedic Trauma is a premier orthopaedic journal, and Dr. Morwood was recently published in it.

Dr. Morwood, who specializes in knee replacements, wrote about how implants can be used to treat difficult fractures at the bottom end of the tibia to allow for immediate weight-bearing. That means a much faster recovery time for patients!

You can learn more about Dr. Morwood’s study by clicking here.

A Day in the Life of Dr. Crawford’s Volunteering, Week 2

March 13, 2019
Moshi, Tanzania, East Africa

Long bone fractures, such as the femur, tibia and humerus, make up the vast majority of our patients’ injuries. Traditionally, these mostly occurred from falls at a height, climbing a tree to get fruit. As Tanzania has become more developed in the past few decades, the injury patterns have changed dramatically. Very few people own cars here so they must rely on public transportation. It is very easy and quite inexpensive to travel long distances in buses. The drivers are usually young men and they often compete with each other for a reputation as the fastest driver. This predictably leads to catastrophes.  My first day volunteering in Tanzania, back in 2008, a speeding bus overturned with 67 people onboard.  Four died at the scene. The driver ran away. There are no emergency services here as we know, so the rest of the injured were loaded on a dump truck and brought on a two-hour drive to our hospital. Five more died en route. I was called down to the emergency room as the staff there were overwhelmed by the inundation of patients. Blood was everywhere and the injured were two-to-a-bed and covering the floor, making it hard to walk. My disaster training was helpful, but there are limits to what can be done in any situation like this, and we triaged the patients to do the most good for the greatest number. We had only a small amount of blood in the blood bank. One of the patients I was in charge of was a 29-year-old whose young daughter was uninjured. The mother was awake when she arrived but clearly had significant abdominal bleeding. She had lost so much blood I could not find a vein to start intravenous fluids, so I had to make an incision (without anesthesia) at her ankle to start an IV. Despite saline solution in large amounts, her abdomen continued to visibly enlarge, and we decided we needed to use the limited blood on patients we thought we could save. Her death and the reaction of her child have continued to bother me since.

KCMC built a new emergency department two years ago, and my wife Sue and I helped equip it with a container of donated medical equipment, including stretchers, monitors, resuscitation equipment, ultrasound, and x-ray. They now have regular blood drives. I am confident my patient from several years ago would live if she came today.

Inexpensive Chinese motorcycles (about $600) have now become the bane of orthopedists’ existence in developing countries, with road traffic injury levels reaching epidemic proportions. On almost every corner there are young men with their piki pikis offering a cheap, fast, and convenient taxi service. Anyone purchasing a motorcycle is supposed to go through a training program and get a license, but it is easy to pay someone with a license to buy a motorcycle for you and you are in business. As with the buses, the drivers compete to be the fastest and weave in and out of traffic, drive on the shoulders, and often pass on the wrong side at high speeds. The consequences of this system are many severe accidents. For those that survive and are able to get transported to the hospital (usually from a Good Samaritan), our work begins.

Four to eight of these patients arrive at our ER daily. Our intern, who is one year removed from medical school, is the first to be called. For an open long bone fracture, triage involves immediate IV antibiotics, tetanus vaccine (we get about 3 cases of tetanus per month), and a splint. As soon as possible, we try to get the patient to the operating room to wash out the wound and remove dirt and dead tissue. The orthopedic resident on call will perform this procedure. More senior backup is available if needed.
Before we started the teaching program at KCMC, these patients would generally have a pin inserted through the bone just below the knee for a femur fracture or through the heel for a tibia fracture and be placed in bed on traction for 2-3 months. Understandably, this leads to severe joint stiffness and muscle atrophy, and the bone often heals with deformity or doesn’t heal at all. Luckily, due to our donations of medical equipment, treatment now is quite different. For the more severe tibia and joint injuries, an external fixator can be placed, which involves several pins placed into the bone connected by an external metal frame. This allows people immediate mobilization.

I feel the most important difference we have made is the donation of a SIGN nail set. The Surgical Implant Generation Network (signfracturecare.org) was started by my friend, Dr. Lew Zirkle, several years ago to address the problem of treating long bone fractures in resource-poor settings. At home, these fractures are treated with metal rods placed down the center of the bone using an x-ray machine to guide the rod. SIGN has developed an ingenious rod that can be placed without the use of x-ray. For a one-time donation, a hospital receives two instrument sets and 100 nails. As long as the patient results are reported back to the SIGN database, every nail that is used is forever replaced for free. The hospital in the capital of Tanzania uses about 1,000 nails per year. Hundreds of thousands of these nails have been used around the world. Our motorcyclist patients can now be treated with a state-of-the-art nail at no cost and be up out of bed 1-2 days after the operation, and usually full weight-bearing by six weeks without the morbidity of prolonged bedrest. The main problem now with these patients is getting them to return to the clinic at six weeks when they feel fine.

Last Friday, I visited two of my former residents who are the orthopedists at the government hospital in Arusha, Tanzania. They are very frustrated to need to still use traction as they have no SIGN program. I promised them I would try to raise funds for a SIGN set when I return home. Like most doctors around the world, they want the best available care for their patients.

Glen Crawford, MD, Atlantic Orthopedics and Sports Medicine

A Day in the Life of Dr. Crawford’s Volunteering, Week 1

March 6, 2019
Moshi, Tanzania, East Africa

I am now at Kilimanjaro Christian Medical Centre in Northern Tanzania. This is my twentieth trip volunteering with Orthopedics Overseas, a group dedicated to teaching orthopedics in less developed countries. My wife, Suzanne, and I came here as medical students in 1985, and were frustrated (as were all the doctors working here) at the difficulty treating needy patients in a resource-poor environment. I started the KCMC teaching program in 2008, and we have had orthopedic surgeons from around North America volunteer here, as well as sponsored doctors from KCMC to come to the United States for specialized training. Sue and I have also sent 7 containers of medical equipment here, the most recent of which arrived the day before we did.

The hospital has around 800 beds and serves as a referral center for 15 million people. It is also a major teaching center, with medical and nursing schools and many postgraduate training programs including the orthopedic residency, which is the main focus of our teaching program. Before starting residency, the physicians have all practiced general medicine for at least three years, and the orthopedics training is four years. When they take their final exams they are expected to be knowledgeable and competent in all aspects of orthopedics. We volunteers especially focus our teaching on aspects of orthopedics the residents may not be exposed to as much while caring for patients here. As an example, I brought an arthroscopy unit here, and we had a teaching session for the residents using cow knees from the market before performing the first arthroscopy in the region on a patient with excellent results. Prior to this they could only read about sports medicine procedures.

Trauma makes up the majority of our work here. As in much of the developing world, road-traffic accident rates are skyrocketing due to the availability of cheap motorcycles, more cars and careless driving. As at home, cell phone use, speeding and alcohol are major contributing factors. Trauma is the leading cause of death and disability ages 20-40. As a referral center, we are sent the most severe cases and there are many compound or open fractures. Last year when I was here for two weeks, we saw three patients with bilateral open femur and tibia fractures (above and below the knee). We now have 80 patients in the hospital. I will relate some of their stories next.

Glen Crawford, MD, Atlantic Orthopedics and Sports Medicine

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Dr. Akhil Sastry Will Teach at the Champions Mako Program

Dr. Akhil Sastry, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, will be on the faculty of Stryker’s Champions MAKO program on May 9 and 10 in Philadelphia, Pennsylvania.

Stryker is one of the world’s leading medical technology companies, and their MAKO system is a surgeon-controlled robotic arm that enables accurate alignment and placement of implants.

Their Champions program is a master’s instructional course for surgeons who have robotics experience, and are working to enhance their skills, technical know-how and understanding of the applications on the partial knee, total knee, and total hip with the MAKO robot.

Dr. Sastry has taught and chaired multiple MAKO courses for Stryker nationally. He began using the MAKO Robotic-Arm Assisted Surgery System in 2016, and was the first surgeon in New Hampshire and Maine to perform a robotic-assisted knee replacement. Dr. Sastry has been participating in their educational programs throughout the country, teaching full knee, partial knee and total hip replacement on the robotic platform.

Dr. Sastry is also the premier robotic-assisted orthopaedic surgeon at Atlantic Orthopaedics and Sports Medicine. He states that the robot allows for a level of precision that enables a quick recovery and fewer issues for the patient once fully rehabilitated.

Atlantic Orthopaedics & Sports Medicine is a leading practice on the Seacoast, with offices in Portsmouth, New Hampshire and York, Maine. Their physicians have full medical staff privileges at both Portsmouth Regional Hospital and York Hospital.

Dr. Cameron Eilts Speaks at Specialist Meeting in Newport, Rhode Island

Dr. Cameron Eilts Speaks at Specialist Meeting in Newport, Rhode Island.

Dr. Cameron Eilts, Doctor of Podiatric Medicine at Atlantic Orthopaedics & Sports Medicine, was a speaker at The Podiatry Institute and The Rhode Island Podiatric Medical Association meeting in Newport, Rhode Island on April 25th through the 28th.

The meeting, called Surgical Pearls by the Sea, discussed current trends in the management of foot, ankle and leg disorders.

Dr. Eilts was a speaker for multiple segments throughout the weekend, and audiences included other Doctors of Podiatric Medicine.

Dr. Eilts is a faculty member at The Podiatry Institute. His specialties include Foot surgery; ankle surgery; wound care; diabetic limb salvage; non-surgical and surgical treatment of foot pain, foot deformity, pediatric flatfoot, ankle and foot fractures, plantar fascia, tendonitis, neuropathy, neuromas, heel spurs, ingrown toenails, hammertoes, warts, corns, calluses, bunions and other podiatry services. Learn more about Dr. Eilts here: https://www.atlanticorthopaedics.org/providers-surgeons-nh-me/eilts/

Atlantic Orthopaedics & Sports Medicine is a leading practice on the Seacoast of New Hampshire. They have offices in Portsmouth, New Hampshire and York, Maine and physicians have full medical staff privileges at both Portsmouth Regional Hospital and York Hospital.

Dr. Akhil Sastry To Teach Robotic Surgery Course In North Carolina

APRIL 27, 2019—Dr. Akhil Sastry, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, will teach a MAKO robotic surgery course on Saturday, April 27 in Pinehurst, North Carolina.

Surgeons in attendance will learn how to perform partial knee, total knee, and total hip surgery with the advanced technology. Dr. Sastry will also share his research demonstrating the benefits of robotic-assisted surgery, such as improved range of motion 90-day post-operation compared to patients who were manually operated on.

Stryker is one of the world’s leading medical technology companies, and their MAKO system is a surgeon-controlled robotic arm that enables accurate alignment and placement of implants.

Dr. Sastry has taught and chaired many courses for Stryker throughout the county. He began using the MAKO Robotic-Arm Assisted Surgery System in 2016, and was the first surgeon in New Hampshire and Maine to perform a robotic-assisted knee replacement.

Dr. Sastry is also the premier robotic-assisted orthopaedic surgeon at Atlantic Orthopaedics and Sports Medicine, and has said the robot allows for a level of precision that enables a quick recovery and fewer issues for the patient once fully rehabilitated.

Atlantic Orthopaedics & Sports Medicine is a leading practice on the Seacoast. They have offices in Portsmouth, New Hampshire and York, Maine, and physicians have full medical staff privileges at both Portsmouth Regional Hospital and York Hospital.

Orthopaedic Surgeon, Michael Morwood Joins Atlantic Orthopaedics & Sports Medicine Practice

Dr. Michael Morwood, Orthopaedic Surgeon, has joined Atlantic Orthopaedics & Sports Medicine practice effective March 1.

Dr. Morwood is entering the practice after his Adult Reconstruction fellowship at the Hofmann Arthritis Institute in Salt Lake City, Utah. His training included techniques in minimally invasive hip replacement, and muscle-sparing total knee replacement. Prior to Salt Lake City, he completed a fellowship in Orthopaedic Trauma at Tampa General Hospital in Florida, a nationally renowned Level 1 Trauma Center. He began his training in 2012 at Duke University, where he completed his internship and residency in Orthopaedic Surgery.

Dr. Morwood specializes in computer-navigated total knee replacement, muscle sparing total knee replacement and anterior total hip replacement. He is also an expert in orthopaedic trauma care, including the treatment of fractures, dislocations, and complex soft-tissue injuries.

“My mission is to improve the lives of my patients by restoring function through providing exceptional care using the highest quality evidence-based practices, innovative technologies, and cost-effective strategies,” said Dr. Morwood.

Dr. Morwood is currently accepting patients, and is excited to begin the next step in his career as a provider at Atlantic Orthopaedics & Sports Medicine. Call 603-431-1121 for an appointment, and visit the website to learn more about Dr. Morwood at atlanticorthopaedics.org.

Learn more about Dr. Morwood.

Dr. Akhil Sastry to Speak at ‘Contemporary Topics in Orthopedics’ Conference

February 22, 2019 — Dr. Akhil Sastry, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, will speak at the 29th Annual Winter Conference for Contemporary Topics in Orthopedics. The conference takes place March 8th-10th at Sugarloaf Mountain Inn, Carrabassett Valley, ME.

Dr. Sastry was invited as a guest speaker to give his lecture, “Advances in Total Hip & Knee Replacement Surgery: The Robotic Revolution.”

Dr. Sastry has co-authored articles in publications and given numerous podium presentations throughout the United States on this topic. He was the first surgeon to perform with Stryker’s MAKO Robotic-Arm technology on the Seacoast and has collected research and data from numerous surgeries to show its positive outcomes.

Robotic-assisted surgery has become increasingly popular in recent years, allowing for more precise surgical techniques, extensive preoperative and patient-specific planning, and improved soft tissue protection.

Other physicians attending the conference will learn from the many lectures speaking about advances in technology, and be able to discuss surgical and medical treatments to improve patient outcomes.

Co-sponsored by St. Joseph Healthcare, Contemporary Topics in Orthopedics is a non-profit organization committed to providing learning opportunities and personal interaction with orthopedic colleagues and allied health professionals in mind, while also providing a forum for paper and research presentations by regional professionals.

Dr. Akhil Sastry Study to be Presented at Orthopaedic Research Society Meeting

FEBRUARY 2, 2019 — Dr. Akhil Sastry, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, will have his surgical research data presented at the 2019 annual Orthopaedic Society Research meeting in Austin, Texas from February 2-5.

The meeting brings together hundreds of orthopaedic surgeons, nationally and internationally, with a mission to support and encourage research in surgery while providing a forum to share information for the well-being of patients.

Dr. Sastry’s research and data was collected from numerous surgeries performed with the MAKO robotic-arm assisted technology and shows its positive outcomes.

Robotic-assisted total joint arthroplasty has become increasingly popular in recent years, allowing for more precise surgical techniques, extensive preoperative and patient-specific planning, and improved soft tissue protection.

Dr. Sastry said it was an honor to be accepted to present his findings, with support from the Cleveland Clinic. His research includes data revealing robotic-assisted surgery patients had faster recovery times, and improved range of motion 90-day post-operation compared to those patients who were manually operated on, among other benefits.

Dr. Sastry was the first surgeon in the area to perform with the MAKO robotic-arm, leading the paradigm shift in how other orthopaedic surgeons think about surgery. He has since become a leading national expert, travelling and teaching other surgeons how to perform total knee, partial knee, and total hip surgery with the robotic-arm.

Dr. Sastry to Chair Stryker’s Robotic Surgery Conference

FEBRUARY 8, 2019 — Dr. Akhil Sastry, Board-Certified Orthopaedic Surgeon and provider at Atlantic Orthopaedics & Sports Medicine, will Chair Stryker’s National MAKO Program on February 8 and 9. He will head the conference in Fort Lauderdale, FL as the leading surgeon there and teach MAKO courses in partial knee, total knee, and total hip surgery to other attending surgeons.

Stryker is one of the world’s leading medical technology companies, and their MAKO system is a surgeon-controlled robotic arm that enables accurate alignment and placement of implants.

This is the second program Stryker has asked Sastry to Chair. He began using the MAKO Robotic-Arm Assisted Surgery System in 2016 and was the first surgeon in New Hampshire and Maine to perform a robotic assisted knee replacement. Sastry has been participating in their educational programs throughout the country teaching full knee, partial knee and total hip replacement on the robotic platform.

Sastry is also the premier robotic-assisted orthopaedic surgeon at Atlantic Orthopaedics and Sports Medicine and has said the robot allows for a level of precision that enables a quick recovery and fewer issues for the patient once fully rehabilitated.

Atlantic Orthopaedics & Sports Medicine is a leading practice on the Seacoast. They have offices in Portsmouth, New Hampshire and York, Maine and physicians have full medical staff privileges at both Portsmouth Regional Hospital and York Hospital.

Dr. Cameron Eilts to Teach National Cadaver Course at The Podiatry Institute

Cameron Eilts, Doctor of Podiatric Medicine at Atlantic Orthopaedics & Sports Medicine, will be teaching a Cadaver Course at The Podiatry Institute in Decatur, Georgia from December 3 through December 6.

Surgeons in various specialties from around the world will attend this course for rearfoot and ankle procedures. The surgeons attending will learn through live surgical observation and hands on participation with cadaver limbs. They will also learn multiple alternative options for fixation of osteotomies and/or fractures and be exposed to new techniques and the latest procedural trends.

Dr. Eilts is a faculty member of The Podiatry Institute, an honor in his specialty. The faculty members are all volunteers who serve without compensation and are committed to ongoing education in the area of foot and ankle surgery.

The Podiatry Institute is a non-profit educational foundation that offers a variety of programs including conferences, workshops and postgraduate courses. The Institute has achieved national and international recognition for its leading role in developing and advancing podiatric medicine and surgery.

Atlantic Orthopaedics & Sports Medicine