Santa Rosa Orthopaedics

1405 Montgomery DriveSanta Rosa, CA 95405(707) 546-1922 fax (707) 528-1602

Santa Rosa Orthopaedics Sports Medicine & Rehabilitation

30 Mark West Springs Road, Ste. 300Santa Rosa, CA 95403(707) 546-1922fax (707) 569-8620

Christian Athanassious, M.D.

Frederick S. Bennett, M.D.

Thomas C. Degenhardt, M.D.

Nathan Ehmer, D.O.

Kai-Uwe Mazur, M.D.

Michael J. McDermott, M.D.

Dominic J. Mintalucci, M.D.

Mark E. Schakel, M.D.

Michael J. Star, M.D.

Gary A. Stein, M.D.

SRO Doctors

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Over the years, SRO has advanced as fast as technology allowed. Lightweight casts are now made of fiberglass, on-site digital X-rays make imaging more accurate and available immediately. Digital images, whether taken on-site or transmitted from another facility, are quickly downloaded into the EHR system and available to each specialist for review.

Perhaps most amazingly, total joint replacement surgery can now be an outpatient procedure in healthy individuals. “Now, we do arthroscopic outpatient surgery, and we do minimally invasive outpatient total joint surgery. That includes knees, wrists, shoulders, and total hip replacements. We also do minimally invasive spine surgeries as outpatient surgery,” said Dr. Stein. “There is a lot less pain and recovery time is much faster.”

In the 1980’s, with the introduction of arthroscopy, the advancement in surgical techniques accelerated. Instead of open incisions, the surgeons were now making small puncture incisions and using tiny cameras to see what was going on inside the joint on a monitor. “And a lot of the tools evolved so you could do procedures you never thought possible, doing it all through a small portal. That made a huge change in the way Orthopaedics was done,” Dr. Stein said.

As Santa Rosa Orthopaedics (SRO) celebrates its 70th

anniversary, it is moving ahead with bringing leading edge musculoskeletal medical services to the North Bay.

In 1946, Dr. Carl E. Anderson, one of Santa Rosa’s first orthopaedic surgeons, founded Santa Rosa Orthopaedics. In the 1960’s, he was joined by Dr. R. Dee Robbins, Dr. T. Wesley Hunter, and Dr. Freeman W. Born. They started with a small office across the street from Santa Rosa Memorial Hospital, and served the community with three exam rooms, and an X-ray room.

Dr. Anderson’s community involvement extended beyond clinical orthopedics. SRO pioneered local philanthropic projects including raising money for a multi-cultural preschool, establishing the Kid Street Learning Center, caring for disabled children, and supplying vegetables to the Rescue Mission. Dr. Anderson also served as an expert witness for medical issues. He was well known for his research on cancerous tumors, and even worked for Governor Ronald Reagan in Sacramento, and attended Reagan’s presidential inauguration.

In 1968, the doctors built a much larger office at the current location on Montgomery Drive, AKA “The Bone Palace”. A typical hospital stay for patients undergoing surgery for total joint replacements in those days was 7-10 days, sometimes 2 weeks.

As the practice continued to expand, more specialists were added, including Dr. James H. Bauer, Dr. Matthew Zwerling and

Dr. Thomas Degenhardt, the first sports medicine fellowship trained orthopedic surgeon in Sonoma County. Dr. Gary Stein joined the practice in 1985, specializing in fracture care and joint replacement surgery. Drs. Mark Schakel and Michael Star later joined the practice bringing their expertise in spine, joint replacement and foot and ankle surgery. Dr. Kai Mazur joined SRO and started the Hand Center in 1988 and later brought on Dr. Dominic Mintalucci in 2013 to expand this center of excellence.

The practice added Traumatologist, Dr. Fred Bennett in 1990 to start the SRO Trauma Team. In 2009 Nathan Ehmer was brought on to handle the increasing need for Orthopaedic Trauma in Sonoma County. Both Dr. Bennett and Ehmer handle the majority of cases at Santa Rosa Memorial Regional Trauma Center.

In 2004, the doctors expanded and opened an office on Stony Point Road. This became the physical and occupational therapy department with an in-house MRI and gym. Dr. Michael McDermott joined the practice in 2006 at the Stony Point location specializing in Sports Medicine. The most recent addition has been Dr. Christian Athanassious, specializing in Spine Surgery with minimally invasive surgical techniques.

Santa Rosa Memorial Hospital became a regional trauma center about 15 years ago, and advances have been made there as well. “The methods of treatment of orthopedic trauma are much more aggressive than they were in the past. People used to spend time in traction and in the hospital for days and weeks healing a fracture.

Now there is immediate fixation, stabilizing the fractures with less invasive techniques so that people can get up and mobilize right away and get out of the hospital quickly, with reduced complications secondary to being in bed. The way people recover has changed dramatically,” Dr. Stein said.

The SRO practice has increased staff from 20 employees in 1985 to 60 full time employees in 2016. SRO has continuously invested to improve infrastructure to better serve patients and the community. “SRO now has 10 orthopaedic surgeons who specialize in every area. We have all the bases covered as far as taking care of people with musculoskeletal problems. It’s good to have partners within your practice that have other sub-specialties, so that if you need to refer a patient, you know they are in good hands,” says Dr. Stein.

In 2014, SRO opened their vanguard facility on Mark West Springs Road, next door to the state-of-the-art Sutter Santa Rosa Regional Hospital. The site boasts 16 offices and a cutting edge physical therapy facility on the third floor. The added space allows the doctors to see more patients, improve patient flow, and compliments the six brand new outpatient surgery rooms on the first floor.

With improvements in surgical and anesthetic techniques, SRO surgeons began performing outpatient joint replacements last year. Anesthetic peripheral nerve block catheters gradually deliver anesthetic to block the nerve to the affected extremity for up to three days.

“It’s a better way of managing the discomfort. And when patients go home they

immediately start outpatient physical therapy, so there is a continuum of care. The physical therapist evaluates them before the surgery and after the surgery before going home. After the surgery the physical therapists make sure patients are on track with what they need to do,” Dr. Stein said. “Having that component of the practice makes the care much more coordinated. Our therapists know our protocols and can access us at any time with questions, and they have direct access to the patient’s medical record, operation reports, and x-rays. It all improves the way the recovery goes for the patient.”

“As SRO looks towards the future to optimize care, the outpatient surgery arena will continue to be enhanced, and as the need arises, additional specialty doctors will be recruited to the practice”, Dr. Stein said.

“It’s a continuum. When you stay on top of things you can provide the best care.”

SRO’s Future Built on a Year Legacy

A Patient’s Story

Con’t on back

Con’t from front

Susan Ellis joined SRO as the new office manager in February of 2016. Susan will work closely with office Administrator, Lorelei DeBenedetti, to oversee staff at both Montgomery and Mark West Springs locations.

Susan has an excellent background in staff communications and development, training, and conflict resolution with both staff and patients. Her immediate goals are to focus on team building and offering a supportive and consistent environment for SRO employees to work in.

Before coming on board with SRO, Susan worked for Health Services Integration, verihealth, Inc and as a Medical Office Manager at Santa Rosa OBGYN Medical Group in Santa Rosa for eighteen years. She brings with her strengths in health care patient care operations, customer, staff and physician relations, insurance claims, medical records, coding procedures and the ability to resolve problems.

When Susan is not working she loves spending time with her friends and her very feisty cat. She enjoys reading, knitting and sewing.

SRO Welcomes Susan Ellis as the New Office Manager

Terri A lives in Santa Rosa with her husband and adorable German Sheppard, Sable. In her spare time, Terri enjoys

cooking, shopping, sewing, aerobics, and

walking her dog. Four years ago, Terri fostered a

golden retriever. In a moment of uncontrollable excitement, the dog lunged forward while Terri held its collar, causing a spiral fracture in Teri’s upper-left arm. In the emergency room, doctors informed Terri that she would require surgery in order for her arm to make a full recovery.

I was nervous when doctors told me that I’d need surgery, so it was a relief to have Dr. Bennett as the on-call surgeon in the ER at the time of my accident. I had heard from friends and physicians of Dr. Bennett’s unparalleled skill as a surgeon. I’m left-handed, and I was worried that I would have a hard time sewing after my injury. I can do everything with my arm that I could do before my accident, and there’s very minimal scarring from my surgery. Dr. Bennett certainly lived up to his great surgical reputation.

Dr. Frederick S. Bennett is a board certified Orthopaedic Surgeon, with subspecialty interest and fellowship training in orthopaedic trauma. He completed

residency training at Los Angeles County- Harbor UCLA Medical Center in 1987, followed by an additional year of fellowship training in the treatment of complex fractures at Cooper Hospital in Camden, New Jersey in association with the University of Pennsylvania. He then spent four years in private practice at the University of Tennessee’s Level 1 Trauma Center in Knoxville before relocating to Santa Rosa in 1997. Since coming to Santa Rosa, Dr. Bennett has been one of the major participants in Sonoma County’s regional trauma system and is part of the Orthopaedic Trauma Team at SRO

1946

2016E

Expertise. Care. Healing.

Joint replacement surgery has come

a long way in the past couple of decades, giving patients who receive artificial knees or hips a very real improvement in the quality of their lives. And with a new procedure performed by Santa Rosa Orthopedic surgeons Michael McDermott, M.D., and Nathan Ehmer, D.O., such surgeries are advancing even further.

Doctors McDermott and Ehmer are pioneering the use of robotic assisted MAKOplasty for some partial knee replacement and hip replacement procedures. These new devices employ computer-aided robotics to help surgeons perform more accurate installations of artificial joints—reducing pain, shortening hospital stays and improving outcomes for SRO’s patients. At the local Sutter Santa Rosa Regional Hospital, the robotic assisted arm is available for total hip replacement surgeries and for partial knee replacements—a common surgery for people suffering knee pain caused

by osteoarthritis. For knees, Dr. McDermott said the RIO system offers a number of benefits, starting with a much smaller “mini-incision” that most patients equate with a faster recovery.

The result is a better balanced knee, faster recovery and

improved performance after healing. “The robotic assisted surgery isn’t right for every patient, but it can help improve outcomes in partial knee cases,”Dr. McDermott said. For total hip replacements, the robotic device operates on the same concept. Successful hip replacement surgery relies heavily on the accurate placement of the acetabular cup (where the rotating head of the femur attaches to the pelvis). Using the RIO to precisely locate the cup reduces the possibility of undue wear or even dislocation of the implant. The robotic arm also helps the surgeon make precision measurements to ensure the leg remains the correct length and the hip the correct width, giving the patient a smooth and natural feeling as he or she begins recovery.

Dr. Mark Schakel, one of a few California board certified and fellowship trained orthopaedic foot and ankle surgeons, north of San Francisco, has worked closely with colleagues at SRO

to establish Sonoma County’s Foot and Ankle Program.

Dr. Schakel’s program offers full-service surgical, nonsurgical, and rehabilitative foot and ankle treatment to patients with foot pain and loss of function. The Foot and Ankle Program teams up with SRO to offer a 10,000 square foot, state-of-the-art physical therapy facility, in-house open extremity MRI capabilities, custom orthotic computer-generated gait analyses, integrated electronic patient records, and a staff of 10 board certified orthopaedic surgeons. This comprehensive approach makes the Foot and Ankle Program at SRO highly respected and the only program of its kind in the Northern California region.

“At the Foot and Ankle Program,” Dr. Schakel explains, “we work closely with

SRO’s experienced physical therapists in order to determine the most effective treatment based on the latest orthopaedic and physical therapy research. I know from experience how complex some foot and ankle cases can be, and my experience motivates me to pay attention to the small details.”

Dr. Schakel’s expertise is an invaluable asset to the quality of foot and ankle care in the area. After completing medical school, Dr. Schakel received his fellowship training in foot and ankle surgery under Dr. Roger Mann, a world-renowned orthopaedic foot and ankle surgeon. Dr. Schakel has also presented papers at national orthopaedic meetings, taught at orthopaedic foot and ankle courses, and published articles in numerous orthopaedic journals and books.

For over 10 years Delores Narcum endured chronic, increasing pain in her hip joints. Eventually the pain grew beyond unbearable. Dr. Michael Star at SRO performed a total-hip replacement on both hips. Now it’s like the pain has been switched off, and Delores can once again enjoy life and a full-range of motion.

Before Dale Downey had his knee replacement, he couldn’t walk more than 100 yards without experiencing overwhelming pain. He feared he would never play golf again, his cherished activity. Dr. Degenhardt replaced his knee and Dale was wonderfully surprised to be up and walking the same day after surgery. He is back on the golf course pain-free for all eighteen holes.

Delores and Dale aren’t alone in their experiences with joint pain. The most common complaints heard by orthopaedic surgeons include pain that worsens with walking, interferes with restful sleep and affects day-to-day mobility. Conditions that can damage the joint, sometimes necessitating joint replacement surgery include Osteoarthritis, Rheumatoid arthritis and Osteonecrosis.

TJR helps restore a more active lifestyle. Additional benefits of the surgery include reduced pain, increased mobility, improved joint function, increased fitness, and a better quality of life.

The Total Joint Program at Santa Rosa Orthopaedic Medical Group provides people in pain with hip, knee, shoulder, elbow, wrist, thumb and finger joint replacement surgery as well as state-of-the-art outpatient physical therapy services to make damaged joints healthy again. SRO surgeons and physical therapists care and pride themselves on getting patients back to the activities they love, helping to re-establish independence and restore livelihood.

Dr. McDermott, Dr. Ehmer, Dr. Bennett, Dr. Stein, Dr. Mazur, Dr. Star, and Dr. Degenhardt make up a collaborative team of multi-specialist orthopaedic surgeons and highly skilled physical and occupational therapists that specialize in TJR.

The program, also offers the latest in advanced minimally invasive surgical techniques including the anterior hip approach and MAKO Robotic Surgery with Dr. Nathan Ehmer and Dr. Michael McDermott.

What is stem cell therapy?

Stem cells essentially contain the ‘code’ for every cell type that makes up each individual organ and structure in the body. Stem cells can help to generate healthy new cells and repair tissues in structures that are injured or damaged. For use in orthopaedics, this kind of treatment generally involves the use of mesenchymal stem cells – which can be derived from bone marrow stromal cells which are obtained from living adult tissue – at times from the patient’s own body or from allograft donor tissues, usually derived from placental membranes.

Under the right conditions, these stem cells can separate into new cells and become part of the musculoskeletal system, helping to form trabecular bone, tendon, articular cartilage, and ligaments. Positive results have been seen in patients as early as six weeks after initial treatment. The ultimate goal of stem cell therapy is to replace unhealthy cells with healthy ones, allowing the body to resume proper function in the otherwise damaged structure. Stem cells can be used in surgery as adjuvant therapy to facilitate healing of tissues.

For some patients, common medical and surgical interventions aimed at relieving pain due to trauma or degenerative conditions may not be the best option. In these cases, stem cell therapy can offer new hope. As technology develops it will be more widely available and sought after as a viable noninvasive treatment for joint pain and other orthopaedic problems.

Robotic Assisted ORTHOPAEDIC SURGERY

Stem Cell Therapy Gives Hope to Patients with Acute and Chronic Joint Pain

The benefits of Total Joint Replacement

Santa Rosa Orthopaedic specialists can help eliminate chronic pain and restore healthier and active lifestyles though Total Joint Replacement (TJR).

Treating chronic pain

Additional benefits

There is a new alternative for those facing the prospect of spinal fusion, it’s called eXtreme Lateral Interbody Fusion (XLIF®).

Dr. Christian Athanassious, Director of the Total Spine Health Program at SRO states, “There are any number of reasons that patients can experience

spine problems. The majority of cases are caused by either instability or by disc, bone or ligaments putting pressure on the nerve roots or cord.”

For patients whose symptoms continue to worsen, and for anyone whose spinal condition indicates the need for surgery, the XLIF® procedure may provide the best outcome.

For those choosing XLIF® minimally invasive back surgery, potential benefits include reduced time in the hospital, shortened recovery time, less blood loss during the procedure, smaller scar/incision and an implant designed for maximum stability of the spine.

The XLIF® technique is designed to treat a range of spinal disorders and is performed via the side (lateral) of the body. Using patented nerve monitoring technology, the surgeon gains lateral access to the spinal column, avoiding any major nerves in the area between the incision and the column. The XLIF procedure has the benefit of avoiding the risks of vascular and/or neural injury as found in traditional approaches.

“Most XLIF® patients are discharged from the hospital just one or two days following surgery,” explains Dr. Athanassious. “Every patient is unique and the orthopaedic surgeon will determine the most appropriate postoperative course for the best outcome.”

Dr. Christian Athanassious is a board eligible spine surgeon with fellowship training in spine surgery from Stanford University. Dr. Athanassious is the director of The Total Spine Health Program at SRO.

Considering back surgery?

Physician Spotlight

Minimally invasive XLIF® provides a quicker recovery and outstanding results.

Advances in orthopaedic surgery have come a long way since the first total hip replacement surgery was performed in 1967. Since that time developments in arthroscopic or minimally invasive surgical techniques combined with innovations in joint replacement have helped to make it possible for patients to receive treatments that not only relieve pain but make it possible for them to resume and maintain active lives. And perhaps one of the more exciting advances in joint repair is stem cell therapy – a new technique that is beginning to show promise for patients.

Although research continues on applications, stem cell procedures in orthopaedics are currently being performed by specialists and orthopaedic physicians across the U.S., including my own practice at Santa Rosa Orthopaedics.

Stem cell therapy has been around for quite some time – primarily used for treatment of conditions like leukemia. Over the past 10 years researchers have been able to develop viable stem cell therapies for orthopaedic use aimed at joint repair, healing fractures and other bone defects. As cell therapy research continues, clinical trials are discovering the treatment very promising for a variety of diseases. Some of the more ambitious hopes include potential regeneration of articular cartilage in hips, knees and other damaged body parts.

By Dr. Gary Stein