Joint Efforts
Patients in need of orthopedic surgery reap the benefits of advances in technology, understanding, and perioperative care.
by Bill Donahue

Change is the only constant, to borrow the wisdom of the Greek philosopher Heraclitus. Although change can be frightening, given the inherent unknowns, it can also lead to dramatic steps forward. Such is the case in the field of medicine, particularly orthopedic medicine. 
“In 1988, when I started training, we were in a period when I thought I had walked into a new age of orthopedic medicine,” says Alexander R. Vaccaro, M.D., Ph.D., M.B.A., the president of Rothman Orthopaedics, as well as an orthopedic surgeon who specializes in the spine. “Now, every five to six years, there has been a new invention or movement that has made things easier or better.” 
Dr. Vaccaro cites buzz-worthy innovations such as robotics-assisted surgery and surgical guidance systems informed by artificial intelligence. Likewise, minimally invasive surgical techniques enable surgeons to complete procedures with dramatically smaller incisions and with significantly less tissue damage. Progress in anesthesia and postoperative recovery strategies have contributed to smoother patient recoveries, too.
“Before, if someone was in their 70s and you wanted to do hip, knee, or spine surgery, you had to first ask, ‘What are the pulmonary and cardiac implications?’” he says. “Now, because we have made anesthesia super-safe, we can routinely operate on octogenarians, or people in their 80s.”
Orthopedic patients also get “back on their feet” much sooner than they used to, as science has shown that postoperative ambulation accelerates the recovery period. Theoretically, a patient who has had total joint arthroplasty—another term for joint replacement—of a knee or hip could go home later the same day.
“It’s such a smoother ride than it was when I first started practicing,” says Dr. Vaccaro.  
Dinesh Dhanaraj, M.D., agrees. As a board-certified orthopedic surgeon with St. Mary Orthopaedics in Langhorne, Dr. Dhanaraj specializes in shoulders, hips and knees, with a subspecialty in sports medicine. He absorbed so much knowledge in his years of medical school, residency, and specialty training, yet he continues to be pleasantly surprised by how rapidly things change for the better. 
“It’s a long road to become an orthopedic surgeon, and you think you learn everything there is to know,” says Dr. Dhanaraj. “I’m seeing things I’ve never seen in 11 years of practice. … You’re still fixing a broken bone, which is standard for orthopedic surgery, but the restorative techniques are changing every six to 12 months.”
He cites MACI, short for matrix-induced autologous chondrocyte implantation, a form of cartilage regeneration and repair. Essentially, MACI uses a patient’s own cells to treat cartilage defects in the knee. Both he and Dr. Vaccaro see great promise in other areas, such as stem-cell therapy, and look forward to how the field will evolve and expand in the years ahead. 

Gaining Perspective
The human body may be an amazingly complex and proficient machine, but parts of it, such as the bones and joints, are prone to breakdown or injury. For anyone in need of a new knee, hip, or shoulder, or some other form of orthopedic repair, Drs. Dhanaraj and Vaccaro offer some preoperative perspective.  
* Shape up. “It’s not about your numerical age but your physiological age,” Drs. Dhanaraj says. “Inevitably, there’s a force of nature working against us—gravity—so there are things patients can do to help their situation prior to surgery. I’m not talking about anything dramatic in terms of weight loss. People are likely to see dramatic improvements even with general [preoperative] lifestyle changes and minimal weight loss of 10 pounds.”
* Ask around. “Everyone has two or three friends who have had experience with a surgeon,” Dr. Vaccaro says. “A friend will say whether that experience was good or bad. If a patient says, ‘I did well,’ that patient will bring two to four patients to you. Every time someone has a bad experience, you can lose six to eight patients.” He might also recommend seeking the advice of a primary medical provider, as well as reviewing online ratings systems, such as the Centers for Medicare & Medicaid Services website, which offers insight on readmission rates, infection rates, and other indicators of postoperative outcomes.  
* Define expectations. “Start thinking about what’s most important—pain, function, performance, or long-term health,” Dr. Dhanaraj says. “We want to have those open discussions and guide the treatment accordingly, because surgery is not always the best option.” 
As with anything in life, attitude is everything.
“Any surgery can be a blessing in disguise,” Dr. Dhanaraj adds. “If they recover, they can come out stronger, and not only recover from the injury but also gain perspective from their setbacks.”

2021 Top Orthopedic Physicians
Earlier this year, for our 2021 Five-star Physicians feature, we asked readers to share their thoughts on the Philadelphia area’s top medical providers devoted to solving patients’ ills, orthopedically speaking. The following list includes readers’ choices, as well as a few of our own, based on individuals and organizations featured in the pages of Suburban Life. In addition to leaders in orthopedic surgery, we included physicians who practice in allied subspecialties such as physical medicine and rehabilitation and sports medicine.

Dr. Joseph A. Abboud
Dr. D. Greg Anderson 
Dr. William V. Arnold 
Dr. Matthew S. Austin 
Dr. Steven A. Caruso 
Dr. P. Maxwell Courtney 
Dr. David V. Craft
Dr. Daniel Fletcher 
Dr. Charles L. Getz 
Dr. Michael F. Harrer 
Dr. Alan S. Hilibrand 
Dr. William J. Hozack 
Dr. Asif M. Ilyas 
Dr. I. David Kaye 
Dr. Christopher Kepler 
Dr. Mark F. Kurd
Dr. Jess H. Lonner 
Dr. Surena Namdari 
Dr. Alvin C. Ong 
Dr. Andre J. Pagliaro
Dr. Javad Parvizi
Dr. Matthew L. Ramsey
Dr. Jeffrey A. Rihn 
Dr. Michael Rivlin 
Dr. Arjun Saxena 
Dr. John R. Schnell 
Dr. Rachel Shakked 
Dr. Peter F. Sharkey
Dr. Alexander R. Vaccaro 
Dr. Gerald R. Williams Jr.
Rothman Orthopaedics
Multiple locations

Dr. Jeffrey S. Abrams 
Dr. Jon W. Ark 
Dr. Steven R. Gecha 
Dr. W. Thomas Gutowski
Dr. David J. Lamb 
Dr. Marc J. Lamb
Princeton Orthopaedic Associates 
Princeton, N.J.

Dr. Kenan Aksu
Dr. Linda D’Andrea
Dr. Jonathan P. Garino
Dr. James T. Guille
Dr. Scott Ritterman
Dr. Mark E. Tantorski
Dr. Richard Ziegler
Premier Orthopaedics
Multiple locations

Dr. Edward Armbruster
Dr. David J. Bozentka
Dr. Daniel C. Farber
Dr. David L. Glaser
Dr. George Russell Huffman
Dr. Eric L. Hume
Dr. Craig Israelite
Dr. Frederick S. Kaplan
Dr. John D. Kelly IV 
Dr. Amrit S. Khalsa
Dr. Gwo-Chin Lee
Dr. L. Scott Levin
Dr. Brian J. Sennett
Dr. Harvey E. Smith
Dr. Keith L. Wapner
Dr. Kristy L. Weber
Penn Medicine
Multiple locations

Dr. James C. Barrese
Dr. Seth Jossefer
Dr. Mark McLaughlin 
Dr. Richard J. Meagher 
Dr. Nazer Qureshi
Dr. Nirav K. Shah 
Dr. Matthew Tormenti
St. Mary Medical Center | Princeton Brain Spine & Sports Medicine
Multiple locations

Dr. Arthur R. Bartolozzi
Dr. Paul H. Steinfield
Dr. Douglas Sutton
Jefferson Health
Multiple locations

Dr. John M. Bednar 
Dr. Randall W. Culp 
Dr. Thomas J. Gillon
Dr. Sidney M. Jacoby
Dr. Patrick M. Kane
Dr. Leonid I. Katolik
Dr. Kenneth A. Kearns
Dr. Rowena McBeath
Dr. Andrew J. Miller 
Dr. A. Lee Osterman 
Dr. Meredith N. Osterman
Dr. Mark S. Rekant
Dr. Eon K. Shin
Dr. Adam B. Strohl 
Dr. Stephanie Sweet 
Dr. Richard J. Tosti
Dr. Matthew S. Wilson
Dr. David S. Zelouf
Dr. Dan A. Zlotolow 
Philadelphia Hand to Shoulder Center
Multiple locations

Dr. Ana Bracilovic 
Dr. Grant Cooper 
Dr. Scott Curtis
Dr. Marco Funiciello 
Dr. Greg Kelley
Dr. Jason Kirkbride
Dr. Zinovy Meyler 
Princeton Joint & Spine Center 
Princeton, N.J.

Dr. Lee M. Buono 
Capital Institute for Neurosciences Center for Spinal Disorders and Spinal Oncology
Pennington, N.J.

Dr. Richard A. Cautilli Jr. 
Dr. George T. Stollsteimer
St. Mary Medical Center

Dr. Jamie L. Engel
Dr. Evan Kovalsky
Dr. Michael J. Messina
Dr. Mark A. Schwartz
Tower Health 
Multiple locations

Dr. Gregory G. Gallant
Dr. Guy A. Lee
Doylestown Health

Dr. David Hardeski
Mercer-Bucks Orthopedics
Multiple locations

Dr. Susan Lee
Dr. James Raphael 
Einstein Healthcare Network 
Multiple locations

Dr. Menachem M. Meller
Lower Bucks Hospital

Dr. Scott A. Rushton 
Main Line Health

Dr. Joseph Thoder
Temple University Hospital

Dr. Scott J. Davidoff
Dr. Marc S. Effron
Dr. Roy M. Lerman
Dr. Denis P. Rogers
Dr. Jeffery J. Rowe
Dr. L. Matthew Schwartz
Main Line Spine
Multiple locations

Dr. Alberto Esquenazi
Dr. Michel Marino
Dr. Nathaniel Mayer
Dr. Jeffrey M. North
Dr. Christopher T. Plastaras
Dr. Michael F. Saulino
Dr. Miriam Segal
Dr. Channarayapatna R. Sridhara
Dr. Thomas Watanabe
Multiple locations

Dr. Jeffrey A. Gehret
Dr. Saloni Sharma
Dr. Jeremy I. Simon 
Dr. David S. Stolzenberg
Rothman Orthopaedics
Multiple locations

Dr. John M. Vasudevan
Penn Medicine
Multiple locations

Dr. Christopher M. Aland
Dr. Michael G. Ciccotti
Dr. Evan J. Conte
Dr. Christopher C. Dodson
Dr. Michael P. Duncan
Dr. William Emper
Dr. Robert W. Frederick
Dr. Kevin Freedman
Dr. William Gomez
Dr. Sommer Hammoud 
Dr. Marc I. Harwood
Dr. Joshua S. Hornstein
Dr. Donald W. Mazur
Dr. Bradley J. Smith
Rothman Orthopaedics
Multiple locations

Dr. Dhimant Balar
Princeton Brain Spine & Sports Medicine
Multiple locations

Dr. Matthew Lewullis
Penn Medicine
Multiple locations

Dr. Lawrence Wells 
Children’s Hospital of Philadelphia 

Published (and copyrighted) in Suburban Life magazine, March 2021.