About Us: Florida Orthopaedic Institute

Florida Orthopaedic Institute physicians are known nationally and throughout the world for their work in orthopaedic surgery and have been named among the best orthopaedic physicians in America. This is accomplished through subspecialization, continuing scientific and clinical research to enhance the art and science of orthopaedic surgery, and by providing orthopaedic education through courses and lectures, journal publications, Fellowship and residency training.

As one of Florida’s largest orthopaedic groups, Florida Orthopaedic Institute’s mission is to provide excellence in clinical outcomes and an exceptional patient experience, while in an environment that fosters growth through teaching, education and research in all aspects of musculoskeletal medicine. All surgeons are fellowship trained, providing a level of care unattainable elsewhere in Tampa Bay.

With expertise in virtually every orthopaedic subspecialty, Florida Orthopaedic Institute is one-stop shop, with the ability to manage all aspects of musculoskeletal care.

Founded in 1989, Florida Orthopaedic Institute has grown from 12 orthopaedists working in one office and one hospital, to over 40 physicians, 25 mid-level providers, 15 Fellows, and a professional staff of more than 700, working in 12 offices and 19 regional hospitals, three Surgery Centers and two Orthopaedic Urgent Care centers.

Florida Orthopaedic Institute’s Divisions include Foot and Ankle, Hand and Wrist, Joint Arthroplasty, Oncology, Orthopaedic Trauma, Pain Management, Rehabilitative Medicine, Shoulder and Elbow, Spine Surgery, and Sports Medicine.

Using data, research, and analytics, Florida Orthopaedic Institute continues to provide innovative care to patients, allowing them the best chance to return to a normal lifestyle.

Additionally, in combination with USF and Tampa General Hospital, Florida Orthopaedic Institute surgeons use the combined strengths of each partner to advance academic orthopaedics through the USF Orthopaedic Surgery Residency Program. This combination assures patients the finest orthopaedic treatment and brings substantial benefits to the community, patients, residents, and medical students alike.

ADULT RECONSTRUCTION SURGERY

Florida Orthopaedic Institute surgeons lead the way with minimally invasive arthroscopic hip surgery, robotic-assisted total knee and hip replacement, tibial trial sensor technology and other cutting-edge orthopaedic techniques.

HIP PRESERVATION SURGERY

Technologies and procedures for care and repair of the hip have evolved significantly in recent years. If oral medication and physical therapy are not effective, patients are now offered the latest advanced technique – hip arthroscopy. For patients with pain related to torn or loose cartilage, or early arthritis with bone impingement, minimally invasive arthroscopic hip surgery is an excellent option which is performed as an out-patient procedure, through one or two small incisions. In many cases, arthroscopic treatment can minimize or significantly delay the need for a hip replacement. The specialists of Florida Orthopaedic Institute are among only a handful within the state of Florida qualified to provide this state-of-the-art therapy.

PRIMARY HIP & KNEE ARTHROPLASTY SURGERY

The arthritis specialists of Florida Orthopaedic Institute use numerous methods to treat arthritis depending on its severity including activity modification, exercise programs, and oral medications to manage milder forms of the disease. For more moderate forms of the disease, cutting-edge regenerative techniques including platelet rich plasma, and stem cell injections are offered to minimize the pain associated with the disease. When the hip or knee joint is either too arthritic, deformed, or both, a variety of replacement options are available, including total hip, partial hip, and total knee replacements.

Hip and knee replacements are one of the most successful operations ever developed, with patient satisfaction rates typically in excess of 90%. Florida Orthopaedic Institute surgeons perform thousands of these joint replacements each year. All have received Fellowship training in their specialty, from some of the world’s best universities and research centers, and now teach younger surgeons these same techniques, lecturing nationally and throughout the world.

These same surgeons have pioneered many of the operative procedures, and designed the very implants used to replace the hip and knee joints. All are board certified and recertified. As a result, these surgeons consistently use the most advanced techniques available, making them leaders in their field.

SAME DAY OUTPATIENT HIP & KNEE JOINT SURGERY

Florida Orthopaedic Institute surgeons have helped pioneer outpatient joint replacement, where patients can go home the same day as the surgery. Traditionally, patients have been admitted to the hospital for a period of two to four days. But with team control, excellent anesthesia, and surgeon expertise, same day replacements can be performed on selected patients. Patients come in an hour before the operation, have surgery, usually stay between three to four hours in the recovery unit, and then go home.

ROBOTIC JOINT REPLACEMENT SURGERY

One recent technique that the Florida Orthopaedic Institute Joint Replacement team has helped pioneer is the Mako® robotic-assisted surgery. This technology helps with the removal of diseased bone while preserving healthy bone and assists the surgeon in the ideal positioning of the implant, based on the patient’s anatomy. Mako technology provides surgeons with patient-specific 3-D models to pre-plan hip and knee replacements. Surgeons guide the Mako robotic arm during surgery, based on a patient-specific plan.

REVISION JOINT REPLACEMENT SURGERY

As high volume joint replacement surgeons, the Florida Orthopaedic Institute team has a tremendous understanding of the problems associated with failed surgery. This expertise has resulted in exceptional experience in solutions for infected joints, loose implants, complex deformities, fractures around these implants, and patients with metabolic bone problems. As one of the leading revision hip and knee centers in the United States, Florida Orthopaedic Institute surgeon’s expertise has restored many failed joint replacements so patients may successfully return to a normal lifestyle.

FOOT & ANKLE SURGERY

With over 20 years of experience, performing thousands of ankle fusions, triple arthrodeses, subtalar fusions and over 300 total ankle replacements, our surgeons are leaders in the field. Over 1,000 procedures were done in 2017 alone.

Since 1989, Florida Orthopaedic Institute surgeons have helped thousands of patients get back on their feet with Tampa Bay’s most advanced orthopedic lower extremity service. Knowledgeable and experienced physicians, therapists and nurses work in concert to cover the total spectrum of foot and ankle musculoskeletal care.

CONSERVATIVE MANAGEMENT BEFORE SURGERY

Whether tendon, ligament, bone injuries, arthritis, or acute/chronic conditions, Florida Orthopaedic Institute surgeons are fellowship trained and have extensive knowledge in the management of all conditions affecting this region of the body. Thankfully, many of these problems require conservative management before requiring surgery. Shoe modifications, bracing, physical therapy, and medications are only a part of what is offered.

When surgery is indicated, the operative experience of the surgeon is critical. With the largest combined experience in Florida, the Florida Orthopaedic Institute team has performed tens of thousands of these procedures including flat foot corrections, ankle and subtalar fusions, midfoot osteotomies, bunion surgery, soft tissue reconstructions, as well as fracture reconstruction.

FRACTURE SURGERY

The foot and ankle surgeons are well respected fracture specialists, managing the most complex of these problems with a national and international reputation. In addition, the devices used to treat these injuries (plates, screws and intramedullary nails) have been developed by members of the team. This expertise is unique in the region and allows for managing problems with predictable outcomes, as well as teaching others through courses, lectures, and publications.

ANKLE ARTHRITIS

Unfortunately, this is a rather common problem and requires careful management to maintain motion while minimizing pain. The first line of treatment remains oral medications, but stem cell injections are frequently used by the staff to minimize the inflammation within the ankle that causes the pain. When this is not effective, arthroscopy may be used remove irritating tissue.

These minimally invasive procedures are designed to prevent the need for an open procedure. However, when arthritic pain and deformity prevents patients from maintaining a normal lifestyle, either a fusion or an ankle replacement is required.

TOTAL ANKLE REPLACEMENT

In 1995, the Agility® total ankle prosthesis became available in the U.S. Tampa General was the third center in the country to implant this device, with Florida Orthopaedic surgeons involved in design, teaching, and evaluation of the implant. Later that year a European ankle known as the S.T.A.R.® was released, and again Florida Orthopaedic surgeons were involved in the first trial of that prosthesis in the U.S.

Since that time, Florida Orthopaedic Institute surgeons (all trained on total ankle replacements) have performed hundreds of replacements. With over 20 years of experience, the foot and ankle surgeons of Florida Orthopaedic Institute remain leaders in the field. Finally, for those patients that are not candidates for an ankle replacement, ankle fusions remain the gold standard. Patients can walk without a limp using modern techniques to remove minimal amounts of bone and position the ankle so the joint below moves well.

REVISIONS & REFERRALS

Because of the combined expertise of the foot and ankle surgeons, as well as their national reputation, patients are referred not only locally, but from all over the country. Many of the referrals are patients with significant post-surgical complications including infections, failed joint replacements, poorly positioned fusions, and non-healed fractures. These patients are sent to the Center for definitive solutions to their problems, and in most cases the Florida Orthopaedic surgeons are able to improve their lives. This ability to solve complex problems and help patients is the driving force behind maintaining the high quality of care offered, and why Florida Orthopaedic Institute is a regional and national referral center.

HAND & WRIST SURGERY

Hand and wrist surgery performed by Florida Orthopaedic Institute fellowship trained surgeons provides treatment for complex fractures, ligamentous, nerve, and arthritis surgery as well as reconstruction, including free tissue transfers and limb replantation. The team consists of surgeons who are all board certified in orthopaedic surgery, have fellowship training in hand surgery, and have a certificate of added qualifications (CAQ) in hand surgery – the highest level of achievement in this discipline.

Additional training allows our surgeons to excel in microvascular surgery, with extensive experience in the replantation of fingers, thumbs, and hands. Active researchers, teachers, and educators, these surgeons train residents, Fellows and other orthopaedic surgeons through their lectures, courses, and publications.

FRACTURE SURGERY

As the staff that have managed the Upper Extremity Fracture Service at Tampa General Hospital for over 25 years, the team treats all the injuries sent to the Level I Trauma Center – the only Level I Trauma facility in the region. This includes injuries to bone, ligament, tendons, nerves, and joints sustained in car, boat, and motorcycle accidents, work-related accidents, including finger and hand amputations, infections and crush injuries.

RECONSTRUCTION

Arthritis of all kinds, both due to wear and tear, as well as the rheumatoid type, are effectively treated with fusions, osteotomies and deformity correction. Whenever possible, joint replacements including partial and total wrist replacement are offered to correct problems associated with this disease.

SHOULDER & ELBOW SURGERY

The quality of the Florida Orthopaedic Institute shoulder surgeons has created one of the preeminent programs in the country. Dr. Mark Frankle, who was Fellowship trained at the Mayo Clinic, is one of the pioneers of Reverse Total Shoulder surgery.

Over the last 25 years, Dr. Frankle has performed thousands of total shoulder procedures, revolutionizing the procedure, the implants and the results. His publications, lectures, courses and books have won him international acclaim.

The Shoulder Service trains residents and Fellows in the complex aspects of arthroscopic rotator cuff surgery, fracture care, and joint replacement of the upper extremity.

While on average, over 60% of total shoulder replacements are performed by surgeons who do approximately two replacements a year, the Shoulder Service performs over 500 replacements a year. High volume surgery means greater efficiencies, faster surgical times and fewer complications.

Because of these superior outcomes and cutting-edge research, the Shoulder Service is dedicated to understanding diseases of the shoulder and producing world-class results.

CENTER FOR ADULT SPINAL DISORDERS

To offer the best possible level of spine care for patients, the Center for Adult Spinal Disorders at Florida Orthopaedic Institute is a unique center of excellence dedicated to the treatment of the spine.

Spine specialists of Florida Orthopaedic Institute focus on prevention, restoration of function, reduction in pain, and control of costs in developing any treatment for back pain. Education, exercise, medication, ultrasound, heat, massage, and chiropractic therapies are applied as nonsurgical options to relieve spine pain. The majority of patients can be successfully treated with physical therapy and medical management. If nonsurgical approaches are not effective, the latest advancements in state-of-the-art spine surgery are offered.

MINIMALLY INVASIVE SPINE SURGERY

Patients that suffer chronic back pain from certain spine conditions, and who have been unresponsive to nonsurgical treatments may be considered candidates for minimally invasive spine surgery.

Minimally invasive spine surgery combines technological advances with state-of-the-art practices that reduce both the size of the incision as well as the hospital stay. Many patients are able to have the surgery performed in an outpatient setting. Minimally invasive spine surgery typically involves fewer risks than open spine surgeries.

ANTERIOR CERVICAL DISCECTOMY WITH FUSION (ACDF)

The fellowship trained surgeons of Florida Orthopaedic Institute routinely perform ACDF surgery, designed to relieve spinal cord or nerve root pressure in the neck by removing all or part of a damaged disc. After all or part of the damaged disc is removed, a bone graft or a cage is inserted into the space where the disc used to be. This prevents the disc space from collapsing and allows the bone to grow together to set up a bony bridge, or fusion, between the upper and lower vertebrae. A small metal plate is affixed to the front of the upper and lower vertebrae to provide stability while the bone fusion heals together, a process that can take up to 18 months.

LUMBAR SPINE SURGERY

Florida Orthopedic Institute spine surgeons are trained in both minimally invasive and open procedures. The most common conditions that may require surgery in the lumbar spine are spinal stenosis, disk herniations, and spondylolisthesis (abnormal motion between bones causing compression of nerves). These three common conditions can be treated by both minimally invasive and traditional open procedures. These procedures range from a laminectomy, which is the removal of bones and tissue that can cause compression of the spinal canal, to fusion procedures that are usually required if there is abnormal motion between bones or if the amount of bone removed could cause abnormal motion. Fusion procedures can be performed from a minimally invasive method from the back, side, or through the abdomen; or with traditional midline open incisions in the low back. The fusions procedures typically include use of an interbody cage which enhances fusion rates as well as aids in the decompression of nerves.

DEFORMITY SURGERY/ADULT SCOLIOSIS

Florida Orthopaedic Institute spine surgeons are also trained in various acquired spinal deformities which can cause a significant amount of patient morbidity if left untreated. These can range from scoliosis that was present in childhood and then progressed later in life, to gradual deformities acquired as patients age, or deformities caused by prior spine surgery. Open procedures are typically required with pedicle screws and rods to aid in placing the patient in a better position to maintain a horizontal gaze. Occasionally, osteotomies in the bone are required to obtain the necessary correction. Minimally invasive techniques are sometimes used to spare the patient the risk of an osteotomy with the insertion of interbody cages.

A COMPREHENSIVE RANGE OF SPINE PROCEDURES

The Florida Orthopaedic Institute surgeons at the Center for Adult Spinal Disorders perform the following spine procedures.

CERVICAL

• ACDF – Anterior cervical discectomy with fusion
• Cervical artificial disc replacement
• Cervical corpectomy and fusion
• Laminaplasty
• Laminectomy
• Laminoforaminotomy
• Posterior cervical fusion
• Posterior cervical laminoplasty
• Posterior cervical laminectomy and fusion

THORACIC

• Instrumented fusion
• Kyphoplasty
• Laminectomy
• Transpedicular decompression and costotraversectomy
• Tumor resection
• Vertebroplasty

LUMBAR

• ALIF – Anterior lumbar interbody fusion
• Deformity correction
• Laminectomy
• Minimally invasive microdiskectomy
• Percutaneous pedicle screws
• Posterolateral fusion
• Revision surgery
• SI joint fusion
• TLIF – Transforaminal lumbar interbody fusion
• XLIF – Lateral lumbar interbody fusion

ORTHOPAEDIC TRAUMA SERVICE

The Orthopedic Trauma Service is a nationally prominent program based at Tampa General Hospital and managed by Florida Orthopaedic Institute, is the only Level I facility in the region. In existence since 1987, the Service has offered leadership in orthopaedic trauma care for 30 years, receiving regional, national and international awards and recognition, both in teaching and training. The program consists of six fellowship trained orthopaedic traumatologists, three trauma Fellows, plus residents providing care for both acute injuries and chronic problems.

Orthopedic trauma surgeons are involved in multi-disciplinary care coordination with general surgery trauma teams, neurosurgeons, plastic and vascular surgeons. Exclusively covering emergency calls at Tampa General, a host of injuries are seen, including open and closed fractures of the upper and lower extremities, pelvic and acetabular fractures, and polytraumatized patients.

Due to our location in Florida, the Orthopedic Trauma Service sees a disproportionate number of watercraft accidents. In addition, acute and chronic infections of the extremities, including necrotizing fasciitis, are managed in an effort to minimize amputations.

The Orthopaedic Trauma Service also specializes in the care of fracture-related problems, such as nonunions, malunions, post-traumatic arthritis, deformity correction, and complex reconstruction of the lower extremity.

The Service has pioneered new techniques such as suprapatellar nail insertion for fractures of the tibia, the use of electromagnetic field sensors for the insertion of locking screws rather than fluoroscopy, calcaneal fracture surgery, and posterior approach to aid in the treatment of ankle fractures.

The Orthopaedic Trauma Service has a dedicated research staff including research nurses and a research coordinator. The Orthopedic Trauma database allows the Service to evaluate patients and report on their outcomes which has resulted in well over 150 publications, all based on the clinical work at Tampa General Hospital. Additionally, the Service was one of only 10 sites nationally involved in the NIH supported LEAP Project to evaluate lower extremity trauma.

The Orthopedic Trauma Service continues to be involved in the METRC studies, sponsored by the Department of Defense evaluating trauma care and specific injury issues in the lower extremity.

Because of the increase in retirees in Florida, the Service sees a high volume of geriatric fractures, and has created the Geriatric Fracture Service, a multi-disciplinary program, to expedite care of these individuals. Results show that early aggressive treatment of their injuries, lowers morbidity as well as mortality.

SPORTS MEDICINE

With the largest and most advanced sports medicine program in the region, doctors from Florida Orthopaedic Institute have served as the team physicians for the Tampa Bay Buccaneers, Tampa Bay Lightning, Tampa Bay Mutiny, Tampa Bay Rowdies, Tampa Bay Storm, University of South Florida, the University of Tampa, Saint Leo University and many high schools throughout Hillsborough County.

THE MOST ADVANCED TREATMENT FOR SPORTS-RELATED INJURIES

Using a multi-disciplinary approach to ensure the most innovative treatment for all sports-related injuries, most surgery is performed on an outpatient basis. However, when multi-ligamentous injuries, significant fractures, or those associated with vascular problems arise, surgery is performed at a local hospital.

Additionally, the Sports Medicine program is associated with both the Athletic Training Program and the Sports Medicine and Related Trauma (SMART) Program within the USF Department of Orthopaedic Surgery. These programs are designed to protect the high school athlete through supervision, rehabilitation and education. Using data collected from the covered high schools, research is published and used to evaluate and develop newer methods of injury prevention.

Overall the combined program offers a comprehensive method to address all aspects of sports-related injuries with a multi-disciplinary approach, not found anywhere else in Tampa Bay.

Credentials

Awards, Research Grants, Publications, Books Published, Book Chapters, Presentations

The Orthopaedic Surgery Residency Training Program

In combination with USF and Tampa General Hospital, Florida Orthopaedic Institute surgeons use the combined strengths of each partner to advance academic orthopedics through the USF Orthopaedic Surgery Residency Program. The Orthopaedic Surgery Residency Training Program at the USF Health Morsani College of Medicine assures patients the finest orthopaedic treatment and brings substantial benefits to the community, patients, residents, and medical students alike.