FOI in the News | Florida Orthopaedic Institute - Part 2
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FOI in the News

Florida Orthopaedic Institute

ConforMIS Knee Replacement Segment with Dr. Palumbo

By | FOI in the News

FOX 13 News

BY: Dr. Joette Giovinco
February 28, 2018

TAMPA (FOX 13) – Golf is one of Ed Kaloust’s passions but he admits, over the past few years knee pain took its toll on his game.

“I was bone on bone. I couldn’t play golf well, I couldn’t walk for more than 20, 30 yards and I’d have to sit down.”

The 77-year-old Medi-Weightloss CEO says he was getting shots into his knees and taking five Advil a day, but his knees kept getting worse.

This device has revolutionized the hearing aid.

“So it really got to a point, in spite of my stubbornness, I knew that I had to do something,” Kaloust recalls.

After thoroughly researching all options that something was a knee replacement called Conformis, custom made to fit only him

“Every implant will have a serial number and even the name of the person on the implant so that implant will be made to match that person and that person alone,” Dr. Brian Palumbo is Kaloust’s orthopedic surgeon.

According to the manufacturer, the process begins with scanning the knee, hip and ankle of the patient. A computer analyzes the information creating a blueprint that’s used to three d print a custom implant.

Palumbo says in addition to matching size, implants are constructed to match the geometric configuration of the patient’s bone.

“The jigs are made in a way you simply have to snap them onto the patient knee and make your resections of the bone and the alignment is already computed into the system,” Palumbo explains.

Palumbo says surgeries are quicker since you do not have to spend time fitting patients with off-the-shelf options or placing stabilizing rods. He says it ultimately results in a more natural fit.

“The more natural you make the patients knee feel during the operation the less challenge they’re going have and less difficulty they’re going to have with their recovery,” Palumbo says.

Ed says, “In my 2nd week i was able to drive to the office and work 3 hours a day, without a cane.”

After spending weeks in rehab Ed continues to exercise, “Finally in my life I’m back in the gym on a regular basis only because of the confidence I have in my knee.”

Kaloust says he plans to have knee replacement surgery on his second knee in November 2018.

There have been some recalls of the devices, including a voluntary recall in 2015 involving 950 devices.

Florida Orthopaedic Institute

ConforMIS Technology with Dr. Palumbo on Bay News 9

By | FOI in the News

Video Courtesy: Bay News 9

Florida Orthopaedic Institute surgeon, Dr. Brian Palumbo, discusses ConforMIS, a 3-D technology used to create a custom knee replacement. The ConforMIS implant is uniquely designed, sized, and shaped for each patient’s needs. Hear from Edward Kaloust, a patient of Dr. Palumbo, as he talks about his quest to finding knee pain relief and his experience with the surgery.

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Tampa Doctors Reattach Teen’s Hand That Was Sawed Off

By | FOI in the News


BY: Shannon Valladolid
February 4, 2018

TAMPA, Fla.  — For any teenager, pouring a glass of milk may seem like no big deal but for 16-year-old Briant Cummings, it’s an accomplishment.

A year ago, while working on a project to repair his boat, Briant accidentally sawed off his hand.

“I turned the piece of metal and I brought it down too fast. So, it sucked my hand through and cut it at an angle,” says Briant.

Emergency crews were ready to fly him from Boca Rotan to Tampa general hospital but they left behind one important thing.

“We forgot the hand at the house because we were freaking out. The hand was still laying in the backyard,” he says.

Once he made it, hand and all, Doctors Jason Nydick, an orthopedic hand surgeon and David Halpern, Chief for the Department of Plastic Surgery at TGH, saved not only Briant’s hand but his life.

“I realized that this was going to be a complex case obviously. I put in a call to Dr. Nydick to assist me with the case,” says Dr. Halpern.

Time was ticking. DR. Nydick was off but he rushed to the hospital to help.

“His circumstances were actually quite good. He was stable, he was young, he was healthy,” says Dr. Halpern.

By the end of the surgery, Briant could move his fingers. Doctors didn’t think it would happen so quickly.

Since this type of surgery isn’t performed daily, doctors from Tampa General were able to learn from it.

“We recently just implemented different measures to make things more efficient just with equipment being available at all times,” says Dr. Nydick.

Thanks to caring doctors, Briant has a second chance to keep doing what he loves.

“I was able to grip the [hook] and I was able to reel it in and cast it out. Really cool. That was the first time. I never thought I would be able to fish again,” says Briant.

Briant will have another surgery soon.

Doctors hope he will be able to pinch his fingers, once it’s complete.

This surgery is also being used as a learning tool to help future physicians.

View the article here:

Florida Orthopaedic Institute

New Years Guide to Exercising with Dr. Pappou

By | FOI in the News


BY: Source: Daytime Web Staff
Published: January 18, 2018, 11:52 am

You’ve made a resolution to work out, and you’re ready to go into warrior mode. Whether you’re a newbie or a seasoned pro, before you hit the high intensity button, there are things to consider. What kind of shape are you in, any injuries, am I fit enough to start working out? Dr. Ioannis Pappou from the Florida Orthopaedic Institute is here to tell us how to up your game safely to prevent injuries.

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Opioid Crisis and Big Pharma

By | FOI in the News


BY: Elaine Silvestrini
December 15, 2017

PART 1: CHAPTER 2: Multi-Faceted Campaign

According to Andrew Kolodny, who co-directs the Opioid Policy Research Collaborative at Brandeis University, the pharmaceutical industry is “almost entirely responsible” for the epidemic, but shares blame with the regulators at the U.S. Food and Drug Administration who failed to enforce the law as they should have.

Kolodny, who is executive director of Physicians for Responsible Opioid Prescribing, said the pharmaceutical industry funded a “multi-faceted campaign” that “changed the way the medical community thought about opioids and changed the culture of opioid prescribing in the United States in a way that would lead to a public health crisis.”

Adriane Fugh-Berman, professor of pharmacology and physiology at Georgetown University Medical Center, said the pharmaceutical industry created the crisis. “That’s been well documented by journalists, in legal documents,” she said. “It’s well documented what Purdue Pharma’s tactics have done.”

The campaign, Kolodny said, was a coordinated message sent through various channels to appear as if it wasn’t directly from drug manufacturers. If that had been apparent, he said, the medical community would have been more skeptical, “less gullible.”

Lunches, Conferences and Textbooks

One pain specialist, however, said that while the drug companies are “not innocent,” doctors bear more responsibility for failing to do their own research and not digging into the bogus information they were given.

Dr. Steven Barna, who practices in Tampa, Florida, said he was trained at Harvard “to give as much narcotics as possible” to alleviate pain. Barna remembers seeing the drug companies in action hosting lunch meetings and conferences. Drug companies sometimes even paid for textbooks, which was a lot of money for a young medical student.

Barna had his fellowship around 2001 and 2002, and remembers combing through thick patient charts, trying to determine which combinations of opioids they hadn’t yet received. That’s how he was trained — to administer various doses of different medications.

But when he became an attending physician responsible for his own patients, he saw that all those drugs over long periods of time weren’t helping them, and they had no quality of life.

So Barna dug deeper into the literature and realized there was no good evidence that opioids were effective at treating chronic, non-cancer pain. He decided to find non-narcotic alternatives to treat these patients.

‘Abuse-Deterrent’ Confusion

Doctors, he said, are educated and are supposed to be smart. “You should be able to look through this stuff and determine what’s right,” he said. “You can argue it’s the physicians’ fault for not being more critical about it.”

But health care professionals frequently don’t understand the dangers. According to one survey, for example, nearly half of internists, family physicians and general practitioners incorrectly thought that “abuse-deterrent” pills were less addictive than their standard counterparts. The pills may be harder to crush or manipulate, but they are just as addictive as traditional forms of opioids.

In that same survey, a third of health care providers wrongly said they believed that most prescription drug abuse is by means other than swallowing pills as intended. In fact, oral ingestion is the most common route by which opioids are abused.

In addition, a quarter of doctors responding to the survey said they were either slightly or not at all concerned about the potential for opioids to be diverted from legal use to the illicit market, even though this practice is common.

Messages from Different Directions

Kolodny and Fugh-Berman said the drug companies overwhelmed the medical establishment with the message from many different directions that appeared to be coming from peers and authority figures.

“It’s a multi-modal effort,” Fugh-Berman said. “It had catastrophic consequences and continues to have catastrophic consequences.”

The fact that the message came from various places is what made it work, Fugh-Berman said. “If it’s what your hear in a lot of different settings, it seems like a consensus,” she explained. “And that’s how industry controls medical discourse. You don’t have to get to everybody. You have to get to opinion leaders, who then affect the opinions of their peers…You have to get to their teachers.”

Opioid makers pumped money into professional societies and organizations, including the Joint Commission on the Accreditation of Healthcare Organizations and the Federation of State Medical Boards, as well as what Fugh-Berman described as “fake organizations” established for this purpose.

Certain doctors, who were dubbed “key opinion leaders,” were given funding to spread the message that opioids were an enlightened option for people in pain, and that those physicians who withheld them in the past were stingy and cruel.

“Many of the people involved in this campaign to increase prescribing did believe what they were saying,” Kolodny said. “But those who were getting paid well may have figured out much quicker that what they were saying wasn’t true if it wasn’t in their financial interest to keep doing this.”

Drug companies like Purdue Pharma, the maker of OxyContin, he said, “gave a megaphone to people who had these views.”


Florida Orthopaedic Institute

Non-motorized Scooters Responsible for Most Child Injuries

By | FOI in the News

ABC Action News

BY: Heather Leigh
December 12, 2017

TAMPA, Fla. — They are popular toys and parents every year are giving them to their kids under the tree, but scooters without a motor are most likely to send them to the emergency room than any other type of toy, according to the U.S. Consumer Product Commission.

2-year-old Valentina is taking a spin on her motorized scooter for the first time.

“The minute you take your eyes off your kid that’s when something happens,” said Jonathan Torres, her father, who caught her from going off the sidewalk curb just in time.

“See, that’s why you have to stay close,” he said. “It’s finding that fine balance between not being that helicopter parent, letting them learn the lesson, bump their knees and get some bruises and also making sure you’re also not putting them in an unsafe situation.”

Last year, 240,000 kids nationwide were taken to the emergency room and 27% of the time it was because of riding toys. And scooters made up more than 70% of the injuries caused by riding toys. The ones WITHOUT motors make up most of the injuries. However, on the flip side, the U.S. Consumer Product Safety Commission says those numbers have been slowly declining over the last 5 years.

“When we were younger and we had skateboards, wrist guards, elbow guards, knee guards, a helmet, I think those were options at the best,” said Dr. Anjan Shah, an Orthopedic Trauma surgeon for the Florida Orthopedic Institute.

He says those things were included with the pair of roller blades he just bought for his kids. He also thinks awareness is up.

Shah says his practice sees about 30 toy injuries a week and about half of those will need surgery. He operated on a 6-year-old Monday.

“He thought he was Spiderman and jumped from a trampoline onto the wall but didn’t stick,” said Dr. Shah, who added the child is going to be fine.

Shah says parents should be researching toys, and testing them out before they buy. Plus, having their kids ride in low traffic areas.

Florida Orthopaedic Institute

Tampa Doctor Finds Medicine’s Core Mission on Guatemalan Trips

By | FOI in the News, Our Physicians

Tampa Bay Times

BY: Jasmine Wildflower Osmond
November 29, 2017

TAMPA — In Antigua Guatemala there is a hospital that you can’t go to with a sudden injury or traditional emergency. While there, Tampa orthopedic surgeon Dr. Kenneth Gustke saw potential patients lining the walls of every corridor, lobby and even the streets outside. All for the chance at lifesaving surgeries.

For thirteen years, Dr. Gustke has been making missionary trips to hospitals like this to perform hip and knee replacements for no cost to the patients.

“It brings us back to the reason that we went into medicine to begin with,” he said. “It’s not the entrepreneurship, or the business stuff, or headaches of paper work. It’s all back to the pure aspect of providing medicine. Providing medical care.”

For the past 20 years, a Los Angeles program started by Dr. Lawrence Dorr called Operation Walk has been organizing volunteer health professionals to go to countries like these and perform life changing knee and hip replacements for no cost to the patient.

For Gustke it can take up to a year to plan one of these trips. The first one was to Havana, Cuba.

In late August, Dr. Gustke brought six people from his team to Antigua, Guatemala: physician’s assistant Susie Heinrichs, nurse anesthetist Jessica Zavesky, registered nurse Marlyn Cua, scrub tech Jose Mesa, and translator Monica Coconubu-Sanchez.

There they were met with 54 other health care providers from across the country. Some who came by themselves to help.

The Hospital de San Pedro in Antigua, was set up by monks and used weekly by different medical missionary groups that come to perform every medical procedure from cleft palates to eye surgeries.

In one part of the hospital Gustke and his team were doing knee replacements, another group would be doing something completely different. Patients for every need lined the walls. Although for most trips he has provided both hip and knee replacements, this most recent trip they only did knees.

They can’t predict how many and what sizes of prosthetics they’ll need beforehand, so in order to help as many people as possible they focused just on knees.

It costs $100,000 to make one of these trips, he said. The majority of that is donated or fundraised through his existing patients at the Florida Orthopaedic Institute, of which he is a founding member. The attending staff for these trips needs to either take vacation days or to take the pay cut. No one gets paid for these trips, but no patients pay either.

“I just rely on patients that are grateful here for the knee and hip replacements I’ve done for them to provide donations to this kind of cause.

Even if a patient isn’t approved, they are often provided with physicals, walkers, therapy or other equipment to make their lives easier, said Susie Heinrich, a physician’s assistant.

Because the hospital is used exclusively by volunteers there is no traditional staff. Everyone cleaned. Everyone screened, and if a patient needed help getting out of bed, it was anyone’s job to step in.

“When we’re there it’s about providing care,” she said. “From the nurses to the scrub techs, we clean the rooms, we mop the floors, we take care of everything.”

For many who did receive surgery, it was life changing, said Monica Coconubu-Sanchez, the translator. One man made 40 three-hour trips just for a chance to be seen.

Like many other patients, the condition of his knees prevented him from walking, working, and taking care of his family. After more than a hundred hours in travel, he was finally given his freedom back.

“The patients are so grateful and their families are so grateful,” Coconubu-Sanchez said. “And it just makes you feel like you’ve done something good.”

Contact Jasmine Wildflower Osmond at

Platelet-Rich Plasma Therapy Helping Jameis Winston, Others Recover Faster from Injuries

Platelet-Rich Plasma Therapy Helping Jameis Winston, Others Recover Faster from Injuries

By | FOI in the News

Tampa Bay Times

BY: Greg Auman
November 28, 2017

TAMPA — As the Bucs work to get quarterback Jameis Winston fully recovered from a right shoulder injury to make a healthy return Sunday, his treatment has included a blood procedure known as platelet-rich plasma therapy.

“PRP has been around for a while, but it’s gotten much more popular in the past five years or so as one of these so-called biologic treatments for injuries,” said Dr. Seth Gasser, vice president and director of sports medicine at the Florida Orthopaedic Institute. “When getting back on the field is really important, it can be another option to try to speed their safe return to play.”

A PRP injection is also known as “blood spinning” because the procedure uses a centrifuge to spin a sample of a patient’s blood, isolating the platelets from the rest. Platelets are crucial in tissue regeneration, and the process creates a concentrated sample — up to seven times as many platelets — that can be safely injected into the injured area to speed recovery.

“The main reason for doing PRP in most cases is to optimize the healing process and minimize the recovery time,” said Dr. Ricardo Colberg of the Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala., which handles about 150 PRP treatments a year. “PRP is estimated to decrease the healing time to roughly half to two-thirds quicker recovery. Let’s say from three months to four to six weeks.”

Winston injured his throwing shoulder in the Bucs’ game at Arizona last month, and he played through the injury for another three weeks, taking additional hits to his shoulder along the way. The Bucs then opted to rest him for three games to allow the shoulder to fully heal, and part of that process was PRP therapy three weeks ago.

On Monday he was cleared to resume practice, and if there are no setbacks, Winston can return to playing Sunday for the Bucs’ game at Green Bay.

“Platelets contain these things called alpha granules, which are full of growth factors that function in things like tissue healing and decreasing inflammation,” said Gasser, who said PRP can be used for arthritis or in post-surgical recovery. “In the case of Jameis, they’re using it for a patient who had some kind of soft tissue injury in the shoulder to help stimulate more complete or rapid healing.”

Gasser said a PRP treatment can cost between $500 and $1,000, and one reason they aren’t more popular with the general public is that they’re generally not covered by insurance.

A treatment can take as little as 15 minutes from when blood is drawn, spun then injected back into the patient. It doesn’t work for everyone, but the only real risk is soreness at the point of injection; because a patient’s own blood is used, there’s no threat of rejection reactions.

The Bucs have supervised Winston’s recovery and declined to make any team physicians or trainers available for comment. Many prominent athletes — golfer Tiger Woods, tennis star Rafael Nadal, former Steelers receiver Hines Ward — have used PRP therapy to aid recovery from injury. Former Bucs defensive end Adrian Clayborn, now with the Falcons, used PRP in returning quickly from knee surgery last year.

PRP treatments are fully allowed by the NFL. It is handled much differently than “blood doping,” in which blood is removed for a longer period of time, allowing the body to replenish the blood and then adding oxygen-rich blood back to the system.

Contact Greg Auman at and (813) 310-2690. Follow @gregauman.

Opioid Alternatives with Dr. Barna on 970 WFLA Tampa Bay

By | FOI in the News

970 WFLA Tampa Bay

Posted By: Fingers
October 31, 2017

Learn more from Dr. Steven Barna of Florida Orthopaedic Institute as he discusses the opiod crisis in Florida and opioid alternatives with Jack Harris on 970 WFLA Tampa Bay.

Dr. Barna starts with a history of the rise of opioids due to an influx in chronic and acute pain. Unfortuantely, opioid addiction can lead to an overdose death. He continues to discuss the different alternatives to opioids, specifically ones that will not cause addiction or cause physical harm to the patient. These are the types of options that Florida Orthopaedic Institute offers, including physical therapy, chiropractic visits, and acupuncture.

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Hip Replacement Benefits: Get Moving Again

By | FOI in the News

WFLA News Channel 8

BY: Daytime Web Staff
12:02 PM, November 14, 2017

Over 300,000 people have had hip replacements each year in the United States. With the number of these surgical procedures on the rise, it is important to understand how a hip replacement can be beneficial and when the optimal time might be to fix your hip issues and significantly impact your quality of life.

To schedule an appointment:

Florida Hospital Tampa Orthopaedic Care Center

(813) 615-7087 or