Departments

Complex knee ligament injuries occur when athletes or patients sustain severe trauma, injuring two or more ligaments in or around the knee. In these cases, surgery is typically needed to repair or reconstruct these important structures. Without this surgery, the knee has potential for being unstable with simple daily activities or athletic pursuits. There is also risk of premature arthritis secondary to the abnormal motion of the knee joint. These injuries can occur during athletics and collision sports, or traumatic events such as falls from heights, or motorcycle or automobile injuries. The most severe of these injuries, a knee dislocation, is typically the result of a high-energy injury resulting in disruption of the normal alignment of the thigh (femur) and the shin (tibia) bones. Unfortunately, these are injuries that can cause both neurologic or blood vessel injuries and can be limb-threatening emergencies. Knee dislocations are fortunately rare, accounting for 0.02-0.2% of all musculoskeletal injuries. To find out more about this program, please fill out a brief survey . A thorough and accurate diagnosis is critical in treating these complicated knee injuries. Proper diagnosis, including identification of the torn ligaments as well as assessment of the location of the tear and associated injuries, is one of the primary challenges with treatment of these injuries. While high-resolution MRI is a critical diagnostic tool, the ability to quickly and accurately diagnose these injuries requires the surgeon to have excellent knowledge of the complex function of the knee ligaments and skilled physical examination techniques. Combined with the MRI images, this allows for an individualized treatment plan for these unique injuries. Through our involvement with Yale New Haven Hospital’s Level 1 Trauma Center program, our orthopaedic and trauma surgeons have developed extensive experience with these injuries over the past 20 years. Our orthopaedists work closely with our general surgery trauma, vascular surgery, plastic surgery and expert musculoskeletal radiology colleagues in order to care for these potentially limb-threatening knee injuries. Prompt diagnosis is of highest importance and we accept referrals and transfers from all outside facilities, which can be arranged through our Yale New Haven Hospital Y Access program (888-YNHH-BED). Patients are occasionally “life flighted” via SkyHealth from outside facilities by helicopter to be treated at our tertiary care center. SkyHealth travels within a 200-mile radius of New Haven. Our team also works closely with affiliated physical therapists who are trained in the management of patients in their recovery phase of healing. As these injuries and procedures are uncommon, a carefully structured rehabilitation program guided by experiences physical therapists is also crucial to patient recovery. Depending upon the clinical situation, care is either performed in an inpatient setting at Yale New Haven Hos

Yale ophthalmologists are committed to addressing the most complex eye problems with vision-saving care. We provide a complete range of services that address minor problems like pink eye to major diseases and conditions, including glaucoma, cataracts, and macular degeneration. We provide medical and surgical care for retinal disease, strabismus, and uveitis, as well as reconstructive and aesthetic ophthalmic plastic surgery and pediatric ophthalmology. Our patient-friendly clinic includes on-site services such as corneal topography, electrophysiologic testing, fluorescein angiography, fundus photography, lasers, optical coherence tomography (OCT), and visual fields. Our practice includes not only highly esteemed physicians, but also world-renowned researchers, which means our patients have access to the latest treatments and advances. Specialized care is offered in the following areas: Comprehensive eye care Cornea, cataract, and refractive surgery Diabetic eye care Glaucoma Neuro-ophthalmology Ocular immunology/uveitis Ocular oncology Optometry and contact lenses Orbital and reconstructive ophthalmic plastic surgery Pediatric ophthalmology Retina, macula, and vitreous diseases New injectable treatments for macular degeneration and diabetic retinopathy to slow or halt vision loss Complex retina surgeries; specialized retina evaluation and care, including laser treatment for premature newborns; medical and surgical care of diabetic retinopathy and macular diseases Cataract surgery with optional premium lenses; donor and artificial corneal transplants Specialty fitting of contact lenses for aphakic adult and pediatric patients, corneal transplant patients, and keratoconus patients Complete spectrum of orbital and reconstructive ophthalmic plastic surgery and cosmetic eye surgery

ACL injuries are common. Approximately 175,000 ACL reconstructions are performed every year in the United States. An ACL tear renders the knee unstable and without surgery most people cannot return to cutting and pivoting types of activity and athletics. Furthermore, a knee with an ACL tear that is not operated on has a significantly higher risk of developing subsequent tearing of the meniscus (cartilage) and degenerative arthritis. For these reasons, most athletically active patients opt to have their ACL reconstructed. Advancements in video technology and surgical instrumentation have allowed ACL operations to be carried out using very minimally invasive techniques. However, not all surgeons are able to offer these cutting-edge techniques as they require the development of new and often more challenging surgical skills that have a steep learning curve and take time to master. Several of our Yale Sports Medicine surgeons are involved in the teaching of these techniques at courses offered throughout the U.S. To find out more about this program, please fill out a brief survey . The surgical faculty are all fellowship-trained and board-certified in Orthopaedic Surgery and the majority are sub-specialty board certified in Orthopaedic Sports Medicine. The team also includes a number of renowned musculoskeletal radiologists who we routinely consult and collaborate with on all aspects of imaging, including plain X-ray, CT scan, and high-resolution MRI. Our anesthesia colleagues are experts in the most up-to-date regional anesthesia techniques so that post-operative pain is kept to a minimum. Experienced and skilled physical therapists also play a critical role on our team. Utilizing the most current machinery and “return to sport” assessment tools, they help us determine when patients are ready to get back into the game. A team of orthopaedic physician assistants, skilled nurses, and athletic trainers round out our comprehensive and compassionate approach to care. ACL reconstructive surgery involves “replacing” the torn tissue with a tendon either from the patient’s body (called an autograft) or from a cadaver (called an allograft). Traditionally, the two most common autografts used in ACL reconstruction have been the bone-patellar tendon-bone graft and hamstring tendons autograft. Recently, the use of the central third of the quadriceps tendon (from the front of the knee) has become more popular, and surgeons in our program are now utilizing this graft on a routine basis for ACL reconstruction. The quadriceps tendon graft is robust and very strong and has a lower incidence of some of the more common complications seen with other graft sources such as anterior knee pain and numbness about the knee. While use of the quadriceps tendon still only represents approximately 11% of all ACL operations, our Sports Medicine division is on the vanguard of this movement as we strive to offer our patients what we feel is the best possible treatment for their cond

Disorders of the cornea, the front layer of the eye responsible for focusing, range from nearsightedness to damage so severe it requires transplants. Our specialists are skilled in surgeries ranging from outpatient procedures to correct nearsightedness to corneal transplants. We also perform operations to repair dry eye and tear disorders, remove benign and malignant tumors, treat scarring, and address many other conditions and injuries. We employ cutting-edge diagnostic tools and surgical procedures. We are dedicated to using our collective knowledge and expertise to repair and improve our patients’ eyesight.

Aging almost always means cataracts—a clouding of the lens of the eye that results in impaired vision. Luckily, surgeons can remove most cataracts in a relatively simple outpatient operation. We offer patients outpatient surgery, anesthesia eye drops, and the latest in imaging, assessment, and diagnostic tools. Our doctors are deeply committed to restoring as much sight as possible with minimal discomfort. Our ophthalmologists excel at all forms of cataract surgery, and use innovative techniques, including small-incision procedures that require no suturing, resulting in faster recovery and better vision. We specialize in cataract removal for patients with complex eye conditions, including corneal disease, glaucoma, and small pupils. Experts in a wide range of eye surgeries, our specialists routinely combine cataract removal with other procedures to minimize time in the surgical suite and speed recovery.

Our specialists fit and provide contact lenses. Whether the needs are straightforward or specialized, our doctors and staff will find the right contact lenses for our patients. We offer the latest materials and designs, customizable to accommodate a wide variety of problems, including astigmatism, corneal transplants, dry eye, and corneal scars or irregularities after trauma. We fit contact lenses made from a wide selection of materials and to diverse specifications. With the aid of state-of the art technology, we are able to fit the following lenses: Silicone hydrogel Toric Multifocal Gas-permeable (including specialty designs) Hybrid (gas-permeable in the center with a soft outer portion) Scleral

The treatment of cartilage injuries remains one of the most difficult challenges in medicine. The Cartilage Repair & Restoration Program brings together world-renowned scientists and physicians to meet this challenge. Our team is dedicated to providing patients with the most advanced and effective treatments for knee meniscus and articular cartilage injuries of the knee and elbow. Our research helps shape the future of cartilage repair and regeneration, with the hope that our patients will benefit from it. We offer the best possible current technology and expertise to enable patients to have a successful return to normal activities. To find out more about this program, please fill out a brief survey . There are two types of cartilage in the body—the meniscus cartilage (the most common example is the shock absorbers of the knee) and articular cartilage, which covers the bones in joints like the knee and elbow to allow smooth joint motion. In cases of extreme or extensive articular cartilage wear, patients develop osteoarthritis and may require a joint replacement. In young and active patients, cartilage injuries or defects can do more than just limit activities due to pain and swelling. If left untreated, these injuries can lead to more serious disability and, in severe cases, arthritis and possible joint replacement. Currently, procedures to repair articular cartilage are not designed to treat the extensive cartilage loss seen in osteoarthritis. However, there are procedures that are highly effective in the treatment of cartilage defects in a particular location, such as those associated with acute injury. In the case of extensive meniscus tissue loss in the knee, however, there are options for treatment such as meniscus allograft transplantation or osteotomy or even non-operative treatments such as the use of unloader braces. Not every patient is a suitable candidate for cartilage restoration or meniscus transplant surgery. These procedures are ideal for active people under age 50. Our experienced providers will assess each patient’s condition and help them make an informed decision. Our Sports Medicine Surgeons are fellowship trained and have expertise in meniscus transplant, osteochondral autograft and allograft procedures, and 2nd and 3rd generation cartilage restoration procedures. The Cartilage Repair & Restoration Program utilizes the highest quality advanced imaging, including magnetic resonance imaging (MRI) for patient evaluation, in collaboration with Yale University’s Department of Radiology & Biomedical Imaging to determine the size and extent of cartilage injury to optimize patient treatment and surgical planning. When surgery becomes necessary for patients with cartilage and meniscus injury, our program offers extensive expertise. Not all surgeons are able to offer “cutting-edge” technology in cartilage restoration, as it entails development of new and sometimes more challenging surgical skills that can re