Office Expansion Elevates Medical Team’s Game
Offices in St. Cloud and Dr. Phillips have just opened, and a new physician has joined Celebration Orthopaedic & Sports Medicine Institute, enhancing the depth and breadth of expertise and complementing their patient-focused approach.
Board certified Orthopaedic & Sports Fellowship trained surgeon, David, Lalli, D.O., who served in the US Navy & has extensive experience treating a broad spectrum of musculoskeletal conditions across multiple age groups. He hails from South Florida where he went to University of Miami for his undergraduate studies & then continued his medical education & earned his medical degree from Nova Southeastern University in Ft. Lauderdale. He then entered active duty service in the US Navy where he gained operational & field experience treating active duty marines & sailors including serving overseas tours in Afghanistan during Operation Enduring Freedom. During his thirteen years of service, he completed an Orthopaedic Residency program at National Naval Medical Center in Bethesda, Maryland. After his service obligation was successfully completed, he continued his passion in Sports Medicine & completed a Sports Medicine Fellowship at the Hughston clinic.
Dr. Lalli practices General Orthopaedic medicine in addition to fostering his passion in his subspecialty as a Fellowship Trained Sports Medicine surgeon. The many conditions he treats includes every aspect of shoulder issues, including shoulder instability and cartilage disorders typically seen in the young to Rotator cuff disease and arthritis of the shoulder seen in the elderly. Additionally, he also excels at treating multiple pathologies of the knee including ligament injuries such as ACL tears as well as the common disorder of knee arthritis. His practice and treatment extend to multiple conditions of the hip, ankle, elbow and hand as well. When you see Dr. Lalli, he will discuss all aspects of treatment and will offer non-operative and operative options as appropriate. Dr. Lalli will primarily be seeing patients in the St. Cloud office, but also has clinic days in Celebration and Kissimmee.
The new physician joins the elite team of Brad Homan, D.O.; Matthew Johnston, D.O.; Joseph E. Robison, M.D.; Jose Amundaray, M.D.; Joshua Britt, D.P.M.; Maahir Haque, M.D.; Douglas McDonald, M.D.
Completing the Celebration Orthopaedic medical team are its experienced physician assistants, Crista Hays, P.A.-C, Michael Taylor, P.A.-C, Amere Hooshmand, PA-C and Soo Lee, PA-C.
Celebration Orthopaedic & Sports Medicine provides comprehensive care and advanced expertise in sports medicine, joint replacement, hand and upper-extremity disorders and microsurgery, spine surgery and foot and ankle surgery. The goal is to return patients to their normal functioning, whatever their age or activity level.
From the front desk to the exam room, compassion for individual patients and team spirit run deep. Numerous patient testimonials on the celebrationorthopaedics.com website express gratitude.
Joint Reconstruction Powerhouse
A specialist with the expertise of Jose Amundaray, M.D., was needed after practice founder, David D. Dore, M.D., retired in 2014, according to Dr. Homan. “Dr. Amundaray was the perfect fit.”
Dr. Amundaray has considerable expertise in treating degenerative conditions of the hip and knee and in performing partial knee replacement surgery. Since the start of an accomplished career some 15 years ago, Dr. Amundaray has performed thousands of joint replacements on the Gulf Coast and more partial knee replacements than most surgeons in the United States. He also is adept in the use of other orthopedic minimally invasive and surgical procedures, such as arthroscopy.
Knowing of Dr. Dore’s retirement and the large Spanish-speaking population in Osceola County, Dr. Amundaray remembers thinking, “Celebration Orthopaedic would be a perfect spot for me.”
After joining Celebration Orthopaedic & Sports Medicine, Dr. Amundaray also accepted the position of director of the Joint Reconstruction Program at Florida Hospital Celebration Health, a post formerly held by Dr. Dore.
A native of Puerto Rico, Dr. Amundaray earned his Bachelor of Science and medical degrees from the University of Puerto Rico, where he also finished his orthopedic surgery residency. He then completed an Adult Reconstruction and Arthroscopy Fellowship at the Florida Knee and Orthopedic Centers in Clearwater, FL.
Best Foot Forward
Joshua Britt, D.P.M., is Celebration Orthopedics’ podiatrist and foot and ankle surgeon. He serves as the Medical Director for Caterpy Laces, Director of Battle Wellness for Battle OCR and a Consultant for Zimmer-subchondroplasty.
Born in Hattiesburg, Miss., and raised in Baton Rouge, La., Dr. Britt earned his undergraduate degree in biochemistry from Southeastern Louisiana University and his medical degree from Barry University School of Podiatric Medicine in Miami. He completed his residency in the Florida Hospital East Orlando Podiatric Medicine and Surgery program.
Dr. Britt specializes in trauma, sports medicine, reconstructive foot and ankle surgery, pediatric foot issues and general foot health care. He partners with running clubs, serving as a resource for prevention and treatment of running-related injuries.
Dr. Britt’s practice is enhanced by his ability to speak fluent Spanish, which he learned during two years of missionary service in Mendoza, Argentina.
Celebration Orthopaedic had been on Dr. Britt’s radar. “I’ve wanted this job ever since I was halfway through residency. When it became available, I jumped on it. This is a good group of professional, forward-thinking doctors, and central Florida is a great area,” Dr. Britt says.
“Dr. Britt has a great personality and sincerely enjoys giving his patients the best foot and ankle care possible. He prides himself on formulating long-lasting relationships with his patients, so he may give them the quality of care they deserve,” says Dr. Johnston. “Adding Dr. Britt to our team was a very easy decision, and we are lucky to have him.”
Excellence Without Surgery
“A large percentage of orthopaedic conditions and injuries have nonsurgical treatment options, and Dr. McDonald possesses a high level of expertise in those areas,” says Dr. Robson. “Having Dr. McDonald as a part of our practice allows us to provide a new level of patient accessibility to our services when other providers are in the operating room.”
“Not every Orthopaedic practice has someone who specializes in nonsurgical conditions, so we are fortunate I can bring that expertise,” says Dr. McDonald. “I often say, ‘I treat all people like I do an athlete, whether the patient participates in an actual sport, or their sport is shopping.’’
Dr. McDonald grew up in Colorado and earned his medical degree from the University of
Colorado. He completed his residency in family medicine at Swedish Medical Center in
Denver and a primary care sports medicine fellowship at Michigan State University.
Dr. McDonald came to Florida in 2002 to become a team physician for the University of Florida Gators athletics. Most recently he was a faculty physician with Florida Hospital’s family medicine residency program in Winter Park. He continues to teach medical students and residents of the University of Central Florida and Florida State University colleges of medicine.
Dr. McDonald also works as a team physician for the Atlanta Braves during spring training and their minor league teams. He was team physician for the University of Florida Gators for six years, during which time the Gators won four national championships including in football and men’s basketball. He also has been the head team physician for the Orlando Solar Bears hockey team and Rollins College and Winter Park High School.
Dr. McDonald has treated patients in the NFL, NBA, NHL, MLB and the Olympics.
Partial Knee Resurfacing
Celebration Orthopedic & Sports Medicine Institute gives patients access to the most beneficial treatments available for orthopedic conditions. Among them is total and partial joint replacement as a treatment for osteoarthritis (OA) in the hip and knee.
Total joint replacement used to be the most common treatment. Today, however, the improved accuracy of image-guided surgery is making the technically challenging partial knee replacement easier. Also called joint resurfacing or unicompartmental knee replacement, partial knee replacement is increasingly the choice when a portion of the knee needs to be replaced.
Traditionally total knee replacement was the only option for patients with rheumatoid arthritis. Nowadays better medication to control the immune system has expanded the opportunity for these patients to benefit from partial knee resurfacing.
Further enhancing outcomes of partial knee replacement is MAKOplasty technology, powered by the surgeon-controlled RIO Robotic Arm Interactive Orthopedic System. Its precision makes the procedure possible even when the most fragile knee tissue is involved. It enables patients to walk the same day as surgery and get back to everyday activities within one week.
Hip resurfacing has similar benefits and associated risks. As with any surgery, expertise plays a strong role in minimizing the risks, first, by understanding what they are and how they might be mitigated; and, second, by having the technical skill to produce the best possible outcomes. The patient should be properly educated, so his or her decisions are informed.
Dr. Amundaray’s fellowship training and expertise give him keen insight into understanding when a patient would best benefit from a total knee replacement and when it would be better to do a partial knee replacement. “I begin by understanding their complaints and tolerances. You could have the same X-ray of another person, but your expectations may be different. You may not want surgery. You may not be able to take certain medications.”
OA often leads to lifestyle limitations as a result of pain and decreased function. Symptoms include:
- Knee pain while walking short distances, standing or climbing stairs.
- Stiffness or discomfort in the knee when getting up from a chair or bed.
- Knee ache with activity.
- Knee swelling.
- A crunching or grating feeling when moving the knee.
“There are additional problems that occur,” says Dr. Amundaray. People get depressed. They tend to gain weight. They don’t want to do things any more.”
Therapy for degenerative joint disease is individualized based on the degree of arthritis, disability and comorbidities. It typically starts conservatively with activity modification, weight loss, physical therapy, oral medication, orthotics and corticosteroid or hyaluronic acid intra-articular injections.
Physical therapy modalities include manual therapy, aquatic therapy, strength training, electrical stimulation and balance and proprioception training. When physical therapy is not possible because of cost, transportation, inconvenience and/or other reason, a self-management program can be effective. Simply walking is helpful.
When conservative treatment has not worked, and the OA seriously limits mobility and quality of life, surgery may be the next option.
“Most of the people who have had a partial knee replacement on one knee and a total knee replacement on the other typically say the partial knee feels more natural,” says Dr. Amundaray.
In addition to better mobility, minimally invasive partial knee replacement typically results in less pain and faster recovery. Whereas, recovery from total knee replacement can take as long as six-to-12 weeks, partial knee replacement requires little if any physical therapy and some can recover within four to six weeks. Recovery depends on a patient’s fitness prior to surgery, determination and pain tolerance, according to Dr. Amundaray.
Dr. Amundaray’s goal is to help patients regain their quality of life. “Every soul I touch, I try to improve their quality of life. I want to see them get around again without pain. If they feel great when they come to the office, you can see it in their face that it’s not hurting that much. “
Drs. Homan and Johnston also perform total joint replacements and partial knee resurfacing using Makoplasty.
Getting You Back in the Game
Dr. Maahir Haque is a fellowship-trained orthopaedic spine surgeon. He specializes in the treatment of neck and back pain using the newest evidence-based methods. Dr. Haque’s primary goal is to provide the highest-quality care to his patients in the least invasive manner, so they may return to their functional lives as quickly and comfortably as possible.
Given his extensive training, Dr. Haque can truly tailor a patient’s treatment plan to his or her individual needs and goals. Whereas spine surgery used to require a lengthy stay in the hospital, many of his patients can go home on the day of their surgeries. He performs spinal injections, endoscopic discectomies, kyphoplasties, minimally-invasive fusion techniques, motion-preserving procedures including disc replacement procedures, revision spine surgical procedures, and complex reconstructive spinal surgeries.
A common cause for patients to visit Dr. Haque is “back pain”. Back strain is a broad category called “soft tissue injury,” which covers muscles, tendons and ligaments. About 80% of back and neck pain is muscle-related.
Another type of strain relates to spinal ligaments that run-in front and in back of the vertebral bodies. Tendons, which also connect muscles in the spine, can develop inflammation, or tendonitis.
Some people believe that part of what makes the back muscles more prone to strain is that they are shorter than other big muscles in the body. The muscles in our thighs that enable us to walk, run and jump are longer and less prone to strain. It’s very unusual to strain a thigh muscle.
Muscles in the back can strain or spasm and form a hard lump, like a charley horse in the leg. Back muscle spasms can be caused by injury and pain, whether the source is muscle strain, or a disc problem. A spasm, defined as an involuntary convulsive contraction of muscle fibers, can be excruciating. The muscle spasm can be steady or come in waves of contractions. Your muscle is sending you a signal that it has been pushed beyond its ability.
Surgery is never appropriate for muscle strain. As with any muscle injury, it’s natural for an individual to stop moving the injured area and wait for it to heal. Ironically, this is counter-productive. Restricting movement causes the muscle to weaken, become less flexible, and receive less circulation. In fact, gentle stretching and exercise is the best way to resolve the injury by getting it moving and increasing circulation.
Recommendations to alleviate pain include:
- Apply ice for five minutes at a time for the first 48 hours, then switch to heat.
- Take anti-inflammatories, preferably ibuprofen like Advil or Nuprin as directed on the bottle. Acetominophen (Tylenol) may be taken for pain, if you are allergic to ibuprofen.
- Try our home remedy exercises. But remember, no exercise should be painful. Stop if they cause an increase in pain or symptoms.
- An appointment with a nonsurgical spine specialist is most appropriate for muscle-related back pain.
- Call us immediately if you experience any emergency, red-flag symptoms.
Conservative and Surgical Podiatric Treatment
The foot and ankle are an intricate network of bones, ligaments, tendons and muscles that often endure injury and overuse. The list of causes for inflammation and pain is long and includes arthritis, bone spurs, plantar fasciitis and tendonitis, to name a few conditions.
Those who are unsure of the cause of intense foot pain, who are diabetic or who have widespread pain that involves both feet should seek immediate medical attention. Often, however, foot pain responds well to rest and cold therapy at home. If discomfort persists after several weeks, consultation with a physician is advised.
In true Celebration Orthopaedic & Sports Medicine form, Dr. Britt motivates his podiatric patients through understanding and education. So, they enter care with realistic goals, they understand their options, they know what to expect and they become actively engaged in their recovery.
“My main goal is to ease anxiety and pain during the recovery process,” he says. Understanding the progression of healing and the expected outcome is key. “Rather than leave a patient open to speculate and be anxious and worry, if they are educated properly from the beginning, they are better able to see the end game.”
In appropriate cases, conservative treatment, using a combination of physical therapy and anti-inflammatory medication, works. Personalized conditioning programs for strengthening and stretching the muscles that support the lower leg, foot and ankle are incorporated to help reduce pain and increase range of motion.
Dr. Britt also is skilled in traumatology, reconstructive foot and ankle surgery, wound care/limb salvage and elective foot and ankle surgery. He uses the latest in reconstructive techniques for: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft-tissue repair, tumor excision, amputation and/or the osteotomy of bone. It may involve bone screws, pins, wires, staples and other fixation devices, as well as casting to stabilize and repair bone.
Fueled by compassion and dedication to his field, Dr. Britt approaches treatment with a technical eye, always seeking opportunities for hardware improvement. In his spare time, he reengineers devices, which he submits to manufacturers/investors for consideration. He also creates YouTube podcasts discussing podiatric advances.
A Team the Clicks
Teamwork is important on and off the field, including within Celebration Orthopaedic & Sports Medicine Institute.
In the words of a patient in February:
“… As a new patient, I can definitely say that it was a pleasing experience. From the moment we stepped in the office, to the nurses, to the consult with Dr. Amundaray to the exit was an eye opener. Everyone made us feel comfortable and pleasant. Will enjoy having Dr. Amundaray as my orthopedic doctor.”
Patients are seen at Celebration, Kissimmee, St. Cloud and Dr. Phillips locations. Appointments can be made by calling (321) 939-0222. Regular business hours are from 8 a.m. to 5 p.m.; extended hours are available. For more information visit CelebrationOrthopaedics.com