Articulating Synergy

Three joint replacement surgeons walk into an OR. No joke: Colonel Todd P. Balog, MD, FAAOS, a new orthopaedic surgeon with St. Clair Medical Group (SCMG), treated 4-star generals and fighter pilots in the Army—while his family waved Terrible Towels on football Sundays at every outpost around the globe. His wife hails from Beaver Falls.

“There’s truly something special about this place,” he says. “And I couldn’t be more excited to be part of the expanded team delivering advanced joint replacement care right here in the South Hills.”

For Brett C. Perricelli, MD, FAAOS, Chief of Orthopaedic Surgery at St. Clair Health, the new orthopaedic surgeon joining South Hills Orthopaedic Surgery Associates, Nathaniel T. Ondeck, MD, MHS, hits even closer to home.

“Dr. Ondeck and I went to the same high school and our families attend the same parish. I knew he was from Murrysville, but it’s amazing to me how connected our team truly is,” Dr. Perricelli says. “That’s a common thread here.”

Emphasis on team, he continues.

“We’ve set up a great infrastructure—consistent communication, best-in-class protocols—but I’m a big believer that we always need to be challenging convention. It’s simple: three experts are better than one.”

Just as quickly, Dr. Perricelli dives into the topline details. “This growth is tied directly to improving your access to top-quality care,” he says. “Adding surgeons of this caliber encourages healthy debates, because with the advancements in joint replacement surgery, there’s almost always more than one way to approach each patient.” The team-wide goal?

“To get you exactly where you want to go,” Dr. Perricelli doesn’t miss a beat. “We’re going to get you ambulating—back to doing the things you love. Feeling happy again. And we’re going to get you there with less pain.”

Dr. Ondeck, a Carnegie Mellon engineering graduate ahead of completing medical school at Yale, followed by residency and fellowship at New York City’s Hospital for Special Surgery, joins St. Clair Health as Orthopaedic Innovation Officer.

“As we move more and more into a robotics-driven era, exploring the world of artificial intelligence [AI] and beyond, it’s critical that we utilize technology to improve patient outcomes as a group,” he says.

A ceaseless desire to test oneself against the best will steer the team into the future.

“We’re always striving to get better,” Dr. Perricelli says. “Orthopaedics is an extremely competitive discipline, and we’re all wired that way.”

That line of thinking and manner of delivering care extends across your entire care team at St. Clair Health.

“You’re interacting with the full suite of us—from the office to the operating room—so that we can guide you through every step of the process, whether that’s an injection for pain management, therapy before and after your operation, arthroscopic interventions, or total joint replacement,” Dr. Perricelli says.

The key to unlocking so much potential in the building? Building the treatment plan around each patient.

“We create personalized treatment goals,” Dr. Perricelli says. “Holistically, we’re dialing you into the optimized correction for your specific indication—that’s where success comes from. We’re taking into account your pain level, lack of joint mobility, and more, all directly against the things you enjoy doing.”

At St. Clair Health, a key factor is understanding the difference between the “weekend warrior” mindset and simply being able to get down on the floor and play with your grandkids—or both.

“We want you to be able to go to church or a ball game and be able to enjoy those activities without sitting there in pain,” Dr. Perricelli says. “Or maybe you’re an electrician or a plumber having a difficult time at work—maybe you can’t work—because of debilitating arthritis. That’s where we come in.”

Time and pressure. Western Pennsylvania’s aging population—ranked fifth in the country for people aged 65 and older, seventh for percentage of population in that group— literally feels the crunch.

“Father Time remains undefeated,” Dr. Perricelli says. “It could be that high school football injury finally catching up with you, or, normal wear and tear from years of yardwork. We see everybody—and we build your treatment plan around that future state you desire to live in.”

It starts with a subset of questions and rankings that work to create a baseline to measure your care plan against.

“How bad is your pain? What is that pain keeping you from doing? What’s been limited— and for how long—and what have you thrown your hands up at and flat-out stopped?”

Here, Dr. Perricelli himself pauses. He’s got an important point to make.

“If I get one thing across, here, it’s this: you don’t have to live in pain.”

That simple truth dovetails directly into your course of treatment.

“Depending on your age, lifestyle, and the goals we’ve established, the next step is determining whether this is something we can manage in the short term with injections, platelet-rich plasma [PRP], physical therapy—or a combination of those things,” Dr. Perricelli says.

“And if you’ve tried some of those options already—or, if you’ve simply been grinning and bearing it to the bone-on-bone point of no return—has the time arrived to replace part or all of the joint?”

Ultimately, if that’s the best course of treatment for you, Dr. Perricelli is adamant that if you’ve got that big vacation planned or you need to walk your daughter down the aisle, “We can circle back to nonsurgical interventions right now knowing that we’ve got the long-term plan set.”

Here, he breaks it down into three essential segments:

“If you’re thinking about short-term relief, an injection may last for two days, two weeks, two months, or two years! A variety of factors—including the severity of arthritis in the hip or knee, previous treatments, and lifestyle— affect the efficacy of this type of treatment.”

For the medium-term, Dr. Perricelli encourages patients to think about physical and occupational therapy (PT/OT) as an ongoing solution.

“In most cases, you’re going to benefit from PT/OT, working through exercises that can help everything around the joint supporting it—the connective tissue that not only helps you now, but can better set you up for success heading into the ultimate replacement.”

Dr. Perricelli points to this ongoing maintenance alongside lifestyle improvements as an often-overlooked element of total patient care.

“Controlling your weight, getting your diabetes in check, increasing your range of motion and flexibility, strengthening the muscles and ligaments around the joint—everything you can do ahead of replacing the joint is going to increase your long-term success.”

St. Clair Health’s consistent success with the more than 800 patients who receive total joint replacements each year is a driving force behind receiving advanced certification for total hip and knee replacement from the Joint Commission— after rigorous on-site review of its practices and policies deemed the multi-year, total-team effort at the highest standard of quality and value.

“As the only hospital in Southwestern Pennsylvania to earn that level of certification, it really proved true our belief that this is the advanced joint replacement center from start to finish—and we’re right here in the South Hills.”

By direct extension, the spirit of teamwork making the dream work is driving Dr. Perricelli’s energy toward the pair of new physicians who will help push the progression of joint replacement surgery at St. Clair Health. While knee arthritis is more common than hip arthritis, Dr. Perricelli’s success with the direct anterior (DA) approach to total hip replacement has pushed the bulk of his work into that arena.

“I’m excited to be challenged by peers who are leaning into this community with tremendous real-world experience,” he says. “There’s a philosophical component related to critical elements like AI, plus a core process component related to anything we can do to continue creating efficiencies. And of course
the integrated services with our awesome PT/OT team as we explore harnessing the power of everything Dunlap Family Outpatient Center [DFOC] and the St. Clair Health system can put at our fingertips.”

Parallel to the services offered inside the crown jewel of St. Clair’s main campus, Dr. Perricelli is steadfast in sharing the spotlight with nonsurgical team members who play key roles in prepping patients for their joint replacement journey.

Among these key players, Molly Keller, Orthopaedic Nurse Navigator, earns a nod for her work with pre-operative joint replacement education at St. Clair Health through specialized, in-person hip and knee classes.

“We want you to have as many opportunities to ask questions along the way as possible,” Dr. Perricelli says. “Because of the in-depth nature of the program, you’re coming in totally prepared for the procedure and the post-operative expectations.”

Integral at every step: Stefanie Herrmann, PA-C, Total Joint Program Physician Assistant, who coordinates the cross-functional effort and collates data for the team. Setting goals. Defining the smoothest transition from start to finish. Achieving success through optimized treatment plans.

“Our commitment to making the entire process the very best is relentless,” Dr. Perricelli says. “Dr. Ondeck arrives highly trained and skilled in the field of robotics—he’ll help guide us toward creating the best robotic technology platform right here at St. Clair. And Dr. Balog brings unique attributes earned during a decorated military career serving all over the world. I can’t think of a better pair of perspectives to help shape your care.”