Typical Surgeries
Total Hip Arthropasty, Anterior Approach
Total Hip Replacement

If your hip has been damaged by arthritis, a fracture, or other conditions, common activities such as walking or getting in and out of a chair may be painful and difficult. Hip replacement surgery is a safe and effective procedure that can relieve your pain, increase motion, and help you get back to enjoying normal, everyday activities.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total hip replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or "press fit" into the bone. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed. The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

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Anterior Cruciate Ligament Reconstruction

One of the most common knee injuries is an anterior cruciate ligament sprain or tear. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

If you have injured your anterior cruciate ligament, you may require surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level.

Anterior cruciate ligament (ACL) reconstruction is done to repair or replace a major ligament in your knee. The ACL helps stabilize your knee joint and prevents the tibia (shin bone) from moving too far forward. ACL reconstruction involves creating a new ligament from grafted tissue.

Anterior Cruciate Ligament ReconstructionACL Repair AP ACL Repair Lateral

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Arthroscopic Rotator Cuff Tear

Rotator cuff repair is a surgery to repair a torn tendon in the shoulder. The procedure can be done with a large ("open") incision or with shoulder arthroscopy, which uses small button-hole sized incisions. The goal is to attach the tendon back to the bone where it tore off. The tendon is attached with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. Sutures are attached to the anchors, which tie the tendon back to the bone.

During arthroscopic rotator cuff repair (RCR), multiple cannulas are inserted into the shoulder joint through small incisions to visualize and repair the injury. Arthroscopic repair leads to less disturbance of the shoulder musculature and possibly less pain following surgery. The rotator cuff is a group of four different muscles that form tendons and insert onto bone.

Arthroscopic Rotator Cuff TearArthroscopic Rotator Cuff Tear

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Biceps Tenodesis

A biceps tenodesis is a procedure that cuts the normal attachment of the biceps tendon on the shoulder socket and reattaches the tendon to the bone of the humerus (arm bone). By performing a biceps tenodesis, the pressure of the bicpes attachment is taken off the cartilage rim of the shoulder socket (the labrum), and a portion of the biceps tendon can be surgically removed.

A biceps tenodesis is done in the event of a biceps tendon rupture or tear.

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Copeland Total Shoulder
Copeland Total Shoulder

The Copeland Total Shoulder is a minimal invasive surgery with maximum benefit and a quick recovery.

The Copeland™ Humeral Resurfacing Head, unlike a total shoulder implant, is designed to cap only the top of the humerus. The implant requires much less bone and cartilage removal, which makes it more conservative than total joint implants.

The Copeland™ implant's design and minimally invasive approach allow patients to potentially recover more quickly and with less pain. It is also potentially less complicated to replace should a future total shoulder replacement become necessary.

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Knee Replacement
Total Knee Replacment

Knee replacement surgery is cartilage replacement. The knee itself is not replaced, only the damaged cartilage and bone ends.

Knee replacement implants include a metal alloy on the end of the thighbone and polyethylene (plastic) on the top of the tibia and underneath the kneecap. The implant is designed to create a new, smoothly functioning joint that can prevent painful bone-on-bone contact.

Our surgeon may elect to replace all or part of your knee, depending on your condition and the extent to which your knee is affected by arthritis.

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Knee Revision Surgery
Mako Partial Knee Replacement

Knee revision surgery, which is also known as revision total knee arthroplasty, is a procedure in which the surgeon removes a previously implanted artificial knee joint, or prosthesis, and replaces it with a new prosthesis.

Knee revision surgery may also involve the use of bone grafts. The bone graft may be an autograft, which means that the bone is taken from another site in the patient's own body; or an allograft, which means that the bone tissue comes from another donor.

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Osteoarthritis

Osteoarthritis is one of the oldest and most common causes of joint pain and known as the degenerative arthritis or joint pain. It is a chronic condition involving the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of the bones as a shock absorber and a lubricant to protect the bones and allow easy movement of joints. When this cartilage wears away the bones rub against each other, causing stiffness, pain and loss of movement in the joint.

There is no cure, but the early stages of Osteoarthritis can be treated with conservative non-surgical treatments. As the cartilage continues to wear away and the symptoms are more severe, surgery may be recommended to correct the damaged bone and cartilage. An observation of your movement, review of your health history and x-rays of the affected joint will help us determine the best course of treatment so that motion can be restored and pain is reduced. The technique of total joint replacement uses prosthetic implants to replace damaged sections of bone and cartilage in the joint with the purpose of restoring function and mobility and to provide relief from pain. The most common reason joints are replaced is osteoarthritis.

The joints most affected are the knees, hips, fingers and shoulders and you may experience these symptoms: joint pain while standing or moving; giving out or locking of joint; near constant pain; decreased activity; abnormal stance or walk; and trouble walking up or down stairs . You will find through the stages that the cartilage loses elasticity and is more easily damaged by injury or use and will cause changes to underlying bones. Cysts may occur under cartilage or bony growths called spurs or osteophytes can develop near the end of the bone and the affected joint. Bits of bone or cartilage float loosely in joint space and the joint lining becomes inflamed. 


Pre-op Medial Joint Arthritis, Arthritic Knee, Arthritic Hip, Arthritic Shoulder

Arthritis pain relief can be found with physical therapy, exercise, and the right weight can help keep your joints moving and relieve pain. Pain relievers known as nosterodial anti-inflammatory drugs (NSAIDs) can help control swelling and pain.  Assisted devices like a cane or walker can help reduce pressure placed on joints and alleviate pain along with resting after an activity.  Joint replacement surgery can restore mobility and provide relief from pain.


Platelet Rich Plasma (PRP) Injections

Platelet Rich Plasma (PRP) is a volume of autologous blood with a platelet level that is significantly increased over the normal concentration. To concentrate platelets, a patient has roughly 30-60cc of their blood drawn, spun down in a centrifuge to separate the blood into various layers. The layer known as PRP (also called the buffy coat) contains high levels of platelets and growth factors. The PRP is then injected into the patient’s tendon, where their tendinosis occurs. The volume injected is roughly 3-6cc, depending on your site of injury.

Platelets, or thrombocytes, circulate throughout a persons blood. They are small cell fragments that contain growth factors that allow our bodies to heal from any trauma that may occur. Some of the growth factors that are beneficial for PRP injections include: Platelet Derived Growth Factor (PDGF), Transforming Growth Factor (TGF), Vascular Endothelial Growth Factor (VEGF) and Fibroblast Growth Factor (FGF).

In short, PRP is a highly concentrated serum that harnesses your body’s OWN healing potential.

WHY PRP INJECTIONS?
Tendinosis has traditionally been treated with therapies such as rest, repeat cortisone injections, long term anti-inflammatory medications, and invasive surgery. These traditional therapies often lead to further tissue degeneration, a “masking” effect of the pain without resolution and require continuous treatments. PRP injections are non-invasive, meant as a one time treatment, low risk, and best of all- derived from your own blood.

Currently, PRP injections are used for:

Tennis Elbow (Lateral Epicondylitis)
Plantar Fasciitis
Achilles Tendinosis
Jumper’s Knee (Patellar Tendinosis)
Hip Bursitis
Rotator Cuff Tendinosis

PRP injections take about 30 minutes in our clinic and require minimal recovery time when compared to surgery.


Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic disease, mainly characterized by inflammation of the lining, or synovium of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability. It affects mostly women and is an autoimmune disease, the cause of which is unknown. The body’s immunological system attacks healthy tissue , causing inflammation and subsequent joint damage.

Rheumatoid arthritis progresses in three stages. The first stage is the swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint. Second is the rapid division and growth of cells or pannus, which causes the synovium to thicken. In the third stage, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved join to lose its shape and alignment, more pain, and loss of movement.

There is no cure and will continue indefinitely and if you want to continue living a productive life style, you are a good candidate for joint replacement surgery.

Arthritis treatment options:

  • Get a proper diagnosis (see your physician)
  • Start an exercise program (see your physician)
  • Activity modifications
  • Heat/cold
  • Nutritional supplements
  • Orthotics/Bracing/Self-Help Devices/Support
  • Control pain
  • Injections
  • See a Surgeon who specializes in arthritis and joint replacement

For more information go to Rheumatoid Arthritis Treatment : Osteoarthritis treatment, arthritis help


Shoulder Labrum Repair

During arthroscopic labrum repair, often called a SLAP or Bankart lesion depending on the tear location, multiple cannulas are inserted into the shoulder joint through small incisions to visualize and repair the injury. The labrum is a soft tissue rim surrounding the joint socket that provides joint stability.

Shoulder Labrum RepairShoulder Labrum Repair

Shoulder Labrum RepairShoulder Labrum Repair

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